A mobile application for STEMI care optimization: Pilot implementation project report.

Background: Clinical outcomes of patients presenting with STEMI are significantly improved by reducing time from vessel occlusion to coronary blood flow restoration. In an effort to improve outcomes, we developed a secure mobile application, STEMIcathAID, and designed a pilot project implementing the app into the workflow for STEMI patients transfer. The aim of the study is to assess the impact of the app on key metrics for STEMI transfer before (historic) and after app launch.

Diagnostic and surgical treatment for traumatic bile peritonitis in dogs and cats.

Objective: To describe short-term outcomes of dogs and cats undergoing surgery for traumatic bile peritonitis.

Animals: 13 dogs and 4 cats.

Methods: Multi-institutional, retrospective study.

The effect of flow rate and catheter diameter on hemolysis during blood transfusions using canine packed red blood cells.

Objective: To evaluate the degree of hemolysis in canine packed RBCs at varying catheter sizes and flow rates as determined by RBC count, Hct, hemoglobin, creatine phosphokinase, and phosphorus. This study hypothesized that changes in flow rate and catheter diameter would change the degree of hemolysis.

Sample: A fresh unit of canine RBCs.

The 21st Century Cures Act and Emergency Medicine - Part 1: Digitally Sharing Notes and Results.

Among the provisions of the 21st Century Cures Act is the mandate for digital sharing of clinician notes and test results through the patient portal of the clinician's electronic health record system. Although there is considerable evidence of the benefit to clinic patients from open notes and minimal apparent additional burden to primary care clinicians, emergency department (ED) note sharing has not been studied. With easier access to notes and results, ED patients may have an enhanced understanding of their visit, findings, and clinician's medical decisionmaking, which may improve adherence to recommendations.

Mobile application to optimize care for ST-segment elevation myocardial infarction patients in a large healthcare system, STEMIcathAID: rationale and design.

Aims: Technological advancements have transformed healthcare. System delays in transferring patients with ST-segment elevation myocardial infarction (STEMI) to a primary percutaneous coronary intervention (PCI) centre are associated with worse clinical outcomes. Our aim was to design and develop a secure mobile application, STEMIcathAID, streamlining communication, and coordination between the STEMI care teams to reduce ischaemia time and improve patient outcomes.

Accuracy of Patient-Specific 3D Printed Drill Guides in the Placement of a Canine Coxofemoral Toggle Pin through a Minimally Invasive Approach.

Objective:  The aim of this study was to evaluate the accuracy of patient-specific three-dimensional printed drill guides (3D-PDG) for the placement of a coxofemoral toggle via a minimally invasive approach.

Materials And Methods:  Pre-procedure computed tomography (CT) data of 19 canine cadaveric hips were used to design a cadaver-specific 3D-PDG that conformed to the proximal femur. Femoral and acetabular bone tunnels were drilled through the 3D-PDG, and a coxofemoral toggle pin was placed.

Integrative analysis of loss-of-function variants in clinical and genomic data reveals novel genes associated with cardiovascular traits.

Background: Genetic loss-of-function variants (LoFs) associated with disease traits are increasingly recognized as critical evidence for the selection of therapeutic targets. We integrated the analysis of genetic and clinical data from 10,511 individuals in the Mount Sinai BioMe Biobank to identify genes with loss-of-function variants (LoFs) significantly associated with cardiovascular disease (CVD) traits, and used RNA-sequence data of seven metabolic and vascular tissues isolated from 600 CVD patients in the Stockholm-Tartu Atherosclerosis Reverse Network Engineering Task (STARNET) study for validation. We also carried out in vitro functional studies of several candidate genes, and in vivo studies of one gene.

Ex Vivo Biomechanical Comparison of Titanium Locking Plate, Stainless Steel Nonlocking Plate, and Tie-in External Fixator Applied by a Dorsal Approach on Ostectomized Humeri of Pigeons ().

To compare the bending strength of a locking plate (LP), nonlocking plate (NLP), and an external skeletal fixator intramedullary pin (ESF-IM) tie-in fixation applied by a dorsal approach in an avian humerus fracture model, 5 left humeri obtained from pigeon () cadavers were randomly assigned to each repair technique ( = 15). The ESF-IM group was repaired with a 0.062-inch intramedullary pin tied-in with two 0.

Effect of Clinical Decision Support on Appropriateness of Advanced Imaging Use Among Physicians-in-Training.

Objective: Clinical decision support (CDS) tools have been shown to reduce inappropriate imaging orders. We hypothesized that CDS may be especially effective for house staff physicians who are prone to overuse of resources.

Materials And Methods: Our hospital implemented CDS for CT and MRI orders in the emergency department with scores based on the American College of Radiology's Appropriateness Criteria (range, 1-9; higher scores represent more-appropriate orders).

Short-Term Outcomes of Treatment of Hip Osteoarthritis With 4 Bone Marrow Concentrate Injections: A Case Series.

The use of mesenchymal stem cells from bone marrow concentrate (BMC) has become an increasingly popular option as an alternative to total joint replacement. Although there is evidence to support the use of BMC injections to improve quality of life for patients with knee osteoarthritis (OA), there is limited evidence to support its use in patients with hip OA. This case series provides the short-term outcomes of 4 hip OA patients who each underwent 4 BMC injections.

