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1.
Appl Ergon ; 120: 104342, 2024 Jul 02.
Article in English | MEDLINE | ID: mdl-38959633

ABSTRACT

This research sought to evaluate the thermal zones of the upper body and firefighter personal protective equipment (PPE) immediately following uncompensable heat stress (0.03 °C increase/min). We hypothesized that the frontal portion of the head and the inside of the firefighter helmet would be the hottest as measured by infrared thermography. This hypothesis was due to previous research demonstrating that the head accounts for ∼8-10% of the body surface area, but it accounts for ∼20% of the overall body heat dissipation during moderate exercise. Twenty participants performed a 21-min graded treadmill exercise protocol (Altered Modified Naughton) in an environmental chamber (35 °C, 50 % humidity) in firefighter PPE. The body areas analyzed were the frontal area of the head, chest, abdomen, arm, neck, upper back, and lower back. The areas of the PPE that were analyzed were the inside of the helmet and the jacket. The hottest areas of the body post-exercise were the frontal area of the head (mean: 37.3 ± 0.4 °C), chest (mean: 37.5 ± 0.3 °C), and upper back (mean: 37.3 ± 0.4 °C). The coldest area of the upper body was the abdomen (mean: 36.1 ± 0.4 °C). The peak temperature of the inside of the helmet increased (p < 0.001) by 9.8 °C from 27.7 ± 1.6 °C to 37.4 ± 0.7 °C, and the inside of the jacket increased (p < 0.001) by 7.3 °C from 29.2 ± 1.7 °C to 36.5 ± 0.4 °C. The results of this study are relevant for cooling strategies for firefighters.

2.
J Anim Ecol ; 2024 Jul 02.
Article in English | MEDLINE | ID: mdl-38956826

ABSTRACT

Killer whales (Orcinus orca) occur seasonally in the eastern Canadian Arctic (ECA), where their range expansion associated with declining sea ice have raised questions about the impacts of increasing killer whale predation pressure on Arctic-endemic prey. We assessed diet and distribution of ECA killer whales using bulk and compound-specific stable isotope analysis (CSIA) of amino acids (AA) of 54 skin biopsies collected from 2009 to 2020 around Baffin Island, Canada. Bulk ECA killer whale skin δ15N and δ13C values did not overlap with potential Arctic prey after adjustment for trophic discrimination, and instead reflected foraging history in the North Atlantic prior to their arrival in the ECA. Adjusted killer whale stable isotope (SI) values primarily overlapped with several species of North Atlantic baleen whales or tuna. Amino acid (AA)-specific δ15N values indicated the ECA killer whales fed primarily on marine mammals, having similar glutamic acid δ15N-phenylalanine δ15N (δ15NGlx-Phe) and threonine δ15N (δ15NThr) as mammal-eating killer whales from the eastern North Pacific (ENP) that served as a comparative framework. However, one ECA whale grouped with the fish-eating ENP ecotype based δ15NThr. Distinctive essential AA δ13C of ECA killer whale groups, along with bulk SI similarity to killer whales from different regions of the North Atlantic, indicates different populations converge in Arctic waters from a broad source area. Generalist diet and long-distance dispersal capacity favour range expansions, and integration of these insights will be critical for assessing ecological impacts of increasing killer whale predation pressure on Arctic-endemic species.

3.
Glob Chang Biol ; 30(6): e17352, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38822670

ABSTRACT

The Arctic is the fastest-warming region on the planet, and the lengthening ice-free season is opening Arctic waters to sub-Arctic species such as the killer whale (Orcinus orca). As apex predators, killer whales can cause significant ecosystem-scale changes. Setting conservation priorities for killer whales and their Arctic prey species requires knowledge of their evolutionary history and demographic trajectory. Using whole-genome resequencing of 24 killer whales sampled in the northwest Atlantic, we first explored the population structure and demographic history of Arctic killer whales. To better understand the broader geographic relationship of these Arctic killer whales to other populations, we compared them to a globally sampled dataset. Finally, we assessed threats to Arctic killer whales due to anthropogenic harvest by reviewing the peer-reviewed and gray literature. We found that there are two highly genetically distinct, non-interbreeding populations of killer whales using the eastern Canadian Arctic. These populations appear to be as genetically different from each other as are ecotypes described elsewhere in the killer whale range; however, our data cannot speak to ecological differences between these populations. One population is newly identified as globally genetically distinct, and the second is genetically similar to individuals sampled from Greenland. The effective sizes of both populations recently declined, and both appear vulnerable to inbreeding and reduced adaptive potential. Our survey of human-caused mortalities suggests that harvest poses an ongoing threat to both populations. The dynamic Arctic environment complicates conservation and management efforts, with killer whales adding top-down pressure on Arctic food webs crucial to northern communities' social and economic well-being. While killer whales represent a conservation priority, they also complicate decisions surrounding wildlife conservation and resource management in the Arctic amid the effects of climate change.


