Remote vision-based digital patient monitoring of pulse and respiratory rates in acute medical wards.

Remote Vision-Based digital Patient Monitoring (VBPM) of pulse (PR) and respiratory rate (RR) was set up in six single rooms in an acute medical and an orthopaedic ward. We compared 102 PR and 154 RR VBPM measurements (from 27 patients) with paired routine nurse measurements. VBPM measurements of RR were validated by reviewing video footage.

Increased seizure frequency in an epilepsy patient receiving medium cut-off dialysis.

This paper presents the case of a male dialysis patient, with generalised epilepsy, who experienced complications after starting medium cut-off (MCO) dialysis. While receiving haemodiafiltration, the patient's epilepsy had been relatively well controlled using two antiseizure medications (brivaracetam and sodium valproate). However, the patient's seizure frequency increased when he was changed to MCO dialysis.

Impact of a standardised rapid response system on clinical outcomes of female patients: an interrupted time series approach.

Background: This study aimed to assess the impact of a standardised rapid response systems (the Between the Flags (BTF)) implemented across New South Wales (NSW), Australia, among female patients.

Methods: We conducted an interrupted time series (2007-2013) population-based linkage study including 5 114 170 female patient (≥18 years old) admissions in all 232 public hospitals in NSW. We studied changes in levels and trends of patient outcomes after BTF implementation among four age groups of female patients.

Computerized Clinical Decision Support Systems for the Early Detection of Sepsis Among Adult Inpatients: Scoping Review.

Background: Sepsis is a significant cause of morbidity and mortality worldwide. Early detection of sepsis followed promptly by treatment initiation improves patient outcomes and saves lives. Hospitals are increasingly using computerized clinical decision support (CCDS) systems for the rapid identification of adult patients with sepsis.

Rare yet catastrophic presentation of undiagnosed antiphospholipid syndrome.

A previously well 31-year-old woman initially presented to the emergency department with pneumonia, however, was found to be hypertensive and have new-onset cardiomegaly. She was admitted for intravenous antibiotics and concurrently a series of investigations were conducted to investigate hypertension and cardiomegaly. During the course of admission, she developed acute kidney injury and was found to have acute chronic occlusion in the abdominal aorta.

Severe psittacosis progressing to suspected organizing pneumonia and the role of corticosteroids.

Background: Psittacosis is a systemic disease usually with respiratory involvement, caused by the obligate intracellular bacterium . Exposure to birds, the main zoonotic reservoir, is a major risk factor for infection. The spectrum of disease is highly variable, ranging from subclinical infection to severe pneumonia requiring mechanical ventilation.

Evaluation of an augmented emergency department electronic medical record-based sepsis alert.

Objective: Electronic medical records-based alerts have shown mixed results in identifying ED sepsis. Augmenting clinical patient-flagging with automated alert systems may improve sepsis screening. We evaluate the performance of a hybrid alert to identify patients in ED with sepsis or in-hospital secondary outcomes from infection.

Reduction of in-hospital cardiac arrest rates in intensive care-equipped New South Wales hospitals in association with implementation of Between the Flags rapid response system.

Background: The NSW Clinical Excellence commission introduced the 'Between the Flags' programme, in response to the death of a young patient, as a system-wide approach for early detection and management of the deteriorating patient in all NSW hospitals. The impact of BTF implementation on the 35 larger hospitals with intensive care units (ICU) has not been reported previously.

Aim: To assess the impact of 'Between the Flags' (BTF), a two-tier rapid response system across 35 hospitals with an ICU in NSW, on the incidence of in-hospital cardiac arrests and the incidence and outcome of patients admitted to an ICU following cardiac arrest and rapid response team activation.

The effectiveness of a standardised rapid response system on the reduction of cardiopulmonary arrests and other adverse events among emergency surgical admissions.

Aim: A standardised rapid response system (RRS), called the "Between-the-Flags" (BTF) program, was implemented across a large health jurisdiction in Australia in 2010. The impact of RRS on emergency surgical admissions is unknown.

