A Qualitative Study on the Outcomes of Participation in a Longitudinal Clinician Educator Curriculum During Internal Medicine Residency.

Background: Despite increasing prevalence of longitudinal clinician educator tracks (CETs) within graduate medical education (GME) programs, the outcomes of these curricula and how participation in these tracks affects early career development remains incompletely understood.

Objective: To describe the experience and outcomes of participating in a CET and its effects on recent internal medicine residency graduates' perceived educator skills and early career development.

Methods: We conducted a qualitative study between July 2019 and January 2020 using in-depth semi-structured interviews of recently graduated physicians from 3 internal medicine residencies at one academic institution who had participated in a CET, the Clinician Educator Distinction (CED).

COVID-19 surge readiness: use cases demonstrating how hospitals leveraged digital identity access management for infection control and pandemic response.

Background: Surging volumes of patients with COVID-19 and the high infectiousness of SARS-CoV-2 challenged hospital infection control/safety, staffing, care delivery and operations as few crises have. Imperatives to ensure security of patient information, defend against cybersecurity threats and accurately identify/authenticate patients and staff were undiminished, which fostered creative use cases where hospitals leveraged identity access and management (IAM) technologies to improve infection control and minimise disruption of clinical and administrative workflows.

Methods: Working with a leading IAM solution provider, implementation personnel in the USA and UK identified all hospitals/health systems where an innovative use of IAM technology improved facility infection control and pandemic response management.

Cost-Effectiveness of Surgical Weight-Loss Interventions for Patients With Knee Osteoarthritis and Class III Obesity.

Objective: Class III obesity (body mass index [BMI] ≥40 kg/m ) is associated with worse knee pain and total knee replacement (TKR) outcomes. Because bariatric surgery yields sustainable weight loss for individuals with BMI ≥40 kg/m , our objective was to establish the value of Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) in conjunction with usual care for knee osteoarthritis (OA) patients with BMI ≥40 kg/m .

Methods: We used the Osteoarthritis Policy model to assess long-term clinical benefits, costs, and cost-effectiveness of RYGB and LSG.

Models for an Ultraviolet-C Research and Development Consortium.

The development of an international, precompetitive, collaborative, ultraviolet (UV) research consortium is discussed as an opportunity to lay the groundwork for a new UV commercial industry and the supply chain to support this industry. History has demonstrated that consortia can offer promising approaches to solve many common, current industry challenges, such as the paucity of data regarding the doses of ultraviolet-C (UV-C, 200 nm to 280 nm) radiation necessary to achieve the desired reductions in healthcare pathogens and the ability of mobile disinfection devices to deliver adequate doses to the different types of surfaces in a whole-room environment. Standard methods for testing are only in the initial stages of development, making it difficult to choose a specific UV-C device for a healthcare application.

Haemophilus Parainfluenzae mural endocarditis with large atrial septal defect and peripheral embolization.

Mural endocarditis is a rare subclass of infective endocarditis (IE) associated with intra-cardiac tumors, prosthesis, valvular vegetation's, or structural abnormalities such as ventricular septal defects. Bacteria classified as HACEK ( species, , and ) are rare causes of IE found in only 1.3% to 10% of cases.

Expanded use of tranexamic acid is safe and decreases transfusion rates in patients with geriatric hip fractures.

Objectives: To determine the effect of a standardized tranexamic acid (TXA) protocol on red blood cell transfusions and adverse events in fragility hip fracture patients.

Design: Retrospective cohort study.

Setting: Academic Tertiary Care Center.

Ultraviolet Radiation Technologies and Healthcare-Associated Infections: Standards and Metrology Needs.

The National Institute of Standards and Technology (NIST) hosted an international workshop on ultraviolet-C (UV-C) disinfection technologies on January 14-15, 2020, in Gaithersburg, Maryland, in collaboration with the International Ultraviolet Association (IUVA). This successful public event, as evidenced by the participation of more than 150 attendees, with 65% from the ultraviolet technology industry, was part of an ongoing collaborative effort between NIST and the IUVA and its affiliates to examine the measurement and standards needs for pathogen abatement with UV-C in the healthcare whole-room environment. Prior to and since this event, stakeholders from industry, academia, government, and public health services have been collaboratively engaged with NIST to accelerate the development and use of accurate measurements and models for UV-C disinfection technologies and facilitate technology transfer.