Subject(s)
Climate Change , Conservation of Natural Resources , Whale, Killer , Animals , Whale, Killer/physiology , Arctic Regions , Endangered Species , Canada
4.
J Surg Res ; 299: 155-162, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38759331

ABSTRACT

INTRODUCTION: Responses to COVID-19 within medical education prompted significant changes to the surgical clerkship. We analyzed the changes in medical student end of course feedback before and after the COVID-19 outbreak. METHODS: Postclerkship surveys from 2017 to 2022 were analyzed including both Likert scale data and free text, excluding the COVID outbreak year 2019-2020. Likert scale questions were compared between pre-COVID (2017-2019) and COVID-era cohorts (2020-2022) with the Mann-Whitney U-test. Free-text comments were analyzed using both thematic analysis and natural language processing including sentiment, word and phrase frequency, and topic modeling. RESULTS: Of the 483 medical students surveyed from 2017 to 2022, 297 responded (61% response rate) to the included end of clerkship surveys. Most medical students rated the clerkship above average or excellent with no significant difference between the pre-COVID and COVID-era cohorts (70.4% Versus 64.8%, P = 0.35). Perception of grading expectations did significantly differ, 51% of pre-COVID students reported clerkship grading standards were almost always clear compared to 27.5% of COVID-era students (P = 0.01). Pre-COVID cohorts more frequently mentioned learning and feedback while COVID-era cohorts more frequently mentioned case, attending, and expectation. Natural language processing topic modeling and formal thematic analysis identified similar themes: team, time, autonomy, and expectations. CONCLUSIONS: COVID-19 presented many challenges to undergraduate medical education. Despite many changes, there was no significant difference in clerkship satisfaction ratings. Unexpectedly, the greater freedom and autonomy of asynchronous lectures and choice of cases became a highlight of the new curriculum. Future research should investigate if there are similar associations nationally with a multi-institutional study.


Subject(s)
COVID-19 , Clinical Clerkship , Natural Language Processing , Students, Medical , Humans , COVID-19/epidemiology , Students, Medical/psychology , Students, Medical/statistics & numerical data , General Surgery/education , Surveys and Questionnaires , Educational Measurement , Female , Male
5.
West J Emerg Med ; 25(3): 320-324, 2024 May.
Article in English | MEDLINE | ID: mdl-38801036

ABSTRACT

Introduction: Bystander provision of naloxone is a key modality to reduce opioid overdose-related death. Naloxone training courses are available, but no standardized program exists. As part of a bystander empowerment course, we created and evaluated a brief naloxone training module. Methods: This was a retrospective evaluation of a naloxone training course, which was paired with Stop the Bleed training for hemorrhage control and was offered to administrative staff in an office building. Participants worked in an organization related to healthcare, but none were clinicians. The curriculum included the following topics: 1) background about the opioid epidemic; 2) how to recognize the signs of an opioid overdose; 3) actions not to take when encountering an overdose victim; 4) the correct steps to take when encountering an overdose victim; 5) an overview of naloxone products; and 6) Good Samaritan protection laws. The 20-minute didactic section was followed by a hands-on session with nasal naloxone kits and a simulation mannequin. The course was evaluated with the Opioid Overdose Knowledge (OOKS) and Opioid Overdose Attitudes (OOAS) scales for take-home naloxone training evaluation. We used the paired Wilcoxon signed-rank test to compare scores pre- and post-course. Results: Twenty-eight participants completed the course. The OOKS, measuring objective knowledge about opioid overdose and naloxone, had improved scores from a median of 73.2% (interquartile range [IQR] 68.3%-79.9%) to 91.5% (IQR 85.4%-95.1%), P < 0.001. The three domains on the OOAS score also showed statistically significant results. Competency to manage an overdose improved on a five-point scale from a median of 2.5 (IQR 2.4-2.9) to a median of 3.7 (IQR 3.5-4.1), P < 0.001. Concerns about managing an overdose decreased (improved) from a median of 2.3 (IQR 1.9-2.6) to median 1.8 (IQR 1.5-2.1), P < 0.001. Readiness to intervene in an opioid overdose improved from a median of 4 (IQR 3.8-4.2) to a median of 4.2 (IQR 4-4.2), P < 0.001. Conclusion: A brief course designed to teach bystanders about opioid overdose and naloxone was feasible and effective. We encourage hospitals and other organizations to use and promulgate this model. Furthermore, we suggest the convening of a national consortium to achieve consensus on program content and delivery.


