Search Results (349)

Previous studies about the COVID-19 pandemic on STEMI patient outcomes have conflicting results. It remains unclear if this may be attributed to regional differences and/or differences during COVID-19 wave periods. Using the American Heart Association Get With The Guidelines–Coronary Artery Disease registry data, we evaluated (1) time metrics related to STEMI system goals and (2) regional variation in STEMI incidence and in-hospital mortality during pandemic wave time periods. The study included all patients 18–100 years old admitted with STEMI (n = 72,516) to 1 of 435 American Heart Association Get With The Guidelines–Coronary Artery Disease hospitals (1 October 2019–31 December 2021). Of these, 70.8% were male and 73.0% non-Hispanic White, with a median age of 63 (IQR 18) years. Compared to pre-pandemic time frames, patients with STEMI had a higher risk profile, delayed time to treatment, were treated with fibrinolytic therapy or primary PCI, and were transferred for primary PCI at similar rates, and had higher adjusted in-hospital mortality (during the second wave in the South and Midwest). Preservation of STEMI systems of care resulted in an overall lower in-hospital mortality rate than predicted, although opportunities exist to improve treatment delays. Regional differences in mortality rates require further study. Full article

This study investigated individuals’ emotional responses to bed bugs and how these were influenced by sex, proximity, and educational intervention. Using a pre-post experimental design, participants (n = 157) completed emotional assessments before and after viewing an educational video about bed bugs. Contrary to our initial hypothesis that only fear and disgust would be observed, participants also exhibited high levels of anxiety and anger. Following the educational intervention, disgust, fear, and anger toward bed bugs increased significantly. Participants experienced greater disgust and fear when imagining encounters with bed bugs in closer proximity, with home infestations giving stronger responses than workplace scenarios. The educational video reduced disgust toward bed bugs in the home but increased fear of them in public spaces, potentially promoting vigilance that could limit bed bug spread. Females reported higher levels of disgust and fear than males across all proximity conditions, supporting evolutionary theories regarding sex-specific disgust sensitivity. The educational video successfully increased participants’ knowledge about bed bugs while simultaneously shifting emotional responses from contamination-based disgust to threat-specific fear. These findings suggest that educational interventions can effectively modify emotional responses to bed bugs, potentially leading to more rational management behaviors by transforming vague anxiety into actionable awareness of specific threats. Full article

The objective of this study was to determine the effects of two levels of a precision biotic (PB) within a reduced CP diet for performance, digestibility, and blood biomarkers in Dekalb White laying hens from 24 to 42 weeks of age. A total of four diets were fed: (1) an industry-standard positive control (PC) diet with a formulated CP level of 17.5%; (2) a negative control (NC) diet with a formulated CP level of 15.5%; (3) NC with 0.5 kg/ton PB (NC+PB1); (4) NC with 0.7 kg/ton PB (NC+PB2). The NC diet decreased hen–day egg production compared to the PC diet, and supplementation with both levels of PB led to intermediate levels of production. There was a similar trend for the feed conversion ratio (FCR), measured in kilograms of feed per dozen eggs. Feed cost was lower in the reduced CP diets compared to the PC. Apparent total tract digestibility was decreased with PB supplementation without differences in apparent ileal digestibility. The increased plasma uric acid levels in the NC+PB2 group suggest a shift in protein metabolism toward higher efficiency in ammonia detoxification. While more research is needed on PB, this research suggests that supplementation with PB in laying hens could potentially improve performance parameters. Full article

Current treatment strategies for partial tendon tears often lack the capacity to promote true tissue regeneration and improve long-term clinical outcomes. This study tested the hypothesis that treatment of a partial defect in the rabbit common calcaneus tendon (CCT) with uncultured, unmodified, autologous, adipose-derived regenerative cells (UA-ADRCs) enables regenerative healing without scar formation. A full-thickness, 3 mm defect was produced in the midsubstance of the right gastrocnemius tendon, a component of the CCT, in adult female New Zealand white rabbits. Animals received either an injection of 28.3 × 10⁶ UA-ADRCs in 0.5 mL Ringer’s lactated solution (RLS) or saline, or RLS or saline alone as sham treatment. Tendons were analyzed 4 or 12 weeks post-treatment using histology, immunohistochemistry and non-destructive biomechanical testing. UA-ADRC-treated tendons showed newly formed connective tissue consistent with tendon regeneration, whereas sham-treated tendons developed scar tissue. Biomechanical testing showed significantly higher percent relaxation in UA-ADRC-treated tendons compared to sham controls (p < 0.05), indicating greater viscoelasticity characteristic of healthy or well-integrated tissue. Together, these findings suggest that UA-ADRC therapy may provide a regenerative, structure-modifying treatment for partial tendon tears. Full article

