Management of adult sepsis in resource-limited settings: global expert consensus statements using a Delphi method.

Purpose: To generate consensus and provide expert clinical practice statements for the management of adult sepsis in resource-limited settings.

Methods: An international multidisciplinary Steering Committee with expertise in sepsis management and including a Delphi methodologist was convened by the Asia Pacific Sepsis Alliance (APSA). The committee selected an international panel of clinicians and researchers with expertise in sepsis management.

Mesenchymal stem cells in tumor microenvironment: drivers of bladder cancer progression through mitochondrial dynamics and energy production.

Mesenchymal stem cells (MSCs) in tumor microenvironment (TME) are crucial for the initiation, development, and metastasis of cancer. The impact and mechanism of MSCs on bladder cancer are uncertain. Here we analyzed 205 patient samples to explore the relationships between tumor-stroma ratio and clinicopathological features.

Comprehensive Characterization of Intraductal Oncocytic Papillary Neoplasm of the Pancreas: A Systematic and Critical Review.

Intraductal oncocytic papillary neoplasm (IOPN) of the pancreas is a recently recognized pancreatic tumor. Here, we aimed to determine its most essential features with the systematic review tool. PubMed, Scopus, and Embase were searched for studies reporting data on pancreatic IOPN.

Social Determinants of Health and Redirection of Care for Infants Born Extremely Preterm.

Importance: Redirection of care refers to withdrawal, withholding, or limiting escalation of treatment. Whether maternal social determinants of health are associated with redirection of care discussions merits understanding.

Objective: To examine associations between maternal social determinants of health and redirection of care discussions for infants born extremely preterm.

Early-Life Outcomes in Relation to Social Determinants of Health for Children Born Extremely Preterm.

Objective: To characterize the relationships between social determinants of health (SDOH) and outcomes for children born extremely preterm.

Study Design: This is a cohort study of infants born at 22-26 weeks of gestation in National Institute of Child Health and Human Development Neonatal Research Network centers (2006-2017) who survived to discharge. Infants were classified by 3 maternal SDOH: education, insurance, and race.

Ablation of lysophosphatidic acid receptor 1 attenuates hypertrophic cardiomyopathy in a mouse model.

Myocardial fibrosis is a key pathologic feature of hypertrophic cardiomyopathy (HCM). However, the fibrotic pathways activated by HCM-causing sarcomere protein gene mutations are poorly defined. Because lysophosphatidic acid is a mediator of fibrosis in multiple organs and diseases, we tested the role of the lysophosphatidic acid pathway in HCM.

Rehabilitation for Total Hip Arthroplasty: A Systematic Review.

We sought to determine the comparative benefits and harms of rehabilitation interventions for patients who have undergone elective, unilateral THA surgery for the treatment of primary osteoarthritis. We searched PubMed, Embase, The Cochrane Register of Clinical Trials, CINAHL, PsycINFO, Scopus, and ClinicalTrials.gov from January 1, 2005, through May 3, 2021.

Prehabilitation for Total Knee or Total Hip Arthroplasty: A Systematic Review.

We sought to systematically review the evidence on the benefits and harms of prehabilitation interventions for patients who are scheduled to undergo elective, unilateral total knee arthroplasty or total hip arthroplasty surgery for the treatment of primary osteoarthritis. We searched PubMed, Embase, The Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, Scopus, and ClinicalTrials.gov from January 1, 2005, through May 3, 2021.

Rehabilitation for Total Knee Arthroplasty: A Systematic Review.

We sought to determine the comparative benefit and harm of rehabilitation interventions for patients who have undergone elective, unilateral total knee arthroplasty for the treatment of primary osteoarthritis. We searched PubMed, Embase, The Cochrane Register of Clinical Trials, CINAHL, PsycINFO, Scopus, and ClinicalTrials.gov from January 1, 2005, through May 3, 2021.

Diffuse pulmonary micronodules related to prior VZV infection.

Background/introduction: Chickenpox is a common viral infection caused by Varicella-zoster virus (VZV). Pneumonia is an infrequent complication of chickenpox infection. Rarely, multiple calcified pulmonary nodules can be the sequela of healed VZV pneumonia.

Association of Dexamethasone with Shunt Requirement, Early Disability, and Medical Complications in Aneurysmal Subarachnoid Hemorrhage.

Background And Purpose: Current guidelines do not support the routine use of corticosteroids in patients with aneurysmal subarachnoid hemorrhage (aSAH). However, corticosteroids use in aSAH has been practiced at some centers by convention. The aim of the study was to determine the incidence of hydrocephalus requiring ventriculoperitoneal shunt (VPS) placement as well as functional outcome on discharge and adverse events attributed to corticosteroids in patients with aSAH treated with different dexamethasone (DXM) treatment schemes.

