Chronic Consequences Research Articles

Fluid biomarkers of chronic traumatic brain injury.

Traumatic brain injury (TBI) is a leading cause of long-term disability across the world. Evidence for the usefulness of imaging and fluid biomarkers to predict outcomes and screen for the need to monitor complications in the acute stage is steadily increasing. Still, many people experience symptoms such as fatigue and cognitive and motor dysfunction in the chronic phase of TBI, where objective assessments for brain injury are lacking. Consensus criteria for traumatic encephalopathy syndrome, a clinical syndrome possibly associated with the neurodegenerative disease chronic traumatic encephalopathy, which iscommonly associated with sports concussion, have been defined only recently. However, these criteria do not fit all individuals living with chronic consequences of TBI. The pathophysiology of chronic TBI shares many similarities with other neurodegenerative and neuroinflammatory conditions, such as Alzheimer disease. As with Alzheimer disease, advancements in fluid biomarkers represent one of the most promising paths for unravelling the chain of pathophysiological events to enable discrimination between these conditions and, with time, provide prediction modelling and therapeutic end points. This Review summarizes fluid biomarker findings in the chronic phase of TBI (≥6 months after injury) that demonstrate the involvement of inflammation, glial biology and neurodegeneration in the long-term complications of TBI. We explore how the biomarkers associate with outcome and imaging findings and aim to establish mechanistic differences in biomarker patterns between types of chronic TBI and other neurodegenerative conditions. Finally, current limitations and areas of priority for future fluid biomarker research are highlighted.

Managing Stress From a Systemic Perspective: Occupational Stress Models

The World Health Organization (WHO) defines stress as a “state of worry or mental tension caused by a difficult situation.” Burnout results from chronic occupational stress that has not been well managed, and is the result of both systemic and personal factors. Systemic structures and planning to optimize work environments are the focus of occupational stress models. To effectively manage stress and avoid the detrimental effects of neglecting both its acute and chronic consequences (such as decreased productivity, low morale, interpersonal conflicts, absenteeism, and other negative outcomes), it is essential to examine various occupational stress models to determine root causes and identify issues at the work unit level. [ Psychiatr Ann . 2024;54(10):e287–e291.]

Hidden scars: the persistent multifaceted health and psychosocial consequences for Syrian torture survivors.

Background: The impact on the physical and mental health of those who survived torture and their close circles in the Syrian regime's detention facilities remains under-studied.Objective: This qualitative study explored Syrian refugees' narrations of captivity and torture, and the consequences of such extreme traumatic events on their physical and psychosocial health.Method: Thirteen audio-recorded interviews were conducted in Arabic with Syrian refugees. Study participants were at least 19 years of age, resided in diverse urban areas of Jordan, had experienced captivity and torture in Syrian detention facilities, and voluntarily agreed to participate in the study. Participation was anonymous, only oral consent was required, and no incentives were provided to participants. Interviews were transcribed and translated into English by a team of researchers, followed by analysis of repetitive themes according to the narrative paradigm.Results: Analysis of interviews elicited three major themes: extreme traumatic experiences of torture, and its physical and psychosocial health consequences. The first major theme was divided into two sub-themes: torture experienced by the participants themselves, and torture experienced by participants' close circles. The second major theme, pertaining to physical health, was divided into two sub-themes: acute and chronic health sequelae. The third major theme, related to psychosocial health, was divided into four sub-themes: mental health symptomatology, impacts on professional life, impacts on interpersonal relationships, and social consequences.Conclusions: Torture experiences of Syrian refugees had adverse consequences for the physical and psychosocial health, functioning, and the overall well-being of survivors and their close circles. Interventions may seek to improve both the acute and chronic health consequences, as well as the mental health symptoms and associated impacts on livelihood, professional, and relationship dynamics. They should span clinical, legal, and advocacy spheres, given that a holistic approach may contribute immensely to survivors' healing process.

