Stability of pathogens on banknotes and coins: A narrative review.

For the prevention of infectious diseases, knowledge about potential transmission routes is essential. Pathogens can be transmitted directly (i.e. respiratory droplets, hand-to-hand contact) or indirectly via contaminated surfaces (fomites). In particular, frequently touched objects/surfaces may serve as transmission vehicles for different clinically relevant bacterial, fungal, and viral pathogens. Banknotes and coins offer ample surface area and are frequently exchanged between individuals. Consequently, many concerns have been raised in the recent past, that banknotes and coins could serve as vectors for the transmission of disease-causing microorganisms. This review summarizes the latest research on the potential of paper currency and coins to serve as sources of pathogenic viral, bacterial, and fungal agents. In contrast to the current perception of banknotes and coins as important transmission vehicles, current evidence suggests, that banknotes and coins do not pose a particular risk of pathogen infection for the public.

Foley catheter technique for the extraction of coins lodged in the upper esophagus of children.

INTRODUCTION: Coins are the most commonly ingested foreign bodies in children. They usually become lodged in the upper oesophagus and should be managed immediately. The aim of the present study was to evaluate the characteristics and outcomes of patients with coins lodged in the upper oesophagus, who underwent coin removal using a silicone Foley balloon catheter without fluoroscopy or anaesthesia and evaluate the safety of the procedure. MATERIALS AND METHODS: Patients who were admitted from January 2007 to December 2022 for coins lodged in the oesophagus and extracted with silicone Foley balloon catheter without anestehesia were evaluated retrospectively. We focused on the patient characteristics and clinical presentations, and the treatment safety, efficacy, and outcomes. RESULTS: 773 patients (416 male, 357 female), with a mean age of 3.5 years (range 6 months to 16 years), who ingested coin and extracted with Foley catether is included. The majority of patients (n = 728, 94.17%) were successfully managed by silicone Foley balloon catheter extraction. Our overall success was 94.17%, with 88.30% of coins retrieved and 5.9% pushed into the stomach. Patients who were successfully treated with Foley catheter were discharged on the same day except for 7 (0.90%) who had minimal bleeding. Only 45 (5.82%) patients required oesophagoscopy in the operating room and these patients were kept overnight for clinical follow-up, without any further interventions. CONCLUSION: A Foley balloon catheter can be used to safely and effectively remove coins that are lodged in the upper oesophagus avoiding the risk of general anesthesia.

Esophageal discoid foreign body detection and classification using artificial intelligence.

BACKGROUND: Early and accurate radiographic diagnosis is required for the management of children with radio-opaque esophageal foreign bodies. Button batteries are some of the most dangerous esophageal foreign bodies and coins are among the most common. We hypothesized that artificial intelligence could be used to triage radiographs with esophageal button batteries and coins. OBJECTIVE: Our primary objective was to train an object detector to detect esophageal foreign bodies, whether button battery or coin. Our secondary objective was to train an image classifier to classify the detected foreign body as either a button battery or a coin. MATERIALS AND METHODS: We trained an object detector to detect button batteries and coins. The training data set for the object detector was 57 radiographs, consisting of 3 groups of 19 images each with either an esophageal button battery, esophageal coin or no foreign body. The foreign bodies were endoscopically confirmed, and the groups were age and gender matched. We then trained an image classifier to classify the detected foreign body as either a button battery or a coin. The training data set for the image classifier consisted of 19 radiographs of button batteries and 19 of coins, cropped from the object detector training data set. The object detector and image classifier were then tested on 103 radiographs with an esophageal foreign body, and 103 radiographs without a foreign body. RESULTS: The object detector was 100% sensitive and specific for detecting an esophageal foreign body. The image classifier accurately classified all 6/6 (100%) button batteries in the testing data set and 93/95 (97.9%) of the coins. The remaining two coins were incorrectly classified as button batteries. In addition to these images with a single button battery or coin, there were two unique cases in the testing data set: a stacked button battery and coin, and two stacked coins, both of which were classified as coins. CONCLUSION: Artificial intelligence models show promise in detecting and classifying esophageal discoid foreign bodies and could potentially be used to triage radiographs for radiologist interpretation.

