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OBJETIVO: Comparar as medidas de pressão arterial sistólica e diastólica obtidas por meio dos métodos auscultatório (esfigmomanômetro de mercúrio) e oscilométrico (aparelho digital Omron HEM-412C). MÉTODOS: Participaram do estudo 22 homens idosos (idade: 67,4 ± 4,8 anos; massa corporal: 79,4 ± 13,1 kg; estatura: 1,7 ± 0,8 m), integrantes de um programa regular de exercícios físicos. O aparelho digital Omron HEM-412C foi conectado em “Y” com o esfigmomanômetro de mercúrio. Três medidas de pressão arterial foram obtidas, com intervalos de dois minutos entre as aferições. Dois avaliadores “cegos” registraram os valores da pressão arterial sistólica e diastólica. RESULTADOS: As medidas de pressão arterial sistólica e diastólica obtidas pelos métodos auscultatório e oscilométrico não apresentaram diferenças significativas (p > 0,05). Correlações positivas e significativas entre os métodos foram observadas para a pressão arterial sistólica (r = 0,96; p < 0,05) e diastólica (r = 0,91; p < 0,05). A média das diferenças (± desvio padrão) da pressão arterial sistólica e diastólica entre ambos os métodos foram 1,5 ± 5,4 mmHg e -0,2 ± 4,5 mmHg, respectivamente. CONCLUSÃO: Os resultados do presente estudo indicam similaridade nos valores das medidas de pressão arterial sistólica e diastólica obtidas por meio do esfigmomanômetro de mercúrio e aparelho digital Omron HEM-412C.

Abstract A Right Ear Advantage (REA) is well-established in perceptual tasks but it has been found also during imagery. It is ascribed to the left temporoparietal activity for language, and it can be absent/reversed in some clinical conditions including auditory hallucinations. We applied 1-Hz repetitive TMS over TP3/TP4 (left/right language areas) identified through neuronavigation in 18 healthy participants, before administering a modified white noise (WN) speech illusion paradigm: a voice was presented at one ear, at the same or lower intensities with respect to binaural WN. In some trials the voice was not presented, but participants were anyway instructed to report in which ear they believed perceiving it in all trials. Results confirmed the REA both when the voice was present (perceptual REA) and when it was absent (imaginative REA). Interestingly, results suggested that the correct localization of the voice when the stimulus was ambiguous (presented at low intensity and “masked” by WN) was better when TMS was applied over the right/left hemisphere, in male participants with a low/high proneness to unusual experiences (e.g., auditory hallucinations), respectively. This interaction must be further explored to shed light on the relationship between hemispheric asymmetries and auditory hallucinations, in healthy and clinical samples.

We studied the application of CT texture analysis in adrenal incidentalomas with baseline characteristics of benignity that are highly suggestive of adenoma to find whether there is a correlation between the extracted features and clinical data. Patients with hormonal hypersecretion may require medical attention, even if it does not cause any symptoms. A total of 206 patients affected by adrenal incidentaloma were retrospectively enrolled and divided into non-functioning adrenal adenomas (NFAIs, n = 115) and mild autonomous cortisol secretion (MACS, n = 91). A total of 136 texture parameters were extracted in the unenhanced phase for each volume of interest (VOI). Random Forest was used in the training and validation cohorts to test the accuracy of CT textural features and cortisol-related comorbidities in identifying MACS patients. Twelve parameters were retained in the Random Forest radiomic model, and in the validation cohort, a high specificity (81%) and positive predictive value (74%) were achieved. Notably, if the clinical data were added to the model, the results did not differ. Radiomic analysis of adrenal incidentalomas, in unenhanced CT scans, could screen with a good specificity those patients who will need a further endocrinological evaluation for mild autonomous cortisol secretion, regardless of the clinical information about the cortisol-related comorbidities.

