Review of 14 drowning publications based on the Utstein style for drowning

Abstract Background The Utstein style for drowning (USFD) was published in 2003 with the aim of improving drowning research. To support a revision of the USFD, the current study aimed to generate an inventory of the use of the USFD parameters and compare the findings of the publications that have used the USFD. Methods A search in Pubmed, Embase, the Cochrane Library, Web of Science and Scopus was performed to identify studies that used the USFD and were published between 01-10-2003 and 22-03-2015. We also searched in Pubmed, Embase, the Cochrane Library, Web of Science, and Scopus for all publications that cited the two publications containing the original ILCOR advisory statement introducing and recommending the USFD. In total we identified 14 publications by groups that explicitly used elements of the USFD for collecting and reporting their data. Results Of the 22 core and 19 supplemental USFD parameters, 6–19 core (27–86%) and 1–12 (5–63%) supplemental parameters were used; two parameters (5%) have not been used in any publication. Associations with outcome were reported for nine core (41%) and five supplemental (26%) USFD parameters. The USFD publications also identified non-USFD parameters related to outcome: initial cardiac rhythm, time points and intervals during resuscitation, intubation at the drowning scene, first hospital core temperature, serum glucose and potassium, the use of inotropic/vasoactive agents and the Paediatric Index of Mortality 2-score. Conclusions Fourteen USFD based drowning publications have been identified. These publications provide valuable information about the process and quality of drowning resuscitation and confirm that the USFD is helpful for a structured comparison of the outcome of drowning resuscitation

Shear induced carboplatin binding within the cavity of a phospholipid mimic for increased anticancer efficacy

Vesicles 107 ± 19 nm in diameter, based on the self-assembly of tetra-para-phosphonomethyl calix[4]-arene bearing n-hexyl moieties attached to the phenolic oxygen centres, are effective in binding carboplatin within the cavity of the macrocycle under shear induced within a dynamic thin film in a continuous flow vortex fluidic device. Post shearing the vesicles maintain similar diameters and retain carboplatin within the cavity of the calixarene in a hierarchical structure, with their size and morphology investigated using DLS, TEM, SEM and AFM. Location of the carboplatin was confirmed using NMR, FTIR, ESI-MS and EFTEM, with molecular modelling favouring the polar groups of carboplatin hydrogen bonded to phosphonic acid moieties and the four member cyclobutane ring directed into the cavity of the calixarene. The loading efficiency and release profile of carboplatin was investigated using LC-TOF/MS, with the high loading of the drug achieved under shear and preferential released at pH 5.5, offering scope for anti-cancer drug delivery. The hierarchical structured vesicles increase the efficacy of carboplatin by 4.5 fold on ovarian cancer cells, lowered the IC<inf>50</inf> concentration by 10 fold, and markedly increased the percent of cells in the S-phase (DNA replication) of the cell cycle

Chemokine Production by G Protein-Coupled Receptor Activation in a Human Mast Cell Line: Roles of Extracellular Signal-Regulated Kinase and NFAT

Chemoattractants are thought to be the first mediators generated at sites of bacterial infection. We hypothesized that signaling through G protein-coupled chemoattractant receptors may stimulate cytokine production. To test this hypothesis, a human mast cell line (HMC-1) that normally expresses receptors for complement components C3a and C5a at low levels was stably transfected to express physiologic levels of fMLP receptors. We found that fMLP, but not C3a or C5a, induced macrophage inflammatory protein (MIP)-1β (CCL4) and monocyte chemoattractant protein-1 (CCL2) mRNA and protein. Although fMLP stimulated both sustained Ca2+ mobilization and phosphorylation of extracellular signal-regulated kinase (ERK), these responses to C3a or C5a were transient. However, transient expression of C3a receptors in HMC-1 cells rendered the cells responsive to C3a for sustained Ca2+ mobilization and MIP-1β production. The fMLP-induced chemokine production was blocked by pertussis toxin, PD98059, and cyclosporin A, which respectively inhibit G(iα) activation, mitgen-activated protein kinase kinase-mediated ERK phosphorylation, and calcineurin-mediated activation of NFAT. Furthermore, fMLP, but not C5a, stimulated NFAT activation in HMC-1 cells. These data indicate that chemoattractant receptors induce chemokine production in HMC-1 cells with a selectivity that depends on the level of receptor expression, the length of their signaling time, and the synergistic interaction of multiple signaling pathways, including extracellular signal-regulated kinase phosphorylation, sustained Ca2+ mobilization and NFAT activation

