Search Results (256)

Aviation is widely recognised to have global-scale climate impacts through the formation of ozone (O₃) in the upper troposphere and lower stratosphere (UTLS), driven by emissions of nitrogen oxides (NO_X). Ozone is known to be one of the most potent greenhouse gases formed from the interaction of aircraft emission plumes with atmospheric species. This paper follows up on previous research, where a Photochemical Trajectory Model was shown to be a robust measure of ozone formation along flight trajectories post-flight. We use a combination of a global Lagrangian chemistry-transport model and a box model to quantify the impacts of aircraft NO_X on UTLS ozone over a five-day timescale. This work expands on the spatial and temporal range, as well as the chemical accuracy reported previously, with a greater range of NO_X chemistry relevant chemical species. Based on these models, route optimisation has been investigated, through the use of network theory and algorithms. This is to show the potential inclusion of an understanding of climate-sensitive regions of the atmosphere on route planning can have on aviation’s impact on Earth’s Thermal Radiation balance with existing resources and technology. Optimised flight trajectories indicated reductions in O₃ formation per unit NO_X are in the range 1–40% depending on the spatial aspect of the flight. Temporally, local winter times and equatorial regions are generally found to have the most significant O₃ formation per unit NO_X; moreover, hotspots were found over the Pacific and Indian Ocean. Full article

Background: Emergency laparoscopic cholecystectomy (ELC) has emerged as a viable alternative to delayed elective surgery for acute gallstone disease, although its widespread adoption is hindered by cultural barriers. This study compares outcomes between elective and emergency laparoscopic cholecystectomy and evaluates the impact of implementing an ELC pathway on elective waiting times, patient outcomes, and overall service delivery. Methods: A prospective cohort study was conducted between December 2021 and December 2023, including all patients undergoing emergency or elective laparoscopic cholecystectomy. One-to-one propensity score matching, correlation statistics, and multivariate logistic regression were used to analyse outcomes. Results: Of 585 patients, 314 (53.4%) underwent emergency and 271 (46.3%) elective cholecystectomies. After matching, 474 patients were analysed (237 per group). The ELC pathway achieved an 81.4% first-presentation procedure rate, with 69.2% managed as day cases and 84.4% discharged the following day. Emergency cases had longer operative times (+9 min), higher rates of subtotal cholecystectomy (8.9% vs. 3.0%, p < 0.001), and more frequent postoperative ERCP (16.9% vs. 4.6%, p < 0.001). Other outcomes were comparable. Introduction of the ELC pathway significantly reduced elective waiting times from a median of nine to three months (R = −0.219, R² = 0.059, p < 0.001) and preoperative admissions (IQR 0–1, R = −0.223, R² = 0.050, p = 0.002). Conclusions: An ELC pathway is a safe and effective alternative to elective gallstone surgery, offering substantial benefits to patients and healthcare systems, while serving as a strategic, cost-conscious approach to reducing surgical waiting times and preoperative admissions. Its success hinges upon surgical expertise in acute decision making, skill in performing subtotal cholecystectomy, and access to institutional resources such as advanced imaging and ERCP services. Full article

Here, we propose an analytical approach to simulating MammoWave, a novel apparatus for breast cancer detection using microwave imaging. The approach is built upon the theory of cylindrical waves emitted by line sources. The sample is modelled as a cylinder with an inclusion. Our results indicate that when compared with phantom measurements, our approach gives an average relative error (between the image generated through measurement with phantoms and the image generated through the analytical simulation approach) of less than 6% when considering the full frequency band of 1–9 GHz. The procedure permits the simulation of the MammoWave imaging system loaded with multilayered eccentric cylinders; thus, it can be used to obtain an insight into MammoWave’s detection capability, without having to perform either time-consuming full-wave simulations or phantom measurements. Full article

