Identifying Nonprovider Factors Affecting Pediatric Emergency Medicine Provider Efficiency.

Objective: The aim of this study was to create a multivariable model of standardized relative value units per hour by adjusting for nonprovider factors that influence efficiency.

Methods: We obtained productivity data based on billing records measured in emergency relative value units for (1) both evaluation and management of visits and (2) procedures for 16 pediatric emergency medicine providers with more than 750 hours worked per year. Eligible shifts were in an urban, academic pediatric emergency department (ED) with 2 sites: a tertiary care main campus and a satellite community site.

The Production of Curli Amyloid Fibers Is Deeply Integrated into the Biology of Escherichia coli.

Curli amyloid fibers are the major protein component of the extracellular matrix produced by Enterobacteriaceae during biofilm formation. Curli are required for proper biofilm development and environmental persistence by . Here, we present a complete and vetted genetic analysis of functional amyloid fiber biogenesis.

AAV6 Vector Production and Purification for Muscle Gene Therapy.

Vectors derived from adeno-associated viruses (AAV) have been generated using numerous naturally occurring and synthetic serotypes of the virus. Such vectors have proven to be extremely useful for a variety of gene transfer studies, both in vitro and in vivo, and are increasingly being used in gene therapy protocols for a variety of human disorders. Methods to produce AAV vectors typically rely on co-transfection of several different plasmid vectors that carry the transgene of interest (the gene to be delivered , in a "transfer plasmid") and helper genes needed for AAV vector replication and packaging (helper plasmids).

Shade Sails and Passive Recreation in Public Parks of Melbourne and Denver: A Randomized Intervention.

Objectives: To test whether shade sails will increase the use of passive recreation areas (PRAs).

Methods: We conducted a stratified randomized pretest-posttest controlled design study in Melbourne, Australia, and Denver, Colorado, in 2010 to 2014. We randomized a sample of 144 public parks with 2 PRAs in full sun in a 1:3 ratio to treatment or control.

Expert Search Strategies: The Information Retrieval Practices of Healthcare Information Professionals.

Background: Healthcare information professionals play a key role in closing the knowledge gap between medical research and clinical practice. Their work involves meticulous searching of literature databases using complex search strategies that can consist of hundreds of keywords, operators, and ontology terms. This process is prone to error and can lead to inefficiency and bias if performed incorrectly.

A Five-Repeat Micro-Dystrophin Gene Ameliorated Dystrophic Phenotype in the Severe DBA/2J-mdx Model of Duchenne Muscular Dystrophy.

Micro-dystrophins are highly promising candidates for treating Duchenne muscular dystrophy, a lethal muscle disease caused by dystrophin deficiency. Here, we report robust disease rescue in the severe DBA/2J-mdx model with a neuronal nitric oxide synthase (nNOS)-binding micro-dystrophin vector. 2 × 10 vector genome particles/mouse of the vector were delivered intravenously to 10-week-old mice and were evaluated at 6 months of age.

US Emergency Department Trends in Imaging for Pediatric Nontraumatic Abdominal Pain.

Objectives: To describe national emergency department (ED) trends in computed tomography (CT) and ultrasound imaging for the evaluation of pediatric nontraumatic abdominal pain from 2007 through 2014.

Methods: We used data from the National Hospital Ambulatory Medical Care Survey to measure trends in CT and ultrasound use among children with nontraumatic abdominal pain. We performed multivariable logistic regression to measure the strength of the association of ED type (pediatric versus general ED) with CT and ultrasound use adjusting for potential confounding variables.

Treatment of Type 1 Diabetes: Synopsis of the 2017 American Diabetes Association Standards of Medical Care in Diabetes.

Description: The American Diabetes Association (ADA) annually updates Standards of Medical Care in Diabetes to provide clinicians, patients, researchers, payers, and other interested parties with evidence-based recommendations for the diagnosis and management of patients with diabetes.

