Gel immersion endoscopic mucosal resection for small gastric neoplastic lesions: A pilot study.

Gastric endoscopic mucosal resection is challenging due to the slippery mucosa, abundant blood vessels, and the presence of mucus. We developed gel immersion endoscopy to secure the visual field, even in a blood-filled gastrointestinal lumen in 2016. Clear gel with appropriate viscosity, instead of water, can prevent rapid mixture with blood and facilitate identification of the culprit vessel. We further optimized the gel for endoscopic treatment, and the resultant product, Viscoclear (Otsuka Pharmaceutical Factory) was first released in Japan in 2020. The viscosity of this gel has been optimized to maximize endoscopic visibility without compromising the ease of its irrigation. The aim of this study is to clarify the effectiveness of gel immersion endoscopic mucosal resection for small-sized early gastric neoplasms. Seven lesions in seven patients were treated by gel immersion endoscopic mucosal resection. The size of all lesions was under 10 mm. The median procedure time was 4.5 min. Intraoperative bleeding occurred in four of seven lesions immediately after snare resection and was easily controlled by endoscopic hemostatic forceps during the gel immersion endoscopy. The R0 resection rate was 100%. In conclusion, gel immersion endoscopic mucosal resection may be a straightforward, rapid, and safe technique for resecting superficial gastric neoplasms <10 mm in diameter.

Comparison of the effects of cold water immersion and percussive massage on the recovery after exhausting eccentric exercise: A three-armed randomized controlled trial.

Introduction: Athletic training requires both challenging stimuli for adaptation and sufficient recovery for improved performance. While cold water immersion (CWI) is already a popular recovery method, handheld percussive massage (PM) devices have also gained popularity in recent years. This study aims to assess the effects of CWI and PM on performance recovery after strenuous eccentric exercises compared to a passive rest (PR) control condition. Methods: Thirty-four healthy physically active participants (9 females, 25 males) were randomly divided into three groups: CWI (n = 11), PM (n = 11), and passive rest (PR) (n = 12). They underwent an exhausting eccentric exercise protocol and different measurements at six time points (baseline, POST1, POST2, POST24, POST48, and POST72) over the time course of 72 h. These included subjective assessments of muscle soreness and perceived stiffness as well as measures of skin temperature, leg volume, creatine kinase activity, and three different jump tests. The eccentric exercise protocol consisted of 15 min downhill running (slope: 12%, speed: 10 km/h) and 3 sets of successive depth jumps (dropping height: 0.5 m) until individual exhaustion. After POST1 measurements, participants received 12 min of either CWI (11 ± 0.5°C), PM (40 Hz) or PR (supine posture). Results: No significant group effects were found for the number of depth jumps performed during the exhaustion protocol. All jump tests displayed a significant group × time interaction effect. Post-hoc analysis indicated significant lower jump heights in ΔPOST2 between CWI and both PM and PR. No other significant group effects were observed at any time point. No significant group × time interaction effects were noted for CK, leg volume, and soreness. The perceived stiffness showed a significant group × time interaction effect. Post-hoc analysis revealed a significant decrease in stiffness for PM compared to PR at ΔPOST2. Conclusion: Neither CWI nor PM showed any significant improvement in performance recovery over the 72-h period following strenuous eccentric exercise compared to PR. CWI showed an immediate performance decline which may be attributed to a cold-related reduction in motor nerve conduction velocity.

Advancements in seawater immersion wound management: Current treatments and innovations.

With advancements in naval warfare, the number and severity of seawater injuries have skyrocketed, necessitating effective seawater immersion (SWI) wound management. The unique marine pathogens, salinity, low temperature and alkalinity of seawater are the main environmental factors that can influence SWI wound healing. The current treatment strategy for SWI wounds follows a standard protocol based on terrestrial wound conditions, neglecting seawater conditions. The key requirements for ideal SWI treatment include good adhesion to the wound surface to minimize further exposure to seawater, enhanced wound healing properties to minimize wound healing time and antibacterial properties to prevent infections from marine pathogens. Current SWI wound-specific treatments range from elaborate techniques like vacuum-sealed drainage and vacuum-assisted closure for severe blast injuries to simple application of hydrogels or collagen dressings for minor injuries. This review discusses the current status and development of various treatment modalities for SWI wounds. The development of these treatment strategies and an understanding of their mechanisms of action make us better prepared to manage and treat SWI injuries.