Dual-mode photoacoustic and ultrasonic quantitative evaluation of cancellous bone

Abstract Bone diseases, especially osteoporosis, is highly prevalent, and the chronic consequences often have debilitating effects on patients. Early diagnosis and intervention are desired, but existing bone assessment methods do not allow for regular screening as required for such early detection. We were inspired to explore the potential of photoacoustic (PA) imaging for bone assessment due to its molecular imaging capabilities and its shared advantages with ultrasonics (US). In this study, an experimental system was constructed for PA/US dual-mode imaging of cancellous bone, and the resulting images were analysed based on a new quantitative framework. The results from the quantitative analysis clearly differentiated cancellous bones with varying apparent densities, demonstrating the potential of such a method for efficient bone assessment.

Abstract P193: Adoptive transfer of placental CD4+ T Cells from preeclamptic patients with a history of COVID-19 causes hypertension and cognitive dysfunction postpartum in a pregnant rat model of preeclampsia

Preeclampsia (PE), new onset hypertension (HTN) during pregnancy, is associated with activated CD4+ T cells, impaired cognitive function, and changes in cerebral blood flow (CBF) autoregulation. Previously, PE women have been shown to develop neurovascular and cardiovascular disorders earlier in life than those that had uneventful pregnancy. COVID-19 (CV) during pregnancy is associated with an increase incidence of the PE phenotype and is also associated with chronic neurovascular and cardiovascular consequences. Previously, we showed adoptive transfer of placental CD4+ T cells from PE women into athymic nude pregnant rats causes a PE phenotype, however we don’t know the role of CD4+ T cells to cause long-term neurovascular or cardiovascular consequences in PE in the presence or absence of a history (Hx) of COVID-19 during pregnancy. Therefore, we hypothesize that CD4+ T cells from PE patients with and without a Hx of CV causes hypertension and neurovascular dysfunction compared to CD4+ T cells from normotensive patients. One million placental CD4+ T cells from Normotensive (NT), CV Hx NT, and PE patients with or without a CV Hx were isolated and injected interperitoneally (i.p.) into pregnant nude athymic rats on gestational day (GD) 12. Dams were allowed to deliver and aged 12-weeks after delivery. At 12-weeks postpartum, blood pressure (MAP) was measured; CBF autoregulation was measured by laser Doppler flowmetry. The Barnes maze and the novel object recognition behavioral assays were used to assess cognitive function 12-weeks postpartum. A two-way ANOVA was used for statistical analysis. At 12-weeks postpartum, MAP increased in CV Hx PE (153±6, n=7, p<0.05) and PE (150±5 mmHg, n=5, p<0.05) compared to CV Hx NT (121±6, n=6) and NT (116±6 mmHg, n=6), respectively. Behavioral analysis showed CV Hx PE and PE exhibited impaired memory and learning (P<0.05) compared to either NT group. Our findings indicate that rat recipients of CD4+ T cells from PE patients in the presence or absence of CV Hx have HTN and cognitive dysfunction in the postpartum period compared to recipients of control CD4 + T cells. These data indicate the importance of CD4+ T cells in long-term consequences of PE and COVID infection during pregnancy.

Early identification and diagnosis, pathophysiology, and treatment of sepsis-related acute lung injury: a narrative review.

Sepsis is a life-threatening organ dysfunction, and the most common and vulnerable organ is the lungs, with sepsis-related acute respiratory distress syndrome (ARDS) increasing mortality. In recent years, an increasing number of studies have improved our understanding of sepsis-related ARDS in terms of epidemiology, risk factors, pathophysiology, prognosis, and other aspects, as well as our ability to prevent, detect, and treat sepsis-related ARDS. However, sepsis-related lung injury remains an important issue and clinical burden. Therefore, a literature review was conducted on sepsis-related lung injury in order to further guide clinical practice in reducing the acute and chronic consequences of this condition. This study conducted a search of the MEDLINE and PubMed databases, among others for literature published from 1991 to 2023 using the following keywords: definition of sepsis, acute lung injury, sepsis-related acute lung injury, epidemiology, risk factors, early diagnosis of sepsis-related acute lung injury, sepsis, ARDS, pathology and physiology, inflammatory imbalance caused by sepsis, congenital immune response, and treatment. This review explored the risk factors of sepsis, sepsis-related ARDS, early screening and diagnosis, pathophysiology, and treatment and found that in view of the high mortality rate of ARDS associated with sepsis. In response to the high mortality rate of sepsis-related ARDS, some progress has been made, such as rapid identification of sepsis and effective antibiotic treatment, early fluid resuscitation, lung-protective ventilation, etc. Sepsis remains a common and challenging critical illness to cure. In response to the high mortality rate of sepsis-related ARDS, progress has been made in rapid sepsis identification, effective antibiotic treatment, early fluid resuscitation, and lung-protective ventilation. However, further research is needed regarding long-term effects such as lung recruitment, prone ventilation, and the application of neuromuscular blocking agents and extracorporeal membrane oxygenation.

