Virtual discharge counseling: An assessment of scalability of a novel patient educational process across a multi-site urban emergency department.

Background: Inadequate counseling at patient discharge from the emergency department can lead to adverse patient outcomes. Virtual discharge counseling can address gaps in discharge counseling and improve patients' understanding of instructions.

Methods: A previously established virtual discharge counseling program was scaled across three emergency departments and expanded to 13 diagnoses.

Treatment of portal vein thrombosis in cirrhosis is associated with no survival advantage: a retrospective controlled study.

Background And Aims: Portal vein thrombosis (PVT) is associated with increased mortality post-transplant, but treatment of the clot is not definitively associated with improvement in mortality. We aimed to assess the effect of anticoagulation (AC), transjugular intrahepatic portosystemic shunt (TIPS), or best supportive care only (SCO) as treatment options in patients with PVT and cirrhosis.

Methods: This was a retrospective controlled cohort study from a large urban health system.

Non-invasive markers of inflammation in alcohol-associated liver disease: A scoping review.

Clinical manifestations of liver inflammation in alcohol-associated liver disease (ALD) can range from asymptomatic to severe alcoholic hepatitis. While biopsy is the gold standard for identifying liver inflammation, it is an invasive procedure with risks of bleeding, visceral damage, and infection. We aim to establish the state of the current literature on non-invasive markers of inflammation in ALD.

Work system barriers and facilitators of a team health information technology.

Designing health IT aimed at supporting team-based care and improving patient safety is difficult. This requires a work system (i.e.

Disseminating child abuse clinical decision support among commercial electronic health records: Effects on clinical practice.

Objectives: The use of electronic health record (EHR)-embedded child abuse clinical decision support (CA-CDS) may help decrease morbidity from child maltreatment. We previously reported on the development of CA-CDS in Epic and Allscripts. The objective of this study was to implement CA-CDS into Epic and Allscripts and determine its effects on identification, evaluation, and reporting of suspected child maltreatment.

Boosting neuregulin 1 type-III expression hastens SMA motor axon maturation.

Intercellular communication between axons and Schwann cells is critical for attaining the complex morphological steps necessary for axon maturation. In the early onset motor neuron disease spinal muscular atrophy (SMA), many motor axons are not ensheathed by Schwann cells nor grow sufficiently in radial diameter to become myelinated. These developmentally arrested motor axons are dysfunctional and vulnerable to rapid degeneration, limiting efficacy of current SMA therapeutics.

Piloting a novel medical student virtual discharge counseling process in the time of the COVID-19 pandemic.

Background: During the COVID-19 pandemic, we identified a gap in adequate discharge counseling for COVID-19 patients in the Emergency Department. This was due to high patient volumes and lack of patient education regarding a novel disease. Medical students were also restricted from clinical areas due to safety concerns, compromising their clinical experience.

Leveraging a natural murine meiotic drive to suppress invasive populations.

Invasive rodents are a major cause of environmental damage and biodiversity loss, particularly on islands. Unlike insects, genetic biocontrol strategies including population-suppressing gene drives with biased inheritance have not been developed in mice. Here, we demonstrate a gene drive strategy () that leverages super-Mendelian transmission of the haplotype to spread inactivating mutations in a haplosufficient female fertility gene ().

Managing multiple perspectives in the collaborative design process of a team health information technology.

We need to design technologies that support the work of health care teams; designing such solutions should integrate different clinical roles. However, we know little about the actual collaboration that occurs in the design process for a team-based care solution. This study examines how multiple perspectives were managed in the design of a team health IT solution aimed at supporting clinician information needs during pediatric trauma care transitions.

Team Cognition in Handoffs: Relating System Factors, Team Cognition Functions and Outcomes in Two Handoff Processes.

Objective: This study investigates how team cognition occurs in care transitions from operating room (OR) to intensive care unit (ICU). We then seek to understand how the sociotechnical system and team cognition are related.

Background: Effective handoffs are critical to ensuring patient safety and have been the subject of many improvement efforts.

Scenario-Based Evaluation of Team Health Information Technology to Support Pediatric Trauma Care Transitions.

Background: Clinicians need health information technology (IT) that better supports their work. Currently, most health IT is designed to support individuals; however, more and more often, clinicians work in cross-functional teams. Trauma is one of the leading preventable causes of children's death.

Gene drives for vertebrate pest control: Realistic spatial modelling of eradication probabilities and times for island mouse populations.

