Time-Critical Emergencies in Suburban Parks and Outdoor Recreation Spaces.

Objective Prior studies have described the patterns of emergency medical service (EMS) activations in national parks in the United States. However, little data exists regarding EMS activations in local and regional outdoor recreational locations. We performed a retrospective analysis of EMS activations originating from parks and recreational areas in suburban Howard County, Maryland, to characterize those activations determined to be time-critical emergencies.

Bleeding Complications between Bivalirudin and Heparin for Extracorporeal Membrane Oxygenation in Neonates with Congenital Diaphragmatic Hernia.

Introduction: Neonates with congenital diaphragmatic hernia (CDH) who undergo repair while on extracorporeal membrane oxygenation (ECMO) are at risk of developing post-operative bleeding complications. Balanced anticoagulation is critical to maintain ECMO flow and avoid bleeding. Heparin has historically been our first-line anticoagulant; however, recently, we transitioned to bivalirudin, a direct thrombin inhibitor.

Inference and applications of ancestral recombination graphs.

Ancestral recombination graphs (ARGs) summarize the complex genealogical relationships between individuals represented in a sample of DNA sequences. Their use is currently revolutionizing the field of population genetics and is leading to the development of powerful new methods to elucidate individual and population genetic processes, including population size history, migration, admixture, recombination, mutation and selection. In this Review, we introduce the readers to the structure of ARGs and discuss how they relate to processes such as recombination and genetic drift.

Fast and Accurate Estimation of Selection Coefficients and Allele Histories from Ancient and Modern DNA.

We here present CLUES2, a full-likelihood method to infer natural selection from sequence data that is an extension of the method CLUES. We make several substantial improvements to the CLUES method that greatly increases both its applicability and its speed. We add the ability to use ancestral recombination graphs on ancient data as emissions to the underlying hidden Markov model, which enables CLUES2 to use both temporal and linkage information to make estimates of selection coefficients.

Contribution of circulating Mfge8 to human T2DM and cardiovascular disease.

MFGE8 is a major exosome (EV) protein known to mediate inflammation and atherosclerosis in type 2 diabetes mellitus (T2DM) in animal studies. The pathophysiological role of this protein in obesity, T2DM, and cardiovascular disease is less investigated in humans. Earlier we reported a rare Asian Indian population-specific missense variant (rs371227978; Arg148His) in the MFGE8 gene associated with increased circulating Mfge8 and T2DM.

Pneumothorax as a Prelude: Unveiling Concurrent HIV and Pneumocystis jirovecii Pneumonia in a Diagnostic Journey.

pneumonia (PCP) is a life-threatening condition found in immunocompromised individuals, especially in human immunodeficiency virus (HIV) positive patients. Here, we report a case of PCP in a presumably immunocompetent 25-year-old male patient who presented with a one-month history of chest pain, dyspnea, and a nonproductive cough with recent development of night sweats. The patient recently immigrated to the United States without any known medical or family history.

Delayed Arterial Hemorrhage From a Lumbar Artery Following Inferior Vena Cava Filter Placement: A Case Report.

Pulmonary embolism (PE) is a feared complication of deep venous thrombosis (DVT) that can lead to respiratory distress and even death. The mainstay of preventing PE is anticoagulation, but other strategies exist. Inferior vena cava (IVC) filters are an alternative strategy for PE prophylaxis in individuals who may have contraindications to receiving anticoagulation.

Dermoscopic Features of Melanocytic Nevi in Cardiofaciocutaneous and Costello Syndromes.

Importance: Somatic variants in the RAS/MAPK pathway genes are commonly associated with melanocytic nevi and melanoma, whereas germline variants in these genes are associated with RASopathies, syndromes involving multiple organs, including the skin. Nevi counts may be higher in some RASopathies, but studies on features observed through dermoscopy are limited.

Objective: To determine the distinguishing dermoscopic features of melanocytic nevi and how the RAS pathway influences them by comparing nevi in patients with cardiofaciocutaneous syndrome (CFC) and Costello syndrome (CS).

The Effects of Osteopathic Manipulative Treatment (OMT) on Postoperative Length of Stay: A Meta-Analysis.

Osteopathic manipulative treatment (OMT) is a therapy used by osteopathic physicians in various medical settings. Postoperatively, OMT can be utilized to optimize the body's function and recovery. This meta-analysis examines the efficacy of OMT in reducing the length of postoperative hospital stays.

