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1.
Proc Natl Acad Sci U S A ; 121(35): e2400194121, 2024 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-39172792

RESUMO

Size-dependent phagocytosis is a well-characterized phenomenon in monocytes and macrophages. However, this size effect for preferential gene delivery to these important cell targets has not been fully exploited because commonly adopted stabilization methods for electrostatically complexed nucleic acid nanoparticles, such as PEGylation and charge repulsion, typically arrest the vehicle size below 200 nm. Here, we bridge the technical gap in scalable synthesis of larger submicron gene delivery vehicles by electrostatic self-assembly of charged nanoparticles, facilitated by a polymer structurally designed to modulate internanoparticle Coulombic and van der Waals forces. Specifically, our strategy permits controlled assembly of small poly(ß-amino ester)/messenger ribonucleic acid (mRNA) nanoparticles into particles with a size that is kinetically tunable between 200 and 1,000 nm with high colloidal stability in physiological media. We found that assembled particles with an average size of 400 nm safely and most efficiently transfect monocytes following intravenous administration and mediate their differentiation into macrophages in the periphery. When a CpG adjuvant is co-loaded into the particles with an antigen mRNA, the monocytes differentiate into inflammatory dendritic cells and prime adaptive anticancer immunity in the tumor-draining lymph node. This platform technology offers a unique ligand-independent, particle-size-mediated strategy for preferential mRNA delivery and enables therapeutic paradigms via monocyte programming.


Assuntos
Monócitos , Nanopartículas , RNA Mensageiro , Monócitos/metabolismo , Nanopartículas/química , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Animais , Camundongos , Humanos , Polieletrólitos/química , Macrófagos/metabolismo , Poliaminas/química , Tamanho da Partícula , Diferenciação Celular , Técnicas de Transferência de Genes , Células Dendríticas/metabolismo , Eletricidade Estática , Polímeros
2.
Proc Natl Acad Sci U S A ; 120(23): e2219396120, 2023 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-37252977

RESUMO

Electric vehicle sales have been growing rapidly in the United States and around the world. This study explores the drivers of demand for electric vehicles, examining whether this trend is primarily a result of technology improvements or changes in consumer preferences for the technology over time. We conduct a discrete choice experiment of new vehicle consumers in the United States, weighted to be representative of the population. Results suggest that improved technology has been the stronger force. Estimates of consumer willingness to pay for vehicle attributes show that when consumers compare a gasoline vehicle to its battery electric vehicle (BEV) counterpart, the improved operating cost, acceleration, and fast-charging capabilities of today's BEVs mostly or entirely compensate for their perceived disadvantages, particularly for longer-range BEVs. Moreover, forecasted improvements of BEV range and price suggest that consumer valuation of many BEVs is expected to equal or exceed their gasoline counterparts by 2030. A suggestive market-wide simulation extrapolation indicates that if every gasoline vehicle had a BEV option in 2030, the majority of new car and near-majority of new sport-utility vehicle choice shares could be electric in that year due to projected technology improvements alone.

3.
J Neurophysiol ; 132(3): 809-821, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-38985934

RESUMO

Efficient communication and regulation are crucial for advancing brain-computer interfaces (BCIs), with the steady-state visual-evoked potential (SSVEP) paradigm demonstrating high accuracy and information transfer rates. However, the conventional SSVEP paradigm encounters challenges related to visual occlusion and fatigue. In this study, we propose an improved SSVEP paradigm that addresses these issues by lowering the contrast of visual stimulation. The improved paradigms outperform the traditional paradigm in the experiments, significantly reducing the visual stimulation of the SSVEP paradigm. Furthermore, we apply this enhanced paradigm to a BCI navigation system, enabling two-dimensional navigation of unmanned aerial vehicles (UAVs) through a first-person perspective. Experimental results indicate the enhanced SSVEP-based BCI system's accuracy in performing navigation and search tasks. Our findings highlight the feasibility of the enhanced SSVEP paradigm in mitigating visual occlusion and fatigue issues, presenting a more intuitive and natural approach for BCIs to control external equipment.NEW & NOTEWORTHY In this article, we proposed an improved steady-state visual-evoked potential (SSVEP) paradigm and constructed an SSVEP-based brain-computer interface (BCI) system to navigate the unmanned aerial vehicle (UAV) in two-dimensional (2-D) physical space. We proposed a modified method for evaluating visual fatigue including subjective score and objective indices. The results indicated that the improved SSVEP paradigm could effectively reduce visual fatigue while maintaining high accuracy.


