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Vein depth and diameter as predictive indicators of visibility and palpability during venipuncture in healthy volunteers
Background The difficulty of venipuncture depends on the visibility and palpability of the vein and is particularly challenging in older adults, patients with abnormal body mass index, and those with chronic diseases. In these populations, vessel fibrosis, scarring, skin atrophy, and subcutaneous fat reduce vein visibility and palpability, making venous access more challenging. Previous studies have shown that visibility and palpability are associated with vein depth and diameter, respectively. The current study therefore aimed to evaluate the validity of vein depth and vein diameter as predictive indicators of vein visibility and palpability during venipuncture. Methods Three nurses evaluated the visibility and palpability of superficial veins suitable for venipuncture in 96 healthy volunteers who participated in this study. Using ultrasound imaging devices, the depth and diameter of superficial veins were measured, after which receiver operating characteristic (ROC) curves were created to identify the optimal cutoff values for predicting vein visibility and palpability. Results Both vein depth and diameter were found to be independent predictors of visibility and palpability (p < 0.05). ROC analysis showed that vein depth was a significant predictor of visibility (AUC = 0.901, 95% CI = 0.834–0.967) and palpability (AUC = 0.724, 95% CI = 0.619–0.829). The optimal cutoff values for vein depth were 1.89 mm for visibility discrimination, with 28.1% of veins exceeding this threshold, and 1.44 mm for palpability, with 59.4% of veins exceeding this threshold. On the other hand, vein diameter was less accurate than vein depth in predicting visibility and palpability (AUC < 0.7). Conclusions Vein depth is an effective predictor of vein visibility and vein palpability. This finding is expected to inform the development of assistive technology for visual and palpatory examinations.
Disposable e-cigarettes and their nicotine delivery, usage pattern, and subjective effects in occasionally smoking adults
Abstract New disposable e-cigarettes are popular, especially among young people. This study aimed to assess their addictive potential by examining puffing behaviors, subjective effects, and conducting laboratory investigations in an experimental setting. Single-center, four-arm, crossover study. Laboratory setting in Munich (LMU-University Hospital), Germany. Eighteen occasionally cigarette-smoking adults aged 19–28. Two disposable e-cigarettes of the same brand (strawberry-kiwi/ tobacco flavored) were tested with a cigarette and a conventional pod e-cigarette as comparators. Usage was ad libitum for 5 min (or the duration of smoking one cigarette) while puffing topography was recorded. Distributed over 30 min blood samples for nicotine plasma concentrations were drawn and hemodynamic parameters and subjective effects assessed. Nicotine delivery of disposable e-cigarettes (Cmax strawberry-kiwi: 7.1 ng/ml, tobacco: 6.9 ng/ml) was similar to the cigarette (8.1 ng/ml) and higher than for the pod e-cigarette (3.1 ng/ml). The nicotine plasma increase in the first minute was the fastest for disposable e-cigarettes. Tmax for the disposable e-cigarettes (strawberry-kiwi: 5 min, tobacco: 6 min) was reached faster than for the cigarette (8 min). Compared to the pod e-cigarette (6 min), tmax was reached faster with the disposable e-cigarette tobacco. Total nicotine uptake was the lowest for the pod e-cigarette. Puffing behavior differed between e-cigarettes and the cigarette and slightly between both disposable e-cigarettes. Satisfaction and motivation to consume the product again were higher for disposables with a slight preference for strawberry-kiwi flavor. New disposable e-cigarettes hold great addictive potential for young people unestablished in smoking. Besides conducting further research, it is crucial to observe usage trends and strengthen regulations. Trial registration number: DRKS00030978. Date of registration: 21.02.2023.
Brain tumor classification using MRI images and deep learning techniques
Brain tumors pose a significant medical challenge, necessitating early detection and precise classification for effective treatment. This study aims to address this challenge by introducing an automated brain tumor classification system that utilizes deep learning (DL) and Magnetic Resonance Imaging (MRI) images. The main purpose of this research is to develop a model that can accurately detect and classify different types of brain tumors, including glioma, meningioma, pituitary tumors, and normal brain scans. A convolutional neural network (CNN) architecture with pretrained VGG16 as the base model is employed, and diverse public datasets are utilized to ensure comprehensive representation. Data augmentation techniques are employed to enhance the training dataset, resulting in a total of 17,136 brain MRI images across the four classes. The accuracy of this model was 99.24%, a higher accuracy than other similar works, demonstrating its potential clinical utility. This higher accuracy was achieved mainly due to the utilization of a large and diverse dataset, the improvement of network configuration, the application of a fine-tuning strategy to adjust pretrained weights, and the implementation of data augmentation techniques in enhancing classification performance for brain tumor detection. In addition, a web application was developed by leveraging HTML and Dash components to enhance usability, allowing for easy image upload and tumor prediction. By harnessing artificial intelligence (AI), the developed system addresses the need to reduce human error and enhance diagnostic accuracy. The proposed approach provides an efficient and reliable solution for brain tumor classification, facilitating early diagnosis and enabling timely medical interventions. This work signifies a potential advancement in brain tumor classification, promising improved patient care and outcomes.
