Development and Implementation of an Escalation Protocol for Internal Medicine Trainees.

Background: Overnight, physicians in training receive less direct supervision. Decreased direct supervision requires trainees to appropriately assess patients at risk of clinical deterioration and escalate to supervising physicians. Failure of trainees to escalate contributes to adverse patient safety events.

Identifying Game-Based Digital Biomarkers of Cognitive Risk for Adolescent Substance Misuse: Protocol for a Proof-of-Concept Study.

Background: Adolescents at risk for substance misuse are rarely identified early due to existing barriers to screening that include the lack of time and privacy in clinic settings. Games can be used for screening and thus mitigate these barriers. Performance in a game is influenced by cognitive processes such as working memory and inhibitory control.

Dual Antiviral Therapy for Persistent Coronavirus Disease 2019 and Associated Organizing Pneumonia in an Immunocompromised Host.

The management of patients with prolonged viral shedding and coronavirus disease 2019 symptoms remains unclear. Combining antivirals, as practiced in other infections, is theoretically advantageous. We present a case of persistent, symptomatic severe acute respiratory syndrome coronavirus 2 infection and associated organizing pneumonia that was successfully treated with an extended course of combination antiviral therapy.

Outcomes of Isolated Digital Flexor Tenolysis: A Systematic Review.

: Flexor tendon injuries form a significant proportion of hand trauma presentations. Insult to the flexor tendon and surrounding sheath may lead to the formation of adhesions between these structures during the repair process. Tenolysis is a surgical release of these adhesions which requires careful consideration.

Diabetes Control During Massachusetts Insurance Reform.

Racial/ethnic disparities in glycemic control-a key diabetes outcome measure-continue to widen, even though the overall prevalence of glycemic control in the US has improved. Health insurance coverage may be associated with improved glycemic control, but few studies examine effects during a period of policy change. We assessed changes in glycemic control by racial/ethnic groups following the Massachusetts Health Insurance Reform for patients at two urban safety-net academic health systems between January 2005 and December 2013.

Late-afternoon communication and patient planning (CAPP) rounds: an intervention to allow early patient discharges.

Objective: Measure effect of late-afternoon communication and patient planning (CAPP) rounds to increase early electronic discharge orders (EDO).

Methods: We enrolled 4485 patients discharged from six subspecialty medical services. We implemented late-afternoon CAPP rounds to identify patients who could have morning discharge the subsequent day.

Preventing Diagnostic Errors in Ambulatory Care: An Electronic Notification Tool for Incomplete Radiology Tests.

Background: Failure to complete recommended diagnostic tests may increase the risk of diagnostic errors.

Objectives: The aim of this study is to develop and evaluate an electronic monitoring tool that notifies the responsible clinician of incomplete imaging tests for their ambulatory patients.

Methods: A results notification workflow engine was created at an academic medical center.

Coughing Up a Lung: A Curious Case of Pertussis.

Pertussis is a commonly underdiagnosed infection with incidence that has been steadily rising in adolescents and adults over the last three decades. Some reports suggested cyclical pattern of pertussis infection occurrence with peaks every two to five years. The complications of pertussis can be infectious or mechanical in the setting of persistent cough.

Racial Differences in Insurance Stability After Health Insurance Reform.

Background: One of the potential benefits of insurance reform is greater stability of insurance and reduced coverage disparities by race and ethnicity.

Objectives: We examined the temporal trends in insurance coverage by racial/ethnic group before and after Massachusetts Insurance Reform by abstracting records across 2 urban safety net hospital systems.

Research Design: We examined adjusted odds of being uninsured and incident rate ratios of gaining and losing insurance over time by race and ethnicity.

Inhaler use and education characteristics among English and non-English speaking patients: A pilot needs assessment survey.

Objective: Identify inhaler use characteristics among English (ESP) and non-English speaking patients (NSP) to develop quality improvement efforts.

Methods: Outpatients were surveyed for technique confidence, education, preferences and disease control. We compared characteristics between ESP and NSP.

Efficacy of Chlorantraniliprole Seed Treatments Against Armyworm (Mythimna unipuncta [Lepidoptera: Noctuidae]) Larvae on Corn (Zea mays).

Mythimna unipuncta (Haworth) (Lepidoptera: Noctuidae) is an important insect pest of corn (Zea mays L.) in North America and can cause severe damage during outbreaks. Insecticides are the main control method; however, development of insecticide resistance poses management challenges and necessitates the use of novel insecticides.

Clinical confirmation to demonstrate similarity for a biosimilar pegfilgrastim: a 3-way randomized equivalence study for a proposed biosimilar pegfilgrastim versus US-licensed and EU-approved reference products in breast cancer patients receiving myelosuppressive chemotherapy.

Background: Chemotherapy-induced neutropenia is a common result of myelosuppressive chemotherapy treatment. Infections such as febrile neutropenia (FN) are sensitive to the duration of neutropenia as well as the depth of absolute neutrophil count (ANC) at nadir. Filgrastim, a granulocyte colony stimulating factor (G-CSF), can stimulate the function of mature neutrophils.