Search Results (2,398)

ABG analysis is the gold standard for assessing acid–base balance, oxygenation, and ventilation in critically ill patients, but it is invasive and associated with patient discomfort and potential complications. Venous blood gas (VBG) analysis offers a less invasive alternative, although its clinical utility remains debated. This review evaluates the current evidence on VBG analysis, exploring its correlation with ABG, clinical applications, and limitations. Studies show a strong correlation between ABG and VBG for pH and a good correlation for bicarbonate and base excess in most cases, while the correlation for pCO₂ remains controversial. Predictably, pO₂ values differ significantly due to oxygen consumption gradients between the arterial and venous blood. VBG analysis is especially valuable for initial assessments, monitoring therapeutic responses, and guiding resuscitation in intensive care settings. It is not merely an alternative to ABG but a complementary tool that can provide unique insights, such as mixed venous oxygen saturation (SvO₂) or indices that require combined ABG and VBG data, like the pCO₂ gap. This review highlights the diagnostic equivalence of VBG in appropriate contexts and advocates for its use when arterial sampling is unnecessary or impractical. Furthermore, VBG analysis could enhance patient care by enabling the timely, less invasive assessment of hemodynamic and metabolic conditions. Future research should focus on refining interpretation algorithms and expanding the clinical applications of VBG to fully realize its potential in critical care practice. Full article

The production of thermal energy in buildings using internal greenhouses makes it possible to obtain substantial gains in energy consumption and, at the same time, contribute to improving occupants’ thermal comfort (TC) levels. This article proposes a study on the producing and transporting of renewable thermal energy in a circular auditorium equipped with an enveloping semi-circular greenhouse. The numerical study is based on software that simulates the building geometry and the building thermal response (BTR) numerical model and assesses the TC level and indoor air quality (IAQ) provided to occupants in spaces ventilated by the proposed system. The building considered in this study is a circular auditorium constructed from three semi-circular auditoriums supplied with internal semi-circular greenhouses. Each of the semi-circular auditoriums faces south, northeast, and northwest, respectively. The semi-circular auditoriums are occupied by 80 people each: the one facing south throughout the day, while the one facing northeast is only occupied in the morning, and the one facing northwest is only occupied in the afternoon. The south-facing semi-circular greenhouse is used by itself to heat all three semi-circular auditoriums. The other two semi-circular greenhouses are only used to heat the interior space of the greenhouse. It was considered that the building is located in a Mediterranean-type climate and subject to the typical characteristics of clear winter days. The results allow us to verify that the proposed heating system, in which the heat provided to the occupied spaces is generated only in the semi-circular greenhouse facing south, can guarantee acceptable TC conditions for the occupants throughout the occupancy cycle. Full article

Background: Osteogenesis imperfecta (OI) is a rare genetic connective tissue disorder characterized by bone fragility, most often caused by pathogenic variants in type I collagen genes. In this context, we aimed to describe the clinical and epidemiological characteristics of patients with OI who were hospitalized for coronavirus disease (COVID)-19 in Brazil between 2020 and 2024. Methods: We conducted a retrospective descriptive analysis using data from the Brazilian Unified Health System (SUS, which stands for the Portuguese Sistema Único de Saúde) through the Open-Data-SUS platform. Patients with a confirmed diagnosis of OI and hospitalization due to COVID-19 were included. Descriptive statistical analysis was performed to evaluate demographic, clinical, and outcome-related variables. We included all hospitalized COVID-19 cases with a confirmed diagnosis of OI between 2020 and 2024. Results: Thirteen hospitalized patients with OI and COVID-19 were identified. Most were adults (9; 69.2%), male (7; 53.8%), self-identified as White (9; 69.2%), and all were residents of urban areas (13; 100.0%). The most frequent symptoms were fever (10; 76.9%), cough (9; 69.2%), oxygen desaturation (9; 69.2%), dyspnea (8; 61.5%), and respiratory distress (7; 53.8%). Two patients had heart disease, one had chronic lung disease, and one was obese. As for vaccination status, five patients (38.5%) had been vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Four patients (30.8%) required admission to an intensive care unit (ICU), and six (46.2%) required noninvasive ventilatory support. Among those admitted to the ICU, only two required invasive mechanical ventilation. The clinical outcome was death in two cases (15.4%). Both patients were male, White, and had not been vaccinated against SARS-CoV-2. One was 47 years old, was not admitted to the ICU, but required noninvasive ventilation. Despite the underlying condition most patients had favorable outcomes, consistent with an international report. Conclusions: This is the first report to describe the clinical and epidemiological profile of patients with OI hospitalized for COVID-19 in Brazil, providing initial insights into how a rare bone disorder intersects with an acute respiratory infection. The generally favorable outcomes observed—despite the underlying skeletal fragility—suggest that individuals with OI are not necessarily at disproportionate risk of severe COVID-19, particularly when appropriately monitored. The occurrence of deaths only among unvaccinated patients underscores the critical role of SARS-CoV-2 vaccination in this population. Although pharmacological treatment data were unavailable, the potential protective effects of bisphosphonates and vitamin D merit further exploration. These findings support the need for early preventive strategies, systematic vaccination efforts, and dedicated clinical protocols for rare disease populations during infectious disease outbreaks. Full article

