A Sampling Train for Rapid Measurement of Regional Lung Deposition

ABSTRACT An experimental system for rapid measurement of regional lung deposition of Di-2-ethylhexyl sebacate (DEHS) aerosol particles was established in the present study. The principal goal was to identify the most relevant components of the sampling train and the proper instruments to be employed. After completing the search for an optimal sampling train and instruments, a human subject test was performed. Overall, the sampling train consisted of a mouthpiece, flow meter, and particle counter. The mouthpiece was attached to a Fleisch pneumotachograph. Several TSI condensation particle counters (CPCs), a PC-LabCard and a personal computer were employed to measure and record the counts of test particles at 100 Hz. A cylinder-piston breathing machine was built to generate a series of "standard" breathing patterns. For non-human subject tests, an acrylic tube, 5 cm diameter × 60 cm length, packed with a piece of 100 ppi foam disks was used as a substitute for the human respiratory tract. The optimal sampling train was determined to be a 1TH Fleisch pneumotachograph with a CPC model 3025A because of its short response time and low flow fluctuation. A healthy non-smoking man volunteered to be the subject, and was asked to follow breathing patterns generated by a cylinder-piston breathing machine. The local deposition efficiency was calculated for 1 μm DEHS particles of each 50 cm 3 volumetric region. The deposition data showed a good agreement with previous studies. Compared to the conventional bolus system, the advantage of the rapid measurement system developed in this work is its simplicity, low exposure, and high efficiency

Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial

Aims  The third Universal Definition of Myocardial Infarction (MI) Task Force classified MIs into five types: Type 1, spontaneous; Type 2, related to oxygen supply/demand imbalance; Type 3, fatal without ascertainment of cardiac biomarkers; Type 4, related to percutaneous coronary intervention; and Type 5, related to coronary artery bypass surgery. Low-density lipoprotein cholesterol (LDL-C) reduction with statins and proprotein convertase subtilisin–kexin Type 9 (PCSK9) inhibitors reduces risk of MI, but less is known about effects on types of MI. ODYSSEY OUTCOMES compared the PCSK9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome (ACS) and elevated LDL-C (≥1.8 mmol/L) despite intensive statin therapy. In a pre-specified analysis, we assessed the effects of alirocumab on types of MI. Methods and results  Median follow-up was 2.8 years. Myocardial infarction types were prospectively adjudicated and classified. Of 1860 total MIs, 1223 (65.8%) were adjudicated as Type 1, 386 (20.8%) as Type 2, and 244 (13.1%) as Type 4. Few events were Type 3 (n = 2) or Type 5 (n = 5). Alirocumab reduced first MIs [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.77–0.95; P = 0.003], with reductions in both Type 1 (HR 0.87, 95% CI 0.77–0.99; P = 0.032) and Type 2 (0.77, 0.61–0.97; P = 0.025), but not Type 4 MI. Conclusion  After ACS, alirocumab added to intensive statin therapy favourably impacted on Type 1 and 2 MIs. The data indicate for the first time that a lipid-lowering therapy can attenuate the risk of Type 2 MI. Low-density lipoprotein cholesterol reduction below levels achievable with statins is an effective preventive strategy for both MI types.For complete list of authors see http://dx.doi.org/10.1093/eurheartj/ehz299</p

Effect of alirocumab on mortality after acute coronary syndromes. An analysis of the ODYSSEY OUTCOMES randomized clinical trial

Background: Previous trials of PCSK9 (proprotein convertase subtilisin-kexin type 9) inhibitors demonstrated reductions in major adverse cardiovascular events, but not death. We assessed the effects of alirocumab on death after index acute coronary syndrome. Methods: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) was a double-blind, randomized comparison of alirocumab or placebo in 18 924 patients who had an ACS 1 to 12 months previously and elevated atherogenic lipoproteins despite intensive statin therapy. Alirocumab dose was blindly titrated to target achieved low-density lipoprotein cholesterol (LDL-C) between 25 and 50 mg/dL. We examined the effects of treatment on all-cause death and its components, cardiovascular and noncardiovascular death, with log-rank testing. Joint semiparametric models tested associations between nonfatal cardiovascular events and cardiovascular or noncardiovascular death. Results: Median follow-up was 2.8 years. Death occurred in 334 (3.5%) and 392 (4.1%) patients, respectively, in the alirocumab and placebo groups (hazard ratio [HR], 0.85; 95% CI, 0.73 to 0.98; P=0.03, nominal P value). This resulted from nonsignificantly fewer cardiovascular (240 [2.5%] vs 271 [2.9%]; HR, 0.88; 95% CI, 0.74 to 1.05; P=0.15) and noncardiovascular (94 [1.0%] vs 121 [1.3%]; HR, 0.77; 95% CI, 0.59 to 1.01; P=0.06) deaths with alirocumab. In a prespecified analysis of 8242 patients eligible for ≥3 years follow-up, alirocumab reduced death (HR, 0.78; 95% CI, 0.65 to 0.94; P=0.01). Patients with nonfatal cardiovascular events were at increased risk for cardiovascular and noncardiovascular deaths (P<0.0001 for the associations). Alirocumab reduced total nonfatal cardiovascular events (P<0.001) and thereby may have attenuated the number of cardiovascular and noncardiovascular deaths. A post hoc analysis found that, compared to patients with lower LDL-C, patients with baseline LDL-C ≥100 mg/dL (2.59 mmol/L) had a greater absolute risk of death and a larger mortality benefit from alirocumab (HR, 0.71; 95% CI, 0.56 to 0.90; Pinteraction=0.007). In the alirocumab group, all-cause death declined wit h achieved LDL-C at 4 months of treatment, to a level of approximately 30 mg/dL (adjusted P=0.017 for linear trend). Conclusions: Alirocumab added to intensive statin therapy has the potential to reduce death after acute coronary syndrome, particularly if treatment is maintained for ≥3 years, if baseline LDL-C is ≥100 mg/dL, or if achieved LDL-C is low. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01663402

