Carbon monoxide (CO) poisoning affects 50,000 people a year in the United States. The clinical presentation runs a spectrum, ranging from headache and dizziness to coma and death, with a mortality rate ranging from 1 to 3%. A significant number of patients who survive CO poisoning suffer from long-term neurological and affective sequelae. The neurologic deficits do not necessarily correlate with blood CO levels but likely result from the pleiotropic effects of CO on cellular mitochondrial respiration, cellular energy utilization, inflammation, and free radical generation, especially in the brain and heart. Long-term neurocognitive deficits occur in 15-40% of patients, whereas approximately one-third of moderate to severely poisoned patients exhibit cardiac dysfunction, including arrhythmia, left ventricular systolic dysfunction, and myocardial infarction. Imaging studies reveal cerebral white matter hyperintensities, with delayed posthypoxic leukoencephalopathy or diffuse brain atrophy. Management of these patients requires the identification of accompanying drug ingestions, especially in the setting of intentional poisoning, fire-related toxic gas exposures, and inhalational injuries. Conventional therapy is limited to normobaric and hyperbaric oxygen, with no available antidotal therapy. Although hyperbaric oxygen significantly reduces the permanent neurological and affective effects of CO poisoning, a portion of survivors still have substantial morbidity. There has been some early success in therapies targeting the downstream inflammatory and oxidative effects of CO poisoning. New methods to directly target the toxic effect of CO, such as CO scavenging agents, are currently under development.

BackgroundCisplatin resistance is a major challenge for advanced head and neck cancer (HNC). Understanding the underlying mechanisms and developing effective strategies against cisplatin resistance are highly desired in the clinic. However, how tumor stroma modulates HNC growth and chemoresistance is unclear.ResultsWe show that cancer-associated fibroblasts (CAFs) are intrinsically resistant to cisplatin and have an active role in regulating HNC cell survival and proliferation by delivering functional miR-196a from CAFs to tumor cells via exosomes. Exosomal miR-196a then binds novel targets, CDKN1B and ING5, to endow HNC cells with cisplatin resistance. Exosome or exosomal miR-196a depletion from CAFs functionally restored HNC cisplatin sensitivity. Importantly, we found that miR-196a packaging into CAF-derived exosomes might be mediated by heterogeneous nuclear ribonucleoprotein A1 (hnRNPA1). Moreover, we also found that high levels of plasma exosomal miR-196a are clinically correlated with poor overall survival and chemoresistance.ConclusionsThe present study finds that CAF-derived exosomal miR-196a confers cisplatin resistance in HNC by targeting CDKN1B and ING5, indicating miR-196a may serve as a promising predictor of and potential therapeutic target for cisplatin resistance in HNC.Electronic supplementary materialThe online version of this article (10.1186/s13059-018-1604-0) contains supplementary material, which is available to authorized users.

Children of Latino immigrants, many of whom live in “mixed-status” families, are a rapidly growing group in the United States. It is widely accepted that their development is affected by multiple and complex factors, including those in their distal context (e.g., laws, institutions, policies). Despite the enormity of the deportation system and its vigorous implementation in recent years, little research has investigated how this particular component of the distal context affects Latino immigrant families. The present survey was designed to statistically explore the impact of detention/deportation on Latino immigrant parents and children ( N = 132). Regression analyses indicated that (1) parents with higher levels of legal vulnerability report a greater impact of detention/ deportation on the family environment (parent emotional well-being, ability to provide financially, and relationships with their children) and children’s well-being (child’s emotional well-being and academic performance) and (2) parents’ legal vulnerability and the impact of detention/deportation on the family predict outcomes for children. Implications for practice and policy are discussed.

The relationship between social capital and health outcomes should take into account geographical setting. Efforts to increase social capital in the hope of decreasing health disparity might be inadequate without eliminating China's unique rural-urban distinction in distributing economic and social resources. Further conceptualization of social capital may be required for the Eastern context.