Enhancing the psychological well-being and sleep quality of healthcare providers with a multimodal psychological support program: a randomized controlled trial.

Background: The COVID-19 pandemic significantly challenged the global healthcare system, especially frontline healthcare professionals, such as those working in intensive care units (ICUs). In late 2022, a sudden increase in COVID-19 cases in China led to a large number of ICU admissions, requiring new ICU staff (non-ICU professionals to work in ICUs), exacerbating their stress. This study aimed to develop an effective stress management strategy for new ICU professionals, focusing on reducing the detrimental effects of stress on their psychological state.

Preoperative hypoxic biomarkers and postoperative delirium in patients with obstructive sleep apnea.

Purpose: Postoperative delirium (POD) in patients with obstructive sleep apnea (OSA) is associated with increased mortality and healthcare costs. In this study, we investigated the association of OSA risk, serum biomarkers for central nervous ischemia (S100B and NSE), and POD.

Methods: After research ethics approval, patients completed the STOP BANG assessment before undergoing elective surgery.

Prophylactic tranexamic acid for reducing blood loss in pregnant females undergoing cesarean section: A systematic review and meta-analysis.

Objective: We aim to assess the efficacy of prophylactic tranexamic acid (TXA) in reducing blood loss after cesarean section (CS).

Methods: We systematically searched PubMed and Embase for randomized controlled trials published between 1990 and 2023 to conduct a meta-analysis on adult women undergoing CS and receiving prophylactic TXA.

Results: Twenty-four trials, comprising 19 584 participants, were included.

Efficacy of bougie first approach for endotracheal intubation with video laryngoscopy during continuous chest compression: a randomized crossover manikin trial.

Background: Endotracheal intubation is challenging during cardiopulmonary resuscitation, and video laryngoscopy has showed benefits for this procedure. The aim of this study was to compare the effectiveness of various intubation approaches, including the bougie first, preloaded bougie, endotracheal tube (ETT) with stylet, and ETT without stylet, on first-attempt success using video laryngoscopy during chest compression.

Methods: This was a randomized crossover trial conducted in a general tertiary teaching hospital.

Machine learning approach for predicting post-intubation hemodynamic instability (PIHI) index values: towards enhanced perioperative anesthesia quality and safety.

Background: Adequate preoperative evaluation of the post-intubation hemodynamic instability (PIHI) is crucial for accurate risk assessment and efficient anesthesia management. However, the incorporation of this evaluation within a predictive framework have been insufficiently addressed and executed. This study aims to developed a machine learning approach for preoperatively and precisely predicting the PIHI index values.

Constructing green superhydrophilic and superoleophobic COFs-MOFs hybrid-based membrane for efficiently emulsion separation and synchronous removal of microplastics, dyes, and pesticides.

Oil spills and micropollutants have become thorny environmental issues, posing serious threat to ecosystem and human health. To settle such dilemma, this study successfully constructed a robust and environmentally-friendly MOFs-COFs hybrid-based membrane (FS-50/COF(MATPA)-MOF(Zr)/PDA@PVDF) for the first time through solution synthesis and solvothermal method, combined with surface modification of FS-50 molecule. Importantly, we employed a simple two-step strategy to obtain the high-aspect-ratio MOFs fibers: (1) solvent regulation to generate smaller needle-like whiskers during the in-situ growth of MOFs on COFs; (2) high pressure induced directional crystallization in filtration process.

Intraoperative Use of Phenylephrine versus Ephedrine and Postoperative Delirium: A Multicenter Retrospective Cohort Study.

Background: The treatment of intraoperative hypotension with phenylephrine may impair cerebral perfusion through vasoconstriction, which has been linked to postoperative delirium. The hypothesis was that intraoperative administration of phenylephrine, compared to ephedrine, is associated with higher odds of postoperative delirium.

Methods: A total of 103,094 hospitalized adults undergoing general anesthesia for noncardiac, non-neurosurgical procedures between 2008 and 2020 at two tertiary academic healthcare networks in Massachusetts were included in this multicenter hospital registry study.

Engineering green MOF-based superhydrophobic sponge for efficiently synchronous removal of microplastics and pesticides from high-salinity water.

Microplastics (MPs) and pesticides are becoming an intractable environmental issue due to their wide spreading and non-degradable nature, posing serious threat to ecosystem and human health. To settle such dilemma, this work reasonably designed a superhydrophobic MOF-based coated sponge (ODSOSS/TiO/Ni-MOF/PDA@Sponge) through the combination of an environmentally friendly in-situ supersaturated coprecipitation and polysesiloxane modification method. Among them, (I) the introduction of polydopamine (PDA) not only improves the adhesion between coatings and sponge, but also enhances the growth of MOF structure through complexation.

Bias in artificial intelligence algorithms and recommendations for mitigation.

The adoption of artificial intelligence (AI) algorithms is rapidly increasing in healthcare. Such algorithms may be shaped by various factors such as social determinants of health that can influence health outcomes. While AI algorithms have been proposed as a tool to expand the reach of quality healthcare to underserved communities and improve health equity, recent literature has raised concerns about the propagation of biases and healthcare disparities through implementation of these algorithms.

Association of Obstructive Sleep Apnea With Postoperative Delirium in Procedures of Moderate-to-High Complexity: A Hospital-Registry Study.

Background: Patients suffering from obstructive sleep apnea (OSA) experience chronic sleep disturbances and desaturation, factors that have been associated with postoperative delirium and that can be aggravated after anesthesia for complex procedures. We investigated whether OSA is associated with delirium after anesthesia, and whether this association is modified by procedural complexity.

Methods: Hospitalized patients ≥60 years who underwent general anesthesia or procedural sedation for procedures of moderate-to-high complexity between 2009 and 2020 at a tertiary health care network in Massachusetts were included.