Methods: We linked the NSW Admitted Patient Data Collection (APDC) and the NSW Registry of Births, Deaths, and Marriages.

Comparison of the quick Sepsis-related Organ Failure Assessment and adult sepsis pathway in predicting adverse outcomes among adult patients in general wards: a retrospective observational cohort study.

Background: Quick Sepsis-related Organ Failure Assessment (qSOFA) is recommended for use by the most recent international sepsis definition taskforce to identify suspected sepsis in patients outside the intensive care unit (ICU) at risk of adverse outcomes. Evidence of its comparative effectiveness with existing sepsis recognition tools is important to guide decisions about its widespread implementation.

Aim: To compare the performance of qSOFA with the adult sepsis pathway (ASP), a current sepsis recognition tool widely used in NSW hospitals and systemic inflammatory response syndrome criteria in predicting adverse outcomes in adult patients on general wards.

Improving the Performance of Clinical Decision Support for Early Detection of Sepsis: A Retrospective Observational Cohort Study.

Sepsis remains a significant global health problem. It is a life-threatening, but poorly defined and recognized condition. Early recognition and intervention are essential to optimize patient outcomes.

Geoff Cloke at 65: a pioneer in organometallic chemistry.

Professor Geoff Cloke FRS celebrates his 65th birthday in 2018. In a career spanning four decades, his research endeavours have accounted for some of the most innovative synthetic chemistry of the modern era, with his many publications describing truly exceptional compounds and experimental methods that portray a unique chemical imagination. In addition to his scientific accomplishments, Cloke can be particularly proud of his successful mentoring, a level of dedication that propelled many students and post-docs on to become research leaders in their own right.

Comment on "Hydride, gold(i) and related derivatives of the unsaturated ditungsten anion [WCp(μ-PCy)(μ-CO)]-" by M. A. Ruiz et al., Dalton Trans., 2014, 43, 16044.

Application of the covalent bond classification to the compounds [M2(η5-C5H5)2(μ-H)(μ-PCy2)(CO)2] (M = Mo, W) identifies the compounds as having two M-M bonds and a 2 electron 3 centre (2e-3c) bond incorporating the bridging hydrogen, in accord with density functional calculations, and assigns their class as ML4X4.

Serum lactate cut-offs as risk stratification tool for in-hospital adverse outcomes in emergency department patients screened for suspected sepsis.

Objectives: We investigated specific lactate thresholds for adverse outcomes in patients presenting to emergency departments (EDs) with suspected sepsis identified based on the performance of a sepsis screening algorithm.

Design And Setting: A standardised sepsis bundle was implemented across public hospitals in New South Wales, Australia, as a quality improvement initiative. A register of all adult ED presentations (≥18 years) meeting predefined criteria for sepsis was created, using a combination of data linkage and direct reporting from 97 participating sites.

London ambulance source data on choking incidence for the calendar year 2016: an observational study.

Introduction: Complete foreign body airway obstruction is a life-threatening emergency, but there are limited data on its epidemiology.

Methods: We conducted a retrospective analysis of data collected routinely from London Ambulance Service calls coded as being for choking was undertaken for the calendar year of 2016.

Results: There were 1916 choking episodes of significant severity to call for emergency assessment in London during 2016, 0.

Lactate ≥2 mmol/L plus qSOFA improves utility over qSOFA alone in emergency department patients presenting with suspected sepsis.

Objective: The Sepsis-3 task force recommends the use of the quick Sequential Organ Failure Assessment (qSOFA) score to identify risk for adverse outcomes in patients presenting with suspected infection. Lactate has been shown to predict adverse outcomes in patients with suspected infection. The aim of the study is to investigate the utility of a post hoc lactate threshold (≥2 mmol/L) added qSOFA score (LqSOFA score) to predict primary composite adverse outcomes (mortality and/or ICU stay ≥72 h) in patients presenting to ED with suspected sepsis.

Comparison of the Between the Flags calling criteria to the MEWS, NEWS and the electronic Cardiac Arrest Risk Triage (eCART) score for the identification of deteriorating ward patients.

