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In today's era of modern healthcare, the intersection between medical practices and environmental responsibility has gained significant attention. One such area of focus is the practice of anesthesia, which plays a crucial role in various surgical procedures. Anesthetics such as nitrous oxide and volatile halogenated ethers (desflurane, isoflurane, sevoflurane) are examples of medical gases that are strong greenhouse gases that contribute to global warming. During medical procedures, most of these anesthetic agents are released into the atmosphere, which exacerbates their influence on the environment. Also anesthesia delivery systems have traditionally utilized high flow rates of gases, leading to not only excessive consumption but also a considerable environmental impact in terms of greenhouse gas emissions. However, the emergence of low-flow anesthesia (LFA) presents a promising solution for achieving emission reduction and cost savings, thereby aligning healthcare practices with sustainability goals. Understanding LFA involves the administration of anesthetic gases to patients at reduced flow rates compared to conventional high-flow methods. This practice requires precision in gas delivery, often incorporating advanced monitoring and control systems. By optimizing gas flow to match the patient's requirements, LFA minimizes wastage and excessive gas release into the environment, subsequently curbing the carbon footprint associated with healthcare operations. Decreasing volatile anesthetic delivery provides safe and effective strategies for anesthesia providers to decrease costs and reduce environmental pollution. Current literature support in favor of LFA represents an area of cost containment and an opportunity to lessen the environmental impact of anesthesia. This article will cover the concept of LFA, the distinctions between low flow and minimal flow, and the potential advantages of LFA, such as those related to patient safety, the environment, and the economy.

Oxidative stress is closely related to various diseases. Ozone can produce redox reactions through its unique response. As a source of the oxidative stress response, the strong oxidizing nature of ozone can cause severe damage to the body. On the other hand, low ozone concentrations can activate various mechanisms to combat oxidative stress and achieve therapeutic effects. Some animal experiments and clinical studies have revealed the potential medical value of ozone, indicating that ozone is not just a toxic gas. By reviewing the mechanism of ozone and its therapeutic value in treating central nervous system diseases (especially ischemic stroke and Alzheimer's disease) and the toxic effects of ozone, we find that ozone inhalation and a lack of antioxidants or excessive exposure lead to harmful impacts. However, with adequate antioxidants, ozone can transmit oxidative stress signals, reduce inflammation, reduce amyloid β peptide levels, and improve tissue oxygenation. Similar mechanisms to those of possible new drugs for treating ischemic stroke and Alzheimer's disease indicate the potential of ozone. Nevertheless, limited research has restricted the application of ozone. More studies are needed to reveal the exact dose-effect relationship and healing effect of ozone.

Sevoflurane has been widely used in clinical anesthesia as an inhalation anesthetic. With the development of medicine, there have been several new applications in recent years, such as daytime surgery, labor analgesia, and combined nerve block for some surgeries. Moreover, as research progresses, it has been found that it not only has potential organ protection effects but can also be used to treat severe asthma and relieve the tracheal spasm state. In addition, local administration can effectively treat vascular ulcers. We briefly review the organ protective effect of sevoflurane, its application in dental treatment, asthma treatment, vascular ulcer treatment and some new progress in clinical application.

The oxygen content in the fish ponds is facing greater challenges than before in the aquaculture of mandarin fish (Siniperca chuatsi) due to the change of climate and eutrophication. Until now, little is known about the molecular mechanisms underlying the harmful effects of hypoxia on this species. In this work, we built transcriptomes for the mandarin fish that were exposed to decreased oxygen concentration at two times points (24 h and 96 h). The respiratory metabolism activities of pyruvate kinase (PK), hexokinase (HK), lactate dehydrogenase (LDH), succinate dehydrogenase (SDH) and malate dehydrogenase (MDH) had different significantly changes during hypoxic treatment. Histological observation of the gill and brain also revealed some damages by hypoxia. A total of 196,355 transcripts were involved in the Gene Ontology analysis, and the numbers of differentially expressed genes (DEGs) in the brain and the gill between the control and experiment groups are 141 and 552 respectively involved in the different hypoxic stress time. The DEGs were then analyzed using KEGG enrichment analysis. The results showed significant differences in the expression of some genes involved in ribosome pathways,biosynthesis of amino acids, hippo signaling pathway, and pentose phosphate pathway,glycolysis/gluconeogenesis pathway and the TCA cycle. The huge number of transcriptome sequences collected in this study has enhanced the mandarin fish gene resources, and the identified DEGs and related pathway analysis give essential information for understanding biological responses to hypoxia.

