Drug-free tracheal intubation by specialist paramedics (critical care) in a United Kingdom ambulance service: a service evaluation.

BACKGROUND: Drug-free tracheal intubation has been a common intervention in the context of out-of-hospital cardiac arrest for many years, however its use by paramedics has recently been the subject of much debate. Recent international guidance has recommended that only those achieving high tracheal intubation success should continue to use it. METHODS: We conducted a retrospective service evaluation of all drug-free tracheal intubation attempts by specialist paramedics (critical care) from South East Coast Ambulance Service NHS Foundation Trust between 1st January and 31st December 2019. Our primary outcome was first-pass success rate, and secondary outcomes were success within two attempts, overall success, Cormack-Lehane grade of view, and use of bougie. RESULTS: There were 663 drug-free tracheal intubations and following screening, 605 were reviewed. There was a first-pass success rate of 81.5%, success within two attempts of 96.7%, and an overall success rate of 98.35%. There were ten unsuccessful attempts (1.65%). Bougie use was documented in 83.4% on the first attempt, 93.5% on the second attempt and 100% on the third attempt, CONCLUSION: Specialist paramedics (critical care) are able to deliver drug-free tracheal intubation with good first-pass success and high overall success and are therefore both safe and competent at this intervention.

A multi-university assessment of patient safety competence during clinical training among baccalaureate nursing students: A cross-sectional study.

AIMS AND OBJECTIVES: To assess the perceived patient safety competence during clinical training of Saudi nursing students. BACKGROUND: Ensuring safety in healthcare settings requires improvements in the educational and clinical practice of professionals. Experts stressed that shared patient safety culture must be of primary importance; they also emphasised the resolute need for theoretically driven research approaches for patient safety competence in healthcare organisations and educational institutions. DESIGN: Descriptive, cross-sectional design. METHODS: This study was conducted in six government universities in Saudi Arabia. A sample of 829 nursing students was surveyed using the health professional education in patient safety survey. Descriptive and inferential statistics were used to analyse the data. The study adhered to the STROBE guideline for cross-sectional studies (See Supporting Information Appendix S1). RESULTS: The percentage of agreement on the items of the health professional education in patient safety survey ranged from 61.5%-76.5%. The dimension "understanding human and environmental factors" received the highest perceived competence, whereas the dimension "working in teams" received the lowest competence. Significant differences in students' patient safety competence from different universities were reported. Male students perceived their competence in "working in teams" higher than the female students. Students in their internship year had significantly higher levels of competence in all the six dimensions of the health professional education in patient safety survey than students in the third- and fourth-year levels. CONCLUSIONS: Saudi nursing students have positive perceptions towards their patient safety competencies. Significant differences were found in the patient safety competence of nursing students between universities, gender and year of study. RELEVANCE TO CLINICAL PRACTICE: The results provide valuable insights and guidance for improving the patient safety competence of nursing students. The findings can be used to guide the creation of policies and interventions that may ensure the continuous development of patient safety competence of nursing students as they navigate the clinical area.

Factors Influencing Arab Nursing Students' Attitudes toward Climate Change and Environmental Sustainability and their Inclusion in Nursing Curricula.

OBJECTIVE: To assess the factors influencing the attitudes of Bachelor of Science in Nursing students toward climate change and environmental sustainability and the inclusion of these concepts in the nursing curricula of four Arab countries. METHOD: A convenience sample of 1,059 students from four Arab countries was surveyed using the Environmental Sustainability Attitudes in Nursing Survey-2 (SANS-2) questionnaire in this descriptive-comparative study. RESULTS: The majority of the respondents exhibited positive attitudes toward the five items of SANS-2, with "Environmental sustainability is an important issue for nursing" receiving the lowest mean score and "Issues about climate change should be included in the nursing curriculum" receiving the highest mean score. Saudi students had more positive attitudes toward environmental sustainability in health care compared with students from Iraq, Egypt, and the Palestinian Territories. Country of residence, type of community, and knowledge about environmental issues and their impact on health in any nursing course were significant factors that influenced attitudes toward environmental sustainability. CONCLUSION: The inclusion of climate change and environmental sustainability in nursing curricula in the Arab region was emphasized by the findings. Including environmental sustainability practices in nursing education will help student nurses develop critical thinking and skills in the adaptive delivery of health care, especially when resources are scarce.

The mechanism of the dielectric relaxation in water.

