Impact of Infectious Diseases Consultation in Patients With Candidemia at a Multisite Health Care System With Established Antimicrobial Stewardship and Telemedicine Services.

Background: Infectious diseases consultation improves outcomes in patients with candidemia, although some facilities lack access to consultation. This multisite health care system study compared in-hospital mortality in patients with candidemia across 3 groups-those who received on-site consultation, telemedicine consultation, or no consultation. All patients were reviewed by an antimicrobial stewardship pharmacist.

Response to high dose ipilimumab plus temozolomide after progression on standard or low dose ipilimumab in advanced melanoma: a retrospective analysis.

Background: Despite advancements in checkpoint inhibitor-based immunotherapy, patients with advanced melanoma who have progressed on standard dose ipilimumab (Ipi) + nivolumab continue to have poor prognosis. Several studies support a dose-response activity of Ipi, and one promising combination is Ipi 10mg/kg (Ipi10) + temozolomide (TMZ).

Methods: We performed a retrospective cohort analysis of patients with advanced melanoma treated with Ipi10+TMZ in the immunotherapy refractory/resistant setting (n = 6), using similar patients treated with Ipi3+TMZ (n = 6) as comparison.

Transverse myelitis after Johnson & Johnson COVID-19 vaccine: illustrative case.

Background: Transverse myelitis is a rare neurological occurrence with varied presentation. Imaging is necessary to properly diagnose this condition; however, identifying the cause of this condition may often be difficult.

Observations: An otherwise healthy patient presented to the clinic with peculiar neurological symptoms without an obvious underlying cause.

Outcomes and antibiotic use in patients with coronavirus disease 2019 (COVID-19) admitted to an intensive care unit.

Antibiotic overuse is high in patients hospitalized with coronavirus disease 2019 (COVID-19) despite a low documented prevalence of bacterial infections in many studies. In this study evaluating 65 COVID-19 patients in the intensive care unit, empiric broad-spectrum antibiotics were often overutilized with an inertia to de-escalate despite negative culture results.

Branched-Chain Amino Acids Are Neuroprotective Against Traumatic Brain Injury and Enhance Rate of Recovery: Prophylactic Role for Contact Sports and Emergent Use.

Branched-chain amino acids (BCAAs) are known to be neurorestorative after traumatic brain injury (TBI). Despite clinically significant improvements in severe TBI patients given BCAAs after TBI, the approach is largely an unrecognized option. Further, TBI continues to be the most common cause of morbidity and mortality in adolescents and adults.

From Shielding to Avoidance: Passenger Augmented Reality and the Layout of Virtual Displays for Productivity in Shared Transit.

Passengers spend considerable periods of time in shared transit spaces, relying on smartphones and laptops for work. However, these displays are limited in size and ergonomics compared to typical multi-monitor setups used in the office, impairing productivity. Augmented Reality (AR) headsets could provide large, flexible virtual workspaces during travel, enabling passengers to work more efficiently.

Latent fingermark development on fired and unfired brass ammunition under controlled and blind conditions.

There has been growing interest in the Foster+Freeman RECOVER® Latent Fingerprint Technology system to develop fingermarks from fired ammunition. Over a six-month period, 1540 fingermarks were deposited on brass.223 ammunition, the majority of which were then fired after different time intervals.

Randomised controlled trial of intermittent vs continuous energy restriction during chemotherapy for early breast cancer.

Background: Excess adiposity at diagnosis and weight gain during chemotherapy is associated with tumour recurrence and chemotherapy toxicity. We assessed the efficacy of intermittent energy restriction (IER) vs continuous energy restriction (CER) for weight control and toxicity reduction during chemotherapy.

Methods: One hundred and seventy-two women were randomised to follow IER or CER throughout adjuvant/neoadjuvant chemotherapy.

Patterns of Fitbit Use and Activity Levels Among African American Breast Cancer Survivors During an eHealth Weight Loss Randomized Controlled Trial.

Purpose: This study examined adherence with a physical activity tracker and patterns of activity among different subgroups of African American/Black breast cancer survivors (AABCS).

Design: Secondary analysis of weight loss trial that used an activity tracker (FitBit) with or without a commercial eHealth program (SparkPeople) over 12 months.

Setting And Subjects: AABCS (N = 44) in New Jersey.

Formation of an Anesthesiology Residency Mentoring Program Using a Mentee-Driven Approach.

Mentorship is crucial to career development and advancement in academic medicine with valuable benefits to residents realized during training and beyond. The primary aims of this program are to train faculty members to provide quality mentorship to every resident in our department and to reduce gender and racial disparities in access to mentorship. We piloted a new mentorship program that combines mentor self-nomination, mentor training with mentee-driven mentor selection.

Catheter-Directed Pharmacologic Thrombolysis for Acute Submassive and Massive Pulmonary Emboli in Children and Adolescents-An Exploratory Report.

Objectives: The objective of this study is to report a single-center experience of the safety and efficacy of pulmonary artery catheter-directed thrombolysis for both massive and submassive pulmonary emboli in the pediatric and adolescent population.

