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Rivers are major contributors of plastic waste to the oceans. Running through the northern part of the 1.3 million-inhabitants City of Durban, South Africa, the Umgeni River is estimated to flush in the order of tens to hundreds of tonnes of plastic waste into the Indian Ocean every year. The riverbanks are lined with plastic and other macro-waste accumulation zones formed due to direct littering and occasional deposition of river debris loads. This study presents the use of Unmanned Aerial Vehicles (UAVs) and hydro-meteorological sensors to (1) identify, quantify and monitor such anthropogenic macro-waste hotspots; and (2) investigate the influence of rainfall, river water level and a major flood event on the spatio-temporal evolution of the hotspots, evidencing the debris' availability to leak into the Indian Ocean. The one-year aerial monitoring (2021-2022) of waste hotspots shows that extreme hydrometeorological events have an immediate but short-term effect on the erosion of debris stocks in riverine systems. We observe that reduction in mean index changes of hotspot surface area after flooding were 2-5 times higher than in non-flood conditions. Despite visual evidence of seasonality in debris erosion between the wet and dry season, only the 'natural' type hotspots showed a significant change. Our findings support reported inconsistencies of macro-debris erosion with hydrological factors. Although the data contributes a baseline for macro-debris erosion in the Umgeni River, future ground truth sampling and finer monitoring scales are important to fully understand debris transfer in river systems. The mapping of waste hotspots and understanding their spatio-temporal transfer dynamics supports policymakers in planning and timing to mitigate environmental pollution., Competing Interests: Declaration of competing interest There are no competing interests. T.M. and R.d.V are employed by The Ocean Cleanup, a non-profit organization advancing scientific understanding and developing solutions to rid the oceans of plastic, headquartered in Rotterdam, the Netherlands., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Anthropogenic litter, such as plastic, is investigated by the global scientific community from various fields employing diverse techniques. The goal is to assess and finally mitigate the pollutants' impacts on the natural environment. Plastic litter can accumulate in different matrices of aquatic and terrestrial ecosystems, impacting both biota and ecosystem functioning. Detection and quantification of macroplastics, and other litter, can be realized by jointly using visual census and remote sensing techniques. The primary objective of this research was to identify the most effective approach for monitoring macroplastic litter in riverine and marine environments through a comprehensive survey based on the experiences of the scientific community. Researchers involved in plastic pollution evaluated four litter occurrence and flux investigation methods (visual census, drone-based surveys, satellite imagery, and GPS/GNSS trackers) through a questionnaire. Traditional visual census and drone deployment were deemed as the most popular approaches among the 46 surveyed researchers, while satellite imagery and GPS/GNSS trackers received lower scores due to limited field validation and short performance ranges, respectively. On a scale from 0 to 5, visual census and drone-based surveys obtained 3.5 and 2.0, respectively, whereas satellite imagery and alternative solutions received scores lower than 1.2. Visual and drone censuses were used in high, medium and low-income countries, while satellite census and GPS/GNSS trackers were mostly used in high-income countries. This work provides an overview of the advantages and drawbacks of litter investigation techniques, contributing i) to the global harmonization of macroplastic litter monitoring and ii) providing a starting point for researchers and water managers approaching this topic. This work supports the selection and design of reliable and cost-effective monitoring approaches to mitigate the ambiguity in macroplastic data collection, contributing to the global harmonization of macroplastic litter monitoring protocols., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: In the COMPLETE (Complete vs Culprit-Only Revascularization to Treat Multi-Vessel Disease After Early PCI for STEMI) trial, complete revascularization in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD) reduced important outcomes compared with culprit-only percutaneous coronary intervention. Whether clinical outcomes in STEMI patients with MVD are influenced by the presence of a left anterior descending (LAD) nonculprit lesion (NCL) remains unknown., Objectives: This study sought to compare: 1) cardiovascular outcomes among patients with an NCL in the proximal/mid-LAD to patients with an NCL in other locations; and 2) the benefit of NCL revascularization in patients with and without a proximal/mid-LAD NCL., Methods: The COMPLETE trial enrolled patients presenting with STEMI and MVD to