Background: Identifying women at highest or lowest risk of perinatal intensive care unit (ICU) admission may enable clinicians to risk stratify women antenatally so that enhanced care or elective admission to ICU may be considered or excluded in birthing plans. We aimed to develop a statistical model to predict the risk of maternal ICU admission.
Methods: We studied 762,918 pregnancies between 2005 and 2018.
Introduction: Anxiety disorders are among the most common mental illnesses in the US. An estimated 31.1% of U.
View Article and Find Full Text PDFNon-carious cervical lesions (NCCLs) become common in individuals over the age of 40 and are progressive. Those that are wedge-shaped in cross-section likely develop hazardous stress concentrations along their sharp axial extent, which can be distributed to lower, safer levels over a larger area via adhesive restoration. Restoration is indicated once a lesion progresses to a minimum restorable axial depth of at least 1.
View Article and Find Full Text PDFRocky mountain spotted fever (RMSF) causes significant illness and death in children. Although historically rare in California, USA, RMSF is endemic in areas of northern Mexico that border California. We describe 7 children with RMSF who were hospitalized at a tertiary pediatric referral center in California during 2017-2023.
View Article and Find Full Text PDFBackground And Objectives: Care plans summarize a child with medical complexity's (CMC) medical history and ongoing care needs. Often, the health care team controls the care plan content, limiting caregivers' ability to edit the document in real time and potentially compromising accuracy and utility. With this study, we aimed to provide caregivers of CMC with online access and shared editing control of their child's care plan and to explore the experiences of caregivers and care team members (CTMs) after using an online collaborative care plan (OCCP).
View Article and Find Full Text PDFObjective: Working memory training for Attention-Deficit/Hyperactivity Disorder (ADHD) has focused on increasing working memory capacity, with inconclusive evidence for its effectiveness. Alternative training targets are executive working memory (EWM) processes that promote flexibility or bolster stability of working memory contents to guide behavior via selective attention. This randomized, placebo-controlled study was designed to assess feasibility, tolerability, and behavioral target engagement of a novel EWM training for ADHD.
View Article and Find Full Text PDFChanges in phenology are occurring from global climate change, yet the impacts of other types of global change on the phenology of animals remain less appreciated. Understanding the potential for synergistic effects of different types of global change on phenology is needed, because changing climate regimes can have cascading effects, particularly on invasive species that vary in their thermal tolerances. Using 25 years of data from 5963 nests and 4675 marked individuals across the entire US breeding range of an endangered predator, the snail kite (Rostrhamus sociabilis plumbeus), we isolated the effects of an invasion of novel prey and warming temperatures on breeding phenology and its demographic consequences.
View Article and Find Full Text PDFPurpose: Factors increasing the risk of maternal critical illness are rising in prevalence in maternity populations. Studies of general critical care populations highlight that severe illness is associated with longer-term physical and psychological morbidity. We aimed to compare short- and longer-term outcomes between women who required critical care admission during pregnancy/puerperium and those who did not.
View Article and Find Full Text PDFA core part of an intensivist's work involves navigating the challenges of End of Life Care. While rates of survival from critical illness have gradually improved, 15%-20% of our patients die during their hospital admission, and a further 20% die within a year. 80% of our patients lack capacity to express their wishes with regard to treatment escalation planning.
View Article and Find Full Text PDFAcidosis is an important immunosuppressive mechanism that leads to tumor growth. Therefore, we investigated the neutralization of tumor acidity to improve immunotherapy response. L-DOS47, a new targeted urease immunoconjugate designed to neutralize tumor acidity, has been well tolerated in phase I/IIa trials.
View Article and Find Full Text PDFBackground: New therapeutics in development for bladder cancer need to address the recalcitrant nature of the disease. Intravesical adoptive cell therapy (ACT) with tumor infiltrating lymphocytes (TIL) can potentially induce durable responses in bladder cancer while maximizing T cells at the tumor site. T cells infused into the bladder directly encounter immunosuppressive populations, such as myeloid derived suppressor cells (MDSCs), that can attenuate T cell responses.