Indoor environmental quality assessment of naturally-ventilated school classrooms within a dense arid urban setting of Cairo, Egypt
Abstract Indoor Environmental Quality (IEQ) has a significant impact on occupant satisfaction in educational buildings. Key influencing factors include indoor air quality, thermal comfort, visual comfort, and acoustical comfort. These parameters are critical as they directly impact students’ health, academic performance, and learning processes, underscoring the urgent need for research in this underexplored context. The novelty of this study is evaluating the IEQ in elementary school classrooms in Nasr City, Egypt, a densely populated city with a hot, arid climate, while also assessing the differences in IEQ among governmental, private, and experimental schools. This study examines the perceptions of fifth-grade students regarding indoor environmental quality (IEQ) in naturally ventilated elementary school classrooms in Nasr City, Egypt, a densely populated city with an arid climate. The research took a questionnaire approach, and questionnaires were distributed to students across five schools. The responses were then analyzed using SPSS software. The results indicate that generally favorable opinions regarding seating location, natural ventilation, and lighting quality. However, assessments vary by school and classroom; for instance, students seated near open windows reported increased energy levels and focus. This implies that there is a need for strategies to optimize in-classroom layout and ventilation systems, which play a significant role in keeping students engaged in learning activities. However, several challenges were identified, including seasonal discomfort related to temperature fluctuations, excessive noise from street and playground activities, and occasional dissatisfaction with air freshness, especially in classrooms with closed windows. The limitations of this study include a restricted sample size, constraints imposed by local authorities on data collection, and a single-grade focus, which limits the generalizability of the findings. This illustrates the importance of conducting further research to authenticate the results across various educational settings. Ultimately, this study emphasizes the importance of targeted indoor environmental quality (IEQ) improvements in schools to enhance students’ learning experiences and overall well-being. The findings provide valuable insights for policymakers and educational stakeholders by highlighting the main challenges and potential benefits of naturally ventilated classrooms in densely populated, arid urban settings, thereby helping fill a gap in publicly available information concerning IEQ in developing nations.
Using smart transportation assets to hedge fossil energy markets: Evidence from quantile-based VAR approach
This study explores the time-varying correlations and quantile spillover connectedness to identify the hedging potential of smart transportation assets for energy markets. The study finds that amid crises like COVID-19 and the Russia-Ukraine conflict, smart transportation indices demonstrate strong safe-haven characteristics against volatility in equity commodity energy and electricity transmission and distribution infrastructure indices. Additionally, the smart transportation, electric vehicle, and drone indices offer limited hedging benefits and safe-haven attributes for carbon emission allowance and natural gas. Furthermore, smart transportation assets are the major spillover transmitters to fossil energy assets across all quantiles. These outcomes hold substantial implications for environmental advocates, investors, and policymakers.
The food security of residents and refugees of Ukraine after the Russian invasion
Abstract In this paper, survey evidence is used to examine the food security impacts of the 2022 Russian invasion of Ukraine. We focus on both residents of Ukraine and those fleeing to one of the wealthiest countries in Europe, Switzerland. Our questionnaire was sent to both Ukrainian residents and migrants to Switzerland between October 2022 and February 2023. 80% of respondents (n = 1267) indicated that they faced some form of food insecurity, most commonly an inability to eat balanced meals and/or running out of food without being able to buy more. Yet the incidence of more severe forms of food insecurity, including cutting and skipping meals for multiple months, eating less than needed, and feeling hungry without eating, affected more than 20% of the surveyed populations in both countries. Food insecurity for both residents of Ukraine and refugees in Switzerland is significantly more severe for households who perceive themselves to have below average income. In Ukraine higher food insecurity is identified in the conflict’s frontline regions and among larger households with less domestic food production. In Switzerland, women report lower access to many coping mechanisms (producing, trading, or borrowing food). This study underscores the urgent need for improved food programs in conflict zones as well as countries that host refugees, particularly where domestic food prices are very high and language barriers reduce income opportunities.
