Prevalence and Patterns of Antibiotic Administration in Neonates With Critical Congenital Heart Defects.

Background: Although data exists demonstrating widespread antibiotic use across other critically ill neonatal populations, there are limited data regarding the frequency of empiric antibiotic use among neonates with critical congenital heart defects (CCHD). The purpose of this study is to describe prevalence of antibiotic treatment in the first 28 days of life in a cohort of neonates with CCHDs.

Methods: A secondary analysis of retrospective electronic health record data of neonates admitted to a Pennsylvania pediatric hospital for cardiac surgery (2016-2020).

Novel, Group-Based Trajectories of Labor Progress in Nulliparous Women With Low-Risk Pregnancies.

Objective: To characterize labor progress among nulliparous women by applying group-based trajectory analysis and examining predictors of group membership.

Design: Retrospective observational.

Setting: An existing biobank and database from a birth hospital in Western Pennsylvania.

The Influence of CYP2B6 Variants and Administration of Propofol on Patient Outcomes after Traumatic Brain Injury.

Management of severe traumatic brain injury (sTBI) typically involves the use of sedation, which inherently results in benefits and risks. The cytochrome P450 enzyme CYP2B6 is involved in the biotransformation of particular drug classes, including many intravenous sedatives. Variants of the gene can lead to decreased systemic clearance of some sedatives, including propofol.

The impact of pain on daily activities in patients with idiopathic inflammatory myopathies: Report from the OMERACT myositis working group.

Background: International focus groups with patients with idiopathic inflammatory myopathies (IIM) conducted by the OMERACT Myositis Working Group over the years demonstrated the pain as an important symptom experienced by these patients. In this study, we aimed to examine the frequency and degree of pain interference, the aspects of daily life impacted by pain, and the factors associated with pain interference in adults with IIM.

Methods: This was a prospective observational study with two visits.

A Quality Improvement Project to Increase Compliance With a Facility Protocol on Surgical Antimicrobial Prophylaxis.

Surgical site infections (SSIs) contribute to negative outcomes for patients and health care organizations. Compliance with clinical practice guidelines likely can help prevent SSIs. An interdisciplinary team at a regional referral center in Michigan sought to reduce SSIs by improving compliance with the facility's preoperative antibiotic selection, dosing, timing, and redosing protocol.

A patient centered assessment of the 2016 ACR-EULAR Myositis Response Criteria: evaluating the meaningfulness of response.

Objectives: The ACR-EULAR Myositis Response Criteria (Total Improvement Score [TIS]) is a composite measure calculated using changes in myositis core set measures. It is unclear if achieving improvement per TIS reflects improvement in any symptoms of myositis patients. In this study, we examined the association between achieving TIS improvement and patient-centered outcome measures (PCOMs).

Pain is Common in Myositis and Associated with Disease Activity.

Background: Understanding pain in myositis remains challenging. This study aimed to assess patient-reported pain and its correlation with myositis core set measures (CSMs), patient-reported outcomes (PROs), and functional measures.

Methods: Fifty subjects underwent baseline, 3-month, and 6-month assessments, evaluating myositis CSMs, functional measures, and patient-reported outcomes.

COVID-19 pandemic's relationship with enrollment at US Alzheimer's Disease Research Centers.

Introduction: We aimed to characterize the COVID-19 pandemic's relationship with enrollment in US Alzheimer's Disease Research Centers (ADRCs).

Methods: Using data on 10,105 participants from 30 ADRCs, we conducted interrupted time series analyses to assess the relationship of the pandemic with enrollment and calculate projected dates of enrollment recovery.

Results: Participants enrolled during the pandemic (vs pre-pandemic) were more likely to have dementia and be referred by health professionals.

Neonatal Diet Type and Associations With Adverse Feeding Outcomes in Neonates With Critical Congenital Heart Defects.