Loss of JCAD/KIAA1462 Protects the Lung from Acute and Chronic Consequences of Chronic Obstructive Pulmonary Disease.

Even with recent advances in pathobiology and treatment options, chronic obstructive pulmonary disease (COPD) remains a major contributor to morbidity and mortality. To develop new ways of combating this disease, breakthroughs in our understanding of its mechanisms are sorely needed. Investigating the involvement of underanalyzed lung cell types, such as endothelial cells (ECs), is one way to further our understanding of COPD. JCAD is a junctional protein in endothelial cells (ECs) arising from the KIAA1462 gene, and a mutation in this gene has been implicated in the risk of developing COPD. In our study, we induced inflammation and emphysema in mice via the global knockout of KIAA1462/JCAD (JCAD-KO) and confirmed it in HPMECs and A549 to examine how the loss of JCAD could affect COPD development. We found that KIAA1462/JCAD loss reduced acute lung inflammation after elastase treatment. Even after 3 weeks of elastase, JCAD-KO mice demonstrated a preserved lung parenchymal structure and vasculature. In vitro, after KIAA1462 expression is silenced, both endothelial and epithelial cells showed alterations in pro-inflammatory gene expression after TNF-α treatment. We concluded that JCAD loss could ameliorate COPD through its anti-inflammatory and anti-angiogenic effects, and that KIAA1462/JCAD could be a novel target for COPD therapy.

Outcomes and Mechanisms Associated With Selective Thalamic Neuronal Loss in Chronic Traumatic Brain Injury

The chronic neuronal burden of traumatic brain injury (TBI) is not fully characterized by routine imaging, limiting understanding of the role of neuronal substrates in adverse outcomes. To determine whether tissues that appear healthy on routine imaging can be investigated for selective neuronal loss using [11C]flumazenil (FMZ) positron emission tomography (PET) and to examine whether this neuronal loss is associated with long-term outcomes. In this cross-sectional study, data were collected prospectively from 2 centers (University of Cambridge in the UK and Weill Cornell Medicine in the US) between September 1, 2004, and May 31, 2021. Patients with TBI (>6 months postinjury) were compared with healthy control participants (all aged >18 years). Individuals with neurological disease, benzodiazepine use, or contraindication to magnetic resonance imaging were excluded. Data were retrospectively collated with nonconsecutive recruitment, owing to convenience and scanner or PET ligand availability. Data were analyzed between February 1 and September 30, 2023. Flumazenil voxelwise binding potential relative to nondisplaceable binding potential (BPND). Selective neuronal loss identified with FMZ PET was compared between groups on voxelwise and regional scales, and its association with functional, cognitive, and psychological outcomes was examined using Glasgow Outcome Scale (GOS) scores, measures of sustained executive attention (animal and sustained fluency), and 36-Item Short Form Health Survey (SF-36) scores. Diffusion tensor imaging was used to assess structural connectivity of regions of cortical damage, and its association with thalamic selective neuronal loss. In this study, 24 patients with chronic TBI (mean [SD] age, 39.2 [12.3] years; 18 men [75.0%]) and 33 healthy control participants (mean [SD] age, 47.6 [20.5] years; 23 men [69.7%]) underwent FMZ PET. Patients with TBI had a median time of 29 (range, 7-95) months from injury to scan. They displayed selective neuronal loss in thalamic nuclei, over and above gross volume loss in the left thalamus, and bilateral central, mediodorsal, ventral-lateral dorsal, anterior, and ventral anterior thalamic nuclei, across a wide range of injury severities. Neuronal loss was associated with worse functional outcome using GOS scores (left thalamus, left ventral anterior, and bilateral central, mediodorsal, and anterior nuclei), worse cognitive outcome on measures of sustained executive attention (left thalamus, bilateral central, and right mediodorsal nuclei), and worse emotional outcome using SF-36 scores (right central thalamic nucleus). Chronic thalamic neuronal loss partially mirrored the location of primary cortical contusions, which may indicate secondary injury mechanisms of transneuronal degeneration. The findings of this study suggest that selective thalamic vulnerability may have chronic neuronal consequences with relevance to long-term outcome, suggesting the evolving and potentially lifelong thalamic neuronal consequences of TBI. FMZ PET is a more sensitive marker of the burden of neuronal injury than routine imaging; therefore, it could inform outcome prognostication and may lead to the development of individualized precision medicine approaches.

