BACKGROUND:PEEP is a cornerstone treatment for children with pediatric ARDS. Unfortunately, its titration is often performed solely by evaluating oxygen saturation, which can lead to inadequate PEEP level settings and consequent adverse effects. This study aimed to assess the impact of increasing PEEP on hemodynamics, respiratory system mechanics, and oxygenation in children with ARDS.METHODS:Children receiving mechanical ventilation and on pressure-controlled volume-guaranteed mode were prospectively assessed for inclusion. PEEP was sequentially changed to 5, 12, 10, 8 cm H2O, and again to 5 cm H2O. After 10 min at each PEEP level, hemodynamic, ventilatory, and oxygenation variables were collected.RESULTS:A total of 31 subjects were included, with median age and weight of 6 months and 6.3 kg, respectively. The main reasons for pediatric ICU admission were respiratory failure caused by acute viral bronchiolitis (45%) and community-acquired pneumonia (32%). Most subjects had mild or moderate ARDS (45% and 42%, respectively), with a median (interquartile range) oxygenation index of 8.4 (5.8–12.7). Oxygen saturation improved significantly when PEEP was increased. However, although no significant changes in blood pressure were observed, the median cardiac index at PEEP of 12 cm H2O was significantly lower than that observed at any other PEEP level (P = .001). Fourteen participants (45%) experienced a reduction in cardiac index of > 10% when PEEP was increased to 12 cm H2O. Also, the estimated oxygen delivery was significantly lower, at 12 cm H2O PEEP. Finally, respiratory system compliance significantly reduced when PEEP was increased. At a PEEP of 12 cm H2O, static compliance had a median reduction of 25% in relation to the initial assessment (PEEP of 5 cm H2O).CONCLUSIONS:Although it may improve arterial oxygen saturation, inappropriately high PEEP levels may reduce cardiac output, oxygen delivery, and respiratory system compliance in pediatric subjects with ARDS with low potential for lung recruitability.

BACKGROUND AND PURPOSE:

Intracranial vessel wall imaging is technically challenging to implement, given the simultaneous requirements of high spatial resolution, excellent blood and CSF signal suppression, and clinically acceptable gradient times. Herein, we present our preliminary findings on the evaluation of a deep learning–optimized sequence using T1-weighted imaging.

Although the progressive histologic steps leading to endometrial cancer (EndoCA), the most common female reproductive tract malignancy, from endometrial hyperplasia are well-established, the molecular changes accompanying this malignant transformation in a single patient have never been described. We had the unique opportunity to investigate the paired histologic and molecular features associated with the 12-yr development of EndoCA in a postmenopausal female who could not undergo hysterectomy and instead underwent progesterone treatment. Using a specially designed 58-gene next-generation sequencing panel, we analyzed a total of 10 sequential biopsy samples collected over this time frame. A total of eight pathogenic/likely pathogenic mutations in seven genes, APC, ARID1A, CTNNB1, CDKN2A, KRAS, PTEN, and TP53, were identified. A PTEN nonsense mutation p.W111* was present in all samples analyzed except histologically normal endometrium. Apart from this PTEN mutation, the only other recurrent mutation was KRAS G12D, which was present in six biopsy samplings, including histologically normal tissue obtained at the patient's first visit but not detectable in the cancer. The PTEN p.W111* mutant allele fractions were lowest in benign, inactive endometrial glands (0.7%), highest in adenocarcinoma (36.9%), and, notably, were always markedly reduced following progesterone treatment. To our knowledge, this report provides the first molecular characterization of EndoCA development in a single patient. A single PTEN mutation was present throughout the 12 years of cancer development. Importantly, and with potential significance toward medical and nonsurgical management of EndoCA, progesterone treatments were consistently noted to markedly decrease PTEN mutant allele fractions to precancerous levels.

