An technique to measure resistance to compression and kinking of endotracheal tubes.

Background: During intraoperative care, ventilatory parameters including peak inflating pressure (PIP) and exhaled tidal volumes are continuously monitored to assess changes in respiratory resistance and compliance. Changes in these parameters, such as an increase in PIP or a decrease in the exhaled tidal volume, may indicate various pathologic processes that may require immediate attention to prevent inadequate ventilation resulting in hypoxemia or hypercarbia. A kinked endotracheal tube (ETT) may mimic other pathologic processes including bronchospasm, mainstem intubation, or ventilator malfunction.

Medical Error: Using Storytelling and Reflection to Impact Error Response Factors in Family Medicine Residents.

Unlabelled: I am a healer, yet sometimes I do more harm than good…David Hilfiker, 1984.

Objectives: Medical error is common and significantly impacts patients, physicians, learners, and public perception of the medical system; however, residents receive little formal training on this topic. Research on error response in practicing physicians is limited, and even more so on medical education interventions to improve this.

Updated Assessment of Practice Patterns of Perioperative Management of Antiplatelet and Anticoagulant Therapy in Interventional Pain Management.

Background: The role of antiplatelet/anticoagulant therapy is well known for its primary and secondary prevention of sequela from cardiovascular disease by decreasing the incidence of acute cerebral, cardiovascular, peripheral vascular, and other thrombo-embolicevents. The overwhelming data show that the risk of thrombotic events is significantly higher than that of bleeding during surgery after antiplatelet drug discontinuation. It has been assumed that discontinuing antiplatelet therapy prior to performing interventional pain management techniques is a common practice, even though doing so may potentially increase the risk of acute cerebral and cardiovascular events.

A historical perspective on clonidine as an alpha-2A receptor agonist in the treatment of addictive behaviors: Focus on opioid dependence.

Clonidine operates through agonism at the alpha-2A receptor, a specific subtype of the alpha-2-adrenergic receptor located predominantly in the prefrontal cortex. By inhibiting the release of norepinephrine, which is responsible for withdrawal symptoms, clonidine effectively addresses withdrawal-related conditions such as anxiety, hypertension, and tachycardia. The groundbreaking work by Gold .

Third-Trimester Ultrasound Diagnosis of Large for Gestational Age and Risk of Cesarean Delivery.

Objective: Determine if knowledge of a third-trimester ultrasound diagnosis of large for gestational age (LGA) independently increases the risk of cesarean delivery (CD).

Study Design: Historical cohort comparing CD rate among patients diagnosed with an LGA fetus on a clinically indicated ultrasound from January 2017 to July 2021 with those without an LGA diagnosis at 34 weeks or later. LGA was defined as an ultrasound-estimated fetal weight greater than or equal to the 90th percentile for the gestational age.

Top Three Healthcare Trends in Orthopaedics Affecting Musculoskeletal Care in the Elderly.

Several trends toward patient-centered multi-care models employing translational research strategies are currently emerging in orthopaedics. These align seamlessly with epigenetics discussions in pain, a clinical approach to pain management that prioritizes tailoring healthcare to individual needs, preferences, and circumstances. Recognizing the unique genetic and epigenetic factors influencing pain perception, healthcare providers can integrate personalized insights into their patient-centered approach, offering more targeted and effective pain management strategies tailored to each individual's experience.

Medical Educator Perceptions of Faculty Effort and Intent to Stay in Academic Medicine.

Purpose: Core roles of medical school faculty are increasingly diverse, substantial, and evolving. In alignment with this dynamic nature of medical education, faculty effort should be accurately appraised, constantly evaluated, and rewarded to ensure faculty satisfaction and promote a culture of belonging. The study goal was to examine the imbalance in official assignments and perceptions of medical school faculty effort in various educator domains.

Review of retropharyngeal and parapharyngeal nodal metastasis of papillary thyroid carcinoma.

Background: Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer. In rare instances, PTC has metastasized to the retropharyngeal and parapharyngeal nodes. This is hypothesized to occur due to an aberrant lymphatic channel or via retrograde lymphatic flow following previous neck dissection.

Proactive Psychiatry: Innovating the Delivery of Consultation-Liaison Services in a Pediatric Hospital.

Background: The benefits of a proactive consultation-liaison psychiatry service have been well documented in the adult population, including decreased length of stay (LOS), increased satisfaction among physicians, and enhanced collaborative care. However, there is no available research on the effectiveness of this model in pediatric hospitals.

Objective: This study compared patients aged 5-18 years on a general medical floor receiving a proactive psychiatry consult to concurrent controls receiving no consult and to historical controls receiving traditional reactive consults.

Tech Gaming Designs, Neurodevelopmental Vulnerabilities, and Risks for Internet Gaming Disorder: What Clinicians Need to Know.

