Study protocol for a randomized controlled trial: Integrating the 'Time-limited Trial' in the emergency department.

Introduction: Time-limited trial (TLT) is a structured approach between clinicians and seriously ill patients or their surrogates to discuss patients' values and preferences, prognosis, and shared decision-making to use specific therapies for a prespecified period of time in the face of prognostic uncertainty. Some evidence exists that this approach may lead to more patient-centered care in the intensive care unit; however, it has never been evaluated in the emergency department (ED). The study protocol aims to assess the feasibility and acceptability of TLTs initiated in the ED.

Pediatric screen time.

Background: Ease of access to technology by the pediatric individual has brought with it new challenges for parents and guardians as they grapple to understand and formulate healthy boundaries between their child and the media. This transition into a media-forward generation has triggered a new wave of research discussing the relationship between early media exposure and the developing pediatric mind; media and the parent-child relationship; and recommendations for healthy boundaries from the American Academy of Pediatrics (AAP) as well as the American Academy of Child and Adolescent Psychiatry (AACAP) and American Psychological Association (APA).

Objectives: This systematic review was written for the purposes of equipping physicians and nurse practitioners to be the bridge between research and their patients.

Phylogenomic analysis of the species of the Mycobacterium tuberculosis complex demonstrates that Mycobacterium africanum, Mycobacterium bovis, Mycobacterium caprae, Mycobacterium microti and Mycobacterium pinnipedii are later heterotypic synonyms of Mycobacterium tuberculosis.

The species within the Mycobacterium tuberculosis Complex (MTBC) have undergone numerous taxonomic and nomenclatural changes, leaving the true structure of the MTBC in doubt. We used next-generation sequencing (NGS), digital DNA-DNA hybridization (dDDH), and average nucleotide identity (ANI) to investigate the relationship between these species. The type strains of Mycobacterium africanum, Mycobacterium bovis, Mycobacterium caprae, Mycobacterium microti and Mycobacterium pinnipedii were sequenced via NGS.