Although relating to the same system, the interpretations of the water spectra from Raman and Dielectric spectroscopy present independent pictures of the nature of water. We show that in the overlap region of the two methods it is possible to combine these views into a coherent concept of what drives the dynamic features of water. In this work, we develop the idea that the dielectric relaxation in water is driven by the migration of defects through the H-bond network, leading to a Debye-like peak in the lower frequencies. The deviation from the Debye law in the higher sub-THz frequencies is traced to a global fluctuation of the same H-bond network, clearly evident in the Raman Spectra. By incorporating these two views, a mathematical formalism is presented that can aptly explicate the dielectric spectra of liquid water.

Stener-like lesion of the lateral meniscus in the setting of a multiligamentous knee injury: A case report.

Traumatic dislocations of the knee can result in significant soft tissue damage including multiligamentous and meniscal knee injury. When a meniscal tear involves the posterior horn, the meniscus loses one of its attachments to the tibia and can become extruded from the joint. Stener-like lesions of the knee have been reported throughout the literature; however, they have been exclusively described as a distal tear of the medial collateral ligament (MCL) lying superficial to the pes anserine tendon which prevents anatomic healing. The purpose of this report is to present a previously unreported unique variant of a lateral meniscus tear in the setting of a MLKI. In this case presentation, the lateral meniscus became extruded superficial to the intact lateral collateral ligament (LCL) resulting in a Stener-like lesion. Corrective recognition of lesions like these and timely surgical intervention is recommended to restore native anatomy and prevent chronic pain, instability, and premature degenerative disease. Level IV, Case report.

Phyto-Photodynamic Therapy of Prostate Cancer Cells Mediated by Yemenite 'Etrog' Leave Extracts.

Cancer therapy, from malignant tumor inhibition to cellular eradication treatment, remains a challenge, especially regarding reduced side effects and low energy consumption during treatment. Hence, phytochemicals as cytotoxic sensitizers or photosensitizers deserve special attention. The dark and photo-response of Yemenite 'Etrog' leaf extracts applied to prostate PC3 cancer cells is reported here. An XTT cell viability assay along with light microscope observations revealed pronounced cytotoxic activity of the extract for long exposure times of 72 h upon concentrations of 175 µg/mL and 87.5 µg/mL, while phototoxic effect was obtained even at low concentration of 10.93 µg/mL and a short introduction period of 1.5 h. For the longest time incubation of 72 h and for the highest extract concentration of 175 µg/mL, relative cell survival decreased by up to 60% (below the IC50). In combined phyto-photodynamic therapy, a reduction of 63% compared to unirradiated controls was obtained. The concentration of extract in cells versus the accumulation time was inversely related to fluorescence emission intensity readings. Extracellular ROS production was also shown. Based on an ATR-FTIR analysis of the powdered leaves and their liquid ethanolic extract, biochemical fingerprints of both polar and non-polar phyto-constituents were identified, thereby suggesting their implementation as phyto-medicine and phyto-photomedicine.

Dielectric relaxation in weakly ergodic dilute dipole systems.

We introduce a method for calculating dipole correlations in systems containing hopping processes exhibiting weak ergodicity breaking. Modeled after the original Kirkwood-Fröhlich theory, the new method provides a bridge extending Fröhlich's insights from the realm of rigid dipoles into weakly non-ergodic fluctuating virtual dipolar entities. Relevant for the investigation of any system containing transport processes, it provides a testable parameter derived primarily from the static dielectric parameters. Three examples of systems including porous silicon, porous glass, and ferroelectric crystals are brought to demonstrate the model's versatility, including direct confirmation of Fröhlich's original idea.

Association of single nucleotide polymorphisms with dyslipidemia and risk of metabolic disorders in the State of Qatar.

