Three-Dimensional Electrical Impedance Imaging During Spontaneous Breathing Trials in Patients With Acute Hypoxic Respiratory Failure: A Pilot Study.

The purpose of this work is to evaluate the feasibility of lung imaging using 3D electrical impedance tomography (EIT) during spontaneous breathing trials (SBTs) in patients with acute hypoxic respiratory failure. EIT is a noninvasive, nonionizing, real-time functional imaging technique, suitable for bedside monitoring in critically ill patients. EIT data were collected in 24 mechanically ventilated patients immediately preceding and during a SBT on two rows of 16 electrodes using a simultaneous multicurrent source EIT system for 3D imaging.

Severity of Impaired Oxygenation and Conservative Oxygenation Targets in Mechanically Ventilated Children: A Post Hoc Subgroup Analysis of the Oxy-PICU Trial of Conservative Oxygenation.

Objectives: A conservative oxygenation strategy is recommended in adult and pediatric guidelines for the management of acute respiratory distress syndrome to reduce iatrogenic lung damage. In the recently reported Oxy-PICU trial, targeting peripheral oxygen saturations (Spo2) between 88% and 92% was associated with a shorter duration of organ support and greater survival, compared with Spo2 greater than 94%, in mechanically ventilated children following unplanned admission to PICU. We investigated whether this benefit was greater in those who had severely impaired oxygenation at randomization.

Leveraging Artificial Intelligence as a Safety Net for Incidentally Identified Lung Nodules at a Tertiary Center.

Background: Artificial intelligence (AI)-powered platforms may be used to ensure that clinically significant lung nodules receive appropriate management. We studied the impact of a commercially available AI natural language processing tool on detection of clinically significant indeterminate pulmonary nodules (IPNs) based on radiology reports and provision of guideline-consistent care.

Study Design: All computed tomography (CT) scans performed at a single tertiary care center in the outpatient or emergency room setting between 20-Feb-2024 and 20-March-2024 were processed by the AI natural language processing algorithm.

Awareness and Attitude Toward Artificial Intelligence Among Medical Students and Pathology Trainees: Survey Study.

Background: Artificial intelligence (AI) is set to shape the future of medical practice. The perspective and understanding of medical students are critical for guiding the development of educational curricula and training.

Objective: This study aims to assess and compare medical AI-related attitudes among medical students in general medicine and in one of the visually oriented fields (pathology), along with illuminating their anticipated role of AI in the rapidly evolving landscape of AI-enhanced health care.

Pathological roles of ubiquitination and deubiquitination systems in sepsis-induced myocardial dysfunction.

Sepsis-induced myocardial dysfunction (SIMD) is a severe complication of sepsis, characterized by impaired cardiac function and high mortality rates. Despite significant advances in understanding sepsis pathophysiology, the molecular mechanisms underlying SIMD remain incompletely elucidated. Ubiquitination and deubiquitination, critical post-translational modifications (PTMs) regulating protein stability, localization, and activity, play pivotal roles in cellular processes, such as inflammation, apoptosis, mitochondrial function, and calcium handling.

Combating Antibiotic-Resistant Bacterial Infection Using Coassembled Dimeric Antimicrobial Peptide-Based Nanofibers.

The emergence of multidrug-resistant (MDR) pathogens, coupled with the limited effectiveness of existing antibiotics in eradicating biofilms, presents a significant threat to global health care. This critical situation underscores the urgent need for the discovery and development of antimicrobial agents. Recently, peptide-derived antimicrobial nanomaterials have shown promise in combating such infections.

Association Between Positive Airway Pressure Therapy and Healthcare Costs Among Older Adults with Comorbid Obstructive Sleep Apnea and Common Chronic Conditions: An Actuarial Analysis.

Study Objectives: To determine the association between adherence to positive airway pressure and healthcare costs among a national sample of older adults with comorbid OSA and common chronic conditions.

Methods: Our data source was a random sample of Medicare administrative claims for years 2016-2019. Inclusion criteria included age >65 years and new diagnosis of OSA.

Characterization and genomic insights into bacteriophages Kpph1 and Kpph9 against hypervirulent carbapenem-resistant .