Background/Objectives: Chronic inflammation is recognized as an important risk factor for a variety of health disorders. Omega-6 polyunsaturated fatty acids (n-6 PUFAs), particularly linoleic (LA) and arachidonic acid (AA), have been shown to be either pro- or anti-inflammatory, and researchers have advocated both for and against reducing their dietary intake. This study sought to correlate the levels of ten inflammation-related biomarkers across multiple pathways with red blood cell (RBC) membrane levels of the major dietary and circulating n-6 PUFAs. Methods: We included 2777 participants (mean age: 66 ± 9 years, 54% women, 9.8% minorities) from the Framingham Offspring and minority-enriched Omni cohorts, and calculated partial correlation coefficients. Results: After multivariable adjustment, RBC LA was inversely correlated (all p ≤ 0.05) with five markers of inflammation, receptors, or pathways: C-reactive protein (r = −0.06); soluble interleukin-6 (r = −0.15); intercellular adhesion molecule-1 (r = −0.09); monocyte chemoattractant protein-1 (r = −0.07); and P-selectin (r = −0.07). RBC AA was inversely correlated (all p ≤ 0.05) with soluble interleukin-6 (r = −0.10); intercellular adhesion molecule-1 (r = −0.14); monocyte chemoattractant protein-1, and (r = −0.06); and osteoprotegerin (r = −0.07). Lipoprotein-associated phospholipase-A2 mass and activity, urinary isoprostanes, and tumor necrosis factor receptor-2 were not significantly correlated with LA or AA. Conclusions: In our large community-based study, we observed weak but statistically significant inverse associations between several types of inflammatory biomarkers with RBC n-6 PUFAs. Our findings do not support the hypothesis that omega-6 fatty acids are pro-inflammatory. Full article

This study presents an analysis of flight crew communication during the crash of United Airlines Flight 232 at Sioux Gateway Airport in Iowa, USA. Conversation analysis (CA) techniques are used to identify five recurring phenomena in the crew communication and five critical interactions. These are combined to produce a description of the communication process during an unprecedented airline emergency. One of the findings is that communication was simplified and the pilots largely used plain language when speaking with air traffic control (ATC). This was an appropriate communication strategy for the context of the Flight 232 accident but would be problematic if applied to other situations. The analysis also identifies aspects of the crew’s performance that are relevant to contemporary crew resource management (CRM) programs: active participation in communication, updating the shared mental model, making problem solving a joint task, expanding the team boundary to accept an off-duty pilot, and managing the workload. Finally, the study highlights significant details of the Flight 232 accident that are often overlooked and may not generalize to other settings. Full article

Background/Objectives: Influenza infection is associated with cardiovascular morbidity and mortality; however, the effect of influenza vaccination on cardiovascular outcomes is not fully understood. This clinical trial aimed to investigate the correlation between cardiovascular outcomes and influenza vaccine (FluVac) in coronary artery disease (CAD) subjects. Methods: This was a randomized single-blinded placebo-controlled trial. Enrolled CAD subjects received 0.5 mL of 2007–2008 trivalent FluVac (15 µg hemagglutinin of each of Solomon Islands/3/2006 (H1N1), Wisconsin/67/2005 (H3N2), and Malaysia/2506/2004 (B)). The subjects were followed up at 1 month (hemagglutinin (HA) antibody titers) and at 12 months post-vaccination for evaluation of outcomes (influenza-like episodes, acute coronary syndrome (ACS), myocardial infarction (MI), coronary revascularization, and death). Results: In total, 278 eligible CAD subjects were randomized to receive either FluVac (n = 137) or a placebo (n = 141), of which consequently 131 and 135 subjects completed the study. Cardiovascular deaths (3/131 [2.29%] vs. 3/135 [2.22%]) and all-cause deaths (4/131 [3.05%] vs. 4/135 [2.96%]) were similar in both groups. Adverse cardiovascular events, including ACS, MI, and coronary revascularization, were less frequent in the vaccine group but did not reach statistical significance. The magnitude of the antibody change and serologic response (≥4-fold HI titer rise) of all three antibodies were significantly higher in the vaccine group compared to the placebo but did not correlate with cardiovascular outcomes in the FluVac group. Conclusions: The influenza vaccine may improve cardiovascular outcomes, though this improvement is not correlated with post-vaccination antibody titers. Despite the controversy, influenza vaccination is recommended in the CAD population (clinicaltrials.gov; NCT00607178). Full article

