Emergency medicine

The abstract was requested to be deleted by the reviewer. This article is protected by copyright. All rights reserved.

Limbal stem cell deficiency (LSCD) and corneal disorders are among the top global threats for human vision. Emerging therapies that integrate stem cell transplantation with engineered hydrogel scaffolds for biological and mechanical support are becoming a rising trend in the field. However, methods for high-throughput fabrication of hydrogel scaffolds, as well as knowledge of the interaction between limbal stem/progenitor cells (LSCs) and the surrounding extracellular matrix (ECM) are still much needed. Here, we employed digital light processing (DLP)-based bioprinting to fabricate hydrogel scaffolds encapsulating primary LSCs and studied the ECM-dependent LSC phenotypes...

BACKGROUND: Treatment of acute ischemic stroke (AIS) with intravenous alteplase within 4.5 h of symptom onset is associated with neurologic improvement. High baseline blood pressure (BP) and BP variability during the first 24 h of AIS is associated with increased early adverse events and death. The purpose of this study is to characterize the incidence of poor neurologic outcome in patients treated with alteplase for AIS who received antihypertensive medications prior to and within the first 24 h following alteplase administration compared with patients who did not...

Cumulative evidence has shown that coronary revascularization should be guided by functional significance of coronary lesions. Fractional flow reserve (FFR) is the gold standard for assessment of hemodynamic significance of coronary stenosis and FFR-guided percutaneous coronary intervention has improved clinical outcomes in patients with coronary artery disease. However, limitations of FFR such as increased operational time and cost, requirement of pressure wire and adenosine and technical difficulties have led to significant underutilization of the method in clinical practice...

Single-cell technologies are emerging as powerful tools for cancer research. These technologies characterize the molecular state of each cell within a tumor, enabling new exploration of tumor heterogeneity, microenvironment cell-type composition, and cell state transitions that affect therapeutic response, particularly in the context of immunotherapy. Analyzing clinical samples has great promise for precision medicine but is technically challenging. Successfully identifying predictors of response requires well-coordinated, multi-disciplinary teams to ensure adequate sample processing for high-quality data generation and computational analysis for data interpretation...

Prior literature has suggested that there are major barriers to the advancement of women in academic emergency medicine (EM) and that few evidence-based solutions exist to resolve this inequity. In this issue of Academic Emergency Medicine, XX et al. (1) describe the creation of a consortium of women physicians across four departments of EM in the northeastern United States with the aim of addressing persistent gender inequities in the academic EM workforce.1-3 By combining resources, consortium leaders developed programming on various topics, including career advancement skills, leadership and recognition, mentorship and sponsorship, research, peer support, coaching, and work/life strategies...

CONTEXT: Non-native English speakers (NNES) in the United States have more than doubled since 1990, increasing the likelihood of NNESs seeking healthcare and experiencing language barriers. Language barriers in healthcare result in ineffective communication, decreased care, and reduction in overall provider satisfaction. OBJECTIVE: To investigate experiences of secondary school athletic trainers (ATs) who provided care to patients that were NNES or communicated with their NNES support systems...

BACKGROUND: Choking refers to a blockage of upper airways by food or other objects resulting in interruption of breathing. It is a medical emergency that needs immediate action by anyone near by the victim to save life. Chocking is a major cause of illness and death in the pediatric population under the age of 5 years. Children at this age spent more time in their school and are at high risk during their feeding and playing. Immediate provision of first aid in response to choking by a preschool teacher will help to decrease the risk of developing life-threatening complications, length of hospital stays, the cost of treatment, and death...

The tomato leaf miner (TLM), Tuta absoluta (Meyrick), is an invasive tomato pest found worldwide. Sustainable control strategies aimed at increasing biological control approaches and decreasing chemical inputs are required, due to the tendency to develop insecticide resistance. In this study, the lethal and sublethal effects of four chemical insecticides (abamectin, indoxacarb, chlorantraniliprole, and spinosad) and the sublethal effects of the entomopathogenic fungus Metarhizium anisopliae (Metschnikoff) on a widespread TLM egg parasitoid, Trichogramma brassicae Bezdenko, were estimated...

The prevalence of chronic kidney disease of unknown etiology (CKDu) is receiving considerable attention due to the serious threat to human health throughout the world. However, the roles of geo-socio-environmental factors in the prevalence of the CKDu endemic areas are still unknown. Sri Lanka is one of the countries most seriously affected by CKDu, where 10 out of 25 districts have been identified as the areas with the high prevalence of CKDu (10-20%). This review summarizes the geographical distribution of CKDu and its probable geochemical, behavioral, sociological, and environmental risk factors based on research related to hydrogeochemical influences on CKDu in Sri Lanka...