Performing stimulation experiments at approximately 1 km depth in the Bedretto Underground Laboratory for Geosciences and Geoenergies necessitates identifying and characterizing the target fault zone for on-fault monitoring of induced fault slip and seismicity, which presents a challenge when attempting to understand seismogenic processes. We discuss the multidisciplinary approach for selecting the target fault zone for experiments planned within the Fault Activation and Earthquake Ruptures (FEAR) project, for which the aim is to induce the fault slip and seismicity for an earthquake magnitude of up to 1.0 while enhancing the monitoring and control of fluid-injection experiments. Structural geological mapping, remote sensing, exploration drilling and borehole logging, ground-penetration radar, and laboratory investigations were employed to identify and characterize the target fault – a ductile–brittle shear zone several meters wide with an intensely fractured volume spanning over 100 m. Its orientation in the in situ stress field favors reactivation in normal to strike-slip regimes. Laboratory tests showed slight velocity strengthening of the fault gouge. The fault's architecture, typical for crystalline environments, poses challenges for fluid flow, necessitating detailed hydraulic and stress characterization before each of the FEAR experiments. This multidisciplinary approach was crucial for managing rock volume heterogeneity and understanding implications for the dense monitoring network. Successfully identifying the fault sets the stage for seismic activation experiments commencing in spring 2024.

Abstract In this article, we investigate situations involving firearm violence in Sweden. The spatiotemporal distribution of records is assessed in different contexts across the country and linked to land use, demographic, and socio-economic characteristics by area and by street segment. The findings emphasize the prevalence of evening shootings, particularly in economically disadvantaged areas where young people congregate in public places often in residential areas, in parks, in playgrounds, and in transit areas. Although two-thirds of shootings took place in larger urban municipalities, our study sheds light on the non-uniform distribution of gun violence along the rural–urban continuum. We conclude by offering suggestions for future research and practical interventions to address this pressing issue that negatively affects people and communities.

Abstract Severe acute respiratory infections, such as community-acquired pneumonia, hospital-acquired pneumonia, and ventilator-associated pneumonia, constitute frequent and lethal pulmonary infections in the intensive care unit (ICU). Despite optimal management with early appropriate empiric antimicrobial therapy and adequate supportive care, mortality remains high, in part attributable to the aging, growing number of comorbidities, and rising rates of multidrug resistance pathogens. Biomarkers have the potential to offer additional information that may further improve the management and outcome of pulmonary infections. Available pathogen-specific biomarkers, for example, Streptococcus pneumoniae urinary antigen test and galactomannan, can be helpful in the microbiologic diagnosis of pulmonary infection in ICU patients, improving the timing and appropriateness of empiric antimicrobial therapy since these tests have a short turnaround time in comparison to classic microbiology. On the other hand, host-response biomarkers, for example, C-reactive protein and procalcitonin, used in conjunction with the clinical data, may be useful in the diagnosis and prediction of pulmonary infections, monitoring the response to treatment, and guiding duration of antimicrobial therapy. The assessment of serial measurements overtime, kinetics of biomarkers, is more informative than a single value. The appropriate utilization of accurate pathogen-specific and host-response biomarkers may benefit clinical decision-making at the bedside and optimize antimicrobial stewardship.

Tobacco addiction is the primary preventable factor contributing to global mortality, and nicotine is one of the substances with the greatest potential for addiction. With a strong affinity for the α4β2 subtype receptor, cytisine (CYT) functions as a partial agonist of the acetylcholine nicotinic cholinergic receptor. It counteracts the effects of nicotine without causing any withdrawal symptoms. These features, combined with its limited mild adverse effects and minimal drug–drug interactions, make cytisine a cost-effective treatment for smoking cessation. The current protocol describes a prospective observational study on the safety and efficacy of CYT administered to inpatient smokers of the Integrated University Hospital of Verona (IUHVR), Veneto (Italy). This is a monocentric, observational, and prospective study on both sex smokers over the age of 18 years admitted to the IUHVR who meet the criteria for recruitment and have given their consent. Eligible participants will be assigned to the CYT intervention based on the West dosing schedule and will be followed up for 12 months from treatment initiation. Evaluation of safety, efficacy, and compliance will be assessed at 7 and 25 days, with follow-up at 3, 6, and 12 months from the start of the treatment (quit day). During each visit, any adverse events or adverse reactions reported by patients following the intake of CYT will be evaluated. This study will contribute, for the first time, to the knowledge about the use of CYT for smoking cessation in a hospital setting.

Summary: Matrix stiffening by lysyl oxidase-like 2 (LOXL2)-mediated collagen cross-linking is proposed as a core feedforward mechanism that promotes fibrogenesis. Failure in clinical trials of simtuzumab (the humanized version of AB0023, a monoclonal antibody against human LOXL2) suggested that targeting LOXL2 may not have disease relevance; however, target engagement was not directly evaluated. We compare the spatial transcriptome of active human lung fibrogenesis sites with different human cell culture models to identify a disease-relevant model. Within the selected model, we then evaluate AB0023, identifying that it does not inhibit collagen cross-linking or reduce tissue stiffness, nor does it inhibit LOXL2 catalytic activity. In contrast, it does potently inhibit angiogenesis consistent with an alternative, non-enzymatic mechanism of action. Thus, AB0023 is anti-angiogenic but does not inhibit LOXL2 catalytic activity, collagen cross-linking, or tissue stiffening. These findings have implications for the interpretation of the lack of efficacy of simtuzumab in clinical trials of fibrotic diseases.