OnabotulinumtoxinA is an FDA-approved treatment for adults with overactive bladder (OAB) who have an inadequate response to, or are intolerant of, oral pharmacotherapies including anticholinergics or beta-3 agonists. However, procedural practices of onabotulinumtoxinA intradetrusor injection vary among practitioners and can affect patient experience. To address this, a panel of six high-volume intravesical onabotulinumtoxinA providers with 100 years of combined experience convened to discuss the best office practices when treating patients with OAB. These key best practices include counseling patients on available OAB therapies, including onabotulinumtoxinA, at the initial consultation in accordance with established AUA and SUFU guidelines in a way that is easily understood. An office setting is preferred over a hospital or surgery center when performing the procedure. Staff involvement, from scheduling to post-procedure, is essential for establishing the relationships necessary to optimize patient experience and encourage compliance and retreatment. Experts generally recommend using a viscous lidocaine bladder instillation for an anesthetic 15 min prior to the reconstitution of onabotulinumtoxinA with 5 to 10 mL of normal saline. A range of one to 20 injection sites is acceptable, with a smaller number preferred. Starting in the lower bladder, experts recommend using a slower speed of injection to improve distribution and decrease patient discomfort. Subsequent treatments should be regularly scheduled at six-month intervals with the option of re-treating earlier if symptoms return, but no sooner than 12 weeks. For office intravesical onabotulinumtoxinA procedures, optimization of the patient experience by the physician and their staff, starting with the initial visit through the post-treatment follow-up, is key to long-term patient compliance. Full article

Users of remotely sensed Earth optical imagery are increasingly demanding a surface reflectance or surface temperature product instead of the top-of-atmosphere products that have been produced historically. Validating the accuracy of surface products remains a difficult task since it involves assessment across a range of atmospheric profiles, as well as many different land surface types. Thus, the standard approaches from the satellite calibration community do not apply, and new technologies need to be developed. The Big Multi-Agency Campaign (BigMAC) was developed to assess current technologies that might be used for the validation of surface products derived from satellite imagery, with emphasis on Landsat. Conducted in August 2021, in Brookings, SD, USA, a variety of measurement technologies were fielded and assessed for accuracy, precision, and deployability. Each technology exhibited its strengths and weaknesses. Handheld spectroradiometers are capable of surface reflectance measurements with accuracies within the 0.01–0.02 absolute reflectance units, but these are expensive to deploy. Unmanned Aircraft System (UAS)-based radiometers have the potential of making measurements with similar accuracy, but these are also difficult to deploy. Mirror-based empirical line methods showed improved accuracy potential, but their deployment also remains an issue. However, there are inexpensive radiometers designed for long-term autonomous use that exhibited good accuracy and precision, in addition to being easy to deploy. Thermal measurement technologies showed an accuracy potential in the 1–2 K range, and some easily deployable instruments are available. The results from the BigMAC indicate that there are technologies available today for conducting operational surface reflectance/temperature measurements, with strong potential for improvements in the future. Full article

