Assessment and management of emergencies during haemodialysis.

The haemodialysis unit is a complex clinical environment. Medical emergencies complicating haemodialysis treatment are relatively infrequent but are associated with high morbidity and mortality. The management of intradialytic emergencies is challenging and relevant to the practice of all nephrology and critical care clinicians.

Frontally polymerized foams: thermodynamic and kinetical aspects of front hindrance by particles.

Frontal polymerization (FP) is a solvent-free, energy-efficient process where a self-propagating polymerization reaction with a characteristic sharp temperature gradient at the front head propagates through the resin to provide the curing conditions. It relies on the enthalpic balance, which spreads the reaction to unreacted resin in the neighborhood. Therefore, the FP is sensitive to the presence of non-reactive volumes, such as boundaries, fillers, or other additives, that retain heat from the front but produce no enthalpy in return.

Importance of imaging-acquisition protocol and post-processing analysis for extracellular volume fraction assessment by computed tomography.

Background: Computed tomography angiography (CTA) assessment of myocardial extracellular volume fraction (CT-ECV) is feasible, although the protocols for imaging acquisition and post-processing methodology have varied. We aimed to identify a pragmatic protocol for CT-ECV assessment encompassing both imaging acquisition and post-processing methodologies to facilitate its clinical implementation.

Methods: We evaluated consecutive patients with severe aortic stenosis undergoing evaluation for transcatheter aortic valve replacement (TAVR).

Endothelial and Leptin Receptor cells promote the maintenance of stem cells and hematopoiesis in early postnatal murine bone marrow.

Mammalian hematopoietic stem cells (HSCs) colonize the bone marrow during late fetal development, and this becomes the major site of hematopoiesis after birth. However, little is known about the early postnatal bone marrow niche. We performed single-cell RNA sequencing of mouse bone marrow stromal cells at 4 days, 14 days, and 8 weeks after birth.

KLF15 controls brown adipose tissue transcriptional flexibility and metabolism in response to various energetic demands.

Brown adipose tissue (BAT) is a specialized metabolic organ responsible for non-shivering thermogenesis. Recently, its activity has been shown to be critical in systemic metabolic health through its utilization and consumption of macronutrients. In the face of energetically demanding states, metabolic flexibility and systemic coordination of nutrient partitioning is requisite for health and survival.

Anisotropic solid-state PLA foaming templated by crystal phase pre-oriented with 3D printing: cell supporting structures with directional capillary transfer function.

Bones represent a superb biomaterial that combines high mechanical stiffness with nutrition delivery to its osteocyte cells through the microscopical Haversian canals and bone canaliculi. Such a structure is hard to reproduce artificially, though. 3D printing delivers an unprecedented shape control of the created objects.

Avoidant and Restrictive Food Intake Disorder: Outcomes for 16 Inpatient Cases to Target Oral Consumption Using a Medical and Behavioral Treatment Model.

Introduction: Avoidant and restrictive food intake disorder (ARFID) is characterized by restrictions in oral intake and does not include concerns related to body image. Despite the evidence-based medical and behavioral treatments, there is limited research as they apply to ARFID, but the extant research supports hospital-based behavioral therapy. Individuals with ARFID may have comorbidities that can affect treatment, which requires multidisciplinary treatment to provide effective care.

Examination of geriatric care processes implemented in level 1 and level 2 geriatric emergency departments.

Introduction: Older adults constitute a large and growing proportion of the population and have unique care needs in the emergency department (ED) setting. The geriatric ED accreditation program aims to improve emergency care provided to older adults by standardizing care provided across accredited geriatric EDs (GED) and through implementation of geriatric-specific care processes. The purpose of this study was to evaluate select care processes at accredited level 1 and level 2 GEDs.

Reach and Adoption of a Geriatric Emergency Department Accreditation Program in the United States.

Study Objective: The objectives of this study were to describe the reach and adoption of Geriatric Emergency Department Accreditation (GEDA) program and care processes instituted at accredited geriatric emergency departments (EDs).

