Notes

Hands-On Workshops Boost Emergency Division Physicians' Self-Reported Knowledge of Child Palm Accidental injuries.
27, 95% CI 1.22-1.34, p < 0.001 for patients who died in hospital), and higher cost for hospital stay (unadjusted median $226065 vs $151459, IQR $117551-434003 vs $76197-287846, exponentiated coefficient 1.40, 95% CI 1.32-1.49, p < 0.001 for survivors; unadjusted median $87996 vs $77056, IQR $42566-186677 vs $34066-149009, exponentiated coefficient 1.26, 95% CI 1.20-1.32, p < 0.001 for patients who died in hospital) adjusted for baseline characteristics and other comorbidities.

In patients with IHCA, GIB as a secondary diagnosis is associated with a higher in-hospital mortality, longer length of stay and higher cost for the admission.
In patients with IHCA, GIB as a secondary diagnosis is associated with a higher in-hospital mortality, longer length of stay and higher cost for the admission.Porphyromonas gingivalis and Filifactor alocis are fastidious oral pathogens and etiological agents associated with chronic periodontitis. Although previous studies showed increased levels of the two obligate anaerobic species in periodontitis patients, methodologies for this knowledge were primarily limited to sampling subgingival plaque, saliva, or gingival crevicular fluid. To evaluate the extent to which P. gingivalis and F. alocis may invade the periodontal tissues, an in situ cross-sectional study was comparatively conducted on the gingival biopsy specimens of patients diagnosed with periodontal health or chronic periodontitis. Immunostained tissue sections for each organism were imaged by Super-Resolution Confocal Scanning Microscopy to determine the relative presence and localization of target bacterial species. Fluorescence-in-situ-hybridization (FISH) coupled with species specific 16S rRNA method was utilized to confirm whether detected bacteria were live within the tissue. In periodontitis, P. gingver novel visual evidence of a potential starting point for systemic spread of opportunistic bacteria during their chronic colonization in gingival epithelium.
Religion and spirituality (R/S) are important resources for coping with stress and are hypothesized to influence health outcomes via modulation of the hypothalamic-pituitary-adrenal (HPA) axis, though this has not been evaluated extensively. In this study, we examined associations between several measures of religiosity or spirituality (R/S) and three HPA axis biomarkers cortisol, dehydroepiandrosterone (DHEA), and cortisol DHEA ratio.

Sample included 216 female postmenopausal Nurses' Health Study II participants who provided up to five timed saliva samples immediately upon awakening, 45 min, 4 h, and 10 h after waking, and prior to going to sleep during a single day in 2013. Multivariable-adjusted linear mixed models with piecewise cubic spline functions and adjustment for potential covariates were used to estimate the cross-sectional associations of eight R/S measures with diurnal rhythms of cortisol, DHEA, and the cortisol/DHEA ratio.