Corrosion resistance and biocompatibility of carbon ion implanted AZ31B magnesium alloy.

The poor corrosion resistance of magnesium limits its clinical applications. Accordingly, in the present study, carbon ions were incorporated into a AZ31b magnesium alloy surface via carbon plasma immersion ion-implantation to improve its corrosion resistance and biocompatibility. The surface morphology and properties of the modified alloy were evaluated by field-emission scanning electron microscopy, water contact angle measurement, Raman scattering, X-ray photoelectron spectroscopy, and energy dispersive X-ray spectroscopy. Furthermore, compositional depth profiles were obtained by glow discharge optical emission spectroscopy, revealing a Gaussian-like distribution of carbon concentration. Electrochemical and hydrogen-evolution analysis demonstrated the successfully improved corrosion resistance of the AZ31b Mg alloy, while its biocompatibility was demonstrated by MTT and cell-adherence assays.

Enhancing radiation therapy student's cultural competency and safety of Canadian Indigenous populations using cultural immersion.

INTRODUCTION: Indigenous peoples in Canada have a higher cancer burden and shorter life expectancy compared to the non-Indigenous population. Canada's colonial legacy has resulted in many Indigenous people experiencing high mistrust in healthcare providers which can result in healthcare avoidance, such as delays seeking preventative care as well as lower screening rates. This may be compounded by language barriers as well as a lack of culturally safe care in healthcare settings. Cultural competency and safety education, which can include cultural immersion methods, has been widely prioritized and implemented in health care and academic institutions. This manuscript reports the results of a pilot cultural immersion experience in an Indigenous community (Maskwacîs, Treaty 6 Territory) for University of Alberta Radiation Therapy Department radiation therapy students and clinical faculty. METHODS: This project used the Etuaptmumk or Two-Eyed Seeing approach as the research framework to tie Western methodologies with Indigenous knowledge. The cultural immersion day included a sweat lodge ceremony, a traditional lunch and a sharing circle. Following the event, two focus groups were conducted to gather participants' perspectives. The discussions were transcribed and the data was analysed thematically. RESULTS: Seven senior radiation therapy students and five faculty members participated in the cultural immersion day. The majority of the feedback from the day was positive. The four main themes that emerged from the focus groups were; (1) enhanced cultural safety, (2) improved peer to peer and peer to educator relationships, (3) responsibility to social accountability, advocacy, and personal growth, and (4) facilitation of a bridge between Western and Indigenous views. CONCLUSION: Support for Indigenous patients with cancer and caregivers is essential to improve care in the radiation therapy department. As this pilot project was a success, the cultural immersion day is now a component of the cultural competency and safety training for radiation therapy students at the University of Alberta. However, more opportunities are needed for staff to consistently facilitate and foster culturally safe care for Indigenous patients undergoing radiation therapy.

Effects of water immersion on immune, intestinal flora and metabolome of Chinese mitten crab (Eriocheir sinensis) after air exposure.

Air exposure stress can induce stress response of Eriocheir sinensis and affect its normal life activities. The goal of this study was to investigate the effects of water immersion on the recovery of hepatopancreas immune-related enzyme activity, intestinal microbial diversity and metabolic level of Chinese mitten crabs after exposure to air. The results show that immersion can effectively alleviate the adverse effects of air exposure on the antioxidant capacity and immune capacity of Chinese mitten crabs, and the longer the time of immersion, the more obvious the recovery effect. Among them, the levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and acid phosphatase significantly increased after exposure to air (P < 0.05), reached a peak at 3 h, began to decline after immersion, and returned to a level close to the initial value at 24 h (P < 0.05). In addition, after exposure to air, the glucose and total cholesterol in haemolymph of Eriocheir sinensis were significantly different from the initial values (P < 0.05), gradually recovered to the initial level after re-immersion. However, changes in intestinal flora and hepatopancreas metabolism caused by air exposure did not fully recover after water exposure, and its negative effects did not completely disappear. The sequencing results showed that the species composition and diversity of intestinal microorganisms of Chinese mitten crab changed after air exposure and immersion treatment. The relative abundance of Actinomycetes increased significantly, while that of Proteobacteria and Firmicutes decreased significantly. Metabolomics analysis showed that air exposure and immersion destroyed the metabolic balance of amino acids and carnitine, reduced the level of carnitine metabolism, hindered the absorption of nutrients, and led to the accumulation of harmful substances.