Background: Different methods have been used to fabricate and measure marginal gap in all-metal crowns, yet a systematic review on this topic has not been conducted. Objective: To review the existing literature regarding the measurement methods employed for the in vitro marginal gap measurement of pre-cemented all-metal single crowns and examine the influence of crown fabrication method on the marginal gap. Materials and Methods: A systematic search was performed from December 2024 backwards across EBSCO Host, Scopus, PubMed, and Web of Science databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and predefined eligibility criteria. The quality of included articles was evaluated using the Joanna Briggs Critical Appraisal Checklist. Results: Ten studies, involving 180 crowns, assessed marginal gaps using computerised superimposition (102 µm), scanning electron microscopy (89 µm), profilometry (100 µm), photogrammetry (59 µm), impression replica techniques (124 µm), and direct view microscopy (35 µm). Marginal gaps varied across crowns constructed with cobalt–chromium (97 µm), titanium (56 µm), noble metals (127 µm), and base metal alloys (35 µm). No significant differences (t = 1.06, p = 0.315) were observed between CAD/CAM (103.21 ± 58.56 µm) and lost wax casting method (71.59 ± 43.94 µm) of crown fabrication when analysed using an independent t-test. Conclusions: Cobalt–chromium was the most used material for AMCs, while titanium alloys produced the lowest mean marginal gap per crown. No significant differences in reported marginal gaps were observed between crowns fabricated using lost wax casting and CAD/CAM techniques. However, the limited number of studies, variation in measurement methods, and inconsistency in methodological rigour restricted the generalisability of the findings. Full article

Cervical cancer remains a significant global public health challenge, affecting over half a million women annually, with a mortality rate of approximately 60%, especially in resource-limited regions. This study presents an advanced methodology for cervical cancer diagnosis through deep learning techniques. Utilizing a publicly available cervical cancer image dataset, the research introduces a novel classification framework that integrates a Neural Feature Extractor (NFE) based on a pre-trained VGG16 architecture and an AutoInt model for automatic feature interaction learning. The extracted features are processed through machine learning classifiers such as KNN, LGBM, Extra Trees, and others for classification tasks. Among these classifiers, KNN achieved the highest accuracy of 99.96%, followed closely by LGBM at 99.92%. This study also assesses the computational complexity of various models, demonstrating that simpler models like LDA exhibit faster prediction times, while more complex models, such as KNN and LGBM, provide higher accuracy. These findings highlight the potential of deep learning frameworks in improving cervical cancer classification accuracy, especially in resource-limited environments. Full article

Addressing the educational needs of children with learning challenges is often a complex issue, with few clear-cut accommodations that lead to high levels of interventional efficacy. This is especially true within the context of the child’s own developmental change, a dynamic school setting, and numerous family considerations. As a result, it is not uncommon for there to be disagreements among the school’s and the family’s perspective on how to best address the child’s educational, socio-emotional, and general developmental needs. This paper addresses this common occurrence in the United States public school system and discusses a model for how independent educational evaluations can be conducted to best inform the process that is intended to lead to appropriate and effective educational support for a student. Full article

Urethral strictures significantly impact patients’ quality of life, with endoscopic treatments such as direct vision internal urethrotomy (DVIU) and dilatation showing high recurrence rates. Drug-coated balloon (DCB) treatment, which delivers paclitaxel locally after dilation, is an innovative, minimally invasive approach aimed at reducing fibrosis and stricture recurrence. Paclitaxel’s antiproliferative and antifibrotic properties inhibit excessive collagen deposition, improving long-term outcomes. DCB treatment is now included in guidelines for managing recurrent bulbar strictures less than 3 cm in length. Recent studies, including the ROBUST trials, have demonstrated the efficacy of Optilume in improving the International Prostate Symptom Score (IPSS) and maximum urinary flow rate (Qmax). DCB has also shown a significant reduction in reintervention rates compared with endoscopic treatments in long-term studies, confirming its safety profile. However, the durability of DCB in complex or longer strictures remains uncertain, and its role as a salvage therapy post-urethroplasty requires further investigation. DCB represents a promising, cost-effective advancement in managing recurrent bulbar urethral strictures, particularly for patients unsuitable for urethroplasty. Future research should focus on refining patient selection criteria and exploring indications for other anatomical sites. Full article

To mitigate the environmental effects of oil spills, a novel hydrophilic–oleophobic mixed-coated filter was developed for efficient oil–water separation and surface oil recovery. The coating consisted of titanium dioxide nanoparticles (TiO₂) and ultra-fine carbon black powder, deposited onto a 304 stainless-steel mesh substrate via spray deposition, followed by high-temperature sintering. This process induced a phase transition in TiO₂ from anatase to rutile, and formed a TiC khamrabaevite. The filter’s performance was evaluated using contact angle measurements and filtration tests with a motor oil–water mixture, while SEM, EDS, and XRD analyses characterized its morphology and coating structure. Contact angle testing confirmed that carbon modification significantly enhanced the oleophobicity of the TiO₂ filter, and SEM imaging demonstrated higher substrate coating adhesion, enabling multiple reuse cycles. These findings highlight the potential of TiO₂ carbon composite coatings in improving oil spill remediation technologies by offering a reusable and efficient filtration system. Full article