View Article and Find Full Text PDFDuring October 2021, the County of San Diego Health and Human Services Agency identified five cases of shigellosis among persons experiencing homelessness (PEH). We conducted an outbreak investigation and developed interventions to respond to shigellosis outbreaks among PEH. Confirmed cases occurred among PEH with stool-cultured ; probable cases were among PEH with -positive culture-independent diagnostic testing.
View Article and Find Full Text PDFBackground: Adoptive cell therapy (ACT) with tumor-infiltrating lymphocytes (TILs) is a promising immunotherapeutic approach for patients with advanced solid tumors. While numerous advances have been made, the contribution of neoantigen-specific CD4T cells within TIL infusion products remains underexplored and therefore offers a significant opportunity for progress.
Methods: We analyzed infused TIL products from metastatic melanoma patients previously treated with ACT for the presence of neoantigen-specific T cells.
In the current genomic era, the search and deployment of new semi-dwarf alleles have continued to develop better plant types in all cereals. We characterized an agronomically optimal semi-dwarf mutation in Zea mays L. and a parallel polymorphism in Sorghum bicolor L.
View Article and Find Full Text PDFAcidosis is an important immunosuppressive mechanism that leads to tumor growth. Therefore, we investigated the neutralization of tumor acidity to improve immunotherapy response. L-DOS47, a new targeted urease immunoconjugate designed to neutralize tumor acidity, has been well tolerated in phase I/IIa trials.
View Article and Find Full Text PDFBackground: The role of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) neutralizing antibody response from natural infection and vaccination, and the potential determinants of this response are poorly understood. Characterizing this antibody response and the factors associated with neutralization can help inform future prevention efforts and improve clinical outcomes in those infected.
Objectives: The goals of this study were to prospectively evaluate SARS-CoV-2 antibody levels and the neutralizing antibody responses among naturally infected adults and to determine demographic and behavioral factors independently associated with these responses.
Background: Children with medical complexity (CMC) are individuals with complex chronic conditions who have substantial health care needs, functional limitations, and significant use of health care. By nature of their health status, they have many care providers across multiple settings, making information sharing critical to their health and safety. Connecting2gether (C2), a web- and mobile-based patient-facing platform, was codeveloped with families to support and empower parental caregivers, improve information sharing, and facilitate care delivery.
View Article and Find Full Text PDFMany ecologists increasingly advocate for research frameworks centered on the use of 'big data' to address anthropogenic impacts on ecosystems. Yet, experiments are often considered essential for identifying mechanisms and informing conservation interventions. We highlight the complementarity of these research frameworks and expose largely untapped opportunities for combining them to speed advancements in ecology and conservation.
View Article and Find Full Text PDFProsthesis discomfort and a lack of skin-like quality is a source of patient dissatisfaction with facial prostheses. To engineer skin-like replacements, knowledge of the differences between facial skin properties and those for prosthetic materials is essential. This project measured six viscoelastic properties (percent laxity, stiffness, elastic deformation, creep, absorbed energy, and percent elasticity) at six facial locations with a suction device in a human adult population equally stratified for age, sex, and race.
View Article and Find Full Text PDFBackground: The Connecting2gether (C2) platform is a web and mobile-based information-sharing tool that aims to improve care for children with medical complexity and their families. A key feature of C2 is secure messaging, which enables parental caregivers (PCs) to communicate with their child's care team members (CTMs) in a timely manner.
Objective: The objectives of this study were to (1) evaluate the use of a secure messaging system, (2) examine and compare the content of messages to email and phone calls, and (3) explore PCs' and CTMs' perceptions and experiences using secure messaging as a method of communication.
Immunotherapy efficacy is limited in melanoma, and combinations of immunotherapies with other modalities have yielded limited improvements but also adverse events requiring cessation of treatment. In addition to ineffective patient stratification, efficacy is impaired by paucity of intratumoral immune cells (itICs); thus, effective strategies to safely increase itICs are needed. We report that dietary administration of L-fucose induces fucosylation and cell surface enrichment of the major histocompatibility complex (MHC)-II protein HLA-DRB1 in melanoma cells, triggering CD4 T cell-mediated increases in itICs and anti-tumor immunity, enhancing immune checkpoint blockade responses.
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