Subject(s)
Naloxone , Narcotic Antagonists , Naloxone/therapeutic use , Humans , Narcotic Antagonists/therapeutic use , Retrospective Studies , Male , Female , Drug Overdose/prevention & control , Drug Overdose/drug therapy , Opiate Overdose/prevention & control , Adult , Program Evaluation , Curriculum , Health Knowledge, Attitudes, Practice , Middle Aged
6.
Perspect Psychol Sci ; : 17456916241252085, 2024 May 16.
Article in English | MEDLINE | ID: mdl-38752984

ABSTRACT

We identify points of conflict and consensus regarding (a) controversial empirical claims and (b) normative preferences for how controversial scholarship-and scholars-should be treated. In 2021, we conducted qualitative interviews (n = 41) to generate a quantitative survey (N = 470) of U.S. psychology professors' beliefs and values. Professors strongly disagreed on the truth status of 10 candidate taboo conclusions: For each conclusion, some professors reported 100% certainty in its veracity and others 100% certainty in its falsehood. Professors more confident in the truth of the taboo conclusions reported more self-censorship, a pattern that could bias perceived scientific consensus regarding the inaccuracy of controversial conclusions. Almost all professors worried about social sanctions if they were to express their own empirical beliefs. Tenured professors reported as much self-censorship and as much fear of consequences as untenured professors, including fear of getting fired. Most professors opposed suppressing scholarship and punishing peers on the basis of moral concerns about research conclusions and reported contempt for peers who petition to retract papers on moral grounds. Younger, more left-leaning, and female faculty were generally more opposed to controversial scholarship. These results do not resolve empirical or normative disagreements among psychology professors, but they may provide an empirical context for their discussion.

7.
Sci Rep ; 14(1): 11146, 2024 05 15.
Article in English | MEDLINE | ID: mdl-38750037

ABSTRACT

Ecological applications of compound-specific stable isotope analysis (CSIA) of amino acids (AAs) include 1) tracking carbon pathways in food webs using essential AA (AAESS) δ13C values, and 2) estimating consumer trophic position (TP) by comparing relative differences of 'trophic' and 'source' AA δ15N values. Despite the significance of these applications, few studies have examined AA-specific SI patterns among tissues with different AA compositions and metabolism/turnover rates, which could cause differential drawdown of body AA pools and impart tissue-specific isotopic fractionation. To address this knowledge gap, especially in the absence of controlled diet studies examining this issue in captive marine mammals, we used a paired-sample design to compare δ13C and δ15N values of 11 AAs in commonly sampled tissues (skin, muscle, and dentine) from wild beluga whales (Delphinapterus leucas). δ13C of two AAs, glutamic acid/glutamine (Glx, a non-essential AA) and, notably, threonine (an essential AA), differed between skin and muscle. Furthermore, δ15N of three AAs (alanine, glycine, and proline) differed significantly among the three tissues, with glycine δ15N differences of approximately 10 ‰ among tissues supporting recent findings it is unsuitable as a source AA. Significant δ15N differences in AAs such as proline, a trophic AA used as an alternative to Glx in TP estimation, highlight tissue selection as a potential source of error in ecological applications of CSIA-AA. Amino acids that differed among tissues play key roles in metabolic pathways (e.g., ketogenic and gluconeogenic AAs), pointing to potential physiological applications of CSIA-AA in studies of free-ranging animals. These findings underscore the complexity of isotopic dynamics within tissues and emphasize the need for a nuanced approach when applying CSIA-AA in ecological research.


