Time Lapse Research Articles

Disparate impact of healthcare access restrictions due to COVID-19 pandemic on breast cancer diagnosis and treatment.

e13518 Background: The COVID-19 pandemic altered healthcare access avenues for patients. In May 2020, 79% of cancer patients in the US in active treatment experienced some delay in their healthcare due to COVID-19 related restrictions. Hispanic patients are known to be disproportionately affected by their social determinants of health, and therefore are at higher risk of being affected by the pandemic. Our institution, designated as a “Hispanic Serving Institute (HSI)”, is ideally suited to study the impact of the pandemic on this population. Methods: In this retrospective study, the institutional breast cancer database was queried for patients managed between January 1, 2018 and April 18, 2022. Socio-demographic variables, screening, and treatment initiation dates were analyzed to determine the impact of COVID-19 related restrictions. Patients were stratified into groups based on date of diagnosis: Group 1 (pre-pandemic), Group 2 (pandemic), and Group 3 (post pandemic). Statistical analyses were conducted using R statistical software (R version 4.1.3). ANOVA or Kruskal Wallis tests with multiple pairwise comparisons using independent samples t-test or Wilcoxon rank sum test and χ2 tests with multiple pairwise comparisons using Fisher’s exact test were used to compare the groups. Interaction models were created to evaluate the association between 1) Ethnicity and 2) Distance from the treatment center on the time lapses between 1) mammogram and biopsy and 2) biopsy and first treatment separately. Results: Of the 488 patients during study period, 163 (33%) patients were Hispanic. Median (IQR) number of days between biopsy and first treatment was similar across all groups [Group 1=39.5 (102.5) days; Group 2= 50 (121) days; Group 3=57 (54) days - p=0.338]. Patients who lived > 50 miles away from the treatment facility experienced longer time lapses between biopsy date and first treatment compared to those living ≤ 50 miles away (β= 40.60, SE (standard error) =20.87, p = 0.052). Compared to Non-Hispanics, Hispanics in Group 2 experienced a shorter time lapse between mammogram and biopsy (β= -17.34, SE=5.46, p = 0.002). However, these patients experienced a longer time lapse between biopsy and initiation of treatment (β= 43.57, SE=18.25, p = 0.017). There was a significantly higher proportion of non-insured patients in the Hispanic group compared to the non-Hispanic group [Hispanic group=12 (7.4%) patients; Non-Hispanic group=8 (2.5%) patients - p=0.020]. Conclusions: Pandemic related delays in breast cancer treatment were observed mainly in Hispanics and patients living more than 50 miles from the treatment center.

On Dynamic Ray Tracing and Anticipative Channel Prediction for Dynamic Environments

Ray tracing algorithms, that can simulate multipath radio propagation in presence of geometric obstacles such as buildings, objects or vehicles, are becoming quite popular, due to the increasing availability of digital environment databases and high-performance computation platforms, such as multi-core computers and cloud computing services. When objects or vehicles are moving, which is the case of industrial or vehicular environments, multiple successive representations of the environment ("snapshots") and multiple ray tracing runs are often necessary, which require a great human effort and a great deal of computation resources. Recently, the Dynamic Ray Tracing (DRT) approach has been proposed to predict the multipath evolution within a given time lapse on the base of the current multipath geometry, assuming constant speeds and/or accelerations for moving objects, using analytical extrapolation formulas. This is done without re-running a full ray tracing for every "snapshot" of the environment, therefore with a great reduction in both human labour and computation time. When DRT is embedded in a mobile radio system and used in real-time, ahead-of-time (or anticipative) field prediction is possible that opens the way to interesting applications. In the present work, a full-3D DRT algorithm is presented that allows to account for multiple reflections, edge diffraction and diffuse scattering for the general case where moving objects can translate and rotate. For the purpose of validation, the model is first applied to some ideal cases and then to realistic cases where results are compared with conventional ray tracing simulation and measurements available in the literature.

