Hepatic sinusoidal obstruction syndrome after immune-checkpoint-inhibitor therapy: when the liver sends SOS.

A woman in her 50s presented to the hospital with new-onset jaundice and ascites. Her medical history included a melanoma of the right shoulder, diagnosed 8 months before, for which she had received four cycles of ipilimumab and nivolumab. Due to the oncological history and previous immunotherapy, an immune-checkpoint-inhibitor (ICI)-induced hepatitis was suspected, and a high-dose corticosteroid treatment was initiated.

Evaluating a multimodal, clinical and work-directed intervention (RTW-PIA) to support sustainable return to work among employees with mental disorders: study protocol of a multicentre, randomised controlled trial.

Background: Mental disorders (MDs) are one of the leading causes for workforce sickness absence and disability worldwide. The burden, costs and challenges are enormous for the individuals concerned, employers and society at large. Although most MDs are characterised by a high risk of relapse after treatment or by chronic courses, interventions that link medical-psychotherapeutic approaches with work-directed components to facilitate a sustainable return to work (RTW) are rare.

A crossover study assessing the protective efficacy of improvised snorkel-based improvised respirators.

Introduction: This study was designed to determine whether improvised respirators based on modified full-face snorkel masks are able to pass a standard qualitative fit test.

Methods: This is a prospective crossover study conducted in 16 staff. Fit-tests were conducted on masks mated to (1) an anaesthetic breathing circuit heat and moisture exchange filter and (2) a CE-marked P3 grade filter.

3D Bioprinting of Prevascularized Full-Thickness Gelatin-Alginate Structures with Embedded Co-Cultures.

The use of bioprinting allows the creation of complex three-dimensional cell laden grafts with spatial placements of different cell lines. However, a major challenge is insufficient nutrient transfer, especially with the increased size of the graft causing necrosis and reduced proliferation. A possibility to improve nutrient support is the integration of tubular structures for reducing diffusion paths.

A crossover trial investigating the atmospheric content of improvised respirators.

Introduction: This study was designed to determine the respiratory safety of improvised respirators based on modified full-face snorkel masks, making comparisons with a purpose-designed mask.

Methods: This is a prospective crossover study conducted on ten recruits. Volunteers wore snorkel masks mated to an anaesthetic heat and moisture exchange filter.

Inflammation induces pro-NETotic neutrophils via TNFR2 signaling.

Cytokines released during chronic inflammatory diseases induce pro-inflammatory properties in polymorphonuclear neutrophils (PMNs). Here, we describe the development of a subgroup of human PMNs expressing CCR5, termed CCR5 PMNs. Auto- and paracrine tumor necrosis factor (TNF) signaling increases intracellular neutrophil elastase (ELANE) abundance and induces neutrophil extracellular traps formation (NETosis) in CCR5 PMNs, and triggering of CCR5 amplifies NETosis.

Influence of respiratory protective equipment on simulated advanced airway skills by specialist tracheal intubation teams during the COVID-19 pandemic.

Background: The COVID-19 pandemic has highlighted the importance of respiratory protective equipment for clinicians performing airway management.

Aim: To evaluate the impact of powered air-purifying respirators, full-face air-purifying respirators and filtering facepieces on specially trained anaesthesiologists performing difficult airway procedures.

Methods: All our COVID-19 intubation team members carried out various difficult intubation drills: unprotected, wearing a full-face respirator, a filtering facepiece or a powered respirator.

Prospective observational study of gender and ethnicity biases in respiratory protective equipment for healthcare workers in the COVID-19 pandemic.

Objective: To describe success rates of respiratory protective equipment (RPE) fit testing and factors associated with achieving suitable fit.

Design: Prospective observational study of RPE fit testing according to health and safety, and occupational health requirements.

Setting: A large tertiary referral UK healthcare facility.

Computational exploration of molecular receptive fields in the olfactory bulb reveals a glomerulus-centric chemical map.

Progress in olfactory research is currently hampered by incomplete knowledge about chemical receptive ranges of primary receptors. Moreover, the chemical logic underlying the arrangement of computational units in the olfactory bulb has still not been resolved. We undertook a large-scale approach at characterising molecular receptive ranges (MRRs) of glomeruli in the dorsal olfactory bulb (dOB) innervated by the MOR18-2 olfactory receptor, also known as Olfr78, with human ortholog OR51E2.