Assuntos
Interfaces Cérebro-Computador , Potenciais Evocados Visuais , Humanos , Potenciais Evocados Visuais/fisiologia , Masculino , Adulto , Feminino , Adulto Jovem , Eletroencefalografia/métodos , Estimulação Luminosa/métodos , Aeronaves
4.
Am J Epidemiol ; 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38957996

RESUMO

Non-benzodiazepine hypnotics ( "Z-drugs") are prescribed for insomnia, but might increase risk of motor vehicle crash (MVC) among older adults through prolonged drowsiness and delayed reaction times. We estimated the effect of initiating Z-drug treatment on the 12-week risk of MVC in a sequential target trial emulation. After linking New Jersey driver licensing and police-reported MVC data to Medicare claims, we emulated a new target trial each week (July 1, 2007 - October 7, 2017) in which Medicare fee-for-service beneficiaries were classified as Z-drug-treated or untreated at baseline and followed for an MVC. We used inverse probability of treatment and censoring weighted pooled logistic regression models to estimate risk ratios (RR) and risk differences with 95% bootstrap confidence limits (CLs). There were 257,554 person-trials, of which 103,371 were Z-drug-treated and 154,183 untreated, giving rise to 976 and 1,249 MVCs, respectively. The intention-to-treat RR was 1.06 (95%CLs 0.95, 1.16). For the per-protocol estimand, there were 800 MVCs and 1,241 MVCs among treated and untreated person-trials, respectively, suggesting a reduced MVC risk (RR 0.83 [95%CLs 0.74, 0.92]) with sustained Z-drug treatment. Z-drugs should be prescribed to older patients judiciously but not withheld entirely over concerns about MVC risk.

5.
J Pediatr ; 274: 114157, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38901776

RESUMO

OBJECTIVE: To investigate characteristics of sport-related concussion (SRC), recreation-related concussion (RRC), and nonsport or recreation-related concussion (non-SRRC) in patients 5 through 12 years old, an understudied population in youth concussion. STUDY DESIGN: This observational study included patients aged 5 through 12 years presenting to a specialty care concussion setting at ≤28 days postinjury from 2018 through 2022. The following characteristics were assessed: demographics, injury mechanism (SRC, RRC, or SRRC), point of healthcare entry, and clinical signs and symptoms. Kruskal-Wallis and chi-square tests were used to assess group differences. Posthoc pairwise comparisons were employed for all analyses (α = 0.017). RESULTS: One thousand one hundred forty-one patients reported at ≤28 days of injury (female = 42.9%, median age = 11, interquartile range (IQR) = 9-12) with the most common mechanism being RRC (37.3%), followed by non-SRRC (31.9%). More non-SRRCs (39.6%) and RRC (35.7%) were first seen in the emergency department (P < .001) compared with SRC (27.9%). Patients with RRC and non-SRRC were first evaluated at specialists 2 and 3 days later than SRC (P < .001). Patients with non-SRRC reported with higher symptom burden, more frequent visio-vestibular abnormalities, and more changes to sleep and daily habits (P < .001) compared with RRC and SRC (P < .001). CONCLUSIONS: In concussion patients 5 through 12 years, RRCs and non-SRRC were more prevalent than SRC, presenting first more commonly to the emergency department and taking longer to present to specialists. Non-SRRC had more severe clinical features. RRC and non-SRRC are distinct from SRC in potential for less supervision at time of injury and less direct access to established concussion health care following injury.

6.
Biotechnol Bioeng ; 121(9): 2907-2923, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38924052

RESUMO

Continuously secreted by all cell types, extracellular vesicles (EVs) are small membrane-bound structures which shuttle bioactive cargo between cells across their external environment. Their central role as natural molecular messengers and ability to cross biological barriers has garnered significant attention in the use of EVs as therapeutic delivery vehicles. Still, harnessing the potential of EVs is faced with many obstacles. A cell line engineering approach can be used to exploit EVs to encapsulate a bespoke cargo of interest. However, full details regarding native EV-loading mechanisms remain under debate, making this a challenge. While Chinese hamster ovary (CHO) cells are well known to be the preferred host for recombinant therapeutic protein production, their application as an EV producer cell host has been largely overlooked. In this study, we engineered CHO DG44 cells to produce custom EVs with bespoke cargo. To this end, genetic constructs employing split green fluorescent protein technology were designed for tagging both CD81 and protein cargoes to enable EV loading via self-assembling activity. To demonstrate this, NanoLuc and mCherry were used as model reporter cargoes to validate engineered loading into EVs. Experimental findings indicated that our custom EV approach produced vesicles with up to 15-fold greater cargo compared with commonly used passive loading strategies. When applied to recipient cells, we observed a dose-dependent increase in cargo activity, suggesting successful delivery of engineered cargo via our custom CHO EVs.