This study aims to examine whether the COVID-19 pandemic affected the adherence to conservative AIS treatment. Adolescent Idiopathic Scoliosis (AIS) is characterized by a lateral curvature of the spine of at least 10 degrees. Compliance rates in conservative treatments are influenced by various factors. From a database of AIS patients, we selected 30 AIS patients who were assessed before, during, and after the COVID-19 pandemic. Data regarding Cobb’s angle, brace prescription, prescribed brace wear time, brace wear compliance, and time dedicated to sports activities were collected over a six-year period from January 2018 to December 2023, divided into three 2-year time periods (before, during, and after COVID-19). There was an increased percentage of AIS patients prescribed with a brace during the pandemic. However, no significant differences in Cobb’s angle were observed. Additionally, the prescribed wear time showed a significant decrease from the pre-COVID period to the post-COVID period (p-value = 0.03). Wear compliance exhibited a decreasing trend from pre- to during- and post-COVID-19 periods without reaching statistically significant differences, and the time dedicated to sports statistically significantly decreased. These differences were statistically significant when comparing the pre- vs. post- and pre- vs. during-COVID-19 periods (p-values 0.01, 0.04, respectively). Our study highlights changes in AIS conservative treatment during and after the COVID-19 pandemic. The increase in the number of patients prescribed with a brace during the pandemic, although not supported by an increase in Cobb’s angle, may be attributed to the concerns about regular monitoring during the reduction of rehabilitation services. The observed decreases in brace compliance and involvement in sport activities, which persisted even in the post-pandemic period, emphasizes the lasting impact of the pandemic on AIS management, necessitating innovative approaches to address these ongoing concerns.

OBJECTIVES:. Anemia has been associated with an increased risk of both cardiac arrest and stroke, frequent complications of COVID-19. The effect of hemoglobin level at ICU admission on a composite outcome of cardiac arrest or stroke in an international cohort of COVID-19 patients was investigated. DESIGN:. Retrospective analysis of prospectively collected database. SETTING:. A registry of COVID-19 patients admitted to ICUs at over 370 international sites was reviewed for patients diagnosed with cardiac arrest or stroke up to 30 days after ICU admission. Anemia was defined as: normal (hemoglobin ≥ 12.0 g/dL for women, ≥ 13.5 g/dL for men), mild (hemoglobin 10.0–11.9 g/dL for women, 10.0–13.4 g/dL for men), moderate (hemoglobin ≥ 8.0 and < 10.0 g/dL for women and men), and severe (hemoglobin < 8.0 g/dL for women and men). PATIENTS:. Patients older than 18 years with acute COVID-19 infection in the ICU. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. Of 6926 patients (median age = 59 yr, male = 65%), 760 patients (11.0%) experienced stroke (2.0%) and/or cardiac arrest (9.4%). Cardiac arrest or stroke was more common in patients with low hemoglobin, occurring in 12.8% of patients with normal hemoglobin, 13.3% of patients with mild anemia, and 16.7% of patients with moderate/severe anemia. Time to stroke or cardiac arrest by anemia status was analyzed using Cox proportional hazards regression with death as a competing risk. Covariates selected through clinical knowledge were age, sex, comorbidities (diabetes, hypertension, obesity, and cardiac or neurologic conditions), pandemic era, country income, mechanical ventilation, and extracorporeal membrane oxygenation. Moderate/severe anemia was associated with a higher risk of cardiac arrest or stroke (hazard ratio, 1.32; 95% CI, 1.05–1.67). CONCLUSIONS:. In an international registry of ICU patients with COVID-19, moderate/severe anemia was associated with increased hazard of cardiac arrest or stroke.

