A Machine Learning Framework for Extending Wave Height Time Series Using Historical Wind Records

This study presents a novel machine learning-based framework that utilizes the ConvLSTM-1D model to extend the hindcast of wave height time series by leveraging historical wind records. This approach was applied to Lake Michigan by incorporating wind data from multiple Automatic Surface Observation Systems (ASOS) stations as input features. A wave height time series from the Wave Information System model (WIS) served as the training, validation, and testing dataset for the proposed model. Several models were developed, considering different numbers of wind stations, revealing the importance of incorporating stations with variable distances and orientations to enhance prediction accuracy. Notably, the improvement in the model performance plateaued after a certain number of stations, underscoring the importance of selecting an optimal number of wind stations. Additionally, an ensemble learning technique was employed to combine multiple models, resulting in further enhancements in prediction accuracy. The developed model added 30 years of wave height predictions to the existing time series, expanding it by 70% which allows insights into the long-term wave climatology of the Lake Michigan. This framework offers a promising avenue for utilizing historical wind records worldwide to extend wave height time series, in turn improving coastal resilience and coastal management plans

Impact of exposure of methicillin-resistant Staphylococcus aureus to polyhexanide in vitro and in vivo.

Staphylococcus aureus (MRSA) resistant to decolonization agents such as mupirocin and chlorhexidine increase the need to develop alternative decolonization molecules. The absence of reported adverse reactions and bacterial resistance to polyhexanide makes it an excellent choice as topical antiseptic. In the present study we evaluated the in vitro and in vivo capacity to generate strains with reduced polyhexanide susceptibility and cross-resistance with chlorhexidine and/or antibiotics currently used in clinic. Here we report the in vitro emergence of reduced-susceptibility to polyhexanide by prolonged-stepwise exposure to low concentrations in broth culture. Reduced susceptibility to polyhexanide was associated with genomic changes in the mprF and purR genes, and with concomitant decreased susceptibility to daptomycin and other cell-wall active antibiotics. However, the in vitro emergence of reduced-susceptibility to polyhexanide did not result in cross-resistance to chlorhexidine antiseptic. During in vivo polyhexanide clinical decolonization treatment, neither polyhexanide reduced-susceptibility nor chlorhexidine cross-resistance were observed. Together, these observations suggest that polyhexanide could be used safely for decolonisation of carriers of chlorhexidine-resistant S. aureus strains but highlight the need for careful use of polyhexanide at low antiseptic concentrations

Unveiling Significant Shoreline Changes in Lake Michigan After a Record-Setting Water Level Increase using High-Resolution Satellite Images

In this paper, high-resolution multispectral satellite images were used to uncover a remarkable shoreline transformation in Lake Michigan coastal areas, driven by a record-setting increase in the water level between 2013 and 2020. Shoreline change analyses were conducted for eleven different natural beaches around the lake, unveiling significant variations of shoreline retreat despite being affected by the same water level increase. The average observed shoreline retreats between 2013 and 2020 for the beaches ranged between 20 m and 62 m. When the passive inundation was excluded, the estimated morphological changes were found to differ significantly from site to site, with some locations experiencing minimal changes, while others encountered considerable morphological changes of up to 38m. The examination of the correlation between the morphological changes and ten hydrodynamic and morphological factors revealed strong correlations with the offshore slopes and beach width, with steeply sloping, wide beaches experiencing more erosion. Notably, wave power, longshore sediment transport divergence, and the number of storms exhibited moderate correlation with the observed morphological changes. The results of the shoreline changes and correlation analysis offer valuable insights into the varied effects of increased water levels on Lake Michigan beaches, including erosion and passive inundation, while shedding light on the key factors driving shoreline erosion in this context. These insights can help decision and policymakers in making informed choices regarding the protection and management of Lake Michigan coastal areas, particularly in anticipation of future incidents of water level increase

Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (VT) size was 500 ml, or 7 to 9 ml kg1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P < 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P < 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high VT and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Efavirenz inhibits the human ether-a-go-go related current (hERG) and induces QT interval prolongation in CYP2B6*6*6 allele carriers

