Browse Articles

Aerosol emission and exposure in non-invasive ventilation

Abstract From the beginning of the COVID-19 pandemic, there has been concern among clinicians whether the use of high-flow nasal cannula (HFNC) and continuous positive airway pressure (CPAP) contributes to aerosol generation and consequently spreading of pathogens. Most guidelines still classify these treatments as high-risk aerosol-generating procedures. The aim of this study was to evaluate differences in aerosol emissions and exposure with CPAP and HFNC compared to no breathing aid (NBA). Aerosol emissions of 16 healthy volunteers using CPAP, HFNC and NBA were measured with a portable aerosol spectrometer. During each measurement, the volunteers were instructed consecutively to breathe normally, breathe deeply, cough and read aloud a predefined text. The Wilcoxon signed-rank test was used in statistical analysis. Non-invasive ventilation (CPAP, HFNC) does not produce significantly more aerosol than the same respiratory activities without a breathing aid (median CPAP-NBA − 4.54 1/L, p = 0.816, and HFNC-NBA 2.27 1/L, p = 0.244), deep breathing (median CPAP-NBA − 2.27 1/L, p = 0.378 and HFNC-NBA 4.55 1/L, p = 0.623), speaking (median CPAP-NBA 0 1/L, p = 0.0523 and HFNC-NBA 9.09 1/L, p = 0.0140), or coughing (median CPAP-NBA − 17.31 1/L, p = 0.587 and HFNC-NBA 1.92 1/L, p = 0.365). The results indicate that both CPAP and HFNC have no clinically meaningful impact on aerosol emission. Therefore, the use of CPAP or HFNC does not expose healthcare personnel to greater concentrations of aerosols when compared to normal breathing in healthy participants.

The role of telehealth in sepsis care in rural emergency departments: A qualitative study of emergency department sepsis telehealth user perspectives

Purpose Sepsis is a leading cause of hospitalization and death in the United States, and rural patients are at particularly high risk. Telehealth has been proposed as one strategy to narrow rural-urban disparities. The objective of this study was to understand why rural emergency department (ED) staff use provider-to-provider telehealth (tele-ED) and how tele-ED care changes the care for rural patients with sepsis. Methods We conducted a qualitative interview study between February 15, 2022, and May 22, 2023, with participants from upper Midwest rural EDs and tele-ED hub physicians in a single tele-ED network that delivers provider-to-provider consultation for sepsis patients. One interviewer conducted individual telephone interviews, then we used standard qualitative methods based on modified grounded theory to identify themes and domains. Findings We interviewed 27 participants, and from the interviews we identified nine themes within three domains. Participants largely felt tele-ED for sepsis was valuable in their practice. We identified that telehealth was consulted to facilitate interhospital transfer, provide surge capacity for small teams, to adhere with provider scope-of-practice policies, for inexperienced providers, and for patients with increased severity of illness or complex comorbidities. Barriers to tele-ED use and impact included increased sepsis care standardization, provider reluctance, and sepsis diagnostic uncertainty. Additionally, we identified that real-time education and training were important secondary benefits identified from tele-ED use. Conclusions Tele-ED care was used by rural providers for sepsis treatment, but many barriers existed that may have limited potential benefits to its use.

Increased risk of anxiety and coping strategies in patients with selected genodermatoses with cornification disruption

