id
stringlengths 11
17
| article_id
stringlengths 8
11
| path
stringlengths 11
60
| section_title
stringlengths 1
1.33k
| educational_score
float64 0
5.16
| domain
stringclasses 4
values | document_type
stringclasses 5
values | domain_scores
listlengths 0
3
| document_type_scores
listlengths 0
4
| text
stringlengths 1
110k
| authors
listlengths 0
8.02k
| article_url
stringlengths 3
63
| license_type
stringclasses 1
value | license_url
stringclasses 15
values | language
stringclasses 45
values | language_score
float64 0
1
|
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
PMC11276386_p16
|
PMC11276386
|
sec[1]/sec[1]/sec[1]/p[1]
|
2.2.2. Stretcher Test (ST) ( Figure 2 )
| 1.050781 |
other
|
Other
|
[
0.10040283203125,
0.004650115966796875,
0.89501953125
] |
[
0.01421356201171875,
0.98193359375,
0.0024204254150390625,
0.001331329345703125
] |
(A) Passing through a corridor on the ground floor.
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276386_p17
|
PMC11276386
|
sec[1]/sec[1]/sec[1]/p[2]
|
2.2.2. Stretcher Test (ST) ( Figure 2 )
| 0.991699 |
other
|
Other
|
[
0.1546630859375,
0.01456451416015625,
0.83056640625
] |
[
0.00916290283203125,
0.98681640625,
0.0020122528076171875,
0.0019311904907226562
] |
(B) Entering and staying in the elevator.
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276386_p18
|
PMC11276386
|
sec[1]/sec[1]/sec[1]/p[3]
|
2.2.2. Stretcher Test (ST) ( Figure 2 )
| 1.040039 |
other
|
Other
|
[
0.09808349609375,
0.004810333251953125,
0.89697265625
] |
[
0.0155792236328125,
0.98095703125,
0.0022449493408203125,
0.0013399124145507812
] |
(C) Continuing down the corridor .
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276386_p19
|
PMC11276386
|
sec[1]/sec[1]/sec[1]/p[4]
|
2.2.2. Stretcher Test (ST) ( Figure 2 )
| 2.513672 |
biomedical
|
Study
|
[
0.99072265625,
0.0022945404052734375,
0.006893157958984375
] |
[
0.99267578125,
0.00695037841796875,
0.00022220611572265625,
0.00023663043975830078
] |
It took the subjects 2 min to cover the necessary distance simulated in this study, which is deemed to be sufficient, based on theoretical calculations previously obtained from the Hospital Provincial de Pontevedra, Spain, the Hospital Clínico Universitario de Santiago, Spain, and the Hospital Universitario Policlinico Umberto I in Rome, Italy. However, the little data provided from real pediatric patients suggested that the distance covered was significantly more (taking an average of 7 min) . The distance covered was measured in meters using a tape measure at the end of the route.
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276386_p20
|
PMC11276386
|
sec[1]/sec[1]/sec[1]/p[5]
|
2.2.2. Stretcher Test (ST) ( Figure 2 )
| 2.933594 |
biomedical
|
Study
|
[
0.9912109375,
0.0075531005859375,
0.0010986328125
] |
[
0.98876953125,
0.01004791259765625,
0.0004863739013671875,
0.0006833076477050781
] |
No resuscitator changes were made during CPR testing and the subjects were not allowed to see any feedback data. Between each test, a minimum rest period of 20 min was allowed so as to avoid the influence of fatigue on the study. The rating of perceived exertion (RPE) was measured on a 0–10 scale using the Borg scale .
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276386_p21
|
PMC11276386
|
sec[1]/sec[2]/p[0]
|
2.3. Variables and Measuring Equipment
| 3.820313 |
biomedical
|
Other
|
[
0.9736328125,
0.024444580078125,
0.0019426345825195312
] |
[
0.44287109375,
0.55029296875,
0.0011682510375976562,
0.0059356689453125
] |
The Laerdal Resusci Baby QCPR ® (Stavanger, Norway) was used with the Laerdal Resusci Anne Skillreporter ® software version 2.0.0.14 (Stavanger, Norway). The latter is a recording system for determining CPR variables. The manikin corresponds to a 3-month-old baby weighing 5.5 kg and it was configured in accordance with the ERC 2021 recommendations . The following parameters were set for the manikin: a compression ratio between 100 and 120/minute, the correct compression depth in a 36–44 mm range and the correct ventilation volume in a range of 6–10 mL/kg , between 35 and 55 mL.
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276386_p22
|
PMC11276386
|
sec[1]/sec[2]/p[1]
|
2.3. Variables and Measuring Equipment
| 2.052734 |
biomedical
|
Study
|
[
0.97705078125,
0.0186309814453125,
0.004436492919921875
] |
[
0.982421875,
0.0147247314453125,
0.0011663436889648438,
0.0015974044799804688
] |
Several variables were collected in relation to CPR (compressions and ventilations), the quality of CPR, and non-CPR variables (self-perceived fatigue and distance covered).
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276386_p23
|
PMC11276386
|
sec[1]/sec[2]/sec[0]/p[0]
|
2.3.1. CPR Variables
| 2.322266 |
biomedical
|
Other
|
[
0.96337890625,
0.03045654296875,
0.006252288818359375
] |
[
0.0102996826171875,
0.9873046875,
0.0005159378051757812,
0.001735687255859375
] |
Chest compression (CC): number of CC; mean depth in mm; mean rate in CC/min; CC with adequate release as a percentage; CC with adequate hand position as a percentage.
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276386_p24
|
PMC11276386
|
sec[1]/sec[2]/sec[0]/p[1]
|
2.3.1. CPR Variables
| 2.251953 |
biomedical
|
Other
|
[
0.98291015625,
0.00858306884765625,
0.00836944580078125
] |
[
0.0469970703125,
0.95068359375,
0.0008015632629394531,
0.0016164779663085938
] |
Ventilations (V): number of total V; number of effective V; mean volume in ml.
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276386_p25
|
PMC11276386
|
sec[1]/sec[2]/sec[1]/p[0]
|
2.3.2. Quality CPR Variables
| 2.298828 |
biomedical
|
Study
|
[
0.9931640625,
0.002285003662109375,
0.004749298095703125
] |
[
0.9716796875,
0.025970458984375,
0.001537322998046875,
0.0006113052368164062
] |
Quality parameters were evaluated and disaggregated into CC quality, V quality and CPR quality. Each variable was expressed as a percentage and its calculation is based on the following formulas published in previous studies .
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276386_p26
|
PMC11276386
|
sec[1]/sec[2]/sec[1]/p[1]
|
2.3.2. Quality CPR Variables
| 2.861328 |
biomedical
|
Other
|
[
0.990234375,
0.0022563934326171875,
0.007633209228515625
] |
[
0.0609130859375,
0.9375,
0.0011167526245117188,
0.0005669593811035156
] |
CC quality is calculated using the formula (CC with adequate depth + CC with adequate release + CC with adequate rate) ÷ 3.
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276386_p27
|
PMC11276386
|
sec[1]/sec[2]/sec[1]/p[2]
|
2.3.2. Quality CPR Variables
| 2.699219 |
biomedical
|
Other
|
[
0.9892578125,
0.0017795562744140625,
0.0091705322265625
] |
[
0.09442138671875,
0.90380859375,
0.0012302398681640625,
0.0006661415100097656
] |
V quality is calculated using the formula Number of V with adequate volume/Number of total V × 100.
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
PMC11276386_p28
|
PMC11276386
|
sec[1]/sec[2]/sec[1]/p[3]
|
2.3.2. Quality CPR Variables
| 2.417969 |
biomedical
|
Other
|
[
0.921875,
0.06414794921875,
0.014190673828125
] |
[
0.045745849609375,
0.95068359375,
0.0015783309936523438,
0.0022258758544921875
] |
CPR quality is calculated using the formula (CC quality + V quality)/2.
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276386_p29
|
PMC11276386
|
sec[1]/sec[3]/p[0]
|
2.4. Statistical Analysis
| 4.105469 |
biomedical
|
Study
|
[
0.99951171875,
0.00028777122497558594,
0.0003333091735839844
] |
[
0.99951171875,
0.0002999305725097656,
0.00029349327087402344,
0.00004482269287109375
] |
The sample size was based on an assumed minimum of an effect size of 0.5, an alpha error probability of 0.05 and a statistical power of 0.80. These assumptions provided a sample size of 26 study participants computed by G*Power 3.1.9.2 software (Heinrich Heine University, Düsseldorf, Germany). All statistical analyses were performed using SPSS for Windows, version 21 (SPSS Inc., IBM, Armonk, NY, USA). The quantitative variables were described with measures of central tendency (median) and dispersion (IQR: interquartile range). The qualitative variables were described with absolute and relative frequencies. The quality and distance covered variables were also described with measures of central tendency (mean), dispersion (SD: standard deviation) and confidence estimators (95% CI: 95% confidence interval). For comparisons, the Shapiro–Wilk test was used first in order to check the normality of the data. For parametric variables, the repeated measures Student’s t test for related samples was used, and for non-parametric variables, the comparisons were analyzed using the Wilcoxon signed-rank test. The effect size (ES) was calculated in significance comparisons with Cohen’s d test (parametric variables) and Rosenthal’s r test (non-parametric variables). The following classification was used for the ES: <0.2: trivial/0.2–0.5: small/0.5–0.8: moderate/0.8–1.3: large/>1.3: very large. A significance value of 0.05 was established in all tests.
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276386_p30
|
PMC11276386
|
sec[2]/sec[0]/p[0]
|
3.1. Demographic Variables
| 2.332031 |
biomedical
|
Study
|
[
0.99267578125,
0.0061798095703125,
0.0011224746704101562
] |
[
0.99169921875,
0.00727081298828125,
0.00038743019104003906,
0.0008730888366699219
] |
Table 1 shows the demographic variables of the participants. Of the 26 participants, 77% (n = 20) were women. The median age was 21 years (IQR: 21–24), the median weight was 65 kg (IQR: 58–81) and the median height was 170 cm (IQR: 160–174).
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276386_p31
|
PMC11276386
|
sec[2]/sec[1]/p[0]
|
3.2. Chest Compression and Ventilation Variables
| 4.152344 |
biomedical
|
Study
|
[
0.99853515625,
0.00115966796875,
0.00036716461181640625
] |
[
0.9990234375,
0.0002579689025878906,
0.0003769397735595703,
0.00010067224502563477
] |
Table 2 shows the variables that reflect the results of chest compressions and ventilations during the tests. The mean depth was lower in the ST (41 mm; IQR: 40–42) than in the CT (42 mm; IQR: 41–43), with a p value = 0.008 and an ES = 0.37. No differences were observed in the mean rate variable (ST: 109 CC/min, IQR: 95–100; CT: 110 CC/min, IQR: 101–115), with a value of p = 0.92. The ST presented a lower percentage of CC with adequate release (ST: 82%, IQR: 63–92 compared to CT: 99%, IQR: 91–100), with a p value < 0.001 and an ES = 0.52. No differences were observed in CC with adequate hand position ( p > 0.05). Regarding ventilations, the number of total V was 20 V (IQR: 18–20) in the ST vs. 18 V (IQR: 18–19) in the CT, with p = 0.010 and IS = 0.36. Despite performing a greater number of ventilation attempts in the ST, the number of effective V was lower compared to the CT (ST: 14 V, IQR: 10–16; CT: 18 V, IQR: 16–18), with a p value = 0.002 and an ES = 0.93. On the other hand, the mean volume did not show any differences between the tests ( p = 0.45).
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276386_p32
|
PMC11276386
|
sec[2]/sec[1]/p[1]
|
3.2. Chest Compression and Ventilation Variables
| 4.125 |
biomedical
|
Study
|
[
0.99755859375,
0.0019407272338867188,
0.0005669593811035156
] |
[
0.9990234375,
0.0003154277801513672,
0.0003681182861328125,
0.00010567903518676758
] |
Figure 3 shows the results of the quality variables. No differences were observed in the CC quality variable: the ST presented a mean of 82% (SD: 10 and 95% CI: 77–86) and the CT presented a mean of 84% (SD: 11 and 95% CI: 80–89) with a value of p = 0.15. However, significantly worse values were observed in V quality in the ST test, with a mean of 18% (SD: 14 and 95% CI: 13–24) compared to the CT, which had a mean of 28% (SD: 21 and 95% CI: 20–36) with a p value = 0.030 and an ES = 0.57. These differences in the quality of the ventilations were relevant to the CPR quality, in which significantly lower values were also observed in the ST, with a mean of 50% (SD: 9 and 95% CI: 46–54), than in the CT, with a mean of 56% (SD: 13 and 95% CI: 51–61), with a p value = 0.025 and an ES = 0.59.
