Search Results (88)

Breastfeeding is universally recognized for its extensive health benefits for both infants and mothers. However, for some women, the experience of breastfeeding can be complicated by intense negative emotional and physical reactions, including phenomena such as dysphoric milk ejection reflex and breastfeeding aversion/agitation. This review explores the neuroendocrine underpinnings of these conditions, emphasizing the interplay between oxytocin, prolactin, and dopamine. Oxytocin, traditionally viewed as a hormone promoting bonding and emotional regulation, can paradoxically provoke a stress response in vulnerable individuals. Prolactin, a key hormone for lactation and maternal behaviors, is implicated in stress resilience and mood regulation, but its dysregulation may contribute to depressive states. Dopamine, critical for reward processing and emotional stability, may underlie the acute emotional dysregulation seen in dysphoric milk ejection reflex. Together, disturbances in these neurohormonal systems may explain the aversive emotional experiences during breastfeeding. An improved understanding of these mechanisms offers critical insights into maternal mental health during lactation and underscores the importance of supportive clinical approaches for affected women. Full article

Background/Objectives: The administration of parenteral medications is essential in managing acute arousal within the Behavioral Assessment Unit (BAU) of the emergency department (ED), where timely and effective intervention is critical. This study aims to evaluate current practices surrounding the use of parenteral medications for patients with acute agitation, focusing on adherence to protocols, medication safety, documentation accuracy, and patient outcomes. Methods: A retrospective analysis was conducted on 177 cases from December 2023 to February 2024. The study assessed the demographics, diagnoses, treatment protocols, and patient outcomes, with a particular emphasis on the use of parenteral medications such as benzodiazepines and antipsychotics. The relationship between medication administration and involuntary admission, mechanical restraint usage, and patient outcomes was also explored. Results: The majority of patients were aged between 21 and 30 years, and there was a predominance of male patients across both groups. Schizophrenia was the most common diagnosis, with a higher prevalence in the parenteral group (34%) compared to the oral-only group (24%), and personality disorders were more frequent in the parenteral group. Intramuscular (IM) medication administration was strongly associated with the use of mechanical restraint, with patients receiving IM medication being 35 times more likely to require restraint, emphasizing the link between more intensive treatment approaches and behavioral challenges. The most frequently administered medications were diazepam (40.6%) and olanzapine (36.5%), with olanzapine, droperidol, and diazepam most commonly used parenterally. Documentation of physical assessments prior to parenteral administration was present in most cases, though comprehensive evaluations such as ECGs were inconsistently performed. Conclusions: Parenteral medications, including benzodiazepines and antipsychotics, were effective in rapidly stabilizing patients, but the study emphasizes reducing dependency on mechanical restraints. Tailoring treatment to patient characteristics and employing alternative de-escalation strategies can improve safety and align with recovery-oriented care. This study highlights the need for evidence-based practices to optimize care and improve patient outcomes in ED settings. Further research is needed to explore long-term outcomes and refine non-coercive care approaches. Full article

Historical earthquake records are crucial for analyzing high-intensity earthquakes that occur over long periods. Since good instrumental data only date back to 1980, there are gaps in our knowledge, and qualitative assessments remain essential to expand our knowledge and integrate more information into the number of variables under analysis. This study examined the hydrological and hydrogeological effects of the 1755 Lisbon earthquake, focusing on regions near rivers and proposing new insights for intensity scales. This information is relevant for seismic risk management and mitigation, to be discussed in regional and national territorial planning strategies. Mapping revealed that most phenomena occurred along the Porto–Tomar tectonic fault, with some extending to other probable faults or geological contrasts. A comparative chart between existing intensity scales and the proposed descriptors highlights agreements and discrepancies, emphasizing the need for more detailed descriptors for intensity levels below X for river-related phenomena. The proposed descriptors include a flow increase with course alterations (intensities VI–VIII), flow suppression and eventual reset (intensity VIII or higher), abnormal current agitation and vertical wave movements (intensities VI–VIII), and cloudy (turbid) water (intensities V–VIII). This work also highlights the need to cross-reference data and the complexity of establishing correlations between effects, ancient descriptions, and descriptors for these intensity scales. Full article

The transesterification process for biodiesel production is constrained by high thermal input, prolonged residence time, and intensive mechanical agitation. This study investigates process intensification via hydrodynamic cavitation using a custom-built Shockwave Power Reactor (SPR), enabling continuous biodiesel synthesis from soybean and used cooking oils. A statistically designed experimental matrix was applied to evaluate the reactor’s transient–stable thermal regime and the influence of operational parameters: rotor speed (1700–3415 rpm), volumetric flow rate (60–105 mL/min), methanol-to-oil molar ratio (6:1 to 12:1), and alkali catalyst type (NaOH or KOH). For benchmarking, conventional alkaline transesterification was optimized. The FAME yields from the SPR system exceeded 96.5% and complied with EN14103 standards. Specific energy analysis showed that cavitation-enhanced transesterification reduced energy consumption and peak temperature compared to traditional methods. The SPR’s capacity to induce high shear and localized turbulence under controlled cavitation offers a promising pathway for low-energy, scalable biodiesel production. Full article

