Postsurgical Pain Risk Stratification to Enhance Pain Management Workflow in Adult Patients: Design, Implementation, and Pilot Evaluation.

Background: Exposure to opioids after surgery is the initial contact for some people who develop chronic opioid use disorder. Hence, effective postoperative pain management, with less reliance on opioids, is critical. The Perioperative Opioid Quality Improvement (POQI) program developed (1) a digital health platform leveraging patient-survey-reported risk factors and (2) a postsurgical pain risk stratification algorithm to personalize perioperative care by integrating several commercially available digital health solutions into a combined platform.

A majority of uninfected adults show preexisting antibody reactivity against SARS-CoV-2.

Preexisting cross-reactivity to SARS-CoV-2 occurs in the absence of prior viral exposure. However, this has been difficult to quantify at the population level due to a lack of reliably defined seroreactivity thresholds. Using an orthogonal antibody testing approach, we estimated that about 0.

Antibody reactivity to SARS-CoV-2 is common in unexposed adults and infants under 6 months.

Background: Pre-existing antibody reactivity against SARS-CoV-2 in unexposed people is a potentially important consideration for COVID-19 severity and vaccine responses. However, it has been difficult to quantify due to a lack of reliable defined background titers in unexposed individuals.

Methods: We measured IgG against multiple SARS-CoV-2 antigens, SARS-CoV and other circulating coronavirus spike proteins using a highly sensitive multiplex assay, and total SARS-CoV-2 spike-specific antibodies (IgG/M/A) using a commercial CLIA assay in 276 adults from the Vancouver area, Canada between May 17th and June 19th 2020.

Beyond the Golden Hours: Caring for Septic Patients After the Initial Resuscitation.

Recognition and management of agitation, delirium, and pain are key areas. Reduced use of sedatives is an important measure that must be coupled with increased patient engagement, mobilization, and exercise. Use of low tidal volumes and low mean airway pressures during mechanical ventilation is helpful.

Vasopressors During Sepsis: Selection and Targets.

Clinicians have greatly improved care for septic shock. Urgent resuscitation using intravenous fluids and vasopressors as well as rapid administration of broad spectrum antibiotics are probably the most basic and universally accepted interventions. Various trials have compared different types of vasopressors, associations of vasopressors and inotropes, and pressure targets.

Precipitation of swine and cattle manure phosphorous using limestone dust.

The effectiveness of SPS and PULPRO, fine limestone dusts, in precipitating swine and dairy manure phosphorous (P) was determined in the laboratory. Both manures were sieved before being treated with limestone, to reproduce the treatment of mechanically separated manure and to observe the precipitation effect of limestone without that of the large manure solid particles. P precipitation was optimized by varying precipitation conditions (propeller blade speeds, mixing time and limestone levels) and limestone particle size.