Morphokinetic changes and apoptotic cell death in vitrified and non-vitrified in vitro-produced ovine embryos.

This article addresses morphokinetic changes and the extent of apoptosis in vitrified and non-vitrified in vitro-derived ovine blastocysts. Cumulus-oocyte complexes were collected after ovarian scarification obtain after slaughter and in vitro maturation was performed in TCM 199 medium supplemented with Earle's Salt, 10 % of FBS, and 5µg/mL of LH/FSH at 38°C for 24h. After maturation, the oocytes were co-incubated with thawed ram semen (IVF) for 19h.Embryo development was monitored with the aid of the Primo Vision Time-Lapse (TL) system. Twenty-five out of thirty-one ovine blastocysts that were vitrified using the Cryotop system at the early blastulation stage of development subsequently re-expanded. Both the vitrified (n=25) and non-vitrified (control group: n=28) blastocysts were examined for detection of apoptosis (TUNEL assay) and total blastomere counts at the time they attained the expanded blastocyst stage. Blastocyst formation occurred earlier in non-vitrified than in vitrified ovine embryos (147:49±20:23 compared with 156:46±19:24; hours:minutes post-insemination; mean ± SD; P<0.05). The average number of blastocyst collapses was greater (2.45±1.64 compared with 1.45±1.64), but the number of weak contractions was less for vitrified than non-vitrified ovine blastocysts (P<0.05). The mean number of blastomeres was greater (131.8±38.6 compared with 91.5±18.3; P<0.05) while the number of TUNEL-positive cells (4.4±1.6 compared with 6.3±2.3) and apoptotic index (3.4±1.2 % compared with 6.9±2.6 %) were less (P<0.05) in non-vitrified compared with vitrified blastocysts. Vitrification of ovine embryos was associated with a delayed blastocyst formation, greater numbers of apoptotic cells, significant reduction in the number of blastomeres, and higher/lower incidence of blastocyst collapse/weak contractions.

Early Spontaneous Twinning Recorded By Time-Lapse.

Monozygotic twins (MZT) are 2.5 times more frequent in ART than in natural conceptions. A number of ART-related mechanisms have been probably linked with MZT. Studies that retrospectively analyze the time-lapse (TL) records resulting in MZT suggest that some morphokinetic traits of the inner cell mass and the trophectoderm could be predictors of MZT, but results are controversial. We present the complete TL record of one case of MZT that split itself at the very moment of the division into two cells, with one of the cells coming out through a hole in the zona pellucida (ZP). Both resulting embryos developed normally, and were vitrified. It is suggested that the hole in the ZP may facilitate the extrusion of some cells of the <day 4 embryo and that this cell development is not constrained by being inside the ZP. Despite the lack of the inhibition of the ZP itself or the influence of the other embryo cells, the totipotent cell was then able to develop correctly from the start. Moreover, the embryo inside the ZP compensated for the loss of this cell apparently without problems. Our findings are discussed in the context of previous literature and ethical problems are addressed.

Multiple-statistical genome-wide association analysis and genomic prediction of fruit aroma and agronomic traits in peaches.