Ethanol concentrations in various biological specimens: Living and postmortem forensic toxicology analysis and comprehensive literature review

Alcohol use upsurges the risk for many chronic ill-health consequences such as hepatitis, malignancies, and disastrous outcomes like road traffic accidents ending in fatal injuries. Biochemical and toxicological analysis of different body fluids is crucial for identifying the cause of death and postmortem interval in many forensic cases. Blood, urine, and vitreous fluid are the most valuable body fluids for detecting alcohol during any toxicological analysis. Alcohol is responsible for widespread morbidity and mortality worldwide. Blood alcohol concentration (BAC) is a necessary toxicological test to investigate various crime and accident scenes. This study comprehensively explores the demographic characteristics, BAC distribution, and correlations of alcohol concentrations in postmortem and living cases. Postmortem cases (N = 166) reveal intriguing demographic patterns, with notable variations in year distribution, nationality, sex, age groups, occupation, smoking habits, place of death, and psychiatric history. Living cases (N = 483) exhibit distinct demographic profiles, emphasizing differences in year distribution, nationality, sex, age groups, and smoking habits.Analysis of BAC distribution reveals diverse patterns in both postmortem and living cases, providing valuable insights into the prevalence of different BAC levels in each group. Correlation analyses unveil strong associations between alcohol concentrations in various biological samples in postmortem cases, highlighting the interdependence of blood, vitreous, and urine alcohol concentrations. Conversely, living cases display a moderate positive correlation between blood and urine alcohol concentrations.Comparative analyses showcase significant differences in mean alcohol concentrations between postmortem and living cases, suggesting variations in alcohol metabolism and distribution. These findings underscore the importance of considering temporal factors in interpreting alcohol concentrations in forensic and clinical contexts.In conclusion, this study enhances our understanding of alcohol-related incidents by delineating demographic profiles, BAC distributions, and correlations between different biological samples. Such insights are crucial for refining investigative and clinical approaches, contributing to the broader fields of forensic science and public health.

Vitis vinifera L. Leaf Extract, a Microbiota Green Ally against Infectious and Inflammatory Skin and Scalp Diseases: An In-Depth Update.

The skin microbiota, with its millions of bacteria, fungi, and viruses, plays a key role in balancing the health of the skin and scalp. Its continuous exposure to potentially harmful stressors can lead to abnormalities such as local dysbiosis, altered barrier function, pathobiont overabundance, and infections often sustained by multidrug-resistant bacteria. These factors contribute to skin impairment, deregulation of immune response, and chronic inflammation, with local and systemic consequences. In this scenario, according to the needs of the bio-circular-green economy model, novel harmless strategies, both for regulating the diverse epidermal infectious and inflammatory processes and for preserving or restoring the host skin eubiosis and barrier selectivity, are requested. Vitis vinifera L. leaves and their derived extracts are rich in plant secondary metabolites, such as polyphenols, with antioxidant, anti-inflammatory, antimicrobial, and immunomodulatory properties that can be further exploited through microbe-driven fermentation processes. On this premise, this literature review aims to provide an informative summary of the most updated evidence on their interactions with skin commensals and pathogens and on their ability to manage inflammatory conditions and restore microbial biodiversity. The emerging research showcases the potential novel beneficial ingredients for addressing various skincare concerns and advancing the cosmeceutics field as well.

