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The evaluation of adult patients suspected of ST-segment elevation myocardial infarction (STEMI) includes a focused history and examination, 12-lead electrocardiogram (ECG), and cardiac serum marker analysis. The ECG plays a pivotal role in the early diagnosis and management of STEMI. A number of ECG entities in this patient population will present with ST-segment elevation and other electrocardiographic abnormalities which can mimic STEMI. In this article, we review the most frequent STEMI mimic patterns, highlight their ECG characteristics, and compare these individual ECG entities to the electrocardiographic abnormalities present with STEMI.

Abstract Background Lowering LDL-cholesterol is a fundamental goal for both primary and secondary prevention of atherosclerotic cardiovascular diseases. Our study aims to analyse potential sex disparities regarding the tolerability and effectiveness of lipid-lowering therapy in patients with and without reported statin intolerance who are being treated at a lipid-outpatient clinic. Methods From 2017 to 2022, n = 1062 patients (n = 612 men, n = 450 women) at high-risk were referred to our lipid-outpatient clinic because of difficulties in lipid control by primary healthcare providers. The main therapeutic objective was to optimize lipid-lowering therapy according to current treatment guidelines. Results Patients presented with high LDL-C baseline levels (4.97 ± 1.81 mmol/l (192 ± 70 mg/dL) in men and 5.46 ± 2.04 mmol/l (211 ± 79 mg/dL) in women). Intolerance towards statins was reported more frequently by women (48.2%) than by men (38.9%, p = 0.004). LDL-C continuously decreased with individual treatment adjustments across follow-up visits. In total, treatment goals (LDL

Endovascular procedures are minimally invasive approaches to treat conditions affecting blood vessels without the need for large incisions. The benefits are less blood loss and faster recovery. One condition commonly treated endovascularly is aortic aneurysmal disease often secondary to atherosclerosis or chronic hypertension. As endovascular aneurysm repair becomes increasingly complex and sophisticated, the intraoperative organization and management of wires from multiple access sites becomes paramount. Often, the physician selects visceral or great vessels for delivery of stent grafts to maintain vessel patency. Loss of wire in critical target vessels and wire contamination pose significant patient risks. WireWatch (BioTex Inc. Houston, Texas, USA) is a novel device designed for intraoperative wire management to improve surgical field organization, provide wire stabilization, and prevent dropped wires. This case describes its use in a 73-year-old female undergoing a fenestrated endovascular aneurysm repair of 5.6 cm types IV thoracoabdominal aortic aneurysm.

Decision-making in complex production environments is challenging as the information and knowledge requirements must be constantly observed since the ecosystems they operate in are continuously changing. Artificial intelligence (AI) can tackle complexity in decision-making by making machines more intelligent. But reacting to changing or new problems and related decision processes to facilitate the understanding of the involved humans is an equally important problem. Therefore, decision support systems are required to assist complex decisions and enable flexibility to support the decision-makers. Within this scope, we will introduce the Democratic AI-based Decision Support System (DAI-DSS), which is designed and implemented within the EU-funded FAIRWork project, considering both human and machine actors during decision-making. The FAIRWork project proposes a model-based approach to both express high-level decision scenarios and formally describe the decision processes, which are then used as input for configuring the decision support system to meet concrete decision problems.

Campylobacteriosis is the most reported gastrointestinal zoonotic disease worldwide and is caused by the consumption of inadequately heated and contaminated food, especially poultry meat. This may result from cross-contamination events during poultry slaughtering and cutting processes. Carcass contact surfaces in slaughterhouses, such as plucking fingers of rubber or stainless-steel surfaces, are high-risk points for contamination, with intestinal contents likely containing Campylobacter bacteria that may result in the cross-contamination of subsequent carcasses. Modification of these food contact surfaces by coating can be beneficial in combating bacterial contamination, as already applied in the packaging materials of the food industry. The aim of this study was to compare the attachment, growth and detachment of Campylobacter jejuni on uncoated and nanoscale silicon dioxide coated stainless steel and plucking fingers during laboratory experiments. The coating partly resulted in significantly reduced attachment and an improved detachment of the target organism on stainless steel. In contrast, there was no significant decrease in Campylobacter adherence to the coated plucking fingers as compared to the uncoated ones. However, a significantly higher reduction of recultivable bacteria on the coated plucking fingers was observed during a five-hour period. In future studies, specific coating parameters should be investigated to further support development, and thus a better adaptation of the coating to the environmental conditions.

