Sublethal toxicities of 2,4-dinitrophenol as inferred from online self-reports.

Introduction: 2,4-dinitrophenol (DNP) is a mitochondrial toxin sometimes used as a weight loss agent. Reports of fatalities from DNP have been increasing since 2000, suggesting an increase in use. Our understanding of DNP toxicity in humans comes from reports to Poison Control and postmortem analyses, sources that are biased to more extreme presentations.

Fostering the Next Generation of Researchers: a Sustainable Mentoring Program for Early Career Toxicologists in Scientific Abstract Review.

The presentation of abstracts at scientific meetings is an important step in the dissemination of scientific discovery. Most scientific meetings recruit volunteer experts to evaluate and score submitted abstracts to determine which ones qualify for presentation. Reviewing an abstract is an important service to one's specialty, but there is typically no formal training or required instruction during medical toxicology fellowship on scientific abstract scoring.

COVID-19 Therapeutics: Use, Mechanism of Action, and Toxicity (Vaccines, Monoclonal Antibodies, and Immunotherapeutics).

SARS-CoV-2 emerged in December 2019 and led to the COVID-19 pandemic. Efforts to develop therapeutics have led to innovations such as mRNA vaccines and oral antivirals. Here we provide a narrative review of the biologic therapeutics used or proposed to treat COVID-19 during the last 3 years.

COVID-19 Therapeutics: Use, Mechanism of Action, and Toxicity (Xenobiotics).

SARS-CoV-2 emerged in 2019 and led to the COVID-19 pandemic. Efforts to develop therapeutics against SARS-Cov-2 led to both new treatments and attempts to repurpose existing medications. Here, we provide a narrative review of the xenobiotics and alternative remedies used or proposed to treat COVID-19.

Translator use not associated with longer time to pain medication in initial evaluation of low-severity geriatric trauma.

Objectives: Determine whether geriatric victims of blunt trauma who preferred to communicate in a language other than English waited longer for pain medication or received more imaging studies than English-speaking patients with the same age and injuries. Secondary outcomes were the type of medication administered and number of imaging studies.

Methods: We conducted a retrospective analysis of all trauma activations to a single academic urban medical center from January 2019 to October 2019.

Efficacy of lipid emulsion therapy in treating cardiotoxicity from diphenhydramine ingestion: a review and analysis of case reports.

Introduction: Lipid emulsion therapy (LET) has been most thoroughly studied to reverse local anesthetic systemic toxicity (LAST). Case reports suggest that LET can successfully rescue cardiovascular collapse from bupropion, amitriptyline, and propranolol. The efficacy of LET against refractory hypotension and dysrhythmias from diphenhydramine, a commonly ingested lipophilic cardiotoxic agent, is less well described.

Diagnosis of Acute Poisoning using explainable artificial intelligence.

Introduction: Medical toxicology is the clinical specialty that treats the toxic effects of substances, for example, an overdose, a medication error, or a scorpion sting. The volume of toxicological knowledge and research has, as with other medical specialties, outstripped the ability of the individual clinician to entirely master and stay current with it. The application of machine learning/artificial intelligence (ML/AI) techniques to medical toxicology is challenging because initial treatment decisions are often based on a few pieces of textual data and rely heavily on experience and prior knowledge.

Mothers' sleep deficits and cognitive performance: Moderation by stress and age.

There are well-known associations between stress, poor sleep, and cognitive deficits, but little is known about their interactive effects, which the present study explored in a sample of mothers of toddlers. Since certain types of cognitive decline start during the 20s and continue into later ages, we also explored whether mothers' age interacted with stress and sleep in the prediction of cognitive functioning. We hypothesized that poorer sleep [measured using one week of 24-hour wrist actigraphy data] and having more chronic stressors [e.

Geospatial correlation between COVID-19 health misinformation and poisoning with household cleaners in the Greater Boston Area.

Introduction: Calls to poison control about exposure to household cleaners have increased during the COVID-19 pandemic. This dynamic may reflect increased exposure from public health efforts as well as health misinformation shared on social media.

Methods: We analyzed the dynamics of calls to the Regional Center for Poison Control and Prevention serving Massachusetts and Rhode Island (MARI PCC) and tweets discussing treating COVID-19 with house cleaners from January 20, 2020 to May 5, 2020.

COVID-19: Therapeutics and Their Toxicities.

SARS-CoV-2 is a novel coronavirus that emerged in 2019 and is causing the COVID-19 pandemic. There is no current standard of care. Clinicians need to be mindful of the toxicity of a wide variety of possibly unfamiliar substances being tested or repurposed to treat COVID-19.

The Role and Promise of Artificial Intelligence in Medical Toxicology.

Artificial intelligence (AI) refers to machines or software that process information and interact with the world as understanding beings. Examples of AI in medicine include the automated reading of chest X-rays and the detection of heart dysrhythmias from wearables. A key promise of AI is its potential to apply logical reasoning at the scale of data too vast for the human mind to comprehend.

Discovery of N-pyridoyl-Δ -pyrazolines as Hsp90 inhibitors.

