Influence and mechanism of solids on the air pressure fluctuations on the building drainage system.

The conventional building drainage system was constructed based on the theory of two-phase flow involving water and air. However, the drainage system contained a more intricate three-phase flow, encompassing water, air, and solids, which was relatively overlooked in research. This study addressed the impact of solids on pressure fluctuations, air flow rates, and hydraulic jump fullness within the drainage system, considering three factors: the mass factor, cross-section factor, and viscosity. The investigation was conducted within a single-stack system using both experimental methods and CFD simulations. The findings revealed a positive correlation between both positive and negative pressures and above three factors. The mass factor and the cross-section factor had a more significant impact on the negative pressure of the system. The maximum growth rates of negative pressure extremes under different mass and cross-section factors reached 7.72 and 16.52%, respectively. In contrast, the viscosity of fecal sludge had a slightly higher effect on the positive pressure fluctuation of the drainage system, with the maximum growth rate of positive pressure extremes at 3.41%.

Airway Stability in Sleep Apnea: Assessing Continuous Positive Airway Pressure Efficiency.

Obstructive Sleep Apnea Syndrome (OSAS) disrupts millions of lives with its burden of airway obstruction during sleep. Continuous Positive Airway Pressure (CPAP) therapy has been scrutinized for its biomechanical impact on the respiratory tract. This study leverages computational fluid dynamics to investigate CPAP's effects at 9cm H2O (882.6Pa) on the computed-tomography-based nasal-to-14-generation full respiratory tract model compared to ambient conditions, focusing on static pressure, airflow velocity, and shear stress. Our findings reveal that CPAP significantly increases static pressure, enhancing airway patency without adverse changes in airflow velocity or harmful shear stress on lung tissue, challenging prior concerns about its safety. Notably, the larynx experiences the highest shear stress due to its narrow anatomy, yet CPAP therapy overall supports airway walls against collapse. This investigation highlights CPAP's critical role in OSAS treatment, offering reassurance about its safety and efficacy. By clarifying CPAP therapy's physiological impacts, our study contributes vital insights for optimizing OSAS management strategies, affirming CPAP's benefit in maintaining open airways with minimal tissue strain.

Lumen air pressure regulated multifunctional microbiotas in membrane-aerated biofilm reactors for simultaneous nitrogen removal and antibiotic elimination from aquaculture wastewater.

In this study, two membrane-aerated biofilm reactors (MABRs) were constructed: one solely utilizing biofilm and another hybrid MABR (HMABR) incorporating both suspended-sludge and biofilm to treat low C/N aquaculture wastewater under varying lumen air pressure (LAP). Both HMABR and MABR demonstrated superior nitrogen removal than conventional aeration reactors. Reducing LAP from 10 kPa to 2 kPa could enhance denitrification processes without severely compromising nitrification, resulting in an increase in total inorganic nitrogen (TIN) removal from 50.2±3.1 % to 71.6±1.0 %. The HMABR exhibited better denitrification efficacy than MABR, underscoring its potential for advanced nitrogen removal applications. A decline in LAP led to decreased extracellular polymeric substance (EPS) production, which could potentially augment reactor performance by minimizing mass transfer resistance while maintaining microbial matrix stability and function. Gene-centric metagenomics analysis revealed decreasing LAP impacted nitrogen metabolic potentials and electron flow pathways. The enrichment of napAB at higher LAP and the presence of complete ammonia oxidation (Comammox) Nitrospira at lower LAP indicated aerobic denitrification and Comammox processes in nitrogen removal. Multifunctional microbial communities developed under LAP regulation, diversifying the mechanisms for simultaneous nitrification-denitrification. Increased denitrifying gene pool (narGHI, nirK, norB) and enzymatic activity at a low LAP can amplify denitrification by promoting denitrifying genes and electron flow towards denitrifying enzymes. Sulfamethoxazole (SMX) was simultaneously removed with efficiency up to 80.2 ± 3.7 %, mainly via biodegradation, while antibiotic resistome and mobilome were propagated. Collectively, these findings could improve our understanding of nitrogen and antibiotic removal mechanisms under LAP regulation, offering valuable insights for the effective design and operation of MABR systems in aquaculture wastewater treatment.

Effects of Melt-Blown Processing Conditions on Nonwoven Polylactic Acid and Polybutylene Succinate.