Background: Neonates with critical congenital heart defects (CCHD neonates) experience high rates of feeding intolerance, necrotizing enterocolitis (NEC), and malnutrition. The benefits of human milk and direct chest/breastfeeding are well known, but research is limited in CCHD neonates. Therefore, the purpose of this study is to examine the impact of neonatal diet and feeding modality on the incidence of feeding intolerance, NEC, and malnutrition among a cohort of CCHD neonates.

Serum cytokine profiles of adults with idiopathic inflammatory myopathies.

Objectives: There is a paucity of available biomarkers of disease activity in idiopathic inflammatory myopathies (IIM), and serum cytokines/chemokines hold potential as candidate biomarkers. We aimed to determine serum cytokine profiles of IIM patients with active disease as compared to patients in remission and healthy controls.

Methods: The IIM patients with active disease (included patients enrolled in repository corticotropin injection trial), in remission, and healthy controls were enrolled in this cross-sectional observational study.

Effects of socioeconomic status and race on survival and treatment in metastatic breast cancer.

Race and socioeconomic factors affect outcomes in breast cancer. We aimed to assess the effect of race and neighborhood socioeconomic status (SES) on overall survival and treatment patterns in patients with metastatic breast cancer (MBC). This is a retrospective cohort study involving patients (N = 1246) with distant breast cancer metastases diagnosed at UPMC Magee Women's Breast Cancer Clinic from 2000-2017.

Discordance between patient- and physician-reported disease activity in adult idiopathic inflammatory myopathy.

Objectives: Patient-reported global disease activity (patient-global) is a myositis core set measure. Understanding the drivers of patient-global is important in patient assessment, and disagreements between physician and patient perception of disease activity may negatively impact shared decision making. We examined the determinants of patient-global and discordance between patient-global and physician-reported global disease activity (physician-global) in idiopathic inflammatory myopathies (IIMs).

Association of Life's Simple 7 with mild cognitive impairment in community-dwelling older adults in China: a cross-sectional study.

Background: Life's Simple 7 (LS7), a metric composed of seven intervenable cardiovascular risk factors, is initiated by the American Heart Association to improve cardiovascular health. The components of LS7 have been reported as risk factors for dementia. However, few studies investigated the association between LS7 metric and mild cognitive impairment (MCI).

Effect of antenatal milk expression education on lactation outcomes in birthing people with pre-pregnancy body mass index ≥25: protocol for a randomized, controlled trial.

Background: Birthing people with pre-pregnancy body mass indices (BMIs) ≥ 25 kg/m, particularly those without prior breastfeeding experience, are at increased risk for suboptimal lactation outcomes. Antenatal milk expression (AME) may be one way to counteract the negative effects of early infant formula supplementation common in this population.

Methods: This ongoing, randomized controlled trial in the United States evaluates the efficacy of a telelactation-delivered AME education intervention versus an attention control condition on lactation outcomes to 1 year postpartum among 280 nulliparous-to-primiparous, non-diabetic birthing people with pre-pregnancy BMI ≥ 25 kg/m.

Design of Lung Transplant Go (LTGO): A randomized controlled trial evaluating the efficacy of a telerehabilitation behavioral exercise intervention to improve physical activity, physical function, and blood pressure control after lung transplantation.

Background: Lung transplantation is an established treatment option for persons with advanced lung disease. After transplantation, lung function typically returns to near normal levels, however exercise capacity remains low due to chronic deconditioning, limited physical function, and inactive lifestyles which undermine the intended benefits of the highly selective, resource-intensive transplant procedure. Pulmonary rehabilitation is recommended to improve fitness and activity tolerance, however due to multiple barriers, lung transplant recipients either never participate, or fail to complete, pulmonary rehabilitation programs.

Use of the Modified Early Warning Score by Medical-Surgical Nurses to Initiate the Rapid Response Team: Impact on Patient Outcomes.

Background: Cardiac arrests are often preceded by several hours of physiological deterioration that may go undetected.

Local Problem: Cardiac arrests frequently occurred on medical-surgical units without prior rapid response team intervention.

