Enhancing Patient Care: Evaluating Clinical Utility in Measurement Instruments.

The evaluation of clinical utility is essential for the successful adoption of new technology in clinical practice. An approach to evaluating clinical utility is presented here using the example of digitized measurement instruments.

Hospital-Onset Bacteremia Among Neonatal Intensive Care Unit Patients.

Importance: The Centers for Disease Control and Prevention plans to introduce hospital-onset bacteremia (HOB) as a health care-associated infection measure. The epidemiology and clinical characteristics of HOB among infants admitted to the neonatal intensive care unit (NICU) are unknown.

Objective: To estimate the rate of HOB among infants admitted to the NICU, measure the association of HOB risk with birth weight group and postnatal age, and estimate HOB-attributable mortality.

Clinical Utility and Usability of the Digital Box and Block Test: Mixed Methods Study.

Background: The Box and Block Test (BBT) is a clinical tool used to measure hand dexterity, which is often used for tracking disease progression or the effectiveness of therapy, particularly benefiting older adults and those with neurological conditions. Digitizing the measurement of hand function may enhance the quality of data collection. We have developed and validated a prototype that digitizes this test, known as the digital BBT (dBBT), which automatically measures time and determines and displays the test result.

Microbiome dysbiosis: a modifiable state and target to prevent Staphylococcus aureus infections and other diseases in neonates.

Bacterial infections present a significant threat to neonates. Increasingly, studies demonstrate associations between human diseases and the microbiota, the communities of microorganisms on or in the body. A "healthy" microbiota with a great diversity and balance of microorganisms can resist harmful pathogens and protect against infections, whereas a microbiota suffering from dysbiosis, can predispose to pathogen colonization and subsequent infection.

A Digital Box and Block Test for Hand Dexterity Measurement: Instrument Validation Study.

Background: The Box and Block Test (BBT) measures unilateral gross manual dexterity and is widely used in clinical settings with a wide range of populations, including older people and clients with neurological disorders.

Objective: In this study, we present a newly developed digitized version of the BBT, called the digital BBT (dBBT). The physical design is similar to the original BBT, but the dBBT contains digital electronics that automate the test procedure, timing, and score measurement.

Association of healthcare worker behaviors with coronavirus disease 2019 (COVID-19) risk during four pandemic periods and characteristics associated with high-risk behaviors.

In a large healthcare worker cohort, we quantified the association between behaviors and risk of coronavirus disease 2019 (COVID-19) during different pandemic phases, adjusting for prior infection and vaccination. Individual characteristics, including personal concerns, were associated with these behaviors. Public health messaging should target high-risk populations and behaviors as the pandemic evolves.

Trends in pediatric community-onset antibiotic susceptibilities over a five-year period in a multihospital health system.

The epidemiology of community-onset infections is evolving. We performed a multihospital, retrospective study of pediatric community-onset susceptibilities between 2015 and 2020. Oxacillin and clindamycin susceptibility remained lower at 67% and 75%, respectively.

CD16+CD163+ monocytes traffic to sites of inflammation during necrotizing enterocolitis in premature infants.

Necrotizing enterocolitis (NEC) is a severe gastrointestinal complication of prematurity. Using suspension and imaging mass cytometry coupled with single-cell RNA sequencing, we demonstrate severe inflammation in patients with NEC. NEC mucosa could be subtyped by an influx of three distinct neutrophil phenotypes (immature, newly emigrated, and aged).

Gestational Age-Specific Complete Blood Count Signatures in Necrotizing Enterocolitis.

Necrotizing enterocolitis (NEC) is characterized by peripheral cell abnormalities, yet few studies have analyzed the complete blood count (CBC) specifically by gestational age (GA). Our objective was to describe GA-specific immune abnormalities in NEC through a comprehensive analysis of the CBC differential. Using a cohort of 246 infants (177 cases, 69 controls) admitted to neonatal intensive care units at a single institution, we retrospectively analyzed CBCs around illness onset in NEC cases compared with controls.

COVID-19 in pregnancy: Placental and neonatal involvement.

Since December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused over 12 million infections and more than 550 000 deaths. Morbidity and mortality appear partly due to host inflammatory response. Despite rapid, global research, the effect of SARS-CoV-2 on the developing fetus remains unclear.

Retroperitoneal calcifying fibrous tumor mimicking an adrenal tumor.

Establishing the etiology of a retroperitoneal tumor may be difficult due to close proximity of multiple organs. Evaluation of retroperitoneal tumors often leads to surgery, many times to obtain a definitive diagnosis and rule out malignancy. Calcifying fibrous tumors (CFT) are very rare soft tissue tumors occurring most often in young patients.

A Survey of Obstetric Healthcare Utilization in the Rural Western Indian Himalayas.

Objectives To determine the socio-economic factors affecting access to antepartum, intrapartum, and postpartum healthcare in the rural Western Indian Himalayas over the past 20 years. Methods Face-to-face surveys were conducted with 197 women in Chamoli District, Uttarakhand from October 2011 to May 2012. Participants who gave birth within the past 20 years were included in the final analysis (n = 158).

Association of the very early rise of human chorionic gonadotropin with adverse outcomes in singleton pregnancies after in vitro fertilization.

Objective: To determine if very early serum hCG, a marker of trophoblast differentiation, is associated with adverse perinatal outcomes in singleton pregnancies.

Design: Retrospective cohort study.

Setting: University fertility program.

Court-ordered caesareans.

Court-ordered caesarean sections are in the news after a number of recent legal decisions authorising surgery for women who lack mental capacity to consent. The decisions have not always been based on good evidence and they raise serious concerns about the protection of the rights of mentally ill women. The authors explain the legal process and question the wisdom of recent judgements.

Using the androgen excess-PCOS society criteria to diagnose polycystic ovary syndrome and the risk of metabolic syndrome in adolescents.

Objectives: To use the Androgen Excess-PCOS Society (AE-PCOS) criteria in adolescents to diagnose polycystic ovary syndrome (PCOS) and identify the prevalence of metabolic risk factors.

Study Design: Retrospective chart review of adolescents (>2 years postmenarche) presenting at a specialty clinic from 2008 through 2010 with complete evaluation for PCOS and metabolic risk were reviewed. Metabolic risk in adolescents with PCOS was compared with those with ≤ 1 AE-PCOS criteria.

[Psychopathologic differentiation of aggressive criminals as an aid in expert assessment].

Psychiatric assessment and treatment of aggressive mentally ill offenders is one of the most difficult tasks in forensic psychiatry. Whereas psychiatric literature mostly refers to a uniform definition of aggression, different forms of aggression have been shown in animal experiments. In this study it was tested, whether a psychopathological differentiation of aggression was possible in men.