Supermarkets, do they make the healthy choice the easy choice? A review of the healthfulness of the supermarket food environment.

The over consumption of high fat, sugar, and salt foods increases population risk of overweight, obesity and diet-related noncommunicable diseases. The food environment mediates consumer food choices and thus plays an important role in diet quality and related health outcomes. The built food environment, where most people in high income countries access their food, has been found to be obesogenic.

How Do Clinicians Use Quotations in Goals of Care Notes?

Background: Quoting patients in electronic medical record (EMR) notes is controversial. Quotations may be used to promote accuracy in documentation. However they also may be used to cast skepticism on patient speech.

Paracetamol prior to catheter balloon insertion for labor induction - A randomized controlled trial: paracetamol prior to catheter-balloon insertion for labor induction.

Background: Assessing maternal pain and satisfaction following administration of paracetamol vs. placebo prior to catheter balloon placement.

Methods: Primiparous women at term admitted for medically-indicated labor induction were randomized to receive intravenous paracetamol 1 gram in 100cc normal saline (N=71) or placebo of 100cc normal saline (N=70) prior to catheter balloon insertion.

ED observation unit-based delayed comfort care pathway for ED patients on life support.

Background: Critically ill ED patients on life support may undergo transition to comfort care as decided by the surrogate decision maker. When several hours are needed for loved ones to arrive and say farewell before initiating comfort care ("delayed comfort care"), these patients require prolonged ED stays or costly intensive care unit (ICU) admissions.

Methods: A novel ED observation unit (EDOU)-based delayed comfort care pathway for ED patients on invasive mechanical ventilation and/or vasopressors was created in 2013 at Stanford Hospital.

Elevating performance and interpretability of in silico classifiers for drug proarrhythmia risk evaluations using multi-biomarker approach with ranking algorithm.

Background And Objective: Using electrophysiological simulations and machine learning to predict drug proarrhythmia risk has gained popularity due to its effectiveness. The leading in silico drug assessment system mainly uses a single biomarker (qNet) to predict proarrhythmia risk, offering good performance and straightforward interpretation. Other advanced classifiers incorporating additional physiological biomarkers provide better predictive capabilities but are less intuitive.

Selenoprotein P predicting mortallity in acute ill patients with dyspnea.

Background And Aims: Good Selenium (Se) status predicts favorable prognoses for various diseases and a reduced overall mortality. The primary objective of the study was to determine whether Selenium status, i.e.

Comparison of Temporal Artery and Rectal Temperature Measurement During Cooling and Rewarming in Neonates Treated for Hypoxic Ischemic Encephalopathy.

Background: Finding an accurate and simple method of thermometry in the neonatal intensive care unit is important. The temporal artery thermometer (TAT) has been recommended for all ages by the manufacturer; however, there is insufficient evidence for the use of TAT in infants, especially to detect hypothermia.

Purpose: To assess the accuracy of the TAT in hypothermic neonates in comparison to a rectal thermometer.

A Novel Artificial Intelligence-Enhanced Digital Network for Prehospital Emergency Support: Community Intervention Study.

Background: Efficient emergency patient transport systems, which are crucial for delivering timely medical care to individuals in critical situations, face certain challenges. To address this, CONNECT-AI (CONnected Network for EMS Comprehensive Technical-Support using Artificial Intelligence), a novel digital platform, was introduced. This artificial intelligence (AI)-based network provides comprehensive technical support for the real-time sharing of medical information at the prehospital stage.

Depression Anxiety Stress Scales (DASS-21) for Finnish-speaking adults: Validation and normative data.

We conducted the first validation of the Depression Anxiety Stress Scales (DASS-21) in Finnish. DASS-21 is a short public domain questionnaire, which presents a way to quickly and effectively screen for mental ill health. We recruited two large samples, one aged 24-45 ( = 3,101 [2,488 women]), and the other aged 60-82 ( = 5,462 [4,473 women]), all employees of the city of Helsinki at inclusion (2017 and 2000-2002).

Population pharmacokinetic analysis of teicoplanin in paediatric patients, including those receiving continuous kidney replacement therapy: a prospective cohort study.

Objectives: Teicoplanin is a commonly used antibiotic in critically ill children. However, teicoplanin dosing is often inaccurate, especially in children undergoing continuous kidney replacement therapy (CKRT). This study aims to develop a population pharmacokinetic (PK) model to optimize teicoplanin dosing in critically ill children, including those on CKRT.

Multiple Model Optimal Sampling Promotes Accurate Vancomycin Area-Under-the-Curve Estimation Using a Single Sample in Critically Ill Children.

Background: Area-under-the-curve (AUC)-directed vancomycin therapy is recommended; however, AUC estimation in critically ill children is difficult owing to the need for multiple samples and lack of informative models.

Methods: The authors prospectively enrolled critically ill children receiving intravenous (IV) vancomycin for suspected infection and evaluated the accuracy of Bayesian estimation of AUC from a single, optimally timed sample. During the dosing interval, when clinical therapeutic drug monitoring was performed, an optimally timed sample was collected, which was determined for each subject using an established population pharmacokinetic model and the multiple model optimal function of Pmetrics, a nonparametric population pharmacokinetic modeling software.

