Outcomes in patients with thrombotic microangiopathy associated with a trigger following plasma exchange: A systematic literature review.

Plasma exchange (PE) outcomes in patients with trigger-associated thrombotic microangiopathy (TMA) have not been comprehensively reviewed. Embase and MEDLINE® were searched on 03/14/2022 for English language articles published after 2007, alongside a congress materials search (2019-2022; PROSPERO: CRD42022325170). Studies with patients with trigger-associated TMA (excluding thrombotic thrombocytopenic purpura, 'typical' hemolytic uremic syndrome caused by Shiga toxin-producing Escherichia coli, post-partum TMA, and TMAs with known genetic cause) who received PE or plasma infusion (PI) and reported treatment response (including measures), safety, patient-/caregiver-reported outcomes, or economic burden data were examined.

A Rare Case of Metformin-Induced Lactic Acidosis and Concomitant Euglycemic Ketoacidosis.

Acidemia arises primarily from the accumulation of carbon dioxide or the loss of bicarbonate, leading to a pH decrease within the body, which can be fatal if severe and not promptly addressed. Metabolic acidemia occurs due to a loss of bicarbonate and can manifest through direct losses of bicarbonate via renal or gastrointestinal routes, or through the accumulation of anions such as lactic acid or ketoacids, leading to an anion gap metabolic acidosis. Many common etiologies for lactic acid and ketoacid generation exist, including medication-induced causes.

Patient-reported pregnancy loss and maternal complications: Insights from the sickle cell disease implementation consortium.

Objective: Sickle cell disease (SCD) is associated with complications during pregnancy and can negatively influence maternal outcomes. Our study aimed to determine the prevalence and predictors of maternal morbidity among participants enrolled in an eight-site SCD Implementation Consortium (SCDIC) registry.

Methods: We conducted a cross-sectional analysis of female registry participants, aged 15-45 years, with a confirmed diagnosis of SCD.

Unmeasured Osmoles: The Hidden Solutes Obscuring a Hyponatremia Evaluation.

Hyponatremia is defined as serum sodium less than 135 mEq/L and is principally a result of water excess relative to total body sodium content. The evaluation of hyponatremia is incomplete without a careful assessment of the patient's volume status, history, and acquisition of both serum and urine osmolality and sodium studies. Many of these studies can be affected by various clinical factors, and these nuances should be considered while interpreting the results.

Do Tasmanian devil declines impact ecosystem function?

Tasmanian eucalypt forests are among the most carbon-dense in the world, but projected climate change could destabilize this critical carbon sink. While the impact of abiotic factors on forest ecosystem carbon dynamics have received considerable attention, biotic factors such as the input of animal scat are less understood. Tasmanian devils (Sarcophilus harrisii)-an osteophageous scavenger that can ingest and solubilize nutrients locked in bone material-may subsidize plant and microbial productivity by concentrating bioavailable nutrients (e.

Gaps during pediatric to adult care transfer escalate acute resource utilization in sickle cell disease.

Guidelines recommend transfer to adult health care within 6 months of completing pediatric care; however, this has not been studied in sickle cell disease (SCD). We hypothesized that longer transfer gaps are associated with increased resource utilization. Transfer gaps were defined as the time between the last pediatric and first adult visits.

Gastrointestinal Myoelectrical Activity (GIMA) Biomarker for Noninvasive Diagnosis of Endometriosis.

Endometriosis represents substantial direct and indirect healthcare costs impacted by an absence of uniformly accurate, non-invasive diagnostic tools. We endeavored to demonstrate gastrointestinal myoelectrical activity (GIMA) biomarkers, unique to endometriosis, will allow non-invasive, uniformly accurate diagnosis or exclusion of endometriosis. Prospective open-label comparative study of 154 patients, age ≥ 18, with or without diagnosed endometriosis.

How do seasonal temperature variations influence interplay between toxic and non-toxic cyanobacterial blooms? Evidence from modeling and experimental data.

Summer cyanobacterial blooms exhibit a dynamic interplay between toxic and non-toxic genotypes, significantly influencing the cyanotoxin levels within a lake. The challenge lies in accurately predicting these toxin concentrations due to the significant temporal fluctuations in the proportions of toxic and non-toxic genotypes. Typically, the toxic genotypes dominate during the early and late summer periods, while the non-toxic variants prevail in mid-summer.

Epigenetic Aging Associations With Psychoneurological Symptoms and Social Functioning in Adults With Sickle Cell Disease.

Sickle cell disease (SCD), the most common inherited blood disorder in the United States, is associated with severe psychoneurological symptoms. While epigenetic age acceleration has been linked to psychoneurological symptom burden in other diseases, this connection is unexplored in SCD. This study aimed to assess the association between epigenetic age acceleration and psychoneurological symptom burden in SCD.

Equity and modeling in sustainability science: Examples and opportunities throughout the process.

Equity is core to sustainability, but current interventions to enhance sustainability often fall short in adequately addressing this linkage. Models are important tools for informing action, and their development and use present opportunities to center equity in process and outcomes. This Perspective highlights progress in integrating equity into systems modeling in sustainability science, as well as key challenges, tensions, and future directions.

The Carolina hysterectomy cohort (CHC): a novel case series of reproductive-aged hysterectomy patients across 10 hospitals in the US south.