We aimed to determine the percentage of COVID-19- associated hospitalizations reported to Los Angeles County (LAC) Public Health that might have been misclassified because of incidentally detected SARS-CoV-2. We retrospectively reviewed medical records from a randomly selected set of hospital discharges reported to LAC Public Health from August to October 2020 for a clinical diagnosis of COVID-19 or a positive SARS-CoV-2 test result. Among the 13,813 discharges from 85 hospitals reported to LAC Public Health as COVID-19-associated hospitalizations from August to October 2020, 346 were randomly selected and reviewed...

BACKGROUND: Sepsis progresses rapidly and is associated with considerable morbidity and mortality. Bedside risk stratification scores can quickly identify patients at greatest risk of poor outcomes; however, there is lack of consensus on the best scale to use. OBJECTIVE: To compare the ability of quick Sequential Organ Failure Assessment (qSOFA), the National Early Warning System (NEWS2), and the Shock Index-which does not require mental status assessment-to predict poor outcomes among patients with suspected sepsis during triage...

This systematic review and meta-analysis aimed to recalculate the efficacy of Brucella abortus S19 and RB51 vaccine strains and discuss the main variables associated with controlled trials to evaluate bovine brucellosis vaccine efficacy. The most commonly used vaccine strain was S19, at a dose of 1010 colony forming units (CFU), followed by RB51 at 1010 CFU. The most commonly used challenge strain was B. abortus 2308, at a dose of 107 CFU, by the intraconjunctival route. Regarding the meta-analysis, trials were grouped according to the vaccine strain and dose to recalculate protection against abortion (four groups) or infection (five groups) using pooled risk ratio (RR) and vaccine efficacy (VE)...

The potential for feed ingredients to serve as a vehicle for African swine fever virus (ASFV) introduction to the US remains a significant concern. It is therefore imperative that channels through which high-risk livestock feeds and feed ingredients are imported into the US from ASFV positive countries are identified and considered into the USDA's ASF National Response Framework. The purpose of this study is to demonstrate the use of a novel analytical tool to categorically quantify pork products and potential high-risk feed ingredients that have entered the US from ASFV-positive countries over a five year period (2016-2020)...

Porcine circovirus 3 (PCV-3) has been detected in diseased and healthy pigs of different ages. Several reports have associated the agent with reproductive failure and mummified and stillborn piglets. One report from North America have proposed a consistent potential association with postweaning disorders. Thus, the present case report aimed to describe the histopathological lesions and their association with the presence of PCV-3 genome in postweaning pigs showing growth-retardation and thrown-back ears. All affected animals displayed multi-organic lymphoplasmacytic periarteritis, lymphocytic myocarditis, and/or lymphoplasmacytic meningoencephalitis...

OBJECTIVES: Individual-level social needs have been shown to substantially impact emergency department (ED) care transitions of older adults. The Geriatric Emergency care Applied Research (GEAR) Network aimed to identify care transition interventions, particularly addressing social needs, and prioritize future research questions. METHODS: GEAR engaged 49 interdisciplinary stakeholders, derived clinical questions, and conducted searches of electronic databases to identify ED discharge care transition interventions in older adult populations...

PURPOSE: To evaluate the feasibility of adding pathology to recent radiologist error characterization schemes of modality and anatomic region and the potential of this data to more specifically inform peer review and peer learning. METHODS: Quality assurance data originating from 349 radiologists in a national teleradiology practice were collected for 2019. Interpretive errors were simply categorized as major or minor. Reporting or communication errors were classified as administrative errors...

Dr. Miller Edwin Preston was a surgeon with a deep interest in trauma and orthopaedics who practiced in Denver in the early 1900s. Dr. Preston arrived in Denver shortly after the creation of Denver's first city hospital in 1860. This hospital would later be renamed to Denver General Hospital and then Denver Health Medical Center. It excels for the quality of its emergency medicine residency program, a very high survival rate for severely injured patients and the clinical pathways and algorithms pertinent to the management of haemodynamically unstable pelvic ring injuries among others...

Importance: The health effects of restrictive immigration and refugee policies targeting individuals from Muslim-majority countries are largely unknown. Objective: To analyze whether President Trump's 2017 executive order 13769, "Protecting the Nation from Foreign Terrorist Entry into the United States" (known as the "Muslim ban" executive order) was associated with changes in health care utilization by people born in targeted nations living in the US. Design, Setting, and Participants: This retrospective cohort study included adult patients treated at Minneapolis-St...

A central theme that governs the functional design of biological networks is their ability to sustain stable function despite widespread parametric variability. Here, we investigated the impact of distinct forms of biological heterogeneities on the stability of a two-dimensional continuous attractor network (CAN) implicated in grid-patterned activity generation. We show that increasing degrees of biological heterogeneities progressively disrupted the emergence of grid-patterned activity and resulted in progressively large perturbations in low-frequency neural activity...