Background: Stent-assisted coil embolization (SACE) is a common endovascular technique for managing intracranial aneurysms. The permanent presence of a stent inside the cerebral artery necessitates the postoperative use of antiplatelets. However, a consensus about how long to continue on it remains debated. This systematic review aims to discuss and quantify the risk of ischemic complications after antiplatelet discontinuation following SACE. Methods: PubMed, Cochrane Library, Scopus, and Web of Science (WOS) were systematically searched for studies assessing the outcomes after antiplatelet discontinuation following SACE for cerebral aneurysms. The primary outcome was the odds of ischemic complications after antiplatelet discontinuation. Using a random-effects model, the pooled event rate, along with a 95% confidence interval (CI), was calculated. The Comprehensive Meta-Analysis software (CMA) software was used for the analysis. The Newcastle–Ottawa Scale (NOS) was used for the quality assessment. Results: A total of five observational cohort studies were included in this systematic review. The studies recruited cases from 2009 and 2020, predominantly in Korea and Japan. Data from 18,425 cases obtained from four studies were analyzed. The duration of antiplatelet therapy varied widely across the included studies. Additionally, most studies reported a median follow-up of 24 months or more after antiplatelet discontinuation. We extracted and analyzed the odds of thromboembolic complications occurring within 6 to 24 months after the discontinuation of antiplatelets. The pooled rate of thromboembolism after antiplatelet discontinuation in this meta-analysis was 0.01 (95% CI: 0.006 to 0.018). Conclusion: This review demonstrates that the risk of thromboembolic complications after discontinuing antiplatelet therapy post-SACE is low. However, no strong consensus exists on the ideal duration for maintaining dual- or single-antiplatelet therapy. Further prospective studies with longer follow-ups are warranted to clarify the optimal durations needed to balance thromboembolic risk with hemorrhagic complications. Full article

Human space exploration presents an unparalleled opportunity to study life in extreme environments—but it also exposes astronauts to physiological stressors that jeopardize key systems like vision. Corneal health, essential for maintaining precise visual acuity, is threatened by microgravity-induced fluid shifts, cosmic radiation, and the confined nature of spacecraft living environments. These conditions elevate the risk of corneal abrasions, infections, and structural damage. In addition, Spaceflight-Associated Neuro-Ocular Syndrome (SANS)—while primarily affecting the posterior segment—has also been potentially linked to anterior segment alterations such as corneal edema and tear film instability. This review examines these ocular challenges and assesses current mitigation strategies. Traditional approaches, such as terrestrial eye banking and corneal transplantation, are impractical for spaceflight due to the limited viability of preserved tissues, surgical complexities, anesthetic risks, infection potential, and logistical constraints. The paper explores emerging technologies like 3D bioprinting and stem cell-based tissue engineering, which offer promising solutions by enabling the on-demand production of personalized corneal constructs. Complementary advancements, including adaptive protective eyewear, bioengineered tear substitutes, telemedicine, and AI-driven diagnostic tools, also show potential in autonomously managing ocular health during long-duration missions. By addressing the complex interplay of environmental stressors and biological vulnerabilities, these innovations not only safeguard astronaut vision and mission performance but also catalyze new pathways for regenerative medicine on Earth. The evolution of space-based ophthalmic care underscores the dual impact of space medicine investments across planetary exploration and terrestrial health systems. Full article

Frequent and severe waterlogging caused by climate change poses significant challenges to urban infrastructure systems, particularly transportation networks (TNs) and distribution networks (DNs), necessitating efficient restoration strategies. This study proposes a collaborative scheduling framework for post-disaster restoration in waterlogging scenarios, addressing the impact of waterlogging on both transportation and distribution systems. The method integrates electric vehicles (EVs), mobile power sources (MPSs), and repair crews (RCs) into a unified optimization model, leveraging an improved semi-dynamic traffic assignment (SDTA) model that accounts for temporal variations in road accessibility due to water depth. Simulation results based on the modified IEEE 33-node distribution network and SiouxFalls 35-node transportation network demonstrate the framework’s ability to optimize resource allocation under real-world conditions. Compared to conventional methods, the proposed approach reduces system load loss by more than 30%. Full article