Abstract People with genodermatoses face physical pain, social discrimination, and daily life challenges, all of which have an impact on their emotional and psychological well-being. The assessment of anxiety and the development of coping strategies are crucial. This study aimed to compare state and trait anxiety between healthy adults (n = 30) and patients with Mendelian Disorders of cornification (MeDOC) (n = 29). Using the State and Trait Anxiety Inventory and Coping in Stressful Situations Questionnaire, we compared anxiety levels and coping strategies between patients with MeDOC and healthy controls. Given the rarity of MeDOC, the study group is small, but the findings are highly relevant and can significantly improve patients’ well-being. Average or high levels of trait anxiety were significantly more common in the study group compared to the control group (25 vs. 18 cases; 86.2% vs. 60%, respectively; p = 0.0488). It was estimated that the risk of average or a high level of trait anxiety was over 4 times higher in the study group than in the control group (OR = 4.2, 95% CI 1.1–15; p = 0.0293). High-level emotion-oriented coping was significantly more frequent in the study group compared to the control group (8 vs. 1 case; 27.6% vs. 3.3%; p = 0.0259), with the risk being 11 times higher in the study group (OR = 11, 95% CI 1.3–95.2; p = 0.0288). No significant correlation was found between demographic, social, educational, clinical factors, and anxiety levels or avoidant-distracted coping. Patients with MeDOC have an increased risk of experiencing anxiety. Understanding the emotions and behaviors of patients with this disease is essential for clinical specialists to guide their coping strategies effectively.

Tracing the emergence of domesticated grapevine in Italy

This study presents an extensive analysis of 1,768 well-preserved waterlogged archaeological grape pips covering approximately 7000 years of history. These samples originate from 25 Italian archaeological sites spanning from the Early Neolithic (6th millemmium BC) to the Medieval period (8th-14th centuries AD). Employing geometric morphometrics and linear discriminant analyses, we compared these archaeological grape pips with modern reference collections to differentiate between wild and domestic grape types. Additionally, we analysed phenotypic changes in grape pip length and shape over the studied period to the present day to highlight traits associated with domestication syndrome. During the Early Neolithic, no evidence of morphologically domesticated grapes was observed. Data from Early Bronze Age sites (ca. 2050–1850 BC) display the same trend observed for the Early Neolithic period. The Middle Bronze Age sites (ca. 1600–1300 BC) continue to exhibit a predominance of wild grape pips. However, a notable transition occurs at the end of the Late Bronze Age (ca. 1300–1100 BC), with the majority of grape pips classified as domestic, indicating the definitive establishment of cultivation practices and selection of domestic grape by these communities. In the Iron Age, grape pips from Etruscan sites dating to the 4th century BC are predominantly domestic, suggesting an advanced viticulture for this period. During the Roman period (1st-6th centuries AD), some sites exhibited a high presence of domestic grape pips and intermediate forms between wild and domestic morphotypes, suggesting introgression between local wild and domestic grape allowing the formation of new varieties. Finally, the Medieval period (8th-14th centuries AD) sites demonstrate a widespread prevalence of domestic grape pips across archaeological sites, indicating a reduction of intermediate forms between wild and domestic morphotypes and displaying morphometric characteristics entirely similar to modern domestic grape references. Overall, our study provides valuable insights into the evolution of grapevine cultivation in Italy, highlighting the gradual transition from wild to domesticated types over millennia.

Shenfu injection alleviates lipopolysaccharide-induced liver injury in septic mice

How we’re battling Trump’s science cuts across small-town America

Shedding new light on the context and temporality of Iberian warrior stelae: The Cañaveral de León 2 Stela and Las Capellanías burial complex (Huelva, SW Spain)