Assuntos
Cricetulus , Vesículas Extracelulares , Animais , Células CHO , Vesículas Extracelulares/metabolismo , Vesículas Extracelulares/química , Vesículas Extracelulares/genética , Cricetinae , Engenharia Celular/métodos , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Proteínas Recombinantes/biossíntese
7.
Epilepsia ; 2024 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-39166918

RESUMO

OBJECTIVE: Among motor vehicle crashes (MVCs), little is known about whether the characteristics and collision features involving drivers with epilepsy differ from those involving drivers without any history of epilepsy. We assessed MVC features and the effect of epilepsy diagnosis on the risk of severe crash-related injuries among drivers. METHODS: A total of 33 174 MVC events among people with epilepsy (PWE) and 663 480 MVC events of age- and sex-matched non-PWE (1:20) were selected. Crash-related features that involved drivers with and without epilepsy were compared, including driver eligibility, medical history of comorbidities and medications, road and environmental conditions, and accident causes. Cox and logistic regression analyses were used to examine the risks of fatality and severe injury among drivers with and without epilepsy. RESULTS: PWE involved in MVCs were more likely to have lower socioeconomic status, comorbidities, scooter drivers without a qualified driver's license, driving under the influence of alcohol, and be involved in single-vehicle accidents than non-PWE. Drivers with epilepsy also had a higher risk of fatality within 30 days of MVC, with an adjusted hazard ratio (aHR) of 1.37 (95% confidence interval [CI], 1.20-1.57) and a higher risk of hospital admission within 3 days after MVC (aHR, 1.33; 95% CI, 1.29-1.38) compared to that of non-PWE. SIGNIFICANCE: The characteristics of MVCs of drivers with epilepsy were distinct from those of non-affected drivers. And higher fatality and injury rates were observed among drivers with epilepsy, which should be considered in further policymaking regarding safe driving of PWE.

8.
Mol Pharm ; 21(3): 1149-1159, 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38288708

RESUMO

The development of biomolecule delivery systems is essential for the treatment of various diseases such as cancer, immunological diseases, and metabolic disorders. For the first time, we found that SARS-CoV-2-encoded nonstructural protein 2 (NSP2) can be secreted from the cells, where it is synthesized. Brefeldin A and H89, inhibitors of ER/Golgi secretion pathways, did not inhibit NSP2 secretion. NSP2 is likely secreted via an unconventional secretory pathway. Moreover, both secreted and purified NSP2 proteins were able to traverse the plasma membrane barrier and enter both immortalized human umbilical vein endothelial cells and tumor cell lines. After entry, the NSP2 protein was localized in only the cytoplasm. Cytochalasin D, a potent inhibitor of actin polymerization, inhibited the entry of NSP2. NSP2 can carry other molecules into cells. Burkholderia lethal factor 1, a monomeric toxin from the intracellular pathogen Burkholderia pseudomallei, has demonstrated antitumor activity by targeting host eukaryotic initiation translation factor 4A. An NSP2-BLF1 fusion protein was translocated across the cellular membranes of Huh7 cells and mediated cell killing. By using different approaches, including protein purification, chemical inhibition, and cell imaging, we confirm that NSP2 is able to deliver heterologous proteins into cells. NSP2 can act as a potential delivery vehicle for proteins.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Proteínas não Estruturais Virais/química , Proteínas não Estruturais Virais/metabolismo , Células Endoteliais/metabolismo , Linhagem Celular Tumoral
9.
Mol Pharm ; 21(9): 4726-4746, 2024 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-39141808

RESUMO

Therapeutic monoclonal antibody (mAb) products for intravenous (IV) administration generally require aseptic compounding with a commercially available diluent. When the administration site is located away from the preparation site, the prepared dosing solution may need to be transported in a vehicle. The impact of vehicle transportation on the product quality of mAbs needs to be evaluated to define safe handling and transportation conditions for dosing solutions. The design and execution of actual vehicle transportation studies require considerable resources and time. In this study, we systematically developed three different laboratory equipment-based methods that simulate vehicle transportation stresses: orbital shaker (OS), reciprocating shaker (RS), and vibration test system (VTS)-based simulation methods. We assessed their feasibility by comparing the impact on product quality caused by each simulated method with that caused by actual vehicle transportation. Without residual polysorbate 80 (PS80) in the mAb dosing solution, transportation via a cargo van led to a considerable increase in the subvisible particle counts and did not meet the compendial specifications for the light obscuration method. However, the presence of as low as 0.0004%w/v (4 ppm) PS80 in the dosing solution stabilized the mAb against vehicle transportation stresses and met the compendial specifications. Vehicle transportation of an IV bag with headspace resulted in negligible micro air bubbles and foaming in both PS80-free and PS80-containing mAb dosing solutions. These phenomena were found to be comparable to the VTS-based simulated method. However, the OS- and RS-based simulated methods formed significantly more micro air bubbles and foaming in an IV bag with headspace than either actual vehicle transportation or the VTS-based simulated method. Despite the higher interfacial stress (micro air bubbles and foaming) in the dosing solution created by the OS- and RS-based simulated methods, 0.0004%w/v (4 ppm) PS80 in the dosing solution was found to be sufficient to stabilize the mAb. The study shows that under appropriate simulated conditions, the OS-, RS-, and VTS-based simulated methods can be used as practical and meaningful models to assess the impact and risk of vehicle transportation on the quality of mAb dosing solutions.