BACKGROUND: Dyslipidemia is recognized as one of the risk factors of cardiovascular diseases (CVDs), type 2 diabetes mellitus (T2DM), and non-alcoholic fatty liver disease (NAFLD). OBJECTIVE: The study aimed to investigate the association between selected single nucleotide polymorphisms (SNPs) with dyslipidemia and increased susceptibility risks of CVD, NAFLD, and/or T2DM in dyslipidemia patients in comparison with healthy control individuals from the Qatar genome project. METHODS: A community-based cross-sectional study was conducted among 2933 adults (859 dyslipidemia patients and 2074 healthy control individuals) from April to December 2021 to investigate the association between 331 selected SNPs with dyslipidemia and increased susceptibility risks of CVD, NAFLD and/or T2DM, and covariates. RESULTS: The genotypic frequencies of six SNPs were found to be significantly different in dyslipidemia patients subjects compared to the control group among males and females. In males, three SNPs were found to be significant, the rs11172113 in over-dominant model, the rs646776 in recessive and over-dominant models, and the rs1111875 in dominant model. On the other hand, two SNPs were found to be significant in females, including rs2954029 in recessive model, and rs1801251 in dominant and recessive models. The rs17514846 SNP was found for dominant and over-dominant models among males and only the dominant model for females. We found that the six SNPs linked to gender type had an influence in relation to disease susceptibility. When controlling for the four covariates (gender, obesity, hypertension, and diabetes), the difference between dyslipidemia and the control group remained significant for the six variants. Finally, males were three times more likely to have dyslipidemia in comparison with females, hypertension was two times more likely to be present in the dyslipidemia group, and diabetes was six times more likely to be in the dyslipidemia group. CONCLUSION: The current investigation provides evidence of association for a common SNP to coronary heart disease and suggests a sex-dependent effect and encourage potential therapeutic applications.

Dielectric spectra broadening as the signature of dipole-matrix interaction. I. Water in nonionic solutions.

Whenever water interacts with another dipolar entity, a broadening of its dielectric relaxation occurs. Often this broadening can be described by the Cole-Cole (CC) spectral function. A new phenomenological approach has been recently presented [A. Puzenko, P. Ben Ishai, and Y. Feldman, Phys. Rev. Lett. 105, 037601 (2010)] that illustrates a physical mechanism of the dipole-matrix interaction underlying the CC behavior in complex systems. By considering the relaxation amplitude Δε, the relaxation time τ, and the broadening parameter α, one can construct a set of 3D trajectories, representing the dynamic behavior of different systems under diverse conditions. Our hypothesis is that these trajectories will contribute to a deeper understanding of the dielectric properties of complex systems. The paper demonstrates how the model describes the state of water in aqueous solutions of non-ionic solutes. For this purpose complex dielectric spectra for aqueous solutions of D-glucose and D-fructose are analyzed.

The remote sensing of mental stress from the electromagnetic reflection coefficient of human skin in the sub-THz range.

Recent work has demonstrated that the reflection coefficient of human skin in the frequency range from 95 to 110 GHz (W band) mirrors the temporal relaxation of stress induced by physical exercise. In this work, we extend these findings to show that in the event of a subtle trigger to stress, such as mental activity, a similar picture of response emerges. Furthermore, the findings are extended to cover not only the W band (75-110 GHz), but also the frequency band from 110 to 170 GHz (D band). We demonstrate that mental stress, induced by the Stroop effect and recorded by the galvanic skin response (GSR), can be correlated to the reflection coefficient in the aforementioned frequency bands. Intriguingly, a light physical stress caused by repeated hand gripping clearly showed an elevated stress level in the GSR signal, but was largely unnoted in the reflection coefficient in the D band. The implication of this observation requires further validation.

Cole-Cole broadening in dielectric relaxation and strange kinetics.

We present a fresh appraisal of the Cole-Cole (CC) description of dielectric relaxation. While the approach is phenomenological, it demonstrates a fundamental connection between the parameters of the CC dispersion. Based on the fractal nature of the time set representing the interaction of the relaxing dipole with its encompassing matrix, and the Kirkwood-Froehlich correlation factor, a new 3D phase space linking together the kinetic and structural properties is proposed. The evolution of the relaxation process is represented in this phase space by a trajectory, which is determined by the variation of external macroscopic parameters. As an example, the validity of the approach is demonstrated on two porous silica glasses exhibiting a CC relaxation process.

Molecular interactions in lyotropic reverse hexagonal liquid crystals: a dielectric spectroscopy study.

A dielectric study of reverse hexagonal mesophases (HII) is presented. Conducted in the frequency range 0.01-1 MHz and temperature range 293

Microwave dielectric spectroscopy study of water dynamics in normal and contaminated raw bovine milk.

