Background: Social media (SoMe) have taken a major place in the medical field, and younger generations are increasingly using them as their primary source to find information. Objective: This study aimed to describe the use of SoMe for medical education among French medical students and assess the prevalence of smartphone addiction in this population. Methods: A cross-sectional web-based survey was conducted among French medical students (second to sixth year of study). The questionnaire collected information on SoMe use for medical education and professional behavior. Smartphone addiction was assessed using the Smartphone Addiction Scale Short-Version (SAS-SV) score. Results: A total of 762 medical students responded to the survey. Of these, 762 (100%) were SoMe users, spending a median of 120 (IQR 60‐150) minutes per day on SoMe; 656 (86.1%) used SoMe for medical education, with YouTube, Instagram, and Facebook being the most popular platforms. The misuse of SoMe in a professional context was also identified; 27.2% (207/762) of students posted hospital internship content, and 10.8% (82/762) searched for a patient’s name on SoMe. Smartphone addiction was prevalent among 29.1% (222/762) of respondents, with a significant correlation between increased SoMe use and SAS-SV score (r=0.39, 95% CI 0.33‐0.45; P<.001). Smartphone-addicted students reported a higher impact on study time (211/222, 95% vs 344/540, 63.6%; P<.001) and a greater tendency to share hospital internship content on social networks (78/222, 35.1% vs 129/540, 23.8%; P=.002). Conclusions: Our findings reveal the extensive use of SoMe for medical education among French medical students, alongside a notable prevalence of smartphone addiction. These results highlight the need for medical schools and educators to address the responsible use of SoMe and develop strategies to mitigate the risks associated with excessive use and addiction.

Background: Social networks are now essential tools for promoting research and researchers. However, there is no study investigating the link between presence or not on professional social networks and scientific publication or citation for a given researcher. Objective: The objective of this study was to study the link between professional presence on social networks and scientific publications/citations among anesthesia researchers. Methods: We included all the French full professors and associate professors of anesthesia. We analyzed their presence on the social networks Twitter (professional account with ≥1 tweet over the 6 previous months) and ResearchGate. We extracted their bibliometric parameters for the 2016-2020 period via the Web of Science Core Collection (Clarivate Analytics) database in the Science Citation Index-Expanded index. Results: A total of 162 researchers were analyzed; 42 (25.9%) had an active Twitter account and 110 (67.9%) a ResearchGate account. There was no difference between associate professors and full professors regarding active presence on Twitter (8/23 [35%] vs. 34/139 [24.5%], respectively; P=.31) or ResearchGate (15/23 [65%] vs. 95/139 [68.3%], respectively; P=.81). Researchers with an active Twitter account (median [IQR]) had more scientific publications (45 [28-61] vs. 26 [12-41]; P<.001), a higher h-index (12 [8-16] vs. 8 [5-11]; P<.001), a higher number of citations per publication (12.54 [9.65-21.8] vs. 10.63 [5.67-16.10]; P=.01), and a higher number of citations (563 [321-896] vs. 263 [105-484]; P<.001). Researchers with a ResearchGate account (median [IQR]) had more scientific publications (33 [17-47] vs. 26 [9-43]; P=.03) and a higher h-index (9 [6-13] vs. 8 [3-11]; P=.03). There was no difference between researchers with a ResearchGate account and those without it concerning the number of citations per publication and overall number of citations. In multivariate analysis including sex, academic status, and presence on social networks, the presence on Twitter was associated with the number of publications (β=20.2; P<.001), the number of citations (β=494.5; P<.001), and the h-index (β=4.5; P<.001). Conclusions: Among French anesthesia researchers, an active presence on Twitter is associated with higher scientific publication and citations.

The management of shock in critical care must transition from a predominantly hemodynamic approach to one that comprehensively addresses the biological intricacies of this complex multisystemic syndrome. A thorough understanding of the metabolic mechanisms involved in shock is pivotal for precise patient phenotyping and accurate risk stratification. Metabolomics, an emerging "-omics" approach, offers a powerful tool for unraveling the molecular underpinnings of shock. By analyzing the metabolic pathways within the cardiovascular system, metabolomics can elucidate the diverse mechanisms leading to circulatory insufficiency. This approach holds significant promise for identifying clinically actionable diagnostic and prognostic biomarkers, which can enhance individualized patient management and potentially prevent the progression to multi-organ failure. Improved insight into the metabolic alterations in shock may pave the way for novel therapeutic strategies and more targeted treatments, ultimately improving patient outcomes in critical care settings. This work provides a comprehensive overview of metabolomic investigations in shock, focusing on septic shock and the main metabolic pathways involved in cardiac and vascular dysfunction.

