What we are working on

To synthesize patient-level evidence on adeno-associated virus-associated thrombotic microangiopathy (AAV-TMA), describing presentation, timing, investigations, management, outcomes, and supporting an initial approach.

We conducted a systematic review (PROSPERO CRD420251150401) in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and reported in accordance with the updated PRISMA 2020 statement. On 16 September 2025, searches were conducted in Medline, Embase, Global Health, Scopus, Web of Science, and CINAHL. We included reports of post-AAV patients with TMA-like presentations. Two reviewers independently screened records and extracted study- and patient-level data. Study quality was appraised using the Joanna Briggs Institute checklists.

We identified 656 records and included 12 records reporting 22 patients. Exposures were primarily onasemnogene abeparvovec (17/22) and fordadistrogene movaparvovec (3/22). Symptom onset clustered within the 5 to 10 days post-infusion window. Renal-predominant features were common (among cases with reporting: hypertension 15/17, oliguria/anuria 13/17, proteinuria 15/16, hematuria 9/9). Schistocytes were present in 16/16 cases, and thrombocytopenia was severe (median 17×10³/µL). ADAMTS13 activity was reported in 9/22, and none were severely deficient. Most patients received corticosteroids; PLEX was used in 6/17 cases and C5 inhibitors in 10/21 cases. ICU admission occurred in 8/10 cases, renal replacement therapy in 7/22, and mortality in 2/22.

Post-systemic AAV-TMA onset clustered in a narrow period with prominent renal involvement. These findings support phenotype- and ADAMTS13-informed triage, balancing thrombotic thrombocytopenic purpura (TTP) coverage with consideration of complement-directed therapy in severe presentations.

Lithium-ion battery fires in electric micromobility devices are an emerging source of burn and inhalation injury. Clinical reports describe prevention strategies related to charging practices, storage, product safety, and regulation. Similar guidance is also produced by fire services, regulators, consumer safety agencies, public health bodies, and manufacturers. This study compared prevention recommendations from the clinical literature with grey-literature guidance to identify where these sources overlap and where non-clinical guidance adds prevention priorities not commonly captured in clinical reports.

A systematic review was conducted in accordance with the Cochrane Handbook and PRISMA 2020 and registered prospectively in PROSPERO (CRD420261341238). Prevention recommendations from a systematic review of micromobility battery fire injuries were used as the clinical reference set. A targeted grey-literature search was conducted across manufacturer guidance, fire service recommendations, regulatory bulletins, consumer safety reports, and public health advisories. Recommendations were extracted, consolidated by meaning, grouped using the review's thematic categories, and compared with the clinical recommendations.

Seventeen grey-literature sources were reviewed. Preliminary mapping showed close overlap for consumer-facing recommendations, including supervised charging, avoidance of overnight or unattended charging, use of manufacturer-approved chargers and batteries, avoidance of damaged or overheating batteries, safe storage away from exits and combustible materials, and product certification. Grey-literature sources placed additional emphasis on certification marks, e-bike conversion kits, battery disposal and recycling, product registration, recall communication, manufacturer and distributor responsibilities, and building-level charging infrastructure.

Clinical and grey-literature recommendations overlapped most clearly on individual behaviours, especially charging practices and product certification. Grey-literature guidance more often addressed structural measures, including regulation, product supply, building-level controls, recall systems, and battery end-of-life handling. Comparing clinical and grey literature prevention discourse identifies areas where clinical recommendations may be strengthened by incorporating structural and policy-level strategies.

Lithium-ion battery fires involving electric mobility devices have been reported; however, their frequency and clinical characteristics have not been well summarized. Burn and inhalation injuries associated with these events, along with their incident characteristics, acute management, and outcomes, were captured in this review.

A systematic review was conducted in accordance with the Cochrane Handbook and PRISMA 2020 and registered prospectively in PROSPERO (CRD420261341238). MEDLINE, Embase, Scopus, Web of Science Core Collection, and CINAHL were searched up to 2026. Backward and forward citation searching and targeted Google Scholar and Google web searches were also performed. Human studies reporting extractable original data on injuries associated with lithium-ion battery fires or explosions involving electric mobility devices were eligible.

Eleven records comprising 334 patients or casualties from seven countries were included. Most were case reports, case series, or observational reports in adults from burn centres. The most severe cases usually followed indoor micromobility fires, often during charging. Across the most directly comparable hospital-based reports, inhalation injury ranged from 33% to 88%, operative management from 40% to 78%, and mortality from 0% to 11%. Reported burn severity was substantial, with mean total body surface area values ranging from 14.5% to 27.5% in the major cohorts. In contrast, one pediatric short-circuit series described uniformly minor hand burns managed non-operatively without mortality.

Lithium-ion battery fires involving electric mobility devices occur predominantly in adults following an indoor battery fire, often during charging. Fires result in combined burn and inhalation injuries, frequent surgeries, prolonged hospitalizations, and mortality. Prevention efforts should focus on certified devices and chargers and on reducing indoor overnight charging.

