Economic impact of prolonged tracheal extubation times on operating room time overall and for subgroups of surgeons: a historical cohort study.

Background: Prolonged tracheal extubation time is defined as an interval ≥ 15 min from the end of surgery to extubation. An earlier study showed that prolonged extubations had a mean 12.4 min longer time from the end of surgery to operating room (OR) exit.

The Value of Auditing the Frequency of Inhalational Anesthetics With a Combination of Very Low Bispectral Index and High Fraction of the Age-Adjusted Minimum Alveolar Concentration.

Background: Previously, a depth of anesthesia bispectral index (BIS™) <45 was considered lowand found to have no clinical benefit. A BIS <35 was considered very low and was not only without evident clinical benefit but also associated with a greater risk of postoperative delirium. We considered the association between BIS and the anesthetic dose of inhalational agents, quantified using the minimum alveolar concentration (MAC) fraction, which was the patient's end-tidal inhalational agent concentration divided by the agent's altitude- and age-adjusted minimum alveolar percentage concentration.

Analysis of longitudinal patterns of child maltreatment reports in the United States.

Background: Child maltreatment is a continuous and prevalent issue, and victims of maltreatment often suffer adverse effects well into adulthood. Since child maltreatment rates tend to be clustered geographically and temporally, intervention programs are best implemented at a local level, targeting local risk factors for sustained and effective reduction over time.

Objective: Quantifying geographic variation in child maltreatment rate trajectories can help states identify local risk factors to guide program development and resource allocation.

Literature search for healthcare management decision-making on how to increase productivity by performing more surgical cases in the same staffed time.

This report shows an example of using literature search for healthcare management decision making, specifically, how anesthesiologists can enhance operating room (OR) productivity. A search was conducted using Scopus to gather relevant research on increasing surgical case numbers. References and citations were then examined.

The impact of terrorist attacks on cultural values as expressed in books.

We assessed the effects of the 9/11/2001 terrorist attacks on the salience of moral words and phrases in the United States, Great Britain, and Spanish-speaking countries, focusing particularly on those phrases related to authority and loyalty. Our predictions were that the 9/11 attacks would increase the salience of authority phrases suggestive of disorder ("chaos", "disobedience", etc, labeled authority-vice) and decrease words and phrases suggestive of organization ("hierarchy", "obedient", etc: authority-virtue) in books published in the United States. Similarly, we anticipated that the salience of phrases consistent with fidelity to members of one's social group ("allegiance", "one for all", loyalty-virtue), would decrease, and those suggestive of social corrosion ("betrays", "back stabs", loyalty-vice) would increase.

The Video Manipulation Effect (VME): A quantification of the possible impact that the ordering of YouTube videos might have on opinions and voting preferences.

Recent research has identified a number of powerful new forms of influence that the internet and related technologies have made possible. Randomized, controlled experiments have shown, for example, that when results generated by search engines are presented to undecided voters, if those search results favor one political candidate over another, the opinions and voting preferences of those voters can shift dramatically-by up to 80% in some demographic groups. The present study employed a YouTube simulator to identify and quantify another powerful form of influence that the internet has made possible, which we have labeled the Video Manipulation Effect (VME).

Applications of a Rayleigh-Taylor model to direct-drive laser fusion.

This paper presents a simple physics-based model for the interpretation of key metrics in laser direct drive. The only input parameters required are target scale, in-flight aspect ratio, and beam-to-target radius, and the importance of each has been quantified with a tailored set of cryogenic implosion experiments. These analyses lead to compact and accurate predictions of the fusion yield and areal density as a function of hydrodynamic stability, and they suggest new ways to take advantage of direct drive.

Clinical- and Cost-Effectiveness of Liver Disease Staging in Hepatitis C Virus Infection: A Microsimulation Study.

Background: Liver disease assessment is a key aspect of chronic hepatitis C virus (HCV) infection pre-treatment evaluation but guidelines differ on the optimal testing modality given trade-offs in availability and accuracy. We compared clinical outcomes and cost-effectiveness of common fibrosis staging strategies.

Methods: We simulated adults with chronic HCV receiving care at US health centers through a lifetime microsimulation across five strategies: (1) no staging or treatment (comparator), (2) indirect serum biomarker testing (Fibrosis-4 index [FIB-4]) only, (3) transient elastography (TE) only, (4) staged approach: FIB-4 for all, TE only for intermediate FIB-4 scores (1.

Petroleum Jelly-Based Foreign Body in the Nasopharynx: A Case Report.

Nasotracheal intubation can reveal unexpected findings like a foreign body in the airway. In such instances, expeditious decision-making is crucial to achieve ideal outcomes. This case report describes a petroleum jelly-based foreign body discovered in the nasopharynx during nasotracheal intubation and the subsequent airway management.