Active learning assignment: Legos and coins to explain glucose metabolism.

This article describes an assignment used in an undergraduate Advanced Exercise Physiology course for seniors. Students' backgrounds in chemistry varied from adequate to almost nonexistent. This presented several challenges for teaching and students' understanding of aerobic oxidation of a glucose molecule. This article presents an assignment for an active-learning team-based approach in the classroom and the adapted version for virtual learning. Students in active, team-based learning were asked to create a short video of glucose oxidation using Lego bricks, coins, or other toys to represent the glucose molecule, the by-products, and the enzymes involved in each pathway. During virtual learning, the assignment was modified to create a video independently in both synchronous and asynchronous course sections. Based on students' responses to an instructor-developed survey on their perceptions of the assignment, 71% reported that the assignment was helpful to understand glucose metabolism.

Esophageal Bougienage for Management of Lodged Esophageal Coins: Safe, Effective, Efficient, and Underused.

OBJECTIVES: The aims of the study are to evaluate outcomes of esophageal bougienage for management of lodged esophageal coins and to assess the extent of bougienage usage and barriers among emergency providers. METHODS: We performed a retrospective chart review of pediatric patients with single lodged esophageal coins presenting to our single academic pediatric emergency department between November 2012 and December 2018. We compared procedural outcomes, complications, length of stay (LOS), and cost between those managed with bougienage and with endoscopy. We further surveyed emergency physicians to assess the extent of bougienage usage and barriers to utilization across different institutions. RESULTS: We identified 205 patients with single lodged esophageal coins presenting during our study window. One hundred forty-seven patients ultimately underwent bougienage with 97% success and no major complications. Fifty-six patients were managed by endoscopy with 100% success and one major complication. Bougienage had significantly lower LOS (median 2.18 vs 11.92 hours, P < 0.001) and hospital charges (median $3533 vs $12,679, P < 0.001) compared with endoscopy. We received 242 completed surveys representing 38 states from primarily academic pediatric emergency physicians. The majority of respondents (90%) used specialist consult with only 4.5% performing bougienage. A total of 36.4% of respondents had never heard of the procedure and only 16.1% had ever performed it. Barriers to usage included lack of provider training (95.6%), perceived risk of complications (94.4%), and perceived lack of success (80.5%). CONCLUSIONS: Bougienage is safe and effective with significant LOS and cost benefits compared with endoscopy. Despite these advantages, the procedure is underused, because of lack of provider education and concerns regarding safety, efficacy, and both family and specialist preference, which are not supported by current literature. These data support the need for broader education regarding the bougienage technique, as well as larger prospective studies of its safety and outcomes.

Comparative Study of Machine-Learning Frameworks for the Elaboration of Feed-Forward Neural Networks by Varying the Complexity of Impedimetric Datasets Synthesized Using Eddy Current Sensors for the Characterization of Bi-Metallic Coins.

A suitable framework for the development of artificial neural networks is important because it decides the level of accuracy, which can be reached for a certain dataset and increases the certainty about the reached classification results. In this paper, we conduct a comparative study for the performance of four frameworks, Keras with TensorFlow, Pytorch, TensorFlow, and Cognitive Toolkit (CNTK), for the elaboration of neural networks. The number of neurons in the hidden layer of the neural networks is varied from 8 to 64 to understand its effect on the performance metrics of the frameworks. A test dataset is synthesized using an analytical model and real measured impedance spectra by an eddy current sensor coil on EUR 2 and TRY 1 coins. The dataset has been extended by using a novel method based on interpolation technique to create datasets with different difficulty levels to replicate the scenario with a good imitation of EUR 2 coins and to investigate the limit of the prediction accuracy. It was observed that the compared frameworks have high accuracy performance for a lower level of difficulty in the dataset. As the difficulty in the dataset is raised, there was a drop in the accuracy of CNTK and Keras with TensorFlow depending upon the number of neurons in the hidden layers. It was observed that CNTK has the overall worst accuracy performance with an increase in the difficulty level of the datasets. Therefore, the major comparison was confined to Pytorch and TensorFlow. It was observed for Pytorch and TensorFlow with 32 and 64 neurons in hidden layers that there is a minor drop in the accuracy with an increase in the difficulty level of the dataset and was above 90% until both the coins were 80% closer to each other in terms of electrical and magnetic properties. However, Pytorch with 32 neurons in the hidden layer has a reduction in model size by 70% and 16.3% and predicts the class, 73.6% and 15.6% faster in comparison to TensorFlow and Pytorch with 64 neurons.