Abstract This study assesses patterns of victimisation and safety perceptions among passengers using railway stations across neighbouring municipalities in Sweden. Exploratory data analysis and logistic regression models underlie the methodology of the study, which shows that the geography of passengers’ victimisation differs from the geographical patterns found for the perception of safety. Findings show that passengers’ safety perceptions are more affected by the physical and social characteristics of transit environments than passengers’ victimisation. Yet, for those who have reduced mobility, the station affects the likelihood of their being victimised. Lack of staff and poor maintenance of the station are two significant attributes associated with the lower levels of safety perceived by passengers as well as levels of crime and panhandling at both the station and on the way to it. Compared with all passengers, women, but in particular those who identify as LGBTQI+ /Non-binary/Other, run a higher likelihood of feeling less safe. The theoretical and practical implications of these results are discussed.

Abstract The causal role of the cerebral hemispheres in positive and negative emotion processing remains uncertain. The Right Hemisphere Hypothesis proposes right hemispheric superiority for all emotions, while the Valence Hypothesis suggests the left/right hemisphere's primary involvement in positive/negative emotions, respectively. To address this, emotional video clips were presented during dorsolateral prefrontal cortex (DLPFC) electrical stimulation, incorporating a comparison of tDCS and high frequency tRNS stimulation techniques and manipulating perspective-taking (first-person vs third-person Point of View, POV). Four stimulation conditions were applied while participants were asked to rate emotional video valence: anodal/cathodal tDCS to the left/right DLPFC, reverse configuration (anodal/cathodal on the right/left DLPFC), bilateral hf-tRNS, and sham (control condition). Results revealed significant interactions between stimulation setup, emotional valence, and POV, implicating the DLPFC in emotions and perspective-taking. The right hemisphere played a crucial role in both positive and negative valence, supporting the Right Hemisphere Hypothesis. However, the complex interactions between the brain hemispheres and valence also supported the Valence Hypothesis. Both stimulation techniques (tDCS and tRNS) significantly modulated results. These findings support both hypotheses regarding hemispheric involvement in emotions, underscore the utility of video stimuli, and emphasize the importance of perspective-taking in this field, which is often overlooked.

Abstract Background Assuring that emergency health care (EHC) is accessible is a key objective for health care planners. Conventional accessibility analysis commonly relies on resident population data. However, the allocation of resources based on stationary population data may lead to erroneous assumptions of population accessibility to EHC. Method Therefore, in this paper, we calculate population accessibility to emergency departments in Sweden with a geographical information system based network analysis. Utilizing static population data and dynamic population data, we investigate spatiotemporal patterns of how static population data over- or underestimates population sizes derived from temporally dynamic population data. Results Our findings show that conventional measures of population accessibility tend to underestimate population sizes particularly in rural areas and in smaller ED’s catchment areas compared to urban, larger ED’s—especially during vacation time in the summer. Conclusions Planning based on static population data may thus lead to inequitable distributions of resources. This study is motivated in light of the ongoing centralization of ED’s in Sweden, which largely depends on population sizes in ED’s catchment areas.

Abstract Serpentinites are major carriers of volatiles in deep subduction zones, releasing most fluids in the 500–650°C range. Despite fundamental implications for mass transfer and intermediate‐depth seismicity, the mechanical role of these fluids is unclear. To characterize the mechanical role of fluids at (ultra)high‐pressure conditions, we perform a petro‐structural analysis on olivine‐rich veins from the Western Alps meta‐ophiolite. Some veins formed through dilational and mixed dilational‐shear fracturing without significant shear‐related deformation. However, field and microstructural observations indicate transient shearing and dilational fracturing at high pore fluid pressures. These include: (a) foliated sheared veins; (b) newly formed olivine and Ti‐clinohumite within mineral lineations coating sheared veins and shear bands; (c) Olivine and Ti‐clinohumite mineral fibers sealing porphyroclasts; (d) mutual crosscutting relationships among dilational and shear features. Dilational veins prevail in low‐strain areas, while sheared veins and shear bands dominate within high‐strain zones toward the ultramafic sliver boundaries. These strain variations underscore the role of local stress regimes during serpentinite dehydration. Consequently, areas experiencing stronger shear stresses around large‐scale blocks or mechanical weakening during fluid circulation are prone to draining overpressurized fluids. These interface‐parallel and fracture‐controlled pathways thus facilitate fluid escape from the dehydrating downgoing slab. Transient events of dilational fracturing and brittle‐ductile shearing, along with strain localization in highly comminuted olivine‐bearing sheared veins, may have resulted from strain rate bursts potentially related to (sub)seismic deformation. These observations are in line with geophysical data indicating high pore fluid pressures within the intermediate‐depth seismicity region.