This research aimed to prepare nonwovens from polylactic acid and polybutylene succinate using the melt-blown process while varying the melt-blown process parameters, including air pressure (0.2 and 0.4 MPa) and die-to-collector distance (15, 30, and 45 cm). Increasing the air pressure and die-to-collector distance resulted in the production of smaller fibers. Simultaneously, the tensile strength was dependent on the polymer, air pressure, and die-to-collector distance used, and the percentage elongation at the break tended to increase with an increasing die-to-collector distance. Regarding thermal properties, the PBS nonwovens exhibited an increased level of crystallinity when the die-to-collector distance was raised, consistent with the degree of crystallinity obtained from X-ray diffraction analysis. Polylactic acid could be successfully processed into nonwovens under all six investigated conditions, whereas nonwoven polybutylene succinate could not be formed at a die-to-collector distance of 15 cm. However, both polymers demonstrated the feasibility of being processed into nonwovens using the melt-blown technique, showing potential for applications in the textile industry.

Nasal CPAP in the Pediatric Ward to Reduce PICU Admissions for Severe Bronchiolitis?

In treating acute bronchiolitis in infants, the decision to use continuous positive airway pressure (CPAP) often involves infant referral from the pediatric ward to the pediatric intensive care unit (PICU). We present our experience of CPAP use in a general pediatric ward, aiming to reduce the pressure on the PICU in recent outbreaks of bronchiolitis. Clinical data of patients less than 12 months of age and admitted for bronchiolitis from 1 October 2021 to 31 March 2023 were retrospectively collected. Of 82 infants admitted for bronchiolitis, 16 (19%) were treated with nasal CPAP (nCPAP group); of the remaining 66, 21 (26%) were treated with a low-flow nasal cannula (LFNC) only, 1 (1%) was also treated a with high-flow nasal cannula (HFNC), 12 (15%) were treated with an HFNC only, and 41 (50%) were treated without oxygen support (no-nCPAP group). Overall, coinfection with RSV and SARS-CoV-2 was observed in three patients and SARS-CoV-2 infection was observed in two patients. None of them required any type of oxygen support. Only 3/16 (19%) infants in the nCPAP group were referred to the PICU due to worsening clinical conditions despite nCPAP support. In our experience of treating epidemic bronchiolitis, nCPAP can be safely managed in a general pediatric ward, thus reducing the burden of admissions to the PICU. Training and regular updating of the pediatric staff, careful monitoring of the patient, and close cooperation with the PICU were instrumental for our team.

Relationship between meteorological factors and mortality in patients with coronavirus disease 2019: A cross-sectional study.

Background: Recent studies on COVID-19 have demonstrated that poverty, comorbidities, race/ethnicity, population density, mobility, hygiene and use of masks are some of the important correlates of COVID-19 outcomes. In fact, weather conditions also play an important role in enhancing or eradicating health issues. Based on Chinese experience, the development of SARS and COVID-19 is partially associated with alterations in climate that align with the seasonal shifts of the "24 solar terms." However, the applicability of this pattern to other countries, particularly the United States, which has the highest global incidence and mortality rates, remains subject to ongoing investigation. We need to find more evidence to in the U.S. states verify the relationship between meteorological factors and COVID-19 outcomes to provide epidemiological and environmental support for the COVID-19 pandemic prevention and resource preservation. Objective: To evaluate the relationship between meteorological factors and Coronavirus Disease 2019 (COVID-19) mortality. Methods: We conducted an ecological cross-sectional study to evaluate the relationship between meteorological factors (maximum temperature, minimum temperature, humidity, wind speed, precipitation, atmospheric pressure) and COVID-19 mortality. This retrospective observational study examines mortality rates among COVID-19 patients in the three US states, California, Texas, and New York, with the highest fatality numbers, between March 7, 2020 and March 7, 2021. The study draws upon data sourced from the publicly accessible Dryad database. The daily corresponding meteorological conditions were retrieved from the National Oceanic and Atmospheric Administration Global Meteorological website (https://www.ncei.noaa.gov/maps/hourly/). This study employed multivariate linear regression analysis to assess the correlation between six meteorological factors and COVID-19 mortality. Gaussian distribution models were utilized to generate smooth curves for examining the linear association between maximum or minimum temperature and mortality. Additionally, breakpoint analysis was conducted to evaluate the threshold effect of temperature. Results: We found that the death toll of patients with COVID-19 decreased with an increase in the highest and lowest ambient temperatures (p < 0.001). In our study, we observed a seasonal difference in mortality rates, with a higher number of deaths occurring during winter months, particularly in January and February. However, mortality rates decreased significantly in March. Notably, we found no statistically significant correlation between relative humidity, average precipitation, and average wind speed with COVID-19 mortality (all p > 0.05). Daily COVID-19 death was negatively correlated with the maximum temperature (ß = -22, 95% CI, -26.2 to -17.79 -, p < 0.01), while the maximum temperature was below 30 °C. Similarly, the number of deaths was negatively correlated with the minimum temperature (ß = -27.46, 95% CI, -31.48 to -23.45, p < 0.01), when the minimum temperature was below 8 °C. Our study found a significant association between temperature and COVID-19 mortality, with every 1 °C increase in maximum or minimum temperature resulting in a decrease of 22 and 27 deceased cases, respectively. The relationship between atmospheric pressure and COVID-19 mortality was not fully elucidated due to its complex interaction with maximum temperature. Conclusions: This empirical study adds to the existing body of research on the impact of climate factors on COVID-19 prevention and resource allocation. Policymakers and health scientists may find these findings useful in conjunction with other social factors when making decisions related to COVID-19 prevention and resource allocation.

