Treatment of Critical Bleeds in Patients With Immune Thrombocytopenia: A Systematic Review.

Objectives: Evidence-based protocols for managing bleeding emergencies in patients with immune thrombocytopenia (ITP) are lacking. We conducted a systematic review of treatments for critical bleeding in patients with ITP.

Methods: We included all study designs and extracted data in aggregate or individually for patients who received one or more interventions and for whom any of the following outcomes were reported: platelet count response, bleeding, disability, or death.

Treatment of critical bleeding events in patients with immune thrombocytopenia: a protocol for a systematic review and meta-analysis.

Background: Critical bleeding events in adults and children with ITP are medical emergencies; however, evidence-based treatment protocols are lacking. Due to the severe thrombocytopenia, (typically platelet count less than 20 × 10/L), a critical bleed portends a high risk of death or disability. We plan to perform a systematic review and meta-analysis of treatments for critical bleeding in patients with ITP that will inform evidence-based recommendations.

Analysis of acidified feed components containing African swine fever virus.

Mitigation of African swine fever (ASF) virus in contaminated feed materials would assist control activities. Various finely-ground pig feed ingredients (5 cereals, 4 plant proteins, 2 animal proteins, 1 oil, 1 compound) were sprayed and mixed thoroughly with a buffered formic acid formulation (0, 1 or 2% vol/vol) to produce a consistent and durable level of formate (1% or 2%) with consistent acidification of cereal ingredients to less than pH 4. No such acidification was noted in other ingredients.

A weakened AMOC may prolong greenhouse gas-induced Mediterranean drying even with significant and rapid climate change mitigation.

The Mediterranean region has been identified as a climate hot spot, with models projecting a robust warming and rainfall decline in response to increasing greenhouse gases. The projected rainfall decline would have impacts on agriculture and water resources. Can such changes be reversed with significant reductions in greenhouse gases? To explore this, we examine large ensembles of a high-resolution climate model with various future radiative forcing scenarios, including a scenario with substantial reductions in greenhouse gas concentrations beginning in the mid-21st century.

Predicting bilgewater emulsion stability by oil separation using image processing and machine learning.

Bilgewater is a shipboard multi-component oily wastewater, combining numerous wastewater sources. A better understanding of bilgewater emulsions is required for proper wastewater management to meet discharge regulations. In this study, we developed 360 emulsion samples based on commonly used Navy cleaner data and previous bilgewater composition studies.

Definition of a critical bleed in patients with immune thrombocytopenia: Communication from the ISTH SSC Subcommittee on Platelet Immunology.

Background: Immune thrombocytopenia (ITP) is an autoimmune disease characterized by low platelet counts and increased risk of bleeding. In preparation for an upcoming guideline, the ITP Emergency Management Guideline Panel, including clinical experts in hematology, emergency medicine, research methodology, and patient representatives, identified the need for a standardized definition of a critical ITP bleed. The goal of the definition was to distinguish critical bleeds from bleeds that may not require urgent treatment, typically in the context of severe thrombocytopenia.

Anthropogenic forcing and response yield observed positive trend in Earth's energy imbalance.

The observed trend in Earth's energy imbalance (TEEI), a measure of the acceleration of heat uptake by the planet, is a fundamental indicator of perturbations to climate. Satellite observations (2001-2020) reveal a significant positive globally-averaged TEEI of 0.38 ± 0.

Surface evolution of synthetic bilgewater emulsion.

Bilgewater is a regulated shipboard produced waste stream that often contains oil-in-water emulsion. Fundamental knowledge of emulsion surface changes is required for improved wastewater treatment; however, limited information is currently available. We have reported the first surface characterization of synthetic bilgewater emulsions using time-of-flight secondary ion mass spectrometry (ToF-SIMS) coupled with optical microscopy.

Identification and characterization of bilgewater emulsions.

Literature on bilgewater focuses on empirically determined treatment methods and lacks specific information on emulsion characteristics. Therefore, this review discusses potential emulsion stabilization mechanisms that occur in bilgewater and evaluates common approaches to study their behavior. Current knowledge on emulsion formation, stabilization, and destabilization is outlined to provide researchers and bilgewater treatment operators with the knowledge needed to determine emulsion prevention and treatment strategies.

Characterisation of flattening filter free (FFF) beam properties for initial beam set-up and routine QA, independent of flattened beams.

Flattening filter free (FFF) beams have reached widespread use for clinical treatment deliveries. The usual methods for FFF beam characterisation for their quality assurance (QA) require the use of associated conventional flattened beams (cFF). Methods for QA of FFF without the need to use associated cFF beams are presented and evaluated against current methods for both FFF and cFF beams.

In Situ Characterization of Oil-in-Water Emulsions Stabilized by Surfactant and Salt Using Microsensors.

Chemically stabilized emulsions are difficult to break because of micelle stability. Many physical and chemical processes have been used for emulsion breaking/separation; however, most operational parameters are based on empirical data and bulk analysis. A multiscale understanding of emulsions is required before these processes can advance further.

IPEM topical report 1: guidance on implementing flattening filter free (FFF) radiotherapy.

Flattening filter free (FFF) beams are now commonly available with new standard linear accelerators. These beams have recognised clinical advantages in certain circumstances, most notably the reduced beam-on times for high dose per fraction stereotactic treatments. Therefore FFF techniques are quickly being introduced into clinical use.

High elastic modulus nanoparticles: a novel tool for subfailure connective tissue matrix damage.