First responder communication in CBRN environments: FIRCOM-CBRN study.

Introduction: Recent terror attacks and assassinations involving highly toxic chemical weapons have stressed the importance of sufficient respiratory protection of medical first responders and receivers. As full-face respirators cause perceptual-motor impairment, they not only impair vision but also significantly reduce speech intelligibility. The recent introduction of electronic voice projection units (VPUs), attached to a respirator, may improve communication while wearing personal respiratory protection.

Fatal Anaphylaxis to Atracurium: A Case Report.

A 52-year-old patient was scheduled for a cystoscopy. Anesthesia was induced by intravenous injection of fentanyl and propofol. After administration of atracurium, he became bradycardic and suffered a cardiac arrest.

Survey of UK Health Care First Responders' Knowledge of Personal Protective Equipment Requirements.

Introduction: An adequate level of personal protective equipment (PPE) is necessary when treating patients with highly infectious diseases or those contaminated with hazardous substances.

Methods: Following National Institute for Health Research's Research Centre (London, United Kingdom) approval, the authors of this study conducted a survey of specialist registrars' knowledge of the respiratory and skin protection requirements needed during a resuscitation scenario with Advanced Life Support. Participant responses were compared to UK national recommendations and to a previous survey in 2009.

Automatic segmentation of odor maps in the mouse olfactory bulb using regularized non-negative matrix factorization.

Segmentation of functional parts in image series of functional activity is a common problem in neuroscience. Here we apply regularized non-negative matrix factorization (rNMF) to extract glomeruli in intrinsic optical signal (IOS) images of the olfactory bulb. Regularization allows us to incorporate prior knowledge about the spatio-temporal characteristics of glomerular signals.

Respiratory protection during simulated emergency pediatric life support: a randomized, controlled, crossover study.

Introduction: Emergency pediatric life support (EPLS) of children infected with transmissible respiratory diseases requires adequate respiratory protection for medical first responders. Conventional air-purifying respirators (APR) and modern loose-fitting powered air-purifying respirator-hoods (PAPR-hood) may have a different impact during pediatric resuscitation and therefore require evaluation.

Objective: This study investigated the influence of APRs and PAPR-hoods during simulated pediatric cardiopulmonary resuscitation.

Personal protection during resuscitation of casualties contaminated with chemical or biological warfare agents--a survey of medical first responders.

Introduction: The threat of mass casualties caused by an unconventional terrorist attack is a challenge for the public health system, with special implications for emergency medicine, anesthesia, and intensive care. Advanced life support of patients injured by chemical or biological warfare agents requires an adequate level of personal protection. The aim of this study was to evaluate the personal protection knowledge of emergency physicians and anesthetists who would be at the frontline of the initial health response to a chemical/biological warfare agent incident.

Evaluation of bag-valve-mask ventilation by paramedics in simulated chemical, biological, radiological, or nuclear environments.

Introduction: Bag-valve-mask ventilation is a key component of life support, but only one handheld resuscitator is designed to operate in contaminated or toxic atmospheres.

Methods: After Institutional Review Board approval, the efficacy of this device was evaluated. The distal trachea of a Laerdal Airway Management Trainer was connected to a mechanical Draeger Volumeter 3000, to enable determination of the minute volume delivered by BVM ventilation.

Lack of agreement between thermodilution and electrical velocimetry cardiac output measurements.

Objective: The modified algorithm for the non-invasive determination of cardiac output (CO) by electrical bioimpedance-electrical velocimetry (EV)-has been reported to give reliable results in comparison with echocardiography and pulmonary arterial thermodilution (PA-TD) in patients either before or after cardiac surgery. The present study was designed to determine whether EV-CO measurements reflect intraindividual changes in CO during cardiac surgery.

Design: Prospective, observational study.

Influence of air-purifying respirators on the simulated first response emergency treatment of CBRN victims.

Aim: Medical first responders and emergency room personnel potentially are threatened by exposure to primary or secondary intoxication by chemical, biological, radiological or nuclear (CBRN) substances. The impact of personal respiratory protection by air-purifying respirators on the performance of resuscitation requires evaluation. This will help to improve major incident planning and measures for protecting medical staff.