Subject(s)
Amino Acids , Beluga Whale , Carbon Isotopes , Nitrogen Isotopes , Animals , Nitrogen Isotopes/analysis , Carbon Isotopes/analysis , Carbon Isotopes/metabolism , Amino Acids/metabolism , Amino Acids/analysis , Beluga Whale/metabolism , Food Chain , Skin/metabolism , Skin/chemistry
9.
bioRxiv ; 2024 May 03.
Article in English | MEDLINE | ID: mdl-38746292

ABSTRACT

Background: Klebsiella pneumonia (Kpn) is the fourth leading cause of infection-related deaths globally, yet little is known about human antibody responses to invasive Kpn. In this study, we sought to determine whether the O-specific polysaccharide (OPS) antigen, a vaccine candidate, is immunogenic in humans with Kpn bloodstream infection (BSI). We also sought to define the cross-reactivity of human antibody responses among structurally related Kpn OPS subtypes and to assess the impact of capsule production on OPS-targeted antibody binding and function. Methods: We measured plasma antibody responses to OPS (and MrkA, a fimbrial protein) in a cohort of patients with Kpn BSI and compared these with controls, including a cohort of healthy individuals and a cohort of individuals with Enterococcus BSI. We performed flow cytometry to measure the impact of Kpn capsule production on whole cell antibody binding and complement deposition, utilizing patient isolates with variable levels of capsule production and isogenic capsule-deficient strains derived from these isolates. Findings: We enrolled 69 patients with Kpn BSI. Common OPS serotypes accounted for 57/69 (83%) of infections. OPS was highly immunogenic in patients with Kpn BSI, and peak OPS-IgG antibody responses in patients were 10 to 30-fold higher than antibody levels detected in healthy controls, depending on the serotype. There was significant cross-reactivity among structurally similar OPS subtypes, including the O1v1/O1v2, O2v1/O2v2 and O3/O3b subtypes. Physiological amounts of capsule produced by both hyperencapsulated and non-hyperencapsulated Kpn significantly inhibited OPS-targeted antibody binding and function. Interpretation: OPS was highly immunogenic in patients with Kpn BSI, supporting its potential as a candidate vaccine antigen. The strong cross-reactivity observed between similar OPS subtypes in humans with Kpn BSI suggests that it may not be necessary to include all subtypes in an OPS-based vaccine. However, these observations are tempered by the fact that capsule production, even in non-highly encapsulated strains, has the potential to interfere with OPS antibody binding. This may limit the effectiveness of vaccines that exclusively target OPS. Funding: National Institute of Allergy and Infectious Diseases at the National Institutes of Health. Research in Context: Evidence before this study: Despite the potential of O-specific polysaccharide (OPS) as a vaccine antigen against Klebsiella pneumoniae (Kpn), the immunogenicity of OPS in humans remains largely unstudied, creating a significant knowledge gap with regard to vaccine development. A search of PubMed for publications up to March 18, 2024, using the terms " Klebsiella pneumoniae " and "O-specific polysaccharide" or "O-antigen" or "lipopolysaccharide" revealed no prior studies addressing OPS antibody responses in humans with Kpn bloodstream infections (BSI). One prior study 1 evaluated antibody response to a single lipopolysaccharide (which contains one subtype of OPS) in humans with invasive Kpn infection; however, in this study OPS typing of the infecting strains and target antigen were not described. Added value of this study: Our investigation into OPS immunogenicity in a human cohort marks a significant advance. Analyzing plasma antibody responses in 69 patients with Kpn BSI, we found OPS to be broadly immunogenic across all the types and subtypes examined, and there was significant cross-reactivity among structurally related OPS antigens. We also demonstrated that Kpn capsule production inhibit OPS antibody binding and the activation of complement on the bacterial surface, even in classical Kpn strains expressing lower levels of capsule.Implications of all the available evidence: While the immunogenicity and broad cross-reactivity of OPS in humans with Kpn BSI suggests it is a promising vaccine candidate, the obstruction of OPS antibody binding and engagement by physiologic levels of Kpn capsule underscores the potential limitations of an exclusively OPS-antigen based vaccine for Kpn. Our study provides insights for the strategic development of vaccines aimed at combating Kpn infections, an important antimicrobial resistant pathogen.

