Race-Specific Spirometry Equations Do Not Improve Models of Dyspnea and Quantitative Chest CT Phenotypes.

Background: Race-specific spirometry reference equations are used globally to interpret lung function for clinical, research, and occupational purposes, but inclusion of race is under scrutiny.

Research Question: Does including self-identified race in spirometry reference equation formation improve the ability of predicted FEV values to explain quantitative chest CT abnormalities, dyspnea, or Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification?

Study Design And Methods: Using data from healthy adults who have never smoked in both the National Health and Nutrition Survey (2007-2012) and COPDGene study cohorts, race-neutral, race-free, and race-specific prediction equations were generated for FEV Using sensitivity/specificity, multivariable logistic regression, and random forest models, these equations were applied in a cross-sectional analysis to populations of individuals who currently smoke and individuals who formerly smoked to determine how they affected GOLD classification and the fit of models predicting quantitative chest CT phenotypes or dyspnea.

Results: Race-specific equations showed no advantage relative to race-neutral or race-free equations in models of quantitative chest CT phenotypes or dyspnea.

Simulation for Clinical Preparedness in Pediatric Emergencies: A Pilot Study.

Positive outcomes for pediatric in-hospital cardiopulmonary arrest remain low with little change in mortality rates. Infrequently used clinical knowledge and skills decline quickly, contributing to poor quality of resuscitation. The aim of this pilot study exploring the outcomes of repeated pediatric mock code simulations with structured debriefing demonstrated statistically significant differences in participants' knowledge of pediatric emergencies, with no significant decline in resuscitation skills.

From Chaos to Competency: Implementing a New Competency Model in a Multihospital System.

The demonstration of nurses' competency has been a challenge for nurse educators for a multitude of reasons. Standardizing competencies across a health care system is especially challenging. One multihospital health care system embarked on a journey to standardize and implement competencies across the system.

Assessing coral reefs on a Pacific-wide scale using the microbialization score.

The majority of the world's coral reefs are in various stages of decline. While a suite of disturbances (overfishing, eutrophication, and global climate change) have been identified, the mechanism(s) of reef system decline remain elusive. Increased microbial and viral loading with higher percentages of opportunistic and specific microbial pathogens have been identified as potentially unifying features of coral reefs in decline.

A diffusion approach to labeling rows and columns in an irregular array.

A robust algorithm is presented for labeling rows and columns in an irregular array. The algorithm is based on hierarchical pattern matching to a local lattice, which is used as a template. Starting from the best local match, the pattern is expanded hierarchically to encompass the entire array.