Assuntos
Anticorpos Monoclonais , Meios de Transporte , Anticorpos Monoclonais/química , Anticorpos Monoclonais/administração & dosagem , Meios de Transporte/métodos , Composição de Medicamentos/métodos , Estudos de Viabilidade , Polissorbatos/química , Administração Intravenosa
10.
Chem Rec ; 24(3): e202300308, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38200590

RESUMO

The transition to sustainable transportation has fueled the need for innovative electric vehicle (EV) charging solutions. Building Integrated Photovoltaics (BIPV) systems have emerged as a promising technology that combines renewable energy generation with the infra-structure of buildings. This paper comprehensively reviews the BIPV system for EV charging, focusing on its technology, application, and performance. The review identifies the gaps in the existing literature, emphasizing the need for a thorough examination of BIPV systems in the context of EV charging. A detailed review of BIPV technology and its application in EV charging is presented, covering aspects such as the generation of solar cell technology, BIPV system installation, design options and influencing factors. Furthermore, the review examines the performance of BIPV systems for EV charging, focusing on energy, economic, and environmental parameters and their comparison with previous studies. Additionally, the paper explores current trends in energy management for BIPV and EV charging, highlighting the need for effective integration and recommending strategies to optimize energy utilization. Combining BIPV with EV charging provides a promising approach to power EV chargers, enhances building energy efficiency, optimizes the building space, reduces energy losses, and decreases grid dependence. Utilizing BIPV-generated electricity for EV charging provides electricity and fuel savings, offers financial incentives, and increases the market value of the building infrastructure. It significantly lowers greenhouse gas emissions associated with grid and vehicle emissions. It creates a closed-loop circular economic system where energy is produced, consumed, and stored within the building. The paper underscores the importance of effective integration between Building Integrated Photovoltaics (BIPV) and Electric Vehicle (EV) charging, emphasizing the necessity of innovative grid technologies, energy storage solutions, and demand-response energy management strategies to overcome diverse challenges. Overall, the study contributes to the knowledge of BIPV systems for EV charging by presenting practical energy management, effectiveness and sustainability implications. It serves as a valuable resource for researchers, practitioners, and policymakers working towards sustainable transportation and energy systems.

11.
J Neurooncol ; 166(3): 395-405, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38321326

RESUMO

PURPOSE: Brain tumours are associated with neurocognitive impairments that are important for safe driving. Driving is vital to maintaining patient autonomy, despite this there is limited research on driving capacity amongst patients with brain tumours. The purpose of this review is to examine MVC risk in patients with brain tumours to inform development of clearer driving guidelines. METHODS: A systematic review was performed using Medline and EMBASE. Observational studies were included. The outcome of interest was MVC or measured risk of MVC in patients with benign or malignant brain tumours. Descriptive analysis and synthesis without meta-analysis were used to summarise findings. A narrative review of driving guidelines from Australia, United Kingdom and Canada was completed. RESULTS: Three studies were included in this review. One cohort study, one cross-sectional study and one case-control study were included (19,135 participants) across United States and Finland. One study evaluated the incidence of MVC in brain tumour patients, revealing no difference in MVC rates. Two studies measured MVC risk using driving simulation and cognitive testing. Patients found at higher risk of MVC had greater degrees of memory and visual attention impairments. However, predictive patient and tumour characteristics of MVC risk were heterogeneous across studies. Overall, driving guidelines had clear recommendations on selected conditions like seizures but were vague surrounding neurocognitive deficits. CONCLUSION: Limited data exists regarding driving behaviour and MVC incidence in brain tumour patients. Existing guidelines inadequately address neurocognitive complexities in this group. Future studies evaluating real-world data is required to inform development of more applicable driving guidelines. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO 2023 CRD42023434608.