SPING Block Analgesia in Non-Operative Management of Proximal Femur Fractures in Older Adults Living with Frailty: A Retrospective Cohort Study.

: Spinal Phenol IN Glycerol (SPING) block is a novel palliative pain treatment for the non-operative management of proximal femur fractures (PFFs) in older adults living with frailty. Effective pain management that aligns with patient preferences and minimizes opioid use is critical in this setting. This study evaluated the patient, safety, and process outcomes of SPING block in this population.

Investigating the Relationship Between Midazolam Serum Concentrations and Paediatric Delirium in Critically Ill Children.

Objectives: Intravenous midazolam is widely used for sedation in critically ill children. Sometimes, these children develop a paediatric delirium (PD). Our aim was to determine the relationship between midazolam serum concentration and the development of new PD in critically ill children.

CiThroModel Improves Prediction of Symptomatic Venous Thromboembolism in Hospitalized Patients With Cirrhosis Without Hepatocellular Carcinoma.

Background & Aims: Venous thromboembolism (VTE) is a recognized complication of acutely ill patients, but its incidence and risk factors in those with cirrhosis are uncertain.

Methods: We retrospectively studied a consecutive cohort of cirrhosis patients non-electively admitted to our medical unit to determine the rates of symptomatic VTE during hospitalization. Firstly, we explored associations with baseline, clinical and laboratory characteristics using logistic regression.

Upper arm movements in the last days of life: A new possible sign of impending death.

One of the most crucial stages of palliative care is the last days and hours of life, which require special attention and knowledgeable identification of clinical signs described as signs of impending death (SID). Our case series of 11 patients receiving home palliative care describes bilateral hypoactive, stereotyped upper arm movements (scratching of the head, forehead, and nose) that were previously unknown or described, often accompanied by SID.

Enoxaparin Venous Thromboembolism Prophylaxis Dosing in Critically Ill Underweight Patients.

Optimal dosing of VTE prophylaxis for specific patient populations remains an area of concern as insufficient evidence exists regarding dosing for underweight patients. The purpose of this study is to compare the incidence of major bleeding events in underweight patients given different prophylactic doses of enoxaparin. This is a retrospective analysis performed at multiple hospitals within a single health care system.

Minimizing Surgical Margins in Basal Cell Carcinoma: A Single Institution's Experience with Excision and Reconstruction Methods.

 Basal cell carcinoma (BCC) is the predominant nonmelanocytic skin cancer, with preservation of both function and aesthetics being essential during tumor removal. Existing surgical margin guidelines primarily target ill-defined BCCs prevalent in Western countries. Therefore, this study aims to demonstrate the efficacy of surgical removal, propose modified guidelines for wide excision tailored to Asian patients, and share experiences with various reconstruction methods.

Children betrayed: The unseen victims of domestic violence and how law enforcement can better protect them.

Domestic violence is a commonplace and serious societal problem with vast public health and economic consequences. Childhood exposure to domestic violence can blight children's biological and social development. Often, local police departments are first responders to domestic violence.

A Study of the Comparison Between Preoperative Ultrasonography Findings With Intraoperative Observations in Laparoscopic Cholecystectomy.

Aim: This study aims to evaluate the accuracy of ultrasonography (US) by comparing preoperative ultrasonographic findings with intraoperative observations during laparoscopic cholecystectomy (LC).

Materials And Methods: An observational analytical study was conducted at a tertiary hospital in Pune over two years and included 98 patients aged 20-80 with symptomatic cholelithiasis confirmed by US. Preoperative parameters assessed included gallstone number, gallbladder volume, wall thickness, and pericholecystic fluid.

Application of Gastric Tube Decompression for Rapid Tip Positioning in Bedside Blind Insertion of Nasoenteric Tubes.

Objective: This study aims to examine the efficacy of gastric tube decompression in rapid tip positioning during bedside blind insertion of nasoenteric tubes.

Methods: Between August 2023 and July 2024, patients who were critically ill in the emergency intensive care unit of a tertiary hospital in Beijing who required nasoenteric tube placement were enrolled in this study. Gastric tube decompression was used to facilitate the tip positioning of nasoenteric tubes inserted blindly (without direct visualization), at the bedside.

Management of children with food allergies by allergists in the United States.

Background: Management of patients with food allergies is complex, especially in cases of patients with multiple and potentially severe food allergies. Although international guidelines exist for food allergy management, the role of the allergist in the decision-making process is key.

Objective: Our aim was to investigate the management patterns and educational needs of practicing allergists treating patients with food allergies.

Association between phase angle and daily creatinine excretion changes in critically ill patients: an approach to muscle mass.

Assessing muscle mass in critically ill patients remains challenging. This retrospective cohort study explores the potential of phase angle (PA°) derived from bioelectrical impedance analysis (BIA) as a surrogate marker for muscle mass monitoring by associating it with daily creatinine excretion (DCE), a structural and metabolic muscle mass marker. In 20 ICU patients, we observed a linear relationship between PA° and DCE at initial (S1) and follow-up (S2) points, with Rho values of 0.