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276386_p33
|
PMC11276386
|
sec[2]/sec[1]/p[2]
|
3.2. Chest Compression and Ventilation Variables
| 4.066406 |
biomedical
|
Study
|
[
0.99853515625,
0.0005779266357421875,
0.0007729530334472656
] |
[
0.99951171875,
0.0001863241195678711,
0.00019443035125732422,
0.00005733966827392578
] |
Figure 4 shows the results for the non-CPR variables. The mean distance covered in the ST was 125 m (SD: 7 and 95% CI: 122–128). On the other hand, perceived fatigue assessed through the Borg scale was significantly higher in the ST (4; IQR: 3–5) than in the CT (2; IQR: 1–2), with a p value <0.001 and an ES = 0.59.
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276386_p34
|
PMC11276386
|
sec[3]/p[0]
|
4. Discussion
| 2.894531 |
clinical
|
Other
|
[
0.368896484375,
0.62109375,
0.00966644287109375
] |
[
0.004413604736328125,
0.978515625,
0.00089263916015625,
0.0160064697265625
] |
In the event of an in-hospital pediatric CA requiring ECMO but out of the PICU or operating room, effective resuscitation maneuvers should start and continue while transferring the infant to a suitable room to perform E-CPR. It is essential to perform quality resuscitative maneuvers while transferring a pediatric casualty to perform E-CPR.
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276386_p35
|
PMC11276386
|
sec[3]/p[1]
|
4. Discussion
| 2.78125 |
biomedical
|
Study
|
[
0.95166015625,
0.044921875,
0.0032062530517578125
] |
[
0.984375,
0.012939453125,
0.0005197525024414062,
0.0019931793212890625
] |
The main objective of this study was to evaluate the quality of manual CPR during intra-hospital transport of the infant manikin on a stretcher.
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276386_p36
|
PMC11276386
|
sec[3]/p[2]
|
4. Discussion
| 3.669922 |
biomedical
|
Study
|
[
0.97802734375,
0.0205535888671875,
0.001216888427734375
] |
[
0.9912109375,
0.007015228271484375,
0.0004220008850097656,
0.0012426376342773438
] |
The main positive finding of this investigation was that the quality of CPR and chest compressions, in particular, can be maintained while transferring the pediatric victim (in our case, an infant manikin) on a stretcher. On the other hand, a negative finding was that despite being properly trained, the participants failed to perform high-quality ventilations, neither standing up nor walking. The poor performance therefore makes it impossible to know if it is actually the transfer itself which deteriorates the ventilation quality or failure of their skills training.
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276386_p37
|
PMC11276386
|
sec[3]/p[3]
|
4. Discussion
| 4.0625 |
biomedical
|
Study
|
[
0.99853515625,
0.0010004043579101562,
0.00023853778839111328
] |
[
0.99755859375,
0.0004107952117919922,
0.001796722412109375,
0.00015628337860107422
] |
Chest compression quality is essential for improving CPR results . Several investigations have shown that CPR with high-quality chest compressions and a high chest compression fraction is associated with increased survival . Our results show that compression quality was generally high in both simulations (84% CT vs. 82% ST) and no difficulties were noted when they were carried out while walking next to the stretcher, with values similar to other studies involving infants . The results of our investigation agree with those of Cheskes et al. who reported that pre-hospital rescuers can perform high-quality manual compressions during transport in out-of-hospital cardiac arrest . Similarly, Loaec et al. demonstrated with an observational study that it is possible to maintain CPR quality during the intra-hospital transport of critically ill infants with chest compression rates and depths that met international recommendations .
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276386_p38
|
PMC11276386
|
sec[3]/p[4]
|
4. Discussion
| 2.111328 |
biomedical
|
Study
|
[
0.97509765625,
0.0193634033203125,
0.00539398193359375
] |
[
0.927734375,
0.0689697265625,
0.0007572174072265625,
0.0023822784423828125
] |
The nursing students that participated in this study performed adequate compressions during transport. Our data confirm that trained rescuers were able to perform quality compressions on the move.
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276386_p39
|
PMC11276386
|
sec[3]/p[5]
|
4. Discussion
| 3.955078 |
biomedical
|
Study
|
[
0.9990234375,
0.0005884170532226562,
0.0003216266632080078
] |
[
0.99560546875,
0.0013208389282226562,
0.002956390380859375,
0.00019180774688720703
] |
Aufderheide et al. observed that incomplete chest recoil during CPR was frequent in real patients in out-of-hospital cardiac arrest , which is consistent with the results of our investigation and is therefore an important point that needs to be improved. One explanation for incomplete chest recoil may be the compression technique used, since various investigations have noted that the two-thumb–encircling hands technique is related to a higher rate of incomplete recoil . Several investigations are currently focused on implementing new compression methods in infant victims , although they are still in the experimental phase, so it is possible that these new techniques could improve this aspect over time.
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276386_p40
|
PMC11276386
|
sec[3]/p[6]
|
4. Discussion
| 4.042969 |
biomedical
|
Study
|
[
0.9990234375,
0.0009508132934570312,
0.00022935867309570312
] |
[
0.99853515625,
0.0009412765502929688,
0.0003285408020019531,
0.0001652240753173828
] |
Suitable ventilation is also fundamental for success during CPR in a pediatric victim, since the most frequent cause of cardiac arrest in infants is respiratory failure . In our investigation, we observed low ventilation quality in the control test and a significant decrease in ventilation quality during intra-hospital transfer. This coincides with Lipman et al.’s investigation which showed a decrease in ventilation volume during intra-hospital transport in a simulated maternal cardiac arrest .
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276386_p41
|
PMC11276386
|
sec[3]/p[7]
|
4. Discussion
| 4.042969 |
biomedical
|
Study
|
[
0.98974609375,
0.00975799560546875,
0.00038886070251464844
] |
[
0.9912109375,
0.00623321533203125,
0.0015134811401367188,
0.0009584426879882812
] |
Similarly, we observed suboptimal ventilation quality values in both tests, with lower values during pediatric intra-hospital transfer (18% ST vs. 28% CT). In the same way, other investigations observed that the instrumental management of the pediatric airway is difficult even for health professionals . Although we have chosen bag-mask ventilation as the more realistic initial airway management in cases of at-ward cardiac arrest, supported by relevant guidelines, we could speculate about the impact of supraglottic devices on the quality of ventilations. Regardless, it is essential to practice this aspect thoroughly during training and perform rolling refreshers during work activity .
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276386_p42
|
PMC11276386
|
sec[3]/p[8]
|
4. Discussion
| 3.380859 |
biomedical
|
Other
|
[
0.59326171875,
0.397216796875,
0.009735107421875
] |
[
0.05584716796875,
0.92529296875,
0.001377105712890625,
0.0175323486328125
] |
Despite the greater number of attempts with the stretcher test, more ventilations were performed in the control test, which implies that ventilation management is hampered due to the stretcher being in motion. This is the main obstacle to overcome and emergency staff need to work on this aspect more in the future in order to improve this critical part of the emergency procedure. So, in a situation where there is a need to transport an infant who is on standby and who does not have an isolated airway, the key question is the following: Is it worth stopping in order to isolate the airway and hence delay an important transfer (e.g., for ECMO)? Or should we transfer the infant directly for ECMO while simultaneously performing CPR and thus delay isolating the airway until we perform ECMO?
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276386_p43
|
PMC11276386
|
sec[3]/p[9]
|
4. Discussion
| 4.027344 |
biomedical
|
Study
|
[
0.98828125,
0.01148223876953125,
0.0004100799560546875
] |
[
0.9052734375,
0.077392578125,
0.014404296875,
0.0030307769775390625
] |
Recent research has shown that instrumental airway management is associated with higher chances of survival compared to advanced management . Pediatric endotracheal intubation is a complex procedure which is performed infrequently and requires ongoing skill maintenance to be successful . In addition, pediatric intubation mistakes are commonplace . For this reason, ventilation with a self-inflating bag mask has become the essential technique for performing ventilations . The recommendation is not to secure the airway but rather to oxygenate and ventilate. The low-quality results of the ventilations in this investigation cannot be attributed to the victim not being intubated. One strategy to improve ventilation could be to perform breaths involving both rescuers: one seals the mask to the victim’s face and opens the airway while the other rescuer squeezes the bag to blow air into the lungs .
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276386_p44
|
PMC11276386
|
sec[3]/p[10]
|
4. Discussion
| 4.046875 |
biomedical
|
Study
|
[
0.99853515625,
0.0013589859008789062,
0.0002770423889160156
] |
[
0.99755859375,
0.0006961822509765625,
0.0016031265258789062,
0.00019180774688720703
] |
The performance of high-quality CPR is an important determinant of survival with a good neurological outcome after cardiac arrest . The total quality of CPR decreased slightly (56% CT vs. 50% ST) during stretcher transfer, mainly due to the ventilatory component. The suboptimal values noted in both situations coincide with Ødegaard et al.’s results. They showed that CPR quality in adult patients did not deteriorate during ambulance transport, but that it was suboptimal both in the static situation and during transport .
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
PMC11276386_p45
|
PMC11276386
|
sec[3]/p[11]
|
4. Discussion
| 2.701172 |
biomedical
|
Study
|
[
0.99462890625,
0.004268646240234375,
0.00115966796875
] |
[
0.80810546875,
0.1724853515625,
0.0157928466796875,
0.003475189208984375
] |
The only study that analyzed the quality of CPR in real pediatric patients during intra-hospital transfer on a stretcher showed that CPR quality was maintained during transport, so they suggest incorporating transport to facilitate ECMO cannulation .
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276386_p46
|
PMC11276386
|
sec[3]/p[12]
|
4. Discussion
| 3.345703 |
biomedical
|
Study
|
[
0.998046875,
0.0012607574462890625,
0.0008907318115234375
] |
[
0.953125,
0.043914794921875,
0.002460479736328125,
0.0005974769592285156
] |
Resuscitation maneuvers are physically demanding even for trained rescuers . The Borg scale is frequently used in research studies to estimate the magnitude of perceived exertion during CPR . It is perfectly logical that fatigue is greater during intra-hospital transport than during static CPR. However, fatigue during transport did not reach crucial values and the normal and sustainable values seen in the tests were similar to those observed in other investigations .
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276386_p47
|
PMC11276386
|
sec[3]/p[13]
|
4. Discussion
| 2.298828 |
biomedical
|
Study
|
[
0.93505859375,
0.053192138671875,
0.01177215576171875
] |
[
0.82666015625,
0.1668701171875,
0.0007948875427246094,
0.00566864013671875
] |
During the 2 min of CPR, the entrance, exit and stay in the elevator were included, since this is common during the intra-hospital transfer of a victim. This is a weak point of this study as elevator times could be longer in other hospitals. The entrance and exit from the elevator were critical moments in the transfer of the patient in cardiorespiratory arrest due to the number of personnel who were involved in the transfer and the narrowness of the elevator. So, it becomes a situation in which we must train personnel properly and describe it clearly in the protocols in order to improve performance.
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276386_p48
|
PMC11276386
|
sec[3]/p[14]
|
4. Discussion
| 2.382813 |
biomedical
|
Study
|
[
0.99609375,
0.002658843994140625,
0.0012559890747070312
] |
[
0.9921875,
0.006572723388671875,
0.0007843971252441406,
0.0005955696105957031
] |
This study has a number of limitations that should be mentioned. On the one hand, the study was carried out in a simulated environment, so the results cannot be extrapolated to clinical practice. On the other hand, elevator times could be longer in other hospitals. Also, we have no comparison of different airway management strategies (mask, supraglottic devices, intratracheal tube).
