A Method to Improve Availability and Quality of Patient Race Data in an Electronic Health Record System.

Background: Although federal regulations mandate documentation of structured race data according to Office of Management and Budget (OMB) categories in electronic health record (EHR) systems, many institutions have reported gaps in EHR race data that hinder secondary use for population-level research focused on underserved populations. When evaluating race data available for research purposes, we found our institution's enterprise EHR contained structured race data for only 51% (1.6 million) of patients.

Consequences of seafood mislabeling for marine populations and fisheries management.

Over the past decade, seafood mislabeling has been increasingly documented, raising public concern over the identity, safety, and sustainability of seafood. Negative outcomes from seafood mislabeling are suspected to be substantial and pervasive as seafood is the world's most highly traded food commodity. Here we provide empirical systems-level evidence that enabling conditions exist for seafood mislabeling in the United States (US) to lead to negative impacts on marine populations and support consumption of products from poorly managed fisheries.

Ten principles for data sharing and commercialization.

Digital medical records have enabled us to employ clinical data in many new and innovative ways. However, these advances have brought with them a complex set of demands for healthcare institutions regarding data sharing with topics such as data ownership, the loss of privacy, and the protection of the intellectual property. The lack of clear guidance from government entities often creates conflicting messages about data policy, leaving institutions to develop guidelines themselves.

Use of Fitbit Data to Evaluate the Effects of an Athletic Performance and Injury Prevention Training Program on Daily Physical Levels in Underrepresented Minority Female High School Athletes: A Prospective Study.

A marginal number of adolescents meet the recommended guidelines of 60 minutes of moderate to vigorous daily physical activity, and even fewer underrepresented minority females achieve this metric as compared to their male and white counterparts. While potential interventions exist to address these low levels of activity, which is a known risk for acute injuries and chronic disease, there is lack of consensus on the devices used to measure the intensity of daily activity levels. Wearable activity trackers such as Fitbit™ have been utilized to quantify human motion and exercise intensity, but there is little precedence for these measures being assessed in adolescent wearers.

Role of Technology in Self-Assessment and Feedback Among Hospitalist Physicians: Semistructured Interviews and Thematic Analysis.

Background: Lifelong learning is embedded in the culture of medicine, but there are limited tools currently available for many clinicians, including hospitalists, to help improve their own practice. Although there are requirements for continuing medical education, resources for learning new clinical guidelines, and developing fields aimed at facilitating peer-to-peer feedback, there is a gap in the availability of tools that enable clinicians to learn based on their own patients and clinical decisions.

Objective: The aim of this study was to explore the technologies or modifications to existing systems that could be used to benefit hospitalist physicians in pursuing self-assessment and improvement by understanding physicians' current practices and their reactions to proposed possibilities.

Challenges of a simplified opt-out consent process in a neonatal randomised controlled trial: qualitative study of parents' and health professionals' views and experiences.

Background: More effective recruitment strategies like alternative approaches to consent are needed to facilitate adequately powered trials. Witholding Enteral feeds Around Transfusion was a multicentre, randomised, pilot trial that compared withholding and continuing feeds around transfusion. The primary clinical outcome was necrotising enterocolitis.

The effects of prolonged exposure to hypoxia and Florida red tide (Karenia brevis) on the survival and activity of stone crabs.

Florida red tides are harmful algae blooms caused by the dinoflagellate Karenia brevis, which occur along Florida's gulf coast almost annually. In recent years Florida red tide blooms have become more common, frequent, and intense. Florida's southwest coast, from Manatee to Collier County, has experienced repeated and prolonged K.

We All Have a Role to Play: Redressing Inequities for Children Living with CAH and Other Chronic Health Conditions of Childhood in Resource-Poor Settings.

CLAN (Caring and Living as Neighbours) is an Australian-based non-governmental organisation (NGO) committed to equity for children living with chronic health conditions in resource-poor settings. Since 2004, CLAN has collaborated with a broad range of partners across the Asia Pacific region to improve quality of life for children living with congenital adrenal hyperplasia (CAH). This exploratory case study uses the Knowledge to Action (KTA) framework to analyse CLAN's activities for children living with CAH in the Asia Pacific.

SARS-CoV-2 Exposure and Infection Among Health Care Personnel - Minnesota, March 6-July 11, 2020.

