Novel treatment of dihydrogen sulfide inhalation using hyperbaric oxygen during mass casualty.

Hydrogen sulfide (H2S) is a toxic gas produced via breakdown of organic matter. Hydrogen sulfide exposure can cause symptoms ranging in severity from mild effects (dizziness, headache, nausea) to severe lactic acidosis, respiratory failure, pulmonary edema, cardiac arrhythmias and death. Treatment modalities include oral countermeasures and 100% FiO2 with supportive therapy. However, case studies utilizing hyperbaric oxygen (HBO2) therapy have been reported with general benefit seen in severe cases of toxicity. In this report, cases of mild to moderate H2S toxicity occurred aboard a U.S. Navy ship, resulting in a mass casualty incident of more than 30 patients. Patient symptoms included dizziness, headaches, nausea, vomiting, and one patient with altered mental status. Most patients' symptoms resolved after several hours of supportive therapy, but six patients had symptoms refractory to 100% FiO2 at 1 atm. These six patients received HBO2 therapy with a USN Treatment Table 9 after consultation with the local emergency room and hyperbaric assets. Four separate chambers were utilized, including two chambers onboard USN ships and the local explosive ordnance disposal (EOD) chamber. Complete resolution of symptoms in all six patients was achieved within the first breathing period. Patients were monitored after treatment aboard the USN ship medical department. No patients required emergency department care. These cases demonstrate an expanded use of HBO2 to include moderate cases of H2S toxicity refractory to first-line therapy.

Pneumomediastinum and the use of hyperbaric oxygen treatment.

Pulmonary barotrauma may occur in diving and can result in a spectrum of injuries referred to as pulmonary over-inflation syndrome (POIS). Pneumomediastinum is a part of the POIS spectrum and only rarely results in respiratory symptoms. We present a case of a civilian diver who developed pneumomediastinum with respiratory symptoms which did not respond to normobaric 100% oxygen. After investigation for pneumothorax, he underwent hyperbaric oxygen treatment which resulted in significant alleviation of his symptoms. This is a novel case example of this treatment algorithm.

The EPIC-KITCHENS Dataset: Collection, Challenges and Baselines.

Since its introduction in 2018, EPIC-KITCHENS has attracted attention as the largest egocentric video benchmark, offering a unique viewpoint on people's interaction with objects, their attention, and even intention. In this paper, we detail how this large-scale dataset was captured by 32 participants in their native kitchen environments, and densely annotated with actions and object interactions. Our videos depict nonscripted daily activities, as recording is started every time a participant entered their kitchen. Recording took place in four countries by participants belonging to ten different nationalities, resulting in highly diverse kitchen habits and cooking styles. Our dataset features 55 hours of video consisting of 11.5M frames, which we densely labelled for a total of 39.6K action segments and 454.2K object bounding boxes. Our annotation is unique in that we had the participants narrate their own videos (after recording), thus reflecting true intention, and we crowd-sourced ground-truths based on these. We describe our object, action and anticipation challenges, and evaluate several baselines over two test splits, seen and unseen kitchens. We introduce new baselines that highlight the multimodal nature of the dataset and the importance of explicit temporal modelling to discriminate fine-grained actions (e.g., 'closing a tap' from 'opening' it up).

Electricity-free amplification and detection for molecular point-of-care diagnosis of HIV-1.

In resource-limited settings, the lack of decentralized molecular diagnostic testing and sparse access to centralized medical facilities can present a critical barrier to timely diagnosis, treatment, and subsequent control and elimination of infectious diseases. Isothermal nucleic acid amplification methods, including reverse transcription loop-mediated isothermal amplification (RT-LAMP), are well-suited for decentralized point-of-care molecular testing in minimal infrastructure laboratories since they significantly reduce the complexity of equipment and power requirements. Despite reduced complexity, however, there is still a need for a constant heat source to enable isothermal nucleic acid amplification. This requirement poses significant challenges for laboratories in developing countries where electricity is often unreliable or unavailable. To address this need, we previously developed a low-cost, electricity-free heater using an exothermic reaction thermally coupled with a phase change material. This heater achieved acceptable performance, but exhibited considerable variability. Furthermore, as an enabling technology, the heater was an incomplete diagnostic solution. Here we describe a more precise, affordable, and robust heater design with thermal standard deviation <0.5°C at operating temperature, a cost of approximately US$.06 per test for heater reaction materials, and an ambient temperature operating range from 16°C to 30°C. We also pair the heater with nucleic acid lateral flow (NALF)-detection for a visual readout. To further illustrate the utility of the electricity-free heater and NALF-detection platform, we demonstrate sensitive and repeatable detection of HIV-1 with a ß-actin positive internal amplification control from processed sample to result in less than 80 minutes. Together, these elements are building blocks for an electricity-free platform capable of isothermal amplification and detection of a variety of pathogens.