angiography-guided complete revascularization vs a culprit lesion-only strategy. All coronary angiograms were evaluated in a central core laboratory. In this prespecified subanalysis, treatment effect according to proximal/mid-NCL location was determined for the coprimary outcomes of: 1) cardiovascular death or new myocardial infarction; and 2) cardiovascular death, new myocardial infarction, or ischemia-driven revascularization. Cox proportional hazards models were performed with an interaction term for treatment allocation and NCL location., Results: Of the 4,041 subjects in COMPLETE, 1,666 patients had a proximal/mid-LAD NCL (41.2%). The first coprimary outcome occurred in 8.5% (2.9%/y) of patients with a proximal/mid-LAD NCL vs 9.9% (3.4%/y) in those without (adjusted HR: 0.83; 95% CI: 0.67-1.03). Complete revascularization had a similar benefit in reducing the first coprimary outcome for patients with a proximal/mid-LAD NCL (7.7% vs 9.2%; HR: 0.85; 95% CI: 0.61-1.18) and those without (8.0% vs 11.9%; HR: 0.65; 95% CI: 0.50-0.86), with no differential treatment effect (interaction P = 0.235) CONCLUSIONS: Among patients presenting with STEMI and multivessel CAD, those with a proximal/mid-LAD NCL had similar event rates to those without. The benefit of complete revascularization between the groups was similar, with no evidence of heterogeneity., Competing Interests: Funding Support and Author Disclosures The COMPLETE trial was funded by the Canadian Institutes of Health Research and through investigator-initiated research grants from AstraZeneca and Boston Scientific. Dr Pinilla-Echeverri has received research grant support from the Fundacion Alfonso Martin Escudero during the conduct of the study; and has received personal fees from Abbott and Conavi, outside of the submitted work. Dr Wood has received grants and other support from Edwards Lifesciences; and has received grants from Abbott and Boston Scientific, outside of the submitted work. Dr Bainey has received speaker honorarium from BI, HLS, and Novartis. Dr Schampaert has received speaker honorarium from Abbott, Boston Scientific, Medtronic, and Philips. Dr Džavík has received speaker honorarium from Medtronic. Dr Storey has received institutional research grants/support from AstraZeneca and Cytosorbents; and has received personal fees from Alfasigma, AstraZeneca, Boehringer Ingelheim/Lilly, Chiesi, Cytosorbents, Daiichi Sankyo, Idorsia, Novartis, Novo Nordisk, Pfizer, and Tabuk; has received personal fees from Bayer, Bristol-Myers Squibb/Pfizer, Haemonetics, Amgen, Portola, and Medscape; and has received grants and personal fees from AstraZeneca, Thromboserin, and Glycardial Diagnostics, outside of the submitted work. work. Dr Mehran has received institutional research payments from Abbott, Abiomed, Affluent Medical, Alleviant Medical, Amgen, AM-Pharma, Arena, AstraZeneca, AtriCure Inc, Biosensors, Biotronik, Boston Scientific, Bristol-Myers Squibb, CardiaWave, CeloNova, CERC, Chiesi, Cleerly Health Inc, Concept Medical, Cytosorbents, Daiichi Sankyo, Duke, Element Science, Essential Medical, Faraday, Idorsia Pharmaceuticals, Janssen, MedAlliance, Mediasphere, Medtelligence, Medtronic, MJH Healthcare, Novartis, OrbusNeich, Penumbra, PhaseBio, Philips, Pi-Cardia, PLx Pharma, Population Health Research Institute, Protembis, RecCor Medical Inc, RenalPro, RM Global, Sanofi, Shockwave, Vivasure, and Zoll; has received personal fees from Affluent Medical, Boehringer Ingelheim, Cardiovascular Research Foundation (CRF), Cordis, Daiichi Sankyo Brasil, E.R. Squibb & Sons, Esperion Science/Innovative Biopharma, EuropaGroup/Boston Scientific, Gaffney Events, Educational Trust, Henry Ford Health Cardiology, Ionis Pharmaceuticals, Lilly and Company, MedCon International, Novartis, NovoNordisk, PeerView Institute for Medical Education, TERUMO Europe N.V., Vectura, VoxMedia, WebMD, IQVIA, Radcliffe, and TARSUS Cardiology; serves on the AMA Scientific Advisory Board; is a SCAI Women in Innovations Committee member; has received faculty and CRF honoraria from JAMA Cardiology (Associate Editor) and ACC (BOT Member and SC Member CTR Program); and holds equity <1% in Elixir Medical, Stel, and CntrolRad (spouse). Dr Bossard has received consulting and speaker fees from Abbott Vascular, Abiomed, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Dachii Sankyo, Novartis, and SIS Medical. Dr Moreno has received personal fees from Medtronic, Boston Scientific, Abbott Vascular, Biotronik, Biosensors, Daiichi-Sankyo, Edwards, Amgen, and Bayer, outside the submitted work. Dr Campo has received research grants from SMT, GADA, Abbott Vascular, and Siemens Healthcare, outside the present work. Dr Cairns has received research grants from Boston Scientific and Edwards Lifesciences. Dr Mehta has received grants and other support from AstraZeneca; has received grants from Boston Scientific during the conduct of the study; and has received grants from AstraZeneca, outside of the submitted work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background and Aims: The use of Friedewald's formula to calculate serum low-density lipoprotein cholesterol (LDL-C) is well-known to have limitations. A modification of it, in 2013, has been proposed to be superior. However, it was not known whether LDL-C values (calculated by the modified formula) meet laboratory performance criteria for their estimation. This study aimed to evaluate this., Methods and Results: LDL-C values were calculated for 129,821 lipid profiles, using both Friedewald's formula and its modified version. Kappa statistics and intra-class correlation coefficient (ICC) were used to determine degree of agreement between directly measured and calculated values for LDL-C. Bias and total percentage error of the values were calculated. LDL-C concentrations calculated by the modified formula showed a greater degree of agreement with directly measured values (kappa = 0.713) than those calculated by Friedewald's formula (kappa = 0.595). Both the formulae produced values with negative biases (-3.47 for the modified formula and -7.62 for Friedewald's formula) and total percentage errors above the recommended limit of 12% (15.57% for the modified formula and 21.77% for Friedewald's formula). ICC showed that values calculated by the modified formula showed a greater degree of agreement with directly measured values, across a range of LDL-C values., Conclusion: Calculated LDL-C values, using the modified formula, showed better agreement with directly measured values, and less bias and percentage total error than those obtained by use of Friedewald's formula. However, the percentage total error with use of the modified formula exceeded the recommended limit for LDL-C., Competing Interests: Declaration of competing interest The authors have no conflict of interests to declare., (Copyright © 2021 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Background: Published data on the clinical, electrocardiographic, and angiographic profile of acute anterior-wall ST-elevation myocardial infarction (STEMI) with right bundle branch block with q in leads V1, V2 (qRBBB) are scarce. The aim of this study was to estimate the incidence of short-term mortality and in-hospital complications in acute qRBBB STEMI and identify the electrocardiographic (ECG) predictors of a poor outcome., Methods: We conducted a single-centre retrospective study among the patients with acute anterior-wall STEMI and qRBBB pattern on ECG. All relevant clinical and treatment data were collected from the electronic medical records. All the ECGs taken during the index hospitalization were subjected to detailed analysis., Results: Among the 272 qRBBB patients included in the study, 64% had thrombolysis in myocardial infarction (TIMI) risk score of ≥6, and 41% were in Killip class III or IV at the time of presentation. The in-hospital mortality rate was 42.6%. There was a high incidence of ventricular tachyarrhythmias (12%), complete heart block (13%), heart failure (69%), and cardiogenic shock (52%). Extreme deviation of mean QRS axis to the right (180 to 269 degrees) in the baseline ECG was associated with high in-hospital mortality (odds ratio: 13.43; 95% confidence interval: 1.48-122.03; P = 0.021)., Conclusions: Acute qRBBB myocardial infarction is a sinister form of acute coronary syndrome that entails high in-hospital mortality and morbidity, necessitating early recognition and prompt institution of reperfusion therapy. Extreme deviation of QRS axis to the right (180 to 269 degrees) is a significant electrocardiographic predictor of in-hospital mortality., (Copyright © 2020 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

Rivers are pivotal carriers of microplastic (MP) towards the oceans. Investigative data on MP pollution in rivers at specific timepoints is continuously compiled. However, such snapshot data can only roughly indicate the long-term extent of contamination and particle fluxes; modelling studies informed by this limited data are prone to large uncertainties. The present study sought to narrow this knowledge gap by examining the differences in MP concentrations, loads and compositions at three nival tributaries and the Rhine River in Basel, Switzerland, as well as two downstream pluvial Lower Rhine River locations in Germany over four seasons throughout 2016-2017. MP concentrations (>0.3 mm) correlated positively with average water discharge and catchment size of the evaluated stream locations and MP concentrations were significantly higher at the downstream pluvial than upstream nival sites. There was no coherent pattern in MP concentration fluctuations between seasons across the six sites investigated, and no correlation with recent precipitation. These findings suggest that temporal variations in MP fluxes towards the North Sea through the year are dominated by the different discharge regimes along the river course. This study also corroborates theoretical models that predict the highest MP loads move downstream the Rhine River during the European winter months., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: Anger related issues in adolescents are an important contributor to adolescent mortality and many negative developmental outcomes. Anger being the most primitive defence