Invasive alien species continue to threaten global biodiversity. CRISPR-based gene drives, which can theoretically spread through populations despite imparting a fitness cost, could be used to suppress or eradicate pest populations. We develop an individual-based, spatially explicit, stochastic model to simulate the ability of CRISPR-based homing and X chromosome shredding drives to eradicate populations of invasive house mice (Mus muculus) from islands.

Dataset of seized wildlife and their intended uses.

The illegal wildlife trade (IWT) threatens conservation and biosecurity efforts. The Internet has greatly facilitated the trade of wildlife, and researchers have increasingly examined the Internet to uncover illegal trade. However, most efforts to locate illegal trade on the Internet are targeted to one or few taxa or products.

Care transition of trauma patients: Processes with articulation work before and after handoff.

While care transitions influence quality of care, less work studies transitions between hospital units. We studied care transitions from the operating room (OR) to pediatric and adult intensive critical care units (ICU) using Systems Engineering Initiative for Patient Safety (SEIPS)-based process modeling. We interviewed twenty-nine physicians (surgery, anesthesia, pediatric critical care) and nurses (OR, ICU) and administered the AHRQ Hospital Survey on Patient Safety Culture items about handoffs, care transitions and teamwork.

Text classification to streamline online wildlife trade analyses.

Automated monitoring of websites that trade wildlife is increasingly necessary to inform conservation and biosecurity efforts. However, e-commerce and wildlife trading websites can contain a vast number of advertisements, an unknown proportion of which may be irrelevant to researchers and practitioners. Given that many wildlife-trade advertisements have an unstructured text format, automated identification of relevant listings has not traditionally been possible, nor attempted.

Development of an influenza pandemic decision support tool linking situational analytics to national response policy.

National influenza pandemic plans have evolved substantially over recent decades, as has the scientific research that underpins the advice contained within them. While the knowledge generated by many research activities has been directly incorporated into the current generation of pandemic plans, scientists and policymakers are yet to capitalise fully on the potential for near real-time analytics to formally contribute to epidemic decision-making. Theoretical studies demonstrate that it is now possible to make robust estimates of pandemic impact in the earliest stages of a pandemic using first few hundred household cohort (FFX) studies and algorithms designed specifically for analysing FFX data.

Comprehensive Care Improvement for Oncologic Fever and Neutropenia from a Pediatric Emergency Department.

Introduction: Rapid time to antibiotics (TTA) for pediatric patients with fever and neutropenia in an emergency department decreases in-hospital mortality. Additionally, national guidelines recommend outpatient antibiotic management strategies for low-risk fever and neutropenia (LRFN). This study had two specific aims: (1) improve the percent of patients with suspected fever and neutropenia who receive antibiotics within 60 minutes of arrival from 55% to 90%, and (2) develop and operationalize a process for outpatient management of LRFN patients by October 2018.

Optimised prophylactic vaccination in metapopulations.

A highly effective method for controlling the spread of an infectious disease is vaccination. However, there are many situations where vaccines are in limited supply. The ability to determine, under this constraint, a vaccination strategy which minimises the number of people that become infected over the course of a potential epidemic is essential.

Dissemination of child abuse clinical decision support: Moving beyond a single electronic health record.

Background: Child maltreatment is a leading cause of pediatric morbidity and mortality. We previously reported on development and implementation of a child abuse clinical decision support system (CA-CDSS) in the Cerner electronic health record (EHR). Our objective was to develop a CA-CDSS in two different EHRs.

A guide to using the internet to monitor and quantify the wildlife trade.

The unrivaled growth in e-commerce of animals and plants presents an unprecedented opportunity to monitor wildlife trade to inform conservation, biosecurity, and law enforcement. Using the internet to quantify the scale of the wildlife trade (volume and frequency) is a relatively recent and rapidly developing approach that lacks an accessible framework for locating relevant websites and collecting data. We produced an accessible guide for internet-based wildlife trade surveillance.

Elucidating user behaviours in a digital health surveillance system to correct prevalence estimates.

Estimating seasonal influenza prevalence is of undeniable public health importance, but remains challenging with traditional datasets due to cost and timeliness. Digital epidemiology has the potential to address this challenge, but can introduce sampling biases that are distinct to traditional systems. In online participatory health surveillance systems, the voluntary nature of the data generating process must be considered to address potential biases in estimates.

Key questions for modelling COVID-19 exit strategies.

Combinations of intense non-pharmaceutical interventions (lockdowns) were introduced worldwide to reduce SARS-CoV-2 transmission. Many governments have begun to implement exit strategies that relax restrictions while attempting to control the risk of a surge in cases. Mathematical modelling has played a central role in guiding interventions, but the challenge of designing optimal exit strategies in the face of ongoing transmission is unprecedented.