Elucidating tricuspid Doppler signal interpolation and its implication for assessing pulmonary hypertension.

Doppler echocardiography plays a central role in the assessment of pulmonary hypertension (PAH). We aim to improve quality assessment of systolic pulmonary arterial pressure (SPAP) by applying a cubic polynomial interpolation to digitized tricuspid regurgitation (TR) waveforms. Patients with PAH and advanced lung disease were divided into three cohorts: a derivation cohort ( = 44), a validation cohort ( = 71), an outlier cohort ( = 26), and a non-PAH cohort ( = 44).

Partnering with a senior living community to optimise teledermatology via full body skin screening during the COVID-19 pandemic: A pilot programme.

Background: Elderly patients in senior communities faced high barriers to care during the COVID-19 pandemic, including increased vulnerability to COVID-19, long quarantines for clinic visits, and difficulties with telemedicine adoption.

Objective: To pilot a new model of dermatologic care to overcome barriers for senior living communities during the COVID-19 pandemic and assess patient satisfaction.

Methods: From 16 November 2020 to 9 July 2021, this quality improvement programme combined in-residence full body imaging with real-time outlier lesion identification and virtual teledermatology.

Infantile ischemic stroke secondary to profound arteriopathy.

Pediatric arterial ischemic stroke (AIS) is an uncommon emergency department (ED) presentation. We share the case of a 4-month-old female with a chief complaint of irritability and difficulty feeding. During ED evaluation, she developed lateral gaze deviation, tongue deviation, and rhythmic leg movements.

Factors driving burnout and professional fulfillment among emergency medicine residents: A national wellness survey by the Society for Academic Emergency Medicine.

Objectives: This study aimed to identify rates of and contributors to burnout and professional fulfillment among emergency medicine (EM) resident physicians.

Methods: This was a cross-sectional, national survey of resident members of the Society for Academic Emergency Medicine (SAEM). Primary outcomes were burnout and professional fulfillment measured using a previously validated instrument with additional domains pertaining to the academic environment.

SARS-CoV-2 Omicron variant: A next phase of the COVID-19 pandemic and a call to arms for system sciences and precision medicine.

Since early 2020, coronavirus diseases 2019 (COVID-19) infection pandemic/endemic is constantly surprising health experts because of continuous variations in the structures of severe acute respiratory coronavirus 2 (SARS-CoV-2) in the form of newly emerged variants. Such mutations have exhibited high mortality and severity due to the newly emerged more infectious sites of SARS-CoV-2, making viral infection more transmissible, infectious, and severe. Recently, SARS-CoV-2 mutated to another variant, namely, Omicron (B.

Skull base osteomyelitis in patients with head and neck cancer: Diagnosis, management, and outcomes in a case series of 23 patients.

Background: Skull base osteomyelitis (SBO) is an infection of the central cranial bones, most commonly resulting from contiguous spread of infection from adjacent head and neck structures. SBO is a well-recognized complication of treatment of head and neck cancer (HNC) that results in significant morbidity.

Methods: We conducted a retrospective chart review of HNC patients diagnosed with SBO.

Polylysine for skin regeneration: A review of recent advances and future perspectives.

There have been several attempts to find promising biomaterials for skin regeneration, among which polylysine (a homopolypeptide) has shown benefits in the regeneration and treatment of skin disorders. This class of biomaterials has shown exceptional abilities due to their macromolecular structure. Polylysine-based biomaterials can be used as tissue engineering scaffolds for skin regeneration, and as drug carriers or even gene delivery vectors for the treatment of skin diseases.

Timing of postoperative oral feeding after head and neck mucosal free flap reconstruction.

Objective: Fistula remains a common complication of upper aerodigestive tract reconstruction. Optimal timing of oral feeding is unknown and the impact of early feeding on swallow function and fistula rates remains controversial. The purpose of this study is to better understand the effects of "early feeding" on fistula rate and swallow in patients with free flap reconstruction of upper aerodigestive tract defects.

Helping the learner to deal with microaggressions in the workplace: Individual, programmatic, and institutional-level responses.