Feasibility and Acceptability of a Palliative Care Intervention Among Older or Adults with Advanced CKD and their Caregivers.

Background: In non-nephrology settings, specialty Palliative Care (PC) improves decision-making, patient's quality of life (QoL), advance care planning (ACP), and certain indicators of the quality of end-of-life (EoL) care. This pilot RCT explored the feasibility and acceptability of a PC intervention, CKD-EDU, for older adults ≥75 years with eGFR ≤25 ml/min and their caregivers.

Methods: Participants randomized to the control group received standard nephrology care and routine kidney therapy (KT) education, while those randomized to CKD-EDU received a decision aid and met with a PC clinician up to three times to discuss KT decisions and EoL planning.

Racial and Ethnic Disparities in Hepatitis C Care in Reproductive-Aged Women With Opioid Use Disorder.

Background: In the United States, hepatitis C virus (HCV) diagnoses among reproductive-aged women are increasing amidst the ongoing opioid and drug overdose epidemic. While previous studies document racial and ethnic disparities in HCV testing and treatment in largely male populations, to our knowledge no national studies analyze these outcomes in reproductive-aged women with opioid use disorder (OUD).

Methods: We analyzed data from a cohort of reproductive-aged women (aged 15-44 years) with diagnosed OUD captured in the TriNetX Research Network, a network of electronic health records from across the United States.

The multifunctional roles of the extracellular matrix in the sessile life of the zygnematophyte Penium margaritaceum: stick, glide and cluster.

Adhesion and consequent adoption of a sessile habit is a common feature of many green algae and was likely a key mechanism in terrestrialization by an ancient zygnematophyte (i.e., the Zygnematophyceae, the group of algae ancestral to land plants).

Palliative Care Acceptability for Older Adults with Advanced CKD: A Qualitative Study of Patients and Nephrologists.

Rationale & Objective: Older adults in the United States often receive kidney therapies that do not align with their goals. Palliative care (PC) specialists are experts in assisting patients with the goals of care discussions and decision support, yet views and experiences of older patients who have received PC while contemplating kidney therapy decisions and their nephrologists remain unexplored. We evaluated the acceptability of CKD-EDU, a PC-based kidney therapy decision support intervention for adults ≥75 years of age.

Aberrant growth and expansion in Penium margaritaceum triggered by disruption of microtubules and the cell wall.

Penium margaritaceum, a unicellular zygnematophyte (Streptophyta), was employed to elucidate changes in cell expansion when cells were challenged with the fungal pectinolytic enzyme, pectate lyase, and/or the microtubule disrupting agent, amiprophos-methyl (APM). Microtubule disruption by APM results in significant swelling at expansion zones. These swollen zones provide an easy marker for the location of expansion zones, particularly in cells with altered cell wall pectin.

Since the COVID-19 pandemic, approximately 90% of elective anesthetics have been ambulatory: A retrospective analysis of statewide data in Florida from 2010 through 2022.

Background: When the vast majority (e.g., ≈90%) of a specialty's elective (scheduled) care is ambulatory (i.

Comparing Nephrologists' Self-Reported Decision-Making Skills and Treatment Attitudes With Their Patients' Experiences of Making Kidney Therapy Decisions and Receiving Nephrology Care.

Background: Dialysis is often initiated in the United States without exploring patients' preferred decision-making style, and conservative kidney management (CKM) is infrequently presented. To improve kidney therapy (KT) decision-making, research on nephrologists' comfort with various decision-making styles, attitudes towards CKM, and reports of patients' lived experiences with KT decision-making is needed.

Methods: We surveyed 28 nephrologists and 58 of their patients aged ≥75 years.

Inhalational Agent Dosing Behaviors of Anesthesia Practitioners Cause Variability in End-Tidal Concentrations at the End of Surgery and Prolonged Times to Tracheal Extubation.

Introduction: Prolonged times to tracheal extubation are intervals from the end of surgery to extubation ≥15 minutes. We examined why there are associations with the end-tidal inhalational agent concentration as a proportion of the age‑adjusted minimum alveolar concentration (MAC fraction) at the end of surgery.

Methods: The retrospective cohort study used 11.

Racial and Ethnic Disparities in Testing of Hepatitis C Virus-Exposed Children Across the United States.

Background: Despite rising hepatitis C virus (HCV) prevalence among pregnant individuals in the United States, HCV testing among exposed infants remains low. Although recent guidelines recommend early ribonucleic acid (RNA) testing for HCV-exposed children to help improve testing rates, national studies describing factors associated with HCV testing and the type of testing completed are lacking.

Methods: In this retrospective national study, we characterized HCV testing and care among HCV-exposed infants born between 2010 and 2020 captured in the electronic health record-based TriNetX Research Network.