Hsp90, as a key molecular chaperone, plays an important role in modulating the activity of many cell signaling proteins and is an attractive target for anticancer therapeutics. Herein, we report the discovery of N-pyridoyl-Δ -pyrazoline analogs as novel Hsp90 inhibitors by integrated approaches of drug design, organic synthesis, cell biology, and qualitative proteomic analysis. Novel chemical compounds were designed and optimized in the adenosine triphosphate-binding site of Hsp90; lead optimized compounds were found to have significant interactions with Asp93 and other amino acids crucial for Hsp90 inhibition.

Incidence of Pediatric Cannabis Exposure Among Children and Teenagers Aged 0 to 19 Years Before and After Medical Marijuana Legalization in Massachusetts.

Importance: Pediatric health care contacts due to cannabis exposure increased in Colorado and Washington State after cannabis (marijuana) policies became more liberal, but evidence from other US states is limited.

Objective: To document the incidence of pediatric cannabis exposure cases reported to the Regional Center for Poison Control and Prevention (RPC) before and after medical marijuana legalization (MML) in Massachusetts.

Design, Setting, And Participants: Cross-sectional comparison of pediatric cannabis exposure cases 4 years before and after MML in Massachusetts.

A Review of Natural Language Processing in Medical Education.

Natural language processing (NLP) aims to program machines to interpret human language as humans do. It could quantify aspects of medical education that were previously amenable only to qualitative methods. The application of NLP to medical education has been accelerating over the past several years.

Maternal Executive Function and Sleep Interact in the Prediction of Negative Parenting.

: Poorer executive function (EF) has been implicated in the etiology of negative parenting (e.g., harsh, reactive, intrusive).

Infrared and Raman spectroscopic studies of Mn ions doped in strontium alumino borate glasses: Describes the role of AlO.

Strontium alumino borate glasses doped with Mn ions (SABM) have been prepared and characterized by XRD, density, Electron paramagnetic resonance (EPR), FT-IR and Raman to investigate the spectral and physical properties of the present glass samples. The FTIR spectra revealed the presence of BO and BO structural units in SABM glasses. The IR peak at ~467 and ~679 cm assigned as the vibration of metal cations (Sr), MnO bond vibrations and bending vibration of AlO in [AlO] units.

Candyflipping and Other Combinations: Identifying Drug-Drug Combinations from an Online Forum.

Novel psychoactive substances (NPS) refer to synthetic compounds or derivatives of more widely known substances of abuse that have emerged over the last two decades. Case reports suggest that users combine substances to achieve desired psychotropic experiences while reducing dysphoria and unpleasant somatic effects. However, the pattern of combining NPS has not been studied on a large scale.

Epidemiology from Tweets: Estimating Misuse of Prescription Opioids in the USA from Social Media.

Background: The misuse of prescription opioids (MUPO) is a leading public health concern. Social media are playing an expanded role in public health research, but there are few methods for estimating established epidemiological metrics from social media. The purpose of this study was to demonstrate that the geographic variation of social media posts mentioning prescription opioid misuse strongly correlates with government estimates of MUPO in the last month.

Differences in Self-expression Reflect Formal Evaluation in a Fourth-year Emergency Medicine Clerkship.

Introduction: Medical schools have begun to incorporate self-reflection exercises into their curricula, with the belief that these exercises help students master the material more deeply and perform better. Reflection may be a potential learning tool for emergency medicine (EM), but there are few data supporting this hypothesis. The authors evaluated the relationship between a linguistic marker of the degree of reflection after a student's shift in an emergency department and that student's clerkship performance.

Identification of Leishmania donovani Topoisomerase 1 inhibitors via intuitive scaffold hopping and bioisosteric modification of known Top 1 inhibitors.

A library of arylidenefuropyridinediones was discovered as potent inhibitors of Leishmania donovani Topoisomerase 1 (LdTop1) where the active molecules displayed considerable inhibition with single digit micromolar EC50 values. This molecular library was designed via intuitive scaffold hopping and bioisosteric modification of known topoisomerase 1 inhibitors such as camptothecin, edotecarin and etc. The design was rationalized by molecular docking analysis of the compound prototype with human topoisomerase 1 (HTop1) and Leishmania donovani topoisomerase 1(LdTop1).

"Irony" of managing refractory anemia with transfusional support in hemophagocytic lymphohistiocytosis.

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening derangement of the immune system in which host macrophages phagocytose the patient's own blood cells. Herein, we present the case of a patient with HLH and associated refractory anemia who developed rapid iron deposition in the liver after transfusion of sixteen units of packed red blood cells (RBCs). Before transfusion, neither a liver biopsy nor computed tomography scan demonstrated iron deposition in the organ parenchyma.

Paraneoplastic orthostatic hypotension associated with acute myeloid leukemia.

Paraneoplastic neuropathies associated with leukemia are rare, and early diagnosis and treatment are crucial due to the potential for irreversible neurological deficits and delay in treatment of the leukemia. This is the first report to describe severe paraneoplastic orthostatic hypotension which resolved after treatment of the acute myeloid leukemia (AML). The patient is a 76 year-old woman who presented with progressive dizziness, anorexia, and fatigue.