Introduction: Traditionally, paper based observation charts have been used to identify deteriorating patients, with emerging recent electronic medical records allowing electronic algorithms to risk stratify and help direct the response to deterioration.

Objective(s): We sought to compare the Between the Flags (BTF) calling criteria to the Modified Early Warning Score (MEWS), National Early Warning Score (NEWS) and electronic Cardiac Arrest Risk Triage (eCART) score.

Design And Participants: Multicenter retrospective analysis of electronic health record data from all patients admitted to five US hospitals from November 2008-August 2013.

Choking on a foreign body: a physiological study of the effectiveness of abdominal thrust manoeuvres to increase thoracic pressure.

The Heimlich manoeuvre is a well-known intervention for the management of choking due to foreign body airway occlusion, but the evidence base for guidance on this topic is limited and guidelines differ. We measured pressures during abdominal thrusts in healthy volunteers. The angle at which thrusts were performed (upthrust vs circumferential) did not affect intrathoracic pressure.

Between the flags: implementing a safety-net system at scale to recognise and manage deteriorating patients in the New South Wales Public Health System.

Quality Problem: In 2005, the Clinical Excellence Commission (CEC) found that unrecognised patient deterioration remained an important problem in New South Wales (NSW) public hospitals.

Initial Assessment: The challenge was to design and implement an effective and sustainable safety-net system in all 225 NSW public hospitals.

Designing A Solution: The CEC's system was designed in collaboration with a broad coalition of partners, including clinicians, managers, system administrators and collaborating agencies.

The classification and representation of main group element compounds that feature three-center four-electron interactions.

This article provides a means to classify and represent compounds that feature 3-center 4-electron (3c-4e) interactions in terms of the number of electrons that each atom contributes to the interaction. Specifically, Class I 3c-4e interactions are classified as those in which two atoms provide one electron each and the third atom provides a pair of electrons (i.e.

Dying in two acute hospitals: would usual care meet Australian national clinical standards?

The Australian Commission for Quality and Safety in Health Care (ACQSHC) has articulated 10 clinical standards with the aim of improving the consistency of quality healthcare delivery. Currently, the majority of Australians die in acute hospitals. But despite this, no agreed standard of care exists to define the minimum standard of care that people should accept in the final hours to days of life.

Exploring Pathways for Activation of Carbon Monoxide by Palladium Iminophosphines.

DFT calculations on palladium(II) methyl complexes incorporating P/N ligands demonstrate that CO activation in the presence of competing ligands, such as CH CN or C H , occurs through an associative mechanism involving CO/ligand exchange, followed by migratory insertion of CO into the PdMe bond. Recent investigations into the Pd coordination of CO and C H and their subsequent insertion into the PdMe bonds of complexes of the type [PdMe(iminophosphine)(NCMe)] are reported.

The occurrence and representation of three-centre two-electron bonds in covalent inorganic compounds.

Although compounds that feature 3-centre 2-electron (3c-2e) bonds are well known, there has been no previous effort to classify the interactions according to the number of electrons that each atom contributes to the bond, in a manner analogous to the classification of 2-centre 2-electron (2c-2e) bonds as either normal covalent or dative covalent. This article provides an extension to the Covalent Bond Classification (CBC) method by categorizing 3c-2e interactions according to whether (i) the two electrons are provided by one or by two atoms and (ii) the central bridging atom provides two, one, or zero electrons. Class I 3c-2e bonds are defined as those in which two atoms each contribute one electron to the 3-centre orbital, while Class II 3c-2e bonds are defined as systems in which the pair of electrons are provided by a single atom.

Electron promotion by surface functional groups of single wall carbon nanotubes to overlying metal particles in a fuel-cell catalyst.

A remarkable promotion: Functional groups added onto single-wall carbon nanotubes (SWNTs) can significantly influence the activity of a noble metal for formic acid oxidation. Phenolate groups on SWNTs under alkaline conditions can double the activity of 20 % w/w Pd compared to unmodified SWNTs. This catalyst has 14 times higher activity than the commercial benchmark catalyst (10 % w/w Pd on Vulcan).