A 36-Year-Old Patient With Crohn Disease and Bilateral Pleural Effusions.

A 36-year-old man with severe Crohn disease complicated by urethral strictures and enterocutaneous and enterovesicular fistulas presented for several weeks of poor appetite, weight loss, failure to thrive, and newly worsening altered mentation. Further history revealed he chronically did not urinate through his urethra, but rather "leaked" through multiple enterocutaneous fistulas in his abdomen and perineum. Medications included ustekinumab (anti-IL12/IL23 monoclonal antibody) for Crohn disease, methadone, and hydrocodone.

Unprecedented toxic blooms of Microcystis spp. in 2019 in the Chowan River, North Carolina.

The Chowan River flows from southern Virginia through northeastern North Carolina and into the Albemarle Sound, a part of the second largest U.S. estuary.

Obstetric Life Support Education for Maternal Cardiac Arrest: A Randomized Clinical Trial.

Importance: Management of maternal cardiac arrest (MCA) requires understanding the unique physiology of pregnancy and modifications to life support. Health care professionals have historically demonstrated inadequate knowledge and skills necessary to treat MCA.

Objective: To evaluate the effect of Obstetric Life Support (OBLS) education on health care professionals' cognitive performance, skills, and self-efficacy in managing MCA.

Expanding the Application of Sentinel-2 Chlorophyll Monitoring across United States Lakes.

Eutrophication of inland lakes poses various societal and ecological threats, making water quality monitoring crucial. Satellites provide a comprehensive and cost-effective supplement to traditional in situ sampling. The Sentinel-2 MultiSpectral Instrument (S2 MSI) offers unique spectral bands positioned to quantify chlorophyll , a water-quality and trophic-state indicator, along with fine spatial resolution, enabling the monitoring of small waterbodies.

Using the ROX Index to Predict Treatment Outcome for High-Flow Nasal Cannula and/or Noninvasive Ventilation in Patients With COPD Exacerbations.

Background: The ratio of oxygen saturation index (ROX index; or S /F /breathing frequency) has been shown to predict risk of intubation after high-flow nasal cannula (HFNC) support among adults with acute hypoxemic respiratory failure primarily due to pneumonia. However, its predictive value for other subtypes of respiratory failure is unknown. This study investigated whether the ROX index predicts liberation from HFNC or noninvasive ventilation (NIV), intubation with mechanical ventilation, or death in adults admitted for respiratory failure due to an exacerbation of COPD.