Health care personnel (HCP) are at increased risk for infection with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), as a result of their exposure to patients or community contacts with COVID-19 (1,2). Since the first confirmed case of COVID-19 in Minnesota was reported on March 6, 2020, the Minnesota Department of Health (MDH) has required health care facilities* to report HCP exposures to persons with confirmed COVID-19 for exposure risk assessment and to enroll HCP with higher-risk exposures into quarantine and symptom monitoring. During March 6-July 11, MDH and 1,217 partnering health care facilities assessed 21,406 HCP exposures; among these, 5,374 (25%) were classified as higher-risk (3).

Implementation of Guidelines on Prevention of Coercion and Violence (PreVCo) in Psychiatry: Study Protocol of a Randomized Controlled Trial (RCT).

Background: Coercive measures are among the most controversial interventions in psychiatry. There is a large discrepancy between the sheer number of high-quality guidelines and the small number of scientifically accompanied initiatives to promote and evaluate their implementation into clinical routine. In Germany, an expert group developed guidelines to provide evidence- and consensus-based recommendations on how to deal with violence and coercion in psychiatry.

Isatuximab as monotherapy and combined with dexamethasone in patients with relapsed/refractory multiple myeloma.

This phase 2 study evaluated isatuximab as monotherapy or combined with dexamethasone in relapsed/refractory multiple myeloma (RRMM). Patients had RRMM refractory to an immunomodulatory drug (IMiD) and a proteasome inhibitor (PI) or had received ≥3 prior lines of therapy incorporating an IMiD and PI. Patients received isatuximab either as monotherapy (20 mg/kg on days 1, 8, 15, and 22 [once weekly] of cycle 1 followed by 20 mg/kg on days 1 and 15 of subsequent cycles; Isa group) or in combination with dexamethasone (40 mg/d [20 mg/d in patients aged ≥75 years] once weekly; Isa-dex group).

Simple Strategies for Improving Inference with Linked Data: A Case Study of the 1850-1930 IPUMS Linked Representative Historical Samples.

New large-scale linked data are revolutionizing quantitative history and demography. This paper proposes two complementary strategies for improving inference with linked historical data: the use of validation variables to identify higher quality links and a simple, regression-based weighting procedure to increase the representativeness of custom research samples. We demonstrate the potential value of these strategies using the 1850-1930 Integrated Public Use Microdata Series Linked Representative Samples (IPUMS-LRS)-a high quality, publicly available linked historical dataset.

Frailty predicts worse outcomes after intracranial meningioma surgery irrespective of existing prognostic factors.

Objective: Frailty has been recognized as a predictor of adverse surgical outcomes across multiple surgical disciplines, but until now the relationship between frailty and intracranial meningioma surgery has not been studied. The goal of the present study was to determine the relationship between increasing frailty (determined using the modified Frailty Index [mFI]) and intracranial meningioma resection outcomes (including hospital length of stay [LOS], discharge location, and reoperation and readmission rates).

Methods: This is a single-center retrospective cohort study of patients who underwent intracranial meningioma resection between August 2012 and May 2018.

The Effect of Frailty versus Initial Glasgow Coma Score in Predicting Outcomes Following Chronic Subdural Hemorrhage: A Preliminary Analysis.

Background Initial Glasgow Coma Score (iGCS) is a well-known predictor of adverse outcomes following chronic subdural hemorrhage (cSDH). Frailty, i.e.

Single-atom replacement as a general approach towards visible-light/near-infrared heavy-atom-free photosensitizers for photodynamic therapy.

Photodynamic therapy has become an emerging strategy for the treatment of cancer. This technology relies on the development of photosensitizers (PSs) that convert molecular oxygen to cytotoxic reactive oxygen species upon exposure to light. In this study, we have developed a facile and general strategy for obtaining visible light/near-infrared-absorbing PSs by performing a simple sulfur-for-oxygen replacement within existing fluorophores.

Associations between blood volatile organic compounds, and changes in hematologic and biochemical profiles, in a population-based study.

Objective: To investigate the influence of volatile organic compound (VOC) levels in blood, on hematological and serum biochemical parameters in the Canadian population.

Methods: We tested the association between seven selected VOCs and hematological profiles and serum tests reflecting liver and kidney function and glucose metabolism using a cross-sectional study design in 3950 participants of the Canadian Health Measures Survey from 2012 to 2015. We used generalized linear mixed models adjusting for age, sex, smoking, alcohol consumption, BMI, education and household income.