Assuntos
Acidentes de Trânsito , Condução de Veículo , Neoplasias Encefálicas , Humanos , Neoplasias Encefálicas/epidemiologia , Acidentes de Trânsito/estatística & dados numéricos
12.
J Sleep Res ; : e14139, 2024 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-38196126

RESUMO

Air forces have developed several methods for reducing fatigue-related accidents. In the Israeli Air Force, the "Dead Tired" workshop was developed with the purpose of presenting aircrew with their objective performance under sleep deprivation conditions. The aim of this study was to examine the cognitive abilities of both aircrew and unmanned aerial vehicle operators, both objectively and subjectively. All Israeli aircrew and unmanned aerial vehicle operators participated in a "Dead Tired" workshop. During the workshop, the participants performed the Psychomotor Vigilance Task, a task that tests their attention abilities, while gathering information on their subjective sleepiness in the form of a Karolinska Sleepiness Scale. Data of 366 participants (25 females), of whom 187 were unmanned aerial vehicle operators and 179 were aircrew, were obtained; and the mean age was 21.8 ± 1.2 years (range 19-26 years). A significant decline in task performance was seen following 20 hr of wakefulness in both unmanned aerial vehicle operators and aircrew (p < 0.001). Unmanned aerial vehicle operators' performance was significantly better throughout the majority of the workshop (p < 0.001). Recovery after the full-night's sleep was seen for unmanned aerial vehicle operators, but not for aircrew (p = 0.008). A high correlation was seen between Psychomotor Vigilance Task performance and Karolinska Sleepiness Scale responses (correlation coefficient = 0.93). Sleep deprivation negatively impacted the performance of both groups of participants. Unmanned aerial vehicle operators were found to be more resilient to the effects of sleep deprivation and were quicker to recover in comparison to aircrew.

13.
J Surg Res ; 295: 332-339, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38061238

RESUMO

INTRODUCTION: Blunt cerebrovascular injury (BCVI) is defined as a nonpenetrating injury to the carotid or vertebral arteries which can be highly morbid. Because BCVI is rare, most studies have been devoted to triaging trauma patients for BCVI identification, with little data available regarding the complications these patients experience after initial evaluation. Here, we analyze the association of complications during admission for BCVI patients. METHODS: The National Trauma Databank was queried from 2007 to 2014 for adults ≥65 y old. Demographics, incidence of BCVI, and injury data were evaluated using univariate analysis. Rates of inpatient complications due to acutely acquired infections and strokes were evaluated using univariate and multivariable analysis. RESULTS: We identified 666,815 non-BCVI and 552 BCVI patients. Patients with a BCVI were typically male, White, younger (65-75-y-old), had three or more comorbidities, and had Medicare insurance. BCVI patients had a mild head injury upon arrival at the emergency department and experienced a motor vehicle accident/fall. The median length of stay in the intensive care unit, days spent on a ventilator, and presence of polytrauma were higher among BCVI patients. BCVI patients had increased odds of experiencing a stroke and pneumonia as complications while admitted compared to their non-BCVI counterparts. CONCLUSIONS: Postinjury, patients who suffered a BCVI had higher odds of stroke and pneumonia than patients who did not experience a BCVI. Additional studies are needed to determine the modifiable risk factors associated with BCVIs among aging adults.


Assuntos
Traumatismo Cerebrovascular , Pneumonia , Acidente Vascular Cerebral , Ferimentos não Penetrantes , Idoso , Humanos , Masculino , Traumatismo Cerebrovascular/complicações , Traumatismo Cerebrovascular/epidemiologia , Medicare , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , Estados Unidos/epidemiologia , Ferimentos não Penetrantes/complicações , Ferimentos não Penetrantes/epidemiologia , Feminino
14.
J Surg Res ; 295: 261-267, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38048749

RESUMO

INTRODUCTION: The impact of obesity on the incidence of blunt pelvic fractures in adults is unclear, and adolescents may have an increased risk of fracture due to variable bone mineral density and leptin levels. Increased subcutaneous adipose tissue may provide protection, though the association between obesity and pelvic fractures in adolescents has not been studied. This study hypothesized that obese adolescents (OAs) presenting after motor vehicle collision (MVC) have a higher rate of pelvic fractures, and OAs with such fractures have a higher associated risk of complications and mortality compared to non-OAs. METHODS: The 2017-2019 Trauma Quality Improvement Program database was queried for adolescents (12-16 y old) presenting after MVC. The primary outcome was a pelvic fracture. Adolescents with a body mass index ≥30 (OA) were compared to adolescents with a body mass index <30 (non-OA). Subgroup analyses for high-risk and low-risk MVCs were performed. Multivariable logistic regression analyses were also performed adjusting for age and sex. RESULTS: From 22,610 MVCs, 3325 (14.7%) included OAs. The observed rate of pelvic fracture was similar between all OA and non-OA MVCs (10.2% versus 9.4%, P = 0.16), as well as subanalyses of minor or high-risk MVC (both P > 0.05). OAs presenting with a pelvic fracture after high-risk MVC had a similar risk of complications, pelvic surgery, and mortality compared to non-OAs (all P > 0.05). However, OAs with a pelvic fracture after minor MVC had a higher associated risk of complications (OR 2.27, CI 1.10-4.69, P = 0.03), but a similar risk of requiring pelvic surgery, and mortality (all P > 0.05). CONCLUSIONS: This national analysis found a similar observed incidence of pelvic fractures for OAs versus non-OAs involved in an MVC, including subanalyses of minor and high-risk MVC. Furthermore, there was no difference in the associated risk of morbidity and mortality except for OAs involved in a minor MVC had a higher risk of complication.