Medical Considerations and Consequences of Eating Disorders.

Eating disorders may result in medical complications that affect every body system with both acute and chronic consequences. Although some medical complications may require acute medical hospitalization to manage, other complications, such as low bone mineral density, may not present until malnutrition has become chronic. It is critical for team members to be aware of the early clinical signs of malnutrition and disordered eating behaviors, as well as longer-term complications that may affect their patients. When identifying eating disorder concerns, appropriate colleagues from the medical, nutrition, and psychiatric fields can be engaged in order to collaborate on stabilizing and improving the health of patients.

Relative Energy Deficiency in Sports (RED-S)

This overview intends to show a possible diagnostic/treatment pathway for athletes with an energy deficiency. This is based on the IOC statement paper (13), which was recently revised in 2023. An interdisciplinary approach is important to reach all aspects. In order to achieve a successful treatment, it is important to involve the whole environment of the affected athlete. The earlier the intervention takes place, the less chronic consequences will occur. However, abnormalities such as primary and secondary amenorrhea, susceptibility to infection or lack of training success should always be considered as possible indications and should be subject to further examination. In addition, it is also important to recognize a current or incipient eating disorder so that professional treatment can be initiated as soon as possible with the primary goal of enabling the athlete to train and compete at the highest level.

Metformin instigates cellular autophagy to ameliorate high-fat diet-induced pancreatic inflammation and fibrosis/EMT in mice

BackgroundChronic pancreatic dysfunction is frequently observed as a consequence of prolonged high-fat diet consumption and is a serious public health concern. This pro-diabetic insult aggravates inflammation-influenced fibrotic lesions and is associated with deregulated autophagy. Metformin, a conventional anti-hyperglycemic drug, might be beneficial for pancreatic health, but the complex molecular regulations are not clarified. Considering the worldwide prevalence of chronic pancreatic dysfunction in obese individuals, we aimed to unwind the molecular intricacies explaining the involvement of oxidative stress, inflammation and fibrosis and to approbate metformin as a plausible intervention in this crossroad. Main methodsAge-matched Swiss Albino mice were exposed to high-fat diet (60 kcal%) against control diet (10 kcal%) to establish diet-induced stress model. Metformin treatment was introduced after 4 weeks to metformin-control and HFD-exposed metformin groups. After 8 weeks, metabolic and molecular outcomes were assessed to establish the impact of metformin on chronic consequences of HFD-mediated injury. Key findingsHigh-fat diet administration to healthy mice primes oxidative stress-mediated chronic inflammation through Nrf2/Keap1/NF-κB interplay. Besides, pro-inflammatory cytokine bias leading to fibrotic (increased TGF-β, α-SMA, and MMP9) and pro-EMT (Twist1, Slug, Vimentin, E-cadherin) repercussions in pancreatic lobules were evident. Metformin distinctly rescues high-fat diet-induced remodeling of pancreatic pro-diabetic alterations and cellular survival/death switch. Further, metformin abrogates the p62-Twist1 crosstalk in an autophagy-dependent manner (elevated beclin1, LC3-II/I, Lamp2) to restore pancreatic homeostasis. ConclusionOur research validates the therapeutic potential of metformin in the inflammation-fibrosis nexus to ameliorate high-fat diet-induced pancreatic dysfunction and related metabolic alterations.

Urogenital schistosomiasis among adult male population in an endemic area of southern Tanzania: a descriptive cross-sectional study

BackgroundUrogenital schistosomiasis (UGS) caused by Schistosoma haematobium is endemic in Southern Tanzania. The disease has significant implications for both socioeconomic and public health. Because infections with S. haematobium usually peak...

Chronic consequences of ischemic stroke: Profiling brain injury and inflammation in a mouse model with reperfusion.

