Misinformation on resuscitation and first aid as an uncontrolled problem that demands close attention: a brief scoping review.

OBJECTIVES: Misinformation is currently recognised by the World Health Organization as an apparent threat to public health. This study aimed to provide an outline of published evidence on misinformation related to the potentially life-saving interventions - first aid and cardiopulmonary resuscitation (CPR). STUDY DESIGN: A scoping review. METHODS: The review was conducted in accordance with the PRISMA Extension for Scoping Reviews. English-language publications describing original studies that evaluated the quality of publicly available information on first aid and/or CPR were included without limitations to the year of publication. RESULTS: Forty-four original studies published between 1982 and 2023 were reviewed. Annual number of publications varied from 0 to 6. The studies have focused on the evaluation of information concerning initial care of cardiac arrest, choking, heart attack, poisoning, burns, and other emergencies. Forty three studies (97.7 %) have reported varying frequencies of misinformation, when public sources, including websites, YouTube videos, and modern artificial intelligence-based chatbots, omitted life-saving instructions on first aid or CPR or contained incorrect information that contradicted relevant international guidelines. Eleven studies (25.0 %) have also revealed potentially harmful advice, which, if followed by an unsuspecting person, may cause direct injury or death of a victim. CONCLUSIONS: Misinformation concerning CPR and first aid cannot be ignored and demands close attention from relevant stakeholders to mitigate its harmful impacts. More studies are urgently needed to determine optimal methods for detecting and measuring misinformation, to understand mechanisms that drive its spread, and to develop effective measures to correct and prevent misinformation.

Immunohistological and serological investigations of morbillivirus infection in Black Sea harbour porpoises (Phocoena phocoena).

In the present study the occurrence of morbillivirus infection in harbour porpoises (Phocoena phocoena) from the Black Sea was investigated. Blood and tissue specimens of lung, brain and spleen from 73 stranded or by-caught harbour porpoises derived from the three Black Sea subregions such as Bulgaria, Georgia and Ukraine were collected between 1997 and 1999 and processed for histology, immunohistochemistry and serology. Age determination was performed according to dental growth layers and body length. The age of the investigated population ranged from neonates to a 12-year-old animal. Morbillivirus-specific neutralizing antibodies were detected in 53% of harbour porpoises. Generally, titres were very low and ranged from 20 to 270. There was no correlation between age, geographical origin and titre levels. The most common histological finding (97%) consisted of a mild to severe granulomatous bronchopneumonia due to lung worm infection. There were no changes indicative of a morbillivirus infection. Using immunohistology none of the animals were positive for morbillivirus antigen. However, the serological data are suggestive of a continuously circulating morbillivirus among harbour porpoises from the Black Sea indicating that harbour porpoises may serve as carriers for fatal diseases in susceptible cetacean species.

Total and organic mercury in the Black Sea harbour porpoise Phocoena phocoena relicta.

This paper reports on mercury (Hg) concentrations in different tissues (liver, muscle, kidney, blubber and brain) of harbour porpoises Phocoena phocoena found dead in the Black Sea between 1997 and 1999, mainly bycaught in fishing nets (n = 79). Total Hg and organic Hg (MeHg) were determined. The main factor affecting Hg accumulation was, as expected, age, with MeHg concentration increasing with age. Accumulation of high concentrations of inorganic Hg in the liver was probably due to a slow demethylation process implying the formation of tiemannite (HgSe). In older adults, liver concentrations reached 35 microg g(-1) dry weight ('ppm') total Hg and 3 microg g(-1) dw MeHg. A geographical comparison with existing data from other regions showed a generally low Hg contamination of Black Sea porpoises, one order of magnitude lower than, e.g. in the North Sea.

Epizootic of morbilliviral disease in common dolphins (Delphinus delphis ponticus) from the Black sea.