10.
Am Surg ; : 31348241244649, 2024 Apr 10.
Article in English | MEDLINE | ID: mdl-38596898

ABSTRACT

Large open chest wall wounds can be difficult to manage due to full-thickness tissue loss with underlying rib fractures and exposed lung parenchyma. Historically, the use of synthetic material has been discouraged in the traumatic setting with the concern that it may be associated with an increased risk of infection. We present 4 patients with large open injuries to the thorax-one from blunt and three from penetrating trauma. We describe our initial management followed by prompt surgical repair using biologic mesh, titanium rib spanning plates, and rotational tissue flaps with Z-plasty of the skin for definite closure. All patients did well post-operatively without complications or wound infections. With the appropriate management, we suspect there may be an advantage in performing immediate reconstruction and closure in large open thoracic injuries utilizing biologic mesh and titanium rib spanning plates with a lower risk of infection than previously believed.

11.
bioRxiv ; 2024 Mar 13.
Article in English | MEDLINE | ID: mdl-38559081

ABSTRACT

Problem: All trainees, especially those from historically minoritized backgrounds, experience stresses that may reduce their continuation in science, technology, engineering, math, and medicine (STEMM) careers. The Johns Hopkins University School of Medicine is one of ~45 institutions with a National Institutes of Health funded Postbaccalaureate Research Education Program (PREP) that provides mentoring and a year of fulltime research to prepare students from historically excluded groups for graduate school. Having experienced the conflation of stresses during the COVID-19 pandemic and related shutdown, we realized our program lacked a component that explicitly helped PREP Scholars recognize and cope with non-academic stresses (financial, familial, social, mental) that might threaten their confidence and success as scientists and future in STEMM. Intervention: We developed an early-intervention program to help Scholars develop life-long skills to become successful and resilient scientists. We developed a year-long series comprised of 9 workshops focused on community, introspection, financial fitness, emotional intelligence, mental health, and soft-skills. We recruited and compensated a cohort of PhD students and postdoctoral fellows to serve as Peer Mentors, to provide a community and the safest 'space' for Scholars to discuss personal concerns. Peer Mentors were responsible for developing and facilitating these Community-Building Wellness Workshops (CBWW). Context: CBWW were created and exectued as part of the larger PREP program. Workshops included a PowerPoint presentation by Peer Mentors that featured several case studies that prompted discussion and provided time for small-group discussions between Scholars and Peer Mentors. We also included pre- and post-work for each workshop. These touch-points helped Scholars cultivate the habit of introspection. Impact: The CBWW exceeded our goals. Both Peer Mentors and Scholars experienced strong mutual support, and Scholars developed life-long skills. Notably, several Scholars who had been experiencing financial, mental or mentor-related stress immediately brought this to the attention of program leadership, allowing early and successful intervention. At the completion of CBWW, PREP Scholars reported implementing many workshop skills into practice, were reshaping their criteria for choosing future mentors, and evaluating career decisions. Strikingly, Peer Mentors found they also benefitted from the program as well, suggesting a potential larger scope for the role of CBWW in academia. Lessons Learned: Peer Mentors were essential in creating a safe supportive environment that facilitated discussions, self-reflection, and self-care. Providing fair compensation to Peer Mentors for their professional mentoring and teaching contributions was essential and contributed meaningfully to the positive energy and impact of this program.

12.
J Biol Chem ; 300(4): 107145, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38460941

ABSTRACT

Extracellular ATP activates P2 purinergic receptors. Whether purinergic signaling is functionally coupled to cellular senescence is largely unknown. We find that oxidative stress induced release of ATP and caused senescence in human lung fibroblasts. Inhibition of P2 receptors limited oxidative stress-induced senescence, while stimulation with exogenous ATP promoted premature senescence. Pharmacological inhibition of P2Y11 receptor (P2Y11R) inhibited premature senescence induced by either oxidative stress or ATP, while stimulation with a P2Y11R agonist was sufficient to induce cellular senescence. Our data show that both extracellular ATP and a P2Y11R agonist induced calcium (Ca++) release from the endoplasmic reticulum (ER) and that either inhibition of phospholipase C or intracellular Ca++ chelation impaired ATP-induced senescence. We also find that Ca++ that was released from the ER, following ATP-mediated activation of phospholipase C, entered mitochondria in a manner dependent on P2Y11R activation. Once in mitochondria, excessive Ca++ promoted the production of reactive oxygen species in a P2Y11R-dependent fashion, which drove development of premature senescence of lung fibroblasts. Finally, we show that conditioned medium derived from senescent lung fibroblasts, which were induced to senesce through the activation of ATP/P2Y11R-mediated signaling, promoted the proliferation of triple-negative breast cancer cells and their tumorigenic potential by secreting amphiregulin. Our study identifies the existence of a novel purinergic signaling pathway that links extracellular ATP to the development of a protumorigenic premature senescent phenotype in lung fibroblasts that is dependent on P2Y11R activation and ER-to-mitochondria calcium signaling.