High-Speed Image Analysis Comparing Loading of Vocal Folds During Coughing and Phonation: A Case Study.

PURPOSE: Coughing is related to voice problems, since it involves firm glottal closure, fast glottal opening, and high subglottic pressure and flow rate. In this study, the glottal area variation and movements of laryngeal structures during coughing and phonation are compared. METHODS: High-speed laryngoscopy recordings were made of a normophonic male participant with a healthy larynx producing a neutral vowel and coughing. Oral air pressure was registered in a mouthpiece, through which an endoscope was inserted into the pharynx. Electroglottography, acoustic, and pressure signals were recorded simultaneously. The glottal width variation at the membranous and cartilaginous parts of the glottis was derived from the high-speed images, and the strong vibration of the false vocal folds was also registered. RESULTS: In coughing, compared to ordinary vowel phonation in nearly the same sound pressure level (93-94 dB6cm), the glottal width was 25% larger at the middle of the vocal folds, the maximum glottal opening velocity was 39% higher, and the maximum glottal width declination rate during glottal closing was up to three times higher. The maximum acceleration was 40% higher, and the maximum deceleration was 47% higher. Fundamental frequency f0 was the highest (ca. 400 Hz) at the beginning of the first phase of a typical coughing process. During the last part of the coughing process, f0 decreased from ca. 250 Hz to ca. 85 Hz at the phonation offset. CONCLUSIONS: The remarkable increase in maximum glottal width declination rate implies much higher vocal fold loading in coughing compared to phonation.

Paediatric sleep apnea event prediction using nasal air pressure and machine learning.

Sleep-disordered breathing is an important health issue for children. The objective of this study was to develop a machine learning classifier model for the identification of sleep apnea events taken exclusively from nasal air pressure measurements acquired during overnight polysomnography for paediatric patients. A secondary objective of this study was to differentiate site of obstruction exclusively from hypopnea event data using the model. Computer vision classifiers were developed via transfer learning to either normal breathing while asleep, obstructive hypopnea, obstructive apnea or central apnea. A separate model was trained to identify site of obstruction as either adeno-tonsillar or tongue base. In addition, a survey of board-certified and board-eligible sleep physicians was completed to compare clinician versus model classification performance of sleep events, and indicated very good performance of our model relative to human raters. The nasal air pressure sample database available for modelling comprised 417 normal, 266 obstructive hypopnea, 122 obstructive apnea and 131 central apnea events derived from 28 paediatric patients. The four-way classifier achieved a mean prediction accuracy of 70.0% (95% confidence interval [67.1-72.9]). Clinician raters correctly identified sleep events from nasal air pressure tracings 53.8% of the time, whereas the local model was 77.5% accurate. The site of obstruction classifier achieved a mean prediction accuracy of 75.0% (95% confidence interval [68.7-81.3]). Machine learning applied to nasal air pressure tracings is feasible and may exceed the diagnostic performance of expert clinicians. Nasal air pressure tracings of obstructive hypopneas may "encode" information regarding the site of obstruction, which may only be discernable by machine learning.