Molds readily grow on wet books, documents, and other library materials where they ruin them chemically, mechanically, and aesthetically. Poor maintenance of libraries, failures of Heating, Ventilation, and Air Conditioning (HVAC) systems, roof leaks, and storm damage leading to flooding can all result in accelerated fungal growth. Moreover, when fungal spores are present at high concentrations in the air, they can be linked to severe respiratory conditions and possibly to other adverse health effects in humans. Climate change and the accompanying storms and floods are making the dual potential of fungi to biodegrade library holdings and harm human health more common. This essay is intended for microbiologists without much background in mycology who are called in to help librarians who are dealing with mold outbreaks in libraries. Our goal is to demystify aspects of fungal taxonomy, morphology, and nomenclature while also recommending guidelines for minimizing mold contamination in library collections. Full article

This study provides a detailed dataset from two modern homes constructed inside an environmentally controlled chamber. These data are used to carefully calibrate a dynamic thermal simulation model of these homes. The calibrated models show good agreement with measurements taken under controlled conditions. The two case study homes, “The Future Home” and “eHome2”, were constructed within the University of Salford’s Energy House 2.0, and high-quality data were collected over eight days. The calibration process involved updating U-values, air permeability rates, and modelling refinements, such as roof ventilation, ground temperatures, and sub-floor void exchange rates, set as boundary conditions. Results demonstrated a high level of accuracy, with performance gaps in whole-house heat transfer coefficient reduced to 0.5% for “The Future Home” and 0.6% for “eHome2”, falling within aggregate heat loss test uncertainty ranges by a significant amount. The study highlights the improved accuracy of calibrated dynamic thermal simulation models, compared to results from the steady-state Standard Assessment Procedure model. By providing openly accessible calibrated models and a clearly defined methodology, this research presents valuable resources for future building performance modelling studies. The findings support the UK’s transition to dynamic modelling approaches proposed in the recently introduced Home Energy Model approach, contributing to improved prediction of energy efficiency and aligning with goals for zero carbon ready and sustainable housing development. Full article

The construction industry is one of the main areas of energy consumption and carbon emissions, and strengthening research on the thermal performance of building facades can effectively promote energy conservation and emission reduction. Compared with traditional static enclosure structures, dynamic skin can adapt its functions, characteristics, and methods based on constantly changing environmental conditions and performance requirements. It has great potential in adapting to the environment, reducing energy consumption, adjusting shading and natural ventilation, and improving human thermal and visual comfort. To comprehensively understand the key technologies of dynamic skin energy-saving design, previous research results were comprehensively compiled from relevant databases. The research results indicate that various types of dynamic skins, intelligent materials, multi-layer facades, dynamic shading, and biomimetic facades are commonly used core technologies for dynamic facades. Parametric modeling, computer simulation, and multi-objective algorithms are commonly used to optimize the performance of dynamic skin. In addition, integrated technology design, interaction design, and lifecycle design should be effective methods for improving dynamic skin energy efficiency, resident satisfaction, and economic benefits. Despite current challenges, dynamic skin energy-saving technology remains one of the most effective solutions for future sustainable building design. Full article