The increasing incidence of infections attributed to hypervirulent carbapenem-resistant (Hv-CRKp) is of considerable concern. Bacteriophages, also known as phages, are viruses that specifically infect bacteria; thus, phage-based therapies offer promising alternatives to antibiotic treatments targeting Hv-CRKp infections. In this study, two isolated bacteriophages, Kpph1 and Kpph9, were characterized for their specificity against the Hv-CRKp NUHL30457 strain that possesses a K2 capsule serotype.

Using flow-cytometry in measuring platelet activity in type 2 diabetes and predicting macrovascular complications.

Platelets are hyperactive in patients with type2 diabetes (T2DM), they adhere to vascular endothelium and play a key role in macrovascular complications. Platelets activity can be measured by flow-cytometry (cluster of differentiation (CD) 41, CD 42, CD 62, CD 63), which allows detection of surface antigens in a sensitive and specific manner. This study aimed to describe platelets activity in T2DM in association with cardiovascular and cerebrovascular complications in relation to duration of diabetes (DM).

Association of Grit and Resilience With Short-Term Post-Transplant Outcomes in Lung Allograft Recipients.

The importance of mental toughness on lung transplant outcomes is unknown. We performed a pilot study to assess whether pretransplant grit and resilience are associated with short-term posttransplant outcomes. We enrolled 31 lung transplant candidates, of whom 7 (26%) had greater mental toughness, defined as the upper tertile for both grit and resilience within our cohort.

Transcranial Doppler Arterial Pressure Gradient Is Associated With Delayed Infarction After Subarachnoid Hemorrhage.

Background And Purpose: While the pulsatility index (PI) measured by transcranial Doppler (TCD) has broader associations with outcomes in neurocritical care, its use in monitoring delayed cerebral infarction (DCI) in patients with aneurysmal subarachnoid hemorrhage (SAH) is not endorsed by current clinical guidelines. Recognizing that arterial pressure gradient (ΔP) can be estimated using PI, we investigated the potential significance of TCD-estimated ΔP.

Methods: In this observational study of 186 SAH patients, we recorded the mean cerebral blood flow velocity (mCBFV) and PI values from the middle cerebral artery, along with corresponding blood pressures.

Left superior cervical ganglia lymph node mimicry and its role in rat ventricular arrhythmias following myocardial infarction.

Aim: Sympathetic overactivation may lead to severe ventricular arrhythmias (VAs) post-myocardial infarction (MI). The superior cervical ganglion (SCG) is an extracardiac sympathetic ganglion which regulates cardiac autonomic tone. We aimed to investigate the characteristics and functional significance of SCG on neuro-cardiac communication post-MI.

Predictive value of peripheral blood indicators plus procalcitonin clearance rate for mortality in cancer patients with sepsis.

This study investigated the predictive value of combining peripheral blood indicators with procalcitonin clearance rate (PCTc) to assess mortality risk in cancer patients with sepsis, aiming to develop a more sensitive and specific clinical tool. A retrospective analysis was conducted on 393 cancer patients with sepsis admitted to South China Hospital of Shenzhen University from January 2019 to January 2024. Collected data included clinical demographics, laboratory indicators such as white blood cell count, neutrophil count (NEUT), platelet count (PLT), lymphocyte count (LYC), C-reactive protein, procalcitonin (PCT), alanine aminotransferase, and the ratio of arterial oxygen partial pressure to inspired oxygen fraction, as well as functional scores like Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment.

NRP1 overexpression potentially enhances osimertinib resistance in NSCLC via activation of the PI3K/AKT signaling pathway.

Resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) is the main cause of mortality in lung cancer. This study aimed to investigate the roles of neuropilin 1 (NRP1) in non-small cell lung cancer (NSCLC). NRP1 expression was assessed in tumor tissues from patients with osimertinib-resistant (OR) NSCLC and osimertinib-responsive NSCLC as well as in patients with paracancerous NSCLC tissues who did not undergo radiotherapy or chemotherapy.

Risk factors for mediastinal lymph node metastases in early-stage non-small-cell lung cancer and prediction model establishment.

This study aimed to explore the risk factors for mediastinal lymph node metastases (MLNM) in patients with early-stage non-small-cell lung cancer (NSCLC) and to establish a predictive model. A retrospective analysis was conducted on the clinical data from NSCLC patients treated at the Second Affiliated Hospital of Guangzhou Medical University and the First Affiliated Dongguan Hospital of Guangdong Medical University between March 2021 and March 2023. Baseline clinical data, laboratory parameters, and pathological features were collected and analyzed.

