The policy case for designating EMS teams for vulnerable patient populations: Evidence from an intervention in Boston.

This study documents more than five years of analysis that drove the policy case, deployment, and retrospective evaluation for an innovative service model that enables Boston Emergency Medical Services (EMS) to respond quickly and effectively to investigation incidents in an area of heavy need in Boston. These investigation incidents are typically calls for service from passers-by or other third-party callers requesting that Boston EMS check in on individuals, often those who may appear to have an altered mental status or to be unhoused. First, this study reports the pre-intervention analytics in 2017 that built the policy case for service segmentation, a new Community Assistance Team designated "Squad 80" that primarily responds to investigation incidents in one broad area of the city with high rates of substance abuse and homelessness, helping patients who often refuse ambulance transport connect to social services.

Can aura migraine be elicited by isolated pulmonary arteriovenous fistula?-A case report.

A pulmonary arteriovenous fistula (PAVM) is an abnormal blood vessel that creates a direct connection between a pulmonary artery and its tributary vein bypassing capillary filter, establishing as a consequence of a low-resistance right-to-left shunting (RLS). The vast majority of PAVMs are congenital appearing more often in females than in males. A great number of patients with PAVMs is suffering concurrently from hereditary hemorrhagic telangiectasia (HHT) whose incidence is around 1 in 5,000.

Policy-Relevant Indicators of Urban Emergency Medical Services COVID-19-Patient Encounters.

In the first two years of the COVID-19 pandemic, members of Boston Emergency Medical Services, the City of Boston's municipal ambulance service, had 7,689 encounters with confirmed-positive Boston residents. As COVID-19 virus strains continue to infect residents in Boston and across the country, understanding the correlation between population positivity, EMS encounters, and hospitalizations can inform healthcare response. This study examines urban virus-surveillance indicators that can serve as an early warning of the volume of Emergency Medical Services (EMS) encounters with COVID-19 positive patients and subsequently how EMS encounters with confirmed COVID-19 patients can serve as an early indicator of future hospital-demand surges.

Worse Cardiac Arrest Outcomes During The COVID-19 Pandemic In Boston Can Be Attributed To Patient Reluctance To Seek Care.

Delays in seeking emergency care stemming from patient reluctance may explain the rise in cases of out-of-hospital cardiac arrest and associated poor health outcomes during the COVID-19 pandemic. In this study we used emergency medical services (EMS) call data from the Boston, Massachusetts, area to describe the association between patients' reluctance to call EMS for cardiac-related care and both excess out-of-hospital cardiac arrest incidence and related outcomes during the pandemic. During the initial COVID-19 wave, cardiac-related EMS calls decreased (-27.

An investigation into the concurrent collection of human scent and epithelial skin cells using a non-contact sampling device.

In criminal investigations, the collection of human scent often employs a non-contact, dynamic airflow device, known as the Scent Transfer Unit 100 (STU-100), to transfer volatile organic compounds (VOCs) from an object/person onto a collection material that is subsequently presented to human scent discriminating canines. Human scent is theorized to be linked to epithelial skin cells that are shed at a relatively constant rate allowing both scent and cellular material to be deposited into the environment and/or onto objects. Simultaneous collection of cellular material, with adequate levels of nuclear deoxyribonucleic acid (nDNA), and human scent using a non-invasive methodology would facilitate criminal investigations.

Mayans: a Y chromosome perspective.

Unlabelled: In spite of the wealth of available cultural and archeological information as well as general interest in the Mayans, little is known about their genetics. In this study, for the first time, we attempt to alleviate this lacuna of knowledge by comprehensively investigating the Y chromosome composition of contemporary Mayan populations throughout their domain. To accomplish this, five geographically targeted and ethnically distinct Mayan populations are investigated using Y-SNP and Y-STR markers.

Biomechanical evaluation between the modified Mason-Allen stitch and the locked double-tie stitch on the infraspinatus of sheep.

Objectives: To evaluate and compare the in vitro biomechanical results from two stitches: the Mason-Allen stitch, as modified by Habermeyer; and the locked double-tie stitch developed at our service, on tendons of the infraspinatus muscle of sheep.

Methods: Twenty tendons from the infraspinatus muscle of sheep were randomly divided into two groups: LDT, on which the locked double-tie stitch was performed; and MA, with the modified Mason-Allen stitch. The evaluation was performed in the mechanics laboratory, using a standard test machine with unidirectional traction, constant velocity of 20 mm per second and a 500 N load cell, without force cycling.

Arthroscopic double-locked stitch: a new technique for suturing rotator cuff tears.

There are a number of reasons for failed rotator cuff tear repair. In such cases the suture-tendon interface seems to be the most vulnerable area, especially when tendon degeneration is present. We describe a new technique, the arthroscopic double-locked suture, that increases the tendon fixation and has the added benefit of being placed parallel to the blood vessels, therefore avoiding damage to the tendon vascularization.

Assessment of the influence of field size on maize gene flow using SSR analysis.