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276386_p49
|
PMC11276386
|
sec[4]/p[0]
|
5. Conclusions
| 2.769531 |
biomedical
|
Study
|
[
0.98486328125,
0.01033782958984375,
0.0048828125
] |
[
0.94189453125,
0.05609130859375,
0.0008292198181152344,
0.0010986328125
] |
Infant in-hospital CPR with stretcher transport involving two rescuers and two attendants is viable and feasible. However, students with previous training in infant CPR perform it with reduced quality during transport on a stretcher, mainly due to the difficulty of ventilation. It is necessary to look for new strategies to improve CPR quality during the transport of a pediatric victim on a stretcher. Another limitation is the presence of distracting factors that may have influenced the results. These factors include participant fatigue, the simulated environment, and psychological stressors.
|
[
"Myriam Santos-Folgar",
"Felipe Fernández-Méndez",
"Martín Otero-Agra",
"Roberto Barcala-Furelos",
"Antonio Rodríguez-Núñez"
] |
https://doi.org/10.3390/children11070865
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276399_p0
|
PMC11276399
|
sec[0]/p[0]
|
1. Introduction
| 4.539063 |
biomedical
|
Study
|
[
0.9990234375,
0.00038504600524902344,
0.0005846023559570312
] |
[
0.9345703125,
0.0019016265869140625,
0.0633544921875,
0.00036144256591796875
] |
GATA proteins are a group of transcription factors capable of specifically recognizing and binding to the WGATAR (W = T or A; R = G or A) consensus sequence, found in a variety of organisms including plants, fungi, nematodes, and insects . Despite structural differences in GATA proteins among different species, most GATA transcription factors in plants contain one or two highly conserved zinc-finger DNA-binding domains, commonly with the sequence CX₂CX₁₈–₂₀CX₂C (type IV zinc-finger domain) . Based on evolutionary relationships and gene structure analysis, the GATA gene family can be divided into four subfamilies, each with distinct differences in the number of exons . This exon–intron pattern and conserved zinc-finger domain highlight the evolutionary conservation and diversification of GATA transcription factors across different plant species, underscoring their crucial roles in plant development and stress responses.
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276399_p1
|
PMC11276399
|
sec[0]/p[1]
|
1. Introduction
| 4.765625 |
biomedical
|
Study
|
[
0.99658203125,
0.001102447509765625,
0.002384185791015625
] |
[
0.7314453125,
0.00171661376953125,
0.265869140625,
0.0007500648498535156
] |
As an important group of regulatory proteins, the GATA gene family has been reported to play a significant role in regulating flower development and responding to abiotic stresses such as drought and salt stress. In terms of flower development, many functions associated with GATA genes have been validated in the model plant Arabidopsis thaliana . For instance, members of the GATA3 family, HANL2 and GNL, primarily participate in the regulation of sepal separation and petal number, while GNC is involved in sepal separation, petal number, and the development of stamens and carpels . Additionally, the GATA3 family functions redundantly with the key transcriptional repressor HANABA TARANU, regulating genes involved in hormone signaling and floral organ specification to control flower development . The paralogs and functionally redundant GATA transcription factors AtGNC and AtGNL / CGA1 control flowering time by repressing the transcription of SOC1 . Moreover, AtGNC and AtGNL are negatively regulated by AP3/PI to promote proper floral organ type differentiation and development . ZIM (GATA-1-type, putative single zinc finger), also known as GATA25, has been identified to be expressed in the shoot apex and flowers during the reproductive stage of Arabidopsis , which is involved in the development of inflorescences and flowers , and plays a role in accelerating flowering time under long-day conditions . GATA transcription factors are essential not only for the floral organs of model plants but also for the flower development of other plants, including apples , wheat , and Brachypodium distachyon . Regarding abiotic stress, previous studies have reported that IbGATA24 in sweet potatoes positively regulates tolerance to drought and salt stress through interaction with IbCOP9-5a . Additionally, OsGATA16 in rice enhances cold tolerance by repressing OsWRKY45-1 during the seedling stage . PdGNC confers drought tolerance by mediating stomatal closure in Populus deltoides . The expression patterns of GATA subfamily I members in tomatoes under abiotic stress indicate responses to cold, drought, and salt stresses .
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276399_p2
|
PMC11276399
|
sec[0]/p[2]
|
1. Introduction
| 4.203125 |
biomedical
|
Study
|
[
0.994140625,
0.0005707740783691406,
0.005336761474609375
] |
[
0.9990234375,
0.0002460479736328125,
0.0009036064147949219,
0.00005620718002319336
] |
Orchidaceae is one of the largest groups of angiosperms, comprising over 750 genera and more than 29,000 species . Due to their rich ornamental value, orchids are in high demand in the horticultural market, forming a vast industrial chain . However, various abiotic stresses have impacted the growth and development of orchids in recent years. These environmental challenges not only hinder the physiological processes essential for orchid survival but also reduce their flowering potential and aesthetic value, thereby affecting their economic viability and conservation . Therefore, understanding the molecular mechanisms of flower development and heat response in orchids is crucial for improving their stress resistance and breeding effectiveness. The GATA gene family plays a significant role in enhancing plant stress resistance and breeding, but to date, no research has focused on GATA genes in orchids. So, our study is the first to comprehensively identify the GATA gene family in Orchidaceae, systematically analyzing phylogenetic relationships, physicochemical properties, chromosomal localization, gene structure, motif composition, collinearity, and promoter characteristics. Additionally, we used qRT-PCR to examine the expression patterns of CgGATAs under heat treatment to explore their functions and mechanisms. We believe this research provides new insights into the study of stress resistance in orchids and offers an important theoretical foundation for future orchid breeding and improvement efforts. By elucidating the molecular mechanisms underlying stress responses, this knowledge can be applied to enhance the resilience of orchids, particularly in their ability to withstand environmental challenges, thereby contributing to the sustainability and economic viability of orchid cultivation.
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
PMC11276399_p3
|
PMC11276399
|
sec[1]/sec[0]/p[0]
|
2.1. Plant Materials and Data Sources
| 4.050781 |
biomedical
|
Study
|
[
0.99658203125,
0.00023996829986572266,
0.0029621124267578125
] |
[
0.99951171875,
0.0003955364227294922,
0.00015592575073242188,
0.000033736228942871094
] |
The plant materials, Cymbidium goeringii , were obtained from Fujian Agriculture and Forestry University in Fujian, China. We selected three pots of C. goeringii with similar growth conditions and subjected them to heat stress in a controlled environment chamber. The heat stress was applied under the following conditions: 16 h of light at 30 °C followed by 8 h of darkness at 38 °C. The samples were subjected to heat stress (40 °C) for 0 h, 6 h, 12 h, and 18 h, respectively, while keeping other conditions constant. Leaf samples from each group were collected at the corresponding time points and rapidly frozen in liquid nitrogen for subsequent experiments. In addition, the whole-genome sequences and annotation files of seven orchid species were downloaded from NCBI and the National Genomics Data Center (NGDC) , with the accession numbers as follows: Phalaenopsis equestris , C. goeringii , C. ensifolium , Dendrobium catenatum , D. chrysotoxum , D. nobile , and Gastrodia elata . The GATA protein sequence of A. thaliana was obtained from TAIR .
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276399_p4
|
PMC11276399
|
sec[1]/sec[1]/p[0]
|
2.2. Identification, Physicochemical Properties and Phylogenetic Tree
| 4.171875 |
biomedical
|
Study
|
[
0.99951171875,
0.0003039836883544922,
0.00039505958557128906
] |
[
0.99951171875,
0.0001672506332397461,
0.0003094673156738281,
0.00006449222564697266
] |
Using 30 AthGATA sequences as query sequences and setting the e-value to 1 × 10 −5 , we employed the Blast tool and Simple HMM Search of TBtools v2.096 to search and identify potential candidate GATA genes in seven orchid genomes, including P. equestris , C. goeringii , C. ensifolium , D. catenatum , D. chrysotoxum , D. nobile , and G. elata . Through conservative structural filtering, incomplete or redundant protein sequences were manually removed. Additionally, the physicochemical properties analysis was conducted using the online software ExPASy 3.0 . Through orchid protein sequences calculations, we obtained results for amino acid composition (AA), isoelectric point (pI), molecular weight (MW), grand average of hydropathicity (GRAVY), instability index (II), and aliphatic index (AI). Additionally, we inputted a total of 179 protein sequences into PhyloSuite v1.2.3 and conducted alignment using MAFFT with default parameters. Subsequently, we constructed a neighbor-joining (NJ) phylogenetic tree of GATAs with a bootstrap value of 1000 and a minimum correlation coefficient set to 0.90. The online software Evolview 3.0 was used for visualization.
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276399_p5
|
PMC11276399
|
sec[1]/sec[2]/p[0]
|
2.3. Chromosomal Localization
| 3.740234 |
biomedical
|
Study
|
[
0.99755859375,
0.00021028518676757812,
0.0021572113037109375
] |
[
0.98876953125,
0.01065826416015625,
0.00029850006103515625,
0.0001361370086669922
] |
We imported the GFF files of each orchid genome into TBtools v2.096 to generate the chromosomal location map for each GATA gene.
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276399_p6
|
PMC11276399
|
sec[1]/sec[3]/p[0]
|
2.4. Gene Structure and Multiple Sequence Alignment
| 4.011719 |
biomedical
|
Study
|
[
0.99853515625,
0.00019085407257080078,
0.0010499954223632812
] |
[
0.9990234375,
0.0005779266357421875,
0.0001958608627319336,
0.000049054622650146484
] |
Using the online tool MEME , we predicted the conserved motifs of GATA genes in seven orchid species. The maximum number of motifs was set to ten, with other parameters kept at default settings. The MAST file was downloaded for gene structure visualization and analyzed using TBtools v2.096 . The multiple sequence alignment was also visualized in TBtools v2.096 with the aligned protein sequences.
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276399_p7
|
PMC11276399
|
sec[1]/sec[4]/p[0]
|
2.5. Synteny Analysis and Cis-Regulatory Element Analysis
| 4.117188 |
biomedical
|
Study
|
[
0.99755859375,
0.0003006458282470703,
0.001922607421875
] |
[
0.99951171875,
0.0002868175506591797,
0.00017321109771728516,
0.0000413060188293457
] |
Using One Step MCScanX-SuperFast in TBtools v2.096 , we identified the collinearity relationships among C. goeringii , D. nobile , D. chrysotoxum , and G. elata . The resulting ctl, collinearity, and GFF files were input into the Dual Synteny Plot function in TBtools v2.096 to generate the visualization. To predict cis-acting elements in four orchid species, we extracted the upstream sequences of GATA genes using GFF files and analyzed these sequences on the PlantCARE website . We excluded common promoter elements and retained those related to stress resistance. The manually curated results were then visualized using TBtools v2.096 .
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276399_p8
|
PMC11276399
|
sec[1]/sec[5]/p[0]
|
2.6. Expression Analysis and RT-qPCR
| 4.101563 |
biomedical
|
Study
|
[
0.9970703125,
0.0003948211669921875,
0.002674102783203125
] |
[
0.99951171875,
0.0002410411834716797,
0.00021028518676757812,
0.00004279613494873047
] |
To study the expression patterns of GATAs in different floral parts of orchids, we first performed quality control on the raw RNA-seq data using fastp . The processed RNA-seq reads were then used for transcript quantification, converting the expression levels of each gene to fragments per kilobase of transcript per million mapped reads (FPKM). We established an RNA-seq transcriptome database for different floral parts at various stages, with three biological replicates for each sample. Finally, the heatmap was generated in TBtools v2.096 based on the FPKM values to visualize the expression of GATA genes at different floral parts.
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276399_p9
|
PMC11276399
|
sec[1]/sec[5]/p[1]
|
2.6. Expression Analysis and RT-qPCR
| 4.113281 |
biomedical
|
Study
|
[
0.99951171875,
0.00023639202117919922,
0.00026154518127441406
] |
[
0.99951171875,
0.0002651214599609375,
0.0002359151840209961,
0.00005120038986206055
] |
The total RNA of C. goeringii was extracted using the FastPure Plant Total RNA Isolation Kit (for polysaccharide- and polyphenol-rich tissues) (Vazyme Biotech Co., Ltd., Nanjing, China) according to the manufacturer’s instructions. The extracted RNA was then reverse transcribed into cDNA using Hifair ® AdvanceFast One-step RT-gDNA Digestion SuperMix for qPCR (Yeasen Biotechnology Co., Ltd., Shanghai, China). The cDNA was then used as a template for qPCR with Hieff ® qPCR SYBR Green Master Mix (High Rox Plus). Primers specific to the target gene and qPCR dye were added, and the analysis was conducted on an ABI 7500 Real-Time System. The primers were designed using Primer Premier 5 software. The RT-qPCR conditions were 5 min at 95 °C for the pre-denaturation process, followed by 40 cycles of 10 s at 95 °C and 30 s at 60 °C during the amplification phase (the cycling stage). The experimental setup utilized 96-well plates with a 20 μL reaction system in each well, and 3 biological replicates were performed in this study. The data obtained were processed using the 2−ΔΔCT method and visualized using GraphPad Prism 7.0.
