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Major Burn Injury Successfully Treated with Cultured Epithelial Autografts, a Case Series Presentation: Establishing Standard Clinical Practices.

J Burn Care Res 2021 Jul 26. Epub 2021 Jul 26.

United States Army Institute of Surgical Research.

Cultured epithelial autografts have been an option for coverage of large surface area burns for over two decades. However, there remains extreme variability in clinical practice in wound bed preparation, application of cultured epithelial autografts, and post-operative wound care and rehabilitation practices, demonstrating the need for a standardized and multidisciplinary approach in the treatment of critically injured patients treated with cultured epithelial autografts. The purpose of this case series was to share the development of a clinical practice guideline and competency checklist in our institution where cultured epithelial autograft case volume is low. Read More

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A Machine Learning-Based Algorithm for the Prediction of Intensive Care Unit Delirium (PRIDE): Retrospective Study.

JMIR Med Inform 2021 Jul 26;9(7):e23401. Epub 2021 Jul 26.

Department of Critical Care Medicine and Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Background: Delirium frequently occurs among patients admitted to the intensive care unit (ICU). There is limited evidence to support interventions to treat or resolve delirium in patients who have already developed delirium. Therefore, the early recognition and prevention of delirium are important in the management of critically ill patients. Read More

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The impact of hindlimb disuse on sepsis-induced myopathy in mice.

Physiol Rep 2021 Jul;9(14):e14979

Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL, USA.

Sepsis induces a myopathy characterized by loss of muscle mass and weakness. Septic patients undergo prolonged periods of limb muscle disuse due to bed rest. The contribution of limb muscle disuse to the myopathy phenotype remains poorly described. Read More

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A retrospective nationwide study on the trends in first-line antidiabetic medication for patients with type 2 diabetes in Japan.

J Diabetes Investig 2021 Jul 26. Epub 2021 Jul 26.

Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan.

Aims/introduction: To investigate the national trend in the prescription of first-line non-insulin antidiabetic agents and total medical costs (TMCs) after prescribing the drug in Japanese patients with type 2 diabetes.

Materials And Methods: Using the National Database of Health Insurance Claims and Specific Health Check-ups of Japan (NDB) covering almost the entire Japanese population, we calculated the proportion of each antidiabetic drug from 2014 to 2017 and determined the factors associated with drug selection. The TMCs in the first year after starting the drugs were calculated, and factors associated with the costs were also determined. Read More

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Very early mobilization in the stroke unit: Functionality, quality of life and disability at 90 days and 1 year post-stroke.

NeuroRehabilitation 2021 Jul 18. Epub 2021 Jul 18.

Multidisciplinary Nursing Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron, Barcelona, Spain.

Background: The evidence of early mobilization after stroke is conflicting, and the recovery period is an important concern.

Objective: To analyse the functionality, quality of life and disability at 90 days and 1 year post-stroke of patients who received a Very Early Mobilization Protocol (VEMP).

Methods: Prospective cohort study in a tertiary stroke unit. Read More

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Effects of nursing care in fast-track surgery on postoperative pain, psychological state, and patient satisfaction with nursing for glioma.

World J Clin Cases 2021 Jul;9(20):5435-5441

Department of Neurosurgery, Chongqing University Cancer Hospital, Chongqing 400030, China.

Background: The brain is the most complex organ in the human body. Treatment for a glioma always involves a multi-disciplinary team. Nursing care in fast-track surgery or enhanced recovery after surgery is such kind of work implemented by an interdisciplinary team to provide services to patients to improve their outcomes. Read More

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Pterygium Complicating Nail Psoriasis and Trachyonychia: Is It Rare?

Skin Appendage Disord 2021 Jun 25;7(4):298-305. Epub 2021 Feb 25.

Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, Dilshad Garden, Delhi, India.

