Search Results (37)

Accurate diagnosis of gastrointestinal (GI) diseases typically requires invasive procedures or imaging studies that pose the risk of various post-procedural complications or involve radiation exposure. Bowel sounds (BSs), though typically described during a GI-focused physical exam, are highly inaccurate and variable, with low clinical value in diagnosis. Interpretation of the acoustic characteristics of BSs, i.e., using a phonoenterogram (PEG), may aid in diagnosing various GI conditions non-invasively. Use of artificial intelligence (AI) and improvements in computational analysis can enhance the use of PEGs in different GI diseases and lead to a non-invasive, cost-effective diagnostic modality that has not been explored before. The purpose of this work was to develop an automated AI model, You Only Listen Once (YOLO), to detect prominent bowel sounds that can enable real-time analysis for future GI disease detection and diagnosis. A total of 110 2-minute PEGs sampled at 44.1 kHz were recorded using the Eko DUO^® stethoscope from eight healthy volunteers at two locations, namely, left upper quadrant (LUQ) and right lower quadrant (RLQ) after IRB approval. The datasets were annotated by trained physicians, categorizing BSs as prominent or obscure using version 1.7 of Label Studio Software^®. Each BS recording was split up into 375 ms segments with 200 ms overlap for real-time BS detection. Each segment was binned based on whether it contained a prominent BS, resulting in a dataset of 36,149 non-prominent segments and 6435 prominent segments. Our dataset was divided into training, validation, and test sets (60/20/20% split). A 1D-CNN augmented transformer was trained to classify these segments via the input of Mel-frequency cepstral coefficients. The developed AI model achieved area under the receiver operating curve (ROC) of 0.92, accuracy of 86.6%, precision of 86.85%, and recall of 86.08%. This shows that the 1D-CNN augmented transformer with Mel-frequency cepstral coefficients achieved creditable performance metrics, signifying the YOLO model’s capability to classify prominent bowel sounds that can be further analyzed for various GI diseases. This proof-of-concept study in healthy volunteers demonstrates that automated BS detection can pave the way for developing more intuitive and efficient AI-PEG devices that can be trained and utilized to diagnose various GI conditions. To ensure the robustness and generalizability of these findings, further investigations encompassing a broader cohort, inclusive of both healthy and disease states are needed. Full article

Special police units like Austria’s EKO Cobra are uniquely trained to manage high-risk operations, including terrorism, amok situations, and hostage crises. This study explores how group dynamics contribute to operational safety and resilience, emphasising the interconnection between risk perception, training, and operational practices. Interviews with current and former EKO Cobra members reveal key risk factors, including overconfidence, insufficient training, inadequate equipment, and the challenges of high-stakes scenarios. Using a structured yet thematically flexible interview analysis approach, the study adopts group dynamics theory as its framework and applies a semi-inductive, semi-deductive qualitative methodology. It examines risk categorisation in ad hoc operations, as well as the interplay between risk perception and training, proposing actionable strategies to enhance safety and preparedness through tailored training programmes. The findings underscore the transformative impact of intensive scenario-based and high-stress training, which enhances situational awareness and reinforces team-based responses through cohesion and effective communication. Group dynamics, including cohesion and effective communication, play a pivotal role in mitigating risks and ensuring operational success. Importantly, this research advocates for continuous, adaptive, and specialised training to address evolving challenges. By linking theoretical frameworks with practical and actionable insights, this study proposes a holistic training approach that promotes both resilience and long-term sustainability in police operations. These findings offer valuable guidance to elite units like EKO Cobra for broader policy frameworks by providing insights that make police operations safer and more effective and resilient. Full article