mechanism, determining its maladaptive nature is a complex phenomenon. Further, it lacks clarity in terms of its definition, demarcation from aggression and hostility, and also its assessment. Available anger rating scales do not represent anger adequately or comprehensively. The concept of anger is dealt with exhaustively in Indian classical texts. According to these texts, anger is an evil virtue that is born out of Rajasic nature and leads to momentary loss of cognitive functional abilities. Manifestation of anger occurs at behavioural (kayika), verbal (vachika) and mental (manasika) levels. Based on these principles, a psychometric scale is developed for assessment of anger in adolescents., Objective: The objective of this study was to develop a psychometric scale for assessment of anger in adolescents based on behavioural (kayika), verbal (vachika) and mental (manasika) levels., Materials & Methods: Item generation was done referring to the existing scales, texts on spirituality and psychology. It also included discussions with children, teachers and parents. Item reduction was carried out using expert opinion, focused group discussion and factor analysis. Testretest reliability was checked with 127 children (63 girls and 64 boys). The final scale was administered to 757 children (427 girls and 330 boys) to ascertain reliability co-efficient values., Results: Co-efficient of Alpha value for final scale recorded 0.804. Test-retest reliability showed .835 correlation., Conclusion: Anger can be assessed holistically using Trikarana (kayika, vachika and manasika) concept as dealt in almost all Indian classical texts. A 23-item adolescent anger scale is a comprehensive tool to assess behavioural, verbal and mental anger in adolescents., (Copyright © 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Published by Elsevier B.V. All rights reserved.)

Dirofilaria immitis, a filarial nematode, causes dirofilariasis in dogs, cats and occasionally in humans. Prevention of the disease has been mainly by monthly use of the macrocyclic lactone (ML) endectocides during the mosquito transmission season. Recently, ML resistance has been confirmed in D. immitis and therefore, there is a need to find new classes of anthelmintics. One of the mechanisms associated with ML resistance in nematodes has been the possible role of ATP binding cassette (ABC) transporters in reducing drug concentrations at receptor sites. ABC transporters, mainly from sub-families B, C and G, may contribute to multidrug resistance (MDR) by active efflux of drugs out of the cell. Gene products of ABC transporters may thus serve as the targets for agents that may modulate susceptibility to drugs, by inhibiting drug transport. ABC transporters are believed to be involved in a variety of physiological functions critical to the parasite, such as sterol transport, and therefore may also serve as the target for drugs that can act as anthelmintics on their own. Knowledge of polymorphism in these ABC transporter genes in nematode parasites could provide useful information for the process of drug design. We have identified 15 ABC transporter genes from sub-families A, B, C and G, in D. immitis, by comparative genomic approaches and analyzed them for polymorphism. Whole genome sequencing data from four ML susceptible (SUS) and four loss of efficacy (LOE) pooled populations were used for single nucleotide polymorphism (SNP) genotyping. Out of 231 SNPs identified in those 15 ABC transporter genes, 89 and 75 of them were specific to the SUS or LOE populations, respectively. A few of the SNPs identified may affect gene expression, protein function, substrate specificity or resistance development and may be useful for transporter inhibitor/anthelmintic drug design, or in order to anticipate resistance development., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Dirofilaria immitis, a filarial parasite, causes cardiopulmonary dirofilariasis in dogs, cats and wild canids. The macrocyclic lactone (ML) class of drugs has been used to prevent heartworm infection. There is confirmed ML resistance in D. immitis and thus there is an urgent need to find new anthelmintics that could prevent and/or control the disease. Targeting ion channels of D. immitis for drug design has obvious advantages. These channels, present in the nematode nervous system, control movement, feeding, mating and respond to environmental cues which are necessary for survival of the parasite. Any new drug that targets these ion channels is likely to have a motility phenotype and should act to clear the worms from the host. Many of the successful anthelmintics in the past have targeted these ion channels and receptors. Knowledge about genetic variability of the ion channel and receptor genes should be useful information for drug design as receptor polymorphism may affect responses to a drug. Such information may also be useful for anticipation of possible resistance development. A total of 224 ion channel genes/subunits have been identified in the genome of D. immitis. Whole genome sequencing data of parasites from eight different geographical locations, four