Pterygium is an irreversible scarring of the nail matrix resulting in a split nail. The deformity is most often post-traumatic, though it can be the end result of aggressive inflammatory diseases involving the nail matrix like nail lichen planus, graft versus host disease, or autoimmune bullous disorders like cicatricial pemphigoid. It is thought to be a result of lymphocytic inflammation-mediated damage to the nail matrix, initiating a fibrotic process which slowly fuses the nail fold with the nail matrix and bed, destroying the nail plate. Read More

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Radiation Therapy After Radical Prostatectomy: What Has Changed Over Time?

Front Surg 2021 9;8:691473. Epub 2021 Jul 9.

Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.

The role and timing of radiotherapy (RT) in prostate cancer (PCa) patients treated with radical prostatectomy (RP) remains controversial. While recent trials support the oncological safety of early salvage RT (SRT) compared to adjuvant RT (ART) in selected patients, previous randomized studies demonstrated that ART might improve recurrence-free survival in patients at high risk for local recurrence based on adverse pathology. Although ART might improve survival, this approach is characterized by a risk of overtreatment in up to 40% of cases. Read More

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Impact of enhanced recovery nursing combined with limb training on knee joint function and neurological function after total knee arthroplasty in patients with knee osteoarthritis.

Am J Transl Res 2021 15;13(6):6864-6872. Epub 2021 Jun 15.

Department of Orthopedics, First Affiliated Hospital of Kunming Medical University Kunming, Yunnan Province, China.

Objective: To investigate the impact of enhanced recovery after surgery (ERAS) nursing combined with limb training on knee joint function and neurological function after total knee arthroplasty in patients with knee osteoarthritis (KOA).

Methods: Eighty-six patients with KOA after TKA were randomly divided into two groups, group A and group B, with 43 patients in each group. Group A was given ERAS nursing, and group B was given limb rehabilitation training combined with ERAS nursing. Read More

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The impact of diagnosis related group payment on the performance of public hospitals.

Authors:
Yafeng Ma Wei Wang

Am J Transl Res 2021 15;13(6):6796-6801. Epub 2021 Jun 15.

Affiliated Hospital of Yangzhou University Yangzhou, Jiangsu Province, China.

Objective: To investigate the practical value of diagnosis related groups (DRGs) according to payment for assessing the performance of public hospitals.

Methods: According to a random number table, 2400 patients were chosen from 3928 inpatients admitted for treatment in our hospital. Based on nodes implemented in the DRGs, these patients were assigned to the control group and the experimental group (1200 patients in each group). Read More

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A Retrospective Quality Improvement Study to Describe Operational Management Strategies in an Inpatient Rehabilitation Facility during the COVID-19 Pandemic.

Arch Phys Med Rehabil 2021 Jul 22. Epub 2021 Jul 22.

Burke Rehabilitation Hospital, Rehabilitation Services Division.

The delivery of care in the inpatient rehabilitation setting was disrupted during the COVID-19 pandemic. As a 150 bed freestanding inpatient rehabilitation facility in the epicenter of the pandemic, Burke Rehabilitation Hospital was required to increase overall bed capacity for regional overflow needs and still maintain our mission to provide inpatient rehabilitation for patients with and without COVID-19. During the period between March and September 2020, Burke Rehabilitation Hospital treated over 300 COVID-19 positive rehabilitation patients, and at one point had a census that was greater than 50% COVID-19 positive. Read More

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Impact of healthcare-associated infection on length of stay.

J Hosp Infect 2021 Aug;114:23-31

Safeguarding Health through Infection Prevention Research Group, Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, UK; National Services Scotland (NSS), UK.

Background: Increased length of stay (LOS) for patients is an important measure of the burden of healthcare-associated infection (HAI).

Aim: To estimate the excess LOS attributable to HAI.

Methods: This was a one-year prospective incidence study of HAI observed in one teaching hospital and one general hospital in NHS Scotland as part of the Evaluation of Cost of Nosocomial Infection (ECONI) study. Read More

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Epidemiology of healthcare-associated infection reported from a hospital-wide incidence study: considerations for infection prevention and control planning.