Methods: For the 2017 Standards of Care, the ADA Professional Practice Committee did MEDLINE searches from 1 January 2016 to November 2016 to add, clarify, or revise recommendations on the basis of new evidence. The committee rated the recommendations as A, B, or C, depending on the quality of evidence, or E for expert consensus or clinical experience.

Racial and Ethnic Differences in Antibiotic Use for Viral Illness in Emergency Departments.

Background And Objectives: In the primary care setting, there are racial and ethnic differences in antibiotic prescribing for acute respiratory tract infections (ARTIs). Viral ARTIs are commonly diagnosed in the pediatric emergency department (PED), in which racial and ethnic differences in antibiotic prescribing have not been previously reported. We sought to investigate whether patient race and ethnicity was associated with differences in antibiotic prescribing for viral ARTIs in the PED.

Diagnostic Overshadowing of the Psychiatric Population in the Emergency Department: Physiological Factors Identified for an Early Warning System.

Background: Many people with mental disorders in the United States remain either medically untreated or inadequately treated, which is often attributed to diagnostic overshadowing, a common occurrence across the nation in emergency departments.

Objective: The aim of this research is to create a tool that supports accurate assessment and distinguishing behavioral symptoms between psychiatric illness and coexisting medical conditions in the emergency department, thus leading to appropriate care and placement.

Design: Retrospective cohort design of 133 psychiatric admissions were reviewed between the years 2011 and 2015.

Examining the Role of the Pediatric Emergency Department in Reducing Unintended Adolescent Pregnancy.

Objectives: To determine pregnancy risk and receptiveness to emergency department (ED)-based pregnancy prevention interventions among adolescents accessing care in the ED.

Study Design: Cross-sectional electronic survey of adolescent females in a pediatric ED used to calculate the Pregnancy Risk Index, a validated measure estimating the annual risk of becoming pregnant based on recent sexual activity, contraceptive method(s), method-specific contraceptive failure rates, and interest in receipt of ED-based contraceptive services.

Results: Of 229 participants, 219 were not pregnant, and 129 reported sexual experience.

Corrigendum: Muscle-specific CRISPR/Cas9 dystrophin gene editing ameliorates pathophysiology in a mouse model for Duchenne muscular dystrophy.

This corrects the article DOI: 10.1038/ncomms14454.

Treatment of a Mandibular Glandular Odontogenic Cyst with Peripheral Ostectomy, Bone Allograft, and Implant Reconstruction: A Case Report.

This article reports on a case of a glandular odontogenic cyst (GOC) in the posterior mandible of a 25-year-old male treated with peripheral ostectomy, bone allograft, and an implant-supported fixed dental prosthesis. During a routine 3-month postoperative visit, a radiograph suggested vertical bone loss on the implant in the location of the mandibular right first molar. The three-walled defect was surgically treated with debridement, bone allograft, and a membrane.

Translation of Cardiac Myosin Activation with 2-deoxy-ATP to Treat Heart Failure via an Experimental Ribonucleotide Reductase-Based Gene Therapy.

Despite recent advances, chronic heart failure remains a significant and growing unmet medical need, reaching epidemic proportions carrying substantial morbidity, mortality, and costs. A safe and convenient therapeutic agent that produces sustained inotropic effects could ameliorate symptoms, and improve functional capacity and quality of life. We discovered small amounts of 2-deoxy-ATP (dATP) activate cardiac myosin leading to enhanced contractility in normal and failing heart muscle.

Quality Improvement in Pediatric Head Trauma with PECARN Rules Implementation as Computerized Decision Support.

Background: For the 1.4 million emergency department (ED) visits for traumatic brain injury (TBI) annually in the United States, computed tomography (CT) may be over utilized. The Pediatric Emergency Care Applied Research Network developed 2 prediction rules to identify children at very low risk of clinically important TBI.

Estimating the incidence of traumatic spinal cord injuries in Switzerland: Using administrative data to identify potential coverage error in a cohort study.

Introduction: Inferences from population-based cohort studies may be inaccurate as a result of biased coverage of the target population. We investigated the presence of absolute coverage error and selection bias in the Swiss Spinal Cord Injury (SwiSCI) cohort study, using a secondary, nationally representative data source. The proposed methodology is applicable to future Swiss cohort studies aiming to assess their cover-age error.