In eutherian mammals, embryo implantation is a critical process for a successful pregnancy. In mice, the activation of the leukemia inhibitory factor (LIF) receptor–STAT3 signaling axis induces embryo adhesion and decidualization. The LIF receptor is believed to function as a heterodimer composed of LIFR (encoded by Lifr) and GP130 (encoded by Il6st); however, their distinct expression patterns in the uterine epithelium immediately prior to implantation suggest divergent functional roles. In this study, we generated uterine epithelium-specific Lifr knockout (Lifr eKO) mice and conducted a comprehensive gene expression analysis of the endometrium before implantation. We compared these results with those from uterine epithelium-specific Gp130 knockout (Gp130 eKO) mice. Similarly to Gp130 eKO mice, Lifr eKO mice were completely infertile. We identified 299 genes with expression changes greater than twofold following gene deletion; among these, 31 genes were downregulated and 57 genes were upregulated in both eKO models. Many of the downregulated genes were previously implicated in uterine function. Hub gene analysis identified Erbb2 and c-Fos as key regulators in both models. Further experiments using an ERBB2 inhibitor suggested that LIFR–ERBB2-mediated signaling plays a crucial role in embryo implantation. Full article

Most raptors are flagship and umbrella species acting as ecosystem engineers. Research on avian parasites in raptors is therefore of interest. There is a lack of studies on Sarcocystis in naturally infected raptors. In the present work, we aimed to identify Sarcocystis spp. in intestinal scrapings of the raptors from Spain. Sarcocystis spp. were identified in 82.5% of the intestinal samples studied by nested PCR and sequencing of the partial ITS1 region and 28S rRNA. A total of nine known Sarcocystis species, S. arctica, S. columbae, S. cornixi, S. glareoli, S. halieti, S. kutkienae, S. cf strixi, S. turdusi, and Sarcocystis sp. ex Corvus corax, and three genetically new organisms, Sarcocystis sp. Rod6, Sarcocystis sp. Rod7, and Sarcocystis sp. 22AvEs1, were identified in the intestines of raptors. This study is the first report of Sarcocystis spp. in the intestines of eleven raptor species from Spain. Furthermore, the new potential definitive hosts have been determined for seven Sarcocystis species. Co-infection of Sarcocystis spp. has also been observed, with more than one species found in 72.5% of birds. Nine different Sarcocystis species were identified in the intestinal samples of the Common Buzzard (Buteo buteo). In conclusion, raptors play an important role in the transmission of Sarcocystis spp. Full article

The skin epidermis provides a barrier that is imperative for preventing transepidermal water loss (TEWL) and protecting against environmental stimuli. The underlying molecular mechanisms for regulating barrier functions and sustaining its integrity remain unclear. RORα is a nuclear receptor highly expressed in the epidermis of normal skin. Clinical studies showed that the epidermal RORα expression is significantly reduced in the lesions of multiple inflammatory skin diseases. In this study, we investigate the central roles of RORα in stabilizing skin barrier function using mice with an epidermis-specific Rora gene deletion (Rora^EKO). While lacking spontaneous skin lesions or dermatitis, Rora^EKO mice exhibited an elevated TEWL rate and skin characteristics of barrier dysfunction. Immunostaining and Western blot analysis revealed low levels of cornified envelope proteins in the Rora^EKO epidermis, suggesting disturbed late epidermal differentiation. In addition, an RNA-seq analysis showed the altered expression of genes related to “keratinization” and “lipid metabolism” in RORα deficient epidermis. A lipidomic analysis further uncovered an aberrant ceramide composition in the Rora^EKO epidermis. Importantly, epidermal Rora ablation greatly exaggerated percutaneous allergic inflammatory responses to oxazolone in an allergic contact dermatitis (ACD) mouse model. Our results substantiate the essence of epidermal RORα in maintaining late keratinocyte differentiation and normal barrier function while suppressing cutaneous inflammation. Full article

This article compares the emission of gaseous pollutants such as CO₂, CO, NO, SO₂, and HCl emissions from the combustion of the selected most popular solid fuels in a low-power boiler. The process was carried out under controlled conditions on a laboratory stand equipped with a Moderator Unica Vento Eko 25 kW boiler. Solid fuels were selected for comparison, such as hard coal with granulation above 60 mm, hard coal with a granulation of 25–80 mm, hard coal with a granulation of 8–25 mm, wood pellets, and mixed firewood. The experiment was carried out in two stages. In stage 1, previously selected solid fuels were combusted under controlled repeatable conditions, while simultaneously measuring gaseous components in the exhaust gases in real time. On the other hand, the second stage involves the combustion of the same fuels under the same conditions with combustion additives that modify the combustion process in terms of reducing the emission of pollutants. At the same time, in the second stage, gaseous components in the exhaust gas were also measured in real time. The experiments carried out have shown that, in addition to the additive, a testing system should be used to assess the profitability and improve the efficiency of energy production and distribution after using a given additive for fuel combustion. Implementation of the use of solid fuel activators on a common scale should also entail research on the emission of dioxins and furans, which may be emitted in increased amounts under the influence of some components contained in combustion modifiers. Full article