Assuntos
Fraturas Ósseas , Obesidade Infantil , Ossos Pélvicos , Adulto , Adolescente , Humanos , Obesidade Infantil/complicações , Obesidade Infantil/epidemiologia , Fraturas Ósseas/epidemiologia , Fraturas Ósseas/etiologia , Acidentes de Trânsito , Ossos Pélvicos/lesões , Veículos Automotores , Estudos Retrospectivos
15.
J Surg Res ; 301: 103-109, 2024 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-38917573

RESUMO

INTRODUCTION: Outcomes from trauma at the major referral hospital [Hospital Nacional de San Benito (HNSB)] in El Petén, Guatemala, have not been analyzed. Empirical evidence demonstrated a high number of motorcycle accidents (MAs). We hypothesized a large incidence of head trauma with poor outcomes in MAs compared to all other forms of blunt trauma. METHODS: Our hypothesis was tested by performing a community observational study and a retrospective chart review in El Petén, Guatemala. An independent observer catalogued 100 motorcycle riders on the streets of El Petén for riding practices as well as helmet utilization. HNSB does not have electronic medical records. For this study, we performed a retrospective chart review of randomly selected nonconsecutive trauma admission at HNSB between March 2018 and June 2023. Blunt trauma was compared between MAs versus all others. Variables were examined by parametric and nonparametric tests as well as contingency table analyses. RESULTS: Most motorcycles riders involved multiple individuals (2.61 ± 0.79/motorcycle). Seventy riders included children (median = 1.0 [Q1-Q3 range = 1.0-3.0]/motorcycle). Overall, only three riders were wearing helmets. Forty-one were women. Of patients presenting to HNSB with trauma, 91 charts were reviewed (33.0 [20.0-37.0] y old; male 89%), 76.7% were blunt, and 23.3% were penetrating trauma. Within blunt trauma, 57.1% were MAs versus 42.9% all others; P = 0.13. MAs were younger (29.5 [20.0-37.0] versus 34.0 [21.8-45.8] y old; P < 0.05) and of similar gender (male 82.5% versus 96.6%; P = 0.1). More MAs had a computed tomography (70.0% versus 30.0%; P < 0.01) and they were more likely to present with head trauma (72.5% versus 46.7%; P = 0.04) but similar Glasgow Coma Scale (15.0 [13.5-15.0] versus 15.0 [12.5-15.0]; P = 0.7). MAs were less likely to require surgical intervention (37.5% versus 56.7%; P = 0.05) but had similar hospital length of stay (4.0 [2-6] versus 4.0 [2-10.5] d; P = 0.5). CONCLUSIONS: Unsafe motorcycle practices in El Petén are staggering. Most trauma at HNSB is blunt, and likely from MAs. More patients with MAs presented with head trauma. However, severe trauma might be transferred to higher level hospitals or mortality might occur on scene, which will need further investigations. Assessment of mortality from trauma admissions is ongoing. These findings should lead to enforcement of safe motorcycle practices in El Petén, Guatemala.

16.
J Surg Res ; 302: 568-577, 2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39178573

RESUMO

INTRODUCTION: There is a growing body of literature that shows geographic social vulnerability, which seeks to measure the resiliency of a community to withstand unforeseen disasters, may be associated with negative outcomes after traumatic injury. For motor vehicle collisions (MVCs) specifically, it is unknown how the resources of a patient's home environment may interact with resources of the environment where the crash occurred. METHODS: We merged publicly available crash data from the state of Michigan with the Michigan Trauma Quality Improvement dataset. A social vulnerability index (SVI) score was calculated for each ZIP code and was then cross-referenced between the location of the MVC (Crash-SVI) and the patient's home address (Home-SVI). SVI was divided into quintiles, with higher numbers indicating greater vulnerability. Adjusted logistic regression models using least absolute shrinkage and selection operator for feature selection and regularization were performed sequentially using patient, vehicular, and environmental variables to identify associations between Home-SVI and Crash-SVI, with mortality and injury severity score (ISS) greater than 15 (ISS15). RESULTS: Between January 2020 and December 2022, a total of 14,706 patients were identified. Most MVCs (75.3% of all patients) occurred in the second through fourth quintiles of SVI. In all cases, Crash-SVI occurred most frequently within the same quintile as the patient's Home-SVI. Average crash speed limits showed a significant negative association with increasing SVI. On adjusted logistic regression, there were significantly increased odds of mortality for the fifth quintile of Home-SVI in comparison to the first quintile when adjusted for patient factors; but this lost significance after the addition of vehicular or environmental variables. In contrast, there were decreased odds of ISS15 for the highest quintiles of Crash-SVI in all logistic regression models. CONCLUSIONS: Geographic social vulnerability markers were associated with lower MVC-associated injury severity, perhaps in part because of the association with lower speed limit in these areas.

