COVID-19 Pandemic Prompts a Paradigm Shift in Global Emergency Medicine: Multidirectional Education and Remote Collaboration.

To date, the practice of global emergency medicine (GEM) has involved being "on the ground" supporting in-country training of local learners, conducting research, and providing clinical care. This face-to-face interaction has been understood as critically important for developing partnerships and building trust. The COVID-19 pandemic has brought significant uncertainty worldwide, including international travel restrictions of indeterminate permanence.

Understanding Graduating Pediatric Emergency Medicine Fellow Priorities for Career Pathways and Faculty Recruitment for Academic or Community Emergency Departments.

Objectives: Factors influencing the employment of pediatric emergency medicine (PEM) fellows in a career in academic medicine versus community emergency department (ED) settings have not previously been explored. The purpose of this study was to explore PEM fellows' priorities in selecting jobs and to identify factors that influence their decisions regarding career choices through a multicenter, qualitative approach. We also explored program directors' beliefs about graduates' job selection priorities.

Delayed emergencies: The composition and magnitude of non-respiratory emergency department visits during the COVID-19 pandemic.

Importance: COVID-19 has been associated with excess mortality among patients not diagnosed with COVID-19, suggesting disruption of acute health care provision may play a role.

Objective: To determine the degree of declines in emergency department (ED) visits attributable to COVID-19 and determine whether these declines were concentrated among patients with fewer comorbidities and lower severity visits.

Design: We conducted a differences-in-differences analysis of all commercial health insurance claims for ED visits in the first 20 weeks of 2018, 2019, and 2020.

Impact of Decipher on use of post-operative radiotherapy: Individual patient analysis of two prospective registries.

Objective: To assess the association between Genomic Classifier (GC)-risk group and post-radical prostatectomy treatment in clinical practice.

Methods: Two prospective observational cohorts of men with prostate cancer (PCa) who underwent RP in two referral centers and had GC testing post-prostatectomy between 2013 and 2018 were included. The primary endpoint of the study was to assess the association between GC-risk group and time to secondary therapy.

A refined panel of 42 microsatellite loci to universally genotype catarrhine primates.

Microsatellite genotyping is an important genetic method for a number of research questions in biology. Given that the traditional fragment length analysis using polyacrylamide gel or capillary electrophoresis has several drawbacks, microsatellite genotyping-by-sequencing (GBS) has arisen as a promising alternative. Although GBS mitigates many of the problems of fragment length analysis, issues with allelic dropout and null alleles often remain due to mismatches in primer binding sites and unnecessarily long PCR products.

Diagnosis and management of immune-related adverse effects of immune checkpoint therapy in the emergency department.

Rapid advances in cancer immunotherapy using immune checkpoint inhibitors have led to significantly improved survival. Rapid identification of the toxicity syndromes associated with these therapeutic agents is very important for emergency physicians because the population of patients diagnosed with cancer is increasing and cancer therapies including immune checkpoint inhibitors have become the first-line treatment for more and more types of cancer. The emergency medicine literature lags behind rapid advances in oncology, and oncology guidelines for rapid recognition and management of these emerging toxicity syndromes are not familiar to emergency physicians.

External validation of genomic classifier-based risk-stratification tool to identify candidates for adjuvant radiation therapy in patients with prostate cancer.

Objective: To externally validate a Genomic Classifier (GC) based risk-stratification nomogram identifying candidates who would benefit from adjuvant radiation (aRT) therapy after radical prostatectomy (RP).

Methods: We identified 350 patients who underwent RP, between 2013 and 2018, and had adverse pathological features (positive margin, and/or pT3a or higher) on final pathology. Genomic profile was available for all these men.

Using biochemistry and biophysics to extinguish androgen receptor signaling in prostate cancer.

Castration resistant prostate cancer (CRPC) continues to be androgen receptor (AR) driven. Inhibition of AR signaling in CRPC could be advanced using state-of-the-art biophysical and biochemical techniques. Structural characterization of AR and its complexes by cryo-electron microscopy would advance the development of N-terminal domain (NTD) and ligand-binding domain (LBD) antagonists.

Racial/Ethnic Disparities in Screening for and Awareness of High Cholesterol Among Pregnant Women Receiving Prenatal Care.

Background Atherosclerotic cardiovascular disease remains a leading cause of morbidity and mortality among women, with younger women being disproportionately affected by traditional cardiovascular risk factors such as dyslipidemia. Despite recommendations for lipid screening in early adulthood and the risks associated with maternal dyslipidemia during pregnancy, many younger women lack access to and utilization of early screening. Accordingly, our objective was to assess the prevalence of and disparities in lipid screening and awareness of high cholesterol as an atherosclerotic cardiovascular disease risk factor among pregnant women receiving prenatal care.

Reading Performance in Blue Cone Monochromacy: Defining an Outcome Measure for a Clinical Trial.

Purpose: Blue cone monochromacy (BCM), a congenital X-linked retinal disease caused by mutations in the gene cluster, is under consideration for intravitreal gene therapy. Difficulties with near vision tasks experienced by these patients prompted this study of reading performance as a potential outcome measure for a future clinical trial.