J Hosp Infect 2021 Aug;114:10-22

Safeguarding Health through Infection Prevention Research Group, Research Centre for Health (ReaCH), Glasgow Caledonian University, Glasgow, UK; National Services Scotland (NSS), UK.

Background: The measure of disease frequency most widely used to report healthcare-associated infection (HAI) is the point-prevalence survey. Incidence studies are rarely performed due to time and cost constraints; they show which patients are affected by HAI, when and where, and inform planning and design of infection prevention and control (IPC) measures.

Aim: To determine the epidemiology of HAI within a general and a teaching hospital in Scotland. Read More

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"The talking bit of medicine, that's the most important bit": doctors and Aboriginal interpreters collaborate to transform culturally competent hospital care.

Int J Equity Health 2021 Jul 23;20(1):170. Epub 2021 Jul 23.

Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, Darwin, NT, 0811, Australia.

Background: In hospitals globally, patient centred communication is difficult to practice, and interpreters are underused. Low uptake of interpreters is commonly attributed to limited interpreter availability, time constraints and that interpreter-medicated communication in healthcare is an aberration. In Australia's Northern Territory at Royal Darwin Hospital, it is estimated around 50% of Aboriginal patients would benefit from an interpreter, yet approximately 17% get access. Read More

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Design of a novel multifunction decision support/alerting system for in-patient acute care, ICU and floor (AlertWatch AC).

BMC Anesthesiol 2021 Jul 24;21(1):196. Epub 2021 Jul 24.

Department of Anesthesiology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.

Background: Multifunction surveillance alerting systems have been found to be beneficial for the operating room and labor and delivery. This paper describes a similar system developed for in-hospital acute care environments, AlertWatch Acute Care (AWAC).

Results: A decision support surveillance system has been developed which extracts comprehensive electronic health record (EHR) data including live data from physiologic monitors and ventilators and incorporates them into an integrated organ icon-based patient display. Read More

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A prospective observational study of community acquired pneumonia in Kenya: the role of viral pathogens.

BMC Infect Dis 2021 Jul 23;21(1):703. Epub 2021 Jul 23.

Department of Medicine, Aga Khan University, Third Parklands Rd, Nairobi, Kenya.

Background: Lower respiratory tract infections continue to contribute significantly to morbidity and mortality across all age groups globally. In sub-Saharan Africa, many studies of community acquired pneumonia in adults have focused on HIV-infected patients and little attention has been given to risk factors and etiologic agents in an urban area with a more moderate HIV prevalence.

Methods: We prospectively enrolled 77 patients admitted to a 280 bed teaching hospital in Kenya with radiographically confirmed community acquired pneumonia from May 2019 to March 2020. Read More

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Factors Associated with Clostridioides (Clostridium) Difficile Infection and Colonization: Ongoing Prospective Cohort Study in a French University Hospital.

Int J Environ Res Public Health 2021 Jul 15;18(14). Epub 2021 Jul 15.

Edouard Herriot Hospital, Hospices Civils de Lyon, 69437 Lyon, France.

Introduction: can be isolated from stool in 3% of healthy adults and in at least 10% of asymptomatic hospitalized patients. , the most common cause of hospital-acquired infectious diarrhea in the developed world, has re-emerged in recent years with increasing incidence and severity. In an effort to reduce the spread of the pathogen, published recommendations suggest isolation and contact precautions for patients suffering from infection (CDI). Read More

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Saliency-guided deep learning network for automatic tumor bed volume delineation in post-operative breast irradiation.

Phys Med Biol 2021 Jul 23. Epub 2021 Jul 23.

Department of Radiation Oncology, University of Texas Southwestern Medical Centre, Dallas, TX 75235, Dallas, Texas, 75235, UNITED STATES.

Efficient, reliable and reproducible target volume delineation is a key step in the effective planning of breast radiotherapy. However, post-operative breast target delineation is challenging as the contrast between the tumor bed volume (TBV) and normal breast tissue is relatively low in CT images. In this study, we propose to mimic the marker-guidance procedure in manual target delineation. Read More

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J receptor activity in idiopathic pulmonary hypertension and its expected change in the presence of pulmonary bed vasodilators.