from ML-susceptible populations and the other four from ML-loss of efficacy (LOE) populations, were used for polymorphism analysis. We identified 1762 single nucleotide polymorphic (SNP) sites (1508 intronic and 126 exonic) in these 224 ion channel genes/subunits with an overall polymorphic rate of 0.18%. Of the SNPs found in the exon regions, 129 of them caused a non-synonymous type of polymorphism. Fourteen of the exonic SNPs caused a change in predicted secondary structure. A few of the SNPs identified may have an effect on gene expression, function of the protein and resistance selection processes., (Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Dirofilaria immitis is a filarial nematode causing infection and heartworm disease in dogs and other canids, cats, and occasionally in humans. Prevention with macrocyclic lactones (ML) is recommended during the mosquito transmission season. Recently, ML resistance has been reported. ABC-B transporter genes are thought to be involved in the mechanism of ML resistance in other nematodes. This study aimed to identify all the ABC-B transporter genes in D. immitis using as a reference the nDi.2.2 D. immitis whole genome, which is not completely annotated. Using bioinformatic tools and PCR amplification on pooled D. immitis genomic DNA and on pooled cDNA, nine ABC transporter genes including one pseudogene were characterized. Bioinformatic and phylogenetic analyses allowed identification of three P-glycoproteins (Pgps) (Dim-pgp-3 Dim-pgp-10, Dim-pgp-11), of two ABC-B half transporter genes (one ortholog of Cel-haf-4 and Cel-haf-9; and one ortholog of Cel-haf-1 and Cel-haf-3), of one ABC half transporter gene (ortholog of Cel-haf-5) that contained an ABC-C motif, and of one additional half transporter that would require functional study for characterization. The number of ABC-B transporter genes identified was lower than in Caenorhabditis elegans and Haemonchus contortus. Further studies are needed to understand their possible role in ML resistance in D. immitis. These ABC transporters constitute a base for ML resistance investigation in D. immitis and advance our understanding of the molecular biology of this parasite., (Copyright © 2016. Published by Elsevier Ltd.)

The scanner, or computed tomography, is the reference imaging test for most thoracic diseases in both adults and children. It has gone through tremendously rapid technological progress over the last few years with the appearance of multirow (or multidetector or multislice) scanners. This technology currently provides volume acquisition of a child's thorax in 2-5 s. These technological advances are particularly useful for exploring airway diseases, largely because of the range of reconstruction possibilities (maximum and minimum intensity projection, volume rendering, virtual endoscopy), which offer advantageous perspectives in pediatrics. Multiplanar imaging and above all three-dimensional imaging provide a totally original analysis in space of the sometimes complex relations between vascular and airway structures, making it possible to understand certain extrinsic bronchial compression mechanisms more precisely. The present study briefly reviews the technical aspects of the thoracic scanner in children and illustrates its role today in volume CT in childhood thoracic diseases using clinical examples taken from our daily practice.

The impact of single dose mass drug administration of diethylcarbamazine (DEC), DEC with albendazole (ALB), and ivermectin (IVR) with albendazole, was examined on the human bancroftian filarial infections in village scale trials in south India, from a follow-up study after 2 years. The treatment arms administered with DEC alone and DEC+ALB demonstrated long-term benefits in reducing microfilaraemia significantly (P<0.05), while antigenaemia reduction was negligible. The arm with ALB+IVR did not show such reductions. Among the antigenaemic and microfilaraemic individuals, 87% became amicrofilaraemic in DEC+ALB arm, which were higher than that observed in the other 2 treatment arms. Among amicrofilaraemics (but Ag+), nearly 35% cleared of infection in DEC+ALB, while 26% and 6% in DEC alone and IVR+ALB arms, respectively. The drug combination DEC+ALB was observed to demonstrate a significant impact in reducing filarial infection even after 2 years post treatment.

Have been selected for this review: 1) the recent and impressive development of high-resolution and spiral CT scan in pediatric thoracic imaging; 2) the emerging of new and promising therapies for asthma (long acting inhaled beta 2-agonists, leukotriene antagonists, anti-IgE monoclonal antibodies); 3) the multifactorial origin of asthma in childhood; 4) the development of thoracoscopic surgery, a minimal-invasive approach beneficial in numerous circumstances.

Acrolein is an unsaturated aldehyde produced by combustion of many organic compounds. Massive exposure may lead to severe pulmonary disease and possibly death. We report a case of intoxication in a 2-year-old boy; an 18-month follow-up showed development of obstructive bronchiolar disease with diffuse bronchiectasis.