AVATAR 2.0: next level communication systems for radiotherapy through face-to-face video, biofeedback, translation, and audiovisual immersion.

Purpose: This paper discusses an advanced version of our audiovisual-assisted therapeutic ambience in radiotherapy (AVATAR) radiolucent display systems designed for pediatric radiotherapy, enabling anesthesia-free treatments, video communication, and biofeedback. The scope of the AVATAR system is expanded here in two major ways: (i) through alternative mounting systems to accommodate a broader range of radiotherapy machines (specifically to fit robotic-arm and toroidal geometry photon radiotherapy and proton radiotherapy systems) and (ii) through additional hardware to provide video-calling, optimized audio for clear communication, and combined video inputs for biofeedback, translation, and other advanced functionalities. Methods and materials: Because robustness requires strong parts and radio-transparency requires thin, light parts, three-dimensional printing was used to rapidly prototype hollow structures and to iteratively improve robustness. Two system designs were made: one that mounts superior and another that mounts inferior to the patient's head. Radiation dose measurements and calculations were conducted to assess dose perturbations at surface and depth due to the screen. Results: For 6-MV volumetric modulated arc therapy (VMAT) plans, with and without the screen, the mean and maximum dose differences inside the planning target volume were 0.2% and 2.6% of the 200 cGy prescription, respectively. For a single static beam through the screen, the maximum measured excess surface dose was 13.4 ± 0.5%, and the largest measured dose attenuation at 5-cm water-equivalent depth was 2.1 ± 0.2%. These percentages are relative to the dose without the screen at those locations. Conclusions: The radiolucent screen systems provided here are shown to give minimal dosimetric effects on megavoltage VMAT photon treatments. For static beams, however, surface dose effects should be considered when these beams pass through the thickest components of the screen. Design files are also provided.

Study on the Chloride-Sulfate Resistance of a Metakaolin-Based Geopolymer Mortar.

The chloride-sulfate corrosion environment of concrete is a significant engineering problem. This paper investigates the effect of the complete/semi-immersion mode on the durability of concrete in a chloride-sulfate environment by using different granulated blast furnace slag (GBFS) dosage rates (10-50%) of a metakaolin (MK)-based geopolymer mortar. The chloride-sulfate corrosion environment is discussed by analyzing the apparent morphology, mass change, and mechanical property change in specimens at the age of 120 d of erosion combined with XRD and SEM. The high Ca content in GBFS has an important effect on the strength and erosion resistance of the metakaolin geopolymer (MGP) group mortar; an increase in the GBFS dosage makes the MGP group mortar denser, and the initial strength of the MGP group mortar is positively correlated with the dosage of GBFS. After 120 d of erosion, the GBFS dosage is negatively correlated with erosion resistance, with the high GBFS dosage groups showing more severe damage. Semi-immersion resulted in more severe deterioration at the immersion-evaporation interface zone due to the difference in the ionic concentration and the 'wick effect' at the immersion-evaporation interface zone. Compared with the commonly used OPC mortar, the M40 and M50 groups have improved strength and corrosion resistance and are suitable for engineering environments in highly erosive areas.

Comparison of Immersion and Portable Ultrasonic Housing to Quantify the Adhesive Bond Thickness and Sizing of Foreign Objects.