'Chinese Cling' is an important founder in peach breeding history due to the pleasant flavor. Genome-wide association studies (GWAS) combined with genomic selection are promising tools in fruit tree breeding, as there is a considerable time lapse between crossing and release of a cultivar. In this study, 242 peaches from Shanghai germplasm were genotyped with 145 456 single-nucleotide polymorphisms (SNPs). The six agronomic traits of fruit flesh color, fruit shape, fruit hairiness, flower type, pollen sterility, and soluble solids content, along with 14 key volatile odor compounds (VOCs), were recorded for multiple-statistical GWAS. Except the reported candidate genes, six novel genes were identified as associated with these traits. Thirty-nine significant SNPs were associated with eight VOCs. The putative candidate genes were confirmed for VOCs by RNA-seq, including three genes in the biosynthesis pathway found to be associated with linalool, soluble solids content, and cis-3-hexenyl acetate. Multiple-trait genomic prediction enhanced the predictive ability for γ-decalactone to 0.7415 compared with the single-trait model value of 0.1017. One PTS1-SSR marker was designed to predict the linalool content, and the favorable genotype 187/187 was confirmed, mainly existing in the 'Shanghai Shuimi' landrace. Overall, our findings will be helpful in determining peach accessions with the ideal phenotype and show the potential of multiple-trait genomic prediction to improve accuracy for highly correlated genetic traits. The diagnostic marker will be valuable for the breeder to bridge the gap between quantitative trait loci and marker-assisted selection for developing strong-aroma cultivars.

Finally! How time lapse in Nobel Prize reception affects emotionality in the Nobel Prize banquet speeches

We have a limited understanding of the role emotions play in academia, as exploring emotions consistently and comparably is challenging due to the powerful influence of contextual factors. However, we have identified an interesting setting to empirically investigate the emotional response in academia by examining Nobel Prize winners. Scientists who aspire to earn a Nobel Prize are under pressure from their environment if they have not yet received the Prize. While there are various indicators that suggest the Nobel Prize is forthcoming, the question of “when” weighs heavily on the minds of leading candidates. Consequently, waiting for the Nobel Prize is emotionally taxing. We therefore hypothesize that Nobel laureates who have experienced a prolonged wait for the award would feel a stronger sense of relief upon receiving it. We are interested in measuring their level of emotionality after receiving the Nobel Prize by analyzing their banquet speeches using linguistic content analysis. Banquet speeches provide a consistent and controlled setting to compare emotionality across scientists and over time, as we can measure the same responses to the same recognition under the same circumstances. We expect that waiting longer for the Nobel Prize will increase the positive emotionality of Nobelists’ speeches. The waiting time is determined by calculating the years since the Nobel Prize-winning work was performed. By conducting this time-lapse study, we find a robust positive correlation between waiting time and positive emotions in Nobel Prize banquet speeches. We conclude that scientists who waited longer for the Nobel Prize reported higher levels of positive emotions during their speeches.

Holistic Approach in Design Research

Holistic Approach in Design Research

Dodatkowy opis i oszacowanie nieruchomości – problemy wybrane

A trend may be observed presently that involves submitting applications of an additional description and evaluation before setting a deadline for a real estate auction. Such requests are submitted by debtors. Issues discussed in this study are aimed at approximating practical problems relating to handling such applications. The most important issues include answers to the following questions: should a lapse of time and change of value of real estate on the market be qualified as a major change of real estate status? Is it admissible to submit an application for an additional description and estimation after the first ineffective auction of real estate? If the answer is positive and, therefore, an additional description and estimation are prepared, is the first or perhaps the second auction of real estate held? The article discusses also issues relating to the cost of an additional description and estimation.

Formation and Aging of the Solid Electrolyte Interphase on Lithium in Bis(fluorosulfonyl)amide-Type Ionic Liquids

The formation and aging of the solid electrolyte interphase (SEI) formed on a Li and Cu electrode in two bis(fluorosulfonyl)amide (FSA–)-type ionic liquids (ILs), 1-methyl-1-butylpyrrolidinium bis(fluorosulfonyl)amide and 1-methyl-1-methoxyethylpyrrolidinium bis(fluorosulfonyl)amide, containing a high concentration of LiFSA were investigated using electrochemical impedance spectroscopy, X-ray photoelectron spectroscopy (XPS), transmission electron microscopy (TEM), and scanning electron microscopy. The intensity of peaks corresponding to the decomposition of the electrolyte in XPS spectra changed with time. The thicknesses of the SEI formed on a Cu electrode in both ILs were estimated to be 20–100 nm by TEM observation. The resistance of SEI increased with the lapse of time although the change in the thickness of the SEI was small, suggesting the aging of the SEI in the ILs was considered to depend on the composition of the SEI rather than the thickness of the SEI. The Li deposits shrank during dissolution. The Li anode became sparse and porous after deposition and dissolution cycles, probably due to the inhomogeneous reaction through the aged SEI. The SEI formation on the surface of the porous deposits was considered to lead to an increase in the polarization and the isolation of the deposits, i.e., the formation of “dead lithium”.