Microaggressions are frequently experienced by learners in the workplace and can create a hostile learning environment. Many faculty educators lack formal training in supporting their learners after incidents of microaggressions. Supervising faculty should be able to recognize and respond to microaggressions against trainees in the clinical environment.

Rapid conversion to virtual obesity care in COVID-19: Impact on patient care, interdisciplinary collaboration, and training.

Objective: The COVID-19 pandemic presents challenges to maintaining interdisciplinary collaboration while transitioning care to telehealth environments. This paper describes how an intensive weight management clinic rapidly transitioned from in-person only to a telehealth environment.

Method: As a program evaluation project, changes to clinic procedures were tracked on a weekly basis.

Creating leaders through scholarship: The development of a physician wellness fellowship in emergency medicine.

Need For Innovation: There is a clear need for physician leaders with expertise in wellness given the high incidence of physician burnout, especially during the COVID-19 pandemic. A fellowship in physician wellness provides structured opportunity for the development of expertise in the science and administration of physician wellness through a tailored curriculum and academic scholarship.

Background: Currently, limited opportunities exist to pursue formal wellness training in graduate medical education.

A nationwide survey of emergency medicine resident workflow efficiency: Are training programs teaching residents to be efficient?

Background: Workflow efficiency (WFE) is essential to the practice of emergency medicine (EM), but a standardized approach to measuring and teaching it during residency is lacking. In this study we sought to describe how EM residency programs in the United States currently measure and teach WFE and to assess the relative importance of WFE teaching to EM residency program leaders.

Methods: We conducted a cross-sectional survey of all accredited EM residency training programs in the United States in Fall 2019.

The Hispanic paradox in the prevalence of obesity at the county-level.

Objective: The percentage of Hispanics in a county has a negative association with prevalence of obesity. Because Hispanic individuals are unevenly distributed in the United States, this study examined whether this protective association persists when stratifying counties into quartiles based on the size of the Hispanic population and after adjusting for county-level demographic, socioeconomic, healthcare, and environmental factors.

Methods: Data were extracted from the 2018 Robert Wood Johnson Foundation County Health Rankings.

Protecting the emergency physician workforce during the coronavirus disease 2019 pandemic through precision scheduling at an academic tertiary care trauma center.

The coronavirus disease 2019 (COVID-19) pandemic created new emergency physician staffing challenges. Emergency physicians may be taken out of the workforce because of respiratory symptoms or pending severe acute respiratory syndrome coronavirus 2 test results. Vulnerable emergency physician populations with increased risk of serious disease and death from COVID-19 include physicians at older ages; those with chronic medical conditions, including cardiac and pulmonary diseases and immunosuppression; and potentially pregnancy.

Emergency department treatment of asthma in children: A review.

Asthma is the most common chronic illness in children, with >700,000 emergency department (ED) visits each year. Asthma is a respiratory disease characterized by a combination of airway inflammation, bronchoconstriction, bronchial hyperresponsiveness, and variable outflow obstruction, with clinical presentations ranging from mild to life-threatening. Standardized ED treatment can improve patient outcomes, including fewer hospital admissions.

A body bag can save your life: a novel method of cold water immersion for heat stroke treatment.

Non-exertional heat stroke is a life-threatening condition characterized by passive exposure to high ambient heat, a core body temperature of 40°C (104°F) or greater, and central nervous system dysfunction. Rapid cooling is imperative to minimize mortality and morbidity. Although evaporative and convective measures are often used for cooling heat stroke patients, cold water immersion produces the fastest cooling.

Acute mental stress and surgical performance.

Background: Stress has been shown to impact adversely on multiple facets critical to optimal performance. Advancements in wearable technology can reduce barriers to observing stress during surgery. This study aimed to investigate the association between acute intraoperative mental stress and technical surgical performance.

Overexpression of micro ribonucleic acid-591 inhibits cell proliferation and invasion of malignant pleural mesothelioma cells.

Background: Malignant pleural mesothelioma (MPM) is an aggressive cancer refractory to current therapies. Reduced expression of micro ribonucleic acid (miR)-591 in a range of cancer types has suggested it is a potent tumor suppressor, and overexpression has been shown to inhibit tumor cell growth. The role of miR-591 in MPM is largely unknown.