Severe burns are among the most traumatic injuries, characterized by tissue damage, systemic inflammation, significant fluid shifts, and a high risk of complications such as infections, organ failure, anemia, malnutrition, and psychological trauma. This article reviews recent literature from the PubMed and Google Scholar databases to outline critical components of burn care, from initial resuscitation and stabilization through rehabilitation. Key topics include early airway management to prevent respiratory compromise, meticulous fluid resuscitation to maintain tissue perfusion while avoiding complications like fluid overload, and optimal pain management. It also discusses nutritional support tailored to the burn patient’s hypermetabolic state and surgical techniques like early debridement and skin grafting. Beyond physical recovery, the review emphasizes the importance of addressing the psychological impact of burn injuries, including depression, anxiety, and post-traumatic stress, which can significantly affect long-term outcomes. By integrating the expertise of a multidisciplinary team with a personalized approach and practical recommendations, this review aims to provide clinicians with a comprehensive framework for managing severe burns, from the initial emergency response to the challenges of inpatient care and, finally, rehabilitation. Full article

Objectives: Emotion perception in music is shaped by cultural background, yet the extent of cultural biases remains unclear. This study investigated how Western listeners perceive emotion in music across cultures, focusing on the accuracy and intensity of emotion recognition and the musical features that predict emotion perception. Methods: White-European (Western) listeners from the UK, USA, New Zealand, and Australia (N = 100) listened to 48 ten-second excerpts of Western classical and Chinese traditional bowed-string music that were validated by experts to convey happiness, sadness, agitation, and calmness. After each excerpt, participants rated the familiarity, enjoyment, and perceived intensity of the four emotions. Musical features were computationally extracted for regression analyses. Results: Western listeners experienced Western classical music as more familiar and enjoyable than Chinese music. Happiness and sadness were recognised more accurately in Western classical music, whereas agitation was more accurately identified in Chinese music. The perceived intensity of happiness and sadness was greater for Western classical music; conversely, the perceived intensity of agitation was greater for Chinese music. Furthermore, emotion perception was influenced by both culture-shared (e.g., timbre) and culture-specific (e.g., dynamics) musical features. Conclusions: Our findings reveal clear cultural biases in the way individuals perceive and classify music, highlighting how these biases are shaped by the interaction between cultural familiarity and the emotional and structural qualities of the music. We discuss the possibility that purposeful engagement with music from diverse cultural traditions—especially in educational and therapeutic settings—may cultivate intercultural empathy and an appreciation of the values and aesthetics of other cultures. Full article

The distribution of light within a microalgal culture and the choice of the best wavelengths are considered the most critical aspects in the scale-up of microalgal culture. Several studies have investigated these features, resulting in a substantial body of literature that analyzes the effects in terms of an increase in biomass production or shift in its composition. This work addresses two types of light quality adjustments: the application of flashing light and shifts in light wavelength. The effects on microalgal culture are examined. Later, the application of these light features to photobioreactor design is described. Specifically, three kinds of photobioreactors are examined: (1) reactors designed to minimize light gradients, (2) reactors where the geometry produces a flashing light effect on the cells and (3) reactors that use filters to obtain a shift in the sunlight wavelength. The results showed that both the effect of flashing lights and wavelength shift strongly depends on various parameters such as the alga taken into consideration, the light intensity, the agitation type, growth medium, light intensity and temperature and, regarding the flashing light also, the frequency and the duty cycle. Despite all these specific differences, this work aims to resume and provide specific instruments for choosing operational parameters in microalgal cultivation and in photobioreactor design to achieve targeted outcomes, such as an increase in biomass production or in high-value compound accumulation. Full article

Lipase production by the strictly aerobic yeast Yarrowia lipolytica is closely related to the content of dissolved oxygen in the culture medium. Some strategies to improve oxygen transfer to microorganisms have already been used, such as the use of perfluorocarbons (PFCs). The present work investigates the influence of agitation speed and the use of perfluorodecalin (PFC) on the profile of the produced lipases. Lipase production increased 2.5-fold with a higher agitation speed (550 to 650 rpm) without PFCs in the medium. The presence of an oxygen carrier led to a significant 91% increase in lipase production at lower shaking speeds compared to the assay without PFC; however, an increase in lipase production was not detected with PFC at 650 rpm. The protein profiles exhibited typical bands for two lipases produced (near 40 and 60 kDa), and these bands became more intense when PFC was added during production, as a result of the large enhancement in lipolytic activity. Additionally, the protein profiles obtained from extracts at 650 rpm were clearer and more selective regardless of the presence of PFC, suggesting an enhancement in specific activity associated with increased shaking. These findings highlight the significant impact of oxygen availability on lipase production, offering valuable insights for industrial applications. Full article