Relationship between workplace violence and mental/physical health of security guards during the COVID-19 pandemic in Taiwan

ObjectivesTo investigate the relationship between workplace violence (WPV) and mental and physical health (MPH) of security guards during the COVID-19 pandemic in Taiwan.MethodsA cross-sectional survey was conducted in 15 representative security companies across northern, central, and southern Taiwan, and outlying islands from July 2021 to June 2022 during the COVID-19 pandemic. 1,200 questionnaires were distributed. A total of 1,032 valid questionnaires were collected.Results13.18% of the participants reported that they had experienced WPV during the COVID-19 pandemic, including physical violence (PhV), psychological violence (PsV), verbal violence (VV), and sexual harassment (SH). The most common violence was VV (54.19%), followed by PsV (20.69%). Community residents and property owners were the primary perpetrators, followed by strangers. The study showed that the security guards who had experienced WPV had higher scores on the 12-item Chinese Health Questionnaire (Taiwan version) (CHQ-12), indicating poorer MPH than those who had never experienced WPV. The result showed that VV had strong correlations with the lack of effective communication, dissatisfaction with treatment and service attitude, and work stress. PsV was strongly associated with excessive waiting times.ConclusionThere were correlations among PhV, VV, and PsV and they had adverse impacts on MPH, except for SH. The study found that the primary perpetrators of WPV against security guards were community residents and property owners. The causes were the lack of effective communication, dissatisfaction with treatment and service attitude, excessive waiting times, and work stress, which further led to turnover intention and poor MPH. The findings of this study have useful implications and it is recommended to enhance the understanding of workplace violence against security guards and to formulate appropriate local and international strategies to address it

Filter quality of electret masks in filtering 14.6–594 nm aerosol particles: Effects of five decontamination methods

<div><p>This study investigates the effects of five decontamination methods on the filter quality (<i>q</i>_<i>f</i>) of three commercially available electret masks—N95, Gauze and Spunlace nonwoven masks. Newly developed evaluation methods, the overall filter quality (<i>q</i>_{<i>f</i>,<i>o</i>}) and the <i>q</i>_<i>f</i> ratio were applied to evaluate the effectiveness of decontamination methods for respirators. A scanning mobility particle sizer is utilized to measure the concentration of polydispersed particles with diameter 14.6–594 nm. The penetration of particles and pressure drop (Δ<i>p</i>) through the mask are used to determine <i>q</i>_<i>f</i> and <i>q</i>_{<i>f</i>,<i>o</i>}. Experimental results reveal that the most penetrating particle size (MPS) for the pre-decontaminated N95, Gauze and Spunlace masks were 118 nm, 461 nm and 279 nm, respectively, and the respective penetration rates were 2.6%, 23.2% and 70.0%. The Δ<i>p</i> through the pretreated N95 masks was 9.2 mm H₂O at the breathing flow rate of heavy-duty workers, exceeding the Δ<i>p</i> values obtained through Gauze and Spunlace masks. Decontamination increased the sizes of the most penetrating particles, changing the <i>q</i>_<i>f</i> values of all of the masks: <i>q</i>_<i>f</i> fell as particle size increased because the penetration increased. Bleach increased the Δ<i>p</i> of N95, but destroyed the Gauze mask. However, the use of an autoclave reduces the Δ<i>p</i> values of both the N95 and the Gauze mask. Neither the rice cooker nor ethanol altered the Δ<i>p</i> of the Gauze mask. Chemical decontamination methods reduced the <i>q</i>_{<i>f</i>,<i>o</i>} values for the three electret masks. The value of <i>q</i>_{<i>f</i>,<i>o</i>} for PM_0.1 exceeded that for PM_0.1–0.6, because particles smaller than 100 nm had lower penetration, resulting in a better <i>q</i>_<i>f</i> for a given pressure drop. The values of <i>q</i>_{<i>f</i>,<i>o</i>}, particularly for PM_0.1, reveal that for the tested treatments and masks, physical decontamination methods are less destructive to the filter than chemical methods. Nevertheless, when purchasing new or reusing FFRs, penetration should be regarded as the priority.</p></div

Experimental setup.

<p>Experimental setup.</p

Le Monde

24 février 18721872/02/24 (A13,N47).Appartient à l’ensemble documentaire : BbLevt

Penetration of 75nm and 300nm particles through mask.

<p>* indicates <i>p</i><0.05.</p