Effect of plan-do-check-active method combined with air pressure wave therapy on the prevention of deep venous thrombosis in critically ill patients in neurosurgery.

BACKGROUND: Deep vein thrombosis (DVT) is prone to occur in the recovery of critically ill neurosurgical patients, increasing economic and psychological pressure, and even endangering life. Plan-Do-Check-Action (PDCA) cycle is a kind of quality management cycle procedure, which can help DVT treatment correctly understand the cause of disease and take effective preventive and nursing measures. The air wave pressure therapy instrument takes pressure therapy as the core, forming circulating pressure on limbs and tissues, promoting the flow of blood and lymph, improving the effect of microcirculation, accelerating the return of limb tissue fluid, and preventing thrombosis and limb edema. METHODS: A total of 98 critical neurosurgery patients were selected as the study subjects. On the basis of PDCA circulation treatment, the patients were treated with air pressure wave for 30 minutes/time, twice/day and 14 days. Before and after treatment, the indexes of coagulation function, hemorheology (plasma viscosity, whole blood high shear viscosity and whole blood low shear viscosity), lower limb circumference (15 cm above and below the patella) and Barthel index (BI) scores were observed and recorded. DVT was observed by vascular Doppler ultrasound before and after treatment, and the incidence was calculated. RESULTS: The prothrombin time (18.09 s) and thrombin time (17.66 s) after treatment were higher than those before treatment (12.98 s, 130.7 s), and fibrinogen decreased (4.21 vs. 3.31 g/L). The hemorheological indexes of the patients after treatment were plasma viscosity (1.49 mPa/s, 10.8 mPa/s), whole blood high shear viscosity (6.34 mPa/s, 4.47 mPa/s), whole blood low shear viscosity (9.89 mPa/s, 6.32 mPa/s), circumference at 15 cm below the patella (52.29 cm, 45.23 cm), and circumference at 15 cm above the patella (36.17 cm, 31.38 cm). The BI score showed that the number of patients with severe dependence on grade A (46/15) and moderate dependence on grade B (50/14) decreased after treatment, and the average BI score of patients with combined treatment increased (43.87 and 79.86). After treatment, the number of patients with DVT (20/4) and the incidence of DVT (20.40816327%, 4.081632653%) decreased significantly (P<0.05). CONCLUSIONS: PDCA circulation combined with barometric wave therapy can significantly improve DVT in critical neurosurgical patients.

Air-mattress system for ballistocardiogram-based heart rate and breathing rate estimation.

Sleep-related problems are widespread. Numerous devices for sleep monitoring are increasingly available, including smartwatches, sleep monitoring rings, etc. These devices accumulate and analyze a substantial quantity of physiological data. In this study, we develop a smart air-mattress system that can effectively aid health measurements. The proposed system adopts an air-mattress system to detect subtle changes in pressure and thereby collect micro physiological signals, including ballistocardiography (BCG) and breathing signals. The system uses ultrasonic signals to detect the subject's turning movements. To increase the signal recognition accuracy, the BCG signal is processed effectively to reduce noise interference engendered by the body movement during sleep and is processed using regression analysis for heart rate and breathing rate estimation. Accordingly, the proposed system is unconstrained and can be used to collect micro BCG signals, breathing signals, heart rate signals, and turning movements for the long-term health-care.

Comparative Analysis of Peak Air Pressure and Oxygen Flow between Conventional and Modified Endotracheal Tube for Retromolar Intubation (PUNTUBE)- An In Vitro Study.

Introduction: In conventional practice for retromolar intubation, endotracheal tube (ET) is bent. This leads to compression of the inner diameter of the tube which in turn reduces airflow. Furthermore, conventionally ETs are stabilised in position using inflated tracheal cuff. Elastic sticky tapes around the exit pose hindrance for surgical procedures on the face. Surgical manipulation and maxillomandibular fixation may lead to compression, damage or accidental extubation of ET. We have developed a modified ET dedicated to retromolar intubation with innovative means for tube stabilisation to solve these problems. Materials and Methods: To study the efficacy of the tube, a comparative in vitro study was done on mannequins. Null hypothesis of no change in air pressure and oxygen concentration in bent conventional ET versus modified ET was formulated. Comparison was done on the basis of the peak air pressure (PEP) and oxygen concentration, which was checked using air-gas monitor. Results: The mean PEP was found to be 24.29 psi with standard deviation (SD) of 9.54 in sequentially bent conventional tube. This was found to be only 10.35 psi with SD of 3.22 in modified ET. Oxygen delivery was found to be 3.96 L/min in bent conventional tube, which was 5.22 L/min in modified tube. Both the findings were statistically significant. Discussion: Modified retromolar tube (PUNTUBE) has been found to be efficient in maintaining low PEP while delivering more oxygen as compared to bent conventional tube. Novel mode of tube stabilisation in the form of PUNSTAB is an easy and effective way of tube stabilisation.

