Early Administration of Intravenous Hydration and Opioid Analgesics Is Correlated with Decreased Admission Rates during Vaso-Occlusive Episodes in Sickle Cell Disease.

Background: Painful vaso-occlusive episodes (VOEs) are the hallmark of sickle cell disease (SCD) and account for frequent visits to the emergency department (ED) or urgent care (UC). Currently, the early administration of analgesics is recommended as initial management; however, there is a need for further understanding of the effect of prompt analgesics and hydration during VOEs. The objective of this study is to analyze the factors associated with the rate of hospital admission in the setting of time to intravenous (IV) analgesics and hydration. Method: This retrospective single-institution study reviewed adult and pediatric patients with SCD who presented with VOEs from January 2018 to August 2023. Results: Of 303 patient encounters, the rates of admission for the overall group, the subgroup which received IV hydration within 60 min of arrival, and the subgroup which received both IV analgesics and hydration within 60 min were 51.8%, 25.6% (RR = 0.46), and 18.2% (RR = 0.33), respectively. Further, factors such as gender and the use of hydroxyurea were found to be significantly associated with the rate of admission. Conclusions: This signifies the importance of standardizing the management of VOEs through the timely administration of IV analgesics and hydration in both adult and pediatric ED/UC.

Perceived inequality in society may not motivate increased food intake in the absence of personal socioeconomic disadvantage.

BACKGROUND: Greater levels of socioeconomic inequality across societies have been associated with higher rates of obesity and cardiometabolic disease. While these relationships could be attributed to poorer quality of health services and lower access to healthier lifestyles among disadvantaged groups in societies with greater economic inequality, this explanation does not account for those who experience relative economic security in such unequal societies (e.g., the middle and upper classes). Here, we tested whether perceptions of greater disparities between social classes in one's society (i.e., perceived societal inequality) may promote eating behaviors that risk excess energy intake. METHODS: In two studies, participants completed an experimental manipulation that situated them as middle class within a hypothetical society that was presented to have either large disparities in socioeconomic resources between classes (high inequality condition) or low disparities (low inequality condition), while keeping the participants' objective socioeconomic standing constant across conditions. In Study 1 (pre-registered), participants (n = 167) completed the perceived societal inequality manipulation before a computerized food portion selection task to measure desired portion sizes for a variety of foods. Study 2 (n = 154) involved a similar design as Study 1, but with inclusion of a neutral control condition (no awareness of class disparities) followed by ad libitum consumption of potato chips. RESULTS: While the high inequality condition successfully elicited perceptions of one's society as having greater socioeconomic inequalities between classes, it did not generate consistent feelings of personal socioeconomic disadvantage. Across both studies, we observed no differences between conditions in average selected portion sizes or actual energy intake. CONCLUSIONS: Taken together with prior research on the effects of subjective socioeconomic disadvantage on increased energy intake, these findings suggest that perceptions of inequality in one's society may be insufficient to stimulate heightened energy intake in the absence of personal socioeconomic disadvantage or inadequacy.

Determination of the nanoparticle- and cell-specific toxicological mechanisms in 3D liver spheroids using scRNAseq analysis.

Engineered nanomaterials (ENMs) are commonly used in consumer products, allowing exposure to target organs such as the lung, liver, and skin that could lead to adverse health effects in humans. To better reflect on toxicological effects in liver cells, it is important to consider the contribution of hepatocyte morphology, function, and intercellular interactions in a dynamic 3D microenvironment. Herein, we used a 3D liver spheroid model containing hepatocyte and Kupffer cells (KCs) to study the effects of three different material compositions, namely vanadium pentoxide (V2O5), titanium dioxide (TiO2), or graphene oxide (GO). Additionally, we used single-cell RNA sequencing (scRNAseq) to determine the nanoparticle (NP) and cell-specific toxicological responses. A general finding was that hepatocytes exhibit more variation in gene expression and adaptation of signaling pathways than KCs. TNF-α production tied to the NF-κB pathway was a commonly affected pathway by all NPs while impacts on the metabolic function of hepatocytes were unique to V2O5. V2O5 NPs also showed the largest number of differentially expressed genes in both cell types, many of which are related to pro-inflammatory and apoptotic response pathways. There was also evidence of mitochondrial ROS generation and caspase-1 activation after GO and V2O5 treatment, in association with cytokine production. All considered, this study provides insight into the impact of nanoparticles on gene responses in key liver cell types, providing us with a scRNAseq platform that can be used for high-content screening of nanomaterial impact on the liver, for use in biosafety and biomedical applications.