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276399_p10
|
PMC11276399
|
sec[2]/sec[0]/p[0]
|
3.1. Phylogenetic Analysis of GATA Genes
| 4.117188 |
biomedical
|
Study
|
[
0.998046875,
0.00021195411682128906,
0.0016984939575195312
] |
[
0.9990234375,
0.0005888938903808594,
0.00023174285888671875,
0.00004082918167114258
] |
As illustrated in Figure 1 , a total of 179 GATA genes were classified into 4 subfamilies, designated as subfamily I, II, III, and IV. Subfamily I contains the largest number of members, with 87 genes, followed by subfamily II with 46 genes, subfamily III with 29 genes, and subfamily IV with 17 genes, the fewest. The majority of orchid GATA genes are concentrated in subfamilies I and II. Notably, a significant proportion of GATA members in subfamily III are from D. catenatum and D. nobile , with five and seven members, respectively.
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276399_p11
|
PMC11276399
|
sec[2]/sec[1]/p[0]
|
3.2. Identification and Physicochemical Properties of the GATA Gene Family
| 4.203125 |
biomedical
|
Study
|
[
0.99951171875,
0.0002970695495605469,
0.0003666877746582031
] |
[
0.99951171875,
0.00016176700592041016,
0.0002963542938232422,
0.00006538629531860352
] |
Using the Arabidopsis GATA protein sequences as a reference, we identified a total of 149 GATA genes across seven orchid species. Specifically, there were 20 in P. equestris , 23 in C. goeringii , 24 in C. ensifolium , 23 in D. catenatum , 20 in D. chrysotoxum , 27 in D. nobile , and 12 in G. elata . To further understand the functions and mechanisms of these GATA proteins, we predicted and analyzed their physicochemical properties . These properties included protein length, isoelectric point, molecular weight, grand average of hydropathicity (GRAVY), aliphatic index (AI), and instability index (II). Our results revealed that protein lengths ranged from 140 amino acids (aa) to 730 aa, with most being around 270 aa. The isoelectric points ranged from 4.97 to 10.33 , with 56 GATA proteins being acidic (isoelectric point below 7) and 93 being basic (isoelectric point above 7). The molecular weights ranged from 15,276.37 Da to 83,833.85 Da , with an average molecular weight of 33,301.98 Da. All GATA proteins had GRAVY values less than 0, with the lowest being −1.051 , indicating that they are hydrophilic proteins. The AI values ranged from 49.17 to 79.78 , and the II values ranged from 35.52 to 85.84 . Detailed physicochemical properties of the related GATA genes are provided in Supplementary Table S1 .
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276399_p12
|
PMC11276399
|
sec[2]/sec[2]/p[0]
|
3.3. Chromosomal Localization of GATA Genes
| 3.582031 |
biomedical
|
Study
|
[
0.99658203125,
0.00023996829986572266,
0.0029659271240234375
] |
[
0.99755859375,
0.002208709716796875,
0.00016570091247558594,
0.00007611513137817383
] |
As shown in Figure 3 , we found that GATA genes are unevenly distributed across the chromosomes. Specifically, we identified one pair of tandemly duplicated genes on P. equestris , two pairs on C. ensifolium , and one pair on D. nobile .
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276399_p13
|
PMC11276399
|
sec[2]/sec[3]/p[0]
|
3.4. Analysis of GATA Gene Structure and Motifs
| 4.28125 |
biomedical
|
Study
|
[
0.9990234375,
0.00037384033203125,
0.0006537437438964844
] |
[
0.99951171875,
0.0001876354217529297,
0.0003814697265625,
0.00006651878356933594
] |
To better understand the gene structure characteristics of the GATA gene family in orchids, we predicted multiple conserved motifs and analyzed the distribution of introns and exons within their sequences . Our results clearly show distinct patterns among the subfamilies. Members of subfamily III predominantly display the motif order of motif6–motif4–motif5–motif1, with motif6 being unique to this subfamily and motifs 4, 5, and 1 highly conserved within it. Subfamily II members mostly follow the motif order of motif5–motif1–motif10, with an overall sequence length averaging around 200–300 bp. In subfamily IV, the motif order is motif5–motif7–motif9, with motifs 7 and 9 being unique to this subfamily. Subfamily I members are characterized by the motif order of motif8–motif3–motif5–motif1–motif2, with motifs 8, 3, and 2 being unique and highly conserved within this subfamily. Additionally, the 149 orchid GATA genes contain between one and eight CDS regions. For example, Dno13G00356 has only one CDS, while most members of subfamilies III and IV contain seven or eight CDS regions. Through multiple sequence alignments of 149 GATA genes, we found that all sequences contain a specific domain , namely the CX 2 CX 18 CX 2 C sequence, which is highly conserved. This domain had several significantly conserved amino acid residues, including cysteine residues (C), glycine residues (G), proline residues (P), asparagine residues (N), and alanine residues (A).
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276399_p14
|
PMC11276399
|
sec[2]/sec[4]/p[0]
|
3.5. Collinearity Analysis of the GATA Gene Family
| 4.117188 |
biomedical
|
Study
|
[
0.9970703125,
0.00035309791564941406,
0.0028133392333984375
] |
[
0.99951171875,
0.00023317337036132812,
0.00018703937530517578,
0.0000388026237487793
] |
To identify duplication events of the GATA gene family in orchids, we conducted collinearity analysis on C. goeringii , D. chrysotoxum , D. nobile , and G. elata . As shown in Figure 6 , there is evidence of collinearity among the GATA genes in these four orchid species, indicating a high level of homology. We identified 24 pairs of collinear relationships between C. goeringii and D. chrysotoxum , 27 pairs between D. chrysotoxum and D. nobile , and 14 pairs between D. nobile and G. elata . Notably, collinear relationships on chromosomes Cg07, Dch-13, Dno-30, and Gel-03 are more abundant than on other chromosomes within the same species. However, the GATA genes in G. elata are notably fewer compared to other orchid species.
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276399_p15
|
PMC11276399
|
sec[2]/sec[5]/p[0]
|
3.6. Cis-Element Analysis
| 4.140625 |
biomedical
|
Study
|
[
0.998046875,
0.00032138824462890625,
0.0015392303466796875
] |
[
0.99951171875,
0.00020134449005126953,
0.0002434253692626953,
0.00003975629806518555
] |
To further investigate the regulatory functions of GATA in orchids, we identified the major cis elements within the 2000 bp upstream regions of the promoters of 4 orchid species, totaling 13 kinds of elements. As shown in Figure 7 , the prominent cis elements in the upstream promoters of orchid GATA genes are abscisic acid responsiveness (190) and MeJA responsiveness (134). Notably, apart from these two elements, gibberellin responsiveness, low-temperature responsiveness, and defense and stress responsiveness also occur frequently in D. chrysotoxum . In the promoter elements of D. nobile , the low-temperature responsiveness element of gene Dno18G01572 appears eight times. In the promoter elements of G. elata , the zein metabolism regulation element of gene Gel19707 appears four times.
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276399_p16
|
PMC11276399
|
sec[2]/sec[6]/p[0]
|
3.7. Heatmap Analysis of Floral Components and Heat-Resistant RT-qPCR Analysis
| 4.191406 |
biomedical
|
Study
|
[
0.99609375,
0.00043082237243652344,
0.003398895263671875
] |
[
0.99951171875,
0.0002627372741699219,
0.00022780895233154297,
0.000043272972106933594
] |
To understand the expression differences of the GATA gene family in different floral components, we compared the expression levels of GATA genes in four orchids. As shown in Figure 8 A, there are 7 genes in C. goeringii (7/23), 13 genes in C. ensifolium (13/24), five genes in D. chrysotoxum (5/20), and 10 genes in P. equestris (10/20) with high expression in floral organs. Notably, in C. goeringii , GL15326 exhibits high expression levels in the sepal, petal, and lip, but is barely expressed in the gynostemium. GL12672 shows high expression in the sepal and petal, while GL15275 and GL20810 demonstrate high expression in the petal and lip. JL010835 exhibits greatly higher expression in the petal, lip, and gynostemium compared to the sepal of C. ensifolium . JL009905 shows elevated expression in lip and gynostemium relative to sepal and petal. JL003363 and JL022408 are highly expressed exclusively in sepal. In D. chrysotoxum , Maker102215 is predominantly expressed in sepal, whereas Maker117426 and Maker62793 show high expression in the other three floral components. Peq000384 , Peq015361 , and Peq007546 display elevated expression in the sepal, while Peq010598 is highly expressed only in the gynostemium.
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276399_p17
|
PMC11276399
|
sec[2]/sec[6]/p[1]
|
3.7. Heatmap Analysis of Floral Components and Heat-Resistant RT-qPCR Analysis
| 4.144531 |
biomedical
|
Study
|
[
0.99853515625,
0.00034427642822265625,
0.0009675025939941406
] |
[
0.99951171875,
0.0001430511474609375,
0.00018703937530517578,
0.0000407099723815918
] |
To further elucidate the expression patterns of GATA genes in C. goeringii under high-temperature stress, we selected five genes for qPCR experiments based on their subfamily classification, the number of promoters, and their expression levels of leaves. The results of the high-temperature treatment reveal three distinct patterns. The first pattern is exhibited by GL17420 , whose expression sharply increases within 6 h and then gradually decreases over time. The second pattern is shown by GL18180 and GL17341 , both of which display a significant downregulation after 6 h of high-temperature treatment, followed by a rapid upregulation at 12 h, and a subsequent decrease in expression at 18 h. The third pattern, opposite to the second, is observed in GL30286 and GL20810 , which show upregulation at 6 h, slight repression at 12 h, and further upregulation at 18 h, with expression levels at 18 h being higher than those at 6 h.
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276399_p18
|
PMC11276399
|
sec[3]/p[0]
|
4. Discussion
| 4.421875 |
biomedical
|
Study
|
[
0.9990234375,
0.00039887428283691406,
0.00040984153747558594
] |
[
0.9990234375,
0.0002224445343017578,
0.0005655288696289062,
0.00010383129119873047
] |
The transcription factor GATA has been extensively studied in many plants and animals. GATA genes participate in various critical biological processes in plants by regulating genes responsible for the development of different tissues and modulating hormone signaling under stress conditions . However, the function and molecular mechanisms of the GATA gene in regulating different floral components and heat tolerance have not yet been explored in orchids. Therefore, in this study, we identified the GATA gene family in orchids for the first time. A total of 149 GATA genes were identified in orchids, including 20 in P. equestris , 23 in C. goeringii , 24 in C. ensifolium , 23 in D. catenatum , 20 in D. chrysotoxum , 27 in D. nobile , and 12 in G. elata . The number is comparable to the GATA genes in the monocot Oryza sativa , but fewer than in other monocots, such as wheat , maize , and Sorghum bicolor . The highest number of GATA family members, 96 genes, has been found in Brassica napus , emphasizing the variability in gene family size influenced by genome size, chromosome number, and gene duplication events . A phylogenetic analysis comparing the 149 GATA genes in orchids with those in A. thaliana revealed that the distribution of GATA genes across different subfamilies in orchids is relatively conserved. Our results indicate that the largest number of members in orchids is found in subfamily I, followed by subfamily II, with subfamily IV having the fewest members. This pattern is similar to the phylogenetic classification observed in apple , B. distachyon , and grape , where subfamily I also has the most members and subfamily IV the fewest. Additionally, the phylogenetic analysis indicates that the number of genes in subfamily III is significantly higher in D. catenatum and D. nobile compared to other orchid species, possibly due to gene duplication events within this subfamily in Dendrobium species. The physicochemical properties results indicate that the instability index of most GATA proteins (145 out of 149) is greater than 40.00, suggesting that they are unstable proteins . All GATA proteins have negative GRAVY values (−0.142 to −1.051), identifying them as hydrophilic proteins. Based on their isoelectric points, the ratio of acidic to basic proteins is approximately 2:3 (56:93). Our results revealed that protein lengths ranged from 140 amino acids (aa) to 730 aa in orchids, whereas GATA factors in soybean encode peptides ranging from 80 to 551 aa . In wheat, TaGATA proteins have lengths ranging from 146 to 499 aa , and in B. napus , GATA proteins range from 101 to 576 aa . This variation in protein length suggests that the GATA gene family exhibits considerable diversity in different species, which may be attributed to species-specific evolutionary adaptations and functional requirements. Additionally, this diversity in amino acid length could influence the stability and functionality of the proteins. Understanding these differences in protein length can provide insights into the evolutionary pressures and functional diversification of GATA proteins across various plant species.