Temporary emergency department (ED) service disruptions in Alberta are publicly posted by Alberta Health Services (AHS), but their cumulative burden has not been systematically reconstructed. We quantified publicly documented ED disruption burden in Alberta using archived public records.

We conducted a retrospective descriptive study of AHS ED service disruption postings from August 1, 2021, to May 31, 2026. Records were identified from archived service-disruption snapshot pages and the AHS news/notice archive. Duplicate captures were collapsed, and repeated, extended, overlapping, or continuous same-site ED disruptions were merged into site-level episodes. Public wording was used to reconstruct disruption intervals, which were clipped to the study window and overlap-adjusted within site-year to estimate annual disruption hours. Notice-derived records were checked against snapshot-derived records to avoid duplicate counting. Source-supported manual intervals were added where routine parsing missed or undercaptured a disruption. Reconstructed intervals were manually reviewed by one author, with targeted second-author review.

The final dataset contained 630 disruption episodes, 656 episode-years, and 154,074.7 total disruption hours. Full-calendar-year episode-years ranged from 114 to 187 annually. Disruption hours peaked in 2023 at 38,896.3 h and remained high in 2024 and 2025, with 36,280.2 h and 31,088.2 h, respectively. The highest overall burdens occurred in Consort, Hardisty, Boyle, Grimshaw, and Two Hills.

Public AHS records document a sustained, geographically concentrated burden of ED service disruption in Alberta. Standardized public reporting of disruption timing and reasons would improve surveillance and help identify communities with recurrent ED access instability.

Rural maternity care depends on the reliable coordination of local hospital, surgical, anesthesia, and maternity backup capacity. Alberta Health Services (AHS) publicly posts temporary hospital service disruptions, but the cumulative burden of publicly documented maternity-related disruptions has not been described. We characterized these disruptions across Alberta using archived public records.

We conducted a retrospective descriptive study of AHS temporary service disruption postings from August 1, 2021, to May 31, 2026. Records were identified from archived active-disruption snapshot pages and the AHS news/notice archive. We included postings that explicitly affected maternity care, labour and delivery availability, caesarean or operative maternity capability, epidural access, or maternity backup. Records were standardized by site, deduplicated into site-level episodes, classified by affected capability, and reconstructed into dated intervals. Earlier reopening notices or later postings were used to truncate intervals when they documented return of service. Overlapping intervals at the same site were unioned to estimate site-level disruption hours. Capability layers were not mutually exclusive.

The dataset included 504 site-level maternity disruption episodes and 558 episode-year records across 45 sites. Total unioned burden was 384,803.2 site-level disruption hours. Annual burden was highest in 2022 at 92,570.5 h and remained substantial through 2025 at 74,182.8 h, with partial-year totals of 26,871.0 h in 2021 and 29,123.0 h through May 2026. By capability layer, maternity/labour and delivery unavailability accounted for 257,528.8 h, operative/caesarean capability unavailability for 176,594.0 h, epidural unavailability for 30,994.7 h, and other named maternity disruptions for 13,448.5 h. The highest-burden sites were Sundre, Rimbey, Three Hills, Slave Lake, and Westlock.

Publicly posted AHS records show recurrent and sustained disruptions in local maternity capability across multiple rural and regional Alberta sites. Several high-burden sites reflect long posted suspensions, including intervals already active at the archive start and therefore left-censored. Reporting by affected capability, rather than only complete service closure, better reflects the operational changes that may affect local access to delivery care and can help identify sites needing closer review of maternity, anesthesia, and operative-delivery coverage.

Wildfires can disrupt hospital operations through direct fire exposure, smoke intrusion, infrastructure strain, evacuation risk, and regional patient redistribution. Existing reviews have focused more broadly on wildfire-related emergency department impacts, emergency medical services response, or hospital evacuation across hazards, rather than specifically on how hospitals and acute-care systems preserved service continuity during wildfire-related disruption. This review synthesised peer-reviewed and selected gray-literature evidence on evacuation, transfer, surge response, and early recovery strategies used to maintain acute-care access during wildfire events.

We conducted a systematic review of studies and operational reports describing wildfire- or bushfire-related disruption to hospitals and acute-care services. We searched MEDLINE, Embase, CINAHL, and Scopus using controlled vocabulary and text words related to wildfires, hospital and critical care settings, and evacuation, transfer, continuity, and recovery processes. We also undertook targeted gray-literature searching using structured Google web searches and searches of relevant hospital, health-system, emergency-preparedness, and government websites. Eligible records included hospital- or system-level reports of evacuation, transfer, service continuity, operational response, or early recovery during real wildfire events. Two reviewers independently screened records and extracted data on setting, disruption type, operational strategies, and reported outcomes. Given expected methodological heterogeneity, findings were synthesised narratively.