We surveyed the air quality conditions in 18 homes with gas stoves for PM_2.5, CO₂, NO₂ and CO using calibrated low-cost sensors. In each home, participants were asked to cook as usual, but to record their cooking activities and mitigation efforts (windows, ventilation fans, etc.). All homes showed enhanced pollutants during, and immediately after, times of cooking or stove use. For each home, we quantified the minutes per day and minutes per minute of cooking over known health thresholds for each pollutant. On average, homes exhibited 38 min per day over one or more of these thresholds, with PM_2.5 and NO₂ being the pollutants of greatest concern. Six homes had much higher occurrences over the health thresholds, averaging 73 min per day. We found an average of 1.0 min over one or more of the health thresholds per minute of cooking when no mitigation was used, whereas when mitigation was used (filtration or vent fan), this value was reduced by 34%. We further investigated several mitigation methods including natural diffusion, a commercial HEPA filter unit, a commercial O₃ scrubber and a ventilation fan. We found that the HEPA unit was highly effective for PM_2.5 but had no impact on any of the gaseous pollutants. The O₃ scrubber was moderately effective for NO₂ but had little impact on the other pollutants. The ventilation fan was highly effective for all pollutants and reduced the average pollutant lifetime significantly. Under controlled test conditions, the pollutant lifetime (or time to reach 37% of the original concentration), was reduced from an average of 45 min (with no ventilation) to 7 min. While no commercial filter showed efficacy for both PM_2.5 and NO₂, the fact that each could be removed individually suggests that a combined filter for both pollutants could be developed, which would significantly reduce health impacts in homes with gas stoves. Full article

Background and Objectives: Acute respiratory failure (ARF) represents an increasingly relevant clinical challenge in older subjects due to population aging and the high prevalence of cardiopulmonary comorbidities. Non-invasive ventilation (NIV), developed as continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP), has become a first-line treatment in various forms of ARF, including acute cardiogenic pulmonary oedema (ACPE) and acute exacerbations of COPD (AECOPD), offering several clinical advantages. In this context, the limited evidence on the efficacy of NIV in older patients leaves considerable uncertainty as to whether it constitutes a valid therapeutic option or represents medical futility in these patients. Materials and Methods: This narrative review explores the use of NIV and its outcomes in four key clinical scenarios in the elderly: ARF due to ACPE, AECOPD, community-acquired pneumonia (CAP), and palliative/end-of-life care. Results: Strong evidence supports NIV use with improved outcomes in ACPE and AECOPD, even in older populations. Conversely, data on its use in pneumonia are inconclusive, with potential harm if applied inappropriately. In palliative care, NIV can help relieve symptoms, but if not used appropriately, it may extend suffering. Conclusions: Age alone does not appear to be a sufficient factor to determine whether or not to use NIV; it becomes relevant only when considered in conjunction with the purpose of its use and the patient’s clinical history and condition. Data remain limited and often conflicting, particularly when investigating the elderly population and patients with a “do not intubate” (DNI) order. There is a need for additional research on these patients, focusing on long-term outcomes and quality of life. Full article

Unveiling temperature patterns within agricultural products remains the most important indicator for their quality assessment during post-harvest treatments. Temperature control and monitoring within vented packages is essential for preserving the quality of perishable goods, such as tomato fruits, by preventing localized temperature maxima that can accelerate spoilage. This study proposes a modeling and simulation approach to systematically investigate how ventilation design choices influence internal airflow distribution and the resulting cooling performance. Our analysis compares three distinct venting configurations (single top vent, single middle vent, and two vents) across two package boundary conditions: an open-top system allowing for dual air exits through the open top boundary and the outlet vent(s), respectively, and a closed-top system with a single exit pathway through the outlet vent(s). All scenarios are simulated to assess airflow patterns, velocity magnitudes, and temperature uniformity within different package designs. Full article

The construction sector presently consumes about 40% of global energy and generates 36% of CO₂ emissions, making facade retrofits a priority for decarbonising buildings. This review clarifies how ventilated facades (VFs), wall assemblies that interpose a ventilated air cavity between outer cladding and the insulated structure, address that challenge. First, the paper categorises VFs by structural configuration, ventilation strategy and functional control into four principal families: double-skin, rainscreen, hybrid/adaptive and active–passive systems, with further extensions such as BIPV, PCM and green-wall integrations that couple energy generation or storage with envelope performance. Heat-transfer analysis shows that the cavity interrupts conductive paths, promotes buoyancy- or wind-driven convection, and curtails radiative exchange. Key design parameters, including cavity depth, vent-area ratio, airflow velocity and surface emissivity, govern this balance, while hybrid ventilation offers the most excellent peak-load mitigation with modest energy input. A synthesis of simulation and field studies indicates that properly detailed VFs reduce envelope cooling loads by 20–55% across diverse climates and cut winter heating demand by 10–20% when vents are seasonally managed or coupled with heat-recovery devices. These thermal benefits translate into steadier interior surface temperatures, lower radiant asymmetry and fewer drafts, thereby expanding the hours occupants remain within comfort bands without mechanical conditioning. Climate-responsive guidance emerges in tropical and arid regions, favouring highly ventilated, low-absorptance cladding; temperate and continental zones gain from adaptive vents, movable insulation or PCM layers; multi-skin adaptive facades promise balanced year-round savings by re-configuring in real time. Overall, the review demonstrates that VFs constitute a versatile, passive-plus platform for low-carbon buildings, simultaneously enhancing energy efficiency, durability and indoor comfort. Future advances in smart controls, bio-based materials and integrated energy-recovery systems are poised to unlock further performance gains and accelerate the sector’s transition to net-zero. Emerging multifunctional materials such as phase-change composites, nanostructured coatings, and perovskite-integrated systems also show promise in enhancing facade adaptability and energy responsiveness. Full article