Sleep is a fundamental feature of life for virtually all multicellular animals, but many questions remain about how sleep is regulated and what biological functions it plays. Substantial headway has been made in the study of both circadian rhythms and sleep in the fruit fly Drosophila melanogaster, much of it through studies of individual fly activity using beam break counts from Drosophila activity monitors (DAMs). The number of laboratories worldwide studying sleep in Drosophila has grown from only a few 20 years ago to hundreds today. The utility of these studies is limited by the quality of the metrics that can be extracted from the data. Many software options exist to help analyze DAM data; however, these are often expensive or have significant limitations. Therefore, we describe here a method for analyzing DAM-based data using the sleep and circadian analysis MATLAB program (SCAMP). This user-friendly software has an advantage of combining several analyses of both sleep and circadian rhythms in one package and produces graphical outputs as well as spreadsheets of the outputs for further statistical analysis. The version of SCAMP described here is also the first published software package that can analyze data from multibeam DAM5Ms, enabling determination of positional preference over time.

Sleep is a fundamental feature of life for virtually all multicellular animals, but many questions remain about how sleep is regulated by circadian rhythms, homeostatic sleep drive that builds up with wakefulness, and modifying factors such as hunger or social interactions, as well as about the biological functions of sleep. Substantial headway has been made in the study of both circadian rhythms and sleep in the fruit fly Drosophila melanogaster, much of it through studies of individual fly activity using Drosophila activity monitors (DAMs). Here, we describe approaches for the activation of specific neurons of interest using optogenetics (involving genetic modifications that allow for light-based neuronal activation) and thermogenetics (involving genetic modifications that allow for temperature-based neuronal activation) so that researchers can evaluate the roles of those neurons in controlling rest and activity behavior. In this protocol, we describe how to set up a rig for simultaneous optogenetic or thermogenetic stimulation and activity monitoring for analysis of sleep and circadian rhythms in Drosophila, how to raise appropriate flies, and how to perform the experiment. This protocol will allow researchers to assess the causative role in the regulation of sleep and activity rhythms of any genetically tractable subset of cells.

Sleep is important for survival, and the need for sleep is conserved across species. In the past two decades, the fruit fly Drosophila melanogaster has emerged as a promising system in which to study the genetic, neural, and physiological bases of sleep. Through significant advances in our understanding of the regulation of sleep in flies, the field is poised to address several open questions about sleep, such as how the need for sleep is encoded, how molecular regulators of sleep are situated within brain networks, and what the functions of sleep are. Here, we describe key findings, open questions, and commonly used methods that have been used to inform existing theories and develop new ways of thinking about the function, regulation, and adaptability of sleep behavior.

Central sleep apnoea (CSA) is characterised by recurrent episodes of airway cessation or reduction in the absence of respiratory effort. Although CSA is less common than obstructive sleep apnoea, it shares similar symptoms. CSA can be secondary to various medical conditions, high altitude and medication exposure. CSA can also emerge during obstructive sleep apnoea therapy. There are a range of treatment options and selecting the right therapy requires an understanding of the pathophysiology of CSA. This review explores the aetiology, pathophysiology and clinical management of non-hypercapnic CSA.

Deepfakes can be close to indistinguishable from authentic video, and are now being used to perpetrate gender based abuse.

The post Deepfakes and gender based violence appeared first on rabble.ca.

Anna Marie, Chris, and Kelley are joined by special guest Ryan Radcliff! Chris swears every time E3 fails, an angel gets its wings. Anna Marie refuses to play games she's in. Kelley wants to pet the cat cream roll. And Ryan is dragging around Paws's corpse as he spins all the wheels.

The post RPG Cast – Episode 589: “Chaos Never Sleeps” appeared first on RPGamer.

Chris force feeds people desserts to make people like each other. Ryan likes bad games, just like Chris. Kelley has a penchant for losing pendants. Matt throws some garbage in the pot and suddenly it's pizza. Now let's grow old and lose stats together.