Forty-seven common dolphins (Delphinus delphis ponticus) were stranded on the northern shores of the Black Sea between mid-July and early September 1994, more than in previous or subsequent years. Two of the 47 dolphins were examined in detail to try to determine the cause of the increased stranding rate. Their lesions included broncho-interstitial pneumonia with type II epithelial cell hyperplasia and multinucleate syncytial cells, neuronal necrosis, gliosis, and non-suppurative meningitis of the brain, necrotic stomatitis, gastroenteritis and cholangitis, and lymphoid depletion of the spleen and lymph nodes. The diseased tissues stained positive in an immunoperoxidase test, using a polyclonal antiserum to measles virus as the primary antibody, and electron microscopy showed that they contained regularly-shaped intranuclear particles about 22 nm in diameter. They were positive by the polymerase chain reaction (PCR) for the nucleoprotein gene of morbillivirus. However, there was no evidence of morbillivirus in frozen tissues either by virus isolation or by antigen capture ELISA. The concentration of sigma DDTS in the blubber of both dolphins was about 50 to 100 times higher than the levels in toothed cetaceans from the North Sea, North Atlantic Ocean, and Baltic Sea. The lesions were consistent with those found in other species with morbilliviral disease, and the positive immunoperoxidase test, PCR and electron microscopical examination confirmed a morbillivirus as the primary cause of these lesions.

[Microphytic algae in the pathology of the cetaceans]. / Mikroskopicheskie vodorosli v patologii kitoobraznykh.

The review includes the analysis of the world literature (1913-1995) about the problems of interrelations, between microorganisms (microphytic algae and cyanobacteria) and marine mammals (whales and dolphins). Special attention is payed to the parasitological, bioindicative and toxicological aspects of microalgae inhabiting the surface of the skin integuments and respiratory organs of cetaceans, as well as their environment. There is the list of the algal species overgrowing the animals bodies and their hosts. The most of the epibionts are belonging to diatoms, there are also some cyanobacteria and green algae. The probability of the influence of the algological factor on the hosts health and a possibility of the microalgae use to evaluate the status of animals and their environment have been discussed.

[Viruses of whales and dolphins]. / Virusy kitov i del'finov.

DNA- and RNA-genome viruses of whales and dolphins belong to families Poxviridae, Herpesviridae, Adenoviridae, Orthomyxoviridae, Paramyxoviridae, Togaviridae, Picornaviridae. Virological, serological and pathomorphological signs of infection have been registered in Odontoceti (bottle-nosed dolphin, Atlantic white-sided dolphin, striped dolphin, harbona porpoise, white-beaked dolphin, common dolphin, sperm whale, pilot whale, white whale) and Musticeti (sei whale, fin whale, gray whale, and bowheaded whale). A brief characteristic of diseases is presented. No relations of some viruses with pathologic states of Cetacea were found.

Ultrastructural changes in the endothelium of lung capillaries during experimental pneumonia.

In 35 guinea pigs a model of pneumonia was produced by transtracheal introduction of a sterile string. Electron microscopic study revealed that in the early stage of pneumonia (3-14 days after onset) endothelial cells in the capillaries of alveolar walls develop changes aimed at intensification of their function in sustaining an enhanced transcapillary gas exchange. In the following stage (1-4 months) endothelial cells develop progressing dystrophic changes leading to structural and functional disturbance of the blood-oxygen barrier. The dystrophic changes in endothelial cells develop later than those in alveolar epithelium.

[Changes in surface activity of surfactant and ultrastructure of the air-blood barrier in alcoholic intoxication in experimental animals]. / Izmeneniia poverkhnostnoi aktivnosti surfaktanta i ul'trastruktura aérogematicheskogo bar'era pri alkogol'noi intoksikatsii v éksperimente.

In the results of complex investigation of the lungs of 26 white rats, it was established, that there is the suppression of surface active properties of surfactant under influence of ethanol. In acute poisoning this suppression is associated with direct injury of surfactant with ethanol and inactivation of surfactant with serum proteins, which appear in the alveolar space because of the edema of air-haematic barrier. In prolonged influence the suppression of the surface activity of surfactant is due to the increase of its catabolism with alveolar macrophages.

Ultrastructural changes of air-blood-barrier and surfactant in chronic non-specific lung diseases.

