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Characterization of aerosol generation during exercise can inform the development of safety recommendations in the face of COVID-19. ⋯ Our data suggest exercise testing is an aerosol-generating procedure and, by extension, other activities that involve exercise intensities at or above 50% of predicted heart rate reserve. Results can guide recommendations for safety of exercise testing and other indoor exercise activities.
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Tobacco, like other popular commodities, both reflected the rhythms of early modern empires and contributed to them. People, goods, and ideas crossing the Atlantic Ocean often traveled as freight in vessels bound upon other business, and much of that was tobacco business. Using a variety of historical examples, the current article explores tobacco's economic, cultural, and labor-related worlds to show how one plant shaped institutions of human enslavement, altered colonial ecologies, offered new sensory possibilities, and ruined fortunes. ⋯ It underwrote the rise of prominent merchant and political families while shaping the daily routines of countless enslaved men, women, and children tasked with growing the plant. Tobacco leaves also offered hopes of medical treatment and trustworthy business dealings, as well as a moment of respite on a long voyage. At every stage of its evolution into a global commodity, tobacco's meanings and roles changed, becoming more fully integrated into European empire and its structures of power and profit in the process.
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IV pushes of phenylephrine may be used for patients with septic shock with the intent of rapidly achieving mean arterial pressure (MAP) goals. However, the clinical effectiveness and safety of this approach are unclear. ⋯ Phenylephrine pushes were associated with a higher incidence of early, but not sustained, hemodynamic stability and were associated independently with higher ICU mortality. Caution is warranted when clinicians are considering the use of phenylephrine pushes in patients with septic shock.