The post RPG Cast – Episode 721: “Skyrim Helmet Sleep Mask” appeared first on RPGamer.

ublisher Bethesda Softworks and developer MachineGames have released a gameplay deep dive video for Indiana Jones and the Great Circle that is nearly 15 minutes in length.

"From locations and puzzles to gear and combat, MachineGames Audio Director, Pete Ward, takes us on a whirlwind journey through the world of The Great Circle," reads the description to the video. "Get ready for launch with this look at Indy’s grand adventure."

View the gameplay deep dive below:

Indiana Jones and the Great Circle will launch for the Xbox Series X|S, PC via Steam and Microsoft Store, and Xbox Game Pass on December 9.

A life-long and avid gamer, William D'Angelo was first introduced to VGChartz in 2007. After years of supporting the site, he was brought on in 2010 as a junior analyst, working his way up to lead analyst in 2012 and taking over the hardware estimates in 2017. He has expanded his involvement in the gaming community by producing content on his own YouTube channel and Twitch channel. You can contact the author on Twitter @TrunksWD.

Full Article - https://www.vgchartz.com/article/463033/indiana-jones-and-the-great-circle-gets-gameplay-deep-dive/

Some extremely fresh vintage workwear that I bought for entirely practical reasons aside, I’m not exactly a fashion person. I have nobody to impress most days but my cat, and the only item of clothing she appears to have an opinion on is my Oodie, which is very comfortable for both of us and also smells like a chicken shop, which I imagine is more pleasant for her than me.

This aside, I found myself taking a whole bunch of Dragon Age: The Veilguard screenshots as I played just to capture the RPG’s various outfits. They are ridiculous. Incredibly intricate and detailed, as well as being obscenely impractical for the most part. I do not like any of them in the sense I would wear them, but I like all of them in the sense that they display artists allowed to run free like caffeinated weasels and indulge their every whim.

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Let’s try and get you up to speed on the fascinating oddity that is simulation game Ecosystem, on the off chance that Nate's coverage of it hasn't stuck with you like an unwelcome brain parasite you’re nonetheless unwilling to get removed for fear of the lingering emptiness it might cause (he once described an eel as “a quaver with erectile dysfunction”). Broadly speaking, this game is Spore’s evolutionary-biology-degree-having cousin. It’s been in early access for about three years now, but with the latest "Crustacean" update, it’s just hit 1.0. Once again, carcinization has come for all things.

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Researchers recently found a possible reservoir of liquid water more than 11 kilometres below Mars's surface – the latest in a long series of potential water discoveries on the Red Planet, hinting at its temperate past

A faint glow from all of the galaxies that have ever existed fills the cosmos, and NASA's New Horizons spacecraft has made the best measurement ever of just how faint it is

AlphaProof, an AI from Google DeepMind, came close to matching the top participants in a prestigious competition for young mathematicians

Computer code dating back to the 1960s is still vital to banks, airlines and governments, but programmers familiar with the language are in short supply. Now AI models are being trained to fill the skills gap

It can be difficult to spot AI generated videos known as deepfakes, but there are ways to spot one if you know what to look for

Experiments show that viewers can usually identify video deepfakes of famous politicians – but fake audio and text are harder to detect

Tigerair has again cancelled flights in and out of Denpasar, and there is no sign of the dispute being resolved.

Scientists have found a new building block of life deep in the cold darkness of interstellar space.

The Health and Human Services Department employs 294 people whose jobs focus on diversity, and the department maintains seven separate "minority health" offices spread across its various agencies, according to a new report that suggests it will be tough for the incoming Trump administration to unwind it all.

A Swiss-engineered robot can climb ladders, showing why it's at the cutting edge of autonomous robotic solutions for harsh industrial settings.