Prevalence and association of non-medical cannabis use with post-procedural healthcare utilisation in patients undergoing surgery or interventional procedures: a retrospective cohort study.

Background: There is paucity of data regarding prevalence and key harms of non-medical cannabis use in surgical patients. We investigated whether cannabis use in patients undergoing surgery or interventional procedures patients was associated with a higher degree of post-procedural healthcare utilisation.

Methods: 210,639 adults undergoing non-cardiac surgery between January 2008 and June 2020 at an academic healthcare network in Massachusetts, USA, were included.

Cognitive function in older patients and their stress challenge using different anesthesia regimes: a single center observational study.

Background: With increasing age older patients are at higher risk for cognitive decline after surgery. Even tailored anesthesia procedures in older patients remain a high risk for postoperative cognitive disorder. Additional stress derived from anxiety and anesthesia itself can negatively impact postoperative cognitive outcomes.

Dose-dependent relationship between intra-procedural hypoxaemia or hypocapnia and postoperative delirium in older patients.

Background: Previous studies indicated an association between impaired cerebral perfusion and post-procedural neurological disorders. We investigated whether intra-procedural hypoxaemia or hypocapnia are associated with delirium after surgery.

Methods: Inpatients ≥60 yr of age undergoing anaesthesia for surgical or interventional procedures between 2009 and 2020 at an academic healthcare network in the USA (Massachusetts) were included in this hospital registry study.

Using ketamine in a patient with a near-occlusion tracheal tumor undergoing tracheal resection and reconstruction: A case report.

Background: Tracheal tumors may cause airway obstruction and pose a significant risk to ventilation and oxygenation. Due to its rarity, there is currently no established protocol or guideline for anesthetic management of resection of upper tracheal tumors, therefore individualized strategies are necessary. There are limited number of reports regarding the anesthesthetic management of upper tracheal resection and reconstruction (TRR) in the literature.

The effect of intraoperative dexmedetomidine administration on length of stay in the post-anesthesia care unit in ambulatory surgery: A hospital registry study.

Study Objective: Dexmedetomidine, which is commonly used for procedural sedation and as adjunct to general anesthesia for ambulatory procedures, may affect patient discharge from the post-anesthesia care unit (PACU). We hypothesized that intraoperative dexmedetomidine use in ambulatory surgery is associated with delayed discharge from the PACU and that this is modified by surgical duration and anesthesia type.

Design: Retrospective cohort study.

Identifying the Gap Between Novices and Experts in Fiberoptic Scope Control.

Background: Fiberoptic intubation (FOI) is key in managing difficult airways. Good scope control increases efficiency and patient safety. Understanding the gap between novices and experts in scope control would help medical educators develop a feedback-based teaching approach for novices.

Using Lumbar X-Ray to Facilitate Modified Taylor's Approach of Spinal Anesthesia in an Elderly Patient With Scoliosis.

In geriatric patients scheduled for hip or knee surgery, neuraxial anesthesia is a safe and effective anesthesia method and may be a better option than general anesthesia. Unfortunately, establishing neuraxial anesthesia is not always easy in this group of patients. Anatomical abnormalities, such as spinal stenosis, scoliosis, and narrowed interspaces, contribute to the difficulties that anesthesiologists face while performing these procedures.

Infective endocarditis at a tertiary-care hospital in China.

Background: The aim of this study was to describe the clinical features and outcome of infective endocarditis at a general hospital in China and to identify the risk factors associated with in-hospital mortality.

Methods: A retrospective study was conducted and all patients diagnosed with definite or possible infective endocarditis between January 2013 and June 2018 according to the modified Duke criteria were included.

Results: A total of 381 patients were included.

Analysis of patient injury based on anesthesiology closed claims data from a major malpractice insurer.

Introduction: The analysis of malpractice claims can provide risk managers with a detailed view of patient mortality and morbidity. The data comes from many institutions, encompasses a diverse group of practitioners and practice settings, and contains detailed clinical information. Analysis can help identify patterns of injury, risk factors, and rare and sentinel events.

Quantitative analysis of continuous intravenous infusions in pediatric anesthesia: safety implications of dead volume, flow rates, and fluid delivery.

Objective: Quantitative characterization of continuous pediatric drug infusions.

Background: The dynamics of drug delivery by continuous infusion to pediatric patients have not been systematically examined. This study extends previously described analytic models to propofol and remifentanil delivery, focusing on infants and toddlers.

Detection of pneumonia using free-text radiology reports in the BioSense system.

Objective: Near real-time disease detection using electronic data sources is a public health priority. Detecting pneumonia is particularly important because it is the manifesting disease of several bioterrorism agents as well as a complication of influenza, including avian and novel H1N1 strains. Text radiology reports are available earlier than physician diagnoses and so could be integral to rapid detection of pneumonia.

NLP-based identification of pneumonia cases from free-text radiological reports.

Radiological reports are a rich source of clinical data which can be mined to assist with biosurveillance of emerging infectious diseases. In addition to biosurveillance, radiological reports are an important source of clinical data for health service research.Pneumonias and other radiological findings on chest x ray or chest computed tomography (CT) are one type of relevant finding to both biosurveillance and health services research.

Implementation of laboratory order data in BioSense Early Event Detection and Situation Awareness System.

Introduction: Laboratory test orders constitute an early outbreak data source. CDC receives laboratory order data in HL7 format from the Laboratory Corporation of America (LabCorp) and plans to use the data in the BioSense Early Event Detection and Situation Awareness System.

Methods: These LabCorp data contain information on tests ordered and include the type of test ordered and the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)-coded reasons for the order.