Iberian late prehistoric stelae stand out as a significant expression of European prehistoric art. For well over a hundred years, the context of use of the c. 300 Iberian stelae known to this date has been intensely discussed. This debate, however, was inherently flawed and limited in its scope, as almost all the available examples were found by chance, and no good-quality empirical evidence was available to understand their primary context. In this paper, we present the first conclusive scientific evidence demonstrating that Iberian late prehistoric stelae were used both as grave markers and landscape landmarks associated with pathways. This incontrovertible evidence stems from fieldwork undertaken in June 2022 and September 2023 at the site of Las Capellanías (Cañaveral de León, Huelva) in south-west Spain, including field walking, geophysics and excavation. The ground-breaking discoveries made at this remarkable site within barely a year reveal the contextual association of three different stelae to as many graves within the context of a large long-standing burial complex. Specifically, in this paper we study Stela #2 through a broad combination of methods ranging from geoarchaeology to luminescence dating and archaeoastronomy, as well as multiple digital visualization and remote sensing techniques. This multidisciplinary approach provides data that reveal multiple lines of evidence concerning the context and temporality of the stela, its manufacture and its graphic design. Altogether, this lays out a much needed and long-awaited reliable empirical base to understand where, when and how Iberian prehistoric stelae were used. “We hewed logs and built his pyre upon the tallest headland where it runs out above the sea: duly we made his funeral, bewailing him with bitter tears. After body and armour were quite burned away, we piled a mound over them and to crown it dragged up a monolith”, Homer, The Odyssey (London, Arcturus, 2021. Trans. by Alexander Pope). “As he spoke he began stripping the spoils from the son of Paeon, but Alexandrus husband of lovely Helen aimed an arrow at him, leaning against a pillar of the monument which men had raised to Ilus son of Dardanus, a ruler in days of old”, Homer, The Illiad (Project Gutenberg, 2022. Trans. by Samuel Butler).

FNA-Tg improves the diagnostic efficacy of FNAC for PTC lateral cervical LN metastasis

Dismal pathological response to neoadjuvant chemotherapy in stage III breast cancer patients in Tanzania: A retrospective review

Response to neoadjuvant treatment in breast cancer has been associated with good oncological outcomes. In Tanzania, a majority of breast cancer patients are diagnosed at stage III; hence, they almost always require neoadjuvant therapy. However, the response to neoadjuvant therapy in these patients remains unknown. This study examined the pathological responses in women with stage III breast cancer who underwent neoadjuvant therapy and identified sociodemographic and clinical predictors of the pathological response in this cohort. This hospital-based retrospective cohort study was conducted between December 2021 and April 2022. It included women with breast cancer who received neoadjuvant therapy and underwent surgery for breast cancer at Muhimbili National Hospital in Tanzania, from January 2018 through December 2021. Data analysis was performed using SPSS version 25. A complete pathological response was identified upon pathological review of the mastectomy specimen. Chi-square tests and Fischer’s exact tests were used to evaluate the factors associated with a complete pathological response, with a p value of less than 0.05 indicating statistical significance. Ethical approval was obtained from the Muhimbili University of Health and Allied Sciences Institutional Review Board. The study complied with the Helsinki Declaration on studies involving human subjects. A total of 181 breast cancer patients were recruited for the study, with a mean age of 51±12.6 (28–89) years. A complete pathological response to neoadjuvant therapy was observed in 40 (22.1%) patients which is relatively lower compared to studies from Western countries. Disease stage at diagnosis was associated with response to neoadjuvant therapy, with those at stage IIIA showing better complete response than those at stages IIIB and IIIC indicating a need to improve diagnostic strategies to capture patients in the earlier stages to improve outcomes.

The influence of hydrometeorological factors on tree growth in mountainous watersheds of the Qilian mountains in China

Cell death and antioxidant responses in Mytilus galloprovincialis under heat stress: Evidence of genetic loci potentially associated with thermal resilience

The global seawater temperature is expected to further rise in the following years. While species have historically adapted to climatic variations, the current pace of climate change may exceed their ability to adapt. The abnormally increased seawater temperatures occasionally lead to high mortalities of marine bivalve mollusks, threatening the productivity of aquaculture and the sustainability of wild populations. This study investigates the antioxidant and cell death mechanisms of the Mediterranean mussel Mytilus galloprovincialis during a 25-day exposure to temperatures of 24°C, 26°C, and 28°C, by analyzing the transcription of key genes and assessing the oxidative damage on days 1, 3, 12, and 25. In addition, individuals resilient (survived at 28°C until day 30) and susceptible (died early at 26°C and 28°C) to thermal stress were collected to investigate potential polymorphisms in associated genes. The results showed increased transcription of antioxidant genes at higher temperatures. Elevated pro-apoptotic indices were initially observed at 26°C and a higher mortality than at 28°C. However, final mortality was much higher at 28°C. At 26°C, mussels exhibited the highest oxidative damage and pro-apoptotic indices after 25 days. At 28°C, although oxidative damage occurred after 24 hours, survivors maintained a prolonged activated antioxidant defense and increased lc3b transcription, which likely contributed to the observed reduction of pro-apoptotic and oxidative damage metrics on day 25, compared to 26°C. Further, the coding sequences of catalase, intracellular Cu-Zn superoxide dismutase (Cu-Zn sod), and fas-associated protein with death domain (fadd) from heat-resilient and heat-susceptible mussels were analyzed. Based on statistical correlation of nucleotide and genotype frequencies with resilience phenotypes, two novel single nucleotide polymorphisms (SNPs) in Cu-Zn sod and one in fadd were detected, potentially correlating with thermal stress resilience. These findings offer valuable insights into the physiological and genetic adaptations of M. galloprovincialis to rising temperatures and highlight loci potentially linking to thermal resilience.