During the COVID-19 pandemic, concerns grew about excessive opioid dosing in Intensive Care Unit (ICU) patients. This study aimed to evaluate opioid dosing in the ICU by comparing objective (Nociception Level Monitor (NOL)) and subjective (Behavioral Pain Score (BPS)) pain measurement tools in COVID-19 and non-COVID-19 ICU patients. This observational study included 40 sedated, mechanically ventilated ICU patients, with half confirmed as COVID-19. Measurements included NOL, BPS, Richmond Agitation Sedation Scale (RASS), Bispectral Index (BIS) and nurse questionnaires. NOL was categorized as <10 (possible excessive analgesia), 10–25 (adequate analgesia), and >25 (possible need for more analgesia). The Time Weighted Average (TWA) assessed the duration of NOL >25 (TWA_NOL>25). Primary outcomes were NOL and BIS over time. COVID-19 patients received higher sufentanil (18 ± 9 µg/h versus 9 ± 6 µg/h) and propofol (307 ± 127 mg/h versus 277 ± 137 mg/h) doses (p < 0.001). No significant differences were found in TWA_NOL>25 (p = 0.78) or BPS (p = 0.1). NOL values were <10 for 63% and 57% of the time in COVID-19 and non-COVID-19 patients. BIS (p < 0.001) and RASS (p = 0.02) were lower in COVID-19 patients. While COVID-19 patients received higher opioid doses, low NOL and BPS were seen in all patients, suggesting high analgesia in all patients. Based on our data, we cannot determine whether higher opioid doses in COVID-19 were warranted. Full article

Background: Severe strokes often require deep sedation, yet the optimal sedation regimen remains unclear. This comparative study compared the efficacy of achieving target sedation depth using inhaled (isoflurane) versus intravenous (propofol) sedation. Methods: This prospective, observational, proof-of-concept study was conducted between July 2022 and June 2023 at two University Hospitals with dedicated neurological intensive care units. We included conservatively treated patients with severe space-occupying strokes (ischemic or haemorrhagic) requiring deep sedation. Patients received either inhaled or intravenous sedation. Sedation targets were defined in the morning rounds using the Richmond-Agitation-Sedation-Scale and were assessed at two subsequent time points (7 p.m. and 7 a.m.) during hospital stay. The primary outcome was the number of days where the predefined sedation target was achieved at both time points, comparing between the two sedation regimens. Secondary and safety outcomes included the incidence of delirium, pneumonia, functional outcomes, mortality, and vasopressor doses. Results: Seventy-nine patients (age 71 [63–81] years, 31 female) were included. Patients sedated with isoflurane achieved the sedation target significantly more often, with 182/444 (41%) compared to 80/497 (16%) assessments in patients sedated with propofol (RR 1.4; 95%-CI: 1.3–1.6). This effect was consistent across all sedation stages, specifically in the deep sedation targets (RR 1.5; 95%-CI: 1.2–1.9) and no-sedation target (RR 5.1; 95%-CI: 2.8–9.4). Secondary and safety outcomes revealed no significant differences. Conclusions: Isoflurane sedation offers a benefit for invasively ventilated stroke patients with respect to sedation targets. Specifically, isoflurane facilitates faster awakening when transitioning from deep sedation to awakening. These data encourage further confirmatory studies for specific stroke-patient groups. Full article

Delirium is a complex neuropsychiatric syndrome with multifactorial pathophysiology, encompassing a wide range of neuropsychiatric symptoms, and its management remains a significant challenge in critical care. Although often managed with antipsychotics, like haloperidol, current research has predominantly focused on dopamine dysregulation as the primary driver of delirium, overlooking its broader neuroanatomical and neurochemical underpinnings. This has led to a majority of research focusing on haloperidol as a treatment for intensive care unit (ICU) delirium. Our review critically evaluates the role of haloperidol in ICU delirium management, particularly in light of recent large-scale randomized controlled trials (RCTs) that have primarily focused on delirium-free days and mortality as the primary endpoints. These studies highlight an limited understanding of the true nature of delirium treatment, which requires a broader, neuropsychiatric approach. We argue that future research should shift focus to neuropsychiatric symptoms such as agitation and psychosis and explore the clinical and functional benefits of reducing these distressing symptoms. Additionally, the stratification of delirium by subtypes and etiology, the enhancement of detection tools, and the adoption of multi-intervention and multi-disciplinary care approaches should be prioritized. Despite the methodological flaws in these studies, the findings support the safety of haloperidol in the ICU setting, with minimal risk of adverse events, particularly cardiac and neuropsychiatric. Moving forward, delirium research must integrate modern neuroscientific understanding and adopt more multi-disciplinary input and nuanced, patient-centered approaches to truly advance clinical care and outcomes. Full article