Stroke is a pervasive and debilitating global health concern, necessitating innovative therapeutic strategies, especially during recovery. While existing literature often focuses on acute interventions, our study addresses the uniqueness of brain tissue during wound healing, emphasizing the chronic phase following the commonly used middle cerebral artery (MCA) occlusion model. Using clinically relevant endpoints in male and female mice such as magnetic resonance imaging (MRI) and plasma neurofilament light (NFL) measurement, along with immunohistochemistry, we describe injury evolution. Our findings document significant alterations in edema, tissue remodeling, and gadolinium leakage through MRI. Plasma NFL concentration remained elevated at 30 days poststroke. Microglia responses are confined to the region adjacent to the injury, rather than continued widespread activation, and boron-dipyrromethene (BODIPY) staining demonstrated the persistent presence of foam cells within the infarct. Additional immunohistochemistry highlighted sustained B and T lymphocyte presence in the poststroke brain. These observations underscore potentially pivotal roles played by chronic inflammation brought on by the lipid-rich brain environment, and chronic blood-brain barrier dysfunction, in the development of secondary neurodegeneration. This study sheds light on the enduring consequences of ischemic stroke in the most used rodent stroke model and provides valuable insights for future research, clinical strategies, and therapeutic development.

Chronic consequences of accidental dural puncture and postdural puncture headache in obstetric anaesthesia - sieving through the evidence.

Accidental dural puncture (ADP) and postdural puncture headache (PDPH) are relatively common complications of neuraxial anaesthesia and analgesia in obstetrics. Both may result in acute and chronic morbidity. This review intends to discuss the chronic implications of ADP and PDPH and raise awareness of severe and potentially life-threatening conditions associated with them. ADP may be associated with a high rate of PDPH, prolonged hospitalization and increased readmissions. Studies have shown that PDPH may lead to chronic complications such as post-partum depression (PPD), post-traumatic stress disorder (PTSD), chronic headache, backache and reduced breastfeeding rates. There are many case reports indicating that major, severe, life-threatening neurologic complications may follow PDPH in obstetric patients including subdural haematoma and cerebral venous thrombosis. Many clinicians still believe that ADP and PDPH are benign and self-limiting conditions whereas there may be serious and devastating consequences of both. It is imperative that all women with ADP and PDPH are appropriately diagnosed and treated.

Microplastic exposure is associated with epigenomic effects in the model organism Pimephales promelas (fathead minnow).

Microplastics have evolutionary and ecological impacts across species, affecting organisms' development, reproduction, and behavior along with contributing to genotoxicity and stress. As plastic pollution is increasing and ubiquitous, gaining a better understanding of organismal responses to microplastics is necessary. Epigenetic processes such as DNA methylation are heritable forms of molecular regulation influenced by environmental conditions. Therefore, determining such epigenetic responses to microplastics will reveal potential chronic consequences of this environmental pollutant. We performed an experiment across two generations of fathead minnows (Pimephales promelas) to elucidate transgenerational epigenetic effects of microplastic exposure. We exposed the first generation of fish to four different treatments of microplastics: two concentrations of each of pre-consumer polyethylene (PE) and PE collected from Lake Ontario. We then raised the first filial generation with no microplastic exposure. We used enzymatic methylation sequencing on adult liver tissue and homogenized larvae to evaluate DNA methylation differences among treatments, sexes, and generations. Our findings show the origin of the plastic had a larger effect in female minnows whereas the effect of concentration was stronger in the males. We also observed transgenerational effects, highlighting a mechanism in which parents can pass on the effects of microplastic exposure to their offspring. Many of the genes found within differentially methylated regions in our analyses are known to interact with estrogenic chemicals associated with plastic and are related to metabolism. This study highlights the persistent and potentially serious impacts of microplastic pollution on gene regulation in freshwater systems.