Subject(s)
Adenosine Triphosphate , Calcium , Cellular Senescence , Fibroblasts , Receptors, Purinergic P2 , Humans , Adenosine Triphosphate/metabolism , Calcium/metabolism , Calcium Signaling , Endoplasmic Reticulum/metabolism , Fibroblasts/metabolism , Lung/metabolism , Lung/cytology , Mitochondria/metabolism , Oxidative Stress , Reactive Oxygen Species/metabolism , Receptors, Purinergic P2/metabolism , Signal Transduction , Type C Phospholipases/metabolism , Cell Line , Cell Proliferation
13.
Psychol Sci ; 35(4): 435-450, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38506937

ABSTRACT

The spread of misinformation is a pressing societal challenge. Prior work shows that shifting attention to accuracy increases the quality of people's news-sharing decisions. However, researchers disagree on whether accuracy-prompt interventions work for U.S. Republicans/conservatives and whether partisanship moderates the effect. In this preregistered adversarial collaboration, we tested this question using a multiverse meta-analysis (k = 21; N = 27,828). In all 70 models, accuracy prompts improved sharing discernment among Republicans/conservatives. We observed significant partisan moderation for single-headline "evaluation" treatments (a critical test for one research team) such that the effect was stronger among Democrats than Republicans. However, this moderation was not consistently robust across different operationalizations of ideology/partisanship, exclusion criteria, or treatment type. Overall, we observed significant partisan moderation in 50% of specifications (all of which were considered critical for the other team). We discuss the conditions under which moderation is observed and offer interpretations.


Subject(s)
Politics , Humans
14.
Philos Trans R Soc Lond B Biol Sci ; 379(1901): 20230079, 2024 May 06.
Article in English | MEDLINE | ID: mdl-38497261

ABSTRACT

Coral growth depends on the partnership between the animal hosts and their intracellular, photosynthetic dinoflagellate symbionts. In this study, we used the sea anemone Aiptasia, a laboratory model for coral biology, to investigate the poorly understood mechanisms that mediate symbiosis establishment and maintenance. We found that initial colonization of both adult polyps and larvae by a compatible algal strain was more effective when the algae were able to photosynthesize and that the long-term maintenance of the symbiosis also depended on photosynthesis. In the dark, algal cells were taken up into host gastrodermal cells and not rapidly expelled, but they seemed unable to reproduce and thus were gradually lost. When we used confocal microscopy to examine the interaction of larvae with two algal strains that cannot establish stable symbioses with Aiptasia, it appeared that both pre- and post-phagocytosis mechanisms were involved. With one strain, algae entered the gastric cavity but appeared to be completely excluded from the gastrodermal cells. With the other strain, small numbers of algae entered the gastrodermal cells but appeared unable to proliferate there and were slowly lost upon further incubation. We also asked if the exclusion of either incompatible strain could result simply from their cells' being too large for the host cells to accommodate. However, the size distributions of the compatible and incompatible strains overlapped extensively. Moreover, examination of macerates confirmed earlier reports that individual gastrodermal cells could expand to accommodate multiple algal cells. This article is part of the theme issue 'Sculpting the microbiome: how host factors determine and respond to microbial colonization'.


Subject(s)
Anthozoa , Dinoflagellida , Sea Anemones , Animals , Symbiosis , Photosynthesis , Larva
15.
Cureus ; 16(2): e54618, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38523918

ABSTRACT

In developed countries, vitamin A deficiency (VAD) remains rare but is a leading cause of global blindness. We describe the case of a 10-year-old girl with autism spectrum disorder (ASD) initially presenting mild VAD symptoms, escalating to severe photophobia and reluctance to leave a darkened room due to a self-restricted diet of fast-food french fries. A timely examination revealed severe VAD and vitamin A supplementation resolved her symptoms in three weeks. This case highlights the challenge of obtaining accurate patient history in ASD, emphasizing the need for routine dietary discussions and micronutrient testing, especially at ages nine and 13 when the United States Department of Agriculture (USDA) recommends increased vitamin A intake. Early intervention can prevent micronutrient deficiencies in pediatric patients, particularly those with ASD.