The sphenomandibularis shown on P45 sheet plastination and dissection

“The only friend I had was my gun”: A mixed-methods study of gun culture in school shootings

Firearms are the leading cause of death for minors in the United States and US gun culture is often discussed as a reason behind the prevalence of school shootings. Yet, few studies systematically analyze if there is a connection between the two: Do school shooters show a distinct gun culture? This article studies gun culture in action in school shootings. It studies if school shooters show distinct meanings and practices around firearms prior to the shooting, as well as patterns in access to firearms. To do so, I analyze a full sample of US school shootings. Relying on publicly available court, police, and media data, I combine qualitative in-depth analyses with cross-case comparisons and descriptive statistics. Findings suggest most school shooters come from a social setting in which firearms are a crucial leisure activity and hold meanings of affection, friendship, and bonding. These meanings translate into practices: all school shooters had easy access to the firearms they used for the shooting. Findings contribute to research on firearms and youth violence, public health, as well as the sociology of culture.

Prediction and evaluation of environmental quality for nursing sow buildings via multisource sensor information fusion

Study on surface deformation induced by shield excavation due to coarse particle content in strongly weathered rock layers

Currently, there is limited research focusing on the surface deformation caused by shield excavation in strongly weathered rock formations with significant coarse particle content. This study, based on the shield tunnel project of the Pearl River Delta Intercity Pazhou Branch Line, investigates the influence of coarse particle content in strongly weathered rock layers on their mechanical properties, as well as its effect on surface subsidence during tunnel shield excavation. By comparing Peck’s formula with random medium theory, the study expands the application of random medium theory in engineering, converting many of Peck’s empirical parameters into corresponding parameters within the random medium framework. Additionally, Peck’s formula is modified to account for the coarse particle content in strongly weathered rock layers. The results show that as the coarse particle content increases, the force transmission mechanism in the strongly weathered rock shifts from compressive deformation typical of fine-grained soils to point-contact force transmission between coarse particles. Furthermore, as the coarse particle content rises, the strata loss rate tends to decrease gradually. The final settlement curve, calculated using the method that considers changes in coarse particle content, is closer to the measured values. This study’s calculation method more accurately reflects the surface deformation behavior caused by shield tunnel construction in strongly weathered rock layers, particularly when coarse particle content is taken into account. It also provides a better understanding of the combined impact of various construction parameters as the coarse particle content changes during the excavation process.

Author Correction: Blockchain-integrated IoT device for advanced inspection of casting defects

Cervical intraepithelial neoplasia grade 1 and long-term risk of progression and treatment

