Background: Chest compressions are life-saving in cardiac arrest but concern by layperson of causing unintentional injury to patients who are not in cardiac arrest may limit provision and therefore delay initiation when required. Aim: To perform a systematic review of the evidence to identify if; among patients not in cardiac arrest outside of a hospital, does provision of chest compressions from a layperson, compared to no use of chest compressions, worsen outcomes. Method: We searched Medline (Ovid), Web of Science Core Collection (clarivate) and Cinahl (Ebsco). Outcomes included survival with favourable neurological/functional outcome at discharge or 30 days; unintentional injury (e.g. rib fracture, bleeding); risk of injury (e.g. aspiration). ROBINS-I was used to assess for risk of bias. Grading of Recommendations, Assessment, Development and Evaluation methodology was used to determine the certainty of evidence. (PROSPERO registration number: CRD42023476764). Results: From 7832 screened references, five observational studies were included, totaling 1031 patients. No deaths directly attributable to chest compressions were reported, but 61 (6 %) died before discharge due to underlying conditions. In total, 9 (<1%) experienced injuries, including rib fractures and different internal bleedings, and 24 (2 %) reported symptoms such as chest pain. Evidence was of very low certainty due to risk of bias and imprecision. Conclusion: Patients initially receiving chest compressions by a layperson and who later were determined by health care professionals to not be in cardiac arrest rarely had injuries from chest compressions.

Cerebral vascular disorders often accompany hypoxia-induced brain injury. In this study, we develop a zebrafish model of hypoxia-induced cerebral vascular injury to replicate the associated phenotypic changes, including cerebrovascular damage, neuronal apoptosis, and neurological dysfunction. We then explored the therapeutic potential of extracellular vesicles derived from Wharton's jelly-derived mesenchymal stem cells (WJ-MSCs) cultured on soy protein-coated surfaces. These vesicles demonstrated superior recovery efficacy, especially in restoring the blood-brain barrier integrity and improving neurological function. Our findings suggest that these potent therapeutic extracellular vesicles, easily produced from WJ-MSCs cultured in the presence of soy proteins, may mitigate hypoxia-induced brain injury by decreasing the severity of vascular disorder caused by oxidative stress. Protein-protein interactome analysis further suggests that multiple signaling pathways are likely involved in restoring normal neurovascular unit function.

Biodiesel is one of the most potential sustainable alternatives to fossil fuels in transportation sector. However, methanol used in biodiesel production is usually synthesized from natural gas. In this work, a feasibility study of biomethanol (bio-MeOH) production from palm oil mill effluent is conducted. Biogas produced from palm oil mill effluent (POME) via anaerobic digestor is used to synthesize bio-MeOH to support sustainable biodiesel production. The treated biogas is converted into syngas via methane steam reforming (MSR) and water gas shift (WGS) processes. Raw syngas from WGS reactor is dehumidified and mixed with an additional amount of carbon dioxide (CO2) to achieve desired 2:1 H2/CO2 molar ratio before being fed into a CO2 hydrogenation reactor to produce bio-MeOH. The raw bio-MeOH is then purified to 99.9 mol% via distillation columns. To reduce utility consumption and CO2 emissions, the bio-MeOH production process is further enhanced via heat integration. The optimized results show that the levelized production cost and carbon emission of the intensified design are 1,101.56 USD and 3.42 tonne-CO2 per tonne-MeOH. For the internal rate of return (IRR) to attain the profitable threshold of 5 %, the selling price of bio-MeOH must be higher than $1,600 USD per tonne-MeOH.

Utilizing sunlight for the photocatalytic reduction of atmospheric carbon dioxide into valuable compounds or energy resources holds promise for sustainable energy applications and mitigating global warming by reducing atmospheric carbon dioxide concentrations. This study investigates Janus membranes capable of concurrently concentrating CO2 from ambient air and photocatalytically converting it to methane under simulated sunlight conditions. Through modulation of thermodynamic and kinetic parameters during membrane formation, adjustments to the pore structure of the Janus membrane are made to enhance CO2 conversion efficiency. Cloud point, viscosity, light transmittance, and dyeing experiments are employed to elucidate the factors influencing the formation of distinct pore structures within the membranes. Characterization techniques such as scanning electron microscopy, energy-dispersive X-ray spectroscopy, ultraviolet–visible spectroscopy, photoluminescence, gas permeation analyzer, and mechanical property assessments are utilized to analyze membrane properties. The photocatalytic reactive layer exhibiting a closed-pore structure effectively prolongs the residence time of CO2 within the reactive layer, resulting in an increased methane yield of 0.70 μmol gcat−1 h−1. Incorporating an optimal quantity of TiO2 (30 wt%) further enhances the methane yield to 1.17 μmol gcat−1 h−1. However, the methane yield of the Janus membrane exhibits a notable decline after prolonged continuous photocatalytic reactions, prompting a detailed examination of factors contributing to the membranes' poor long-term stability. This study introduces a novel approach to enhance the CO2 conversion efficiency of photocatalytic Janus membranes by regulating the pore structure of the reactive layer. The findings contribute to the advancement of high-performance Janus membranes, offering a promising avenue for future research and development endeavors.

Pei-Lin Lee serves as Clinical Associate Professor, School of Medicine, National Taiwan University; Consultant, Center of Sleep Disorder, National Taiwan University Hospital. Her current academic positions at international sleep societies include American Academy of Sleep Medicine Fellow and Co-Chair International Assembly; Asian Society of Sleep Medicine, Sleep Medicine Education Task Force committee member. Her current research focuses on the era of new technology and big data in sleep medicine; and intervention on sleep and metabolism in sleep disordered breathing.