16.
Am Surg ; 90(6): 1797-1799, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38549202

ABSTRACT

Retroperitoneal abscess as a sequela of penetrating trauma can pose a difficult clinical scenario for surgeons and literature to inform decision making is sparse. It is logical to follow a "step-up" approach applied to other etiologies of infected retroperitoneal fluid collections, such as infected pancreatic necrosis and perinephric abscess. Video-assisted retroperitoneal debridement (VARD) is a well-established approach in infected pancreatic necrosis when surgical debridement is warranted. Minimally invasive retroperitoneal approaches have emerged in a broadening range of etiologies and specialties. We describe our experience utilizing VARDs in two patients that developed retroperitoneal abscesses following gunshot injuries to bowel and proximal urinary system. Both failed a conservative approach including antibiotic and percutaneous drains. Rapid improvement and subsequent discharge were observed within days of VARD procedure. We believe VARD to be a viable approach to post-trauma retroperitoneal abscesses when surgical drainage is indicated, and anatomy is favorable.


Subject(s)
Abdominal Abscess , Debridement , Video-Assisted Surgery , Wounds, Gunshot , Humans , Abdominal Abscess/etiology , Abdominal Abscess/surgery , Debridement/methods , Drainage/methods , Retroperitoneal Space , Wounds, Gunshot/surgery , Wounds, Gunshot/complications
17.
Behav Brain Sci ; 47: e36, 2024 Feb 05.
Article in English | MEDLINE | ID: mdl-38311460

ABSTRACT

We propose a friendly amendment to integrative experiment design (IED), adversarial-collaboration IED, that incentivizes research teams from competing theoretical perspectives to identify zones of the design space where they possess an explanatory edge. This amendment is especially critical in debates that have high policy stakes and carry a strong normative-political charge that might otherwise prevent free exchange of ideas.


Subject(s)
Research Design
18.
Ecol Appl ; 34(3): e2952, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38417451

ABSTRACT

Animals balance costs of antipredator behaviors with resource acquisition to minimize hunting and other mortality risks and maximize their physiological condition. This inherent trade-off between forage abundance, its quality, and mortality risk is intensified in human-dominated landscapes because fragmentation, habitat loss, and degradation of natural vegetation communities is often coupled with artificially enhanced vegetation (i.e., food plots), creating high-risk, high-reward resource selection decisions. Our goal was to evaluate autumn-winter resource selection trade-offs for an intensively hunted avian generalist. We hypothesized human access was a reliable cue for hunting predation risk. Therefore, we predicted resource selection patterns would be spatiotemporally dependent upon levels of access and associated perceived risk. Specifically, we evaluated resource selection of local-scale flights between diel periods for 426 mallards (Anas platyrhynchos) relative to wetland type, forage quality, and differing levels of human access across hunting and nonhunting seasons. Mallards selected areas that prohibited human access and generally avoided areas that allowed access diurnally, especially during the hunting season. Mallards compensated by selecting for high-energy and greater quality foraging patches on allowable human access areas nocturnally when they were devoid of hunters. Postseason selection across human access gradients did not return to prehunting levels immediately, perhaps suggesting a delayed response to reacclimate to nonhunted activities and thus agreeing with the assessment mismatch hypothesis. Last, wetland availability and human access constrained selection for optimal natural forage quality (i.e., seed biomass and forage productivity) diurnally during preseason and hunting season, respectively; however, mallards were freed from these constraints nocturnally during hunting season and postseason periods. Our results suggest risk-avoidance of human accessible (i.e., hunted) areas is a primary driver of resource selection behaviors by mallards and could be a local to landscape-level process influencing distributions, instead of forage abundance and quality, which has long-been assumed by waterfowl conservation planners in North America. Broadly, even an avian generalist, well adapted to anthropogenic landscapes, avoids areas where hunting and human access are allowed. Future conservation planning and implementation must consider management for recreational access (i.e., people) equally important as foraging habitat management for wintering waterfowl.