The role of water in bovine milk is more complicated than that of a background solvent. To understand the interaction between water and the constituents of milk, an extensive dielectric study of the γ-dispersion of raw bovine milk was carried out over the frequency range 0.1-50GHz and the interval of temperatures (10°C-42°C). Samples were provided by utilizing an extended donor pool. The results reveal that the temperature dependence of the characteristic relaxation times is described by the Arrhenius law. Furthermore, it conforms to a Meyer-Neldel compensation, whereby the pre-factor of the relaxation times is dependent on the activation energy. This entropy/enthalpy compensation is traced to the interaction between bulk water dynamic clusters and other milk constituents. A statistical correlation between the Somatic Cell Count, a traditional measure of milk quality, and the relaxation times is provided as well, opening new vistas for the industrial classification of milk.

Dielectric Response of Cytoplasmic Water and Its Connection to the Vitality of Human Red Blood Cells: I. Glucose Concentration Influence.

The vitality of red blood cells depends on the process control of glucose homeostasis, including the membrane's ability to "switch off" d-glucose uptake at the physiologically specific concentration of 10-12 mM. We present a comprehensive study of human erythrocytes suspended in buffer solutions with varying concentrations of d-glucose at room temperature, using microwave dielectric spectroscopy (0.5 GHz-50 GHz) and cell deformability characterization (the Elongation ratio). By use of mixture formulas the contribution of the cytoplasm to the dielectric spectra was isolated. It reveals a strong dependence on the concentration of buffer d-glucose. Tellingly, the concentration 10-12 mM is revealed as a critical point in the behavior. The dielectric response of cytoplasm depends on dipole-matrix interactions between water structures and moieties, like ATP, produced during glycolysis. Subsequently, it is a marker of cellular health. One would hope that this mechanism could provide a new vista on noninvasive glucose monitoring.

RETRACTED: USP1 Regulates Cellular Senescence by Controlling Genomic Integrity.

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted at the request of the authors. We, the authors, were made aware of irregularities associated in western blots shown in our article. We have further investigated the matter and found that the paper contains multiple examples of incorrect data use and image flipping in four figures, including the vertical flipping and reuse of the panel in Figures 1B and 3D, similar flipping and incorrect blot image in Figure 2C, and incorrect data use in Figure 4A. All of these figures were assembled by the corresponding author (O.B.) who takes full responsibility for the inaccuracies. Under these circumstances, we believe that the most responsible course of action is to retract the paper. We sincerely apologize to the scientific community for any inconvenience resulting from the publication and retraction of this manuscript.

Morphology of human sweat ducts observed by optical coherence tomography and their frequency of resonance in the terahertz frequency region.

It is crucial to understand the various biological effects induced by terahertz (THz) electromagnetic waves with the rapid development of electronic and photonic devices operating in the THz frequency region. The presence of sweat glands plays an important role in THz wave interactions with human skin. We investigated the morphological features of sweat ducts using optical coherence tomography (OCT) to further understand such phenomena. We observed remarkable features of the ducts, such as their clear helical structure. The intersubject and intrasubject variations in the diameter of sweat ducts were considerably smaller than the variations in other structural parameters, such as length and number of turns. Based on the sweat duct dimensions and THz dielectric properties of skin measured using terahertz time-domain spectroscopy (THz-TDS), we calculated the resonating frequency of the sweat duct under the assumption of it functioning as a helical antenna. Here, we show that the resonance frequency in the axial mode of operation lies in the THz wave region with a centre frequency of 0.44 ± 0.07 THz. We expect that these findings will further our understanding of the various health consequences of the interaction of THz waves with human beings.

Neural Correlates of Three Neurocognitive Intervention Strategies: A Preliminary Step Towards Personalized Treatment for Psychological Disorders.

Brain-based behavioral interventions targeting specific neurocognitive mechanisms show initial promise in the treatment of emotional disorders, but personalization of such approaches will be facilitated if brain targets are empirically established. As a preliminary step, we conducted a proof-of-concept study to test whether particular emotion regulatory neural circuitry can be differentially targeted by specific neurocognitive tasks, and whether these tasks effectively inhibit amygdala activity. Eleven healthy individuals underwent an idiographic sadness and guilt induction. Brain response was measured via fMRI during 4 subsequent emotion regulation conditions: fixation, cognitive reappraisal (selected to target the ventrolateral prefrontal cortex), working memory practice (selected to target the dorsolateral prefrontal cortex), and visual distraction (Tetris; selected to target occipital cortex). In whole-brain comparisons to fixation, hypotheses were upheld. Reappraisal uniquely activated left ventrolateral prefrontal cortex, working memory practice uniquely activated left dorsolateral prefrontal cortex, and Tetris uniquely activated bilateral occipitoparietal cortex, activations that were largely robust at the single-subject level. All tasks inhibited amygdala activity relative to fixation. Data support examining whether repeated exposure to these tasks in psychiatric patients affects neural abnormalities implicated in emotional disorders. Ideally, psychiatric treatment will be accelerated by matching specific treatments to patients with specific neural profiles.