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276399_p19
|
PMC11276399
|
sec[3]/p[1]
|
4. Discussion
| 4.589844 |
biomedical
|
Study
|
[
0.9990234375,
0.0004718303680419922,
0.0003573894500732422
] |
[
0.998046875,
0.0004324913024902344,
0.0012674331665039062,
0.00017130374908447266
] |
The GATA gene structure analysis results reveal that each subfamily contains unique motifs and conserved motif sequences. Notably, motif8, motif3, and motif2 are specific to subfamily I, motif7 and motif9 are exclusive to subfamily IV, and motif6 is distinctive to subfamily III. These findings suggest that each subfamily may possess certain specialized functions, distinguishing them from other subfamilies. In A. thaliana , subfamily I of the GATA family comprises 14 members, each with 2 exons. Subfamily II includes ten members with two to three exons, while subfamily III consists of three members, each containing seven exons. Subfamily IV lacks characteristic gene structure features . Our results reveal that in orchids, subfamily I includes 73 members with 2 exons (73/87). Subfamily II consists of 31 members with 2 exons (31/46), with the remaining 14 members having 3 exons. Most members of subfamilies III and IV have seven or eight CDS. This clearly indicates that the exon distribution in orchid GATA subfamilies I, II, and III is similar to that in A. thaliana . However, subfamily IV in orchids distinctly features seven exons. Additionally, the pattern of having fewer introns in subfamilies I and II and a higher number of introns in subfamilies III and IV is also observed in Fagopyrum tataricum and Eucalyptus urophylla . This suggests a conserved evolutionary mechanism influencing exon–intron structure across different species, contributing to the functional diversity of GATA genes. In addition to the exon number, we found that intron lengths in subfamilies III and IV are generally longer than those in subfamilies I and II. During gene evolution, longer introns are often favored as they enhance the efficiency of natural selection by increasing recombination between adjacent exons , suggesting that introns may have significant implications for the evolution and functional diversification of the GATA gene family.
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
PMC11276399_p20
|
PMC11276399
|
sec[3]/p[2]
|
4. Discussion
| 4.488281 |
biomedical
|
Study
|
[
0.9990234375,
0.0004036426544189453,
0.00037169456481933594
] |
[
0.99853515625,
0.0002474784851074219,
0.0009140968322753906,
0.00012373924255371094
] |
Gene duplication is a major driving force behind the expansion of gene families, significantly contributing to novelty and diversification in plants . Segmental duplication, tandem duplication, and transposition events are considered crucial mechanisms in plant evolution . Based on the synteny analysis of the GATA gene family in four orchid species and their chromosomal localization, this study identified two pairs of tandemly duplicated genes in P. equestris and C. ensifolium , namely Peq014233 / 34 and JL010246 / 47 , both belonging to subfamily I. Additionally, two pairs of tandemly duplicated genes were identified in C. ensifolium and D. nobile , namely JL017903 / 04 and Dno04G00750 / 51 , both belonging to subfamily II. These findings suggest that these four pairs of genes may co-regulate related biological processes through their transcriptional activities. Additionally, we identified 24 syntenic relationships between C. goeringii and D. chrysotoxum , 27 between D. chrysotoxum and D. nobile , and 14 between D. nobile and G. elata . This comparative analysis indicates that the GATA genes in these orchid species do not correspond one to one, suggesting that duplication events have occurred within the orchid GATA gene family, leading to its expansion. Cis-acting elements are DNA sequences with regulatory activity that control gene expression, playing a crucial role in development and physiology . They ensure the correct spatiotemporal pattern of gene expression, which is essential for proper development and environmental responses . In this study, we predicted the cis-acting elements in the promoter regions of 82 GATA genes, identifying elements associated with growth and development, physiological regulation, abiotic stress, and plant hormones. Our results revealed that abscisic acid (ABA) response elements were the most frequently occurring, followed by methyl jasmonate (MeJA) elements. The plant hormone ABA plays a significant role in helping plants adapt to abiotic environmental stresses , while MeJA assists plants in coping with various types of environmental stress, such as salt stress, drought, and low temperatures, thereby enhancing plant resilience and survival through multiple mechanisms. Notably, Dno18G01572 contains eight low-temperature responsive elements, indicating its high sensitivity to environmental changes and its potential role in regulating various cold adaptation mechanisms. Similarly, six GATA genes in D. chrysotoxum are significantly enriched with multiple low-temperature responsive elements. Gel019707 is not only involved in zein metabolism regulation but also plays a crucial role in endosperm expression. In summary, we suggest that the GATA genes in Dendrobium may play a significant role in cold adaptation and environmental stress response. By regulating stress physiology and hormone signal transduction, these genes enhance the plant’s defense capabilities against fluctuating environmental conditions.
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276399_p21
|
PMC11276399
|
sec[3]/p[3]
|
4. Discussion
| 4.433594 |
biomedical
|
Study
|
[
0.99853515625,
0.0005288124084472656,
0.0010957717895507812
] |
[
0.99853515625,
0.00023436546325683594,
0.0010433197021484375,
0.0000908970832824707
] |
The orchid family is one of the largest among flowering plants, with its flowers being essential for the study of plant developmental biology . In Arabidopsis , GNC and GNL have been identified as genes that inhibit flowering . In B. napus , the expression of the BnGATA2.5 gene has been linked to flowering time . Previous research on the GATA gene has primarily focused on its influence on flowering time regulation or organ abscission, whereas detailed studies on GATA expression in various floral parts are relatively scarce. By integrating transcriptome data from different floral parts of four orchid species, our study reveals that GATA genes exhibit significant tissue-specific expression. Specifically, In C. goeringii , C. ensifolium , D. chrysotoxum , and P. equestris , GATA genes exhibit significant tissue-specific expression, with seven, thirteen, five, and ten genes, respectively, showing high expression in floral parts, which indicates the critical regulatory role of GATA genes in floral organ development and provides a crucial basis for further exploration of their specific mechanisms in flower organ formation and functional regulation. Furthermore, the GATA gene family plays an important role in plant responses to abiotic stresses, contributing to enhanced tolerance to low temperatures and drought. Previous studies have indicated that in barley, GATA gene expression levels are markedly upregulated under flooding conditions . In chickpeas ( Cicer arietinum ), under abscisic acid and dehydration stress, these genes may participate in regulating chickpeas’ response to water stress in an abscisic acid-dependent manner . Regarding plant cold resistance, OsGATA16 exerts a positive regulatory role in enhancing cold resistance during the seedling stage of rice by binding to the promoter of OsWRKY45-1 and suppressing its expression .
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
PMC11276399_p22
|
PMC11276399
|
sec[3]/p[4]
|
4. Discussion
| 4.3125 |
biomedical
|
Study
|
[
0.9990234375,
0.00043702125549316406,
0.0006165504455566406
] |
[
0.99951171875,
0.00018918514251708984,
0.00042057037353515625,
0.00007039308547973633
] |
Furthermore, our study reveals that in the first pattern, the expression of GL17420 initially increases and then decreases under high-temperature treatment. This pattern suggests that GL17420 may play a crucial role in the early stages of high-temperature stress by rapidly responding to heat stimuli, such as through the expression of heat shock proteins, and then gradually adapting as the stress continues. In the second pattern, GL18180 and GL17341 are significantly downregulated initially, followed by a rapid upregulation and subsequent decrease under high-temperature treatment. This pattern likely reflects the complex roles of these genes in regulating the response to heat stress. The initial downregulation may be associated with the suppression of non-essential physiological processes to conserve energy, while the later upregulation could be to activate specific defense mechanisms or repair damage. The third pattern , which is opposite to the second, involves an initial upregulation, followed by a slight repression, and then a final upregulation. This pattern indicates a sustained positive response of these genes to high-temperature stress. These results suggest that the GATA genes in C. goeringii exhibit dynamic, time-dependent expression patterns under heat stress, revealing diverse regulatory mechanisms employed by different GATA genes in response to high-temperature stress.
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276399_p23
|
PMC11276399
|
sec[4]/p[0]
|
5. Conclusions
| 4.21875 |
biomedical
|
Study
|
[
0.9990234375,
0.0003390312194824219,
0.0007853507995605469
] |
[
0.99951171875,
0.00016307830810546875,
0.0003314018249511719,
0.00006175041198730469
] |
We identified a total of 20 PeqGATAs , 23 CgGATAs , 24 CeGATAs , 23 DcaGATAs , 20 DchGATAs , 27 DnoGATAs , and 12 GelGATAs , classified into 4 subfamilies. Phylogenetic analysis, gene structure, promoter prediction, chromosomal localization, and functional validation were conducted on the GATA genes from seven orchid species. Our study reveals that subfamilies I and II have fewer and shorter introns, while subfamilies III and IV have more and longer introns. This pattern suggests a conserved evolutionary mechanism, enhancing our understanding of GATA gene structure in orchids. The results revealed significant tissue-specific expression of GATA genes in floral organs and diverse regulatory mechanisms under heat stress. GL17420 shows a rapid response, while GL18180 and GL17341 first downregulate and then upregulate, and GL30286 and GL20810 first upregulate, then are slightly inhibited, and finally upregulate again. We believe that these findings provide valuable insights into potential genetic resources for enhancing the heat tolerance of C. goeringii and other orchids.
|
[
"Qinyao Zheng",
"Ye Huang",
"Xin He",
"Meng-Meng Zhang",
"Zhong-Jian Liu"
] |
https://doi.org/10.3390/genes15070915
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276413_p0
|
PMC11276413
|
sec[0]/p[0]
|
1. Introduction
| 3.994141 |
biomedical
|
Study
|
[
0.99951171875,
0.0003063678741455078,
0.0002970695495605469
] |
[
0.82421875,
0.0021209716796875,
0.1732177734375,
0.0003921985626220703
] |
Although it is known that mechanical ventilation causes lung injury, it is less widely appreciated that ventilation also injures the diaphragm as well . Controlled ventilation for patients with acute respiratory failure leads to muscle atrophy in the diaphragm due to oxidative stress-mediated protein degradation . Since Levine et al. reported in 2008 that short-duration controlled ventilation in brain-dead organ donors causes marked atrophy of diaphragm myofibers, more studies using ultrasonography have shown that diaphragm atrophy and dysfunction are frequent complications that occur during mechanical ventilation and are associated with poor outcomes . This has led to the need for noninvasive and reproducible methods of monitoring the diaphragm’s condition and function .
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276413_p1
|
PMC11276413
|
sec[0]/p[1]
|
1. Introduction
| 3.744141 |
biomedical
|
Other
|
[
0.9990234375,
0.00052642822265625,
0.000354766845703125
] |
[
0.12298583984375,
0.7705078125,
0.10455322265625,
0.0018262863159179688
] |
Several technologies are currently available for this purpose; however, many have limitations, such as being invasive, less cost-effective, and difficult to use at the bedside. Diagnostic ultrasonographic devices are ideal in this regard, and they are becoming an important tool for visualizing and quantifying diaphragm morphology and function. Additionally, respiratory muscles like the diaphragm and abdominal muscles are relatively close to the body surface, making them easier to observe with ultrasonography.
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276413_p2
|
PMC11276413
|
sec[0]/p[2]
|
1. Introduction
| 3.986328 |
biomedical
|
Review
|
[
0.9970703125,
0.0018587112426757812,
0.0010080337524414062
] |
[
0.0193023681640625,
0.0205230712890625,
0.95849609375,
0.0014867782592773438
] |
This article first summarizes the mechanisms of diaphragm muscle injury and describes the diaphragm evaluation method (diaphragm ultrasonography) using ultrasonographic equipment, its clinical applications, and its limitations. Furthermore, we discuss a recently published expert consensus and provide a perspective for the future.
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276413_p3
|
PMC11276413
|
sec[1]/p[0]
|
2. Mechanisms of Diaphragm Muscle Injury Induced by Mechanical Ventilation
| 3.679688 |
biomedical
|
Other
|
[
0.9990234375,
0.0004801750183105469,
0.0003933906555175781
] |
[
0.1923828125,
0.7802734375,
0.02606201171875,
0.0013608932495117188
] |
To prevent diaphragm dysfunction, it is essential to understand the mechanisms of diaphragm muscle injury. Atrophy due to a suppression of inspiratory effort and injury owing to an excessive load are the two most important diaphragm injuries during mechanical ventilation.