This investigation specifically aims to enhance the understanding of digestate flow and mixing behavior across typical temperatures in bioreactors in agricultural biogas plants, facilitating energy-efficient mixing. Experimental tests confirmed that digestate exhibits non-Newtonian characteristics, allowing its flow behavior to be captured by rheological models. This study validated that digestate rheology significantly varies with temperature, which influences flow resistance, mixing efficiency and overall energy requirements. Two rheological models—the Bingham and Ostwald models—were applied to characterize digestate behavior, with the Ostwald model emerging as the most effective for Computational Fluid Dynamic (CFD) simulations, given its balance between predictive accuracy and computational efficiency. Specifically, results suggest that, while three-parameter models, like the Herschel–Bulkley model, offer high precision, their computational intensity is less suitable for large-scale modeling where efficiency is paramount. The small increase in the accuracy of the shearing process description does not compensate for the significant increase in CFD calculation time. Higher temperatures were found to reduce flow resistance, which in turn enables increased flow rates and more extensive mixing zones. This enhanced mass transfer and mixing potential at elevated temperatures are especially pronounced in peripheral areas of the bioreactor, farthest from the agitators. By contributing a model for rheological behavior under realistic bioreactor conditions, this study supports the optimization of energy use in biogas production. These findings emphasize that temperature adjustments within bioreactors could serve as a reliable control strategy to maintain optimal production conditions while minimizing operational costs. Full article

This study utilized passive acoustic emissions from a fluidized bed containing spherical inert ABS particles, captured by an external piezoelectric microphone, to monitor fluidization agitation intensity. Acoustic signals were recorded during fluidization profiles achieved under air velocities ranging from 0.5 to 3.0 m/s and during the drying of water or maltodextrin aqueous solution (1:5 w/w) introduced as droplets. Analyzing audio features like waveforms, the Discrete Fourier Transform (DFT), and Mel Frequency Cepstral Coefficients (MFCCs) revealed changes corresponding to the agitation intensity of the particles. The MFCC coefficients were input into a three-layer artificial neural network (ANN) to predict fluidization dynamics based on air velocity, liquid flow rate, and drying time. The ANN efficiently learned from the data, achieving high predictive accuracy (R² > 0.8) after 15 epochs of training, showcasing the robustness of MFCC coefficients for modeling. This approach highlights that the application of passive acoustic signals and neural networks allows for real-time monitoring of fluidization behavior during drying processes. Full article

Concern over microplastics (MPs) in the environment is rising. Microplastics are generally known to exist in aquatic settings, but less is known about their occurrence in soil ecosystems. When plastic waste builds up in agricultural areas, it can have a negative impact on the environment and food sources, as well as have an indirect effect on all trophic levels of the food chain. This paper addresses the relationship between microplastics and the management of plastic waste, which contributes to their accumulation, and it describes the sources and the movement processes of microplastics in agricultural soils as a result of natural events and disasters. Evaluating the impact of weather on coastal microplastic contamination is critical, as extreme weather events have become more frequent in recent years. This study sheds light on how weather patterns affect the dispersion of plastic waste in terrestrial habitats, including the impacts of seasonality and extreme weather. According to the results of this review, typhoons, monsoons, rainfall, and floods contribute significantly more microplastics to the surface sediment through surface runoff and wind transport, particle redistribution caused by agitated waves, and fragmentation under intense abrasion forces. Severe weather conditions have the potential to disperse larger and more varied kinds of microplastics. Full article

Black-odor water, which is caused by the excessive accumulation of nitrogen and phosphorus in water, is a significant problem. Immobilized microorganisms are considered to be an effective technical solution, but there are still many key parameters to be determined, such as organic matter dissolution, insufficient stability, and insufficient phosphorus removal capacity, among other problems. In this study, the optimum raw material ratios of immobilized microorganism gel beads were determined by means of a response surface experiment. The optimal ratio of raw materials was 5% polyvinyl alcohol (PVA), 1% sodium alginate (SA), and 6% bacterial powder. In addition, the nitrogen and phosphorus removal performance of the materials was improved by loading inorganic compounds, such as 0.5 wt.% zeolite, 0.5 wt.% iron powder, and 0.2 wt.% activated carbon. Tolerance analysis determined that these gel beads could maintain a good performance in a series of harsh environments, such as during intense agitation, at high temperatures, and at low pH values, etc. The total nitrogen (TN), ammonia nitrogen (NH₃-N), and phosphorus (TP) removal efficiencies were 88.9%, 90%, and 95%. Full article