Ex vivo biomechanical evaluation of pigeon (Columba livia) cadaver intact humeri and ostectomized humeri stabilized with caudally applied titanium locking plate or stainless steel nonlocking plate constructs.

OBJECTIVE To evaluate mechanical properties of pigeon (Columba livia) cadaver intact humeri versus ostectomized humeri stabilized with a locking or nonlocking plate. SAMPLE 30 humeri from pigeon cadavers. PROCEDURES Specimens were allocated into 3 groups and tested in bending and torsion.

PREDICTIVE MODELING OF HOSPITAL READMISSION RATES USING ELECTRONIC MEDICAL RECORD-WIDE MACHINE LEARNING: A CASE-STUDY USING MOUNT SINAI HEART FAILURE COHORT.

Reduction of preventable hospital readmissions that result from chronic or acute conditions like stroke, heart failure, myocardial infarction and pneumonia remains a significant challenge for improving the outcomes and decreasing the cost of healthcare delivery in the United States. Patient readmission rates are relatively high for conditions like heart failure (HF) despite the implementation of high-quality healthcare delivery operation guidelines created by regulatory authorities. Multiple predictive models are currently available to evaluate potential 30-day readmission rates of patients.

MIP-3β/CCL19 is associated with the intrathecal invasion of mononuclear cells in neuroinflammatory and non-neuroinflammatory CNS diseases in dogs.

Background: Chemokines such as MIP-3β/CCL19 are important factors in the mechanism of cell migration and pathogenesis of central nervous system (CNS) inflammatory reactions. The hypothesis of this study is that CCL19, also known as MIP-3β, is involved in the pathogenesis of inflammatory and non-inflammatory CNS diseases of dogs. Experiments were performed on cerebrospinal fluid (CSF) and serum samples of dogs affected with steroid responsive meningitis-arteritis (SRMA) during the acute phase as well as during treatment.

Periorbital adenocarcinoma in a bearded dragon (Pogona vitticeps).

A 4.5-year-old female bearded dragon (Pogona vitticeps) presented for periorbital swelling affecting the left eye. A well-organized, hypoechoic mass was noted ventral and medial to the globe on ocular ultrasound.

Coronary heart disease in the elderly: identifying established and subclinical disease with stress testing.

Although cardiovascular disease is a major cause of mortality, morbidity, and healthcare expense in the United States, diagnosis in elderly patients, especially those who are asymptomatic, can be challenging. Noninvasive testing offers an opportunity to identify these patients, but guidelines reflect uncertainty of the impact of diagnosis on long-term outcomes. We review the role of different forms of noninvasive testing in both symptomatic and asymptomatic patients, as well as patients under consideration for elective surgery.

Adjuvant therapy with methylene blue in the treatment of right ventricular failure after pulmonary embolectomy.

Severe pulmonary embolism often leads to right ventricular failure after surgical embolectomy secondary to ischaemia reperfusion injury and acute lung injury (ALI). Acute right ventricular dysfunction is traditionally treated with inotropes and vasopressors to maintain cardiac output and coronary perfusion as well as selective pulmonary vasodilators to provide right ventricular afterload reduction. We report the first case of utilisation of methylene (MB) in a patient with acute right ventricular failure and vasoplegic shock after surgical pulmonary embolectomy.

Lipid management in the geriatric patient.

Elderly individuals are at higher risk for cardiovascular events, and thus this population stands to gain a greater reduction in events from lipid therapy than younger individuals. Multiple primary and secondary prevention trials have demonstrated that the benefits of statins in geriatric patients are equivalent to, or greater than, those seen in younger patients. Combination therapy with non-statin agents should be considered in patients who do not meet cholesterol goals or who have concomitant hypertriglyceridemia or low levels of high-density lipoprotein cholesterol.

Complex genomic rearrangement in CCS-LacZ transgenic mice.

The cardiac conduction system (CCS)-lacZ insertional mouse mutant strain genetically labels the developing and mature CCS. This pattern of expression is presumed to reflect the site of transgene integration rather than regulatory elements within the transgene proper. We sought to characterize the genomic structure of the integration locus and identify nearby gene(s) that might potentially confer the observed CCS-specific transcription.

Red tides in the Gulf of Mexico: Where, when, and why?

[1] Independent data from the Gulf of Mexico are used to develop and test the hypothesis that the same sequence of physical and ecological events each year allows the toxic dinoflagellate Karenia brevis to become dominant. A phosphorus-rich nutrient supply initiates phytoplankton succession, once deposition events of Saharan iron-rich dust allow Trichodesmium blooms to utilize ubiquitous dissolved nitrogen gas within otherwise nitrogen-poor sea water. They and the co-occurring K.

Effects of angiotensin II on expression of the gap junction channel protein connexin43 in neonatal rat ventricular myocytes.

Objectives: To elucidate signal transduction pathways regulating expression of myocardial gap junction channel proteins (connexins) and to determine whether mediators of cardiac hypertrophy might promote remodeling of gap junctions, we characterized the effects of angiotensin II on expression of the major cardiac gap junction protein connexin43 (Cx43) in cultured neonatal rat ventricular myocytes.

Background: Remodeling of the distribution of myocardial gap junctions appears to be an important feature of anatomic substrates of ventricular arrhythmias in patients with heart disease. Remodeling of intercellular connections may be initiated by changes in connexin expression caused by chemical mediators of the hypertrophic response.