Perspectives and Recommendations Regarding Standards for Ultraviolet-C Whole-Room Disinfection in Healthcare.

Patient well-being must be the driving force for determining standards for disinfection systems based on ultraviolet-C (UV-C) radiation. Reductions of inoculated bacteria on carriers is the optimal method of validating a UV-C-emitting system. We make specific, evidence-based recommendations regarding room description, organism selection, carrier material, quantity, orientations, and locations.

Optimizing Peritoneal Dialysis-Associated Peritonitis Prevention in the United States: From Standardized Peritoneal Dialysis-Associated Peritonitis Reporting and Beyond.

Peritoneal dialysis (PD)-associated peritonitis is the leading cause of permanent transition to hemodialysis among patients receiving PD. Peritonitis is associated with higher mortality risk and added treatment costs and limits more widespread PD utilization. Optimizing the prevention of peritonitis in the United States will first require standardization of peritonitis definitions, key data elements, and outcomes in an effort to facilitate nationwide reporting.

Clinical impact of concomitant tricuspid valve procedures during left ventricular assist device implantation.

Background: Tricuspid regurgitation (TR) is common in patients with end-stage heart failure receiving left ventricular assist devices (LVADs), but the benefit of concomitant tricuspid valve procedures (TVPs) remains uncertain. This study examined the impact of TVP at the time of LVAD implantation on clinical outcomes and quality of life (QOL) metrics.

Methods: We included adult patients in the Interagency Registry for Mechanical Circulatory Support database with various degrees of TR who received continuous-flow LVADs from 2008 to 2017.

Psychiatric Comorbidity and Outcomes After Left Ventricular Assist Device Implantation for End-Stage Heart Failure.

Background: Psychiatric comorbidities play a key role in patient selection for left ventricular assist devices (LVADs), but their impact on clinical outcomes is unknown.

Objectives: The goal of this study was to examine the clinical impact of psychiatric illness on outcomes in patients receiving LVADs for end-stage heart failure (HF).

Methods: The study identified adults in the Interagency Registry for Mechanically Assisted Circulatory Support with psychiatric comorbidities (history of alcohol abuse, drug use, narcotic dependence, depression, and other major psychiatric diagnoses) receiving continuous-flow LVADs from 2008 to 2017.

Assessing the Impact of Referral on Multidisciplinary Tumor Board Outcomes in Patients With Hepatocellular Carcinoma.

Background And Aims: Hepatocellular carcinoma (HCC) is a complex and unique cancer. At many tertiary care institutions, optimal treatment is planned at a multidisciplinary liver tumor board (MDLTB). This study examined the impact of referral on MDLTB outcomes for patients with HCC.

Safety and cardiovascular efficacy of spironolactone in dialysis-dependent ESRD (SPin-D): a randomized, placebo-controlled, multiple dosage trial.

The safety and efficacy of spironolactone is uncertain in end-stage renal disease. We randomized 129 maintenance hemodialysis patients to placebo (n=51) or spironolactone 12.5 mg (n=27), 25 mg (n=26), or 50 mg (n=25) daily for 36 weeks in a double-blind, placebo-controlled, multiple dosage trial to assess safety, tolerability and feasibility and to explore cardiovascular efficacy.

Thyroid function in end stage renal disease and effects of frequent hemodialysis.

Introduction: End-stage renal disease (ESRD) is associated with perturbations in thyroid hormone concentrations and an increased prevalence of hypothyroidism. Few studies have examined the effects of hemodialysis dose or frequency on endogenous thyroid function.

Methods: Within the Frequent Hemodialysis Network (FHN) trials, we examined the prevalence of hypothyroidism in patients with ESRD.