This study proposes an enhanced Kepler Optimization (EKO) algorithm, incorporating fractional-order components to develop a Proportional-Integral-First-Order Double Derivative (PI–(1+DD)) controller for frequency stability control in multi-area power systems with wind power integration. The fractional-order element facilitates efficient information and past experience sharing among participants, hence increasing the search efficiency of the EKO algorithm. Furthermore, a local escaping approach is included to improve the search process for avoiding local optimization. Applications were performed through comparisons with the 2020 IEEE Congress on Evolutionary Computation (CEC 2020) benchmark tests and applications in a two-area system, including thermal and wind power. In this regard, comparisons were implemented considering three different controllers of PI, PID, and PI–(1+DD) designs. The simulations show that the EKO algorithm demonstrates superior performance in optimizing load frequency control (LFC), significantly improving the stability of power systems with renewable energy systems (RES) integration. Full article

The Swiss Ticino regional pulmonary embolism response team (PERT) features direct access to various pharmacomechanical PE management options within a hub/spoke system, by integrating evidence, guidelines’ recommendations and personal experiences. This system involves a collaborative management of patients among the hospitals distributed throughout the region, which refer selected intermediate–high or high PE patients to a second-level hub center, located in Lugano at Cardiocentro Ticino, belonging to the Ente Ospedaliero Cantonale (EOC). The hub provides 24/7 catheterization laboratory activation for catheter-based intervention (CBI), surgical embolectomy and/or a mechanical support system such as extracorporeal membrane oxygenation (ECMO). The hub hosts PE patients after percutaneous or surgical intervention in two intensive care units, one specialized in cardiovascular anesthesiology, to be preferred for patients without relevant comorbidities or with hemodynamic instability and one specialized in post-surgical care, to be preferred for PE patients after trauma or surgery or with relevant comorbidities, such as cancer. From April 2022 to December 2023, a total of 65 patients were referred to the hub for CBI, including ultrasound-assisted catheter-directed thrombolysis (USAT) or large-bore aspiration intervention. No patient received ECMO or underwent surgical embolectomy. Full article

The aim of the research is to assess changes in odour concentration in the ventilated air of a production hall, using different types of biofilter fillings and different types of membranes. Deodorisation was carried out using a mobile combined biofilter at a plant producing lard and liquid oils. Ventilated air from the hall contained organic and inorganic pollutants. Two types of fillings were used for technological tests: stumpwood chips mixed with pine bark and a mix of stumpwood chips with pine bark and green waste compost. Two types of membranes were also used, differing in thickness, permeability, and water resistance. The subjects of the research were the air supplied to the filter, lifted directly from the bed, and the air above the membranes. The deodorisation efficiency—the percentage reduction in the odour concentration value as a result of air flow through the bed and membranes—was calculated. The filtration methods used allowed the selection of the most advantageous technological variant from the point of view of deodorisation effectiveness: a mix of stumpwood chips with pine bark and the Pro Eko Tex UV membrane. It has a total odour reduction efficiency of 99.3–99.9% and has been added to full-scale implementation works. Full article