Background Efavirenz (EFV) has been associated with torsade de pointes despite marginal QT interval lengthening. Since EFV is metabolized by the cytochrome P450 (CYP) 2B6 enzyme, we hypothesized that EFV would lengthen the rate-corrected QT (QTcF) interval in carriers of the CYP2B6*6 decreased functional allele. Objective The primary objective of this study was to evaluate EFV-associated QT interval changes with regard to CYP2B6 genotype and to explore mechanisms of QT interval lengthening. Methods EFV was administered to healthy volunteers (n=57) as a single 600 mg dose followed by multiple doses to steady-state. Subjects were genotyped for known CYP2B6 alleles and ECGs and EFV plasma concentrations were obtained serially. Whole-cell, voltage-clamp experiments were performed on cells stably expressing hERG and exposed to EFV in the presence and absence of CYP2B6 expression. Results EFV demonstrated a gene-dose effect and exceeded the FDA criteria for QTcF interval prolongation in CYP2B6*6/*6 carriers. The largest mean time-matched differences ΔΔQTcF were observed at 6 hrs (14 ms; 95% CI [1; 27]), 12 hrs (18 ms; 95% CI [−4; 40] and 18 hrs (6 ms; 95% CI [−1; 14]) in the CYP2B6*6/*6 genotype. EFV concentrations exceeding 0.4 µg/mL significantly inhibited outward hERG tail currents (P<0.05). Conclusions This study demonstrates that homozygous carriers of CYP2B6*6 allele may be at increased risk for EFV-induced QTcF interval prolongation via inhibition of hERG

Enhanced control of self-doping in halide perovskites for improved thermoelectric performance

Metal halide perovskites have emerged as promising photovoltaic materials, but, despite ultralow thermal conductivity, progress on developing them for thermoelectrics has been limited. Here, we report the thermoelectric properties of all-inorganic tin based perovskites with enhanced air stability. Fine tuning the thermoelectric properties of the films is achieved by self-doping through the oxidation of tin (ΙΙ) to tin (ΙV) in a thin surface-layer that transfers charge to the bulk. This separates the doping defects from the transport region, enabling enhanced electrical conductivity. We show that this arises due to a chlorine-rich surface layer that acts simultaneously as the source of free charges and a sacrificial layer protecting the bulk from oxidation. Moreover, we achieve a figure-of-merit (ZT) of 0.14 ± 0.01 when chlorine-doping and degree of the oxidation are optimised in tandem

Cairo's Urban Transformation: Mohandeseen and Zamalek Narratives

Im Gegensatz zu anderen Großstädten der Welt hat Kairo im Laufe seiner langen Geschichte einen bedeutenden Wandel durchlaufen. Während einige Elemente der Vergangenheit noch sichtbar sind, allen voran die Pyramiden von Gizeh, sind andere Elemente längst verschwunden. Es ist schwer vorstellbar, dass das historische Kairo einst das Zentrum einer fruchtbaren, von Seen durchzogenen Landschaft war, vor allem wenn man mit den heutigen Realitäten einer dichten, meist grauen Stadtlandschaft konfrontiert wird, die von einer dünnen Staubschicht und einer Vielzahl von Umweltproblemen bedeckt ist. Kairo ist die größte Mega-Stadt auf dem afrikanischen Kontinent und verändert sich weiterhin schnell, sowohl formal als auch informell. Um die Transformation Kairos zu steuern und die informelle Entwicklung auf dem verbleibenden fruchtbaren Land einzuschränken, werden neue staatlich finanzierte Wüstenstädte geplant, gebaut und bewohnt. Gleichzeitig haben massive Hochhäuser die einst charakteristischen großen, wohlhabenden Villensiedlungen in regulär entwickelten Kernstadtgebieten wie Zamalek und Mohandeseen ersetzt. In Zamalek hat sich diese Transformation dazu geführt, dass sich viele Bürger der Oberschicht in die Wüstenstädte zurückziehen und Spuren des Verfalls hinterlassen, während Mohandeseen zu einem der teuersten Gebiete in Kairo geworden ist, das fast keine Spuren des Garden City-Konzepts hinterlässt, das seine frühe Entwicklung bestimmt hat. Während viel Aufmerksamkeit auf die Erweiterung und Verbesserung informeller Gebiete und die Schaffung neuer Wüstenstädte gerichtet wird, ist es auch wichtig, aus der Vergangenheit zu lernen und die zukünftige Transformation von Kernstadtgebieten wie Mohandeseen und Zamalek zu steuern. Im Folgenden wird die Transformation ausgewählter Gebiete in Monhandeseen um die Libanon Street und den Assuan Square sowie um Zamalek im Norden des Gezira Sporting Club untersucht.Not unlike other major cities around the world, Cairo has undergone a significant transformation over the course of its long history. While some elements of the past are still visible, the most notable being the Pyramids of Giza, other elements have long since disappeared. It is hard to imagine that historic Cairo was once at the center of a fertile landscape dotted with lakes, especially when confronted with today’s realities of a dense mostly gray cityscape covered by a thin layer of dust and a host of environmental problems. Cairo is the largest mega-city on the African continent and it continues to transform rapidly, both formally and informally. In an effort to guide Cairo’s transformation and limit informal development on its remaining fertile land, new state funded desert cities are being planned, built and inhabited. At the same time, massive tower blocks have replaced the once characteristic large prosperous villa estates within formally developed core-city areas such as Zamalek and Mohandeseen. In Zamalek this transformation has caused many upper class residents to withdraw to the desert cities leaving behind signs of decay, while Mohandeseen has become one of the most expensive areas in Cairo leaving almost no trace of the Garden City concept which guided its early development. While much needed attention goes to the expansion and improvement of informal areas and to the creation of new desert cities, it is also important to learn from the past as well as to guide the future transformation of core-city areas such as Mohandeseen and Zamalek. The following investigates the transformation of select areas of Mohandeseen around Lebanon Street and Aswan Square in addition to Zamalek to the north of the Gezira Sporting Club