Respir Physiol Neurobiol 2021 Jul 20:103742. Epub 2021 Jul 20.

Department of Cardiology, All India Institute of Medical Sciences, Delhi, India.

Juxtapulmonary receptors (J) lying in the lung parenchyma are stimulated naturally by any condition that produces interstitial oedema, transient increases in interstitial volume and pressure or raised pulmonary capillary pressure. There is no information available about the level of their stimulation in patients with idiopathic pulmonary hypertension (IPH) who have high levels of pulmonary artery systolic pressures. The aim of the present study therefore was to find the level of these receptors activity in these patients at their prevailing pulmonary artery systolic pressures. Read More

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[Comparison of two screening scales used by 120 dispatchers for early identification of pre-hospital stroke patients and telephone guidance for treatment].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2021 Jun;33(6):752-754

Kaifeng 120 Emergency Medical Center, Kaifeng 475000, Henan, China. Corresponding author: Duan Baomin, Email:

Objective: To observe the effect of two different screening scales used by 120 dispatchers to early identify stroke patients and give telephone guidance for treatment.

Methods: From October 2018 to August 2019, 2 027 stroke and suspect stroke patients who called the Kaifeng 120 Emergency Center were enrolled. The differences in the final positive rate of stroke diagnosis and the incidence of adverse events were compared and analyzed in 1 020 cases using recognition of stroke in the emergency room (ROSIER) and 1 007 cases using facial drooping, arm weakness, speech difficulties and time (FAST) scale scores for telephone guidance. Read More

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[The role of respiratory therapists in the treatment of coronavirus disease 2019 patients in China].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2021 Jun;33(6):744-747

Department of Critical Care Medicine, West China Hospital, Chengdu 610041, Sichuan, China. Corresponding author: Wang Bo, Email:

Objective: To investigate the clinical practice of Chinese respiratory therapists (RTs) participating in the treatment of coronavirus disease 2019 (COVID-19) patients and summarize the experience and role of RTs in the treatment of pandemic infectious diseases.

Methods: A self-designed questionnaire was used to investigate the RTs who treated COVID-19 patients in 31 provinces, cities and autonomous regions in China. The survey questionnaire included the basic work of RTs, the specific work of the treatment for COVID-19 patients and problems encountered at work. Read More

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The Prognosis and Feasibility of Extensive Clinical Target Volume in Postoperative Radiotherapy for Esophageal Squamous Cell Carcinoma: A Phase II Clinical Trial.

Front Oncol 2021 2;11:669575. Epub 2021 Jul 2.

Department of Radiotherapy, Fudan University Shanghai Cancer Center, Shanghai, China.

Background: This trial aims to explore the feasibility and safety of postoperative radiotherapy covering all regional lymph node areas for locally advanced thoracic esophageal squamous cell carcinoma patients treated with intensity-modulated radiation therapy (IMRT).

Methods: This was a single-center single-arm, phase II clinical trial initiated in 2014. Patients who were treated with radical transthoracic resection and had negative margins within 3 months and histologically confirmed esophageal squamous cell carcinoma (pT3-4 or N+, M0 determined by the 7th edition of the AJCC guidelines) were recruited in this trial. Read More

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Emfit Bed Sensor Activity Shows Strong Agreement with Wrist Actigraphy for the Assessment of Sleep in the Home Setting.

Nat Sci Sleep 2021 16;13:1157-1166. Epub 2021 Jul 16.

Department of Neurology, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, USA.

Purpose: Wrist-worn actigraphy via research-grade devices, a well-established approach to the assessment of rest-activity, is limited by poor compliance, battery life, and lack of direct evidence for time spent physically in the bed. A non-invasive bed sensor (Emfit) may provide advantages over actigraphy for long-term sleep assessment in the home. This study compared sleep-wake measurements between this sensor and a validated actigraph. Read More

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Converting hip and knee arthroplasty cases to same-day surgery due to COVID-19.