Marian Wilson,1,2,&ast; Lillian Skeiky,2,3,&ast; Rachael A Muck,2,3 Megan A Miller,4 Devon A Hansen,2,3 Rhonda M Williams,4,5 Mark P Jensen,5 Hans PA Van Dongen2,3 1College of Nursing, Washington State University, Spokane, WA, USA; 2Sleep and Performance Research Center, Washington State University, Spokane, WA, USA; 3Department of Translational Medicine and Physiology, Washington State University, Spokane, WA, USA; 4Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA, USA; 5Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA&ast;These authors contributed equally to this workCorrespondence: Marian Wilson, College of Nursing, Washington State University, 103 E. Spokane Falls Blvd, Spokane, WA, 99202, USA, Tel +1 509 324 7443, Email marian.wilson@wsu.eduIntroduction: Chronic pain is highly prevalent in US military Veterans. Non-opioid and non-pharmacologic treatments are recommended when clinically appropriate, but research on the mechanisms underlying benefits of these treatments is lacking. Here, we examined the role of sleep in the effects of three non-pharmacologic pain treatments in Veterans. Specifically, we investigated whether treatment effects on sleep predicted treatment effects on pain occurring later, or vice versa.Methods: Veterans enrolled in a randomized controlled trial were invited to participate in this supplementary sleep study. A total of 174 Veterans were randomized to one of three 8-session, in-person, group-based pain treatments: hypnosis, mindfulness meditation, or education control. Measurements included self-reported sleep disturbance, pain intensity, and pain catastrophizing; sleep duration was assessed with actigraphy. Sleep and pain measurements were obtained at baseline, posttreatment, and 3-month posttreatment follow-up.Results: At baseline, average pain intensity was moderate (mean ± SD: 5.7 ± 1.7 on the 0– 10 Numeric Rating Scale), pain catastrophizing was just below the clinically relevant threshold (mean ± SD: 28.6 ± 12.2 on the Pain Catastrophizing Scale), and subjective sleep disturbance exceeded the US population average (mean ± SD: 58.5 ± 8.1 on the Patient Reported Outcomes Measurement Information System Sleep Disturbance – Short Form). By contrast, objective sleep duration was consistent with the recommended daily sleep amount of 7– 8 h for adults (mean ± SD: 8.3 ± 1.4 h). Across treatment conditions, pain intensity, pain catastrophizing, and subjective sleep disturbance were significantly less at posttreatment and 3-month follow-up than at baseline (p < 0.001). Actigraphic sleep duration did not differ significantly as a function of time. There was a high degree of covariation among the measures of pain intensity, pain catastrophizing, and sleep disturbance (p < 0.05). However, self-reported sleep disturbance was not significantly correlated with actigraphic sleep duration (|r| 0.05). Sleep and pain variables observed at prior assessments predicted these same variables at subsequent assessments. There was no significant evidence that changes in pain preceded changes in sleep or that changes in sleep preceded changes in pain (all p > 0.05).Discussion: For this study’s Veterans, treatment-related changes in sleep and pain appeared to occur in parallel. The concomitant changes in sleep and pain suggest that therapies improving pain in Veterans may yield attendant benefits for the treatment of sleep, and possibly vice versa.Keywords: chronic pain, complementary and integrative treatments, sleep, Veterans

The field of 3D and 4D printing is advancing rapidly, offering new ways to control the transformation of programmable 3D structures in response to external stimuli. This study examines the impact of 3D printing parameters, namely the UV ink thickness (applied using a UV inkjet printer on pre-3D-printed programmable structures) and thermal activation, on the dimensional and surface changes to high-stress (HS) and low-stress (LS) programmable samples and on print quality. The results indicate that HS samples shrink in the longitudinal direction, while expanding in terms of their height and width, whereas LS samples exhibit minimal dimensional changes due to lower programmed stress. The dynamic mechanical analysis shows that UV ink, particularly cyan and CMYK overprints, reduces the shrinkage in HS samples by acting as a resistive layer. Thicker ink films further reduce the dimensional changes in HS samples. Thermal activation increases the surface roughness of HS structures, leading to the wrinkling of UV ink films, while LS structures are less affected. The surface gloss decreases significantly in HS structures after UV ink application; however, thermal activation has little impact on LS structures. UV ink adhesion remains strong across both HS and LS samples, suggesting that UV inks are ideal for printing on programmable 3D structures, where the colour print quality and precise control of the shape transformation are crucial.