High-performance materials, such as carbon fiber laminates, are costly to manufacture and are often used in demanding environments requiring the use of high-resolution non-destructive testing (NDT) methods to confirm the integrity of the parts. One NDT method that has shown promise for qualifying carbon fiber laminates is the use of immersion ultrasound with spherically focused probes. However, many parts may not be submersible in an immersion tank due to size or material constraints. These parts must be scanned with contact transducers with inferior resolutions or with expensive and messy systems such as bubblers. This research presents the use of a novel housing system that allows for the use of focused immersion transducers in an out-of-tank portable ultrasonic scanning application. This work presents a comparison between scans taken using a custom high-resolution immersion system and scans taken using the presented housing. There are a wide variety of potential inspection applications for this novel system, and the present work focused on two specific applications: the quantification of the spatially varying adhesive thickness in bonded carbon fiber laminates and the quantification of foreign object inclusions in carbon fiber laminates. The results presented show that scans using the portable housing are comparable in quality to scans performed using an immersion system. Specifically, both inspection approaches had an average error of 0.04 mm when quantifying the adhesive thickness of a bonded composite, and for the foreign object detection, the error in quantifying the dimensions of the embedded foreign object was 0.1 mm and 0.2 mm for the immersion system and the portable inspection system, respectively. The demonstration was performed in a laboratory setting, but a discussion is provided for the necessary improvements needed to extend the system for use in field applications.

Cardiac electrical and functional activity following an outdoor cold-water swimming event.

AIMS: Participation in outdoor cold-water swimming (OCWS) events combines endurance exercise and cold exposure. Concerns have emerged about the potential risk of acute adverse cardiac events during OCWS, particularly during endurance events. We analysed the effect of prolonged OCWS on cardiac function in trained athletes. METHODS: The swimming event consisted of laps over a 1000-m course, for up to 6 h, in water at 15 °C. Twenty participants (11 males, 47.3 ± 8.6 years old) were included. Core temperature (Tcore) was monitored using an ingestible temperature sensor during and up to 1 h after the swim. Body composition, blood pressure, electrocardiogram (ECG), and transthoracic echocardiography were assessed 1 day before the event and within the first hour upon completion of the swim. RESULTS: Mean body mass index was 27.1 ± 5.1 kg/m2 and fat mass was 25.2 ± 9.1 %. Mean duration of swimming was 214 ± 115 min. Minimum Tcore was 35.6 ± 1.3 °C. A significant lengthening of the QT interval corrected (QTc) for heart rate was observed post-exercise (437.7 ± 27.7 vs. 457.2 ± 35.9 ms, p = 0.012), with 5 participants exhibiting post-exercise QTc >500ms. OCWS did not alter the biventricular systolic function and left ventricular relaxation. No correlation was observed between ΔQTc and ΔTcore. CONCLUSION: OCWS seemed to acutely delay post-exercise cardiac repolarization without alteration of cardiac function in a healthy trained population. Additional investigations would be warranted to explore the clinical implications of QT lengthening and its relationship with autonomic nervous system regulation during OCWS.

Effects of video game immersion and task interference on cognitive performance: a study on immediate and delayed recall and recognition accuracy.

This study investigates the cognitive impacts of video game immersion and task interference on immediate and delayed recall as well as recognition tasks. We enrolled 160 subjects aged 18 to 29, who were regular players of "shoot-em-up" video games for at least 3 years. Participants were assigned to one of three experimental groups or a control group. The experimental conditions varied in the timing and type of tasks: the first group performed a video game session between recall tasks, the second group multitasked with video games and recall tasks simultaneously, and the third group engaged in task switching from video games to recall tasks. Using the Rey Auditory Verbal Learning Test, we measured the effects of these conditions on cognitive performance, focusing on error types and recall accuracy. Results indicated that multitasking and task switching significantly affected the subjects' performance, with notable decrements in recall and recognition accuracy in conditions of high task interference. The study highlights the cognitive costs associated with multitasking in immersive digital games and provides insights into how task similarity and interference might increase error rates and affect memory performance.

Influence of Avatar Identification on the Attraction of Virtual Reality Games: Survey Study.