There is a magmatic lull period in the East Kunlun orogen (EKO) during the Jurassic to the Cretaceous. However, due to the lack of records of magmatic activity restricts our understanding of the late Mesozoic magmatic-tectonic evolution of the EKO. Herein, an integrated study of geochronology, whole-rock geochemistry and Sr-Nd isotopes were conducted for the Cretaceous mafic dykes in the EKO, Northern Tibet Plateau, to reveal their petrogenesis and geodynamic implications. LA-ICP-MS Zircon U-Pb dating reveals that the studied mafic dykes comprising diabase and diabase porphyry emplaced at ca. 80.9 ± 0.8 Ma. The Cretaceous mafic dykes have low contents of SiO₂ (46.36 wt.%~47.40 wt.%) but high contents of MgO (6.79 wt.%~7.38 wt.%), TiO₂ (1.91 wt.%~2.13 wt.%), Nb (12.4~18.3 ppm) and Nb/U ratio (31~39), resembling Nb-enriched mafic dykes. They exhibit chondrite-normalized rare earth element (REE) and primitive mantle-normalized trace element patterns, remarkably similar but not identical to the oceanic island basalts (OIB). The moderate REE fractionation ((La/Yb)_N = 3.55~5.37), weak negative Eu anomalies (δEu = 0.87~0.97) and relative enrichment of Rb, Ba, K, as well as high contents of Cr and Ni and slightly depleted Sr-Nd isotopes (εNd(t) = −0.18~1.33), suggest that the studied dykes originate from a partial melting of spinel lherzolite and a little of garnet which was previously modified by subducted sediments. Combined with other evidence, we propose that the studied Cretaceous Nb-enriched mafic dykes in the Northern Tibet Plateau were formed in the intraplate setting, which may be a partial melting of the enriched mantle in the lower lithosphere caused by the activity of the East Kunlun strike-slip fault. Full article

Anthropogenic chemicals are fundamental for maintaining our standard of living in modern society. Unfortunately, some chemicals are persistent and can enter waste streams and, ultimately, the environment. Commonly used household products, including pharmaceuticals and personal care products, are notable sources of contaminants. The aim of this study was to develop an ‘Up-the-Pipe Solutions’ framework to raise awareness within the wider community about the presence and potential risks of the chemicals found in household products. There is potential to reduce the levels of contaminants in waste streams or substitute them with less harmful alternatives by raising awareness. This framework is based on ‘The Natural Step’ and the concept of essentiality; it recognises the importance of engaging with communities to raise awareness of each individual’s contribution to the problem. Our daily activities and behavioural patterns can have adverse consequences, including the release of persistent contaminants in main waste streams from our kitchens, bathrooms, and green wastes. The ‘Up-the-Pipe Solutions’ framework was successfully used in a small community to engage with school children, local authorities, and Māori leaders to raise awareness of chemical pollution. Full article

The Triassic Paleo-Tethyan magmatic belt in the East Kunlun Orogen (EKO) hosts a small number of porphyry-skarn deposits. The controls of these deposits, especially those in the eastern EKO, are poorly understood. In this contribution, we report new petrological, zircon U-Th-Pb-Hf isotopic, whole-rock elemental with Sr-Nd isotopic, and mineral chemistry data of the Delong quartz diorite and mafic enclaves to constrain their petrogenesis and metal fertility. The quartz diorite and mafic enclaves are emplaced in the Late Triassic (ca. 234 Ma). They are medium-K, metaluminous, enriched in large-ion lithophile elements (e.g., Rb, Ba, Th) and light rare earth elements (e.g., La, Ce, Nd), and relatively depleted in high field strength elements (e.g., Nb, Ta, Ti, P) and heavy rare earth elements (e.g., Gd, Er, Tm, Yb). The quartz diorite show similar (⁸⁷Sr/⁸⁶Sr)_i (0.712584~0.713172) and more depleted εNd(t) (−6.4~−5.7) and εHf(t) (−2.3~+2.6) to those of mafic enclaves ((⁸⁷Sr/⁸⁶Sr)_i = 0.712463~0.713093; εNd(t) = −6.4~−6.0; εHf(t) = −9.4~−4.8). Geochemical compositions of zircon, amphibole, and biotite yield high water content (5.3 wt.%~6.9 wt.% and 6.1 wt.%~7.3 wt.% based on amphibole, respectively) and high redox state for both the quartz diorite and mafic enclaves. These data, together with petrography, indicate the Delong intrusion was formed by mingling of magmas from enriched mantle and lower continental crust with juvenile materials. The oxidized and water-rich features of these magmas denote they have potential for porphyry Cu (±Au ± Mo) deposits, as do some Triassic magmatic rocks in the eastern EKO that show similar geochemical and petrographic characteristics with the Delong intrusion. Full article