Digital gaming has surged in recent decades and is widely available to individuals of all ages. Although the construct of play and games is anthropologically linked to human development, the central question remains: Does the exponential technological advancement target vulnerabilities linked to the risk of addiction? A growing burden of individuals who blur the lines between use, misuse, and addiction adds to the list of many confounders linked to mental health crises. The growing body of literature led to the addition of internet gaming disorder (IGD) to the conditions that need further research section of the .

Prenatal parvovirus B19 infection.

Parvovirus B19 (B19V) causes erythema infectiosum, a.k.a.

Homeostatic Synaptic Plasticity of Miniature Excitatory Postsynaptic Currents in Mouse Cortical Cultures Requires Neuronal Rab3A.

Following prolonged activity blockade, amplitudes of miniature excitatory postsynaptic currents (mEPSCs) increase, a form of plasticity termed "homeostatic synaptic plasticity." We previously showed that a presynaptic protein, the small GTPase Rab3A, is required for full expression of the increase in miniature endplate current amplitudes following prolonged blockade of action potential activity at the mouse neuromuscular junction in vivo (Wang et al., 2011), but it is unknown whether this form of Rab3A-dependent homeostatic plasticity shares any characteristics with central synapses.

Factors Influencing Participation and Engagement in a Teen Safe Driving Intervention: A Qualitative Study.

(1) Background: Few teen driving safety programs focus on increasing parental engagement with high-risk teen drivers, specifically those with a traffic violation. This study explored parents'/guardians' ('parents') experiences with a teen driving safety program, ProjectDRIVE, including facilitators and barriers to program engagement. (2) Methods: We conducted virtual, semi-structured interviews with parents who completed ProjectDRIVE, which included in-vehicle driving feedback technology and individualized virtual training with parents on effective parent-teen communication.

Adaptive Filtering with Fitted Noise Estimate (AFFiNE): Blink Artifact Correction in Simulated and Real P300 Data.

(1) Background: The electroencephalogram (EEG) is frequently corrupted by ocular artifacts such as saccades and blinks. Methods for correcting these artifacts include independent component analysis (ICA) and recursive-least-squares (RLS) adaptive filtering (-AF). Here, we introduce a new method, AFFiNE, that applies Bayesian adaptive regression spline (BARS) fitting to the adaptive filter's reference noise input to address the known limitations of both ICA and RLS-AF, and then compare the performance of all three methods.

How Physicians are Trained to Interact With the Dying: A Thematic Analysis of Medical Student Exposures to End-Of-Life Cases.

Physicians-in-training feel uncomfortable coping with the grief they experience while delivering end-of-life care, and medical schools offer minimal formal curricular offerings on end of life care. Few studies have identified what experiences medical students have with death while training or what lessons they are being taught by more senior physicians at bedside. This qualitative study conducted semi-structured interviews prior to and six months into the medical school clinical year.

Compassionate Curiosity: Mitigating the Effects of Bias Through Motivational Interviewing.

There is strong evidence that the implicit biases of health care professionals affect the treatment of patients, and that minority and other marginalized patients are disproportionately harmed. Assumptions made about patient knowledge or lack thereof function as judgments that are prone to bias, which then affect the education and advice imposed upon patients. We review how the motivational interviewing (MI) approach to patient engagement includes components of evidence-based bias-mitigating strategies, such as understanding circumstances from the patient's point of view, and therefore we propose that the MI approach can reduce the impact of bias in patient care.

Enrolling High-Acuity Emergency General Surgery Patients in a Prospective Longitudinal Cohort Study.

Over three million patients are admitted to hospitals annually with high-acuity conditions mandating emergency abdominal or skin/soft-tissue operation. Patients with these high-acuity emergency general surgery (HA-EGS) diseases experience significant morbidity/mortality, yet the quality of life (QOL) impact on survivors is not well studied. Acuity, transfer patterns, and adverse social determinants of health (SDOH) documented in epidemiologic studies are cited reasons for inability to measure patient-reported outcomes (PROs) among HA-EGS survivors.

Post-Acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) After Infection During Pregnancy.

Objective: To estimate the prevalence of post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) after infection with SARS-CoV-2 during pregnancy and to characterize associated risk factors.

Methods: In a multicenter cohort study (NIH RECOVER [Researching COVID to Enhance Recovery]-Pregnancy Cohort), individuals who were pregnant during their first SARS-CoV-2 infection were enrolled across the United States from December 2021 to September 2023, either within 30 days of their infection or at differential time points thereafter. The primary outcome was PASC , defined as score of 12 or higher based on symptoms and severity as previously published by the NIH RECOVER-Adult Cohort, at the first study visit at least 6 months after the participant's first SARS-CoV-2 infection.