Metabolomic signature of pediatric diabetic ketoacidosis: key metabolites, pathways, and panels linked to clinical variables.

Background: Diabetic ketoacidosis (DKA) is a serious complication of type 1 diabetes (T1D), arising from relative insulin deficiency and leading to hyperglycemia, ketonemia, and metabolic acidosis. Early detection and treatment are essential to prevent severe outcomes. This pediatric case-control study utilized plasma metabolomics to explore metabolic alterations associated with DKA and to identify predictive metabolite patterns.

Identification of children with a nondiagnostic ultrasound at a low appendicitis risk using a pediatric Appendicitis Risk Calculator.

Objectives: Up to 50% of ultrasounds (USs) for suspected pediatric appendicitis are nondiagnostic. While the validated low-risk clinical pediatric Appendicitis Risk Calculator (pARC) score < 15% and the low-risk US with nonvisualized appendix and no periappendiceal inflammation carry relatively low appendicitis risks, the contribution of the combination of both characteristics to this risk has never been assessed. The primary objective was to determine the proportion of children with the low-risk US-low-risk pARC combination with appendicitis.

CanadiEM: Accessing a Virtual Community of Practice to Create a Canadian National Medical Education Institution.

Background: The rise of free open-access medical education (FOAM) has led to a wide range of online resources in emergency medicine. Canadian physicians have been active contributors to FOAM.

Objectives: We aimed to create a virtual community of practice that would serve as a national platform for collaboration, learning, and knowledge dissemination.

Clinical Suspicion and Language Translation in the Pediatric Emergency Department.

Elucidating a medical history and gaining patient consent and buy-in are difficult in any teenager presenting to a North American pediatric emergency department, but especially so when they present with limited English fluency. Translators can make this process easier, but both limited availability and impreciseness in translation can reduce their utility. We describe 2 teenage females who presented to our pediatric emergency department within 48 hours with similar presentations but no obvious organic cause or examination findings to suggest a specific diagnosis.

[Microsurgical approach to the ambient cistern].

Objective: To describe a step-by-step approach to the ambient cistern by the suboccipital retrosigmoid supracerebellar infratentorial (RSI) approach.

Description: The RSI approach is performed in the same manner as the suboccipital retrosigmoid approach, usually used to access the pathology of the cerebellopontine angle, with the following modifications: (1) we always use the semi-sitting position, (2) the craniotomy-craniectomy must expose the transverse sinus and extend 5 cm medially to the inion, (3) when performing the dural opening it is necessary to mobilize the dura with the transverse sinus upwards, (4) under magnification with surgical microscope the cerebellomedullary cistern should be opened in order to drain cerebrospinal fluid for relaxing the cerebellum, and (5) arachnoidal adherences and bridging veins must be coagulated and cut if necessary. These maneuvers create a wide corridor to the ambient cistern.

Does oxygen delivery explain interindividual variation in forearm critical impulse?

Within individuals, critical power appears sensitive to manipulations in O2 delivery. We asked whether interindividual differences in forearm O2 delivery might account for a majority of the interindividual differences in forearm critical force impulse (critical impulse), the force analog of critical power. Ten healthy men (24.

Persistence of functional sympatholysis post-exercise in human skeletal muscle.

Blunting of sympathetic vasoconstriction in exercising muscle is well-established. Whether it persists during the early post-exercise period is unknown. This study tested the hypothesis that it persists in human skeletal muscle during the first 10 min of recovery from exercise.

A collaboratively-derived science-policy research agenda.

The need for policy makers to understand science and for scientists to understand policy processes is widely recognised. However, the science-policy relationship is sometimes difficult and occasionally dysfunctional; it is also increasingly visible, because it must deal with contentious issues, or itself becomes a matter of public controversy, or both. We suggest that identifying key unanswered questions on the relationship between science and policy will catalyse and focus research in this field.