Particulate matter (PM), polycyclic aromatic hydrocarbons (PAHs), and heavy metals (HMs) present in polluted air are strongly associated with an increased risk of respiratory diseases. In our study, we grouped cities based on their pollution levels using a method called Ward’s cluster analysis and looked at the increased cancer risk from PM₁₀-bound harmful substances for adult men and women living in Polish cities. The analysis was based on data from 8 monitoring stations where concentrations of PM₁₀, PAHs, and HMs were measured simultaneously between 2018 and 2022. The cluster analysis made it possible to distinguish three separate agglomeration clusters: cluster I (Upper Silesia, Wroclaw) with the highest concentrations of heavy metals and PAHs, with mean levels of lead 14.97 ± 7.27 ng·m⁻³, arsenic 1.73 ± 0.60 ng·m⁻³, nickel 1.77 ± 0.95 ng·m⁻³, cadmium 0.49 ± 0.28 ng·m⁻³, and ∑PAHs 15.53 ± 6.44 ng·m⁻³, cluster II (Warsaw, Łódź, Lublin, Cracow) with dominant road traffic emissions and low emissions, with average levels of lead 8.00 ± 3.14 ng·m⁻³, arsenic 0.70 ± 0.17 ng·m⁻³, nickel 1.64 ± 0.96 ng·m⁻³, and cadmium 0.49 ± 0.28 ng·m⁻³, and cluster III (Szczecin, Tricity) with the lowest concentration levels with favourable ventilation conditions. All calculated ILCR values were in the range of 1.20 × 10⁻⁶ to 1.11 × 10⁻⁵, indicating a potential cancer risk associated with long-term exposure. The highest ILCR values were reached in Upper Silesia and Wroclaw (cluster I), and the lowest in Tricity, which was classified in cluster III. Our findings suggest that there are continued preventive actions and stricter air quality control. The results confirm that PM₁₀ is a significant carrier of airborne carcinogens and should remain a priority in both environmental and public health policy. Full article

Background: Brain injuries, including stroke and traumatic brain injury (TBI), pose a major healthcare challenge due to their severe consequences and complex recovery. While ischemic strokes are more common, hemorrhagic strokes have a worse prognosis. TBI often affects young adults and leads to long-term disability. A critical concern in these patients is the frequent development of chronic critical illness, compounded by metabolic disturbances and malnutrition that hinder recovery. Objective: This study aimed to compare changes in nutritional status parameters under standard enteral nutrition protocols and clinical outcomes in prolonged/chronic critically ill patients with TBI or stroke versus such a population of patients without TBI or stroke. Methods: This matched prospective–retrospective cohort study included intensive care unit (ICU) patients with TBI or stroke from the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology and patients without these conditions from the eICU-CRD database. Inclusion criteria comprised age 18–74 years, ICU stay >5 days, and enteral nutrition. Patients with re-hospitalization, diabetes, acute organ failure, or incomplete data were excluded. Laboratory values and clinical outcomes were compared between the two groups. Propensity score matching (PSM) was used to balance baseline characteristics (age, sex, and body mass index). Results: After PSM, 29 patients with TBI or stroke and 121 without were included. Univariate analysis showed significant differences in 21 laboratory parameters and three hospitalization outcomes. On day 1, the TBI/stroke group had higher hemoglobin, hematocrit, lymphocytes, total protein, and albumin, but lower blood urea nitrogen (BUN), creatinine, and glucose. By day 20, they had statistically significantly lower calcium, BUN, creatinine, and glucose. This group also showed less change in lymphocytes, calcium, and direct bilirubin. Hospitalization outcomes showed longer mechanical ventilation duration (p = 0.030) and fewer cases of acute kidney injury (p = 0.0220) in the TBI/stroke group. Conclusions: TBI and stroke patients exhibit unique metabolic patterns during prolonged/chronic critical illness, differing significantly from other ICU populations in protein/glucose metabolism and complication rates. These findings underscore the necessity for specialized nutritional strategies in neurocritical care and warrant further investigation into targeted metabolic interventions. Full article