Objectives: The objective of this study is to outline a framework for how fatty acids may be acting as mediators/suppressors and/or moderators of an individual’s genetic predisposition for cardiovascular lipid biomarkers. Methods: All UK Biobank participants with demographic and lifestyle variables, circulating cardiovascular lipids, and NMR-measured fatty acid data collected at the baseline visit (N = 229,859) were included in analyses. We fit four separate linear regression models, one for each of the following common measures of cardiovascular lipids: total cholesterol, HDL-c, LDL-c, and total triglycerides. Each model predicted cardiovascular lipids by an individual’s FADS (a well-known fatty acid desaturase gene complex) haplotype, with the addition of individual ω-3 (DHA, non-DHA, and total), ω-6 (LA, non-LA, and total), or SFA factors as additive (mediation/suppression) or using an interaction term (with FADS) (moderation). All models were adjusted for a wide range of demographic and medical history variables and evaluated against a Bonferroni-adjusted significance level (p < 8.9 × 10⁻⁴). Results: Across 56 models (four lipids × seven FAs × two conceptual models (mediation/suppression and moderation)), we found evidence of 19 moderation, 12 mediation, and 16 suppression effects of the FADS–lipid relationship. For example, adjusting for circulating DHA levels as a mediator, the association of the genotype with HDL-c substantially lessened for both minor genotypes reflecting >122% mediation of the association of FADS by DHA. Additionally, we found evidence that LDL-c is moderated, to some extent, by all fatty acid measures. Conclusions: This analysis demonstrates that an individual’s fatty acid profile can act as a mediator/suppressor or moderator of the association of the FADS genotype and various cardiovascular biomarkers. Future work is necessary to expand this cross-sectional examination to determine directionality and temporality of the mediation and moderation evidence presented. This research has been conducted using the UK Biobank Resource under Application Number 85092. Full article

In light of the potential effects of spaceflight on the anterior segment of the eye, there is a pressing need for anterior segment imaging to be available and accessible to monitor astronauts’ ocular health, including alterations to the cornea and lens. We aim to highlight the clinical basis and need for anterior segment imaging for astronauts. We explore the impacts of spaceflight-associated hazards, including microgravity and radiation, on astronauts’ risk of developing anterior segment pathology including risk of ocular trauma, infection, dry eye symptoms, cataracts, and possibly additional pathologies from increased radiation exposure. Such risks highlight the potential value that longitudinal assessment of anterior ocular structures would offer in future spaceflight missions. Specifically, anterior segment imaging would enable evaluations of corneal morphology, including longitudinal monitoring for microgravity-induced changes, and evaluation of interventions that aim to preserve anterior segment health during spaceflight. Lastly, non-invasive anterior segment imaging allows for unique insights into astronaut ocular health and can be performed routinely through modalities such as anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM). We discuss these modalities and their implications for astronaut health during future spaceflight. Full article

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects over 2% of the population worldwide and is characterized by repetitive behaviors, restricted areas of interest, deficits in social communication, and high levels of anxiety. Currently, there are no known effective treatments for the core features of ASD. The previous literature has established erythropoietin (EPO) as a promising antidepressant, working as a potent neurogenic and neurotrophic agent with hematopoietic side effects. Carbamoylated erythropoietin (CEPO), a chemically engineered non-hematopoietic derivative of EPO, appears to retain the neuroprotective factors of EPO without the hematologic properties. Recent evidence shows that CEPO corrects stress-related depressive behaviors in BALB/cJ (BALB) mice, which also have face validity as an ASD mouse model. We investigated whether CEPO can recover deficient social and anxiety-related behavioral deficits compared to C57BL/6J controls. After administering CEPO (40 μg/kg in phosphate-buffered saline) or vehicle over 21 days, we analyzed the mice’s performance in the three-chamber social approach, the open field, the elevated plus maze, and the Porsolt’s forced swim tasks. CEPO appeared to correct sociability in the three-chamber social approach task to C57 levels, increasing the amount of time the mice interacted with novel, social mice overall rather than altering the overall amount of exploratory activity in the maze. Consistent with this finding, there was no concomitant increase in the distance traveled in the open field, nor were there any alterations in the anxiety-related measures in the task. On the other hand, CEPO administration improved exploratory behavior in the elevated plus maze. This study marks the first demonstration of the benefits of a non-erythropoietic EPO derivative for social behavior in a mouse model of autism and merits further investigation into the mechanisms by which this action occurs. Full article