Methods: We analyzed a cross-section of a cohort of US EDs that received GEDA from May 2018 to March 2021. We obtained data from the American College of Emergency Physicians and publicly available sources.

Moving the needle on fall prevention: A Geriatric Emergency Care Applied Research (GEAR) Network scoping review and consensus statement.

Background: Although falls are common, costly, and often preventable, emergency department (ED)-initiated fall screening and prevention efforts are rare. The Geriatric Emergency Medicine Applied Research Falls core (GEAR-Falls) was created to identify existing research gaps and to prioritize future fall research foci.

Methods: GEAR's 49 transdisciplinary stakeholders included patients, geriatricians, ED physicians, epidemiologists, health services researchers, and nursing scientists.

ED-DEL: Development of a change package and toolkit for delirium in the emergency department.

Delirium is a common and deadly problem in the emergency department affecting up to 30% of older adult patients. The 2013 Geriatric Emergency Department guidelines were developed to address the unique needs of the growing older population and identified delirium as a high priority area. The emergency department (ED) environment presents unique challenges for the identification and management of delirium, including patient crowding, time pressures, competing priorities, variable patient acuity, and limitations in available patient information.

Association of dementia diagnosis with urinary tract infection in the emergency department.

Objectives: Overdiagnosis of urinary tract infections (UTI) among people living with dementia is a nationally recognized problem associated with morbidity from antibiotics as well as multidrug-resistant bacteria. However, whether this problem also exists in the emergency department (ED) is currently unknown.

Methods: To examine the association between dementia and UTI diagnosis in the ED we performed a retrospective analysis of Medicare beneficiaries older than 65 years old who presented to an ED in 2016.

Older adult visits to the emergency department for ambulatory care sensitive conditions.

Objectives: Ambulatory-care-sensitive conditions (ACSCs) represent emergency department (ED) visits and hospital admissions that might have been avoided through earlier primary care intervention. We characterize the current frequency and cost of ACSCs among older adults (≥65 years of age) in the ED.

Methods: This study is a retrospective analysis of Centers for Medicare and Medicaid Services (CMS) national claims data distributed by the Research Data Assistance Center, a CMS contractor based at the University of Minnesota.

Process Evaluation of a Community-Based Microbial Larviciding Intervention for Malaria Control in Rural Tanzania.

Microbial larviciding can be an effective component of integrated vector management malaria control schemes, although it is not commonly implemented. Moreover, quality control and evaluation of intervention activities are essential to evaluate the potential of community-based larviciding interventions. We conducted a process evaluation of a larval source management intervention in rural Tanzania where local staff were employed to apply microbial larvicide to mosquito breeding habitats with the aim of long-term reductions in malaria transmission.

A randomized clinical trial of a virtual-training program for teaching applied-behavior-analysis skills to parents of children with autism spectrum disorder.

Parents play an important role in the treatment of their children's symptoms of autism spectrum disorder (ASD); thus, developing effective, efficient, socially acceptable, and accessible procedures for training parents to implement applied-behavior-analysis (ABA) interventions is critically important. One potential approach involves delivering training via a virtual private network (VPN) over the internet (Fisher et al., 2014).

30-Day Emergency Department Revisit Rates among Older Adults with Documented Dementia.

Objectives: Published literature on national emergency department (ED) revisit rates among older adults with dementia is sparse, despite anecdotal evidence of higher ED utilization. Thus we evaluated the odds ratio (OR) of 30-day ED revisits among older adults with dementia using a nationally representative sample.

Design: We assessed the frequency of claims associated with a 30-day ED revisit among Medicare beneficiaries with and without a dementia diagnosis before or at index ED visit.

Radial torsion in dogs with medial compartment disease.

Objective: To evaluate the magnitude and direction of radial torsion (RT) in dogs with medial compartment disease (MCD).