The Impact of Simulation Prebriefing on Perceptions of Overall Effectiveness, Learning, and Self-Confidence in Nursing Students.

Aim: The aim of this study was to evaluate the impact of simulation prebriefing on nursing students' perceptions of overall effectiveness, learning, and self-confidence.

Background: Most research highlights debriefing as the most important component influencing learning outcomes; the focus on prebriefing is limited.

Method: This quasiexperimental design study compared outcomes among four groups of undergraduate students (n = 119) at two schools of nursing: no prebriefing, prebriefing with learning engagement and orientation activities, prebriefing with orientation activities, and prebriefing with learning engagement activities.

HIV-1 Frameshift RNA-Targeted Triazoles Inhibit Propagation of Replication-Competent and Multi-Drug-Resistant HIV in Human Cells.

The HIV-1 frameshift-stimulating (FSS) RNA, a regulatory RNA of critical importance in the virus' life cycle, has been posited as a novel target for anti-HIV drug development. We report the synthesis and evaluation of triazole-containing compounds able to bind the FSS with high affinity and selectivity. Readily accessible synthetically, these compounds are less toxic than previously reported olefin congeners.

Individual and Neighborhood Characteristics of Children Seeking Emergency Department Care for Firearm Injuries Within the PECARN Network.

Objective: The objective was to describe the characteristics of children seeking emergency care for firearm injuries within the PECARN network and assess the influence of both individual and neighborhood factors on firearm-related injury risk.

Methods: This was a retrospective, multicenter cross-sectional analysis of children (<19 years old) presenting to 16 pediatric EDs (2004-2008). ICD-9-CM E-codes were used to identify and categorize firearm injuries by mechanism/intent.

Progress toward Gene Therapy for Duchenne Muscular Dystrophy.

Duchenne muscular dystrophy (DMD) has been a major target for gene therapy development for nearly 30 years. DMD is among the most common genetic diseases, and isolation of the defective gene (DMD, or dystrophin) was a landmark discovery, as it was the first time a human disease gene had been cloned without knowledge of the protein product. Despite tremendous obstacles, including the enormous size of the gene and the large volume of muscle tissue in the human body, efforts to devise a treatment based on gene replacement have advanced steadily through the combined efforts of dozens of labs and patient advocacy groups.

Pharmacologic Therapy for Type 2 Diabetes: Synopsis of the 2017 American Diabetes Association Standards of Medical Care in Diabetes.

Description: The American Diabetes Association (ADA) annually updates the Standards of Medical Care in Diabetes to provide clinicians, patients, researchers, payers, and other interested parties with evidence-based recommendations for the diagnosis and management of patients with diabetes.

Methods: For the 2017 Standards, the ADA Professional Practice Committee updated previous MEDLINE searches performed from 1 January 2016 to November 2016 to add, clarify, or revise recommendations based on new evidence. The committee rates the recommendations as A, B, or C, depending on the quality of evidence, or E for expert consensus or clinical experience.

Effectiveness of progesterone, cerclage and pessary for preventing preterm birth in singleton pregnancies: a systematic review and network meta-analysis.

Background: Preterm birth (PTB) is the leading cause of infant death, but it is unclear which intervention is best to prevent it.

Objectives: To compare progesterone, cerclage and pessary, determine their relative effects and rank them.

Search Strategy: We searched Medline, EMBASE, CINAHL, Cochrane CENTRAL and Web of Science (to April 2016), without restrictions, and screened references of previous reviews.

Accuracy of Postresuscitation Team Debriefings in a Pediatric Emergency Department.

Study Objective: Guideline committees recommend postresuscitation debriefings to improve performance. "Hot" postresuscitation debriefings occur immediately after the event and rely on team recall. We assessed the ability of resuscitation teams to recall their performance in team-based, hot debriefings in a pediatric emergency department (ED), using video review as the criterion standard.