High-flow nasal oxygen in acute hypoxemic respiratory failure: A narrative review of the evidence before and after the COVID-19 pandemic.

High-flow nasal oxygen (HFNO) is a type of non-invasive advanced respiratory support that allows the delivery of high-flow and humidified air through a nasal cannula. It can deliver a higher inspired oxygen fraction than conventional oxygen therapy (COT), improves secretion clearance, has a small positive end-expiratory pressure, and exhibits a washout effect on the upper air space that diminishes dead space ventilation. HFNO has been shown to reduce the work of breathing in acute hypoxemic respiratory failure (AHRF) and has become an interesting option for non-invasive respiratory support. Evidence published before the COVID-19 pandemic suggested a possible reduction of the need for invasive mechanical ventilation compared to COT. The COVID-19 pandemic has resulted in a substantial increase in AHRF worldwide, overwhelming both acute and intensive care unit capacity in most countries. This triggered new trials, adding to the body of evidence on HFNO in AHRF and its possible benefits compared to COT or non-invasive ventilation. We have summarized and discussed this recent evidence to inform the best supportive strategy in AHRF both related and unrelated to COVID-19.

Persistence of lower vocal intensity in vocal fold paralysis with cricothyroid impairment after hyaluronate injection.

Background: Unilateral vocal fold paralysis (UVFP) affects the glottal gap, voice, and aerodynamics, whereas injection laryngoplasty (IL) using hyaluronate is an effective treatment for UVFP by decreasing the glottal gap to improve voice. Previous studies have shown that the involvement of cricothyroid (CT) muscle in UVFP patients further affects patients' aerodynamics, but it remains unclear whether the difference remains after IL. This study investigates whether the aerodynamic features observed in UVFP with CT involvement could still be observed after IL. Methods: This study recruited UVFP patients with dysphonia, and IL was performed within 6 months of initial symptoms. All subjects received assessments including videolaryngoscopy, voice analysis, and aerodynamics at three time points: before IL, 1 month after IL, and 6 months after IL. The glottal gap, voice, and aerodynamics between patients with and without CT involvement (the CT+ and CT- groups) were compared, and the change (Δ) before and after IL and repeated-measures analysis of variance (ANOVA) were also compared between the two groups. Result: A total of 71 patients with UVFP (22 in the CT+ group and 49 in the CT- group) were analyzed. After IL, the CT+ group showed a lower sound pressure level (SPL), higher Δair pressure, and smaller Δaerodynamic power than the CT- group. Conclusion: The CT+ group had a lower SPL, even after elevating air pressure to attempt to achieve a higher vocal intensity. The results suggest that although closure of the glottal gap was achieved by IL, the CT+ group still had a lower loudness and needed to sustain a higher peak air pressure when producing voice. Level of evidence: Level 4.

Systematic review and meta-analysis of efficacy and safety of continuous positive airways pressure versus high flow oxygen cannula in acute bronchiolitis.

INTRODUCTION: There are a trend towards increasing use of High-Flow Nasal Cannula (HFNC), outside of paediatric intensive care unit. Give this trend is necessary to update the actual evidence and to assess available published literature to determinate the efficacy of HFNC over Continuous Positive Air Pressure (CPAP) as treatment for children with severe bronchiolitis. METHODS: We searched MEDLINE, EMBASE, LILACS, and COCHRANE Central, and gray literature in clinical trials databases ( www. CLINICALTRIALS: gov ), from inception to June 2022. The inclusion criteria for the literature were randomized clinical trials (RCTs) that included children < 2 years old, with acute moderate or severe bronchiolitis. All study selection and data extractions are performed independently by two reviewers. RESULTS: The initial searches including 106 records. Only five randomized controlled trial that met the inclusion criteria were included in meta-analysis. The risk of invasive mechanical ventilation was not significantly different in CPAP group and HFNC group [OR: 1.18, 95% CI (0.74, 1.89), I² = 0%] (very low quality). The risk of treatment failure was less significantly in CPAP group than HFNC group [OR: 0.51, 95% CI (0.36, 0.75), I² = 0%] (very low quality). CONCLUSION: In conclusion, there was no significant difference between HFNC and CPAP in terms of risk of invasive mechanical ventilation. CPAP reduces de risk of therapeutic failure with a highest risk of non severe adverse events. More trials are needed to confirm theses results.

