Mckinnonschwartz2906

Platelet transfusion is challenging in emergency medicine because of short platelet shelf life and stringent storage conditions. Platelet-derived extracellular vesicles (PEV) exhibit platelet-like properties. A plasma generated from expired platelet units rich in procoagulant PEV may be able to combine the benefits of plasma and platelets for resuscitation while increasing shelf life and utilizing an otherwise wasted resource.

Freeze-thaw cycling of platelet-rich plasma (PRP) followed by centrifugation to remove platelet remnants was utilized to generate platelet-enhanced plasma (PEP). An in vitro model of dilutional coagulopathy was also designed and used to test PEP. Rotational thromboelastometry and calibrated automated thrombography were used to assess clotting and extracellular vesicles (EV) procoagulant activity. Capture arrays were used to specifically measure EV subpopulations of interest (ExoView™, NanoView Biosciences). Captured vesicles were quantified and labeled with Annexin-V-FITC, CD41-PE, on fluid containing high PEV concentration with preliminary evidence, indicating a potential for upscaling the approach using platelet concentrates. Commercial lysate manufacturer workflows may be suitable for this, but further optimization and characterization of PEP is required.

Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac condition and the most common cause of sudden cardiac death (SCD) in patients below the age of 35. Genetic testing is a vital part of HCM diagnostics, yet correlation with clinical phenotypes remains complex. Identifying clinical predictors of informative genetic testing may prevent unnecessary investigations and improve cost-effectiveness of services. This article reviews the current literature pertinent to identifying such predictors.

Five literature databases were screened using a suitably designed search strategy. Studies investigating the correlation between having a positive genetic test for HCM and a range of clinical and radiological parameters were included in the systematic review.

Twenty-nine observational studies of a total of 9,486 patients were included. The main predictors of informative genetic testing were younger age, higher septal thickness, reverse septal curvature, family history of HCM and SCD and the absence of hypertension. Two externally validated scoring systems have also been developed the Mayo and Toronto scores. Novel imaging markers and complex algorithmic models are emerging predictors.

Using clinical predictors to decide whom to test is a feasible alternative to investigating all comers. Nonetheless, currently there is not enough evidence to unequivocally recommend for or against this strategy. Further validation of current predictors and identification of new ones remain open research avenues.

Using clinical predictors to decide whom to test is a feasible alternative to investigating all comers. Nonetheless, currently there is not enough evidence to unequivocally recommend for or against this strategy. Further validation of current predictors and identification of new ones remain open research avenues.High surface water-groundwater connectivity characterizes watersheds underlain by karsts, increasing contaminant transport risks. However, karsts are highly complex, making research necessary to understand the transport of contaminants from the surface, through the aquifer, to discharge areas. In Yucatan, the lack of waste water treatment raises the risk of groundwater contamination. We monitored stable isotopes (δ18 O-NO3 and δ15 N-NO3 ), cadmium, and lead to document waste water contamination and transport during the rainy and dry seasons, using water samples collected along the Ring of Cenotes during each season. selleck Specific conductance and pH showed no consistent seasonality, with conductance ranging from 0.5 to 55 mS/cm and pH ranging from 6.6 to 8.6 for most samples. Nitrate concentrations in the cenotes averaged 205 ± 260 μM and no seasonal pattern was observed. Cd and Pb concentrations were 0.1 to 37.9 μg/L and 0.2 to 243.2 μg/L, respectively. Nitrate stable isotope values were 2.6 to 27.2‰ for δ18 O and 1.2 to 20.7‰ for δ15 N. The statistical relationship between δ15 N and δ18 O, in dry season samples, indicated that denitrification was occurring. A scale measure for waste water recognition showed (1) high variability among sites probably related with dry/rainy seasons and/or diverse anthropogenic activities; and (2) specific water quality variables that contribute to contamination at each site during each season. Importantly, our analyses indicate that in the area surrounding the Ring of Cenotes, waste water exhibits spatial and temporal patterns related to complex transport and dilution processes, as is the case in karsts in general.This study investigates the generalizability and predictive validity of associations between gastrointestinal (GI) symptoms and youth anxiety to establish their utility in community mental health decision-making. We analyzed data from youth ages 3 to 21 years in volunteer cohorts collected in Los Angeles (N = 327) and New York City (N = 102), as well as the Healthy Brain Network cohort (N = 1957). Youth GI distress was measured through items taken from the parent-reported Child Behavior Checklist (CBCL). We examined generalizability of GI-anxiety associations across cohorts and anxiety reporters, then evaluated the performance of these models in predicting youth anxiety in holdout data. Consistent with previous work, higher levels of gastrointestinal distress were associated with more parent-reported youth anxiety behaviors in all three cohorts. Models trained on data from the Healthy Brain Network cohort predicted parent-reported and child-reported anxiety behaviors, as well as clinician-evaluated anxiety diagnoses, at above chance levels in holdout data. Models which included GI symptoms often, but not always, outperformed models based on age and sex alone in predicting youth anxiety. Based on the generalizability and predictive validity of GI-anxiety associations investigated here, GI symptoms may be an effective tool for child-facing professionals for identifying children at risk for anxiety (Preprint https//psyarxiv.com/zgavu/).