Acute brain injury (ABI) remains one of the leading causes of death and disability world-wide. Its treatment is challenging due to the heterogeneity of the mechanisms involved and the variability among individuals. This systematic review aims at evaluating the impact of anti-histone treatments on outcomes in ABI patients and experimental animals and defining the trend of nucleosome levels in biological samples post injury. We performed a search in Pubmed/Medline and Embase databases for randomized controlled trials and cohort studies involving humans or experimental settings with various causes of ABI. We formulated the search using the PICO method, considering ABI patients or animal models as population (P), comparing pharmacological and non-pharmacological therapy targeting the nucleosome as Intervention (I) to standard of care or no treatment as Control (C). The outcome (O) was mortality or functional outcome in experimental animals and patients affected by ABI undergoing anti-NET treatments. We identified 28 studies from 1246 articles, of which 7 were experimental studies and 21 were human clinical studies. Among these studies, only four assessed the effect of anti-NET therapy on circulating markers. Three of them were preclinical and reported better outcome in the interventional arm compared to the control arm. All the studies observed a significant reduction in circulating NET-derived products. NETosis could be a target for new treatments. Monitoring NET markers in blood and cerebrospinal fluid might predict mortality and long-term outcomes. However, longitudinal studies and randomized controlled trials are warranted to fully evaluate their potential, as current evidence is limited.

Impaired peripheral perfusion is linked to poor outcomes in critically ill patients, but the relationships among common bedside assessment tools remain unclear. This study aimed to evaluate whether these parameters provide overlapping or complementary prognostic information across ICU subgroups. Adult ICU patients with an expected stay ≥ 3 days were included. On day 1, six peripheral perfusion parameters were simultaneously measured: Peripheral Perfusion Index (PPI), Mottling Score (MS), Capillary Refill Time (CRT), central-to-peripheral temperature gradient (ΔT), Skin Blood Flow at basal temperature (SBFBT), and forearm tissue oxygenation (rSO₂). The primary outcome was correlation between parameters; secondary outcomes included subgroup consistency and associations with ICU mortality. Fifty-five patients were included (median age 64; 65.5% male). Circulatory shock (36.4%) was the leading admission cause, followed by acute brain injury (ABI; 29.1%) and acute respiratory failure (ARF; 25.4%). Strong correlations were found between PPI, CRT, SBFBT, and ΔT, while rSO₂ showed no significant associations. Correlations were strongest in circulatory shock, weaker in ABI and ARF subgroups. CRT had the highest predictive value for ICU mortality (AUC = 0.75, p = 0.007), followed by MS (AUC = 0.72), SBFBT, and PPI. ΔT showed limited performance, and rSO₂ was the weakest predictor. Most bedside peripheral perfusion parameters were strongly interrelated, particularly PPI, SBFBT, and ΔT. In contrast, rSO₂ appeared poorly correlated and less predictive. CRT emerged as the most reliable marker of ICU mortality.

Background: The different waves of SARS-CoV-2 infection have strained hospital resources and, notably, intensive care units (ICUs). Identifying patients at risk of developing a critical condition is essential to correctly refer patients to the appropriate structure and to spare limited resources. The soluble form of RAGE (sRAGE), the endoplasmic stress response and its surrogates, GRP78 and VEGF-A, may be interesting markers. Methods: This was a prospective monocenter cohort study of adult patients admitted to the ICU for severe COVID-19 pneumonia. The plasma levels of sRAGE, GRP78 and VEGF-A were measured within the first 24 h. Patients were classified as critical if they further needed vasopressor therapy, renal replacement therapy, or invasive mechanical ventilation, or died during their ICU stay, and were otherwise classified as not critical. Results: A total of 98 patients were included and 39 developed a critical condition. Critical patients presented higher sRAGE (626 [450–1043] vs. 227 [137–404] pg/mL, p < 0.0001), interleukin-6 (43 [15–112] vs. 11 [5–20] pg/mL, p < 0.0001), troponin T (17 [9–39] vs. 10 [6–18] pg/mL, p = 0.003) and NT-pro-BNP (321 [118–446] vs. 169 [63–366] pg/mL, p = 0.009) plasma levels. No difference was observed for VEGF-A and GRP78. The variables independently associated with worsening in the ICU were sRAGE (1.03 [1.01–1.05] per 10 pg/mL) and age (1.7 [1.2–2.4] per 5 years). An sRAGE value of 449.5 pg/mL predicted worsening with a sensitivity of 77% and a specificity of 80%. Conclusion: sRAGE may allow the identification of patients at risk of developing a critical form of COVID-19 pneumonia, and thus may be useful to correctly refer patients to the appropriate structure of care.