A Multi-Analytical Approach on Silver-Copper Coins of the Roman Empire to Elucidate the Economy of the 3rd Century A.D.

In this study, 160 silver-copper alloy denarii and antoniniani from the 3rd century A.D. were studied to obtain their overall chemical composition. The approach used for their characterisation is based on a combination of physical, chemical, and chemometric techniques. The aim is to identify and quantify major and trace elements in Roman silver-copper coins in order to assess changes in composition and to confirm the devaluation of the currency. After a first cataloguing step, µ-EDXRF and SEM-EDX techniques were performed to identify the elements on the coins' surface. A micro-destructive sampling method was employed on a representative sample of the coins to quantify the elements present in the bulk. The powder obtained from drilling 12 coins (keeping the two categories of coins separate) was dissolved in an acidic medium; heated and sonicated to facilitate dissolution; and then analysed by ICP-AES and ICP-MS. The two currencies had different average alloy percentages; in particular, the % difference of Ag was about 8%. The other elements were found in concentrations <1 wt%. Of these, the element highest in concentration were Pb and Sn, which is in agreement with the literature. The multivariate analysis performed on the data acquired revealed two groups of coins, corresponding to the two currencies.

Chest Radiograph Alone Is Sufficient as the Foreign Body Survey for Children Presenting With Coin Ingestion.

OBJECTIVES: Radiographic survey of the entire aerodigestive tract (nares to anus) is common practice in children presenting to the emergency department following coin ingestion. The purpose of our study was to determine the optimal protocol for radiographic survey post-coin ingestion. We hypothesized that for children presenting with a clear history of coin ingestion a frontal chest radiograph including the entire esophagus is adequate to guide treatment. METHODS: We reviewed the clinical history and radiographic surveys of 134 patients presenting with suspected or witnessed coin ingestion to the emergency department of a tertiary care pediatric hospital between January 2012 and June 2016. Patient demographics, presenting symptoms, anatomic coverage of survey, type, number and location of radiopaque foreign bodies, intervention, and follow-up were recorded. RESULTS: Coins were identified on radiographic surveys in 109 of 134 patients; 25 of 134 patients had no coin. Of those with coins, none of 109 had coin(s) in the airway, 42 of 109 had coin(s) in the esophagus, and 67 of 109 had coin(s) distal to the esophagus. Of those with esophageal coins, 35 of 42 reported symptoms, 7 of 42 were asymptomatic, 40 of 42 underwent endoscopic coin removal, and 2 of 42 had no intervention. Of 92 of 134 surveyed patients with no coin or coin distal to the esophagus, 30 of 92 reported symptoms, 62 of 92 were asymptomatic, 90 of 92 had no further intervention, and 2 of 92 eventually underwent endoscopic coin removal for specific indications (abdominal pain, delayed passage). When there was no coin found in the esophagus, the negative predictive value for intervention was 97.8%. CONCLUSIONS: Following a clear history of coin ingestion, a frontal chest radiograph including the entire length of the esophagus provides sufficient information to direct patient management.

Trends and clinical features of intentional and accidental adult foreign body ingestions in the United States, 2000 to 2017.

