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T-cell large granular lymphocytic (T-LGL) leukaemia is frequently associated with an autoimmune phenomenon; approximately one-third of patients have rheumatoid arthritis (RA). Intriguingly, one-third of patients with rheumatoid arthritis exhibit clonal T-cell patterns. Here, we present a patient with RA undergoing evaluation for neutropenia and splenomegaly who was later diagnosed with T-LGL leukaemia. [ABSTRACT FROM AUTHOR]

BACKGROUND:Hospitals are subject to federal financial penalties for excessive 30-day hospital readmissions for acute myocardial infarction (AMI). Prospectively identifying patients hospitalized with AMI at high risk for readmission could help prevent 30-day readmissions by enabling targeted interventions. However, the performance of AMI-specific readmission risk prediction models is unknown. METHODS AND RESULTS:We systematically searched the published literature through March 2017 for studies of risk prediction models for 30-day hospital readmission among adults with AMI. We identified 11 studies of 18 unique risk prediction models across diverse settings primarily in the United States, of which 16 models were specific to AMI. The median overall observed all-cause 30-day readmission rate across studies was 16.3% (range, 10.6%-21.0%). Six models were based on administrative data; 4 on electronic health record data; 3 on clinical hospital data; and 5 on cardiac registry data. Models included 7 to 37 predictors, of which demographics, comorbidities, and utilization metrics were the most frequently included domains. Most models, including the Centers for Medicare and Medicaid Services AMI administrative model, had modest discrimination (median C statistic, 0.65; range, 0.53-0.79). Of the 16 reported AMI-specific models, only 8 models were assessed in a validation cohort, limiting generalizability. Observed risk-stratified readmission rates ranged from 3.0% among the lowest-risk individuals to 43.0% among the highest-risk individuals, suggesting good risk stratification across all models. CONCLUSIONS:Current AMI-specific readmission risk prediction models have modest predictive ability and uncertain generalizability given methodological limitations. No existing models provide actionable information in real time to enable early identification and risk-stratification of patients with AMI before hospital discharge, a functionality needed to optimize the potential effectiveness of readmission reduction interventions.

The article provides an overview of a special issue focused on critical information literacy (CIL) and its evolving scope. The editors aimed to explore new dimensions of CIL in the context of changing societal challenges and to connect it with existing theoretical frameworks. The special issue includes diverse papers that touch upon various aspects of life and society, expanding the understanding and application of CIL.

This paper presents the findings of research which explored Scottish school libraries' information provision and information literacy (IL) support in the run-up to two major political events: the 2014 Scottish Independence Referendum (SIR) and the 2015 General UK Parliamentary Election (GE). To do this, the project identified, through an online survey, what political information seeking secondary school students engaged in through school libraries, what information provision and IL support was available to students relating to political issues and events, and what barriers school libraries faced in providing these aspects of political education. It also identified what information seeking students engaged in, what levels of information provision and IL support relating to politics are provided by school libraries, and set out to explore the perceptions and experiences of library staff relating to work in this area. Analysis of the results indicates that there are mixed levels of provision across school libraries in Scotland and that this variation may be influenced by inconsistent policies from local councils and individual schools themselves, as well as variations in the experience and views of library staff. Key activities to support young people's political education are identified, and several reasons library staff do not engage in political work are discussed. The findings are linked to previous research, with a discussion of the need to encourage and support school library staff to contribute to the political education of students alongside teaching staff. Several recommendations for schools and library staff are made, relating to a consideration of the role of school libraries, how they can provide relevant political information, the importance of clear policies around political information provision and the support required for school library workers. [ABSTRACT FROM AUTHOR]

Marine mammals are important indicators for ecosystem health and serve as sentinel species for infectious agents including zoonoses. Histological examination of tissues from a stranded Florida manatee Trichechus manatus latirostris revealed protozoal cysts in the cerebrum and intrahistiocytic tachyzoites in the liver and caudal mesenteric lymph node. Disseminated Toxoplasma gondii infection was confirmed by immunohistochemistry and sequencing of the nuclear ribosomal internal transcribed spacer region of formalin-fixed tissues. The lack of baseline information on Florida manatees' exposure to this pathogen prompted a study into the seroprevalence of T. gondii in 2 separate geographic habitats in Florida, USA, during the winters from 2011-2014. Serum was collected during routine health assessments of 44 apparently healthy manatees from Crystal River (n = 26) on the west central coast of Florida and Brevard County (n = 18) on the east coast of Florida. Serum was screened for detection of T. gondii immunoglobulin G (IgG) antibodies via the modified agglutination test. Two animals from Crystal River from 2011 and 2012 (7.7%) and one animal from Brevard County from 2011 (5.6%) tested positive for T. gondii antibodies. Overall seroprevalence for T. gondii was low in the 2 sampled populations and may reflect a low seroprevalence or animal susceptibility. However, continued monitoring of this pathogen in aquatic ecosystems is warranted due to both possible anthropogenic sources and zoonotic potential.