Effect of the COVID-19 Pandemic on Pediatric Intestinal Failure Healthcare Delivery.

Background: The coronavirus disease 2019 (COVID-19) pandemic has influenced how healthcare is being provided, particularly in patients whose diagnoses require multidisciplinary care, such as pediatric intestinal failure (IF). We sought to ascertain the effects of the COVID-19 pandemic on healthcare delivery for pediatric patients with IF.

Methods: A 20-question survey was administered to members of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Intestinal Rehabilitation (IR) Special Interest Group.

Chameleons, red herrings, and false localizing signs in neurocritical care.

False localizing signs (FLS) and other misleading neurological signs have long been an intractable aspect of neurocritical care. Because they suggest an incorrect location or etiology of the pathological lesion, they have often led to misdiagnosis and mismanagement of the patient. Here, we reviewed the existing literature to provide an updated, comprehensive descriptive review of these difficult to diagnose signs in neurocritical care.

Effect of disease-modifying agents and their association with mortality in multi-morbid patients with heart failure with reduced ejection fraction.

Aims: An increasing proportion of patients with heart failure with reduced ejection fraction (HFrEF) have co-morbidities. The effect of these co-morbidities on modes of death and the effect of disease-modifying agents in multi-morbid patients is unknown.

Methods And Results: We performed a prospective cohort study of ambulatory patients with HFrEF to assess predictors of outcomes.

Correlates of seclusion and restraint of patients admitted to psychiatric inpatient treatment via a German emergency room.

Coercive measures in psychiatry are associated with negative consequences for both patients and staff. When it comes to preventing coercive measures, innovative models of care like the Weddinger Modell focusing on recovery, participation and supported decision-making have proven successful. However, observations from clinical practice show that emergency admissions to psychiatric facilities pose a great challenge in this regard and that most coercive measures take place during or shortly after emergency admission.

Demographics and Outcomes of Interhospital Neurosurgical Transfer Patients Undergoing Spine Surgery.

Objective: Interhospital patient transfer (IHT) of patients is common and accounts for a significant portion of health care costs, yet the variables driving neurosurgical IHT have not been systematically described. We analyzed variables that distinguished spine surgery patients who underwent IHT from patients who did not undergo IHT to report on the effect of frailty on IHT.

Methods: A retrospective chart review was performed to collect data on consecutive patients undergoing spinal procedures during 2015-2017.

Long-term performance of left ventricular leads in cardiac resynchronisation therapy.

Background: Cardiac resynchronisation therapy (CRT) confers symptomatic and survival benefits in chronic heart failure with reduced ejection fraction (HFrEF). There remains a paucity of data on long-term performance of left ventricular (LV) leads, particularly with newer quadripolar lead designs.

Methods: This single-centre study utilised an electronic, outpatient HFrEF database to identify CRT recipients (2008-2014).

Symptom Burden, Perceived Control, and Quality of Life Among Patients Living With Multiple Myeloma.

Background: New therapies for multiple myeloma (MM) have improved survival rates but often expose patients to heightened toxicities and prolonged treatment, leading to increasing complications and side effects. We evaluated the association between symptom burden, perceived control over illness, and quality of life (QoL) among a national sample of patients with MM.

Methods: For this observational, cross-sectional study, we used data from the Cancer Experience Registry research initiative to examine symptom- and functioning-related concerns among 289 patients with MM across the illness trajectory.

Addition of Thiotepa to Total Body Irradiation and Cyclophosphamide Conditioning for Allogeneic Hematopoietic Stem Cell Transplantation in Pediatric Acute Lymphoblastic Leukemia.

Total body irradiation (TBI)/cyclophosphamide (CY) is a standard-of-care conditioning regimen in allogeneic hematopoietic stem cell transplant (HSCT) for pediatric acute lymphoblastic leukemia (ALL). This study sought to identify whether the addition of thiotepa (TT) to TBI/CY improves HSCT outcomes for pediatric patients with ALL. A retrospective analysis was performed on 347 pediatric ALL patients who underwent HSCT between 1995 and 2015, with 242 receiving TBI/CY/TT and 105 patients receiving TBI/CY.