A fluid–structure interaction study to analyze the severity of carotid artery stenosis at different locations and its effect on various hemodynamic biomarkers

The study on arterial stenosis has gained rapid interest among researchers in the last decade because of its chronic consequences. Several researchers have tried to investigate stenosis and plaque progression in the carotid artery with different simulation models. In this study, a realistic 3-D geometry of the carotid artery has been used to analyze the effect of varying degrees of stenosis present at different locations of the carotid artery on various hemodynamic parameters. An extensive range of stenosis degrees, starting from a healthy artery(0 %stenosis) to 10%, 30%, 50%, 75%, and 90% stenosis, have been studied. These degrees of stenosis were planted at different locations of the artery grown simultaneously. The whole study was done under the realm of Fluid–Structure Interaction multiphysics. The change in velocity profiles at the areas of stenosis has been found along with the wall shear stress and arterial displacement. The magnitude of velocity and wall shear stress in the case of multiple stenosis locations has been found to be dependent on each other. The presence or absence of one stenosis affects the other, and given the regular and irregular patterns of the velocity profile, wall shear stress, and displacement, their inclusion in blood flow simulation studies having multiple stenoses should be considered.

Quality of Life of Dialysis Patients: Exploring the Influence of Membrane Hemocompatibility and Dialysis Practices on Psychosocial and Physical Symptoms

Hemodialysis (HD) is a life-sustaining membrane-based therapy that is essential for managing kidney failure. However, it can have significant physical and psychological effects on patients due to chronic or acute consequences related to membrane bioincompatibility. End-stage renal disease (ESRD) patients on hemodialysis have a high incidence of psychiatric illness, particularly depression and anxiety disorders, and poor quality of life has been observed. Dialysis can also lead to physical symptoms of its own, such as fatigue, loss of appetite, anemia, low blood pressure, and fluid overload, in addition to the symptoms associated with kidney failure. Therefore, this critical review aims to comprehensively understand the impact of dialysis membrane bioincompatibility and the use of varying molecular weight cut-off membranes on the physical and psychological symptoms experienced by dialysis patients. We analyzed the latest research on the correlation between major inflammatory biomarkers released in patients’ blood due to membrane incompatibility, as well as the critical influence of low levels of hemoglobin and vital proteins such as human serum albumin due to the use of high-cut-off membranes and correlated these factors with the physical and psychological symptoms experienced by dialysis patients. Furthermore, our study aims to provide valuable insights into the impact of dialysis on critical symptoms, higher hospitalization rates, and the quality of life of First Nations, as well as child and youth dialysis patients, in addition to diabetic dialysis patients. Our goal is to identify potential interventions aiming to optimize the dialysis membrane and minimize its negative effects on patients, ultimately improving their well-being and long-term outcomes.

Transdermal alcohol concentration features predict alcohol-induced blackouts in college students.

Alcohol-induced blackouts (AIBs) are common in college students. Individuals with AIBs alsoexperienceacute and chronic alcohol-related consequences. Research suggests that how students drink is an important predictor ofAIBs. We used transdermal alcohol concentration (TAC) sensors to measure biomarkers of increasing alcohol intoxication (rise rate, peak, and rise duration) in a sample of college students. We hypothesized that the TAC biomarkers would be positively associated with AIBs. Students were eligible to participate if they were aged 18-22 years, in their second or third year of college, reported drinking 4+ drinks on a typical Friday or Saturday, experienced ≥1 AIB in the past semester, owned an iPhone, and were willing to wear a sensor for 3 days each weekend. Students (N = 79, 55.7% female, 86.1% White, Mage = 20.1) wore TAC sensors and completed daily diaries over four consecutive weekends (89.9% completion rate). AIBs were assessed using the Alcohol-Induced Blackout Measure-2. Logistic multilevel models were conducted to test for main effects. Days with faster TAC rise rates (OR = 2.69, 95% CI: 1.56, 5.90), higher peak TACs (OR = 2.93, 95% CI: 1.64, 7.11), and longer rise TAC durations (OR = 4.16, 95% CI: 2.08, 10.62) were associated with greater odds of experiencing an AIB. In a sample of "risky" drinking college students, three TAC drinking features identified as being related to rising intoxication independently predicted the risk for daily AIBs. Our findings suggest that considering how an individual drinks (assessed using TAC biomarkers), rather than quantity alone, is important for assessing risk and has implications for efforts to reduce risk. Not only is speed of intoxication important for predicting AIBs, but the height of the peak intoxication and the time spent reaching the peak are important predictors, each with different implications for prevention.