BACKGROUND: In gaming, the embodied interaction experience of avatars serves as a key to emotional sublimation in artistic creation. This presents the emotional expression of art in a more vivid form, which is a critical factor in the high attractiveness of virtual reality (VR) games to players. Intertwined with players' physiological and psychological responses, immersion is an essential element for enhancing gaming attractiveness. OBJECTIVE: This study aims to explore how to help players establish a sense of identity with their embodied avatars in VR game environments and enhance the attractiveness of games to players through the mediating effect of immersion. METHODS: We conducted a structured questionnaire survey refined through repeated validation. A total of 402 VR users were publicly recruited through the internet from March 22, 2024, to April 13, 2024. Statistical analysis was conducted using the SPSS and Amos tools, including correlation analysis, regression analysis, and mediation effect verification. We divided the self-differentiation theory into 4 dimensions to validate their impact on avatar identification. Subsequently, we correlated the effects of avatar identification, game immersion, and game attractiveness and proposed a hypothetical mediating model. RESULTS: Regression analysis of the predictor variables and the dependent variable indicated a significant positive predictive effect (P<.001); the variance inflation factor values for each independent variable were all <5. In the hypothesis testing of the mediating effect, the total mediating effect was significant (P<.001). Regarding the direct impact, both the effect of avatar identification on immersion and the effect of immersion on game attractiveness were significant (P<.001). However, the direct effect of avatar identification on game attractiveness was not significant (P=.28). Regarding the indirect impact, the effect of avatar identification on game attractiveness was significant (P<.001). The results indicate a significant positive correlation between different dimensions of the self-differentiation theory and identification with avatars. Moreover, immersion in the game fully mediated the relationship between identification with avatars and game attractiveness. CONCLUSIONS: This study underscores that the embodiment of avatar identification is influenced by dimensions of self-differentiation, and the impact of identification with avatars on game attractiveness is contingent upon full mediation by immersion. These findings deepen our understanding of the role of avatar identification in VR gaming.

Cold Environment-Associated Extremity Lesions or Severe Hypothermia Help Differentiate Between Frostbitten and Trench Foot (Immersion Foot).

Cold associated foot injuries, such as frostbite and trench foot (immersion foot) are relatively common in cold environments. The former is classified as a freezing cold injury, and the latter as a nonfreezing cold injury. Trench foot is sometimes misdiagnosed as frostbite, and rapid rewarming exacerbates the condition. This paper aims to help differentiate between frostbitten foot and trench foot. This study included patients with frostbitten foot or trench foot treated at our hospital between December 2005 and May 2023. The differences in sex, age, month of injury, conditions at the time of injury, injury distribution, foot lesion laterality, other complications upon arrival (finger frostbite, immersion hand, or hypothermia), and presence and distribution of sensory disturbance at discharge were noted among the groups. A total of 16 patients (14 men) with frostbitten foot and 3 patients (3 men) with trench foot were identified. Finger frostbite observed in nine and zero patients with frostbitten foot and trench foot, respectively; and severe hypothermia on arrival observed in five and zero patients with frostbitten foot and trench foot, respectively. Physical findings at the initial examination showed that the frostbitten feet were dry, and the lesions were distal and clearly demarcated, whereas feet with trench foot were wet, and the lesions covered the entire sole and were not clearly demarcated. Accurate differentiation between frostbitten foot and trench foot and appropriate initial treatment are important. The presence of finger frostbite, immersion hand or severe hypothermia may help to differentiate between frostbitten foot and trench foot.

Feeling senseless sensations: a crossmodal EEG study of mismatched tactile and visual experiences in virtual reality.

To create highly immersive experiences in virtual reality (VR) it is important to not only include the visual sense but also to involve multimodal sensory input. To achieve optimal results, the temporal and spatial synchronization of these multimodal inputs is critical. It is therefore necessary to find methods to objectively evaluate the synchronization of VR experiences with a continuous tracking of the user. In this study a passive touch experience was incorporated in a visual-tactile VR setup using VR glasses and tactile sensations in mid-air. Inconsistencies of multimodal perception were intentionally integrated into a discrimination task. The participants' electroencephalogram (EEG) was recorded to obtain neural correlates of visual-tactile mismatch situations. The results showed significant differences in the event-related potentials (ERP) between match and mismatch situations. A biphasic ERP configuration consisting of a positivity at 120 ms and a later negativity at 370 ms was observed following a visual-tactile mismatch. This late negativity could be related to the N400 that is associated with semantic incongruency. These results provide a promising approach towards the objective evaluation of visual-tactile synchronization in virtual experiences.

Shorter Migration Distance and Breeding Latitude Correlate With Earlier Egg-Laying Across the Northeastern Pacific Ocean Range of the Rhinoceros Auklet (Cerorhinca monocerata).