Background: Hysterectomy is a common surgery among reproductive-aged U.S. patients, with rates highest among Black patients in the South.

Inflammatory markers in persons with clinically-significant depression, anxiety or PTSD: A systematic review and meta-analysis.

Background: Depression, anxiety and PTSD appear to be risk factors for dementia, but it is unclear whether they are causal or prodromal. The inflammatory-mediated neurodegeneration hypothesis suggests a causal link, proposing that mental illness is associated with an inflammatory response which, in turn, triggers neurodegenerative changes that lead to dementia. Existing meta-analyses have yet to examine inflammatory markers in depression, anxiety or PTSD with the view to exploring the inflammatory-mediated neurodegeneration hypothesis.

Ethnoracial Differences in Premenopausal Hysterectomy: The Role of Symptom Severity.

Objective: To evaluate whether greater symptom severity can explain higher hysterectomy rates among premenopausal non-Hispanic Black compared with White patients in the U.S. South rather than potential overtreatment of Black patients.

Understanding the effects of overnight vital signs monitoring on sleep duration and disruptions in hospitalized children: A scoping review.

Problem: Overnight vital signs are typically taken every four hours on pediatric acute care units, despite limited evidence supporting the efficacy of this practice. Vital signs are often ordered and collected without considering the patient's clinical status or potential impact that they may have on sleep. We sought to understand the impact that overnight vital sign monitoring has on sleep duration and disruptions among hospitalized children in an acute care setting.

Air All in the Wrong Places: A Case of Pneumorrhachis Secondary to Chronic Vomiting.

Pneumorrhachis (PR) is a rare phenomenon in which air is present in the spinal canal. PR can be stratified into different categories based on etiology, with spontaneous PR being the least common. In this report, we describe the case of a 33-year-old male with a four-year history of emesis secondary to chronic gastroparesis who presented with pleuritic chest pain radiating to the neck.

International manufacturing and trade in colistin, its implications in colistin resistance and One Health global policies: a microbiological, economic, and anthropological study.

Background: The emergence of colistin-resistant Enterobacterales is a global public health concern, yet colistin is still widely used in animals that are used for food as treatment, metaphylaxis, prophylaxis, and growth promotion. Herein, we investigate the effect of colistin-resistant Enterobacterales in Pakistan, global trade of colistin, colistin use at the farm level, and relevant socioeconomic factors.

Methods: We conducted a microbiological, economic, and anthropological study of colistin-resistant Escherichia coli in humans, animals, and the environment and international trade and knowledge of colistin in Pakistan, Bangladesh, Nigeria, China, India, and Viet Nam.

Differences in leaf gas exchange strategies explain Quercus rubra and Liriodendron tulipifera intrinsic water use efficiency responses to air pollution and climate change.

Trees continuously regulate leaf physiology to acquire CO while simultaneously avoiding excessive water loss. The balance between these two processes, or water use efficiency (WUE), is fundamentally important to understanding changes in carbon uptake and transpiration from the leaf to the globe under environmental change. While increasing atmospheric CO (iCO ) is known to increase tree intrinsic water use efficiency (iWUE), less clear are the additional impacts of climate and acidic air pollution and how they vary by tree species.

Feasibility of intraoperative quantitative neuromuscular blockade monitoring in children using electromyography.

Background: Quantitative train-of-four (TOF) monitoring remains essential in optimizing anesthetic outcomes by assessing the depth and recovery from neuromuscular blockade. Despite this, residual neuromuscular blockade, defined as a TOF ratio <0.90, remains a concern in both adult and pediatric patients.

Use of the QuickSort with older adults whose lifestyle decision-making capacity is being questioned.

Objectives: Cognitive impairment affects older adults' capacity to live independently and make lifestyle decisions (lifestyle decision-making capacity; LS-DMC). Cognitive screens and clinical interviews are often used to assess people's need for living-supports prior to conducting comprehensive LS-DMC assessments in busy clinical settings. This study investigated whether the QuickSort - a brief new cognitive screen - provides efficient and accurate information regarding patients' LS-DMC when initially interviewed.

isocalcR: An R package to streamline and standardize stable isotope calculations in ecological research.

The use of stable isotopes to characterize ecosystem dynamics and infer leaf gas exchange processes has become increasingly prevalent over the last few decades within the ecological community. While advancements in theory and our understanding of the physiological processes controlling isotopic signatures in plants has been well-documented, no standardized tool currently exists to facilitate the computation of common isotope-derived plant physiological indices. Here, we present isocalcR, an R package intended to facilitate the use of stable isotope data from plant tissues by providing an integrated collection of functions and recommended reference data.

Antibiotic resistance genes in the gut microbiota of mothers and linked neonates with or without sepsis from low- and middle-income countries.

Early development of the microbiome has been shown to affect general health and physical development of the infant and, although some studies have been undertaken in high-income countries, there are few studies from low- and middle-income countries. As part of the BARNARDS study, we examined the rectal microbiota of 2,931 neonates (term used up to 60 d) with clinical signs of sepsis and of 15,217 mothers screening for bla, bla, bla and bla-like genes, which were detected in 56.1%, 18.

Incorporating Expected Outcomes Into Clinical Decision-Making for Total Knee Arthroplasty.

Objective: Expected outcomes (e.g., expected survivorship after a cancer treatment) have improved decision-making around treatment options in many clinical fields.