Subject(s)
Ducks , Ecosystem , Animals , Humans , Biomass , Ducks/physiology , Wetlands , Predatory Behavior
19.
J Therm Biol ; 119: 103805, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38335849

ABSTRACT

In the present experiment, we evaluated the impact of rapid heat stress (RHS) on salivary cortisol and C-reactive protein production pre-RHS, post-RHS, and 24 and 48 h post-RHS exposure among firefighters. Previous research has demonstrated that RHS increases salivary cortisol during RHS and immediately post-RHS exposure. However, no research has evaluated the duration necessary to return to baseline cortisol levels following RHS. Additionally, no studies have analyzed the impact of RHS on inflammatory biomarkers, such as C-reactive protein. This study hypothesized that salivary cortisol and C-reactive protein levels would increase following RHS and then return to pre-RHS levels within 24 h post-exposure. Twenty-four participants performed a steady-state treadmill protocol in an environmental chamber (35 °C; 45% humidity) in full firefighter personal protective equipment until reaching either a core temperature (Tc) of 39 °C or a volitional maximum. The subjects had their saliva collected via the passive drool protocol pre-RHS, post-RHS, and 24 and 48 h post-RHS. Pre-RHS of 0.23 ± 0.03 µg/dL increased post-RHS to 0.51 ± 0.06 µg/dL (p < 0.001). This finding supports previous literature demonstrating the immediate impact of RHS. There were no changes in C-reactive protein. The novel finding of this study is that salivary cortisol levels return to baseline in the 24 h post-RHS exposure. This indicates that 24 h is recommended to recover from RHS and should be applied to prevent the chronic stress response.


Subject(s)
C-Reactive Protein , Firefighters , Humans , Hydrocortisone , Biomarkers , Heat-Shock Response
20.
Neurology ; 102(5): e208117, 2024 Mar 12.
Article in English | MEDLINE | ID: mdl-38350046

ABSTRACT

BACKGROUND AND OBJECTIVES: Altered metabolism is observed in amyotrophic lateral sclerosis (ALS). However, without a standardized methodology to define metabolic changes, our understanding of factors contributing to and the clinical significance of altered metabolism in ALS is limited. METHODS: We aimed to determine how geographic variation in metabolic rates influences estimates and accuracy of predicted resting energy expenditure (REE) in patients with ALS and controls, while validating the effectiveness of cohort-specific approaches in predicting altered metabolic rate in ALS. Participants from 3 geographically distinct sites across Australia, China, and the Netherlands underwent REE assessments, and we considered 22 unique equations for estimating REE. Analyses evaluated equation performance and the influence of demographics on metabolic status. Comparisons were made using standardized and local reference values to identify metabolic alterations. RESULTS: 606 participants were included from Australia (patients with ALS: 140, controls: 154), the Netherlands (patients with ALS: 79, controls: 37) and China (patients with ALS: 67, controls: 129). Measured REE was variable across geographic cohorts, with fat-free mass contributing to this variation across all patients (p = 0.002 to p < 0.001). Of the 22 predication equations assessed, the Sabounchi Structure 4 (S4) equation performed relatively well across all control cohorts. Use of prediction thresholds generated using data from Australian controls generally increased the prevalence of hypermetabolism in Chinese (55%, [43%-67%]) and Dutch (44%, [33%-55%]) cases when compared with Australian cases (30%, [22%-38%]). Adjustment of prediction thresholds to consider geographically distinct characteristics from matched control cohorts resulted in a decrease in the proportion of hypermetabolic cases in Chinese and Dutch cohorts (25%-31% vs 55% and 20%-34% vs 43%-44%, respectively), and increased prevalence of hypometabolism in Dutch cases with ALS (1% to 8%-10%). DISCUSSION: The identification of hypermetabolism in ALS is influenced by the formulae and demographic-specific prediction thresholds used for defining alterations in metabolic rate. A consensus approach is needed for identification of metabolic changes in ALS and will facilitate improved understanding of the cause and clinical significance of this in ALS.


Subject(s)
Amyotrophic Lateral Sclerosis , Basal Metabolism , Humans , Energy Metabolism , Amyotrophic Lateral Sclerosis/epidemiology , Amyotrophic Lateral Sclerosis/metabolism , Australia/epidemiology , Body Composition
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