Background Cervical intraepithelial neoplasia grade 1 (CIN1) is often managed by active surveillance, as the risk of progression to high grade lesions is reported to be low, but long-term data is sparse. To inform management of CIN1, we estimated risk of progression and occurrence of treatment in women attending a cervical cancer screening program. Methods We used nationwide, registry data on all women aged 25–69 years attending the Norwegian Cervical Cancer Screening Program in 2002–2019. The eligible source population was women with at least one cytology registration (n = 1,771,876). Women with a histologically confirmed, first CIN1 diagnosis were included (n = 26,130) and followed for detection of CIN2+, defined as histologically confirmed CIN2, CIN3, adenocarcinoma in situ (AIS), or cervical cancer. CIN3+ was defined as CIN3, AIS, or cervical cancer. Treatment included both excision and ablation. Results Overall, the cumulative incidence of CIN2+ increased to 9.5% (95% confidence interval (CI), 8.8 to 9.5) during the first year and to 19.0% (95% CI, 18.4–19.5) during the first five years. For women with high-grade cytology, 5-year cumulative incidence reached 26.0% (95% CI, 25.0–27.0), whereas for women with normal or low-grade cytology, but HPV16 and/or HPV18 positive status, the corresponding estimate was 25.0% (95% CI, 23.3–26.8). Other high-risk HPV genotypes and HPV negative status were associated with lower risks (5-year cumulative incidence 15.5% (95% CI, 14.5–16.6) and 8.2% (95% CI, 7.1–9.5), respectively). Detection of CIN3+ was substantial (cumulative incidence 5.7% (95% CI, 5.4–6.0) and 12.7% (95% CI, 12.2–13.1) after 1 and 5 years, respectively), and overall, cumulative incidence of treatment was 15.2% (95% CI, 14.7–15.7) after 5 years, following similar patterns as observed for CIN2+. Conclusions A differentiation of follow-up guidelines by index cytology and HPV16/18 status for women diagnosed with CIN1, might be warranted.

A fast secure and more reliable underwater communication system based on light fidelity technology

Abstract Underwater communication is essential for industries such as marine research, offshore exploration, defense, and telecommunications. Traditional methods, including acoustic and radio waves, suffer from bandwidth limitations, high latency, and interference. Light Fidelity (Li-Fi) technology presents a promising alternative, offering high bandwidth and reduced interference. However, challenges such as signal attenuation, environmental obstacles, and security vulnerabilities must be addressed to ensure reliable and secure communication. This paper proposes a Li-Fi-based underwater communication system that enhances data reliability through deterministic Line-of-Sight transmission and minimal external interference. Security is reinforced using the Advanced Encryption Standard and reliability is ensured through the Cyclic Redundancy Check algorithm. The system successfully transmits various data formats, including text, images, and GIFs. Our findings demonstrate the feasibility of Li-Fi for underwater applications, highlighting its adaptability and potential to overcome existing communication challenges. We aimed to provide a comprehensive understanding of the underlying principles of Li-Fi technology and its adaptability to the challenges posed by underwater communication environments.

Human cytomegalovirus infection induces L1 expression through UL38-dependent mTOR-KAP1 pathway

Human cytomegalovirus (HCMV) and LINE-1 (L1) can co-inhabit a common host and closely interact with each other within a single cell. We have previously shown that HCMV exploits this opportunistic interaction by upregulating L1 expression that promotes its own productive life cycle by facilitating HCMV DNA replication. However, the mechanism by which HCMV increases L1 expression remains unknown. Here, we report that HCMV infection functionally inactivates KRAB-associated protein 1 (KAP1), a key epigenetic repressor of L1, through phosphorylation. HCMV infection of cells activates mTOR kinase that phosphorylates S824 residue of KAP1 and reduces its epigenetic repressive function, leading to increased chromatin accessibility of L1 promoter region. Treatment of potent mTOR inhibitor to the HCMV-infected cells was sufficient to reduce KAP1 phosphorylation and block L1 expression. Furthermore, cells infected with a mutant virus lacking UL38, an HCMV mTOR pathway activator, showed reduced KAP1 S824 phosphorylation and abolished L1 expression. Our results highlight the synergistic interaction between HCMV and L1 where HCMV UL38 serves as a primary viral regulator of L1 expression by upregulating the mTOR-KAP1 pathway.

Role of peripheral cytokines and orbitofrontal cortex subregion structure in schizophrenia agitation