Molecular interactions in reverse hexagonal mesophase in the presence of Cyclosporin A.

The present work investigates the detailed molecular structure of the H(II) mesophase of GMO/tricaprylin/phosphatidylcholine/water system in the presence of hydrophobic model peptide Cyclosporin A (CSA) via ATR-FTIR analysis. The conformation of the peptide in the hexagonal mesophase, as well as its location and specific interactions with the components of the carrier, were studied. Incorporation of phosphatidylcholine to the ternary GMO/tricaprylin/water system caused competition for water binding between the hydroxyl groups of GMO and the phosphate groups of the phosphatidylcholine (PC) leading to dehydration of the GMO hydroxyls in favor of phospholipid hydration. Analysis of CSA solubilization effect on the H(II) mesophase revealed a significant increase in the strength of hydrogen bonding with surfactant hydrogen-bonded carbonyls, indicating interaction of the peptide with the CO groups of the surfactants. The peptide probably caused partial replacement of the intramolecular hydrogen bonds of the mesophase carbonyl groups with intermolecular hydrogen bonds of these carbonyl groups with the peptide. Furthermore, analysis of the Amide I' peak in the FTIR spectra of the peptide demonstrated that two pairs of its internal hydrogen bonds are disrupted when it is incorporated. The partial disruption of the internal hydrogen bonds seems to cause an outward rotation of the peptide amide groups involved, resulting in more efficient intermolecular hydrogen-bonding ability. Apparently, this conformational change increased the hydrophilic properties of CSA, even making it susceptible to a weak interaction with the GMO hydroxyl groups in the interfacial region.

From the microscopic to the mesoscopic properties of lyotropic reverse hexagonal liquid crystals.

In the present study we aimed to explore a correlation between the microstructural properties of the lyotropic reverse hexagonal phase (HII) of the GMO/tricaprylin/phosphatidylcholine/water system and its mesoscopic structure. The mesoscopic organization of discontinuous and anisotropic domains was examined, in the native state, using environmental scanning electron microscopy. The topography of the HII mesophases was imaged directly in their hydrated state, as a function of aqueous-phase concentration and composition, when a proline amino acid was solubilized into the systems as a kosmotropic (water-structure maker) guest molecule. The domain structures of several dozen micrometers in size, visualized in the environmental scanning electron microscopy, were found to possess fractal characteristics, indicating a discontinuous and disordered alignment of the corresponding internal water rods on the mesoscale. On the microstructural level, SAXS measurements revealed that as water content (Cw) increases the characteristic lattice parameter of the mesophases increases as well. Using the water concentration as the mass measure of the mixtures, a scaling relationship between the lattice parameter and the concentration was found to obey a power law whereby the derived fractal dimension was the relevant exponent, confirming the causal link between the microscopic and mesoscopic organizations. The topography of the HII mesophase was found to be affected by the microstructural parameters and the composition of the samples. Thermal analysis experiments involving these systems further confirmed that the behavior of water underpins both microscopical and mesoscopic features of the systems. It was shown that both the swelling of the lattice parameter and the mesoscopic domains is correlated to the bulk water concentration in the water rods.

Non-Debye response for the structural relaxation in glass-forming liquids: test of the Avramov model.

The experimentally observed characteristic features of the alpha-relaxation process in glass-forming liquids are the non-Arrhenius behavior of the structural relaxation times and the non-Debye character of the macroscopic relaxation function. The Avramov model in which relaxation is considered as an energy activation process of surmounting random barriers in liquid energy landscape was successfully applied to describe the temperature and pressure dependences of the macroscopic relaxation times or viscosity. In this paper, we consider the dielectric spectrum associated with Avramov model. The asymmetrical broadening of the loss spectra was found to be related directly to dispersion of the energy barrier distribution. However, it turns out that temperature dependence of the spectrum broadening as predicted by the Avromov model is at odds to experimental observation in glass-forming liquids.