Food Habits of the Mountain Hawk-Eagle (Nisaetus nipalensis orientalis) During the Nesting Period in Japan

ABSTRACT The Mountain Hawk Eagle (Nisaetus nipalensis orientalis) is classified as endangered in Japan and poorly studied throughout its range. We assessed prey fed to a nestling between hatching and fledging (16 April to 31 July) in central Japan. We used a time lapse camera to record prey deliveries and facilitate prey identification, and we estimated prey biomass and energy content across the nesting season. Of 140 prey items delivered to the single nestling, 65 (46.4%) were of five species of snake, 50 (35.7%) were of nine species of birds, 24 (17.1%) were of seven species of mammals, and one was unknown. The diurnal feeding rhythm showed a peak in prey deliveries at midday; all three classes of prey were delivered at various times of the day in a balanced manner. Snakes were especially prominent in the early stages of the brooding period, but diet shifted toward young birds and mammals in the latter half of the season when the prey species' young had become independent of their parents. Snakes made up the greatest percentage of biomass delivered, followed by mammals and then birds. However, mammals provided more energy per g of prey mass than birds and snakes. The adult eagles relied on large snakes awakened from hibernation in early spring, when prey was scarce, and then shifted to mammals with higher energy value during the peak growth period of the eaglet. An additional 233 prey remains collected from 31 other Mountain Hawk-Eagle nests comprised 20 species of birds and 10 species of mammals, and several unidentified snakes. Pooling results, we identified five species of snakes, 24 species of birds, and 14 species of mammals. These results add to the knowledge of the hawk-eagle's diet and will help to inform management of the species.

Daf-42 is an evolutionarily young gene essential for dauer development in Caenorhabditis elegans.

Under adverse environmental conditions, nematodes arrest into dauer, an alternative developmental stage for diapause. Dauer endures unfavorable environments and interacts with host animals to access favorable environments, thus playing a critical role in survival. Here, we report that in Caenorhabditis elegans, daf-42 is essential for development into the dauer stage, as the null mutant of daf-42 exhibited a "no viable dauer" phenotype in which no viable dauers were obtained in any dauer-inducing conditions. Long-term time lapse microscopy of synchronized larvae revealed that daf-42 is involved in developmental changes from the pre-dauer L2d stage to the dauer stage. daf-42 encodes large, disordered proteins of various sizes that are expressed in and secreted from the seam cells within a narrow time window shortly before the molt into dauer stage. Transcriptome analysis showed that the transcription of genes involved in larval physiology and dauer metabolism is highly affected by the daf-42 mutation. Contrary to the notion that essential genes that control the life and death of an organism may be well conserved across diverse species, daf-42 is an evolutionarily young gene conserved only in the Caenorhabditis genus. Our study shows that dauer formation is a vital process that is controlled not only by conserved genes but also by newly emerged genes, providing important insights into evolutionary mechanisms.

Prevalence, Severity and Associated Risk Indicators of Molar Incisor Hypomineralization amongst 8-13-year-old Children of Vadodara District Gujarat: A Cross-sectional Study.

