Electronic Sepsis Screening Among Patients Admitted to Hospital Wards: A Stepped-Wedge Cluster Randomized Trial.

Importance: Sepsis screening is recommended among hospitalized patients but is supported by limited evidence of effectiveness.

Objective: To evaluate the effect of electronic sepsis screening, compared with no screening, on mortality among hospitalized ward patients.

Design, Setting, And Participants: In a stepped-wedge, cluster randomized trial at 5 hospitals in Saudi Arabia, 45 wards (clusters) were randomized into 9 sequences, 5 wards each, to have sepsis screening implemented at 2-month periods.

Sex-based differences in hematological values after normalization to body mass or fat-free mass in adults matched for aerobic fitness.

Blood properties influence aerobic exercise performance. While vascular volumes and hemoglobin mass (Hb) are elevated in trained individuals, evidence of sex differences in vascular volumes is equivocal due to inadequate matching of aerobic fitness between males and females. This cross-sectional study aimed to compare hematological values normalized to body mass (BM) and fat-free mass (FFM) between males ( = 45) and females ( = 34) matched for aerobic fitness (V̇Omax) normalized to FFM (mL∙kg FFM∙min ).

The Effect of Duration on Performance and Perceived Fatigability During Acute High-Intensity Interval Exercise in Young, Healthy Males and Females.

Few studies have explored the kinetics of performance and perceived fatigability during high-intensity interval training, despite its popularity. We aimed to characterize the kinetics of fatigability and recovery during an 8 × 4-min HIIT protocol, hypothesizing that most muscle function impairment would occur during the initial four intervals. Fifteen healthy males and females (mean ± standard deviation; age = 26 ± 5 years, V̇Omax = 46.

Proactive patient safety: enhancing hospital readiness through simulation-based clinical systems testing and healthcare failure mode and effect analysis.

Background: Recognizing and identifying latent safety threats (LSTs) before patient care commences is crucial, aiding leaders in ensuring hospital readiness and extending its impact beyond patient safety alone. This study evaluated the effectiveness of a combination of Simulation-based Clinical Systems Testing (SbCST) with Healthcare Failure Mode and Effect Analysis (HFMEA) with regard to mitigating LSTs within a newly constructed hospital.

Methods: Three phases of the combined SbCST and HFMEA approach were implemented across all hospital settings.

The influence of sex, hemoglobin mass, and skeletal muscle characteristics on cycling critical power.

Critical power (CP) represents an important threshold for exercise performance and fatiguability. We sought to determine the extent to which sex, hemoglobin mass (Hb), and skeletal muscle characteristics influence CP. Before CP determination (i.

The risk factors, consequences, and interventions of discharge against medical advice - A narrative review.

Discharge against medical advice (DAMA) represents an increasingly burdensome public health issue that leads to worse outcomes for patients and high costs to society. While the rate of patients who DAMA is higher within certain institutions and geographic locations, the problem is present across all healthcare systems. DAMAs are often challenging as they occur suddenly and can be unsatisfactory.

Impact of a same day admission project in reducing the preoperative bed occupancy demand in a pediatric inpatient hospital.

Background: A same day admission approach was established for pediatric patients undergoing elective surgery owing to an increase in demand for bed availability and the need for medical, logistical, psychological, and fiscal improvements. This study aimed to assess the effectiveness of the same day admission approach for reducing demand for preoperative bed occupancy in pediatric inpatient units.

Method: Data on elective surgery patients considered for same day admission were prospectively collected in an Excel spreadsheet.

Utilization of High-pressure Suction for EBUS-TBNA Sampling in Suspected Lung Cancer.

Background: Sample adequacy for immediate molecular testing is paramount in lung cancer. To date, several endobronchial ultrasound with transbronchial needle aspiration (EBUS-TBNA) sampling setups have been evaluated, however, the utilization of high-pressure suction (HPS) has not yet been reported.The aim of this study was to evaluate the utilization of HPS onto the needle and its effect on sample volume and adequacy for molecular testing in patients with suspected lung cancer.

Primary Healthcare in Saudi Arabia: An Evaluation of Emergent Health Trends.

Introduction: The Kingdom of Saudi Arabia (KSA) is experiencing an increasing demand for healthcare due to a growing population and unhealthy changes in lifestyle, fostering the need for critical examination of the current status of primary healthcare in the KSA with analysis of health-related trends among its growing population.

Methods: A review of the literature was therefore undertaken, followed by a survey of primary healthcare centers at three facilities in Riyadh, to assess the current activities, understand challenges, compare existing practices with international best practices, and asses the level of patient satisfaction. The level of satisfaction with primary care services was examined by using observational surveys and retrospective reviews from the previous 20 years.

10 kHz 2D thermometry in turbulent reacting flows using two-color OH planar laser-induced fluorescence.

10 kHz two-color OH planar laser-induced fluorescence (PLIF) thermometry was demonstrated in both laminar Hencken flames and turbulent premixed jet flames using two injection-seeded optical parametric oscillators (OPOs) pumped by a high-speed three-legged burst-mode laser. The two burst-mode OPOs generate ∼5/ at 282 nm and 286 nm to excite the (5) and (14) transitions of the ← (1,0) system of OH, respectively. PLIF images were collected simultaneously from each of the two transitions and ratios of intensities from the two images were used to determine local temperatures.

Optimal care for the management of older people non-weight bearing after lower limb fracture: a consensus study.

Background: Older people who are non-weight-bearing after a lower limb fracture are at risk of poor outcomes but there are no clinical guidelines for this group of patients. Given the paucity of the research evidence base, we conducted a consensus exercise to ascertain expert opinion about the management of this group.

Methods: A three-round e-Delphi technique was planned to use the online JISC survey tool with a multidisciplinary panel of health professionals.

