Notes

Parents' perception of health-related quality lifestyle in children along with teens with unwanted weight.
852 (95% CI, 0.783-0.920), 0.857 (95% CI, 0.778-0.937) and 0.893 (95% CI, 0.819-0.968) of EGFR mutation vs. wild-type, 19 deletion mutation vs. wild-type and 21 L858R vs. wild-type, respectively. Only calcification showed significant differences between the EGFR 19 deletion and 21 L858R mutations.

EGFR 21 L858R mutation was more likely to be nonsolid texture with air bronchograms and pleural retraction on CT images. And they were more likely to be associated with lower FDG metabolic activity compared with those wild-types. The sex difference was mainly caused by the 19 deletion mutation, and calcification was more frequent in them.
EGFR 21 L858R mutation was more likely to be nonsolid texture with air bronchograms and pleural retraction on CT images. And they were more likely to be associated with lower FDG metabolic activity compared with those wild-types. The sex difference was mainly caused by the 19 deletion mutation, and calcification was more frequent in them.
Despite a high prevalence in the pediatric trauma population, there remains a lack of large population-based epidemiological studies on pediatric pelvic fractures. MitoPQ molecular weight Using a de-identified national clinical registry, we investigated the epidemiological features of pediatric pelvic fractures.

We performed a retrospective analysis of data obtained from the IBM Watson Health Explorys Platform (Armonk, NY). From all children ages 0-14, two cohorts were created, children diagnosed with a traumatic injury and children diagnosed with a fracture of the pelvis. We then calculated the overall incidence of pelvic fractures, mortality rate, and identified common associated injuries, fracture locations, and complications.

2,690 pediatric pelvic fractures were identified yielding an incidence of 9.8/100,000 children per year with a mortality rate of 0.3%. Pelvic fractures were more common among Caucasians than in African Americans and Asians, and more common in males than females. The most common types of pelvic fracture were fractures of the ilium (42%), pubis (18%), sacrum (11%), ischium (10%), and acetabulum (8%). Most common associated injuries included injury of the lower extremity (43%), intracranial injury (16%), chest injury (13%), injury of the abdomen (9%), and urogenital injury (3%). Rates of common complications associated with malunion were low back pain (10%), acquired leg length discrepancy (1%), and acquired scoliosis (0.3%).

The current incidence of pediatric pelvic fracture is 9.8/100,000 children per year with a mortality rate of 0.3%. Further study utilizing large data sets may help to better understand associated injuries, risks of poor outcomes, and optimize treatment strategies.
The current incidence of pediatric pelvic fracture is 9.8/100,000 children per year with a mortality rate of 0.3%. Further study utilizing large data sets may help to better understand associated injuries, risks of poor outcomes, and optimize treatment strategies.
The objective of this study was to present clinician and caregiver perspectives regarding telehealth neurodevelopmental evaluation delivered at the onset of the coronavirus disease 2019 (COVID-19) pandemic. Specifically, we sought to describe telehealth neurodevelopmental evaluations, examine associations between child characteristics and diagnostic factors, determine the impact of technology and family barriers, and report on clinician and caregiver satisfaction with telehealth evaluation.

In response to the COVID-19 pandemic, in-person clinical services at a large children's hospital neurodevelopmental clinic were transitioned to telehealth. Data are presented for 254 remote evaluations of children (18-212 months; referral concern 51% autism spectrum disorder [ASD], 24% developmental delay/intellectual disability, 25% other neurodevelopmental concern) conducted from May to July 2020. Data were gathered from electronic health records as well as clinician and caregiver surveys.

A clinical diagnosis was s with neurodevelopmental disabilities and provided an unprecedented opportunity to evaluate the deployment of telehealth evaluation to meet the need for ongoing diagnostic care. Our findings suggest that telehealth holds significant promise for neurodevelopmental assessment both within the context of a global pandemic and beyond.
Our objective was to determine the extent surgical disciplines categorize, define, and study errors, then use this information to provide recommendations for both current practice and future study.

The report "To Err is Human" brought the ubiquity of medical errors to public attention. Variability in subsequent literature suggests the true prevalence of error remains unknown.

In January 2020, PubMed, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials were searched. Only studies with Oxford Level of Evidence Level 3 or higher were included.

Of 3,064 studies, 92 met inclusion criteria 6 randomized controlled trials, 4 systematic reviews, 24 cohort, 10 before-after, 35 outcome/audit, 5 cross sectional and 8 case-control studies. Over 15,933,430 patients and 162,113 errors were represented. There were 6 broad error categories, 13 different definitions of error, and 14 study methods.

Reported prevalence of error varied widely due to a lack of standardized categorization, definitions, and study methods. Future research should focus on immediately recognizing errors to minimize harm.
Reported prevalence of error varied widely due to a lack of standardized categorization, definitions, and study methods. Future research should focus on immediately recognizing errors to minimize harm.
To determine whether surgical opioid prescriptions are associated with increased risk of opioid initiation by operative patients' spouses.