Methods: A pre/postintervention design was used to evaluate a protocol to guide the use of the Modified Early Warning Score (MEWS) by medical-surgical nurses to escalate the care of deteriorating adult patients.

Mechanisms by Which Cultural-Centric Narrative Influences Interest in ADRD Research Among African American Adults.

Background And Objectives: Insufficient ethnoracial diversity is a pervasive challenge in Alzheimer's disease (AD) research. The Recruitment Innovations for Diversity Enhancement (RIDE) is grounded in the premise that culturally informed narratives of research participation can inspire individuals from a given culture-sharing group to consider research enrollment. This study examines factors associated with interest in AD research among Black or African American adults following exposure to RIDE narrative campaign materials.

Shift work organization on nurse injuries: A scoping review.

Background: Extended work hours and shift work can result in mistimed sleep, excessive sleepiness, and fatigue, which affects concentration and cognition. Impaired concentration and cognition negatively affect employee safety.

Objective: To examine the evidence of the impact of shift work organization, specifically work hours and scheduling, on nurse injuries including needlestick and sharps injuries, drowsy driving and motor vehicle crashes, and work-related accidents causing a near miss or actual injury to the nurse.

Evidence-based interconversion of the Glasgow Outcome and modified Rankin scales: pitfalls and best practices.

Objective: The aim of this study was to provide the evidence base to guide interconversion of the modified Rankin Scale (mRS) and Glasgow Outcome Scale (GOS) in neurological research.

Methods: A retrospective analysis of paired mRS and GOS recordings was conducted using datasets with the following selection criteria: (1) patients had haemorrhagic stroke, (2) simultaneous mRS and GOS measurements were available, and (3) data sharing was possible. The relationship between mRS and GOS was assessed using correlation analysis.

A Genome-Wide Association Study of Outcome After Aneurysmal Subarachnoid Haemorrhage: Discovery Analysis.

Candidate gene studies have identified genetic variants associated with clinical outcomes following aneurysmal subarachnoid haemorrhage (aSAH), but no genome-wide association studies have been performed to date. Here we report the results of the discovery phase of a two-stage genome-wide meta-analysis of outcome after aSAH. We identified 157 independent loci harbouring 756 genetic variants associated with outcome after aSAH (p < 1 × 10), which require validation.

An evaluation of documentation and follow-up on the use of SBIRT in an outpatient behavioral health clinic through the use of the CRAFFT tool.

Background: Substance use among adolescents continues to present as a public health concern. Screening, Brief Intervention and Referral to Treatment (SBIRT) is an effective process that has been proven to identify, reduce, and prevent at-risk use of substances when appropriately applied. The CRAFFT tool is an evidence-based screen used to identify substance use in adolescents aged 12-21 years of age.

Nurse Leader Preparation for Disasters: A Cross-sectional Survey.

Objective: The aim of this study was to evaluate nurse leader confidence in emergency management and disaster preparedness.

Background: There is a dearth of evidence in the literature regarding the preparation of nurse leaders to manage emergencies and disasters. Research suggests significant gaps in nurse leader confidence across roles and in structured education that prepares nurse leaders across the spectrum of experience to manage in a crisis.

Temporal Variability in Inflammatory Gene Methylation and Delirium in Critically Ill Patients.

Background: Intensive care unit (ICU) delirium is associated with a proinflammatory state and poor outcomes. An epigenetic mechanism may modify inflammation.

Objective: To identify inflammatory gene methylation trajectory groups and explore their clinical and demographic variability.

Adoption of Consensus Guidelines for Safe Prevention of the Primary Cesarean Delivery by Freestanding Birth Centers.

Introduction: Slow or arrested progress in labor is the most frequent (64%) indication for nonemergent transfer of laboring people from freestanding birth centers to the hospital. After the 2014 publication of the Consensus Statement on Safe Prevention of Primary Cesarean Delivery (Consensus Statement), many freestanding birth centers changed their clinical practice guidelines to allow more time for active labor in the birth center prior to hospital transfer. The result of these changes has not been evaluated in birth centers.