Inclusive banking, financial regulation and bank performance: cross-country evidence

This paper investigates whether inclusive banking can boost bank-level performance, using an international sample of 1,740 banks over the period 2004-2015. We find that there is a significant positive association between financial inclusion and bank efficiency. Greater financial inclusion helps banks in reducing the volatility of their deposit-funding share as it provides more stable long-term funds for banks, while also mitigating the adverse effects of their return volatility. The association is stronger in countries with limited restrictions on banking activities or more capital regulation stringency as the deposit channel enables greater flow of low-cost funds for high-return investments. The results are robust to instrumental variable analysis, multiple dimensions of financial inclusion (supply, demand, and pro-access policy), and a difference-in-differences estimator that exploits cross-country and temporal variations in actively promoting an inclusive agenda, further confirming that inclusive financial development can be beneficial for banks

Impact of nurse-led, multidisciplinary home-based intervention on event-free survival across the spectrum of chronic heart disease

Background: We sought to determine the overall impact of a nurse-led, multidisciplinary home-based intervention (HBI) adapted to hospitalized patients with chronic forms of heart disease of varying types. Methods and Results: Prospectively planned, combined, secondary analysis of 3 randomized trials (1226 patients) of HBI were compared with standard management. Hospitalized patients presenting with heart disease but not heart failure, atrial fibrillation but not heart failure, and heart failure, as well, were recruited. Overall, 612 and 614 patients, respectively, were allocated to a home visit 7 to 14 days postdischarge by a cardiac nurse with follow-up and multidisciplinary support according to clinical need or standard management. The primary outcome of days-alive and out-of-hospital was examined on an intention-to-treat basis. During 1371 days (interquartile range, 1112-1605) of follow-up, 218 patients died and 17 917 days of hospital stay were recorded. In comparison with standard management, HBI patients achieved significantly prolonged event-free survival (90.1% [95% confidence interval, 88.2-92.0] versus 87.2% [95% confidence interval, 85.1-89.3] days-alive and out-of-hospital; P=0.020). This reflected less all-cause mortality (adjusted hazard ratio, 0.67; 95% confidence interval, 0.50-0.88; P=0.005) and unplanned hospital stay (median, 0.22 [interquartile range, 0-1.3] versus 0.36 [0-2.1] days/100 days follow-up; P=0.011). Analyses of the differential impact of HBI on all-cause mortality showed significant interactions (characterized by U-shaped relationships) with age (P=0.005) and comorbidity (P=0.041); HBI was most effective for those aged 60 to 82 years (59%-65% of individual trial cohorts) and with a Charlson Comorbidity Index Score of 5 to 8 (36%-61%).Conclusions: These data provide further support for the application of postdischarge HBI across the full spectrum of patients being hospitalized for chronic forms of heart disease.Simon Stewart, Joshua F. Wiley, Jocasta Ball, Yih-Kai Chan, Yasmin Ahamed, David R. Thompson, Melinda J. Carringto

Impacts of Dietary Lysine and Crude Protein on Performance, Hepatic and Renal Functions, Biochemical Parameters, and Histomorphology of Small Intestine, Liver, and Kidney in Broiler Chickens