Models of migratory behavior predict trade-offs between fitness costs and benefits with respect to migration distance. Shorter migration distances may confer a fitness benefit by facilitating earlier breeding, however this is rarely investigated. We tested this hypothesis using a large-scale geolocation (GLS) dataset from 109 rhinoceros auklets (Cerorhinca monocerata), a differentially migrating seabird, that was tagged at 12 breeding colonies along the Pacific Coast of North America, spanning southern California to the eastern Aleutian Islands, Alaska. Using GLS-based position estimates, we determined the geographic centroid of the pelagic areas occupied by birds in winter (1 January-28 February) and then calculated the distance between their wintering centroids and colony of origin. We then used GLS light-intensity and salt-water immersion (wet/dry) data to determine each individual's date of egg-laying the following spring. Rhinoceros auklets were very widely distributed across the northeastern Pacific Ocean in winter. Among all individuals, the distance between winter centroids and breeding colonies ranged from < 100 to > 2500 km, being greater among individuals originating from colonies at higher latitudes. As predicted, migration distance and colony latitude were positively related to lay date: after accounting for colony-level differences in phenology, individuals that migrated shorter distances tended to lay their eggs earlier, a pattern that emerged across all populations. Our study links the migration distance of rhinoceros auklets to a fitness-related outcome, underscoring the selective pressure that migration exerts on subsequent breeding activity.

High immersion/escapism motivation makes gaming disorder risk less dependent of playtime among highly engaged male gamers.

In the realm of gaming-related concerns, the relationship between gaming time (GT) and gaming disorder (GD) remains an intriguing and complex subject. Although increased GT is not a reliable predictor of GD risk, the circumstances under which this relationship strengthens or weakens remain relatively unknown. This study explores the roles of immersion/escapism motive (IEM) and GT in the context of GD among highly engaged gamers (N = 294), each dedicating a minimum of 20 hours weekly to gaming. The findings confirm that IEM significantly moderates the relationship between GT and GD in the male sample. Specifically, low and moderate levels of IEM result in a stronger relationship between GT and GD. In the case of women, the effect was not significant. These findings suggest the importance of comprehensive assessments of gaming motivations when addressing gaming-related issues, particularly in GD research. Moreover, they emphasize the value of adopting a complex approach to comprehending the development of problematic gaming behaviors.

The mechanical and hydrochemical properties of cemented calcareous soil under long-term soaking.

This study investigates the impact of long-term water immersion on the mechanical and hydrochemical properties of cemented calcareous soil, emphasizing the critical role of carbonate content in mechanical performance. Utilizing hydrochemical analysis and triaxial testing, the research revealed that prolonged immersion disrupts the acid-base balance of the solution, resulting in an increased concentration of ions and chemicals. Significant dissolution of carbonates and soluble minerals occurs, which reacts with carbon dioxide to generate bicarbonate ions, thereby elevating the alkalinity of the soaking solution. Additionally, the gradual dissolution of clay minerals compromises the cementitious structure, leading to particle reorientation and interlocking. The study quantitatively assesses the changes in soil properties, demonstrating a substantial reduction in soil cohesion by up to 86.1% and an increase in the internal friction angle by 37.5%. Furthermore, the gradual dissolution of clay minerals compromises the cementitious structure, resulting in particle reorientation and interlocking that contribute to the observed mechanical changes. The findings underscore the importance of understanding the effects of extended immersion on the stability and engineering applicability of cemented calcareous soils.

Impact of glossopharyngeal insufflation and complete exhalation on breath-hold performance and physiological parameters in elite skin divers.

