Systolic blood pressure (SBP) is a potential indicator that could guide when to use a resuscitative endovascular balloon occlusion of the aorta (REBOA) in trauma patients with life-threatening ...injuries. This study aims to determine the optimal SBP threshold for REBOA placement by analyzing the association between SBP pre-REBOA and 24-hour mortality in severely injured hemodynamically unstable trauma patients.
We performed a pooled analysis of the aortic balloon occlusion (ABO) trauma and AORTA registries. These databases record the details related to the use of REBOA and include data from 14 countries worldwide. We included patients who had suffered penetrating and/or blunt trauma. Patients who arrived at the hospital with a SBP pre-REBOA of 0 mm Hg and remained at 0 mm Hg after balloon inflation were excluded. We evaluated the impact that SBP pre-REBOA had on the probability of death in the first 24 hours.
A total of 1,107 patients underwent endovascular aortic occlusion, of these, 848 met inclusion criteria. The median age was 44 years (interquartile range IQR, 27-59 years) and 643 (76%) were male. The median injury severity score was 34 (IQR, 25-45). The median SBP pre-REBOA was 65 mm Hg (IQR, 49-88 mm Hg). Mortality at 24 hours was reported in 279 (32%) patients. Math modeling shows that predicted probabilities of the primary outcome increased steadily in SBP pre-REBOA below 100 mm Hg. Multivariable mixed-effects analysis shows that when SBP pre-REBOA was lower than 60 mm Hg, the risk of death was more than 50% (relative risk, 1.5; 95% confidence interval, 1.17-1.92; p = 0.001).
In patients who do not respond to initial resuscitation, the use of REBOA in SBPs between 60 mm Hg and 80 mm Hg may be a useful tool in resuscitation efforts before further decompensation or complete cardiovascular collapse. The findings from our study are clinically important as a first step in identifying candidates for REBOA.
Prognostic and Epidemiological; Level IV.
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•Induction.•Magnetic nanoparticles (MNPs) synthesis and functionalization.•Antimicrobial activity of MNPs.•Antimicrobial drug delivery by MNPs.•MNPs biodistribution and toxicity.
In ...the last years, the antimicrobial resistance against antibiotics has become a serious health issue, arise as global threat. This has generated a search for new strategies in the progress of new antimicrobial therapies. In this context, different nanosystems with antimicrobial properties have been studied. Specifically, magnetic nanoparticles seem to be very attractive due to their relatively simple synthesis, intrinsic antimicrobial activity, low toxicity and high versatility. Iron oxide NPs (IONPs) was authorized by the World Health Organization for human used in biomedical applications such as in vivo drug delivery systems, magnetic guided therapy and contrast agent for magnetic resonance imaging have been widely documented. Furthermore, the antimicrobial activity of different magnetic nanoparticles has recently been demonstrated. This review elucidates the recent progress of IONPs in drug delivery systems and focuses on the treatment of infectious diseases and target the possible detrimental biological effects and associated safety issues.
The close location of the HAWC observatory to the largest volcano in Mexico allows to perform a search for neutrino-induced horizontal muon and tau charged leptons. The section of the volcano located ...at the horizon reaches values of slant depth larger than 8 km of rock, making it an excellent shield for the cosmic ray horizontal background. We report the search method and background suppression technique developed for the detection of Earth-skimming neutrinos with HAWC, as well as a model that describes the remaining background produced by scattered muons. We show that by increasing the detection energy threshold we could use HAWC to search for neutrino-induced charged leptons.
The radio galaxy M87 is the central dominant galaxy of the Virgo Cluster. Very High Energy (VHE,\(\gtrsim 0.1\) TeV) emission, from M87 has been detected by Imaging Air Cherenkov Telescopes (IACTs ). ...Recently, marginal evidence for VHE long-term emission has also been observed by the High Altitude Water Cherenkov (HAWC) Observatory, a gamma ray and cosmic-ray detector array located in Puebla, Mexico. The mechanism that produces VHE emission in M87 remains unclear. This emission is originated in its prominent jet, which has been spatially resolved from radio to X-rays. In this paper, we constructed a spectral energy distribution from radio to gamma rays that is representative of the non-flaring activity of the source, and in order to explain the observed emission, we fit it with a lepto-hadronic emission model. We found that this model is able to explain non-flaring VHE emission of M87 as well as an orphan flare reported in 2005.
Recently, the region surrounding eHWC J1842-035 has been studied extensively by gamma-ray observatories due to its extended emission reaching up to a few hundred TeV and potential as a hadronic ...accelerator. In this work, we use 1,910 days of cumulative data from the High Altitude Water Cherenkov (HAWC) observatory to carry out a dedicated systematic source search of the eHWC J1842-035 region. During the search we have found three sources in the region, namely, HAWC J1844-034, HAWC J1843-032, and HAWC J1846-025. We have identified HAWC J1844-034 as the extended source that emits photons with energies up to 175 TeV. We compute the spectrum for HAWC J1844-034 and by comparing with the observational results from other experiments, we have identified HESS J1843-033, LHAASO J1843-0338, and TASG J1844-038 as very-high-energy gamma-ray sources with a matching origin. Also, we present and use the multi-wavelength data to fit the hadronic and leptonic particle spectra. We have identified four pulsar candidates in the nearby region from which PSR J1844-0346 is found to be the most likely candidate due to its proximity to HAWC J1844-034 and the computed energy budget. We have also found SNR G28.6-0.1 as a potential counterpart source of HAWC J1844-034 for which both leptonic and hadronic scenarios are feasible.
