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Lifeguard teams carry out their work in extremely hot conditions in many parts of the world. The aim of this study was to analyze the impact of high temperatures on physiological parameters during cardiopulmonary resuscitation (CPR). A randomized quasi-experimental cross-over design was used to test physiological lifesaving demands (50 min acclimatization +10 min CPR) in two different thermal environments: Thermo-neutral environment (25 °C) vs Hyperthermic environment (37 °C). The data obtained from 21 lifeguards were included, this covers a total of 420 min of resuscitation. The CPR performance was constantly maintained during the 10 min. The Oxygen uptake (VO 2) ranged from 17 to 18 ml/min/kg for chest compressions (CC) and between 13 and 14 ml/min/kg for ventilations (V) at both 25 °C and 37 °C, with no significant difference between environments (p > 0.05). The percentage of maximum heart rate (%HR max) increased between 7% and 8% at 37 °C (p < 0.001), ranging between 75% and 82% of HR max. The loss of body fluids (LBF) was higher in the hyperthermic environment; LBF: (37 °C: 400 ± 187 g vs 25 °C: 148 ± 81 g, p < 0.001). Body temperature was 1 °C higher at the end of the test (p < 0.001). The perceived fatigue (RPE) increased by 37° an average of 2 points on a scale of 10 (p = 0.001). Extreme heat is not a limiting factor in CPR performance with two lifeguards. Metabolic consumption is sustained, with an increase in CC, so V can serve as active rest. Nevertheless, resuscitation at 37 °C results in a higher HR, is more exhausting and causes significant loss of fluids due to sweating.

PurposeHyperthermic intrathoracic chemotherapy (HITOC) is an additive, intraoperative treatment for selected malignant pleural tumors. To improve local tumor control, the thoracic cavity is perfused with a cisplatin-containing solution after surgical cytoreduction. Since cisplatin is probably carcinogenic to humans, potential contamination of surfaces and pathways of exposure should be systematically investigated to enable risk assessments for medical staff and thus derive specific recommendations for occupational safety.MethodsWipe sampling was performed at pre-selected locations during and after ten HITOC procedures, including on the surgeon's gloves, for the quantitation of surface contaminations with cisplatin. After extraction of the samples with hydrochloric acid, platinum was determined as a marker for cisplatin by voltammetry.ResultsHigh median concentrations of cytostatic drugs were detected on the surgeons’ (1.73 pg Cis-Pt/cm2, IQR: 9.36 pg Cis-Pt/cm2) and perfusionists’ (0.69 pg Cis-Pt/cm2, IQR: 1.73 pg Cis-Pt/cm2) gloves. The display of the perfusion device showed partially elevated levels of cisplatin up to 4.92 pg Cis-Pt/cm2 and thus could represent an origin of cross-contamination. In contrast, cisplatin levels on the floor surfaces in the area of the surgeon and the perfusion device or in the endobronchial tube were relatively low.ConclusionWith a correct use of personal protective equipment and careful handling, intraoperative HITOC appears to be safe to perform with a low risk of occupational exposure to cisplatin.

Previous studies using tympanic thermometers on pets have presented inconsistent conclusions. The first aim of the current study was to compare the assessed temperatures using tympanic and rectal thermometers on healthy cats in a home environment and in cats admitted to clinical care. The second aim was to compare assessed stress (Fear, Anxiety and Stress scale, FAS) in healthy cats during the tympanic and rectal measurements. The non-clinical sample included 25 cats, and the clinical sample included 36 cats. The FAS score (mean ± SD) in the non-clinical sample was significantly higher (p < 0.0001) during the rectal measurements (2.9 ± 0.9) than during the in-ear measurements (1.6 ± 0.9), and the temperature (mean ± SD) in both the right and left ears was higher (mean bias 0.3 ± 0.8 °C, 95% limit of agreement [−1.3, 1.8]) than the rectal temperature. The cats in the clinical sample were categorized as either hypothermic (<36.7 °C, n = 5), normothermic (36.7–38.9 °C, n = 34), or hyperthermic (>38.9 °C, n = 8) according to their rectal temperature. In the hypothermic and normothermic cats, the left ear temperature was higher (mean bias 0.4 ± 0.4 °C, [−0.4, 1.2]) than the rectal temperature. In the hyperthermic cats, the left ear temperature was slightly higher (mean bias 0.1 ± 0.3 °C, [−0.4, 0.6]) than the rectal temperature. The results indicate that the currently used tympanic thermometer can be a non-stressful tool to screen for pyrexia in cats in clinical care. However, there is a risk of normothermic cats being falsely diagnosed with pyrexia. This method is not recommended in a home environment owing to the wider limits of agreements and lower precision in the non-clinical sample, complicating the interpretation of the assessed temperatures. In the current study, there were few hypothermic (n = 5) and hyperthermic cats (n = 8), as well as cats with temperatures above 40.0 °C (n = 2); thus, further studies are needed to fully establish this method’s accuracy for these patient groups.

Background: Appendiceal neoplasms account for less than 1% of gastrointestinal cancers but are increasing in incidence worldwide. Their marked histological variations and differences create multiple challenges for prognosis and management planning, as current staging systems are limited in certain aspects for capturing the entire disease complexity. Methods: We synthesized data from 18 large observational studies, including 67,001 patients diagnosed between 1973 and 2024. Using advanced computational modeling, we combined multiple statistical methods and machine learning techniques to improve risk stratification, survival prediction, treatment optimization, and forecasting. A novel overlap-aware weighting methodology was applied to prevent double-counting across overlapping registries. Results: Our multi-dimensional risk model outperformed TNM staging (C-index 0.758 vs. 0.689), identifying five prognostic groups with five-year overall survival ranging from 88.7% (low-risk neuroendocrine tumors (NETs)) to 27.3% (high-risk signet-ring cell carcinomas (SRCC)). Hierarchical survival analysis demonstrated marked variation across histological variants, with goblet cell adenocarcinoma showing the most favorable outcomes. Causal inference confirmed the survival benefit of hyperthermic intraperitoneal chemotherapy (HIPEC) in stage IV disease (five-year overall survival (OS) 87.4%) and highlighted disparities in outcomes by race and institutional volume. Time-series forecasting projected a 25% to 50% increase in incidence by 2030, highlighting the growing risk of global burden. Conclusions: By integrating multi-database evidence with advanced modeling and statistical methodologies, our findings demonstrate valuable insights and implications for individualized prognosis, better management decision-making, and health system planning. Our proposed approach and demonstrated methodologies are warranting better progression and advancements in precision oncology and utilization of computational modeling techniques in big data as well as digital health progression landscape.