Methods: Clinically and molecularly diagnosed patients with BCM ( = 17; ages 15-63 years) and subjects with normal vision ( = 22; ages 18-72 years) were examined with the MNREAD acuity chart for both uniocular and binocular conditions.

The Stanford Integrated Psychosocial Assessment for Transplant Is Associated With Outcomes Before and After Liver Transplantation.

The Stanford Integrated Psychosocial Assessment for Transplant (SIPAT) is a standardized psychosocial evaluation tool used in liver transplantation (LT) evaluation. We assessed the impact of the SIPAT score and subdomains on transplant waitlisting decisions and post-LT outcomes including immunosuppression (IS) nonadherence, biopsy-proven rejection, andmortality/graft failure. We conducted a single-center observational cohort study of 1430 patients evaluated for LT.

Outcomes of Childhood Cholestasis in Alagille Syndrome: Results of a Multicenter Observational Study.

Alagille syndrome (ALGS) is an autosomal dominant multisystem disorder with cholestasis as a defining clinical feature. We sought to characterize hepatic outcomes in a molecularly defined cohort of children with ALGS-related cholestasis. Two hundred and ninety-three participants with ALGS with native liver were enrolled.

Left Ventricular Dysfunction in Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC): Can We Separate ARVC From Other Arrhythmogenic Cardiomyopathies?

Arrhythmogenic right ventricular cardiomyopathy was first described as a right ventricular disease that is an important cause of death in young adults. However, with the advent of advanced imaging, arrhythmogenic right ventricular cardiomyopathy has been found to commonly have biventricular involvement, and a small portion of patients have left ventricular-dominant forms. On the other hand, a number of primarily left ventricular disease such as sarcoid and myocarditis can be arrhythmogenic and have right ventricular involvement.

Multicenter, Double-Blind, Randomized Trial of Emricasan in Hepatitis C-Treated Liver Transplant Recipients With Residual Fibrosis or Cirrhosis.

Despite achieving sustained virologic response (SVR) to hepatitis C virus (HCV) therapy, there remains a post liver transplantation population with advanced fibrosis/cirrhosis. Emricasan is an orally active, pan-caspase inhibitor that suppresses apoptosis and inflammation, potentially decreasing hepatic inflammation and fibrosis. We aimed to determine the safety and efficacy of emricasan (IDN-6556-07) in a double-blind, randomized, placebo-controlled, multicenter study in reducing or preventing the progression of hepatic fibrosis in HCV liver transplant recipients with residual fibrosis or cirrhosis after achieving SVR.

Second-line treatments and outcomes for immune thrombocytopenia: A retrospective study with electronic health records.

Background: Second-line treatment for immune thrombocytopenia (ITP) is not well reported for patients treated in real-world clinical settings.

Objective: The purpose of this study was to compare outcomes of four second-line treatments for ITP.

Patients/methods: Included adult patients had at least two medical records containing ITP diagnoses and second-line eltrombopag, romiplostim, rituximab, or splenectomy.

Development and evaluation of an EHR-based computable phenotype for identification of pediatric Crohn's disease patients in a National Pediatric Learning Health System.

Objectives: To develop and evaluate the classification accuracy of a computable phenotype for pediatric Crohn's disease using electronic health record data from PEDSnet, a large, multi-institutional research network and Learning Health System.

Study Design: Using clinician and informatician input, algorithms were developed using combinations of diagnostic and medication data drawn from the PEDSnet clinical dataset which is comprised of 5.6 million children from eight U.

Adapting to the Educational Challenges of a Pandemic: Development of a Novel Virtual Urology Subinternship During the Time of COVID-19.

Objective: To design, implement, and evaluate learner attitudes of a virtual urologic surgery clinical rotation for medical students.

Methods: Ten senior medical students at the Perelman School of Medicine at the University of Pennsylvania were enrolled. Students were administered a precourse test on their perceived confidence of their urologic knowledge, confidence in identifying urologic conditions, comfort with performing urologic evaluations, and confidence placing consults for urologic issues.

Efficacy and Safety of Hydroxychloroquine vs Placebo for Pre-exposure SARS-CoV-2 Prophylaxis Among Health Care Workers: A Randomized Clinical Trial.

Importance: Health care workers (HCWs) caring for patients with coronavirus disease 2019 (COVID-19) are at risk of exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Currently, to our knowledge, there is no effective pharmacologic prophylaxis for individuals at risk.

Objective: To evaluate the efficacy of hydroxychloroquine to prevent transmission of SARS-CoV-2 in hospital-based HCWs with exposure to patients with COVID-19 using a pre-exposure prophylaxis strategy.

Patient Frailty Is Independently Associated With the Risk of Hospitalization for Acute-on-Chronic Liver Failure.

There is significant interest in identifying risk factors associated with acute-on-chronic liver failure (ACLF). In transplant candidates, frailty predicts wait-list mortality and posttransplant outcomes. However, the impact of frailty on ACLF development and mortality is unknown.

Boricua Founder Variant in Causes Epileptic Encephalopathy With Hyperkinetic Movements.

Objective: To describe a founder mutation effect and the clinical phenotype of homozygous c.737_739delGAG (p.Gly246del) variant in 15 children of Puerto Rican (Boricua) ancestry presenting with early infantile epileptic encephalopathy (EIEE-37) with prominent movement disorder.