The present study aimed to investigate the effects of increasing dietary lysine (Lys) levels with an adequate dietary crude protein (CP) content, as well as the effects of a reduction in dietary CP content with the recommended amino acid (AAs) level, on the performance, blood biochemical parameters, and histomorphology of the duodenum, liver, and kidney in broiler chickens. A total of 500 broiler chickens were randomly distributed into five dietary treatment groups, following a completely randomized design, where, at the beginning, the control group (C) was fed a diet containing the standard CP and Lys levels: 23% CP with 1.44% Lys during the starter period; 21.5% CP with 1.29% Lys during the growing period; and 19.5% CP with 1.16% Lys during the finishing period. The Lys content was increased by 10% above the recommended control basal requirements in the second group (Gr1) and by 20% in the third group (Gr2), while using the same recommended CP percentage as the C group. The fourth group (Gr3) had a 1% lower CP content and the fifth group had a 2% lower CP content than the C group, with the same recommended AA level as the C group. Increasing the Lys content in the Gr1 group improved the broilers’ weight gains (p \u3c 0.05) during the starter, growing, and finishing periods. Decreasing dietary CP with the standard AA levels (Gr3 and Gr4) did not significantly affect (p \u3e 0.05) the live weight gain, feed intake, or feed conversion ratio (FCR) of the broilers compared with those fed with the C diet. Blood total bilirubin, direct and indirect bilirubin, triglycerides, cholesterol, low-density lipoprotein (LDL), and very LDL were not different among the experimental groups. However, blood aspartate aminotransferase levels were increased (p \u3c 0.05) in the Gr1 and Gr3 groups compared with the other treatment groups. All dietary treatments decreased the serum creatinine levels (p \u3c 0.05) compared with the C group. The Gr2 broilers had greater serum total protein and globulin (p \u3c 0.05) than those receiving the other treatments. Increasing dietary Lys levels resulted in a significant improvement in duodenum villus height and width (p \u3c 0.05), while the low-CP diets resulted in shorter villi length and width, along with degenerated areas and lymphocytic infiltration. Low dietary CP content induced hepatocyte disorganization and moderate degeneration, along with vacuolated hepatic cells, excessive connective tissue, and lymphocytic infiltration. The cortical regions of the kidney exhibited obvious alterations in the Gr3 and Gr4 groups and large interstitial spaces were found between tubules. Renal tubules in the Gr3 and Gr4 groups were smaller in size and some of these tubules were atrophied. In conclusion, reducing dietary CP levels to 1% or 2% lower than the recommended level did not negatively affect growth performance, inducing minimal influence on the blood metabolic indicators of health status, and resulting in moderate alterations to the histomorphology of the duodenum, liver, and kidney. Furthermore, increasing the Lys content by 10% above the recommended level improved the growth performance, health status, and histomorphology of the duodenum, liver, and kidney in broiler chickens

Multiplex plasma protein assays as a diagnostic tool for lung cancer

Lack of the established noninvasive diagnostic biomarkers causes delay in diagnosis of lung cancer (LC). The aim of this study was to explore the association between inflammatory and cancer‐associated plasma proteins and LC and thereby discover potential biomarkers. Patients referred for suspected LC and later diagnosed with primary LC, other cancers, or no cancer (NC) were included in this study. Demographic information and plasma samples were collected, and diagnostic information was later retrieved from medical records. Relative quantification of 92 plasma proteins was carried out using the Olink Immuno‐Onc‐I panel. Association between expression levels of panel of proteins with different diagnoses was assessed using generalized linear model (GLM) with the binomial family and a logit‐link function, considering confounder effects of age, gender, smoking, and pulmonary diseases. The analysis showed that the combination of five plasma proteins (CD83, GZMA, GZMB, CD8A, and MMP12) has higher diagnostic performance for primary LC in both early and advanced stages compared with NC. This panel demonstrated lower diagnostic performance for other cancer types. Moreover, inclusion of four proteins (GAL9, PDCD1, CD4, and HO1) to the aforementioned panel significantly increased the diagnostic performance for primary LC in advanced stage as well as for other cancers. Consequently, the collective expression profiles of select plasma proteins, especially when analyzed in conjunction, might have the potential to distinguish individuals with LC from NC. This suggests their utility as predictive biomarkers for identification of LC patients. The synergistic application of these proteins as biomarkers could pave the way for the development of diagnostic tools for early‐stage LC detection

Comparative Assessment of sCO2 Cycles, Optimal ORC, and Thermoelectric Generators for Exhaust Waste Heat Recovery Applications from Heavy-Duty Diesel Engines

Data Availability Statement: Data available on request due to privacy.Copyright © 2023 by the authors. This study aimed to investigate the potential of supercritical carbon dioxide (sCO2), organic Rankine cycle (ORC), and thermoelectric generator (TEG) systems for application in automotive exhaust waste heat recovery (WHR) applications. More specifically, this paper focuses on heavy-duty diesel engines applications such as marine, trucks, and locomotives. The results of the simulations show that sCO2 systems are capable of recovering the highest amount of power from exhaust gases, followed by ORC systems. The sCO2 system recovered 19.5 kW at the point of maximum brake power and 10.1 kW at the point of maximum torque. Similarly, the ORC system recovered 14.7 kW at the point of maximum brake power and 7.9 kW at the point of maximum torque. Furthermore, at a point of low power and torque, the sCO2 system recovered 4.2 kW of power and the ORC system recovered 3.3 kW. The TEG system produced significantly less power (533 W at maximum brake power, 126 W at maximum torque, and 7 W at low power and torque) at all three points of interest due to the low system efficiency in comparison to sCO2 and ORC systems. From the results, it can be concluded that sCO2 and ORC systems have the biggest potential impact in exhaust WHR applications provided the availability of heat and that their level of complexity does not become prohibitive.This research received no external funding