Association between measures of resuscitation in the critical care resuscitation unit and in-hospital mortality among patients with sepsis.

Objectives: We hypothesized that lactate clearance and reduction of the Sequential Organ Failure Assessment (SOFA) score during patients' critical care resuscitation unit (CCRU) stay would be associated with lower in-hospital mortality.

Methods: This was a retrospective study of adult patients who had sepsis diagnoses and were admitted to the CCRU in 2018. Multivariable logistic regression analysis was performed to assess the association of clinical factors, lactate clearance, and SOFA reduction with hospital mortality.

Use of Esmarch bandage does not increase peripheral vein size in healthy volunteers: A randomized clinical trial.

Introduction: Ultrasound is used for peripheral intravenous (PIV) cannulation in patients with difficult landmark-guided IV access in the Emergency Department. Distal-to-proximal application of an Esmarch bandage on the target limb has been suggested as a method for increasing vein size and ease of cannulation.

Methods: This study was a single-blinded crossover randomized controlled trial comparing basilic vein size under ultrasound with use of an Esmarch bandage in addition to standard IV tourniquet ("tourniquet + Esmarch") compared to use of a standard IV tourniquet alone.

Comparison of Fixed Versus Weight-Based Prothrombin Complex Concentrate Dosing Strategies for Factor Xa Inhibitor Reversal.

Our institution introduced fixed-dose prothrombin complex concentrate (PCC) to streamline order verification and medication administration. Previous studies using fixed-dose PCC for vitamin K antagonist reversal showed comparable efficacy to weight-based dosing. To compare fixed versus weight-based PCC dosing for reversal of Factor Xa Inhibitor (FXaI) effects.

The Clinical Assessment of Prosocial Emotions (CAPE): Initial tests of reliability and validity in a clinic-referred sample of children and adolescents.

Recent changes to diagnostic criteria for serious conduct problems in children and adolescents have included the presence of elevated callous-unemotional traits to define etiologically and clinically important subgroups of youth with a conduct problem diagnosis. The Clinical Assessment of Prosocial Emotions (CAPE) is an intensive assessment of the symptoms of this limited prosocial emotions specifier that uses a structured professional judgment method of scoring, which may make it useful in clinical settings when diagnoses may require more information than that provided by behavior rating scales. The present study adds to the limited tests of the CAPE's reliability and validity, using a sample of clinic-referred children ages 6-17 years of age, who were all administered the CAPE by trained clinicians.

Myotubularin-related proteins regulate KRAS function by controlling plasma membrane levels of polyphosphoinositides and phosphatidylserine.

KRAS is a small GTPase, ubiquitously expressed in mammalian cells, that functions as a molecular switch to regulate cell proliferation and differentiation. Oncogenic mutations that render KRAS constitutively active occur frequently in human cancers. KRAS must localize to the plasma membrane (PM) for biological activity.

The Medical Costs of Firearm Injuries in the United States: A Systematic Review.

Background: Firearm injury poses a significant public health burden in the United States.

Objectives: The purpose of this systematic review was to provide a comprehensive accounting of the medical costs of firearm injuries in the United States.

Methods: A systematic literature review was conducted to identify studies published between January 1, 2000 and July 13, 2022 that reported medical costs of firearm injuries.

Differential burdens of blacklegged ticks ( on sympatric rodent hosts.

In the United States, there has been a steady increase in diagnosed cases of tick-borne diseases in people, most notably Lyme disease. The pathogen that causes Lyme disease, is transmitted by the blacklegged tick (). Several small mammals are considered key reservoirs of this pathogen and are frequently-used hosts by blacklegged ticks.

Sensitivity of in Tennessee and North Carolina to Mefenoxam, Oxathiapiprolin, Mandipropamid, and Fluopicolide.

causes devastating disease in a range of hosts, including tobacco ( L.), tomato, citrus, strawberry, and numerous ornamentals. Black shank, caused by , is the most economically important disease to tobacco production in Tennessee and North Carolina.

POCUS for Diastolic Dysfunction: A Review of the Literature.

Emergency and critical care physicians frequently encounter patients presenting with dyspnea and normal left ventricular systolic function who may benefit from early diastolic evaluation to determine acute patient management. The current American Society of Echocardiography Guidelines approach to diastolic evaluation is often impractical for point of care ultrasound (POCUS) evaluation, and few studies have evaluated the potential use of a simplified approach. This article reviews the literature on the use of a simplified diastolic evaluation to assist in determining acute patient management.

Clinical outcomes and echocardiographic characteristics between African American and Caucasian patients with acute pulmonary embolism.

Background: Despite socioeconomic disparities, no association between clinical presentation and poor outcomes explains a higher mortality in African Americans with pulmonary embolism (PE). The objective is to identify the co-morbidities and echocardiographic characteristics associated with increased mortality in African American patients.

Methods: This is a cross-sectional study of Caucasian or African American patients with PE diagnosed between October 2015 and December 2017 at University of Maryland Medical Center.

Association between resuscitation in the critical care resuscitation unit and in-hospital mortality.

