Supporting Children's Mental Health Needs in Disasters.

Public health emergencies, including climate-related and manmade disasters such as active shooter incidents, occur regularly in the United States. A comprehensive approach is needed to ensure that children's mental health needs are adequately addressed following disasters. This article summarizes the latest evidence on how health systems can effectively address children's unique developmental, social, emotional, and behavioral needs in the context of disasters.

Real-world comparative claims analysis of a novel single-branched aortic stent graft device versus thoracic endograft placement with extra-anatomic debranching/revascularization in zone 2 aortic disease.

Background: Thoracic endovascular aortic repair (TEVAR) involving landing zone 2 can require extra-anatomic debranching (SR-TEVAR) to ensure left subclavian artery perfusion, resulting in increased costs. A single-branch device (Thoracic Branch Endoprosthesis [TBE], WL Gore, Flagstaff, AZ) provides a total endovascular solution. Comparative cost analysis of patients undergoing zone 2 TEVAR requiring left subclavian artery preservation with TBE versus SR-TEVAR is presented.

Surgical debranching versus branched endografting in zone 2 thoracic endovascular aortic repair.

Background: Left subclavian artery (LSA) revascularization has been recommended for patients undergoing elective thoracic endovascular aortic repair (TEVAR) with a proximal zone 2 landing requiring coverage of the LSA. The clinical standard of care remains surgical LSA revascularization. However, recently, the feasibility of using branched endografts has been demonstrated.

Pediatric exploratory ingestions involving novel pill pack packaging.

Pill packs are novel packaging systems designed to contain multiple medications and increase medication access but are not child-resistant and increase the risk of pediatric ingestions. We present two pediatric ingestion cases suspected to involve pill packs. Case 1 describes a 19-month-old male presenting to the Emergency Department with altered mental status and unsteady gait after a suspected clonidine and buspirone ingestion.

Intravascular lithotripsy during transcarotid arterial revascularization for highly calcified lesions in high-risk patients.

Transcarotid arterial revascularization (TCAR) with flow reversal offers a less invasive option for carotid revascularization in high-risk surgical patients. TCAR has been shown to have similar complication rates for stroke and mortality compared with carotid endarterectomy and lower complication rates compared with transfemoral carotid artery stenting. A relative contraindication for carotid stenting includes heavily calcified lesions.

Human CTC1 promotes TopBP1 stability and CHK1 phosphorylation in response to telomere dysfunction and global replication stress.

CST (CTC1-STN1-TEN1) is a heterotrimeric, RPA-like complex that binds to single-stranded DNA (ssDNA) and functions in the replication of telomeric and non-telomeric DNA. Previous studies demonstrated that deletion of CTC1 results in decreased cell proliferation and telomere DNA damage signaling. However, a detailed analysis of the consequences of conditional CTC1 knockout (KO) has not been fully elucidated.

Outcomes of Open Versus Percutaneous Access for Patients Enrolled in the GREAT Registry.

Background: Arterial access and device delivery in endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR) have evolved from open femoral or iliac artery exposure to selective percutaneous arterial access. Although regional application of percutaneous access for these 2 procedures varies widely, the use of this technique continues to increase. Currently, differences in the use of percutaneous access between EVAR and TEVAR have not been well explored.

Prospective multicentre validation study of a new standardised version of the 400-point hand assessment.

Background: Hand rehabilitation needs valid evaluation tools; the 400-point Hand Assessment (HA) is an exhaustive but not standardised tool. The aim of this study was to validate a standardised version of this test.

Methods: A modified version and a standardised prototype was made for this prospective validation study (four centres, three countries).

Antibody epitope repertoire analysis enables rapid antigen discovery and multiplex serology.

The detection of pathogen-specific antibodies remains a cornerstone of clinical diagnostics. Yet, many test exhibit undesirable performance or are completely lacking. Given this, we developed serum epitope repertoire analysis (SERA), a method to rapidly discover conserved, pathogen-specific antigens and their epitopes, and applied it to develop an assay for Chagas disease caused by the protozoan parasite Trypanosoma cruzi.

3D characterisation and quantification of an offshore freshened groundwater system in the Canterbury Bight.

Although offshore freshened groundwater (OFG) systems have been documented in numerous continental margins worldwide, their geometry, controls and emplacement dynamics remain poorly constrained. Here we integrate controlled-source electromagnetic, seismic reflection and borehole data with hydrological modelling to quantitatively characterise a previously unknown OFG system near Canterbury, New Zealand. The OFG system consists of one main, and two smaller, low salinity groundwater bodies.

Codesigning health and other public services with vulnerable and disadvantaged populations: Insights from an international collaboration.

Background: Codesign has the potential to transform health and other public services. To avoid unintentionally reinforcing existing inequities, better understanding is needed of how to facilitate involvement of vulnerable populations in acceptable, ethical and effective codesign.