Gadofosveset-enhanced lung magnetic resonance imaging to detect ongoing vascular leak in pulmonary fibrosis.

Vascular leak is increased diffusely in the lungs in pulmonary fibrosis and is not limited to radiographic areas of disease involvement.

Moving Towards a Cure for MS: Increased Immunosuppression and Striving for No Evidence of Disease Activity (NEDA).

Multiple sclerosis (MS) is a chronic central nervous system demyelinating disease. The cause is unknown, but likely results from a combination of genetic predisposition and environmental exposures leading to autoimmune destruction of the brain and spinal cord. The most common phenotype of MS is relapsing-remitting (RRMS), characterized by episodes of neurological symptoms, typically lasting days to weeks, followed by symptom remission.

Implementing Alcohol Misuse SBIRT in a National Cohort of Pediatric Trauma Centers-a type III hybrid effectiveness-implementation trial.

Background: The American College of Surgeons mandates universal screening for alcohol misuse and delivery of an intervention for those screening positive as a requirement for certification as a level 1 trauma center. Though this requirement has been mandated for over a decade, its implementation has been challenging. Our research team completed an implementation study supporting seven pediatric trauma centers' compliance with the requirement by developing and implementing an institutional alcohol Screening, Brief Intervention and Referral to Treatment (SBIRT) policy for adolescent trauma patients.

A modified nontransposed brachiobasilic arteriovenous fistula versus brachiocephalic arteriovenous fistula for maintenance hemodialysis access.

Objective: With the growing need for reliable and durable upper arm hemodialysis access, we sought to compare the performance of a novel modified nontransposed brachiobasilic arteriovenous fistula (mNT-BBAVF) with that of the more traditional brachiocephalic arteriovenous fistula (BCAVF).

Methods: Briefly, to construct an mNT-BBAVF, an incision is made on the ulnar side of the elbow. The brachial artery and basilic vein are then isolated, and a side-to-side anastomosis is performed without transposition of the basilic vein.

Cost-effectiveness of dalteparin vs unfractionated heparin for the prevention of venous thromboembolism in critically ill patients.

Importance: Venous thromboembolism (VTE) is a common complication of acute illness, and its prevention is a ubiquitous aspect of inpatient care. A multicenter blinded, randomized trial compared the effectiveness of the most common pharmocoprevention strategies, unfractionated heparin (UFH) and the low-molecular-weight heparin (LMWH) dalteparin, finding no difference in the primary end point of leg deep-vein thrombosis but a reduced rate of pulmonary embolus and heparin-induced thrombocytopenia among critically ill medical-surgical patients who received dalteparin.

Objective: To evaluate the comparative cost-effectiveness of LMWH vs UFH for prophylaxis against VTE in critically ill patients.

Effects of a web-based educational module on pediatric emergency medicine physicians' knowledge, attitudes, and behaviors regarding youth violence.

Introduction: Youth seen in the emergency department (ED) with injuries from youth violence (YV) have increased risk for future violent injury and death. Pediatric emergency medicine (PEM) physicians rarely receive training in, or perform, YV screening and intervention. Our objective was to examine effects of a web-based educational module on PEM physicians' knowledge, attitudes, and behaviors regarding YV screening and interventions in the ED.

Multicenter pilot treatment trial for psychogenic nonepileptic seizures: a randomized clinical trial.

Importance: There is a paucity of controlled treatment trials for the treatment of conversion disorder, seizures type, also known as psychogenic nonepileptic seizures (PNES). Psychogenic nonepileptic seizures, the most common conversion disorder, are as disabling as epilepsy and are not adequately addressed or treated by mental health clinicians.

Objective: To evaluate different PNES treatments compared with standard medical care (treatment as usual).

Embedding the Family Check Up and Evidence-Based Parenting Programs in Head Start to Increase Parent Engagement and Reduce Conduct Problems in Young Children.

Parent engagement (i.e., enrollment, ongoing attendance, participation quality) remains a major obstacle to fully realizing the benefits of evidence-based preventive parent management training in community settings.

Terminal hospitalizations of nursing home residents: does facility increasing the rate of do not resuscitate orders reduce them?

Context: Terminal hospitalizations are costly and often avoidable with appropriate advance care planning.

Objectives: This study examined the association between advance care planning, as measured by facility rate of do not resuscitate (DNR) orders in U.S.

Preventive healthcare for underserved women: results of a prison survey.

Objectives: We sought to determine the preventive healthcare needs of incarcerated women in the following areas: cervical cancer and breast cancer screening, sexually transmitted infection (STI) screening, hepatitis screening and vaccination, and smoking cessation.

Methods: A cross-sectional interview survey of a random sample of 100 incarcerated women at the Rhode Island Department of Corrections (RIDOC) in Cranston, Rhode Island, was conducted.

Results: Participants were 62% white, 11% African American, 13% Hispanic, and 14% of mixed race.