2024 HRS perspective on advancing workflows for CIED remote monitoring.

Cardiac implantable electronic devices (CIEDs) generate substantial data, often stored in image or PDF formats. Remote monitoring, now an integral component of patient care, places considerable administrative burdens on clinicians and staff, in large part due to the challenge of integrating these data seamlessly into electronic health records. Since 2006, the Heart Rhythm Society, in collaboration with the CIED industry, has led an initiative to establish a unified standard nomenclature.

Metaverse technologies in acute care medical education: A scoping review.

Background: The concept of the metaverse is a virtual world that immerses users, allowing them to interact with the digital environment. Due to metaverse's utility in collaborative and immersive simulation, it can be advantageous for medical education in high-stakes care settings such as emergency, critical, and acute care. Consequently, there has been a growth in educational metaverse use, which has yet to be characterized alongside other simulation modalities literature.

The Role of Ombuds in Graduate Medical Education: Fostering Wellness and Psychological Safety.

The authors propose an educational innovation in graduate medical education, the creation of an Education Ombudsperson. Although this role has been implemented for faculty and students within the medical field, it has not been described in residency programs. The Ombudsperson for house staff is distinct from institutional or programmatic leadership.

Identification of Candidate Characteristics that Predicted a Successful Anesthesiology Residency Program Match in 2024: An Anonymous, Prospective Survey.

Background: The primary aim of our study was to identify candidate characteristics that predicted a successful outcome for applicants to anesthesiology residency programs in the 2024 Main Residency Match. The secondary aim of our study was to assess the impact of gold and silver signals on the application process.

Methods: The Baylor Scott & White Research Institute institutional review board approved this study.

Surgical and Neurointensive Management for Acute Spinal Cord Injury: A Narrative Review.

Spinal cord injury (SCI) following high-energy trauma often leads to lasting neurologic deficits and severe socioeconomic impact. Effective neurointensive care, particularly in the early stages post-injury, is essential for optimizing outcomes. This review discusses the role of neurointensive care in managing SCI, emphasizing early assessment, stabilization, and intervention strategies based on recent evidence-based practices.

Comparison of the Impact of tNGS with mNGS on Antimicrobial Management in Patients with LRTIs: A Multicenter Retrospective Cohort Study.

Background: tNGS and mNGS are valuable tools for diagnosing pathogens in lower respiratory tract infections (LRTIs), which subsequently influence treatment strategies. However, the impact of tNGS and mNGS on antimicrobial stewardship in patients with LRTIs remains unclear.

Methods: Patients diagnosed with LRTIs who underwent tNGS or mNGS between June 2021 and January 2024 were included.

Comparison of Clinical Characteristics and Mortality Outcome in Critical COVID-19 Patients Infected with Alpha and Omicron Variants.

Objective: Early reports have indicated that the Omicron variant of coronavirus disease 2019 (COVID-19) may be associated with low mortality. However, the mortality rate of critical patients in Taiwan with COVID-19 caused by different variants has not been well described.

Methods: This retrospective cohort study was conducted at the Linkou Branch of Chang Gung Memorial Hospital, Taiwan, from April 2020 to September 2022.

Molecular Epidemiological Characteristics of -Carrying ST-11 in Hospitalized Patients.

Purpose: To investigate the molecular epidemiology and risk factors of carbapenem-resistant (CRKP) infection.

Patients And Methods: Patient's clinical data and CRKP strains were collected from November 2017 to December 2018 at a tertiary hospital in Wuhan, China. The antimicrobial susceptibilities, carbapenem-resistant genes, multi-locus sequence typing (MLST), homologous analysis, and risk factors for CRKP were determined.

Localizing and Tailoring the Debriefing Assessment for Simulation in Healthcare to Optimize Fit.

Introduction Debriefing in healthcare simulation is helpful in reinforcing learning objectives, closing performance gaps, and improving future practice and patient care. The Debriefing Assessment for Simulation in Healthcare (DASH) is a validated tool. However, localized rater training for the DASH has not been described.

Enterococcus hirae Bacteremia Complicated by Septic Spondylitis and Acute Pyelonephritis: A Case Report.

, a rare human pathogen, has limited clinical data. This case report presents a case of sepsis, pyelonephritis, and septic spondylitis treated successfully with ampicillin. An 82-year-old woman was hospitalized for acute pyelonephritis and sepsis, presenting with fever and abdominal pain.