PURPOSE: This study examined the physiological responses of ten elite divers to normal breathing (BHn), glossopharyngeal inhalation (BHi), and complete exhalation (BHe) prior to five maximal breath-hold (BH) efforts. METHODS: Breath-hold time (BHT), hemological variables, mean arterial pressure (MAP), other hemodynamic indices, and diaphragmatic activity (DA) were recorded. During BHs, phases were identified as easy-going (EPh: minimal DA), struggling (SPh: increased DA), PhI (MAP transition), PhII (MAP stabilization), and PhIII (steep MAP increase). RESULTS: BHi significantly extended BHT (309.14 ± 12.91 s) compared to BHn (288.77 ± 10.99 s) and BHe (151.18 ± 10.94 s) (P = 0.001). BHT, EPh, and SPh in BHi increased by 7.05%, 2.57%, and 11.08% over BHn, respectively. PhIII appeared earlier in BHe than in other conditions (P < 0.001) and accounted for 47.07%, 44.96%, and 60.18% of BHT in BHn, BHi, and BHe, respectively. SPh comprised 47.10%, 46.01%, and 45.13% of BHT in BHn, BHi, and BHe, respectively, with SPh onset coinciding with PhIII onset in BHn and BHi but not in BHe. Bradycardia was more pronounced in BHe, maintaining better stroke volume. No significant differences in red blood cells or maximal MAP were noted across conditions. CONCLUSION: Glossopharyngeal inhalation improves BHT and extends EPh and SPh durations. PhIII onset is linked to SPh in BHn and BHi but not in BHe. BHe triggers an earlier MAP rise, leading to stronger parasympathetic responses. Despite similar maximal MAP across conditions, the higher BHT and tissue hypoxemia in BHi and BHn suggest MAP is a key limiting factor in apnoea.

Continuous Casting Slab Mold: Key Role of Nozzle Immersion Depth.

Based on a physical water model with a scaling factor of 0.5 and a coupled flow-heat transfer-solidification numerical model, this study investigates the influence of the submerged entry nozzle (SEN) depth on the mold surface behavior, slag entrapment, internal flow field, temperature distribution, and initial solidification behavior in slab casting. The results indicate that when the SEN depth is too shallow (80 mm), the slag layer on the narrow face is thin, leading to slag entrapment. Within a certain range of SEN depths (less than 170 mm), increasing the SEN depth reduces the impact on the mold walls, shortening the "plateau period" of stagnated growth on the narrow face shell. This allows the upper recirculation flow to develop more fully, resulting in an increase in the surface flow velocity and an expansion in the high-temperature region near the meniscus, which promotes uniform slag melting but also heightens the risk of slag entrainment due to shear stress at the liquid surface (with 110 mm being the most stable condition). As the SEN depth continues to increase, the surface flow velocity gradually decreases, and the maximum fluctuation in the liquid surface diminishes, while the full development of the upper recirculation zone leads to a higher and more uniform meniscus temperature. This suggests that in practical production, it is advisable to avoid this critical SEN depth. Instead, the immersion depth should be controlled at a slightly shallower position (around 110 mm) or a deeper position (around 190 mm).

Effects of Water Immersion Versus Epidural as Analgesic Methods during Labor among Low-Risk Women: A 10-Year Retrospective Cohort Study.

BACKGROUND: Adequate pain relief during childbirth is a very important issue for women and healthcare providers. This study investigates the effects on maternal and neonatal outcomes of two analgesic methods during labor: water immersion and epidural analgesia. METHODS: In this retrospective observational cohort study at a first-level hospital, in Spain, from 2009 to 2019, 1134 women, low-risk singleton and at term pregnancy, were selected. Among them, 567 women used water immersion; 567 women used epidural analgesia for pain control. Maternal outcomes included mode of birth and perineum condition. Neonatal outcomes included 5 min Apgar score, umbilical cord arterial pH, and Neonatal Intensive Care Unit admissions. Chi-square tests and Mann-Whitney U tests, together with their effect sizes (Cramer's V, odds ratio, and Cohen's d) were used to test the main hypotheses. RESULTS: Spontaneous vaginal birth was almost 17 times more likely in the water immersion group (OR = 16.866 [6.540, 43.480], p < 0.001), whereas the odds of having a cesarean birth were almost 40 times higher in the epidural group (OR = 39.346 [3.610, 429.120], p < 0.001). The odds of having an intact perineum were more than two times higher for the water immersion group (OR = 2.606 [1.290, 5.250], p = 0.007), whereas having an episiotomy was more than eight times more likely for the epidural group (OR = 8.307 [2.800, 24.610], p < 0.001). Newborns in the water immersion group showed a better 5 min Apgar score and umbilical cord arterial pH and lower rates in admissions at the Neonatal Intensive Care Unit. CONCLUSIONS: Women choosing water immersion as an analgesic method were no more likely to experience adverse outcomes and presented better results than women choosing epidural analgesia.