This study presents the living coccolithophore communities and the morphological variability of Emiliania huxleyi in the South Aegean Sea from three sampling regions during winter-early spring (March 2017, March 2019) and summer (August 2019). Emphasis is given to March 2017 to monitor the variations in coccolithophore assemblages after an exceptionally cold event in December 2016, which resulted in newly produced dense waters that ventilated the Aegean deep basins. The assemblages displayed distinct seasonality with the predominance of E. huxleyi and Syracosphaera molischii during winter-early spring, associated with the water column mixing. By contrast, summer assemblages were featured by holococcolithophores and typical taxa of warm, oligotrophic upper waters. It seems that the phytoplanktonic succession as well as the nutrient supply to the upper euphotic layers were affected by the water column perturbation during the extreme winter of 2016–2017, which led to strong convective mixing and dense water formation. The decreased coccosphere densities during March 2017, accompanied by the notable presence of diatoms, were most probably associated with a prolonged diatom bloom, causing delay in the development of the coccolithophore community and resulting in a nitrogen-limited setting. Emiliania huxleyi morphometry showed the characteristic seasonal calcification trend of the Aegean, with the dominance of smaller coccoliths in the summer and increased coccolith length and width during the cold season. The intense cold conditions and wind-induced mixing during the winter of 2016–2017 possibly increased the absorption of atmospheric CO₂ in surface waters, causing increased acidity and the subsequent presence of etched/undercalcified E. huxleyi coccoliths and other taxa, most probably implying in situ calcite dissolution. Full article

Thermal simulations of buildings play a critical role in optimizing energy efficiency, thermal comfort, and heating, ventilation and air conditioning (HVAC) systems design. Accurate weather data is essential for reliable simulations, as local weather and climate have a significant impact on energy requirements for space heating and cooling and thermal comfort. This study conducted a literature review regarding the sources, types, and uncertainties of weather data used for thermal simulations of buildings, including typical meteorological years (TMYs) and extreme weather files under current and future climates. Additionally, this paper evaluates methods for weather data processing, including interpolation, downscaling, and synthetic generation, to improve simulation accuracy. Finally, approaches are proposed for constructing weather files for the future and extreme conditions under a changing climate. This review aims to provide a guide for researchers and practitioners to enhance the reliability of thermal modeling through informed construction, selection, and application of weather data. Full article

Background and Objectives: This study aims to identify risk factors associated with MDRO infections and assess their impact on patient outcomes in Egyptian ICUs. Materials and Methods: The widespread overuse of antimicrobials has led to antibiotic multidrug resistance, posing significant challenges in intensive care units (ICUs) and leading to increased morbidity, mortality, and healthcare costs. A prospective observational study was conducted over 12 months, including 113 adult patients admitted to the ICU with confirmed bacterial infections. Comprehensive medical assessments and routine investigations were performed, including multisource cultures based on clinical suspicion. Patient histories, underlying conditions, and disease progression were documented. Patients were classified into two groups: those infected with MDROs and those without MDRO infections. Results: Significant differences were observed between patients with and without MDRO infections regarding temperature, pH, PaO₂, HCO₃, serum creatinine levels, high-dose inotropes, and inotrope dependence (p-values: 0.01, 0.028, 0.036, 0.008, <0.001, 0.013, 0.029, 0.039, <0.001, and 0.003, respectively). Additionally, cerebrovascular stroke and renal failure were significantly more frequent in MDRO-infected patients (p-values: 0.048 and 0.007, respectively). MDROs accounted for 42% of infections. The most commonly detected MDRO was Klebsiella spp. (52%). Patients with MDRO infections showed significantly higher mortality (42.6%), increased incidence of ARDS, invasive ventilation, and longer ventilation durations. Independent risk factors included prior antibiotic use (OR: 3.2; 95% CI: 1.5–6.8) and invasive device presence (OR: 2.7; 95% CI: 1.2–5.9). Conclusions: Cerebrovascular stroke and renal failure appear to be risk factors for MDRO infections. MDRO infections in ICUs are associated with poor clinical outcomes and increased complications. Improved antimicrobial stewardship and targeted prevention strategies are urgently required. Full article