Overview of acute seizure management in US nursing homes.

INTRODUCTION: Residents in NH are more likely to be diagnosed with epilepsy or seizures, which are associated with higher mortality and complicate care. This setting provides unique challenges in the treatment of seizures however, little is known about current management practices in NH. Most studies in the literature concentrate on the use of antiseizure medications (ASMs) but little is known about the management of the acute seizure and clinical guidance is needed to ensure the safety of this vulnerable population. The objective of this study was to survey current practices, identifying knowledge deficits and inform future educational endeavors, including acute seizure action plans (ASAPs). METHODS: A survey was developed pertaining to a broad spectrum of clinical aspects in the management of acute seizures in NH, distinguishing first time seizures from those in the setting of a known seizure disorder. It was sent to NH medical directors throughout the US and data was gathered from those who had at least one new case of new onset/epilepsy in the last 3 years. RESULTS: Ninety-one NH directors responded with 52 % having a seizure protocol. Nurses are responsible in the majority of cases for protocol activation. Regardless of the patient's seizure history, rescue medications are given in the majority of cases, oral benzodiazepines, followed by intravenous and then rectal benzodiazepines. Newer intranasal and intramuscular formulations of benzodiazepines were less frequently prescribed. The most commonly prescribed ASM is levetiracetam, followed by lamotrigine, valproic acid and phenytoin. Staff training and in-service education occur infrequently. Respondents thought no-cost seizure education would be highly beneficial. CONCLUSIONS AND IMPLICATIONS: Only approximately half of NH have protocols for the acute management of seizures. Rescue medications are given regardless of seizure history and often older ASMs are used for long-term management. Our study highlights areas of knowledge deficits and treatment areas for improvement, identifying the need and potential for ASAPs in NHs.

The role of light wavelengths in regulating algal-bacterial granules formation, protein and lipid accumulation, and microbial functions.

High value-added products recovery from algal-bacterial granular sludge (ABGS) has received great attention recently. This study aimed to explore the role of different light wavelengths in regulating granule formation, protein and lipid production, and microbial functions. Bacterial granular sludge (BGS, R0) was most conducive to forming ABGS under blue (R2) light with the highest chlorophyll a (10.2 mg/g-VSS) and diameter (1800 µm), followed by red (R1) and white (R3) lights. R0-R3 acquired high protein contents (>164.8 mg/g-VSS) with essential amino acids above 44.4%, all of which were suitable for recycling, but R2 was the best. Also, blue light significantly increased total lipid production, while red light promoted the accumulation of some unsaturated fatty acids (C18:2 and C18:3). Some unique algae and dominant bacteria (e.g., Stigeoclonium, Chlamydomonas, and Flavobacteria) enrichment and some key functions (e.g., amino acid, fatty acid, and lipid biosynthesis) up-regulation in R2 might help to improve proteins and lipids quality. Combined, this study provides valuable guidance for protein and lipid recovery from ABGS.

Approaches to Understanding the Solution-State Organization of Spray-Dried Dispersion Feed Solutions and Its Translation to the Solid State.

It is well established that polymers adopt a range of conformations and solution-state organization in response to varying solution environments, although very little work has been done to understand how these effects might impact the physical stability and bioavailability of spray-dried amorphous dispersions (SDDs). Potentially relevant solution-state polymer-solvent/cosolute interactions include preferential solvation, hydrodynamic size (i.e., polymer swelling or collapse), and solvent quality effects (i.e., attractive or repulsive self-interactions). Of particular interest is the investigation of preferential solvation, defined as the relative attraction or rejection of a cosolvent and/or cosolute from the local environment of a solvated macromolecule, which often occurs in multicomponent macromolecular solutions. As spray drying and other solvent-based dispersion processing necessitates the use of complex media consisting of at least three or more components (drug, polymer, solvent(s), and other possible excipients), the prevalence of this phenomenon is likely. This work characterizes largely unexplored solution-state properties in model spray-dried dispersion feed solutions using light scattering and viscometric techniques to add greater context and guidance in studying these information-rich materials. These systems are found to exhibit complex non-intuitive behavior, which serves to highlight the potential utility of preferential solvation in spray-dried dispersion processing and stability. It is hypothesized that solution-state organization of the liquid feed can be engineered and translated to the solid-state for the optimization of SDD properties.

Microscopic Characterization of Individual Aerosol Particles in a Typical Industrial City and Its Surrounding Rural Areas in China.

Transmission electron microscopy was used to analyze individual aerosol particles collected in Lanzhou (urban site) and its surrounding areas (rural site) in early 2023. The results revealed that from the pre-Spring Festival period to the Spring Festival period, the main pollutants at the urban site decreased significantly, while the PM2.5 and SO2 concentrations increased at the rural site. During the entire sampling period, the main particles at the urban site were organic matter (OM), secondary inorganic aerosols (SIA), and OM-SIA particles, while those at the rural site were OM, SIA, and soot particles. The degree of external mixing of single particles in both sites increased from the pre-Spring Festival period to the Spring Festival period. The proportion of the OM particles increased by 11% at the urban site, and the proportion of SIA particles increased by 24% at the rural site. During the Spring Festival, the aging of the soot particles was enhanced at the urban site and weakened at the rural site. At the urban site, the SIA particle size was more strongly correlated with the thickness of the OM coating during the pre-Spring Festival period, while the correlation was stronger at the rural site during the Spring Festival.

Topical Photodynamic Therapy Generates Bioactive Microvesicle Particles: Evidence for a Pathway Involved in Immunosuppressive Effects.