Introduction: Patients who present in shock have high expected mortality and early resuscitation is crucial to improve their outcomes. The Critical Care Resuscitation Unit (CCRU) is a specialized unit at the University of Maryland Medical Center (UMMC) that prioritizes early resuscitation of critically ill patients. We hypothesized that lactate clearance and reduction of Sequential Organ Failure Assessment (SOFA) score during CCRU stay would be associated with lower in-hospital mortality.

Dimension-reduction simplifies the analysis of signal crosstalk in a bacterial quorum sensing pathway.

Many pheromone sensing bacteria produce and detect more than one chemically distinct signal, or autoinducer. The pathways that detect these signals are typically noisy and interlocked through crosstalk and feedback. As a result, the sensing response of individual cells is described by statistical distributions that change under different combinations of signal inputs.

Lipid intensive drug therapy for sepsis pilot: A Bayesian phase I clinical trial.

Objectives: Cholesterol may be protective in sepsis. Patients with early sepsis may have critically low cholesterol levels that are associated with poor outcomes. The study objective was to test the safety of a fish oil-containing lipid injectable emulsion for stabilizing early cholesterol levels in sepsis.

Time to vasopressor initiation and organ failure progression in early septic shock.

Objective: Research evaluating the relationship between vasopressor initiation timing and clinical outcomes is limited and conflicting. We investigated the association between time to vasopressors, worsening organ failure, and mortality in patients with septic shock.

Methods: This was a retrospective study of patients with septic shock (2013-2016) within 24 hours of emergency department (ED) presentation.

Quantitative and Qualitative Assessments of Cholesterol Association With Bacterial Infection Type in Sepsis and Septic Shock.

Background: Reduced cholesterol levels are associated with increased organ failure and mortality in sepsis. Cholesterol levels may vary by infection type (gram negative vs positive), possibly reflecting differences in cholesterol-mediated bacterial clearance.

Methods: This was a secondary analysis of a combined data set of 2 prospective cohort studies of adult patients meeting Sepsis-3 criteria.

Intergenerational Influences on Faith-based Strategies Used in Response to Racial Discrimination Among Young African American Adults.

Objective: In this report, we used a qualitative descriptive design to explore young African American adults' intergenerationally influenced strategies to experienced racial discrimination.

Methods: The study was guided by a qualitative descriptive design using criterion and snowball sampling, and semi-structured interview questions. We also explored, quantitatively, gender differences among the racial discrimination experiences encountered and the strategies used.

LIPid Intensive Drug therapy for Sepsis Pilot (LIPIDS-P): Phase I/II clinical trial protocol of lipid emulsion therapy for stabilising cholesterol levels in sepsis and septic shock.

Introduction: Sepsis is a life-threatening, dysregulated response to infection. Both high-density lipoprotein and low-density lipoprotein cholesterol should protect against sepsis by several mechanisms; however, for partially unknown reasons, cholesterol levels become critically low in patients with early sepsis who experience poor outcomes. An anti-inflammatory lipid injectable emulsion containing fish oil is approved by the Food and Drug Administration as parenteral nutrition for critically ill patients and may prevent this decrease in serum cholesterol levels by providing substrate for cholesterol synthesis and may favourably modulate inflammation.

Depletion of phosphatidylinositol 4-phosphate at the Golgi translocates K-Ras to mitochondria.

Ras proteins are small GTPases localized to the plasma membrane (PM), which regulate cellular proliferation, apoptosis and differentiation. After a series of post-translational modifications, H-Ras and N-Ras traffic to the PM from the Golgi via the classical exocytic pathway, but the exact mechanism of K-Ras trafficking to the PM from the ER is not fully characterized. ATP5G1 (also known as ATP5MC1) is one of the three proteins that comprise subunit c of the complex of the mitochondrial ATP synthase.

Training rugby athletes with an external attentional focus promotes more automatic adaptions in landing forces.

Training to reduce landing forces is a common component of anterior cruciate ligament injury prevention programmes. The purpose of this study was to compare the effects of training incorporating instructions promoting an internal versus external attentional focus on landing forces in adolescent rugby athletes. Twenty-two rugby athletes were randomly allocated to groups that received instructions promoting an internal versus an external focus during a two week training programme.

The influence of fatigue on decision-making in athletes: a systematic review.

A potential challenge associated with sports is that athletes must often perform the cognitive processing associated with decision-making (i.e., movement selection) when fatigued.

Decision Making Influences Tibial Impact Accelerations During Lateral Cutting.

Lower-extremity musculoskeletal injuries are common in sports such as basketball and soccer. Athletes competing in sports of this nature must maneuver in response to the actions of their teammates, opponents, etc. This limits their ability to preplan movements.

Extended-release oral treprostinil in the management of pulmonary arterial hypertension: clinical evidence and experience.

Treprostinil diolamine is the first oral prostacyclin approved for the treatment of pulmonary arterial hypertension (PAH) to improve exercise capacity. Clinical studies have demonstrated modest benefit as monotherapy, whereas no difference in exercise capacity was observed with combination therapy. However, these trials were limited by subtherapeutic dosing owing to intolerable adverse effects.