The lunar nodal phase cycle and winter atmospheric pressure as possible determinants of moth abundance: Analyses of a 30-year time series from South Norway.

According to the plant stress hypothesis, population peaks of herbivores such as moths are caused by plant stress factors that force plants to reallocate stored defensive proteins to transportable and easily digestive N-compounds. A suggested plant stress factor is ionization caused by cosmic ray muons, which are modulated by the 9.3-year lunar nodal phase cycle, solar activity, and atmospheric pressure. Vascular plants are more sensitive to ionization than are bryophytes, and woody plants are more sensitive than are herbaceous plants, but the difference may be less during dormancy in winter. We selected the 14 most common moth species from a 30-year light-trapping study in southern Norway to test whether the fluctuation patterns of species from three different feeding guilds were correlated with lunar/solar cycles, or with atmospheric pressure in winter, when muon fluxes are higher than in other seasons. The population indices of three species feeding on deciduous woody plants were positively correlated with the lunar nodal phase index, and there was a similar tendency for the remaining three species. No positive correlations with the lunar index were found for species feeding on herbs or mosses. For nine species, that is, from all three guilds, there was a significant negative correlation between the population index and winter atmospheric pressure in the previous year. The results are in accordance with predictions deduced from the cosmic ray hypothesis, but thorough investigations of the proposed physiological mechanisms are needed for the hypothesis to be widely accepted.

Effectiveness of six-step complex decongestive therapy for treating upper limb lymphedema after breast cancer surgery.

BACKGROUND: Complex decongestive therapy (CDT) is currently recommended as the standard treatment for lymphedema. CDT is a four-step detumescence therapy that can effectively treat upper limb lymphedema after breast cancer surgery, and is considered non-invasive, painless and without side effects. AIM: To determine the effectiveness of a six-step CDT involving a foam granule bandage for the treatment of upper extremity lymphedema pressure after breast cancer surgical intervention. METHODS: The study included 100 patients with upper extremity lymphedema after breast cancer surgery. The surgical methods were mastectomy plus axillary lymph node dissection and breast preservation plus sentinel lymph node biopsy. The study population was further divided into the experimental group and control group with 50 cases in each group. The control group was given conventional CDT (four-step method), which included skin care, freehand lymphatic drainage, foam granule pressurized bandage, and functional exercise. In the experimental group, a six-step CDT method was applied that involved a foam particle bandage combined with air wave pressure therapy in addition to the four steps of conventional CDT. Patients in both groups were given one course of treatment daily (20 times), and the changes in body moisture and subjective symptoms were measured before and after treatment, preoperatively and 20 times after treatment. RESULTS: No statistically significant differences in 50-Hz bioelectrical impedance and extracellular moisture ratio were observed between the two groups before treatment, suggesting comparability of the baseline data. After treatment, the 50-Hz bioelectrical impedance of the experimental group was significantly higher than that in the control group, and the extracellular moisture ratio was significantly lower than that in the control group. A comparison of the differences between the two groups before and after treatment indicated that the treatment effect in the experimental group was better than that in the control group. After 20 treatments, according to subjective evaluations, the tightness and swelling of the limbs in the experimental group were significantly reduced as compared with those in the control group. CONCLUSION: The six-step CDT method can effectively reduce lymphedema, promote lymphatic circulation, and alleviate the subjective symptoms of patients, and thereby improve the quality of life and treatment compliance among patients.

Air-Pressure-Supported Application of Cultured Human Keratinocytes in a Fibrin Sealant Suspension as a Potential Clinical Tool for Large-Scale Wounds.