Adverse effects of surgical opioids on operative patients have been well described. Whether risks of surgical opioids extend to operative patients' family members is unknown.

This was a retrospective cohort study of opioid-naïve, married patients undergoing 1 of 11 common surgeries from 1/1/2011-6/30/2017. The adjusted association between surgical opioid prescriptions and opioid initiation by the operative patient's spouse in the 6-months following surgery was assessed. Secondary analyses assessed how this association varied with postoperative time.

There were 318,022 patients (mean ± SD age 48.8 ± 9.3 years; 49.5% women). Among the 50,833(16.0%) patients that did not fill a surgical opioid prescription, 2,152(4.2%) had spouses who filled an opioid prescription within 6-months of their surgery. In comparison, among the 267,189(84.0%) patients who filled a surgical nce of preoperative counseling on safe opioid use, storage, and disposal for both patients and their partners.
To perform a scoping review of imaging-based machine-learning models to predict clinical outcomes and identify biomarkers in patients with PDAC.

Patients with PDAC could benefit from better selection for systemic and surgical therapy. Imaging-based machine-learning models may improve treatment selection.

A scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses-scoping review guidelines in the PubMed and Embase databases (inception-October 2020). The review protocol was prospectively registered (open science framework registration m4cyx). Included were studies on imaging-based machine-learning models for predicting clinical outcomes and identifying biomarkers for PDAC. The primary outcome was model performance. An area under the curve (AUC) of ≥0.75, or a P-value of ≤0.05, was considered adequate model performance. Methodological study quality was assessed using the modified radiomics quality score.

After screening 1619 studies, 25 studies with . Although these models mostly have good performance scores, their methodological quality should be improved.
We utilised a population dataset to compare outcomes for patients where surgery was independently performed by trainees to cases led by a consultant.

Emergency laparotomy is a common, high-risk, procedure. While trainee involvement to improve future surgeons' experience and ability in the management of such cases is crucial, some studies have suggested this is to the detriment of patient outcomes. In the UK, appropriately skilled trainees may be entrusted to perform emergency laparotomy without supervision of a consultant (attending).

Patients who underwent emergency laparotomy between 2013 and 2018 were identified from the National Emergency Laparotomy Audit (NELA) of England and Wales. To reduce selection and confounding bias, the inverse probability of treatment weighting (IPTW) approach was used, allowing robust comparison of trainee-led and consultant-led laparotomy cases accounting for eighteen variables, including details of patient, treatment, pathology, and preoperative mortality risk. Groups were compared for mortality and length of stay.

A total of 111,583 patients were included in the study. The operating surgeon was a consultant in 103,462 cases (92.7%) and a trainee in 8,121 cases (7.3%). Mortality at discharge was 11.6%. Trainees were less likely to operate on high-risk and colorectal cases. After weighting, mortality (12.2% vs 11.6%, p = 0.338) was equivalent between trainee- and consultant-led cases. Median length of stay was 11 (IQR 7,19) vs. 11 (7,20) days (p = 0.004), respectively. Trainee-led operations reported fewer cases of blood loss >500 ml (9.1% vs 11.1%, p < 0.001).

Major laparotomy maybe safely entrusted to appropriately skilled trainees without impacting patient outcomes.
Major laparotomy maybe safely entrusted to appropriately skilled trainees without impacting patient outcomes.
To identify disparities in access to NAT for PDAC at the prehospital and intrahospital phases of care.

Delivery of NAT in PDAC is susceptible to disparities in access. There are limited data that accurately locate the etiology of disparities at the prehospital and intrahospital phases of care.

Retrospective cohort of patients ≥18 years old with clinical stage I-II PDAC from the 2010-2016 National Cancer Database. Multiple logistic regression was used to assess 2 sequential outcomes (1) access to an NAT facility (prehospital phase) and (2) receipt of NAT at an NAT facility (intrahospital phase).

A total of 36,208 patients were included for analysis in the prehospital phase of care. Higher education, longer travel distances, being treated at academic/research or integrated network cancer programs, and more recent year of diagnosis were independently associated with receipt of treatment at an NAT facility.All patients treated at NAT facilities (31,099) were included for the second analysis. Higher education level and receiving care at an academic/research facility were independently associated with increased receipt of NAT. Non-Black racial minorities (including American Indian, Asian, Pacific Islanders), being Hispanic, being uninsured, and having Medicaid insurance were associated with decreased receipt of NAT at NAT facilities.

Non-Black racial minorities and Hispanic patients were less likely to receive NAT at NAT facilities compared to White and non-Hispanic patients, respectively. Discrepancies in administration of NAT while being treated at NAT facilities exist and warrant urgent further investigation.
Non-Black racial minorities and Hispanic patients were less likely to receive NAT at NAT facilities compared to White and non-Hispanic patients, respectively. Discrepancies in administration of NAT while being treated at NAT facilities exist and warrant urgent further investigation.
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