Manufacture Techniques of Chitosan-Based Microcapsules to Enhance Functional Properties of Textiles

In recent years, the textile industry has been moving to novel concepts of products, which could deliver to the user, improved performances. Such smart textiles have been proven to have the potential to integrate within a commodity garment advanced feature and functional properties of different kinds. Among those functionalities, considerable interest has been played in functionalizing commodity garments in order to make them positively interact with the human body and therefore being beneficial to the user health. This kind of functionalization generally exploits biopolymers, a class of materials that possess peculiar properties such as biocompatibility and biodegradability that make them suitable for bio-functional textile production. In the context of biopolymer chitosan has been proved to be an excellent potential candidate for this kind of application given its abundant availability and its chemical properties that it positively interacts with biological tissue. Notwithstanding the high potential of chitosan-based technologies in the textile sectors, several issues limit the large-scale production of such innovative garments. In facts the morphologies of chitosan structures should be optimized in order to make them better exploit the biological activity; moreover a suitable process for the application of chitosan structures to the textile must be designed. The application process should indeed not only allow an effective and durable fixation of chitosan to textile but also comply with environmental rules concerning pollution emission and utilization of harmful substances. This chapter reviews the use of microencapsulation technique as an approach to effectively apply chitosan to the textile material while overcoming the significant limitations of finishing processes. The assembly of chitosan macromolecules into microcapsules was proved to boost the biological properties of the polymer thanks to a considerable increase in the surface area available for interactions with the living tissues. Moreover, the incorporation of different active substances into chitosan shells allows the design of multifunctional materials that effectively combine core and shell properties. Based on the kind of substances to be incorporated, several encapsulation processes have been developed. The literature evidences how the proper choices concerning encapsulation technology, chemical formulations, and process parameter allow tuning the properties and the performances of the obtained microcapsules. Furthermore, the microcapsules based finishing process have been reviewed evidencing how the microcapsules morphology can positively interact with textile substrate allowing an improvement in the durability of the treatment. The application of the chitosan shelled microcapsules was proved to be capable of imparting different functionalities to textile substrates opening possibilities for a new generation of garments with improved performances and with the potential of protecting the user from multiple harms. Lastly, a continuous interest was observed in improving the process and formulation design in order to avoid the usage of toxic substances, therefore, complying with an environmentally friendly approach

Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS study

BACKGROUND: Limited information is available regarding intraoperative ventilator settings and the incidence of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgical procedures. The aim of this post-hoc analysis of the 'Multicentre Local ASsessment of VEntilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study was to examine the ventilator settings of patients undergoing neurosurgical procedures, and to explore the association between perioperative variables and the development of PPCs in neurosurgical patients. METHODS: Post-hoc analysis of LAS VEGAS study, restricted to patients undergoing neurosurgery. Patients were stratified into groups based on the type of surgery (brain and spine), the occurrence of PPCs and the assess respiratory risk in surgical patients in Catalonia (ARISCAT) score risk for PPCs. RESULTS: Seven hundred eighty-four patients were included in the analysis; 408 patients (52%) underwent spine surgery and 376 patients (48%) brain surgery. Median tidal volume (VT) was 8 ml [Interquartile Range, IQR = 7.3-9] per predicted body weight; median positive end-expiratory pressure (PEEP) was 5 [3 to 5] cmH20. Planned recruitment manoeuvres were used in the 6.9% of patients. No differences in ventilator settings were found among the sub-groups. PPCs occurred in 81 patients (10.3%). Duration of anaesthesia (odds ratio, 1.295 [95% confidence interval 1.067 to 1.572]; p = 0.009) and higher age for the brain group (odds ratio, 0.000 [0.000 to 0.189]; p = 0.031), but not intraoperative ventilator settings were independently associated with development of PPCs. CONCLUSIONS: Neurosurgical patients are ventilated with low VT and low PEEP, while recruitment manoeuvres are seldom applied. Intraoperative ventilator settings are not associated with PPCs