BACKGROUND AND AIMS: Foreign body ingestions (FoBIs) are a common cause for medical attention. However, trends and patterns of adult FoBIs as well as associations with clinical comorbidities and behavioral attributes have not been elucidated beyond single institutional experiences. METHODS: We utilized survey data from the National Electronic Injury Surveillance System to examine fundamental characteristics of adult FoBIs involving consumer products between 2000 and 2017 across the United States. Data regarding the circumstances of FoBIs were abstracted from narrative data. Relationships among time, intent, demographics, and behavioral attributes were assessed using regression analyses, accounting for survey structure. RESULTS: Adult FoBIs have increased in incidence over the past 2 decades from 3 to 5.3 per 100,000 persons. Examination of consumer products revealed that jewelry (15.4%), nails (7.2%), and toothpicks (6.9%) were the most commonly ingested products. The most common products ingested varied over time, and the number of unique consumer product categories ingested increased from 103 to 143 in the time period studied. Intentional ingestions accounted for 14% of adult FoBIs and frequently involved plastic bagging (13.6%), batteries (13%), nails (10.1%), and desk supplies (6.8%). Adjusted regression analyses demonstrated that compared with accidental FoBIs, intentional FoBIs have increased over time. Intentional FoBIs were more frequently associated with younger age, substance abuse, police custody, and mental and cognitive illnesses relative to accidental FoBIs. CONCLUSIONS: Our results indicate that adult FoBIs are an increasing burden of disease in the United States with social, psychiatric, and behavioral contributors to this trend.

A comprehensive study of nickel levels in everyday items in Brazil.

BACKGROUND: Nickel is a ubiquitous element used in many everyday items. In recent decades nickel has become a leading allergen, which has become a public health problem. OBJECTIVE: To evaluate frequently used nickel products in Brazil. We investigated if these objects release nickel that is capable of inducing sensitization or cause clinical manifestations in terms of allergic contact dermatitis (ACD). METHODS: Dimethylglyoxime (DMG) spot tests assessed nickel release from several common utensils used in everyday life in São Paulo and Rio de Janeiro, Brazil. RESULTS: We tested 46 coins (two denominations) and 90 common utensils. Approximately 91.1% produced nickel-positive results using the DMG spot test. CONCLUSIONS: The DMG limit of detection was 1.67 ppm of nickel. We observed that many objects in our test series released nickel above the DMG test limit. This observation suggests that nickel-sensitive individuals may be exposed to nickel, representing a public health issue.

Contamination of coins and banknotes as sources of transmission of parasitic pathogens: a pilot study from Iran.

OBJECTIVE: This study was conducted to determine the presence, type, and rate of parasitic contamination in Iranian currencies. STUDY DESIGN: This was a cross-sectional study. METHODS: Coins and banknotes of different denominations were randomly collected from sellers and markets in Tabriz, Northwest of Iran, for examining parasitic contamination. RESULTS: Entamoeba coli and Giardia intestinalis were the most identified species of parasites in this study. Other parasites detected were Cryptosporidium parvum, Ascaris lumbricoides, Entamoeba histolytica, Fasciola hepatica, and Toxocara cati. A high rate of parasitic contamination was found in banknotes compared with coins, and a statistically significant association was found between parasitic contamination and the apparent condition of the currencies. The notes of lower denominations showed the highest contamination rates. The highest parasitic contamination was found in coins and banknotes obtained from public toilet services, butchers, and beggars. CONCLUSIONS: The findings emphasize the role of circulating coins and banknotes in the risk of pathogenic parasite transmission.

Isolation, characterization, and genome insights into an anaerobic sulfidogenic Tissierella bacterium from Cu-bearing coins.