17.
Conserv Biol ; 38(2): e14159, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37551769

RESUMO

Wildlife mortality due to collisions with vehicles (roadkill) is one of the predominant negative effects exerted by roads on many wildlife species. Reducing roadkill is therefore a major component of wildlife conservation. Roadkill is affected by various factors, including road attributes and traffic volume. It is theorized that the effect of traffic volume on roadkill probability should be unimodal. However, empirical evidence for this theory is lacking. Using a large-scale roadkill database of 18 wildlife species in Israel, encompassing 2846 km of roads over 10 years, we explored the effects of traffic volume and road attributes (e.g., road lighting, verge vegetation) on roadkill probability with a multivariate generalized linear mixed model. A unimodal effect of traffic volume was identified for the striped hyena (Hyaena hyaena), whereas 5 species demonstrated a novel quadratic U-shaped effect (e.g., golden jackal [Canis aureus]). Four species showed a negative linear effect (e.g., wild boar [Sus scrofa]). We also identified varying effects of road attributes on roadkill. For instance, road lighting and roadside trees decreased roadkill for several species, whereas bus stops and concrete guardrails led to increased roadkill. The theorized unimodal effect of traffic volume may only apply to large, agile species, and the U-shaped effect could be related to intraspecies variability in traffic avoidance behavior. In general, we found that both high-traffic and low-traffic roads can pose a high mortality risk for wildlife. It is therefore important to monitor roadkill on low-traffic roads and adapt road attributes to mitigate roadkill. Road design for effective roadkill mitigation includes reducing the use of concrete guardrails and median barriers where possible and avoiding dense bushes in verge landscaping. These measures are complemented by employing wildlife detection systems, driver warnings, and seasonal speed reduction measures on low-traffic roads identified as roadkill hotspots.


Riesgo de mortalidad de fauna presentado por las carreteras de mucho y poco tráfico Denneboom et al. 23­229 Resumen La mortalidad de fauna por colisiones con vehículos es uno de los efectos negativos predominantes que tienen las carreteras sobre muchas especies. Por lo tanto, la reducción de esta mortalidad es un componente principal de la conservación de la fauna. Esta mortalidad se ve afectada por varios factores, incluyendo las características de la carretera y el volumen de tráfico. Se piensa que el efecto del volumen de tráfico sobre la probabilidad de las colisiones debería ser unimodal; sin embargo, la evidencia empírica para esta teoría no es suficiente. Usamos una base de datos de colisiones de 18 especies de fauna en Israel que engloba 2,846 km de carreteras durante diez años para explorar con un modelo mixto lineal generalizado multivariado los efectos del volumen de tráfico y las características de la carretera (p. ej., iluminación, vegetación de borde) sobre la probabilidad de colisiones. Identificamos un efecto unimodal del volumen del tráfico para la hiena rayada (Hyaena hyaena), mientras que cinco especies demostraron un efecto cuadrático novedoso en forma de U, como el chacal dorado (Canis aureus). Cuatro especies mostraron un efecto negativo lineal, como el jabalí salvaje (Sus scrofa). También identificamos varios efectos de las características de la carretera sobre las colisiones. Por ejemplo, la iluminación y los árboles en los bordes disminuyeron las colisiones para varias especies, mientras que las paradas de camión y los quitamiedos de concreto resultaron en un incremento de las colisiones. La teoría del efecto unimodal del volumen de tráfico podría aplicar sólo para especies grandes y ágiles, mientras que el efecto en forma de U podría relacionarse con la variabilidad de comportamiento para evitar colisiones que hay entre las especies. En general, descubrimos que tanto las carreteras con poco y mucho tráfico pueden representar un riesgo de mortalidad para la fauna. Por lo tanto, es importante monitorear las colisiones en las carreteras con poco tráfico y adaptar las características de la carretera para mitigar las colisiones. El diseño de las carreteras para una mitigación efectiva incluye reducir el uso de quitamiedos de concreto y barreras centrales en donde sea posible y evitar los arbustos densos en el paisajismo de los bordes. Estas medidas están complementadas con el uso de sistemas de detección de fauna, señalamientos para los conductores y medidas estacionales de reducción de la velocidad en las carreteras de poco tráfico identificadas como puntos calientes de colisiones.