Optimal management of older people with frailty non-weight bearing after lower limb fracture: a scoping review.

Background: Patients with lower limb fractures who are non-weight bearing are at risk of the complications of the associated immobility and disability, particularly people with frailty, but there is lack of clarity about what constitutes optimal care for such patients. A scoping literature review was conducted to explore what evidence is available for the management of this patient group.

Methods: MEDLINE (PubMed) CINAHL, EMBASE and the Cochrane databases of published literature and the HMIC and SIGLE sites for grey literature were searched for primary research studies and expert reports, using an iterative approach initially including the key term 'non-weight bearing'.

Laboratory Performance Evaluation of Pristine and Used Headgear for Girls' Lacrosse.

Girls' lacrosse participation and head injury rates have increased . In response, optional headgear was implemented following the recently developed ASTM International (ASTM) lacrosse headgear performance standards. It remains unknown how lacrosse headgear responds to blunt impacts after use.

The Epidemiology of Injuries in Middle School Football, 2015-2017: The Advancing Healthcare Initiatives for Underserved Students Project.

Background: Although data exist on injuries in youth football leagues, there are limited recent data on injury incidence in middle school football. Updated injury incidence estimates can help drive the development of injury prevention strategies.

Purpose: Describe the epidemiology of injuries in middle school football during school years 2015-2016 to 2017-2018.

Schoolteachers' and Administrators' Perceptions of Concussion Management and Implementation of Return-to-Learn Guideline.

Background: Concussions are a public health concern and concussion management in school requires a team approach. We examined schoolteachers' and administrators' perceptions of concussions, management, and implementation of return-to-learn (RTL) guidelines.

Methods: We audio-recorded and transcribed semistructured interviews with teachers (N = 16) and administrators (N = 6) from a public school system.

Sex-related marijuana expectancies as predictors of sexual risk behavior following smoked marijuana challenge.

Marijuana use has been associated with sexual risk behavior, but the mechanisms that underlie this relationship are not well understood. The present study examined whether marijuana acutely increased sexual risk on a behavioral decision-making task and whether sex-related marijuana outcome expectancies influenced sexual risk decisions after marijuana administration. Participants were heterosexual marijuana users (n = 126) who were randomly assigned to 1 of 4 study conditions using a 2 × 2 factorial design crossing drug administration (received 2.

Impact of new International Association of Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria on perinatal outcomes in a regional tertiary hospital in New South Wales, Australia.

Aims: We compared the impact of new gestational diabetes (GDM) diagnostic criteria by IADPSG with previous criteria to ascertain concordance between the two criteria; and whether women discordant for GDM between the old and new criteria had increased pregnancy complications.

Methods: Oral glucose tolerance tests of pregnant women across time periods using old criteria and new criteria were collected. Maternal data and perinatal outcomes were compared between diagnostic concordant and discordant women.

Reducing patient waiting time and length of stay in an Acute Care Pediatric Emergency Department.

Prolonged waiting times and length of stay in Pediatric Emergency Department, are the two of the most challenging patient and clinical outcomes of healthcare institution. These emerged due to various reasons, namely: the use of triaging process and patient flow criteria that eventually lead to bottlenecks and overcrowding in the ED. After realizing the root causes of the prolonged waiting times and length of stay, the KASCH ED instigated a team to study the factors and thereby arrive at a considerable conclusion that will result in an improvement.

Concussion Rates in U.S. Middle School Athletes, 2015-2016 School Year.

Introduction: Concussion incidence estimates in middle school sports settings are limited. This study examines concussion incidence in nine U.S.

Multispecies absorption spectroscopy of detonation events at 100 kHz using a fiber-coupled, time-division-multiplexed quantum-cascade-laser system.

A mid-infrared fiber-coupled laser system constructed around three time-division-multiplexed quantum-cascade lasers capable of measuring the absorption spectra of CO, CO, and NO at 100 kHz over a wide range of operating pressures and temperatures is demonstrated. This system is first demonstrated in a laboratory burner and then used to measure temperature, pressure, and concentrations of CO, CO, and NO as a function of time in a detonated mixture of NO and CH. Both fuel-rich and fuel-lean detonation cases are outlined.

Multi-mode acquisition (MMA): An MS/MS acquisition strategy for maximizing selectivity, specificity and sensitivity of DIA product ion spectra.

In proteomics studies, it is generally accepted that depth of coverage and dynamic range is limited in data-directed acquisitions. The serial nature of the method limits both sensitivity and the number of precursor ions that can be sampled. To that end, a number of data-independent acquisition (DIA) strategies have been introduced with these methods, for the most part, immune to the sampling issue; nevertheless, some do have other limitations with respect to sensitivity.

Using topic coding to understand the nature of change language in a motivational intervention to reduce alcohol and sex risk behaviors in emergency department patients.

Objective: To elucidate patient language that supports changing a health behavior (change talk) or sustaining the behavior (sustain talk).

Methods: We developed a novel coding system to characterize topics of patient speech in a motivational intervention targeting alcohol and HIV/sexual risk in 90 Emergency Department patients. We further coded patient language as change or sustain talk.

A difficult case of recurrent hypoglycaemia: role of insulin assays in establishing the diagnosis.

Background: Insulin assays are designed to detect endogenous insulin, however, insulin assays produced by different manufacturers may detect exogenous recombinant insulin, with varying degrees of cross-reactivity between different assays. We report a fascinating and difficult case of recurrent hypoglycaemia, where the final diagnosis was established with the help of insulin assays using different platforms.

Case Report: A 24-year-old female presented with recurrent hypoglycaemic episodes on a background of Type 1 diabetes mellitus and a completely resected synovial sarcoma of the right hip several years previously.