Recent reports on antimicrobial effects of metallic Cu prompted this study of anaerobic microbial communities on copper surfaces. Widely circulating copper-containing coinage was used as a potential source for microorganisms that had had human contact and were tolerant to copper. This study reports on the isolation, characterization, and genome of an anaerobic sulfidogenic Tissierella sp. P1from copper-containing brass coinage. Dissimilatory (bi)sulfite reductase dsrAB present in strain P1 genome and the visible absorbance around 630 nm in the cells suggested the presence of a desulfoviridin-type protein. However, the sulfate reduction rate measurements with 35SO42- did not confirm the dissimilatory sulfate reduction by the strain. The P1 genome lacks APS reductase, sulfate adenylyltransferase, DsrC, and DsrMK necessary for dissimilatory sulfate reduction. The isolate produced up to 0.79 mM H2S during growth, possibly due to cysteine synthase (CysK) and/or cysteine desulfhydrase (CdsH) activities, encoded in the genome. The strain can tolerate up to 2.4 mM Cu2+(150 mg/l) in liquid medium, shows affinity to metallic copper, and can survive on copper-containing coins up to three days under ambient air and dry conditions. The genome sequence of strain P1 contained cutC, encoding a copper resistance protein, which distinguishes it from all other Tissierella strains with published genomes.

Hoarding all of the chips: Slot machine gambling and the foraging for coins.

Predictions made by the "incentive hope" hypothesis account for overconsumption in unpredictable food environments. However, when applied to uncertain gambling situations, there are several areas where this theory falls short. Most notably, it has trouble explaining why, in slot machine gambling, players are motivated by extended play to spend time trying to resolve uncertainty, rather than hoarding monetary gains.

The handedness of historiated spiral columns.

Trajan's Column in Rome (AD 113) was the model for a modest number of other spiral columns decorated with figural, narrative imagery from antiquity to the present day. Most of these wind upwards to the right, often with a congruent spiral staircase within. A brief introductory consideration of antique screw direction in mechanical devices and fluted columns suggests that the former may have been affected by the handedness of designers and the latter by a preference for symmetry. However, for the historiated columns that are the main focus of this article, the determining factor was likely script direction. The manner in which this operated is considered, as well as competing mechanisms that might explain exceptions. A related phenomenon is the reversal of the spiral in a non-trivial number of reproductions of the antique columns, from Roman coinage to Renaissance and baroque drawings and engravings. Finally, the consistent inattention in academic literature to the spiral direction of historiated columns and the repeated publication of erroneous earlier reproductions warrants further consideration.

Suspected esophageal coin--look again.

A 4-year-old presented to the emergency department, asymptomatic, with the strong suspicion (by history, physical examination, and initial radiographic interpretation by the emergency physician) of an esophageal coin. Closer inspection revealed radiographic signs associated with disk battery ingestion, a surgical emergency. In the operating room superimposed coins, mimicking the radiographic appearance of a disk (button) battery, were extracted. This case highlights the important management differences between ingested coins and batteries, the need for cautious interpretation of radiographs, and presents a rare mimic of a serious ingestion.

"Mint" Condition: Contact Dermatitis in an Adolescent Numismatist.

Allergic contact dermatitis (ACD) is common in children and adolescents. A history of persistent rash despite appropriate treatment should raise suspicion of ACD. We present the case of a 16-year-old boy with chronic dermatitis suspected of being a possible nickel allergy. He and his mother denied known common exposures. Patch testing confirmed allergies to multiple metals and several preservatives. A detailed social history revealed that the patient was an avid coin collector. Information about hobbies and activities should be elicited in any patient in whom ACD is suspected to determine exposures they may not initially have considered relevant. This case highlights the importance of pre- and posttest counseling and exposure history.

Special Issue: Coinage Metal (Copper, Silver, and Gold) Catalysis.

The subject of catalysis by coinage metals (copper, silver, and gold) comes up increasingly day-by-day. This Special Issue aims to cover the numerous aspects of the use of these metals as catalysts for several reactions. It deals with synthesis and characterization of copper, silver and gold based catalysis, their characterization and use, both for heterogeneous and homogeneous catalysis, and some of their potential applications.