As our submersible descended, the waters grew darker around us. Looming teeth, some as long as a man’s leg, skirted the edge of our floodlights. The captain was sure this area held caves filled with golden bounty, but to those creatures of the deep it was our flesh and blood that were the true prizes… […]

Rats perform better on memory tests when certain brainwave-producing neurons are stimulated while they sleep. If we can boost these brainwaves in people, it could help treat memory impairments in those with dementia

Zapping the skin with electricity could stop bacteria that live there harmlessly from entering the body and causing blood poisoning

New research into the moments between wakefulness and sleep could bring hope for insomniacs and even make us more creative problem-solvers

Samples from the asteroid Ryugu contain key ingredients in the biological cookbook.

<a href="https://bluetechker.com/" rel="nofollow ugc">Blue Techker</a> naturally like your web site however you need to take a look at the spelling on several of your posts. A number of them are rife with spelling problems and I find it very bothersome to tell the truth on the other hand I will surely come again again.

Organizing business events can be a challenge. There’s always the concern that guests will lose interest or become disengaged. When organizing team-building activities and office parties, it becomes essential to add something extra that keeps everyone active and involved. That way, the event not only meets expectations but exceeds them, leaving people excited and talking […]

The post 4 Creative Ways to Keep Guests Engaged at Your Next Business Event appeared first on Chart Attack.

As a truck owner who’s watching every penny, you know how quickly maintenance expenses can get out of hand. There’s always another issue, another part to replace, another tool you didn’t know you needed. But there’s good news – plenty of ways exist to keep those trucks running smoothly without draining your wallet. With a […]

The post Maintenance Tips for Budget-Conscious Truck Owners ─ Keeping Costs Down appeared first on Chart Attack.

"You’ve taken this idea way too far," a mentor told Prof. Fei-Fei Li.

Susan Holt, who repeatedly emphasized her differences with the prime minister leading up to last month’s election, was on more welcoming terms Tuesday after their first official meeting in Fredericton.

‘Singham Again’ had an ensemble cast which includes Ajay Devgn, Akshay Kumar, Ranveer Singh, Tiger Shroff, Kareena Kapoor Khan, Deepika Padukone, Arjun Kapoor and Jackie Shroff

Each and every day new mobile games are hitting the App Store, and so each week we put together a …

Continue reading "Out Now: ‘Harvest Moon Home Sweet Home’, ‘Ocean Keeper Mobile’, ‘Ogu and the Secret Forest’, ‘Death Travelers’, ‘Snake.io’, ‘RWBY: Arrowfell’ and More"

One thing I love is when a game can successfully blend two fairly different types of gameplay into one cohesive …

Continue reading "TouchArcade Game of the Week: ‘Ocean Keeper’"

The numbers don't lie: Games as "live" services bring in more money over time.

With some simple lifestyle changes, you can lower your risk of osteoporosis.

Canadians are watching the U.S. election results with trepidation, knowing they have no control over the outcome that will still affect them. Polling shows Vice-President Kamala Harris and former president Donald Trump are neck-and-neck. 

If it seems like the Christmas shopping season starts earlier every year, you're not wrong. In response to growing customer demand, stores of all stripes brought out their festive collections weeks before the unofficial start of the holiday shopping season.

The family of the late Murray Sinclair remember his life as they are joined by members of the public, the Canadian Governor General and prime minister during a commemorative service at Winnipeg's Canada Life Centre to honour his legacy Sunday afternoon.

Recently-released dolls tied to the new Wicked movie inadvertently carry the address of an adult website.

Office for National Statistics data suggests homeworkers get more sleep and exercise on average.

The Subject Expert Committee (SEC), which advises the national drug regulator on matters related to approval of new drugs and medical devices and clinical trials, has recommended grant of market authorisation for

Whilst the timeline set for adhering to the revised Schedule M of the Drugs and Cosmetics Act ends on December 31 for pharmaceutical companies with a turnover of less than Rs. 250 crore, the union ministry's

Scientific American staff and sleep experts share advice on how to get better sleep in the stressful days leading up to the U.S. presidential election—and those that come after

A heart attack unleashes immune cells that stimulate neurons in the brain, leading to restorative slumber