Study Design: Case-control study.

Sample Population: Twenty-eight healthy dogs and 28 dogs with confirmed MCD.

Evaluating motion detection to score sleep disturbance for children: A translational approach to developing a measurement system.

Information obtained via direct observation of children's sleep disturbance throughout the night in their home can guide the assessment and treatment process, but watching live or via recorded video might be impractical in terms of time expenditures. In Experiment 1, we assessed the accuracy and reliability of a motion-detection camera with human motor movements. In Experiment 2, we tested the system's generality by using it to obtain in-home measures of sleep disturbance for three children with autism spectrum disorder and compared the accuracy to a continuous measurement system.

Association Between Physical Therapy in the Emergency Department and Emergency Department Revisits for Older Adult Fallers: A Nationally Representative Analysis.

Objectives: To determine whether providing physical therapy (PT) services in the emergency department (ED) improves outcomes for older adults who fall.

Design: We used Medicare claims data to examine differences in recurrent fall-related ED revisit rates of older adults who presented to the ED for a ground-level fall and whether they received PT services in the ED. Our logistic regression model controlled for age, sex, Medicaid eligibility, acute injury, and certain known chronic comorbidities associated with risk of falling.

Delirium as a predictor of mortality in US Medicare beneficiaries discharged from the emergency department: a national claims-level analysis up to 12 months.

Background: Delirium is common among seniors discharged from the emergency department (ED) and associated with increased risk of mortality. Prior research has addressed mortality associated with seniors discharged from the ED with delirium, however has generally relied on data from one or a small number of institutions and at single time points.

Objectives: Analyse mortality rates among seniors discharged from the ED with delirium up to 12 months at the national level.

Motivation and satisfaction among community health workers administering rapid diagnostic tests for malaria in Western Kenya.

Background: The continued success of community case management (CCM) programs in low-resource settings depends on the ability of these programs to retain the community health workers (CHWs), many of whom are volunteers, and maintain their high-quality performance. This study aims to identify factors related to the motivation and satisfaction of CHWs working in a malaria CCM program in two sub-counties in Western Kenya.

Methods: We interviewed 70 CHWs who were trained to administer malaria rapid diagnostic tests as part of a broader study evaluating a malaria CCM program.

Assessing the independent and combined effects of subsidies for antimalarials and rapid diagnostic testing on fever management decisions in the retail sector: results from a factorial randomised trial in western Kenya.

Objectives: There is an urgent need to understand how to improve targeting of artemisinin combination therapy (ACT) to patients with confirmed malaria infection, including subsidised ACTs sold over-the-counter. We hypothesised that offering an antimalarial subsidy conditional on a positive malaria rapid diagnostic test (RDT) would increase uptake of testing and improve rational use of ACTs.

Methods: We designed a 2×2 factorial randomised experiment evaluating 2 levels of subsidy for RDTs and ACTs.

Innovative public-private partnership to target subsidised antimalarials: a study protocol for a cluster randomised controlled trial to evaluate a community intervention in Western Kenya.

Introduction: There are concerns of inappropriate use of subsidised antimalarials due to the large number of fevers treated in the informal sector with minimal access to diagnostic testing. Targeting antimalarial subsidies to confirmed malaria cases can lead to appropriate, effective therapy. There is evidence that community health volunteers (CHVs) can be trained to safely and correctly use rapid diagnostic tests (RDTs).

Outcomes of an inpatient medical nutritional rehabilitation protocol in children and adolescents with eating disorders.

Background: Medical stabilization through inpatient nutritional rehabilitation is often necessary for patients with eating disorders (EDs) but includes the inherent risk of refeeding syndrome. Here we describe our experience of implementing and sustaining an inpatient nutritional rehabilitation protocol designed to strategically prepare patients with EDs and their families for discharge to a home setting in an efficient and effective manner from a general adolescent medicine unit. We report outcomes at admission, discharge, and 4-weeks follow-up.