Targeting Inflammation and Oxidative Stress to Improve Outcomes in a TNBS Murine Crohn's Colitis Model.

Inflammation and oxidative stress are implicated in the pathogenesis of Crohn's disease. Cerium oxide nanoparticle (CNP) conjugated to microRNA 146a (miR146a) (CNP-miR146a) is a novel compound with anti-inflammatory and antioxidative properties. We hypothesized that local administration of CNP-miR146a would improve colitis in a 2,4,6-Trinitrobenzenesulfonic acid (TNBS) mouse model for Crohn's disease by decreasing colonic inflammation.

Online Scan of Campus Health Resources and HPV Vaccination Information on College and University Websites in the State of Oregon.

This study is the first to report the results of a scan of the official webpages of all public and private colleges and universities in the state of Oregon, including but not limited to student health services webpages and student handbooks, to identify available services, policies, and educational information on HPV vaccination. The purpose is to describe vaccination services (with a focus on the HPV vaccine), prevention efforts, and institutional policies on vaccination on college and university websites in Oregon. An online scan was conducted from September to November 2020 to collect and describe data from college/university websites across Oregon.

A generalized cumulative noise exposure metric for community response analysis.

In community noise studies, there is often a desire to understand how the annoyance response to multiple noise events aggregates over a long period of time. Many cumulative response metrics, such as day-night level (DNL), are based on the idea that humans respond, on average, to the sum of frequency-weighted acoustic energy over time. This paper introduces a generalization of DNL that includes a parameter, b, that ranges between zero and one.

Correction of In-Patient Severe Hypernatremia in an 81-Year-Old Female With Hypopituitarism.

Hypernatremia has been significantly associated with in-hospital mortality and discharge to long-term care facilities. The appropriate correction of electrolyte disturbances, especially sodium, is important to consider to prevent the addition of central nervous system disturbances, such as cerebral edema and eventual brain injury. The importance of maintaining a proper correction of hypernatremia has been well studied and used in clinical practice.

100 ancient genomes show repeated population turnovers in Neolithic Denmark.

Major migration events in Holocene Eurasia have been characterized genetically at broad regional scales. However, insights into the population dynamics in the contact zones are hampered by a lack of ancient genomic data sampled at high spatiotemporal resolution. Here, to address this, we analysed shotgun-sequenced genomes from 100 skeletons spanning 7,300 years of the Mesolithic period, Neolithic period and Early Bronze Age in Denmark and integrated these with proxies for diet (C and N content), mobility (Sr/Sr ratio) and vegetation cover (pollen).

The selection landscape and genetic legacy of ancient Eurasians.

The Holocene (beginning around 12,000 years ago) encompassed some of the most significant changes in human evolution, with far-reaching consequences for the dietary, physical and mental health of present-day populations. Using a dataset of more than 1,600 imputed ancient genomes, we modelled the selection landscape during the transition from hunting and gathering, to farming and pastoralism across West Eurasia. We identify key selection signals related to metabolism, including that selection at the FADS cluster began earlier than previously reported and that selection near the LCT locus predates the emergence of the lactase persistence allele by thousands of years.

A Multi-Method Examination of Peer Functioning in Children with and without Cognitive Disengagement Syndrome.

Objective: Cognitive disengagement syndrome (CDS) includes excessive daydreaming, mental confusion, and hypoactive behaviors that are distinct from attention-deficit/hyperactivity disorder inattentive (ADHD-IN) symptoms. A growing number of studies indicate that CDS symptoms may be associated with ratings of social withdrawal. However, it is important to examine this association in children specifically recruited for the presence or absence of CDS, and to incorporate multiple methods including direct observations of peer interactions.

The Effect of Steroids on Prenatally Diagnosed Lung Lesions.

Background: Open fetal resection for large lung lesions has virtually been replaced by maternal steroid administration. Despite this paradigm shift, little is known about the effects steroids have on lung lesion growth in utero.

Methods: A 10-year retrospective review of all prenatally diagnosed lung lesions cared for at our fetal care center was performed.

Surgical Necrotizing Enterocolitis - Can We Predict the Need for Gastrostomy Tube Placement?

Introduction: Necrotizing enterocolitis (NEC) is a significant cause of morbidity and mortality among extremely premature infants. Approximately 50% of cases progress to surgery, frequently resulting in resection of necrotic bowel and ostomy creation. Premature neonates are at risk for bronchopulmonary dysplasia and feeding failure; surgery in these patients is higher risk.