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276413_p4
|
PMC11276413
|
sec[1]/sec[0]/p[0]
|
2.1. Disuse Atrophy
| 4.261719 |
biomedical
|
Study
|
[
0.99951171875,
0.00023365020751953125,
0.00014972686767578125
] |
[
0.99658203125,
0.0002803802490234375,
0.0029850006103515625,
0.00010919570922851562
] |
Disuse atrophy due to a suppression of inspiratory effort and excessive respiratory support is the most important mechanism of diaphragm injury during mechanical ventilation . In animal studies, controlled ventilation or high levels of pressure support ventilation caused acute muscle atrophy, damage of myofibers, and dysfunction . Levine et al. reported that diaphragm inactivity for up to 18–69 h in brain-dead patients was associated with noticeable atrophy of the diaphragm; however, it did not cause atrophy in the pectoralis major. Furthermore, histological studies in humans have revealed that disuse of the diaphragm activated the proteolytic pathways, leading to both diaphragmatic atrophy and mitochondrial dysfunction, resulting in reduced contractility .
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276413_p5
|
PMC11276413
|
sec[1]/sec[1]/p[0]
|
2.2. Concentric Load-Induced Injury
| 4.164063 |
biomedical
|
Study
|
[
0.99951171875,
0.00023090839385986328,
0.00011909008026123047
] |
[
0.98095703125,
0.0014095306396484375,
0.017578125,
0.000217437744140625
] |
Insufficient ventilatory support against inspiratory effort overloads the diaphragm and causes muscle injury. In histological investigations in healthy subjects and patients with chronic obstructive pulmonary disease (COPD), contraction of the diaphragm against excessive load caused acute diaphragm injury, inflammation, and weakness . Importantly, in critically ill patients with systemic inflammation, mechanical stimuli can exacerbate sarcolemma and thus contribute to diaphragmatic dysfunction .
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
PMC11276413_p6
|
PMC11276413
|
sec[1]/sec[2]/p[0]
|
2.3. Eccentric Load-Induced Injury
| 4.296875 |
biomedical
|
Study
|
[
0.99951171875,
0.0003268718719482422,
0.00025200843811035156
] |
[
0.96435546875,
0.0014705657958984375,
0.03369140625,
0.00027680397033691406
] |
It is known that muscle injury occurs when muscles eccentrically contract during lengthening , and this also applies to the diaphragm . This muscle injury is supposed to occur in mechanically ventilated patients. One possible cause is patient–ventilator asynchrony. With asynchronies, such as premature cycling, ineffective effort, and reverse triggering, the diaphragm will be forced to contract during the expiratory phase of the machine cycle, which results in diaphragm injury . Another cause is post-inspiratory diaphragm activity, or so-called “diaphragm braking”. The diaphragm contracts even during the expiratory phase and suppresses the rate of decrease in lung volume to prevent acute alveolar collapse and following atelectasis . This physiological contraction during the expiratory phase is potentially injurious to the diaphragm . Diaphragm braking is strong in situations where alveoli are predisposed to collapse such as when the positive end-expiratory pressure (PEEP) is set low . In addition, it has been suggested that the diaphragm may contract during expiration if the expiratory muscles are recruited, especially in patients with a small airway obstruction . However, the effects of eccentric contraction that occurs with expiratory muscle recruitment on diaphragmatic function remains unknown.
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276413_p7
|
PMC11276413
|
sec[1]/sec[3]/p[0]
|
2.4. Longitudinal Atrophy
| 4.195313 |
biomedical
|
Study
|
[
0.99951171875,
0.00019943714141845703,
0.00015687942504882812
] |
[
0.99560546875,
0.0024871826171875,
0.0019683837890625,
0.00013434886932373047
] |
It is hypothesized in animal studies that if the diaphragm is maintained in a contracted state at a higher PEEP, the abrupt lowering of PEEP, such as during spontaneous breathing trials, can cause longitudinal atrophy . A higher PEEP shortens the length of sarcomeres (the basic contractile unit of muscle fibers composed of two main protein filaments, actin and myosin) in the longitudinal direction, and gradually, some sarcomeres drop out and others regain their original length (reconstruction). Here, the sudden lowering of the PEEP causes overstretching of the sarcomeres, leading to a change in the length–tension relationship of the diaphragm that may cause impaired contractility.
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276413_p8
|
PMC11276413
|
sec[2]/p[0]
|
3. Basics of Diaphragm Ultrasonography
| 3.933594 |
biomedical
|
Study
|
[
0.99853515625,
0.0009565353393554688,
0.0002734661102294922
] |
[
0.6103515625,
0.11865234375,
0.269287109375,
0.001712799072265625
] |
There are two approaches to diaphragm ultrasonography. One is the intercostal approach at the zone of apposition (the origin of the diaphragm in contact with the inner surface of the rib cage), and the other is the subcostal approach with the liver as the acoustic window. The former is primarily used to assess diaphragm thickness and contraction, while the latter is used to assess diaphragmatic exercise. Diaphragmatic exercise can be assessed under various conditions, such as during quiet breathing, maximum inspiration, and short diaphragm contractions during sniffing. Reference values for each parameter used in diaphragm ultrasonography are shown in Table 1 . For intensive care unit (ICU) patients, cutoff values that showed differences in clinical outcomes, such as success in spontaneous breathing trials (SBTs) or weaning from mechanical ventilation, are indicated.
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276413_p9
|
PMC11276413
|
sec[2]/sec[0]/p[0]
|
3.1. Intercostal Approach
| 4.082031 |
biomedical
|
Other
|
[
0.99072265625,
0.00860595703125,
0.0006470680236816406
] |
[
0.138427734375,
0.84814453125,
0.006641387939453125,
0.006683349609375
] |
The intercostal approach involves positioning a 10–15 MHz linear transducer vertically along the cephalocaudal axis at the right 8th–11th intercostal space on the anterior or mid-axillary line in the zone of apposition . The diaphragm appears at a depth of 2–4 cm as a layered structure between the pleura and peritoneum, with a white linear structure in the center . During measurements, the thickness of the pleura and peritoneum should not be included. The normal diaphragm thickness in healthy individuals is approximately 1.6 mm (1.9 mm in males and 1.4 mm in females) .
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276413_p10
|
PMC11276413
|
sec[2]/sec[0]/p[1]
|
3.1. Intercostal Approach
| 4.054688 |
biomedical
|
Study
|
[
0.99951171875,
0.00040984153747558594,
0.00031685829162597656
] |
[
0.72021484375,
0.27001953125,
0.00858306884765625,
0.0010519027709960938
] |
The diaphragm thickens upon contraction, and the thickening fraction of the diaphragm (TFdi) is the measure of diaphragmatic contraction activity . The TFdi can be determined using B-mode or M-mode as the percentage increase in diaphragm thickness during inspiration: (end-inspiratory diaphragm thickness−end-expiratory diaphragm thickness)/end-expiratory diaphragm thickness × 100. The TFdi is around 37% in healthy individuals at rest , but it shows considerable variability during maximum breathing efforts .
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276413_p11
|
PMC11276413
|
sec[2]/sec[0]/p[2]
|
3.1. Intercostal Approach
| 4.109375 |
biomedical
|
Study
|
[
0.99951171875,
0.00015294551849365234,
0.0002014636993408203
] |
[
0.99755859375,
0.00046825408935546875,
0.0019664764404296875,
0.00006562471389770508
] |
Measuring diaphragm thickness is subject to technical and methodological limitations. The diaphragm is extremely thin, around 1.5–2.0 mm, so slight measurement errors can lead to an overestimation or underestimation of diaphragm thickness and the TFdi. Goligher et al. reported that marking the transducer position on the skin reduced the absolute difference in end-expiratory diaphragm thickness to 0.2 mm and lower within the same examiner and to 0.4 mm and lower between different examiners. Notably, this difference corresponds to about 10% of the diaphragm thickness. Additionally, it is important to note that the TFdi does not account for the duration of diaphragm contraction (inspiratory time) or contraction frequency (respiratory rate), nor does it consider the involvement of accessory inspiratory and expiratory muscles .
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276413_p12
|
PMC11276413
|
sec[2]/sec[1]/p[0]
|
3.2. Subcostal Approach
| 4.105469 |
biomedical
|
Study
|
[
0.9970703125,
0.002613067626953125,
0.0002467632293701172
] |
[
0.921875,
0.015838623046875,
0.060394287109375,
0.001659393310546875
] |
To observe diaphragmatic movement using the subcostal approach, a low-frequency (2–5 MHz) transducer is placed just below the costal margin along the midclavicular line. The patient should be in a semi-recumbent position, and the ultrasound beam should be directed as cranially as possible, perpendicular to the diaphragm dome . In this view, the diaphragm appears as a bright line covering the liver or spleen. The right side is easier to image, since the liver is an acoustic window. Conversely, the spleen does not serve as an effective acoustic window, making it challenging to obtain clear images of the left diaphragm. This approach allows for the visualization of diaphragmatic exercise in over 95% of cases during quiet breathing but becomes difficult during maximum respiration, especially on the left side . Da Conceicao D et al. recently explored a new approach to assess diaphragmatic motion by measuring the excursion of the uppermost point of the zone of apposition at the mid-axillary line using a high-frequency linear transducer and reported that this new approach had a higher success rate bilaterally (both 100%) than the subcostal approach (98.7% on the right side and 34.7% on the left side) .
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276413_p13
|
PMC11276413
|
sec[2]/sec[1]/p[1]
|
3.2. Subcostal Approach
| 3.824219 |
biomedical
|
Other
|
[
0.99169921875,
0.006988525390625,
0.0015287399291992188
] |
[
0.037078857421875,
0.95947265625,
0.0015745162963867188,
0.0020503997802734375
] |
Typically, the diaphragm moves toward the transducer during inspiration. To quantify this exercise, place the M-mode line perpendicular to the direction of the exercise and measure the excursion distance. Setting the sweep speed to about 10 mm/second allows for the visualization of approximately three respiratory cycles within a single image.
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276413_p14
|
PMC11276413
|
sec[2]/sec[1]/p[2]
|
3.2. Subcostal Approach
| 4.023438 |
biomedical
|
Study
|
[
0.99951171875,
0.0003864765167236328,
0.0003230571746826172
] |
[
0.970703125,
0.026123046875,
0.0026607513427734375,
0.00029659271240234375
] |
However, excursion measurement is only feasible during unassisted spontaneous breathing (e.g., with a T-piece or low continuous positive airway pressure [CPAP]). This limitation arises because it is impossible to distinguish between diaphragm exercise due to spontaneous contraction and that due to inspiratory pressure support from a mechanical ventilator, and because excursion is significantly influenced by the lung volume . Therefore, excursion cannot be used to evaluate the work of breathing, and the TFdi can work for this purpose.
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276413_p15
|
PMC11276413
|
sec[3]/sec[0]/p[0]
|
4.1. Evaluation of Diaphragm Thickness
| 4.078125 |
biomedical
|
Study
|
[
0.99951171875,
0.00028061866760253906,
0.00020897388458251953
] |
[
0.98486328125,
0.000370025634765625,
0.0146026611328125,
0.0001361370086669922
] |
Diaphragm atrophy occurs early after the initiation of mechanical ventilation and is associated with diaphragm dysfunction . Zambon et al. demonstrated a linear correlation between the duration of mechanical ventilation and the rate of diaphragm atrophy, with a decrease of 7.5% per day under controlled ventilation and an increase of 2.3% per day during spontaneous breathing or CPAP. Previous studies reported that the end-expiratory diaphragm thickness decreased by >10% in 41% and 63% of patients and increased by >10% in 24% and 19% of patients, with both groups experiencing prolonged mechanical ventilation and higher mortality rates. In both studies, a decrease in the thickness of the diaphragm was observed until the third day of mechanical ventilation and during both controlled and partially assisted ventilation. These findings suggest the importance of monitoring changes in diaphragm thickness over time.
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276413_p16
|
PMC11276413
|
sec[3]/sec[1]/p[0]
|
4.2. Evaluation of Diaphragm Function
| 3.958984 |
biomedical
|
Other
|
[
0.99609375,
0.0036525726318359375,
0.000385284423828125
] |
[
0.2222900390625,
0.74951171875,
0.0244598388671875,
0.003673553466796875
] |
Diaphragm dysfunction is a common issue that can impact the outcomes of ICU patients . It is often indicated by an excursion of <10 mm during resting breathing or a TFdi of <20% during maximal breathing . In cases of unilateral diaphragmatic paralysis, both the excursion and TFdi of the paralyzed side decrease , making diaphragm ultrasonography a suitable diagnostic tool. However, it is crucial to observe both sides, including the left diaphragm, which can be challenging to visualize.