Sunlight-induced degradable squarazine based electron deficient receptor 3,4-bis((E)-2-((perfluorophenyl)methylene)hydrazinyl)cyclobut-3-ene-1,2-dione, L has been reported here. Naked-eye colorimetric analysis, UV-Vis, IR and ¹H, 19F, ³¹P-NMR spectrometric results show that this receptor L high affinity with cyanide anion. The strength of the receptor L towards colorimetrically responded anions are calculated by UV-Vis spectrometric titrations and it is found to be 9.9597 × 10³ for cyanide. Interestingly, upon exposure of those anionic complexes under sunlight, the colors of those respective anionic complexes are disappeared. From this result, it is clear that these anionic complexes are capable to discharge the bound anion via CN free rotation. As evidenced from spectroscopic and colorimetric results, it is also clear that this anionic complex is not only release the bound anion, but also undergone self-degradation upon sunlight exposure. To the best of our knowledge, this is the first example for cyanide sensing of anion accomplished with self-degradation of anion complex upon exposure on sunlight.

Aquatic systems with low zinc levels can experience a significant decrease in carbon dioxide uptake and limited growth of phytoplankton species. In this study, we describe the use of a new fluorescent sensor based on NH₂-MIL-53(Al), and modified with glutaraldehyde and sulfadoxine, for selectively detecting zinc ions in water and blood serum samples. Characterization of the synthesized material was performed using X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), Brunauer-Emmett-Teller (BET) surface area analysis, X-ray photoelectron spectroscopy (XPS), and scanning electron microscopy (SEM), confirming successful functionalization and preservation of the MOF structure. The sensor's performance for Zn²⁺ detection was evaluated by spectrofluorometry, demonstrating a significant fluorescence enhancement upon Zn²⁺ binding due to the interaction between Zn²⁺ ions and the sulfonamide groups. With a detection limit as low as 3.14 × 10^-2 ppm, the sensor demonstrates high selectivity for Zn²⁺ over other common metal ions. The sensor's response is rapid, stable, and reproducible, making it suitable for practical applications. Real sample analysis was conducted in tap water and blood serum samples, with the results compared to those obtained using ICP-OES and a colorimetric test with 5-bromo-PAPS. The comparison confirmed the high accuracy and reliability of the fluorescent sensor in detecting Zn²⁺ ions in complex matrices. NH₂-MIL-53(Al) modified with glutaraldehyde and sulfadoxine shows potential as a selective fluorescent sensor for Zn²⁺ detection, making it a valuable tool for monitoring the environment and biology.

In this study, simultaneous determination of levodopa (LEV) and carbidopa (CBD) in binary mixtures, pharmaceutical formulation, and biological sample was conducted using the application of simple, fast, sensitive, and accurate UV-spectrophotometry in combination with chemometrics methods. The first method is net analyte signal (NAS) based on the multivariate calibration methods. The limit of detection (LOD) and limit of quantification (LOQ) were 0.9758, 0.7633 µg/mL and 2.956, 2.313 µg/mL over the linear range of 5-40 and 0.5-20 µg/mL for LEV and CBD, respectively. In the NAS approach, the mean recovery values of mixtures were 100.12 % for LEV and 99.65 % for CBD, where root mean square error (RMSE) values were 0.0106 and 0.0141 for LEV and CBD, respectively. The second method is absorbance subtraction (AS) based on the absorption factor technique for analyzing the isosbestic point. This model was constructed at an isosbestic point of 261 nm in the range of 5-40 and 0.5-20 µg/mL with coefficient determination (R²) of 0.9985 and 0.9996 for LEV and CBD, respectively. AS method could estimate LEV and CBD with LOD values of 1.924 and 0.5657 μg/mL and LOQ values of 5.833 and 1.714 μg/mL, respectively. The recovery percentage was between 91.50 % to 104.60 % with RMSE of 0.1455 for LEV and 92.00 % to 106.66 % with RMSE of 0.2508 for CBD. The introduced approaches have the benefit of concurrent analysis of the mentioned components without any pretreatment. Statistical comparison of the results of real sample analysis with high-performance liquid chromatography (HPLC) did not show a significant difference. These methods can replace HPLC in quality control laboratories when fast, precise, and low-cost analysis is needed.