Molar incisor hypomineralization (MIH) is an emerging clinical problem as the affected tooth is prone to dental caries with the lapse of time. To assess the prevalence, severity, and associated risk indicators of MIH amongst 8-13 years of children of Vadodara District, Gujarat, India. A cross-sectional study with a sample size of 3,000 government schoolchildren. A total of 1,500 children each from urban and rural areas were randomly selected and examined. Only permanent incisors and first molars were examined. MIH was diagnosed clinically based on the diagnostic criteria established by the European Academy of Paediatric Dentistry (EAPD), 2003. To check the relation between the two variables-Pearson's chi-squared test was applied. Fisher's exact test was applied when less than five expected values were found. A total of 286 children (9.6 %) had MIH, with 189 (rural) and 97 (urban) children. MIH was significantly higher in the rural population as compared to the urban. In the rural area, the cause was found to be a child suffering from an illness (>15 days) which was 35.98%, and in the urban area was due to prolonged use of antibiotics before 4 years of age, which was 28.87%. The overall prevalence rate of MIH among the screened children between the age-group 8 and 13 was found to be 9.6%. Males were more affected. The severity of MIH was more in molars compared to incisors and more in children of rural areas. Protocol for early diagnosis and follow-up to access the squeal of breakdown should be undertaken along with parents and health workers. Shah VU, Dave BH, Chari DN, et al. Prevalence, Severity and Associated Risk Indicators of Molar Incisor Hypomineralization amongst 8-13-year-old Children of Vadodara District Gujarat: A Cross-sectional Study. Int J Clin Pediatr Dent 2023;16(2):280-286.

Rapid history matching of petroleum production from well logs and 4D seismic via Machine Learning techniques in the Norne Field, offshore Norway

Predicting oil and gas reservoir behaviour requires multiple property modelling using various formulae, relationships and empirical techniques, which is time-consuming and often ineffective in precisely capturing non-linear dependencies. Artificial Intelligence (AI) or Machine Learning (ML) techniques can build time-series models for modelling dynamic reservoir properties such as water, oil and gas saturation, and pressure, thus capturing changes caused by hydrocarbon production. Here, 4D (time lapse) seismic surveys have been used to model the changes in water saturation using AI techniques such as multi-linear regression, multi-variable kriging and random forest. Statistical testing of the resulting 3D reservoir models using R-Squared, RMSE (root-mean-square error) and MAPE (mean absolute percentage error) indicated the random forest technique gave the best results and stratification had a negligible effect. Increasing the training size set from 10% to 80% improved the statistics as expected though the rate of improvement falls rapidly above a training dataset size of 40%. This indicates that 3D models with good accuracy could be obtained even with limited data. Similar techniques can be run to build 3D time-series pressure models and the results can be used for improved history matching, forward estimation of production data and estimation of reserves.

Predictive stability, novel HPLC-MS analysis and semi-automatic compounding process for the emergency implementation of a production line of pancuronium in injectable solution.

During the early months of the COVID-19 pandemic, the international medical product supply chain was tight, causing breaks in the availability of neuromuscular blocking agents essential for the treatment of patients in intensive care units. The present study describes the pharmaceutical development of an injectable 2 mg/mL solution of pancuronium bromide (PC) in a very short lapse of time. The sterile solution was compounded into a good manufacturing practice grade A clean room, filtered (0.2 µm) and filled into 10 mL type I glass, manually sealed with bromobutyl rubber stoppers. A novel HPLC-MS stability indicating method for pancuronium quantification and its degradation product was developed and validated. This fast, sensitive and straightforward method was used to study the stability of the formulation using a semi-predictive method, enabling a very fast attribution of a temporary shelf-life, which was confirmed by a classic prospective stability study. The production line and the analytical tools set-up were performed in six weeks and the semi-predictive stability study was conducted in 90 days, allowing us to predict a shelf life, which was successfully confirmed by prospective study. In conclusion, using innovative methods, we were able to rapidly overcome the shortage of a critical drug.

Contribution of collegial support meetings (CSM) in the management of complex situations of patients with advanced cancer.