(1) Background: Mastery of auscultation can be challenging for many healthcare providers. Artificial intelligence (AI)-powered digital support is emerging as an aid to assist with the interpretation of auscultated sounds. A few AI-augmented digital stethoscopes exist but none are dedicated to pediatrics. Our goal was to develop a digital auscultation platform for pediatric medicine. (2) Methods: We developed StethAid—a digital platform for artificial intelligence-assisted auscultation and telehealth in pediatrics—that consists of a wireless digital stethoscope, mobile applications, customized patient-provider portals, and deep learning algorithms. To validate the StethAid platform, we characterized our stethoscope and used the platform in two clinical applications: (1) Still’s murmur identification and (2) wheeze detection. The platform has been deployed in four children’s medical centers to build the first and largest pediatric cardiopulmonary datasets, to our knowledge. We have trained and tested deep-learning models using these datasets. (3) Results: The frequency response of the StethAid stethoscope was comparable to those of the commercially available Eko Core, Thinklabs One, and Littman 3200 stethoscopes. The labels provided by our expert physician offline were in concordance with the labels of providers at the bedside using their acoustic stethoscopes for 79.3% of lungs cases and 98.3% of heart cases. Our deep learning algorithms achieved high sensitivity and specificity for both Still’s murmur identification (sensitivity of 91.9% and specificity of 92.6%) and wheeze detection (sensitivity of 83.7% and specificity of 84.4%). (4) Conclusions: Our team has created a technically and clinically validated pediatric digital AI-enabled auscultation platform. Use of our platform could improve efficacy and efficiency of clinical care for pediatric patients, reduce parental anxiety, and result in cost savings. Full article

Background. Ultrasound-accelerated thrombolysis (USAT) is a safe and effective treatment for patients with intermediate–high-risk pulmonary embolism (PE). In all studies investigating USAT in the setting of PE, the recombinant tissue-plasminogen activator (rt-PA) alteplase or actilyse was used. Currently, there is a shortage of alteplase (Alteplase, Boehringer Ingelheim) in Europe. It is unknown whether the efficacy of urokinase (UK) is comparable with alteplase for USAT in patients with PE. Methods. Patients with intermediate–high-risk PE undergoing USAT with urokinase and alteplase were included in this study. One-to-one nearest neighbour matching was performed to account for baseline differences. We identified one patient treated with USAT and UK (n = 9) for each patient treated with USAT and alteplase (n = 9). Results. A total of 56 patients underwent USAT. The treatment was successful in all patients. The propensity score matched the identified nine pairs of patients. There were no statistically significant differences in the change in right ventricle-to-left ventricle (RV/LV) ratio (0.4 ± 0.3 versus 0.5 ± 0.4, p = 0.54), systolic pulmonary artery pressure (17.3 ± 8.0 versus 18.1 ± 8.1, p = 0.17), or improvement of RV function (5.8 ± 3.8 versus 5.1 ± 2.6, p = 1.0). The complication rates were comparable (11% in both groups, p = 0.55). There were no deaths in hospital or during 90 days in either group. Conclusions. In this case-matched comparison, the short-term clinical and echocardiographic outcomes showed comparable results between USAT–UK and USAT–rt-PA. Full article

Ultrasound-accelerated thrombolysis (USAT) is an advanced interventional therapy for patients with intermediate–high-risk pulmonary embolism (PE) who deteriorated on anticoagulation or for high-risk patients for whom systemic thrombolysis is contraindicated. The aim of this study is to investigate the safety and efficacy of this therapy with a focus on the improvement of vital signs and laboratory parameters. Seventy-nine patients with intermediate–high-risk PE were treated with USAT from August 2020 to November 2022. The therapy significantly decreased the mean RV/LV ratio from 1.2 ± 0.22 to 0.9 ± 0.2 (p < 0.001) as well as the mean PAPs from 48.6 ± 11 to 30.1 ± 9.0 mmHg (p < 0.001). The respiratory and heart rate decreased significantly (p < 0.001). Serum creatinine decreased significantly from 1.0 ± 0.35 to 0.9 ± 0.3 (p < 0.001). There were 12 access-associated complications, which could be treated conservatively. One patient had haemothorax after the therapy and had to be operated on. USAT is an effective therapy for patients with intermediate–high-risk PE, with favourable hemodynamic, clinical, and laboratory outcomes. Full article