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276413_p17
|
PMC11276413
|
sec[3]/sec[1]/p[1]
|
4.2. Evaluation of Diaphragm Function
| 3.923828 |
biomedical
|
Study
|
[
0.9970703125,
0.0026035308837890625,
0.00026869773864746094
] |
[
0.57177734375,
0.306396484375,
0.11883544921875,
0.0027141571044921875
] |
In emergency settings, noninvasive ventilation (NIV) is used for patients with acute exacerbations of COPD. An improvement in excursion 1 h after initiating NIV has been associated with successful NIV outcomes . Lung hyperinflation due to air trapping can restrict diaphragmatic movement ; hence, evaluating diaphragm function can help assess NIV effectiveness and potentially prevent delays in intubation for patients with acute exacerbations of COPD.
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276413_p18
|
PMC11276413
|
sec[3]/sec[2]/p[0]
|
4.3. Evaluation of Respiratory Effort
| 4.035156 |
biomedical
|
Study
|
[
0.99951171875,
0.0004467964172363281,
0.00011408329010009766
] |
[
0.990234375,
0.005069732666015625,
0.004608154296875,
0.0003006458282470703
] |
The proper monitoring of respiratory effort in mechanically ventilated patients is crucial for optimizing diaphragm activity and ensuring lung and diaphragm protection . Although specific indicators for diaphragm-protective respiratory efforts are not yet established, the levels observed in healthy individuals and patients who have been successfully weaned from mechanical ventilation serve as a reference value ( Table 1 ) . The TFdi correlates with invasive measures like transdiaphragmatic pressure (Pdi) and the pressure–time product (PTP) of esophageal pressure, making it useful for noninvasive monitoring of the work of breathing.
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276413_p19
|
PMC11276413
|
sec[3]/sec[2]/p[1]
|
4.3. Evaluation of Respiratory Effort
| 4.085938 |
biomedical
|
Study
|
[
0.99951171875,
0.0002086162567138672,
0.00022649765014648438
] |
[
0.998046875,
0.0001926422119140625,
0.0015993118286132812,
0.00005930662155151367
] |
In contrast, Oppersma et al. , in a study examining the diaphragm evaluation capability of speckle tracking (see below), demonstrated that the Pdi and diaphragm muscle potentials did not correlate with the TFdi when 13 healthy volunteers were given a respiratory load of up to 50% of the maximum inspiratory pressure. Recent studies in mechanically ventilated patients also showed a weak correlation between the TFdi and Pdi (ρ = 0.11, p = 0.008) and no correlation with the transdiaphragmatic PTP (ρ = 0.04, p = 0.396). Thus, the TFdi has limitations as a measure of the work of breathing. These discrepancies arise because the TFdi does not account for the time components (inspiratory time and respiratory rate) that are integral to PTP, and while the TFdi directly reflects diaphragm activity, the Pdi is influenced by factors other than diaphragmatic activity .
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276413_p20
|
PMC11276413
|
sec[3]/sec[3]/p[0]
|
4.4. Prediction of Weaning Outcomes
| 4.023438 |
biomedical
|
Study
|
[
0.99951171875,
0.000274658203125,
0.0002467632293701172
] |
[
0.99169921875,
0.0003039836883544922,
0.0079498291015625,
0.00010067224502563477
] |
There have been many attempts to predict weaning outcome by performing diaphragm ultrasonography during SBT. DiNino et al. reported that a ΔTFdi ≥ 30% during SBT had a sensitivity of 88% and a specificity of 71% (area under the curve [AUC] 0.79) for predicting extubation failure (reintubation or NIV use within 48 h), which surpassed the predictive ability of the rapid shallow breathing index (RSBI). On the other hand, it has been reported that an excursion < 10 mm before the start of SBT did not predict extubation failure (AUC 0.61) , whereas an excursion < 10 mm 30 min after the start of SBT predicted extubation failure at a high rate .
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276413_p21
|
PMC11276413
|
sec[3]/sec[3]/p[1]
|
4.4. Prediction of Weaning Outcomes
| 4.078125 |
biomedical
|
Study
|
[
0.99951171875,
0.0002930164337158203,
0.00022602081298828125
] |
[
0.9951171875,
0.0003299713134765625,
0.0045013427734375,
0.00010138750076293945
] |
There have been attempts to enhance the predictive ability by considering the time component of excursion. Spadaro et al. defined diaphragmatic RSBI (D-RSBI) as the respiratory rate divided by the excursion (mm), reporting that a D-RSBI > 1.3 during SBT predicted weaning failure (SBT failure or reintubation/NIV use within 48 h) with a high probability compared to RSBI alone (AUC: D-RSBI 0.89, RSBI 0.72). Palkar et al. introduced the excursion–time (E-T) index, calculated by multiplying the excursion (cm) by the inspiratory time (seconds), and reported that a difference of <3.8% between the E-T index during assisted control ventilation and after the start of SBT predicted extubation failure with a sensitivity of 79.2% and a specificity of 75%.
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276413_p22
|
PMC11276413
|
sec[3]/sec[3]/p[2]
|
4.4. Prediction of Weaning Outcomes
| 4.089844 |
biomedical
|
Study
|
[
0.9990234375,
0.0007476806640625,
0.0002377033233642578
] |
[
0.99462890625,
0.000431060791015625,
0.00472259521484375,
0.00015401840209960938
] |
Indeed, the frequency of diaphragm dysfunction during the weaning phase is high, ranging from 30% to 70% , but many cases are successfully extubated . The excursion of 191 cases who successfully underwent SBT with a T-piece showed no correlation with reintubation within 7 days following extubation, with only the cough intensity being related to successful extubation . While noting the variation in the definition of extubation failure across studies and the differing management of patients who failed SBT or those who were extubated in a palliative manner, the authors concluded that the success of extubation after successful SBT is determined by factors other than diaphragm function.
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276413_p23
|
PMC11276413
|
sec[3]/sec[3]/p[3]
|
4.4. Prediction of Weaning Outcomes
| 3.929688 |
biomedical
|
Review
|
[
0.99853515625,
0.0007333755493164062,
0.0005846023559570312
] |
[
0.409423828125,
0.00687408447265625,
0.5830078125,
0.0007796287536621094
] |
Additionally, Mayo et al. argued that although diagnostic ultrasonography is a useful bedside tool in critical care settings, identifying the factors contributing to weaning failure through a single ultrasonographic examination is difficult, emphasizing the importance of cross-sectional evaluation of the heart, lungs, diaphragm, and pleural space (including pleural effusion). Similarly, Tuinman et al. proposed the ABCDE ultrasound approach, a systematic ultrasound evaluation of the heart, lungs, and respiratory muscle pump, in patients with weaning failure.
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276413_p24
|
PMC11276413
|
sec[4]/p[0]
|
5. Expert Consensus
| 4.011719 |
biomedical
|
Study
|
[
0.99755859375,
0.0019369125366210938,
0.00047469139099121094
] |
[
0.974609375,
0.0084686279296875,
0.016326904296875,
0.0005412101745605469
] |
Considering the rapid dissemination of diaphragm ultrasonography in recent years, an expert consensus utilizing the Delphi method with 14 panelists ( Table 2 ) was published in 2022 to establish high-quality protocols and recommendations . Discussions were held on 75 questions across seven domains: anatomy and physiology, transducer settings, technique, the effects of mechanical ventilation, learning and expertise, daily practice, and future directions. A convergence of opinions was observed in 61% of the questions, demonstrating agreement on high-quality and homogeneous measurement methods and highlighting areas lacking consensus, namely questions requiring further research.
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276413_p25
|
PMC11276413
|
sec[4]/p[1]
|
5. Expert Consensus
| 4.066406 |
biomedical
|
Study
|
[
0.9990234375,
0.0009126663208007812,
0.00017321109771728516
] |
[
0.99169921875,
0.0029850006103515625,
0.004901885986328125,
0.0003426074981689453
] |
Initially, unresolved measurement issues encountered in daily practice, such as at what height within the zone of apposition to measure the diaphragm thickness and which mode to use for the TFdi measurement , did not reach a unified consensus. Furthermore, cutoff values for the increase in diaphragm thickness from a histological perspective were not determined due to the difficulty in distinguishing between muscle hypertrophy and inflammation, edema, and fibrosis ultrasonographically. Additionally, cutoff values for diaphragm dysfunction based on the TFdi were not specified due to the likelihood of measurement errors; moreover, there were possible variations according to measurement conditions (with or without ventilatory assistance, during respiratory distress, during SBT, etc.) or outcomes that we want to predict (SBT or extubation failure and inadequate or excessive respiratory assistance).
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276413_p26
|
PMC11276413
|
sec[5]/p[0]
|
6. Future Perspectives
| 1.751953 |
biomedical
|
Other
|
[
0.9833984375,
0.003444671630859375,
0.01319122314453125
] |
[
0.0260009765625,
0.8896484375,
0.08111572265625,
0.0034275054931640625
] |
The expert consensus in the preceding section also summarized the prospects and research topics regarding diaphragm ultrasonography.
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999993 |
PMC11276413_p27
|
PMC11276413
|
sec[5]/p[1]
|
6. Future Perspectives
| 4.050781 |
biomedical
|
Study
|
[
0.99951171875,
0.00018095970153808594,
0.0001742839813232422
] |
[
0.99365234375,
0.0003676414489746094,
0.0058441162109375,
0.00009399652481079102
] |
In recent years, the expectations for diaphragm ultrasonography using new technologies have been rising. Speckle tracking is one such example. This method involves tracking the position of speckles on ultrasonographic images to quantify tissue strain and assess motion and deformation . Unlike tissue doppler imaging, speckle tracking does not require angle correction for motion direction and can measure the strain and strain rate in two directions. Oppersma et al. used speckle tracking to measure the diaphragm strain and strain rate (acceleration of deformation) when healthy individuals were subjected to respiratory loads of up to 50% of the maximum inspiratory pressure. They found that both the strain and strain rate were strongly correlated with the Pdi and electromyogram of the diaphragm. Goutman et al. also reported that speckle tracking could accurately measure excursion in two directions, unlike M-mode, and quantify the movement of the left diaphragm.
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276413_p28
|
PMC11276413
|
sec[5]/p[2]
|
6. Future Perspectives
| 4.015625 |
biomedical
|
Study
|
[
0.99951171875,
0.0002002716064453125,
0.0001971721649169922
] |
[
0.9990234375,
0.0005283355712890625,
0.0003254413604736328,
0.00006943941116333008
] |
Shear wave elastography is a technique for quantifying tissue elasticity. As changes in muscle elasticity due to injuries or fibrosis may reflect functional impairment, its application to the diaphragm is being investigated. A study involving 15 healthy individuals showed that changes in diaphragm elasticity evaluated through shear wave elastography were correlated with changes in the Pdi .