Subfailure matrix injuries such as sprains and strains account for a considerable portion of ligament and tendon pathologies. In addition to the lack of a robust biological healing response, these types of injuries are often characterized by seriously diminished matrix biomechanics. Recent work has shown nanosized particles, such as nanocarbons and nanocellulose, to be effective in modulating cell and biological matrix responses for biomedical applications.

Beam characteristics of energy-matched flattening filter free beams.

Purpose: Flattening filter free (FFF) linear accelerators can increase treatment efficiency and plan quality. There are multiple methods of defining a FFF beam. The Elekta control system supports tuning of the delivered FFF beam energy to enable matching of the percentage depth-dose (PDD) of the flattened beam at 10 cm depth.

Effect of prolotherapy on cellular proliferation and collagen deposition in MC3T3-E1 and patellar tendon fibroblast populations.

Proliferative therapy, or prolotherapy, is a treatment for damaged connective tissues involving the injection of a solution (proliferant) which causes local cell death and triggers the body's wound healing cascade. Physicians vary in their use of this technique; it is employed for ligaments but has also been investigated for tissues such as cartilage. Physicians also vary in treatment regiments using different dosses of the proliferant.

Perianesthesia challenges in geriatric pain management.

The perianesthesia nurse is continually challenged to provide safe and effective pain management. This task becomes more difficult when working with an aging population. Success begins with understanding the challenges in controlling surgical pain and in communicating information regarding pain management prior to the surgery.

The amino acid sequence GPLY is not necessary for normal endocytosis of the human insulin receptor B isoform.

The human insulin receptor (hIR) cytoplasmic juxtamembrane domain contains two tyrosine (Y) residues which exist in GPLY and NPEY motifs that have been implicated in endocytic function. We have previously shown that the NPEY motif is not necessary for endocytosis of the B isoform (exon 11+) of hIR. To examine the role of the GPLY sequence in transmembrane insulin signaling and endocytic functions of hIR-B, we constructed a mutant receptor, hIR delta GPLY, that lacks the GPLY sequence (residues 962-965), and stably expressed it in CHO cells.

Influence of selenium status in merino weaners on resistance to trichostrongylid infection.

Weaned merino lambs, grazing pastures low in selenium, were used to investigate the effect of selenium status on immunity to trichostrongylids. Six weeks following selenium supplementation to 14 of the 27 sheep using intraruminal selenium pellets, 5000 Ostertagia circumcincta and 5000 Trichostrongylus colubriformis larvae were administered orally to all sheep. At four weeks after infection, the mean total worm burden in the selenium supplemented sheep (5537 +/- 343, n = 14) was not significantly different (P greater than 0.

Evaluation of the use of an oxygen conservation device in long-term oxygen therapy.

An oxygen-conserving delivery system employing a flow reducing oxygen pendant (OP) cannula was evaluated during home use for oxygen savings, cost reduction, and patient acceptance. Twenty-one male outpatients receiving home oxygen from liquid systems by conventional nasal cannula (NC) were fitted with OP and followed for 1 month. Oxyhemoglobin saturations (SaO2) were successfully maintained with a threefold reduction in mean O2 flow rate from 1.

Crystal-associated cholangiohepatopathy and photosensitisation in lambs.

Four outbreaks of hepatogenous photosensitisation occurred in weaned lambs in north eastern Victoria during the summers of 1985 and 1986. Attack rates varied between 7% and 43% and case fatality rates between 60% and 71%. Clinical signs included photosensitisation and jaundice.

Age-related changes in activities of the superoxide dismutase enzymes in tissues of the sheep and the effect of dietary copper and manganese on these changes.

Activities of the copper-zinc- and manganese-containing superoxide dismutase enzymes (CuSOD and MnSOD) were studied in tissues of the sheep to determine the dependence of these activities on sheep age, and their relationship to tissue and dietary mineral concentrations. Tissue samples were obtained from day-old through 16-week-old lambs from flocks grazing pastures normal or high in copper and manganese, and from adult sheep. In liver, lung, heart, kidney and skeletal muscle, activities of CuSOD and MnSOD in day-old and week-old lambs were only half those measured in 16-week-old and adult sheep.

Differences between serum and plasma ceruloplasmin activities and copper concentrations: investigation of possible contributing factors.

Values for ceruloplasmin activities and copper concentrations were found to be lower in serum than in paired samples of plasma in both sheep and cattle. Ceruloplasmin activities in serum were 13-40% lower relative to plasma for nine different groups of animals, and 10-65% lower for individual animals (n = 112). As the values are not directly interchangeable, plasma rather than serum should be used when estimating copper nutrition in these animals.

Investigations into combined dietary deficiencies of copper, selenium, and vitamin E in the rat.

Interactions between dietary Cu, Se, and vitamin E in ascorbate-induced hemolysis of erythrocytes obtained from rats fed diets deficient or adequate in these elements were investigated. Hemolysis was affected by all three dietary factors, through closely interrelated but distinct mechanisms. In vitamin E-deficient cells, hemolysis was increased and the amount of hemolysis was directly related to the amount of hemoglobin breakdown.

The role of dietary copper, manganese, selenium, and vitamin E in lipid peroxidation in tissues of the rat.

The role of dietary Cu and Mn in maintaining tissue integrity, through the effects of these metals on activity of the superoxide dismutase (SOD) enzyme, and their interactions in peroxidative pathways involving Se and vitamin E was investigated. Weanling rats were fed diets deficient in Mn, Cu, Se, and/or vitamin E for 35 days, in a factorial experimental design. Dietary effects on peroxidation, measured in mitochondrial fractions prepared from liver and heart tissue, were compared with changes in the activities of glutathione peroxidase and the Cu and MnSOD enzymes.