Collegial support meetings (CSM) have been set up in the Gustave Roussy Cancer Center for inpatients whose complex care requires a multi-professional approach involving many participants: oncologists but also health-caregivers, a member of the palliative care team, an intensivist, and a psychologist. This study is aimed at describing the role of this newly multidisciplinary meeting implemented in a French Comprehensive Cancer Center. Each week, the health-caregivers decide which situations should be examined, depending on the difficulty of a case. The discussion goes on to include the goal of treatment, the intensity of care, ethical and psychosocial issues, and the patient's life plan. Finally, to obtain feedback from the teams, a survey has been distributed to assess the interest in the CSM. In 2020, 114 inpatients were involved, and 91% were in an advanced palliative situation. During the CSMs, 55% of the discussions focused on whether to continue specific cancer treatment-29% about whether to continue invasive medical care-50% about optimizing supportive care. We estimate that between 65 and 75% of CSMs influenced further decisions. Death occurred during the hospitalization for 35% of the patients that were discussed. The lapse of time between last chemotherapy and death was 24days (IQR, 28.5). CSMs were well received, since 80% of the teams find these meetings useful. CSMs reach conclusions for medical and nursing staff involved, in order to improve the management of inpatients with cancer in advanced palliative situation and to define the better goals of care.

Technical challenges and innovative solutions for bedside alarms

The guidelines advocate, in patients with chest pain, comparison of the acute ECG with a previously made, non-ischemic ECG that serves as a reference, to corroborate the working diagnosis of acute coronary syndrome (ACS). Our approach of this serial comparison is to compute the differences between the ST vectors at the J point and 60 ms thereafter (∆ST(J + 0), ∆ST(J + 60)) and between the ventricular gradient (VG) vectors (∆VG). In the current study, we investigate if reference ECGs remain valid in time.We studied 6 elective non-ischemic ECGs (ECG0, ECG1, …, ECG5), 5 years apart, in 88 patients. Within each patient, serial comparisons were done 1) between all successive ECGs, and 2) between each of ECG1, ECG2, …, ECG5 and ECG0, computing, in addition to ∆ST(J + 0), ∆ST(J + 60) and ∆VG, the difference in heart rates, ∆HR. Additionally, relevant clinical events and the diagnoses associated with each ECG were collected. Linear regression was used to assess trends in ∆ST(J + 0), ∆ST(J + 60) and ∆VG; multiple linear regression was used to assess the influence of the clinical events and diagnoses on ∆ST(J + 0), ∆ST(J + 60) and ∆VG.There were no trends in the differences between successive ECGs. Positive trends were seen with increasing time lapses between ECGs: ∆ST(J + 0), ∆ST(J + 60) and ∆VG increased per year by 0.65 μV, 1.45 μV and 3.69 mV∙ms, respectively. Extrapolation to a time lapse of 0 yielded 50.92 μV, 36.63 μV and 20.91 mV∙ms for the short-term reproducibility of ∆ST(J + 0), ∆ST(J + 60) and ∆VG, respectively. Multiple linear regression revealed that clinical variables could explain only 10%, 17% and 13% of the variability in ∆ST(J + 0), ∆ST(J + 60) and ∆VG, respectively.With a view on ischemia detection thresholds in the order of magnitude of 58 μV for ∆ST and 26 mV·ms for ∆VG, our study suggests that it is important to have a recent ECG available for the detection of myocardial ischemia, as an “aged” ECG may have lost its validity as a reference.

Intracellular Monitoring by Dendritic Cells – a New Way to Stay Informed – From Simple Scavenger to Active Gatherer.