This study identifies the optimal combination of active and passive thermoplastic materials for producing multi-material programmable 3D structures. These structures can undergo shape changes with varying radii of curvature over time when exposed to hot water. The research focuses on examining the thermal, thermomechanical, and mechanical properties of active (PLA) and passive (PRO-PLA, ABS, and TPU) materials. It also includes the experimental determination of the radius of curvature of the programmed 3D structures. The pairing of active PLA with passive PRO-PLA was found to be the most effective for creating complex programmable 3D structures capable of two-sided transformation. This efficacy is attributed to the adequate apparent shear strength, significant differences in thermomechanical shrinkage between the two materials, identical printing parameters for both materials, and the lowest bending storage modulus of PRO-PLA among the passive materials within the activation temperature range. Multi-material 3D printing has also proven to be a suitable method for producing programmable 3D structures for practical applications such as phone stands, phone cases, door hangers, etc. It facilitates the programming of the active material and ensures the dimensional stability of the passive components of programmable 3D structures during thermal activation.

Reflexões sobre o acesso aberto

Resumo A relação entre o acesso aberto e o impacto das publicações científicas vem sendo analisada ao longo das duas últimas décadas. O papel das vias de disponibilização, no entanto, ainda carece de estudos. Objetiva-se, aqui, a análise, na área da Odontologia, da disponibilização e do impacto dos artigos publicados entre 2002 e 2018, por (co)autores com afiliação brasileira, por tipo de acesso (aberto ou fechado) e pelas vias de acesso aberto. Trata-se de um estudo cientométrico de natureza básica, e abordagem descritiva, a partir de 14.551 artigos recuperados na coleção principal da Web of Science em janeiro de 2021. Identificou-se que, apenas 24% da produção da Odontologia brasileira está em acesso aberto. A disponibilização simultânea, nas vias verde e dourada, foi mais frequente do que a presença em apenas uma delas. Itens em acesso aberto dourado, ou com acesso simultâneo verde e dourado foram majoritariamente publicados por editores nacionais, enquanto os apenas na via verde foram publicados somente por editores internacionais. Não houve vantagem de citação para o acesso aberto, e as publicações em periódicos nacionais obtiverem menor impacto. Por fim, identificou-se que artigos em acesso aberto apenas verde, publicados de 2004 a 2018, apresentaram maior impacto em citações que a produção em acesso fechado.

Fiber optic sensors integrated into fuel cell stacks have the potential to significantly enhance the temperature control and health monitoring of fuel cells. Inhomogeneous loading, both within individual cells and across different cells in a stack, leads to the formation of local hotspots that accelerate aging and degrade performance. This study investigates the behavior and feasibility of incorporating polyimide-coated optical fiber sensors into bipolar plates for precise and spatially resolved temperature monitoring. The sensor is successfully integrated into a single cell of a fuel cell stack, positioned on the bipolar plate in direct contact with the membrane. Pre-tests are conducted to thoroughly evaluate the technical properties of the fiber in relation to specific cell requirements. Additionally, a physical prototype featuring the sensor is developed and employed to validate its effectiveness under realistic operating conditions. The temperature measurement obtained via the fiber exhibits a continuous profile throughout the entire length, covering both the active area and distributor region of the cell. Throughout the entire 60 min test period, the measuring system provided continuous and uninterrupted temperature measurements, encompassing the start of the stack, the heating phase, the subsequent stable operating point, and the cooling phase. However, some technical challenges are identified, as mechanical pressure exerted on the fiber influences the measured temperature. While this work demonstrates promising results, further advancements are necessary to address inhomogeneous loading within fuel cells and hotspot mitigation. The precise monitoring of temperature distribution enables early detection of potential damage, facilitating timely interventions to improve the service life and overall performance of fuel cells.