Assuntos
Animais Selvagens , Conservação dos Recursos Naturais , Animais , Probabilidade , Acidentes de Trânsito/prevenção & controle
18.
Environ Sci Technol ; 58(28): 12297-12303, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-38968232

RESUMO

The ongoing transition toward electric vehicles (EVs) is changing materials used for vehicle production, of which the consequences for the environmental performance of EVs are not well understood and managed. We demonstrate that electrification coupled with lightweighting of automobiles will lead to significant changes in the industry's demand not only for battery materials but also for other materials used throughout the entire vehicle. Given the automotive industry's substantial consumption of raw materials, changes in its material demands are expected to trigger volatilities in material prices, consequently impacting the material composition and attractiveness of EVs. In addition, the materials recovered during end-of-life recycling of EVs as the vehicle fleet turns over will impact recycled material supplies both positively and negatively, impacting material availabilities and the economic incentive to engage in recycling. These supply chain impacts will influence material usage and the associated environmental performance of not only the automotive sector but also other metal-heavy industries such as construction. In light of these challenges, we propose the need for new research to understand the dynamic materials impacts of the EV transition that encompasses its implications on EV adoption and fleet life cycle environmental performance. Effectively coordinating the coevolution of material supply chains is crucial for making the sustainable transition to EVs a reality.


Assuntos
Automóveis , Reciclagem , Eletricidade
19.
Environ Sci Technol ; 58(12): 5325-5335, 2024 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-38409740

RESUMO

Upgrading to the CHINA 7 standard is crucial for managing air pollution from passenger vehicles in China. Meanwhile, China aims to achieve carbon neutrality by 2060, which necessitates large-scale replacement of gasoline vehicles with electric vehicles in the future. Consequently, the public might view upgrading gasoline vehicles to the CHINA 7 standard as redundant. However, the emission reduction benefits of upgrading standards in the context of uncertain electrification ambitions have not received adequate attention. Here, we show that upgrading standards will compensate for the absence of emissions reductions due to hindered electrification efforts. In the best scenario, China's CO2 emissions can be reduced to 0.047 Gt and NOx to 8.2 × 103 t in 2050. In nonextreme electrification scenarios with CHINA 7 standard, the emission intensity reduction will remain the main driver for emission reductions, outweighing the electrification contribution. In extreme electrification scenarios, upgrading standards will tackle the increased emissions from plug-in hybrid electric vehicles. Our fleet-level results advocate for early standards upgrades to enhance resilience against air pollution risks arising from uncertainties in electrification. Our evidence from China, with one of the most stringent emission standards, can provide a reference point for the world on the upgrading passenger vehicle emission standard issue.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Emissões de Veículos/prevenção & controle , Emissões de Veículos/análise , Poluentes Atmosféricos/análise , Gasolina , Incerteza , Poluição do Ar/prevenção & controle , Poluição do Ar/análise , China , Veículos Automotores
20.
Environ Sci Technol ; 58(28): 12488-12497, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-38958408

RESUMO

Monitoring of volatile organic compounds (VOCs) in air is crucial for understanding their atmospheric impacts and advancing their emission reduction plans. This study presents an innovative integrated methodology suitable for achieving semireal-time high spatiotemporal resolution three-dimensional measurements of VOCs from ground to hundreds of meters above ground. The methodology integrates an active AirCore sampler, custom-designed for deployment from unmanned aerial vehicles (UAV), a proton-transfer-reaction mass spectrometry (PTR-MS) for sample analysis, and a data deconvolution algorithm for improved time resolution for measurements of multiple VOCs in air. The application of the deconvolution technique significantly improves the signal strength of data from PTR-MS analysis of AirCore samples and enhances their temporal resolution by 4 to 8 times to 4-11 s. A case study demonstrates that the methodology can achieve sample collection and analysis of VOCs within 45 min, resulting in >120-360 spatially resolved data points for each VOC measured and achieving a horizontal resolution of 20-55 m at a UAV flight speed of 5 m/s and a vertical resolution of 5 m. This methodology presents new possibilities for acquiring 3-dimensional spatial distributions of VOC concentrations, effectively tackling the longstanding challenge of characterizing three-dimensional VOC distributions in the lowest portion of the atmospheric boundary layer.


Assuntos
Poluentes Atmosféricos , Monitoramento Ambiental , Compostos Orgânicos Voláteis , Compostos Orgânicos Voláteis/análise , Monitoramento Ambiental/métodos , Poluentes Atmosféricos/análise , Espectrometria de Massas/métodos , Algoritmos , Aeronaves
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