There was little evidence of association between the eight R/S mearisons made, could be due to chance. Future research using larger, more diverse samples of individuals is needed to better understand the relationship between R/S and HPA axis biomarkers.State-level policy interventions have been critical in managing the spread of the new coronavirus. Here, we study the lag time between policy interventions and change in COVID-19 outcome trajectory in the United States. We develop a stepwise drifts random walk model to account for non-stationarity and strong temporal correlation and subsequently apply a change-point detection algorithm to estimate the number and times of change points in the COVID-19 outcome data. Furthermore, we harmonize data on the estimated change points with non-pharmaceutical interventions adopted by each state of the United States, which provides us insights regarding the lag time between the enactment of a policy and its effect on COVID-19 outcomes. We present the estimated change points for each state and the District of Columbia and find five different emerging trajectory patterns. We also provide insight into the lag time between the enactment of a policy and its effect on COVID-19 outcomes.There is an urgent need to identify which COVID-19 patients will develop life-threatening illness so that medical resources can be optimally allocated and rapid treatment can be administered early in the disease course, when clinical management is most effective. To aid in the prognostic classification of disease severity, we perform untargeted metabolomics on plasma from 339 patients, with samples collected at six longitudinal time points. Using the temporal metabolic profiles and machine learning, we build a predictive model of disease severity. We discover that a panel of metabolites measured at the time of study entry successfully determines disease severity. Through analysis of longitudinal samples, we confirm that most of these markers are directly related to disease progression and that their levels return to baseline upon disease recovery. Finally, we validate that these metabolites are also altered in a hamster model of COVID-19.Massive vaccination offers great promise for halting the global COVID-19 pandemic. However, the limited supply and uneven vaccine distribution create an urgent need to optimize vaccination strategies. We evaluate SARS-CoV-2-specific antibody responses after Sputnik V vaccination of healthcare workers in Argentina, measuring IgG anti-spike titers and neutralizing capacity after one and two doses in a cohort of naive or previously infected volunteers. By 21 days after receiving the first dose of the vaccine, 94% of naive participants develop spike-specific IgG antibodies. A single Sputnik V dose elicits higher antibody levels and virus-neutralizing capacity in previously infected individuals than in naive ones receiving the full two-dose schedule. The high seroconversion rate after a single dose in naive participants suggests a benefit of delaying administration of the second dose to increase the number of people vaccinated. The data presented provide information for guiding public health decisions in light of the current global health emergency.Inflammation, due to infectious pathogens or other non-infectious stimuli, during pregnancy is associated with elevated risk for neurodevelopmental disorders such as schizophrenia and autism in the offspring. Although historically identified through retrospective epidemiologic studies, the relationship between maternal immune activation and offspring neurodevelopmental disease risk is now well established because of clinical studies which utilized prospective birth cohorts, serologically confirmed infection records, and subsequent long-term offspring follow-up. These efforts have been corroborated by preclinical research which demonstrates anatomical, biochemical, and behavioural alterations that resemble the clinical features of psychiatric illnesses. Intervention studies further demonstrate causal roles of inflammatory mediators, such as cytokines, in these long-lasting changes in behaviour and brain. This review summarizes a selection of maternal immune activation literature that explores the relationship between these inflammatory mediators and the neuropsychiatric-like effects later observed in the offspring. This literature is presented alongside emerging information regarding SARS-CoV-2 infection in pregnancy, with discussion of how these data may inform future research regarding the effects of the present coronavirus pandemic on emerging birth cohorts.Delivery of psychological and psychosocial treatments by non-specialists in low-and middle-income countries (LMIC) is a growing strategy to address the global mental health treatment gap. click here However, little is known about which competencies are essential for non-specialists to effectively deliver treatment. Psychotherapy research in high-income countries suggests that effective treatment requires competency in common factors. Therefore, our objective was to identify how common factors are described in evidence-supported non-specialist interventions in LMICs. To meet this objective, we identified and coded common factors by reviewing 16 evidence-supported manuals for psychological treatments delivered by non-specialists in LMICs. World Health Organization (WHO) manuals and other non-proprietary manuals, with positive randomized control outcomes, were included in the review. Fifteen common factors were identified and described in most manuals 'promoting hope and realistic expectancy of change' and 'confidentiality' were described in 15 manuals (94%), followed by 'giving praise' and 'psychoeducation' (88% of manuals), and 'rapport building' (81% of manuals). Descriptions of common factors were similar across manuals, suggesting that training and competency evaluation approaches can be harmonized across interventions. Compiling these descriptions from the manuals can inform foundational training in common factors for diverse cadres of non-specialists around the world.The gut microbiota-the community of microorganisms in the gut-has been implicated in many physical and mental disorders in addition to intestinal diseases. Diets are the most studied and promising factors for altering it. Indeed, certain dietary interventions that increase fiber intake rapidly change levels of certain nutrients that can modify the composition of the microbiota, promoting richness and diversity. Recent intriguing evidence from several human clinical trials suggested that the composition and diversity of patients' gut microbiotas at baseline can influence their responses to cancer immunotherapy. If the factors that influence the gut microbiota were fully understood, it is conceivable that manipulating them could boost therapeutic responses in cancer patients. In this review, we investigate the possibility of using fruits, vegetables, or whole grains to enhance response to cancer therapies in humans, as current evidence suggests that these dietary components can manipulate and enhance diversity of the gut microbiota. Accordingly, dietary interventions with locally available fruits, vegetables, and whole grains might be an affordable and safe approach to enhancing the diversity of the gut microbiota before immunotherapy, in turn improving patients' responses to their treatments.
The novel coronavirus (COVID-19) pandemic resulted in a severe reduction in operative opportunities for trainees. We hypothesized that augmenting independent practice with a bench model of vascular anastomoses using regular videoconferences and individual feedback would provide meaningful benefit in maintenance of technical skills in senior lung transplant surgical fellows.

A lung transplantation virtual technical skills course was developed. Surgical fellows were provided with a bench model and surgical instruments. Using a virtual communication platform, teaching sessions were held twice weekly, and fellows performed an anastomosis on camera. Video recordings were reviewed and critiqued by attending staff. At the end of the 3-month course, participants were surveyed about their experience. Warm ischaemic time was compared between fellows' five most recent cases before and after the pandemic.

Seven senior surgical fellows participated and provided feedback. Fellows had graduated medical school an average of 14 years prior to fellowship, and spent an average of 5 hours (range 1.
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