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276413_p29
|
PMC11276413
|
sec[6]/p[0]
|
7. Conclusions
| 3.804688 |
biomedical
|
Review
|
[
0.9970703125,
0.002307891845703125,
0.0006546974182128906
] |
[
0.03570556640625,
0.1522216796875,
0.81005859375,
0.0019016265869140625
] |
Diaphragm ultrasonography is a minimally invasive, versatile examination that can be performed at the bedside. Diaphragm ultrasonography enables the diagnosis of conditions such as phrenic nerve palsy and diaphragm dysfunction, assessing the respiratory effort of lung- and diaphragm-protective ventilation and predicting the success or failure of weaning from mechanical ventilation. However, no clinical studies demonstrate that diaphragm ultrasonography improves patient outcomes; thus, further research is needed to determine effective utilization methods that lead to meaningful therapeutic interventions.
|
[
"Taiga Itagaki",
"Yusuke Akimoto",
"Takuya Takashima",
"Jun Oto"
] |
https://doi.org/10.3390/diagnostics14141481
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276425_p0
|
PMC11276425
|
sec[0]/p[0]
|
1. Introduction
| 3.880859 |
biomedical
|
Review
|
[
0.9990234375,
0.0003325939178466797,
0.0007147789001464844
] |
[
0.277099609375,
0.017059326171875,
0.70556640625,
0.0005269050598144531
] |
Obesity is a public health problem worldwide; in Mexico, its prevalence among school-age children is 18.1% . For several years, the most used tool in both clinical and population diagnoses has been body mass index (BMI), which is considered to be a good indicator of general adiposity . However, BMI has limitations, including its inability to reflect the distribution of body fat ; therefore, complementary measurements, such as waist circumference (WC) and waist-to-hip ratio (WHR), which are associated with abdominal obesity and higher metabolic risk, have also been used to evaluate subjects with obesity .
|
[
"Enrique Romero-Velarde",
"Karen G. Córdova-García",
"Laura C. Robles-Robles",
"Ingrid J. Ventura-Gómez",
"Clío Chávez-Palencia"
] |
https://doi.org/10.3390/children11070868
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276425_p1
|
PMC11276425
|
sec[0]/p[1]
|
1. Introduction
| 3.853516 |
biomedical
|
Study
|
[
0.9990234375,
0.0003273487091064453,
0.0008606910705566406
] |
[
0.599609375,
0.002063751220703125,
0.39794921875,
0.0003495216369628906
] |
Recently, neck circumference (NC) has been proposed as an indicator of upper trunk adiposity and as an alternative criterion for the diagnosis of overweight and obesity . Different studies have reported a direct correlation between NC and BMI and other indicators of adiposity, such as WC, although the strength of the correlation varies among studies that include populations of children and adolescents . Furthermore, some studies have indicated that the correlation is weaker and even non-significant when obese subjects are evaluated .
|
[
"Enrique Romero-Velarde",
"Karen G. Córdova-García",
"Laura C. Robles-Robles",
"Ingrid J. Ventura-Gómez",
"Clío Chávez-Palencia"
] |
https://doi.org/10.3390/children11070868
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276425_p2
|
PMC11276425
|
sec[0]/p[2]
|
1. Introduction
| 3.785156 |
biomedical
|
Review
|
[
0.99560546875,
0.00171661376953125,
0.0025424957275390625
] |
[
0.0166473388671875,
0.0012502670288085938,
0.98193359375,
0.0002868175506591797
] |
Due to its correlation with WC, NC has been considered to be a potential indicator of metabolic risk associated with the accumulation of visceral fat . A recent systematic review reported that NC was consistently and significantly correlated with high-density lipoprotein cholesterol, insulin, and blood pressure. However, the authors recommended its use in conjunction with other metabolic risk indicators and not as a single indicator .
|
[
"Enrique Romero-Velarde",
"Karen G. Córdova-García",
"Laura C. Robles-Robles",
"Ingrid J. Ventura-Gómez",
"Clío Chávez-Palencia"
] |
https://doi.org/10.3390/children11070868
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276425_p3
|
PMC11276425
|
sec[0]/p[3]
|
1. Introduction
| 3.949219 |
biomedical
|
Study
|
[
0.99951171875,
0.00013124942779541016,
0.0004839897155761719
] |
[
0.99755859375,
0.0007195472717285156,
0.001689910888671875,
0.00005441904067993164
] |
The correlation between NC and body fat percentage (%BF) evaluated using plethysmography and bioelectrical impedance (BIA) has also been reported, with r values between 0.44 and 0.67, although among females, these values reach up to 0.83 in the case of BIA at 11 years of age .
|
[
"Enrique Romero-Velarde",
"Karen G. Córdova-García",
"Laura C. Robles-Robles",
"Ingrid J. Ventura-Gómez",
"Clío Chávez-Palencia"
] |
https://doi.org/10.3390/children11070868
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999993 |
PMC11276425_p4
|
PMC11276425
|
sec[0]/p[4]
|
1. Introduction
| 4.066406 |
biomedical
|
Study
|
[
0.99951171875,
0.0002703666687011719,
0.0002510547637939453
] |
[
0.99951171875,
0.00019097328186035156,
0.0003597736358642578,
0.000049233436584472656
] |
More frequently, correlations between NC and these anthropometric indicators have been reported for groups of children and adolescents in general and not according to body weight categories . It is important to evaluate whether the correlation between NC and variables routinely used in the evaluation and diagnosis of overweight and obesity, such as BMI and WC, is consistent in children with normal weight, overweight, or obesity. As such, NC could be used as an alternative measurement to identify children and adolescents at metabolic risk, particularly because of its greater accessibility during anthropometric evaluation. Therefore, the objective of this study was to evaluate NC and its correlation with %BF and other indicators of adiposity in children with normal weight, overweight, and obesity in a sample population with a high prevalence of obesity, such as Mexico. The identification of adiposity indicators is crucial for early intervention and implementation of preventive measures.
|
[
"Enrique Romero-Velarde",
"Karen G. Córdova-García",
"Laura C. Robles-Robles",
"Ingrid J. Ventura-Gómez",
"Clío Chávez-Palencia"
] |
https://doi.org/10.3390/children11070868
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276425_p5
|
PMC11276425
|
sec[1]/p[0]
|
2. Materials and Methods
| 4.109375 |
biomedical
|
Study
|
[
0.9990234375,
0.0008406639099121094,
0.00021469593048095703
] |
[
0.99951171875,
0.0003371238708496094,
0.0002636909484863281,
0.00011056661605834961
] |
This cross-sectional study included children 5 to 10 years of age, recruited from the outpatient clinic of the Pediatrics Division of the Hospital Civil de Guadalajara “Dr. Juan I. Menchaca” between October 2020 and May 2021. The outpatient clinic serves pediatric patients in general, as well as patients from different subspecialty clinics. Apparently healthy children without acute illnesses were recruited with parental consent. Individuals with systemic diseases, such as diabetes mellitus and hypothyroidism, genetic or congenital diseases, a history of chronic steroid use by any means, or those presenting with vomiting or diarrhea 5 days before the evaluation were excluded. A correlation coefficient between NC and BMI (0.6) was used to calculate the sample size, with a minimum of 75 subjects. Consecutive children were included and divided into 3 groups according to BMI: normal weight (−2 to 1 standard deviation[s] [SD]); overweight (>1 to 2 SDs); and obesity (>2 SDs) using WHO criteria and reference tables .
|
[
"Enrique Romero-Velarde",
"Karen G. Córdova-García",
"Laura C. Robles-Robles",
"Ingrid J. Ventura-Gómez",
"Clío Chávez-Palencia"
] |
https://doi.org/10.3390/children11070868
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276425_p6
|
PMC11276425
|
sec[1]/p[1]
|
2. Materials and Methods
| 3.316406 |
biomedical
|
Study
|
[
0.998046875,
0.0013561248779296875,
0.0005106925964355469
] |
[
0.9990234375,
0.00075531005859375,
0.0001327991485595703,
0.00011008977890014648
] |
Two researchers visited the outpatient clinic during the week to identify potentially eligible subjects for inclusion in this study. Subjects were invited to participate and, for those who accepted, general data, including age, sex, family, and sociodemographic characteristics, were obtained, in addition to measuring weight and height to calculate BMI (kg/m 2 ), NC, mid-upper arm circumference (MUAC), WC, and tricipital skinfold thickness (TSF).
|
[
"Enrique Romero-Velarde",
"Karen G. Córdova-García",
"Laura C. Robles-Robles",
"Ingrid J. Ventura-Gómez",
"Clío Chávez-Palencia"
] |
https://doi.org/10.3390/children11070868
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276425_p7
|
PMC11276425
|
sec[1]/p[2]
|
2. Materials and Methods
| 4.105469 |
biomedical
|
Study
|
[
0.9990234375,
0.00070953369140625,
0.00022459030151367188
] |
[
0.9970703125,
0.00231170654296875,
0.0006356239318847656,
0.0001850128173828125
] |
Body weight, with excess clothing and shoes removed, was measured using a scale (model 700, Seca, Hamburg, Germany). Height was measured using a stadiometer (model 220, Seca), ensuring the position of the head in the Frankfort plane, with the subjects keeping their feet and knees together, and with the back of the trunk, buttocks, and heels abutted to the posterior plane of the stadiometer. To measure WC, MUAC, and NC, a 6 mm wide Rosscraft metal measuring tape was used. Mid-upper arm circumference was measured in the middle of the left arm. Waist circumference was measured as the minimum circumference between the costal margin and iliac crest. Neck circumference was measured with the patient standing upright and the head in the Frankfort horizontal plane, with the tape placed at the midpoint of neck height. Tricipital skinfold thickness was measured using a Harpenden skinfold caliper (Baty International, Burgess Hill, UK) at mid-height of the right arm.
|
[
"Enrique Romero-Velarde",
"Karen G. Córdova-García",
"Laura C. Robles-Robles",
"Ingrid J. Ventura-Gómez",
"Clío Chávez-Palencia"
] |
https://doi.org/10.3390/children11070868
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276425_p8
|
PMC11276425
|
sec[1]/p[3]
|
2. Materials and Methods
| 3.4375 |
biomedical
|
Study
|
[
0.9990234375,
0.0005240440368652344,
0.00047087669372558594
] |
[
0.98876953125,
0.01068115234375,
0.0005106925964355469,
0.00022268295288085938
] |
Subsequently, body composition measurements were performed using an electrical bioimpedance device , which required subjects to fast for approximately 4 h, have an empty bladder, and metallic objects removed.
|
[
"Enrique Romero-Velarde",
"Karen G. Córdova-García",
"Laura C. Robles-Robles",
"Ingrid J. Ventura-Gómez",
"Clío Chávez-Palencia"
] |
https://doi.org/10.3390/children11070868
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
PMC11276425_p9
|
PMC11276425
|
sec[1]/p[4]
|
2. Materials and Methods
| 4.027344 |
biomedical
|
Study
|
[
0.99951171875,
0.0003199577331542969,
0.0002053976058959961
] |
[
0.99951171875,
0.0002856254577636719,
0.0002999305725097656,
0.00006115436553955078
] |
Statistical analysis. Quantitative variables are expressed as mean and standard deviation or median and interquartile range according to their distribution; the Kolmogorov–Smirnov and Shapiro–Wilk tests were used to corroborate the normality of the distribution of the variables. Anthropometric characteristics were compared among the groups, and the relationship between anthropometric variables (i.e., weight, BMI, NC, MUAC, WC, and TSF) and %BF obtained by BIA was determined using Pearson or Spearman correlation tests depending on the distribution of each variable. Subsequently, the same analysis was performed separately for each group (i.e., normal weight, overweight, and obese). Multivariate models were constructed with %BF as the dependent variable and anthropometric parameters as independent variables. Statistical analysis was performed using SPSS version 20.0 (IBM Corporation, Armonk, NY, USA).
|
[
"Enrique Romero-Velarde",
"Karen G. Córdova-García",
"Laura C. Robles-Robles",
"Ingrid J. Ventura-Gómez",
"Clío Chávez-Palencia"
] |
https://doi.org/10.3390/children11070868
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276425_p10
|
PMC11276425
|
sec[1]/p[5]
|
2. Materials and Methods
| 1.147461 |
biomedical
|
Other
|
[
0.96044921875,
0.004608154296875,
0.03497314453125
] |
[
0.05584716796875,
0.9404296875,
0.00144195556640625,
0.0024051666259765625
] |
This study was approved by the hospital’s ethics and research committee. Informed consent was obtained from all subjects involved in the study.
|
[
"Enrique Romero-Velarde",
"Karen G. Córdova-García",
"Laura C. Robles-Robles",
"Ingrid J. Ventura-Gómez",
"Clío Chávez-Palencia"
] |
https://doi.org/10.3390/children11070868
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276425_p11
|
PMC11276425
|
sec[2]/p[0]
|
3. Results
| 3.951172 |
biomedical
|
Study
|
[
0.9990234375,
0.0007109642028808594,
0.000278472900390625
] |
[
0.99951171875,
0.0002605915069580078,
0.0001659393310546875,
0.00008314847946166992
] |
In total, 116 children were included in the present study. However, 4 with BMI values below—2 SDs were excluded; as such, the analysis was performed with 112 subjects (71 boys, 41 girls), with a mean (±SDs) age of 7.7 ± 1.4 years. The average age of the study subjects was different between children with normal weight and overweight ( p = 0.03); the distribution by sex was not different between groups. The mean ages of the mothers and fathers were 32.5 and 36.4 years, respectively, with mean BMI values in the overweight category for both ( Table 1 ). Among mothers and fathers, 68% and 70.5% were overweight or obese, respectively.
|
[
"Enrique Romero-Velarde",
"Karen G. Córdova-García",
"Laura C. Robles-Robles",
"Ingrid J. Ventura-Gómez",
"Clío Chávez-Palencia"
] |
https://doi.org/10.3390/children11070868
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.