Design: A 22-month retrospective review of the electronic medical record and picture archiving and communication system was performed of patients less than 21 years old, presenting with massive or submassive pulmonary emboli treated with pulmonary artery catheter-directed thrombolysis at a single, tertiary care pediatric hospital. Multiple variables were analyzed including indications, technical success, clinical efficacy, and complications.

Fluid Overload in Pediatric Severe Traumatic Brain Injury.

Objective: Pediatric traumatic brain injury is a major public health problem in the United States. Hypertonic saline therapy is a well-established treatment in patients with severe traumatic brain injury (Glasgow Coma Scale ≤ 8) who have intracranial hypertension. In children, fluid overload is associated with increased mortality, ventilator duration, and length of PICU stay, even when controlling for severity of illness.

Comparison of 2 canine celiotomy closure models for training novice veterinary students.

Objective: To compare a low-fidelity foam and fabric (FF) model to a high fidelity silicone (SI) model for teaching canine celiotomy closure.

Study Design: Prospective blinded comparison of learning outcomes.

Sample Population: Second-year veterinary students who had never performed surgery as a primary surgeon (n = 46) and veterinarians experienced in performing canine celiotomy (n = 10).

Establishing an Antimicrobial Stewardship Collaborative Across a Large, Diverse Health Care System.

Unlabelled: Alarming trends in antibiotic resistance sparked a National Action Plan endorsing antimicrobial stewardship programs (ASPs) in health care facilities. Atrium Health consists of 28 acute care facilities with varying levels of ASP maturity. The organization sought to establish an ASP collaborative across a diverse network by uniting local resources with a central advisory team.

A Randomized Trial Comparing Freely Moving and Zonal Instruction of Veterinary Surgical Skills Using Ovariohysterectomy Models.

Timely, specific feedback is the most important feature of simulation-based training, but providing adequate instructor supervision is challenging. Students' ( = 76) surgical skills were assessed after training using either the traditional (T) method of large-group teaching by multiple instructors or the alternative method of one instructor assigned (A) to a defined group of students. Instructors rotated to a different group of students for each laboratory session.

Effect of Different Instructional Methods on Contamination and Personal Protective Equipment Protocol Adherence among Veterinary Students.

Proper use of personal protective equipment (PPE) is crucial to prevent disease spread. Recent studies in human medicine have shown disconcerting inconsistencies in the use of PPE in hospital wards. In this study, we compared the effect of three instructional methods for PPE use on contamination and protocol adherence among veterinary students.

Moving anesthesiology educational resources to the point of care: experience with a pediatric anesthesia mobile app.

Background: Educators in all disciplines recognize the need to update tools for the modern learner. Mobile applications (apps) may be useful, but real-time data is needed to demonstrate the patterns of utilization and engagement amongst learners.

Methods: We examined the use of an anesthesia app by two groups of learners (residents and anesthesiologist assistant students [AAs]) during a pediatric anesthesiology rotation.

Evaluation of a method to assess digitally recorded surgical skills of novice veterinary students.

Objective: To evaluate a method to assess surgical skills of veterinary students that is based on digital recording of their performance during closure of a celiotomy in canine cadavers.

Sample Population: Second year veterinary students without prior experience with live animal or simulated surgical procedure (n = 19) METHODS: Each student completed a 3-layer closure of a celiotomy on a canine cadaver. Each procedure was digitally recorded with a single small wide-angle camera mounted to the overhead surgical light.

Loss of Gas6 and Axl signaling results in extensive axonal damage, motor deficits, prolonged neuroinflammation, and less remyelination following cuprizone exposure.

The TAM (Tyro3, Axl, and MerTK) family of receptor tyrosine kinases (RTKs) and their ligands, Gas6 and ProS1, are important for innate immune responses and central nervous system (CNS) homeostasis. While only Gas6 directly activates Axl, ProS1 activation of Tyro3/MerTK can indirectly activate Axl through receptor heterodimerization. Therefore, we generated Gas6 Axl double knockout (DKO) mice to specifically examine the contribution of this signaling axis while retaining ProS1 signaling through Tyro3 and MerTK.

Purine Biosynthesis Enzymes in Hippocampal Neurons.

Despite reports implicating disrupted purine metabolism in causing a wide spectrum of neurological defects, the mechanistic details of purine biosynthesis in neurons are largely unknown. As an initial step in filling that gap, we examined the expression and subcellular distribution of three purine biosynthesis enzymes (PFAS, PAICS and ATIC) in rat hippocampal neurons. Using immunoblotting and high-resolution light and electron microscopic analysis, we find that all three enzymes are broadly distributed in hippocampal neurons with pools of these enzymes associated with mitochondria.

Development and Validation of a Model for Training Equine Phlebotomy and Intramuscular Injection Skills.

Simulation in veterinary education offers a solution for bridging the gap between observation and performance of clinical skills. An equine neck model was created that allows repetitive practice of jugular phlebotomy, intramuscular (IM) injection, and intravenous catheterization. The aim of this study was to validate the model for jugular phlebotomy and IM injection.