One of the factors that may influence the rate of cross-fertilization is the relative size of the pollen donor and receptor fields. We designed a spatial distribution with four varieties of genetically-modified (GM) yellow maize to generate different sized fields while maintaining a constant distance to neighbouring fields of conventional white kernel maize. Samples of cross-fertilized, yellow kernels in white cobs were collected from all of the adjacent fields at different distances.

Prognostic significance of valvuloarterial impedance and left ventricular longitudinal function in asymptomatic severe aortic stenosis involving three-cuspid valves.

The purpose of the present study was to evaluate the role of left ventricular global afterload and various echocardiographic parameters of systolic function in a prospective cohort of 52 asymptomatic patients with severe aortic stenosis (indexed aortic valve area 0.4 ± 0.1 cm²/m²) and normal left ventricular ejection fraction (61 ± 5%).

FLUOROSCOPY DURATION IN ORTHOPEDIC SURGERY.

Objective: To ascertain the mean length of radiation emission from fluoroscopic devices during several types of orthopedic surgery and which of these required greater use of radiation.

Methods: The times taken to perform sixteen different types of surgery (total of 80 procedures) were measured. At the end of each procedure, the length of time for which fluoroscopy was used directly from the image intensifier was ascertained.

Y-STR profiling in two Afghanistan populations.

Afghanistan's unique geostrategic position in Eurasia has historically attracted commerce, conflict and conquest to the region. It was also an important stop along the Silk Road, connecting the far eastern civilizations with the western world. Nevertheless, limited genetic studies have been performed in Afghan populations.

Y-STR diversity in the Himalayas.

Linguistic and ethnic diversity throughout the Himalayas suggests that this mountain range played an important role in shaping the genetic landscapes of the region. Previous Y-chromosome work revealed that the Himalayas acted as a biased bidirectional barrier to gene flow across the cordillera. In the present study, 17 Y-chromosomal short tandem repeat (Y-STR) loci included in the AmpFlSTR® Yfiler kit were analyzed in 344 unrelated males from three Nepalese populations (Tamang, Newar, and Kathmandu) and a general collection from Tibet.

Effects of surgical ventricular reconstruction on diastolic function at midterm follow-up.

Objective: Limited data are available on the effects of surgical ventricular reconstruction on diastolic function. The aim of the present study was to evaluate changes in diastolic function induced by surgical ventricular reconstruction at 2 time intervals after surgery (discharge and follow-up) and to assess the impact of diastolic changes on clinical outcome.

Methods: A total of 129 patients (65 +/- 9 years, 14 women) underwent echocardiographic Doppler evaluation before surgical ventricular reconstruction, at discharge, and at follow-up (median 7 months).

Effect of volunteers on maize gene flow.

Regulatory approvals for deliberate release of GM maize events into the environment have lead to real situations of coexistence between GM and non-GM, with some fields being cultivated with GM and conventional varieties in successive seasons. Given the common presence of volunteer plants in maize fields in temperate areas, we investigated the real impact of GM volunteers on the yield of 12 non-GM agricultural fields. Volunteer density varied from residual to around 10% of plants in the field and was largely reduced using certain cultural practices.

Evaluation of intensivists' knowledge on brain death.

Background And Objectives: Failure or delay to diagnose brain death leads to needless occupation of a hospital bed, emotional and financial losses, and unavailability of organs for transplants. The intensive care physician plays an essential role in this diagnosis. This study intended to evaluate intensivists' knowledge concerning brain death.

Pollen-mediated gene flow in maize in real situations of coexistence.

We present the first study on cross-fertilization between Bt and conventional maize in real situations of coexistence in two regions in which Bt and conventional maize were cultivated. A map was designed and the different crops were identified, as were the sowing and flowering dates, in Bt and conventional maize fields. These data were used to choose the non-transgenic fields for sampling and analysis by the real-time quantification system-polymerase chain reaction (RTQ-PCR) technique.

The effects of summarization instruction on text comprehension of students with learning disabilities.

This study examined the effectiveness of a summarization strategy for increasing comprehension of expository prose in students with learning disabilities. Thirty students with learning disabilities from Grades 6 through 9 were randomly assigned to experimental and control groups. In addition, 15 students without disabilities served as a normal comparison group for comprehension.

Pharmacologic manipulation of the respiratory control center in the infant.

The respiratory control center receives afferent stimuli from mechanical and neuromechanical sources. Information from both these sources, combined with voluntary and involuntary CNS control, effects stimulation of the respiratory muscles. In the infant, insufficiency of one or more of these elements of the respiratory control center is associated with considerable morbidity and mortality.

Psoas muscle pancreatic pseudocyst: CT--US diagnosis and percutaneous drainage.

We present 2 cases of psoas muscle pancreatic pseudocysts. In both cases there was no clinical or laboratory evidence of recent acute pancreatitis. The route of extension for the pseudocyst from the pancreas to the psoas was the perirenal space.