The study of changes of ultrastructure of air-blood-barrier components in comparison with indices of surfactant surface activity was carried out on fragments of lung tissue, cut from 36 patients with bronchiectasis, chronic abscess and fibrosis of post-pneumonic nature. Our data indicate, that in patients with chronic non-specific lung diseases the areas, more distant from the focus of affection, have changes, involving all the components of air-blood-barrier. Dystrophic and destructive processes, taking place in some pneumocytes of the 2nd type, result in suppression of the surface active characteristics of surfactant. On the other hand, processes of compensatory nature, directed to making up a deficiency of surfactant, take place.

[The pulmonary surfactant status in lung immaturity]. / Sostoianie surfaktanta legkikh pri ikih nezrelosti.

Combined study of lungs of 85 foetuses and newborns of various gestational age and 8 newborns dying during the first month of life showed the lung surfactant (LS) system to develop in parallel with formation of respiratory parts and lung capillary network. The level of the LS surface activity increases with the increase of the duration of pregnancy and is determined by the maturation degree of the type II alveolocytes. Changes of the surface activity of the lung extract surface-active fraction in the process of lung maturation correlate with the fractional phospholipid distribution. Morphofunctional immaturity of lungs is characterized, besides histological features, by the ultrastructural immaturity of the type II alveolocytes and biochemical immaturity of LS.

[Surface-active properties of pulmonary surfactant and the functional activity of type II alveolocytes at various times of the day under experimental conditions]. / Poverkhnostno-aktivnye svoistva surfaktanta legkikh i funktsional'naia aktivnost' al'veolotsitov II tipa v razlichnoe vremia sutok v éksperimente.

Complex examination of lungs in 24 healthy guinea pigs in different periods of day using physicochemical, biochemical and electron-microscopic methods has revealed that the highest surface activity of the pulmonary surfactant (PS) is observed in the evening and at night, as phospholipids contain the highest amount of a surfactant of the phosphatidylcholine fraction the most active in the surface-active respect. An increase in the content of PS phospholipids in this period of the day appears to be a consequence of synthesis and secretion intensification in the second-type alveolocytes, that may be due to an increased effect of the vagus nerve.

[Pulmonary surfactant in guinea pigs after toxic exposure to CCl4]. / Surfaktant legkikh morskikh svinok posle toksicheskogo vozdeistviia CCl4.

The surface-active properties of lung surfactant were studied in 32 guinea pigs given CCl4 according to a schedule. The surface activity of the surfactant is inhibited in the experimental animals under the effect of hepatotrophic poison (CCl4) due to the disturbed metabolism of its phospholipids, which is a consequence of the diminished lipid-synthesizing function of the liver. Diminution of the surface-active properties of the lung surfactant and disturbance of its qualitative composition may be regarded as the cause of the development of extensive atelectases in the animals' lungs.

[Ultrastructure of the blood-air barrier in comparison with the indices of surfactant surface activity]. / Ul'trastruktura aérogematicheskogo bar'era v sopostavlenii s pokazateliami poverkhnostnoi aktivnosti surfaktanta.

Ultrastructure of the air-blood barrier and surface surfactant activity were studied at different time periods of nonspecific inflammation of the lungs in guinea pigs. The animals were sacrificed 3 days, 2 weeks and 1, 2 and 4 months after beginning of the experiment. It has been demonstrated that in early periods of lung inflammation there was edema of all components of the air-blood barrier. Subsequent development of inflammation is accompanied by surface activity decrease associated with dystrophic changes in the epithelial cells of alveoli. At the same time there are compensatory changes in the lungs, directed to eliminate deficiency of surfactant.

[Surface activity of the surfactant in experimental compression atelectasis]. / Poverkhnostnaia aktivnost' surfaktanta pri éksperimental'nom kimpressionnom atelektaze.

Surface surfactant activity was studied at different time periods of compression atelectasis, induced by hydrothorax in 35 guinea pigs. The animals were slaughtered 30 and 60 minutes or 3, 12 and 24 hours after hydrothorax. It has been demonstrated that experimental compression atelectasis is accompanied by surface activity lowering, associated with disorders in surfactant secretion into the alveolar lumen. The qualitative composition of surfactant phospholipids remains unchanged, which may play an essential role in the recovery of lung tissue aeration.