This case report investigates the occurrence of green discoloration in serum and citrate plasma samples collected from a male adult patient following a multivisceral organ transplant. In collected samples, it was necessary to investigate the influence of sample discoloration on the results of laboratory tests and to determine the appropriate approach to sample management. Hematology, coagulation and blood gas analysis showed no flags, but the biochemical lipemia index was susceptible to positive interference, necessitating dilution of the native sample. Despite the green discoloration, both native and diluted samples exhibited minimal interference on routine clinical chemistry analyses, demonstrating the reliability of the laboratory test results. This case report underscores the influence of preanalytical factors on the results of laboratory tests, the need for a thorough assessment of the sample adequacy for laboratory testing and the strict application of appropriate guidelines in the sample management in order to make an accurate diagnosis and ensure optimal patient care.

Introduction: Subclinical hypothyroidism (SCH) is an independent risk factor for cardiovascular diseases due to endothelial dysfunction and atherosclerosis development. The aim of this study was to determine whether the levothyroxine therapy could impact the concentrations of endothelial dysfunction blood markers, namely endothelin-1 (ET-1), asymmetric dimethylarginine (ADMA) and endocan, in patients with a mild form of SCH (thyroid-stimulating hormone (TSH) ≤ 10 mIU/L).

Materials and methods: In this case-control prospective study, SCH patients and healthy controls were recruited during their regular health examinations. Medical specialists prescribed levothyroxine to SCH patients if necessary. The endothelial dysfunction markers, as well as other biochemical markers, were measured in all subjects at baseline, and after 6 months of levothyroxine treatment following the euthyroidism.

Results: Our study showed higher ADMA (248.00 (168.78-540.20) vs. 166.30 (140.60-243.40) μg/L, P = 0.002), endocan (114.30 (63.45-194.65) vs. 67.26 (50.80-126.10) ng/L, P = 0.004), low-density lipoprotein cholesterol (LDL) (3.3 ± 0.6 vs. 3.7 ± 0.9 mmol/L, P = 0.043) and non-high-density lipoprotein cholesterol (non-HDL) (3.8 ± 0.7 vs. 4.2 ± 1.0 mmol/L, P = 0.020) concentrations in patients with a mild form of SCH in comparison with healthy subjects. In SCH patients, after 6 months of levothyroxine treatment following the euthyroidism, we observed a significant decrease in endocan (91.47 (61.88-200.03) vs. 97.90 (55.18-154.88) ng/L, P = 0.004), and total cholesterol concentrations (CHOL) (6.2 ± 1.0 vs. 5.8 ± 1.0 mmol/L, P = 0.039).

Conclusions: A mild form of SCH is associated with higher concentrations of endocan, ADMA, LDL and non-HDL. The potential benefits of levothyroxine therapy were shown through the significant decrease of endocan and CHOL concentrations in SCH patients, thus contributing the atherosclerosis prevention.

Introduction: Knowledge and systematic evaluation of analytical errors is the task of internal analytical quality control management. The aim of this study was to assess whether the Westgard rules proposed by Bio-Rad's Westgard Advisor software are more efficient in the monitoring of analytical performance than those previously in use.

Materials and methods: The study was carried out on the nephelometer Atellica NEPH630 (Siemens Healthineers, Erlangen, Germany). Five parameters were chosen: serum immunoglobulin A (IgA), alpha 1 - antitrypsin (AAT), prealbumin, lipoprotein (a) (Lp(a)) and ceruloplasmin. The study was divided into 4 phases (A, B, C, D): phase A - old rules used (1_3s, R_4s and 2_2s); phase B - first introduction of new rules (30 days), (1_3s/2_2s for IgA; 1_3s/2_2s/R_4s/4_1s/10_x for the remaining parameters); Phase C - second intervention (after 60 days) 1_3s/2_2s/R_4s/4_1s for IgA and Lp(a), 1_3s/2_2s/R_4s/4_1s/8_x for prealbumin and ceruloplasmin and 1_3s/2_2s/R_4s/4_1s/10_x for AAT; and Phase D - values at the end of the study (1_3s for IgA, 1_3s/2_2s/3_2s/R_4s/3_1s/12_x for AAT and ceruloplasmin, 1_3s/2_2s/R_4s/4_1s/8_x for prealbumin and 1_3s/2_2s/R_4s/4_1s/10_x for Lp(a).

Results: At the end of the study the coefficient of variation (CV%), bias (%) and sigma for IgA were 2.55%, - 1.09% and 5.33, respectively; for AAT 3.88, - 2.21 and 3.25; for prealbumin 3.99, - 0.14 and 2.95; for Lp(a) 8.02, - 0.34 and 3.81; for ceruloplasmin 2.48, - 3.65 and 3.49.

Conclusions: By using newly suggested rejection rules, we did not observe an improvement in monitoring of analytical performance.