Immune signatures at birth could be associated with clinical outcomes and will improve our understanding of immunity prenatal programming.
Data come from 235 newborns from the cohort study NELA. ...Production of cytokines was determined using Luminex technology. Associations between cytokine concentrations with sex and season of birth were examined by multivariate regression models.
Umbilical cord blood cells produced high levels of inflammatory cytokines, moderate levels of Th1/Th2/Tr-related cytokines, and low levels of Th17 cytokines. Compared to females, male newborn cells secreted higher levels of Th2 (peptidoglycan-stimulated IL-13, odds ratio OR = 2.26; 95% CI 1.18, 4.31, p value = 0.013) and Th17 (polyinosinic:polycytidylic acid-stimulated IL-23, OR = 1.82, 95% CI 1.01, 3.27, p value = 0.046) and lower levels of Th1 (olive-stimulated IL-2, OR = 0.56, 95% CI 0.31, 0.99, p value = 0.047) cytokines. Also, children born during warm seasons showed decreased innate cytokine response to peptidoglycan (IL-6, OR = 0.28, 95% CI 0.15, 0.52, p value < 0.001) compared to those born in cold seasons; meanwhile, adaptive immunity cytokines were more frequently secreted by children born during warm seasons in response to allergen extracts (IL-10, OR = 2.11, 95% CI 1.12, 3.96, p value = 0.020; IL-17F, OR = 3.31, 95% CI 1.83, 5.99, p value < 0.001).
Newborns showed specific cytokines signatures influenced by sex and season of birth.
There is a limited number of population-based studies on the immune status at birth and the influence of prenatal and perinatal factors on it. Characterization of cytokine signatures at birth related to the prenatal environment could improve our understanding of immunity prenatal programming. Newborns exhibit specific unstimulated and stimulated cytokine signatures influenced by sex and season of birth. Unstimulated and stimulated cytokine signatures in newborns may be associated with the development of related clinical outcomes later in life.
Abstract
Aims
Atrial fibrillation (AF) is a progressive cardiac arrhythmia that increases the risk of hospitalization and adverse cardiovascular events. There is a clear demand for more inclusive and ...large-scale approaches to understand the molecular drivers responsible for AF, as well as the fundamental mechanisms governing the transition from paroxysmal to persistent and permanent forms. In this study, we aimed to create a molecular map of AF and find the distinct molecular programmes underlying cell type-specific atrial remodelling and AF progression.
Methods and results
We used a sheep model of long-standing, tachypacing-induced AF, sampled right and left atrial tissue, and isolated cardiomyocytes (CMs) from control, intermediate (transition), and late time points during AF progression, and performed transcriptomic and proteome profiling. We have merged all these layers of information into a meaningful three-component space in which we explored the genes and proteins detected and their common patterns of expression. Our data-driven analysis points at extracellular matrix remodelling, inflammation, ion channel, myofibril structure, mitochondrial complexes, chromatin remodelling, and genes related to neural function, as well as critical regulators of cell proliferation as hallmarks of AF progression. Most important, we prove that these changes occur at early transitional stages of the disease, but not at later stages, and that the left atrium undergoes significantly more profound changes than the right atrium in its expression programme. The pattern of dynamic changes in gene and protein expression replicate the electrical and structural remodelling demonstrated previously in the sheep and in humans, and uncover novel mechanisms potentially relevant for disease treatment.
Conclusions
Transcriptomic and proteomic analysis of AF progression in a large animal model shows that significant changes occur at early stages, and that among others involve previously undescribed increase in mitochondria, changes to the chromatin of atrial CMs, and genes related to neural function and cell proliferation.
We present the detection of VHE gamma-ray emission above 100 TeV from HAWC J2227+610 with the HAWC observatory. Combining our observations with previously published results by VERITAS, we interpret ...the gamma-ray emission from HAWC J2227+610 as emission from protons with a lower limit in their cutoff energy of 800 TeV. The most likely source of the protons is the associated supernova remnant G106.3+2.7, making it a good candidate for a Galactic PeVatron. However, a purely leptonic origin of the observed emission cannot be excluded at this time.
Astroph. J. 940(2) (2022) 141 This paper reports on the $\gamma$-ray properties of the 2018 Galactic nova
V392 Per, spanning photon energies $\sim$0.1 GeV to 100 TeV by combining
observations from ...the Fermi Gamma-ray Space Telescope and the HAWC Observatory.
In one of the most rapidly evolving $\gamma$-ray signals yet observed for a
nova, GeV $\gamma$ rays with a power law spectrum with index $\Gamma = 2.0 \pm
0.1$ were detected over eight days following V392 Per's optical maximum. HAWC
observations constrain the TeV $\gamma$-ray signal during this time and also
before and after. We observe no statistically significant evidence of TeV
$\gamma$-ray emission from V392 Per, but present flux limits. Tests of the
extension of the Fermi/LAT spectrum to energies above 5 TeV are disfavored by 2
standard deviations (95\%) or more. We fit V392 Per's GeV $\gamma$ rays with
hadronic acceleration models, incorporating optical observations, and compare
the calculations with HAWC limits.
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