Bone Jt Open 2021 Jul;2(7):545-551

Orthopaedics, St Michael's Hospital, Toronto, Ontario, Canada.

Aims: In 2020, the COVID-19 pandemic meant that proceeding with elective surgery was restricted to minimize exposure on wards. In order to maintain throughput of elective cases, our hospital (St Michaels Hospital, Toronto, Canada) was forced to convert as many cases as possible to same-day procedures rather than overnight admission. In this retrospective analysis, we review the cases performed as same-day arthroplasty surgeries compared to the same period in the previous 12 months. Read More

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Ward-level factors associated with methicillin-resistant Staphylococcus aureus acquisition-an electronic medical records study in Singapore.

PLoS One 2021 22;16(7):e0254852. Epub 2021 Jul 22.

Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.

Background: Methicillin-Resistant Staphylococcus aureus (MRSA) is endemic in hospitals worldwide. Intrahospital transfers may impact MRSA acquisition risk experienced by patients. In this study, we investigated ward characteristics and connectivity that are associated with MRSA acquisition. Read More

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Six-Month Pulmonary Function After Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019 Patients.

Crit Care Explor 2021 Jul 16;3(7):e0494. Epub 2021 Jul 16.

Department of Critical Care, Centres Hospitaliers Jolimont, La Louvière, Belgium.

Objectives: Venovenous extracorporeal membrane oxygenation has been largely used in patients with refractory acute respiratory distress syndrome due to coronavirus disease 2019. Few data on long-term pulmonary function among venovenous extracorporeal membrane oxygenation survivors are available.

Design: Retrospective, observational cohort. Read More

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Targeted Minimal Staff-to-Patient Ratios Are Unachievable - A Nationwide Survey in German ICUs During the COVID-19 Pandemic.

Cureus 2021 Jun 19;13(6):e15755. Epub 2021 Jun 19.

Department of Anesthesiology and Intensive Care Medicine, University Medical Center Goettingen, Goettingen, DEU.

Introduction Adequate staffing in the intensive care units (ICUs) is the most important factor to provide optimal care and ensure favorable outcomes in critically ill patients. Recently, the need for ICU beds has reached unprecedented levels and the management and treatment of critically ill patients has been in focus. The aim of the study was to assess the targeted and actual nurse-to-patient (NPR) and physician-to-patient ratios (PPR) regarding patients with and without COVID-19. Read More

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Mathematical Model Predicts that Acceleration of Diabetic Wound Healing is Dependent on Spatial Distribution of VEGF-A mRNA (AZD8601).

Cell Mol Bioeng 2021 Aug 15;14(4):321-338. Epub 2021 Jun 15.

Department of Biomedical Engineering, University of Virginia, Charlottesville, VA USA.

Introduction: Pharmacologic approaches for promoting angiogenesis have been utilized to accelerate healing of chronic wounds in diabetic patients with varying degrees of success. We hypothesize that the distribution of proangiogenic drugs in the wound area critically impacts the rate of closure of diabetic wounds. To evaluate this hypothesis, we developed a mathematical model that predicts how spatial distribution of VEGF-A produced by delivery of a modified mRNA (AZD8601) accelerates diabetic wound healing. Read More

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Can health service equity alleviate the health expenditure poverty of Chinese patients? Evidence from the CFPS and China health statistics yearbook.

BMC Health Serv Res 2021 Jul 21;21(1):718. Epub 2021 Jul 21.

Swinburne Business School, Swinburne University of Technology, Melbourne, Australia.

Objectives: To comprehend the relationship between various indicators of health service equity and patients' health expenditure poverty in different regions of China, identify areas where equity in health service is lacking and provide ideas for improving patients' health expenditure poverty.

Method: Data from China Family Panel Studies (CFPS) in 2018 and the HFGT index formula were used to calculate the health expenditure poverty index of each province. Moreover, Global Moran's I and Local Moran's I test are applied to measure whether there is spatial aggregation of health expenditure poverty. Read More

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