Although effective in treating actinic damage, topical photodynamic therapy (PDT) has been shown to be immunosuppressive through unknown mechanisms, which could potentially limit its effectiveness. Multiple types of environmental stressors, including PDT, can produce the immunosuppressive lipid mediator platelet-activating factor (PAF). Because PAF can produce subcellular microvesicle particles (MVPs), these studies tested whether PDT can generate PAF and MVP release and whether these are involved in PDT-induced immunosuppression. Previously, topical PDT using blue light and 5-aminolevulinic acid was found to be a potent stimulus for PAF production in mice and human skin explants and human patients, and we show that experimental PDT also generates high levels of MVP. PDT-generated MVPs were independent of the PAF receptor but were dependent on the MVP-generating enzyme acid sphingomyelinase. Patients undergoing topical PDT treatment to at least 10% of body surface area showed local and systemic immunosuppression as measured by inhibition of delayed-type hypersensitivity reactions. Finally, using a murine model of contact hypersensitivity, PDT immunosuppression was blocked by genetic and pharmacologic inhibition of acid sphingomyelinase and genetic inhibition of PAF receptor signaling. These studies describe a mechanism involving MVP through which PDT exerts immunomodulatory effects, providing a potential target to improve its effectiveness.

N-doped carbon intercalated Fe-doped MoS2 nanosheets with widened interlayer spacing: An efficient peroxymonosulfate activator for high-salinity organic wastewater treatment.

Peroxymonosulfate (PMS) heterogeneous catalysis dominated by nonradical pathway showed excellent adaptability for pollutant removal in complex water matrixes. Herein, ultra-small Fe-doped MoS2 nanosheets with N-doped carbon intercalation (CF-MoS2) were synthesized via a one-step hydrothermal method to treat high salinity organic wastewater. CF-MoS2 exhibited an expanded interlayer spacing by 1.63 times and the specific surface area by 9 times compared with Fe-doped MoS2 (F-MoS2), substantially increasing the active sites. Homogeneous Fe2+ catalytic experiments confirmed that the promotion of carbon intercalated MoS2 (C-MoS2) on Fe3+/Fe2+ redox cycle was much higher than pure MoS2. Besides, the considerable removal of tetracycline (TC) under high salinity conditions (0-7.1%) was attributed to the dominant role of PMS nonradical oxidation pathways, including 1O2 and surface-bound radicals. The catalytic sites included Fe3+/Fe2+, Mo4+/Mo5+/Mo6+, C=O, pyridine N, pyrrolic N and hydroxyl groups. Finally, density functional theory (DFT) was employed to get the radical electrophilic attack sites and nucleophile attack sites of TC, and the results were consistent with the TC degradation products determined by HPLC-MS. This work would broaden the application of MoS2-based catalysts, especially for PMS catalytic removal of organic pollutants from high salinity wastewater.

Research status and prospect of purification technology of sulfur-containing odor gas.

Catalytic purification of sulphur-containing malodorous gases has attracted wide attention because of its advantages of high purification efficiency, low energy consumption and lack of secondary pollution. The selection of efficient catalysts is the key to the problem, while the preparation and optimisation of catalysts depend on the analysis of experimental results and in-depth mechanistic analysis. By analysing the published literature, bibliometric analysis can identify existing research hotspots, the areas of interest and predict development trends, which can help to identify hot catalysts in the catalytic purification of sulphur-containing odours and to investigate their catalytic purification mechanisms. Therefore, this paper uses bibliometric analysis, based on Web Of Science and CNKI databases, CiteSpace and VOS viewer software to collate and analyse the literature on the purification of sulphur-containing odour pollutants, to identify the current research hotspots, to summarise the progress of research on the catalytic purification of different types of sulphur-containing odours, and to analyse their reaction mechanisms and kinetics. On this basis, the research progress of catalytic purification of different kinds of sulfur odour is summarized, and the reaction mechanism and dynamics are summarized.

Insights into the seasonal characteristics of single particle aerosols in Chengdu based on SPAMS.

To investigate the seasonal characteristics in air pollution in Chengdu, a single particle aerosol mass spectrometry was used to continuously observe atmospheric fine particulate matter during one-month periods in summer and winter, respectively. The results showed that, apart from O3, the concentrations of other pollutants (CO, NO2, SO2, PM2.5 and PM10) were significantly higher in winter than in summer. All single particle aerosols were divided into seven categories: biomass burning (BB), coal combustion (CC), Dust, vehicle emission (VE), K mixed with nitrate (K-NO3), K mixed with sulfate and nitrate (K-SN), and K mixed with sulfate (K-SO4) particles. The highest contributions in both seasons were VE particles (24%). The higher contributions of K-SO4 (16%) and K-NO3 (10%) particles occurred in summer and winter, respectively, as a result of their different formation mechanisms. S-containing (K-SO4 and K-SN), VE, and BB particles caused the evolution of pollution in both seasons, and they can be considered as targets for future pollution reduction. The mixing of primary sources particles (VE, Dust, CC, and BB) with secondary components was stronger in winter than in summer. In summer, as pollution worsens, the mixing of primary sources particles with 62 [NO3]- weakened, but the mixing with 97 [HSO4]- increased. However, in winter, the mixing state of particles did not exhibit an obvious evolution rules. The potential source areas in summer were mainly distributed in the southern region of Sichuan, while in winter, besides the southern region, the contribution of the western region cannot be ignored.