Antiphospholipid antibody (aPL)-induced activation of the mTOR (mammalian target of rapamycin) signaling pathway in endothelial cells plays a role in the pathogenesis of vascular lesions in antiphospholipid syndrome (APS). However, there are no data on whether this mechanism also contributes to the development of skin ulcers commonly observed in APS. We investigated the activation of mTOR in skin specimens from aPL-positive and aPL-negative patients with leg ulcers. Patients with leg ulcers who had primary or secondary APS or no detectable aPLs were included in the study. Biopsies were taken from the ulcer edges and the adjacent non-ulcerated skin areas. Activation of mTORC1 (mTOR Complex1) and mTORC2 (mTOR Complex2) in endothelial cells was determined by immunohistochemical analysis of phosphorylated ribosomal S6 protein (pS6RP) and phosphorylated protein kinase B (pAKT), respectively. In all aPL-positive patients, regardless of whether they had primary or secondary APS, we found a positive immunohistochemical reaction to pS6RP (mTORC1 activation) in the endothelial cells of the ulcer samples. On the other hand, pS6RP could not be detected in samples from aPL-negative chronic venous ulcers. Furthermore, pS6RP was not present in samples taken from the unaffected skin adjacent to the ulcers in aPL-positive patients. The pAKT reaction (mTORC2) was negative in both aPL-positive and aPL-negative patients, both in the ulcers and in the periulcer skin. Activation of the mTOR pathway may contribute to ulcer development in APS. The mTORC1 may be a target for therapeutic modification in APS-associated skin ulcers. Full article

Isoprene emissions can affect the oxidizing capacity of the atmosphere and are likely to increase with an increase in the world’s biomass. The emission of isoprene is strongest in tropical forested regions, suggesting a major portion of tropospheric chemistry occurs in the tropics. As well as deforestation and reforestation having a direct impact on the world’s climate through land cover, there is also an indirect environmental impact (e.g., global warming, air pollution) through the resulting change in isoprene emissions. Previously, incomplete understanding of isoprene oxidation chemistry caused a model-measurement breakdown for concentrations of HO_x radicals observed over certain low-NO_x regions, such as the pristine Amazon rainforest. Over the last decade, however, understanding of isoprene oxidation chemistry has been vastly improved. Numerous research studies have provided evidence for the involvement of 1,6-H and 1,5-H shift reactions in the isoprene oxidation mechanism, which increases the level of HO_x recycling that occurs. As well as helping to reduce the model-measurement breakdown observed, the updated isoprene oxidation mechanism affects the tropospheric burdens of other species, including carbon monoxide (CO), methane (CH₄), ozone (O₃), organic peroxides (ROOH), secondary organic aerosol (SOA), and organic nitrates (RONO₂). There are still gaps in the understanding of the impacts and oxidation chemistry of isoprene emissions, which this literature review identifies and discusses. In the future, there is still much scope for further research, including modeling future reforestation scenarios with isoprene emissions and their impacts on both global and regional scales. Full article

There is a significant body of literature to suggest that coronary artery disease (CAD) is a highly sex-specific disease. The study of sex-specific therapeutics and sex-specific responses to treatment for CAD remains underreported in the literature. Sodium-glucose transporter 2 (SGLT2) inhibitors are of growing interest in the treatment of ischemic heart disease and heart failure; however, the sex-specific response to SGLT2 inhibitors is unknown. We studied an SGLT2 inhibitor, canagliflozin, in a swine model of metabolic syndrome (MS) and chronic myocardial ischemia with emphasis on the sex-specific outcomes. Yorkshire swine (n = 21) were obtained at 6 weeks of age and fed a high-fat diet to induce MS. Left thoracotomy was performed on all swine at 11 weeks of age for the placement of an ameroid constrictor to model chronic myocardial ischemia. Swine recovered for two weeks, then were assigned to either the drug group, CAN 300 mg daily group (M = 5, F = 5), or the control group (CON, M = 5, F = 6). Both groups received 5 weeks of therapy. After completion of therapy, swine underwent functional assessment and terminal harvest. The male animals treated with CAN (CAN-M) had significant increases in stroke volume and cardiac output (p = 0.047, p < 0.001) compared to control males (CON-M), which were not seen in females treated with CAN (CAN-F) compared to control females (CON-F). Effective arterial elastance was decreased in CAN-M compared to CON-M. The CAN-F group had a significant increase in ischemic myocardial capillary density compared to CON-F (p = 0.04). There was no difference in capillary density between the CAN-M and CON-M groups. CAN treatment resulted in sex-specific changes in angiogenesis and myocardial function. The CAN-M group had significant improvements in cardiac function based on afterload reduction, stroke volume, and increased cardiac output not seen in the CAN-F group. The CAN-F group had increased ischemic myocardial capillary density. These findings provide a foundation for further investigation of the sex-specific effects of SGLT-2 inhibitors in humans. Full article