Abstract The ability of dendritic cells (DCs) to acquire antigen from their environment is critical for the induction of an adaptive immune response and the maintenance of tolerance. Despite its importance, it is tacitly assumed that DCs acquire antigen by scavenging extracellular material via endocytosis or macropinocytosis. Here, using labeled RNA and time lapse imaging, we observe DCs siphoning material directly from live neighboring keratinocytes. This contact dependent mechanism of antigen uptake – which we term intracellular monitoring– accounts for a large percentage of RNA transferred to DCs, and cannot be blocked by inhibitors of known antigen uptake processes. It is exclusive to DCs, as other cell types do not efficiently siphon RNA from neighboring cells, and common among most DCs subsets tested. Langerhans cells with a conditional gene deletion can successfully overcome their deficiency by siphoning RNA and protein from their neighbors, but only if the deleted protein is expressed in the donating cell. Such behavior reframes our understanding of DCs from mere scavengers to highly informed supervisors with extensive access to the cytosol of surrounding cells. Intracellular monitoring may therefore play important roles in the maintenance of tolerance, defense against infection, and detection of cancerous cells.

4D interpretation of time-lapse electrical resistivity monitoring data to identify preferential flow path in a landfill, South Korea.

Monitoring the leakage of leachate from a landfill is critical in preventing possible contamination in the surrounding area. Time-lapse (TL) electrical resistivity tomography (ERT) has been performed along eleven survey lines at four different time points in a landfill in Korea. The TL data sets were interpreted using an in-house 4D inversion algorithm. Changes in 4D inversion results were analyzed in order to interpret a leachate-contaminant region. Since the rainy season started during obtaining TL ERT data sets, the effects of precipitation on TL ERT data are also analyzed. Changes in electrical resistivity (ER) showed that precipitation increases ER of contaminant zones. As hydrogeochemical data offer contamination information in some areas where boreholes are located, these are helpful to interpret and compare with ERT inversion results to evaluate the extent of the contaminated plume. We also classified soil textures from particle size analysis on soil samples and analyzed electrical conductivity (EC) and dissolved oxygen (DO) using groundwater samples obtained from observation wells in the survey site. The information on soil structure as well as the results of 4D inversion provided insight into the location of a preferential flow path.

Effect of the time to antivenom administration on recovery from snakebite envenoming-related coagulopathy in French Guiana.

Snakebite (SB) envenoming is an acute emergency requiring an early care delivery. We aimed to search for the time to reach healthcare facilities in various regions of French Guiana (FG) and to assess the impact of time to antivenom (AV) on the correction of coagulation parameters in these patients. This is a prospective observational study conducted in Cayenne General Hospital between January 1st, 2016, and July 31st, 2022. We included all patients hospitalized for SB envenoming less than 48h after the bite, and receiving antivenom (AV). We assessed the time lapse between SB and medical attention and the time needed to return of the coagulation parameters to normal. Overall, 119 patients were investigated, and 48.7% were from remote areas. The median time from SB to AV therapy was 09:15 h (05:32-17:47). The time was longer in patients from remote rural locations. AV was dispensed within the first six hours after the SB in 45 cases (37.8%). Time from SB to reaching normal plasma fibrinogen concentration was 23:27 h (20:00-27:10) in patients receiving AV≤6h vs. 31:23 h (24:00-45:05) in those receiving AV>6h (p<0.001). Whereas, the time from AV administration to reach normal fibrinogen dosage was similar in the two groups. Patients from rural settings in FG suffer from a delay in AV administration after SB envenoming leading to an extended time in which patients are coagulopathic. Once AV is administered, clotting parameters recover at a similar rate. Supplying remote healthcare facilities with AV and with medical teams trained in its use should be planned.

Foreshadowing Terror: Exploring the Time of Online Manifestos Prior to Lone Wolf Attacks

Previous research has highlighted the prominent behavior of lone wolf terrorists to produce and share a manifesto publicly, outlining their frustrations and motivations for their eventual terrorist attack. This article aims to explore this phenomenon, focusing on the timelapse between when a terrorist manifesto is posted online and when the eventual attack occurs, discussing the time difference between the two events for 12 cases of lone wolf terrorism. The results revealed that the average time lapse between when a manifesto was posted online and when the terrorist attack occurs is one hour, 43 min. Limitations and implications are discussed in detail.