The treatment of large-scale skin wounds remains a therapeutic challenge. In most cases there is not enough autologous material available for full coverage. Cultured epithelial autografts are efficient in restoring the lost epidermal cover; however, they have some disadvantages, such as difficult application and protracted cell cultivation periods. Transplanting a sprayed keratinocyte suspension in fibrin sealant as biological carrier is an option to overcome those disadvantages. Here, we studied different seeding techniques regarding their applicability and advantages on cell survival, attachment, and outgrowth in vitro and thereby improve the cell transfer to the wound bed. Human primary keratinocytes were suspended in a fibrin sealant. WST-8 assay was used to evaluate the vitality for 7 days. Furthermore, the cells were labeled with CellTracker™ CM-Di-I and stained with a life/dead staining. Cell morphology, shape, and distribution were microscopically analyzed. There was a significant increase in vitality while cultivating the cells in fibrin. Sprayed cells were considerably more homogenously distributed. Sprayed cells reached the confluent state earlier than dripped cells. There was no difference in the vitality and morphology in both groups over the observation period. These findings indicate that the sprayed keratinocytes are superior to the application of the cells as droplets. The sprayed application may offer a promising therapeutic option in the treatment of large chronic wounds.

Cumulative effects of air pollution and climate drivers on COVID-19 multiwaves in Bucharest, Romania.

Over more than two years of global health crisis due to ongoing COVID-19 pandemic, Romania experienced a five-wave pattern. This study aims to assess the potential impact of environmental drivers on COVID-19 transmission in Bucharest, capital of Romania during the analyzed epidemic period. Through descriptive statistics and cross-correlation tests applied to time series of daily observational and geospatial data of major outdoor inhalable particulate matter with aerodynamic diameter ≤ 2.5 µm (PM2.5) or ≤ 10 µm (PM10), nitrogen dioxide (NO2), ozone (O3), sulfur dioxide (SO2), carbon monoxide (CO), Aerosol Optical Depth at 550 nm (AOD) and radon (222Rn), we investigated the COVID-19 waves patterns under different meteorological conditions. This study examined the contribution of individual climate variables on the ground level air pollutants concentrations and COVID-19 disease severity. As compared to the long-term average AOD over Bucharest from 2015 to 2019, for the same year periods, this study revealed major AOD level reduction by ~28 % during the spring lockdown of the first COVID-19 wave (15 March 2020-15 May 2020), and ~16 % during the third COVID-19 wave (1 February 2021-1 June 2021). This study found positive correlations between exposure to air pollutants PM2.5, PM10, NO2, SO2, CO and 222Rn, and significant negative correlations, especially for spring-summer periods between ground O3 levels, air temperature, Planetary Boundary Layer height, and surface solar irradiance with COVID-19 incidence and deaths. For the analyzed time period 1 January 2020-1 April 2022, before and during each COVID-19 wave were recorded stagnant synoptic anticyclonic conditions favorable for SARS-CoV-2 virus spreading, with positive Omega surface charts composite average (Pa/s) at 850 mb during fall- winter seasons, clearly evidenced for the second, the fourth and the fifth waves. These findings are relevant for viral infections controls and health safety strategies design in highly polluted urban environments.

Comparison of high flow nasal cannula and non-invasive positive pressure ventilation in children with bronchiolitis: A meta-analysis of randomized controlled trials.

Background: The effects of high-flow nasal cannula (HFNC) compared to non-invasive positive pressure ventilation (NIPPV) on children with bronchiolitis remain unclear. Methods: This meta-analysis was performed following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement. Randomized controlled trials (RCTs) were identified from a comprehensive search in PubMed, EMBASE, Cochrane Library, and Web of Science without time and language limitations. Primary endpoints include the rate of treatment failure, the rate of need for intubation, and the pediatric intensive care unit (PICU) length of stay. Results: Five RCTs including 541 children of less than 24 months were enrolled in the meta-analysis. Compared to the NIPPV group, the rate of treatment failure was significantly higher in the HFNC treatment group (I 2 = 0.0%, P = 0.574; RR 1.523, 95% CI 1.205 to 1.924, P < 0.001). No significant difference was noted in the need for intubation (I 2 = 0.0%, P = 0.431; RR 0.874, 95% CI 0.598 to 1.276, P = 0.485) and the PICU length of stay (I 2 = 0.0%, P = 0.568; WMD = -0.097, 95% CI = -0.480 to 0.285, P = 0.618) between the HFNC group and the NIPPV treatment. Conclusion: Compared to the NIPPV group, HFNC therapy was associated with a significantly higher treatment failure rate in children suffering from bronchiolitis. The intubation rate and the PICU length of stay were comparable between the two approaches.