Background/Objectives: The misuse of veterinary drugs is a growing concern, with increasing evidence of their presence in illicit drug markets and their use as alternatives to traditional substances. Methods: This study explores Reddit discussions on the misuse of veterinary drugs on Reddit, focusing on xylazine, carfentanil, medetomidine, pentobarbital, phenylbutazone, and acepromazine. Reddit was utilised for its abundant real-time data on users’ thoughts and experiences with substance misuse. Through a combination of manual and Artificial Intelligence (AI)-driven thematic analysis, we examined posts and comments to explore patterns of misuse. Results: The themes analysed included adverse effects, polysubstance misuse, routes of administration, motivations for misuse, and methods of obtaining these drugs. Our findings revealed that xylazine, medetomidine, carfentanil, and pentobarbital exhibit significant potential for misuse, while phenylbutazone and acepromazine are not widely misused. Despite this, phenylbutazone and acepromazine have been identified as adulterants in the illicit drug supply in the United States. The most discussed themes included motivations for misuse, followed by public experiences and perceptions, as well as adverse effects. Conclusions: The dual-method approach of combining manual interpretation with AI analysis allowed for a comprehensive understanding of social media discussions. This research highlights the importance of monitoring online platforms for early indicators of emerging drug trends, offering valuable insights to inform public health policies and intervention strategies. Impact Statement: This research highlights the growing public health risk posed by veterinary drug misuse, underscoring the need for enhanced monitoring, regulatory frameworks, and education to address their diversion into illicit markets. By leveraging social media as an early detection tool for emerging drug trends, our findings can inform targeted interventions. Full article

Bovine respiratory disease (BRD) is a major economic and animal welfare issue in the beef industry. Mycoplasma bovis is one of the main causal organisms, particularly in chronic cases. Due to the difficulty of isolating M. bovis from clinical isolates, there is a lack of information on the genetic diversity of this pathogen in the Texas panhandle region of the United States. Therefore, our objective was to provide genome-level characterization of M. bovis isolated from the lung lesions of beef and dairy cattle in the Texas panhandle. Fifty-four isolates displaying mycoplasma-like growth were recovered from bovine lung lesions by the Texas Veterinary Medical Diagnostic Laboratory in 2021 and 2022. Of these isolates, 32 were determined to be M. bovis via species-specific qPCR using the uvrC gene. Long-read whole-genome sequencing was used to identify key virulence factors, antimicrobial resistance genes, and to assess the genetic diversity of these isolates. Fisher’s exact tests were used to identify associations between isolate characteristics and host metadata, including the state of origin, type of operation, animal age, and animal sex. Our results indicate that there is considerable genetic diversity among the M. bovis isolates, despite their shared geography in the Texas panhandle, though significant clustering based on host metadata was observed. Analysis of the pangenome showed that the M. bovis isolates in this study also harbor a diverse array of virulence genes, but no antimicrobial resistance genes were identified in this study. Full article

A forty-year record (1984–2023) of glacier mass balance and areal extent measurement documented the decline and loss of the Ice Worm Glacier in the North Cascade Range, Washington. After a period of minor variations from 1944 to 1986, the glacier lost 83% of its area from 1986 to 2023 and had a cumulative mass loss of −31.5 m w.e. In 2023, the area at 32,000 m² and the majority of the ice thickness at 2–10 m was insufficient to generate movement. The bottom of the glacier was observed in all existing crevasse features, and stream channels in 2023 at depths of 2–10 m. An ice cave extended the length of the glacier in 2024 illustrating an ice thickness of less than 8 m. This glacier area loss has led to declining glacier runoff into Hyas Creek and the Cle Elum River. Full article