Objective: To explore citizens' involvement in codesigning public services for vulnerable groups, identify challenges and suggest improvements.

Delivery of Community-Based Palliative Care: Findings from a Time and Motion Study.

Background: Use of palliative care has increased substantially as the population ages and as evidence for its benefits grows. However, there is limited information regarding which care activities are necessary for delivering high-quality, interdisciplinary, community-based palliative care.

Objectives: This study aims to identify and measure the discrete clinical and administrative activities completed by a multidisciplinary team in a hospice provider-led model for providing community-based palliative care.

Analysis and Visualization of Discrete Fracture Networks Using a Flow Topology Graph.

We present an analysis and visualization prototype using the concept of a flow topology graph (FTG) for characterization of flow in constrained networks, with a focus on discrete fracture networks (DFN), developed collaboratively by geoscientists and visualization scientists. Our method allows users to understand and evaluate flow and transport in DFN simulations by computing statistical distributions, segment paths of interest, and cluster particles based on their paths. The new approach enables domain scientists to evaluate the accuracy of the simulations, visualize features of interest, and compare multiple realizations over a specific domain of interest.

Pilot Study of Massage to Improve Sleep and Fatigue in Hospitalized Adolescents With Cancer.

Background: Adolescents with cancer experience many troubling symptoms, including sleep disruptions that can affect mood and quality of life. Massage is a safe and popular intervention that has demonstrated efficacy in pediatric and adult patients with cancer. This study aimed to assess the feasibility of conducting a massage intervention to help with sleep in hospitalized adolescent oncology patients.

Association Between Proton Pump Inhibitor Exposure and Infection in Elderly, Hospitalized Patients.

This study did not find a statistically significant association between infections and use of proton pump inhibitors.

Enhancing undergraduate community placements: a critical review of current literature.

In the face of the UK-wide policy shift to increased home care, inspiring and enabling the next generation of community nurses is more urgent than ever. The quality of the pre-registration practice learning experience is highly influential on career choices at the point of qualification. Given that 50% of learning by pre-registration students takes place in practice, mentors have a crucial role to play in preparing the next generation of nurses to work in the community.

Later school start time is associated with improved sleep and daytime functioning in adolescents.

Objective: Chronic insufficient sleep is a growing concern among adolescents and is associated with a host of adverse health consequences. Early school start times may be an environmental contributor to this problem. The purpose of this study was to examine the impact of a delay in school start time on sleep patterns, sleepiness, mood, and health-related outcomes.

Hydrogeologic controls on induced seismicity in crystalline basement rocks due to fluid injection into basal reservoirs.

A series of Mb 3.8-5.5 induced seismic events in the midcontinent region, United States, resulted from injection of fluid either into a basal sedimentary reservoir with no underlying confining unit or directly into the underlying crystalline basement complex.

[Reproducibility study of the "400 Points assessment", a measurement of the hand's functional ability].

Objectives: Evaluate the inter-rater and test-retest reproducibility of the "400 Points assessment", a measurement of the functional ability of the hand. The scale included four tests: function of the hand, prehension strengths, handling and displacement of things, and function with both hands.

Methods: Thirty patients with hand injuries were participated.

Fronto-temporal spontaneous resting state functional connectivity in pediatric bipolar disorder.

Background: The recent upsurge in interest about pediatric bipolar disorder (BD) has spurred the need for greater understanding of its neurobiology. Structural and functional magnetic resonance imaging studies have implicated fronto-temporal dysfunction in pediatric BD. However, recent data suggest that task-dependent neural changes account for a small fraction of the brain's energy consumption.

Self-reported health status of students in-processing into military medical advanced individual training.

It is important to be aware of the health and injury status of students in military training settings in order to adequately plan for their progression through required physical training and provision of health care to meet their needs. This paper describes the self-reported health status of students arriving in two medical training Battalions at Ft. Sam Houston.

Origin and extent of fresh paleowaters on the Atlantic continental shelf, USA.

While the existence of relatively fresh groundwater sequestered within permeable, porous sediments beneath the Atlantic continental shelf of North and South America has been known for some time, these waters have never been assessed as a potential resource. This fresh water was likely emplaced during Pleistocene sea-level low stands when the shelf was exposed to meteoric recharge and by elevated recharge in areas overrun by the Laurentide ice sheet at high latitudes. To test this hypothesis, we present results from a high-resolution paleohydrologic model of groundwater flow, heat and solute transport, ice sheet loading, and sea level fluctuations for the continental shelf from New Jersey to Maine over the last 2 million years.

Endotracheal spindle cell lipoma presenting as a chronic cough.

An elderly gentleman with a chronic cough was found to have a large midtracheal lesion on computed tomography scan. Endotracheal extirpation with an electrocautery snare successfully removed the lesion. Histologic and immunohistochemical analyses revealed the lesion to be a spindle cell lipoma.