‘I’m not just a vet, I’m also a human.’ A qualitative interview study on boundary management between work and private life among small animal veterinarians
Introduction Many studies of veterinarians underline the importance of work-life balance, yet our understanding of how veterinarians manage the boundary between private and professional life is still limited. In line with previous research that speaks of “boundary management” in this context, it is the overall aim of this study to investigate the conflicts and challenges veterinarians face in relation to temporal, physical and psychological boundaries between work and private life, and to explore the coping strategies they employ to navigate these challenges. Methods The study is based on qualitative, semi-structured individual focused interviews with 20 small animal veterinarians resident in Germany (n = 8), Switzerland (n = 7) and Austria (n = 5), who specialised in the field of hospice and palliative care. A structured coding process, incorporating both deductive and inductive elements, was utilized to analyse the data through two cycles of coding, thereby identifying key themes. Results The study identified that the veterinarians have to deal with conflicting private and professional appointments, accessibility outside of opening hours through information and communication technologies, professional concerns occupying the veterinarian’s private life and unwanted insights into the animal owners’ lives. Coping strategies show that veterinarians are willing to integrate professional aspects into their private lives and accept accompanying negative consequences because they are convinced that they are acting in the best interest of the animals. At the same time, boundary management for veterinarians means a conscious demarcation from the animal owner along temporal, physical and psychological boundaries, e.g., ensuring that the relationship remains a professional business relationship and does not become too personal. In addition, our data suggest that previous negative experiences of a lack of work-life balance led to stricter boundaries and more of a “self-care” mindset.
Time course of physiological and biochemical responses of Thymus vulgaris to short-term salinity stress in hydroponics
Investigation of flexural mechanical and creep properties of sleeve reinforced pultruded glass fibre reinforced polymer composite for crossarm application
Survival and prognostic factors in rhino-orbito-cerebral mucormycosis: A 3-year cohort study
Whale earwax, fungal fertilizer and chocolate emissions: exhibition explores biodiversity research
Designing a multi-epitope vaccine against African swine fever virus using immunoinformatics approach
New-onset mental disorders increase among patients with metabolic diseases after the COVID-19 pandemic
Why the green-technology race might not save the planet
Jurassic fish choking on floating belemnites
Abstract Tharsis, an extinct genus of ray-finned fish (Actinopterygii) in the Late Jurassic, has but tiny teeth and is considered a micro-carnivore/visual zooplanktivore. A recent review of collection material, however, uncovered several specimens of Tharsis from the Late Jurassic (ca. 152 Ma) Plattenkalk deposits of the Solnhofen Archipelago with belemnites wedged in mouth and gill apparatus. In all cases, the rostrum reexits through the gill apparatus, whereas the broad phragmocone of the belemnite is firmly lodged in the mouth opening. Apparently, these micro-carnivore fish were in the habit of sucking remnants of decaying soft tissue or overgrowth such as algae or bacterial growth from floating objects, but when a streamlined floating belemnite rostrum accidentally was sucked into the mouth, they were no longer able to get rid of these deadly objects.
Enhanced hierarchical attention mechanism for mixed MIL in automatic Gleason grading and scoring
Risk profiling for cirrhosis and hepatocellular carcinoma in HFE hemochromatosis using mobilizable iron stores and alcohol consumption
Abstract HFE hemochromatosis (HH) may cause cirrhosis and hepatocellular carcinoma (HCC). Progression to these endpoints depends on the severity of iron overload and cofactors, such as alcohol. We evaluated alcohol and iron-related risk factors in relation to cirrhosis at diagnosis and future development of HCC in a retrospective analysis of 197 HH subjects. The proportion of subjects either with cirrhosis or who developed HCC during follow-up were 29/197 (14.7%) or 10/197 (5.1%), respectively. The median (IQR) follow-up time after diagnosis was 15.2 (4.6 to 22.1) years. The median mobilizable iron stores and daily alcohol consumption (IQR) were 6.0 (3.8–11.0) g and 20 (0–40) g, respectively. An optimal logistic regression model for the odds of cirrhosis was developed by adding candidate liver insult variables (mobilizable iron, alcohol consumption, and age as a surrogate for duration of exposure) in a forward stepwise strategy using area under the receiver operating characteristic curve (AUROC) analysis and the corrected Akaike information criterion. This model demonstrated an AUROC (95% CI) of 0.966 (0.935–0.996), with sensitivity 76 (58–88)% and specificity 97 (93–99) % for prediction of cirrhosis and had a negative predictive value of 99.4 (95% CI 96.7–99.97) % for development of HCC. Thus, future risk of HCC can be assessed from mobilizable iron stores and alcohol consumption of HH subjects.