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Preference between medical outcomes and travel times: an analysis of liver transplantation.

Langenbecks Arch Surg 2021 Jul 29. Epub 2021 Jul 29.

Institute for Research in Operative Medicine, Faculty of Health, School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, Building 38, 51109, Cologne, Germany.

Background: There is evidence of a volume outcome relationship for liver transplantation. In Germany, there is a minimum volume threshold of 20 transplantations per year for each center. Thresholds potentially lead to centralization of the healthcare supply, generating longer travel times. Read More

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Voluntary blood donation among female health care university students in Saudi Arabia, knowledge and status.

J Family Med Prim Care 2021 Jun 2;10(6):2353-2357. Epub 2021 Jul 2.

King Abdullah International Medical Research Center, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.

Context: Blood donation is an essential lifesaving procedure. There is a continuous effort to supply the high demand in hospitals.

Aims: To assess the current status, knowledge, and attitudes of female health care students in King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS) regarding blood donation. Read More

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A Step-by-Step Sonographic Approach to Vascular Anomalies in the Pediatric Population: A Pictorial Essay.

Indian J Radiol Imaging 2021 Jan 13;31(1):157-171. Epub 2021 May 13.

Department of Radio-Diagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India.

Vascular anomalies are a common cause of soft-tissue masses in children and often referred for ultrasonographic (USG) evaluation. They are broadly classified as vascular tumors (hemangiomas, hemangioendotheliomas, and angiosarcomas) or vascular malformations (venous malformations, lymphatic malformations, and arteriovenous malformations). Findings on USG and Doppler imaging can be used to categorize vascular anomalies into high- or low-flow lesions, which forms the basis for further workup, diagnosis, and management. Read More

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January 2021

Providing Food and Nutrition Services during the COVID-19 Surge at the Javits New York Medical Station.

Int J Environ Res Public Health 2021 07 12;18(14). Epub 2021 Jul 12.

Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.

Military field hospitals typically provide essential medical care in combat zones. In recent years, the United States (US) Army has deployed these facilities to assist domestic humanitarian emergency and natural disaster response efforts. As part of the nation's whole-of-government approach to the coronavirus disease (COVID-19) pandemic, directed by the Federal Emergency Management Agency and the Department of Health and Human Services, during New York City's (NYC) initial surge of COVID-19, from 26 March to 1 May 2020, the US Army erected the Javits New York Medical Station (JNYMS) field hospital to support the city's overwhelmed healthcare system. Read More

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Construction and validation of an ultraviolet germicidal irradiation system using locally available components.

PLoS One 2021 23;16(7):e0255123. Epub 2021 Jul 23.

Pulmonary and Critical Care Medicine, VA Portland Health Care System, Portland, OR, United States of America.

Coronavirus disease (COVID-19), the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, is responsible for a global pandemic characterized by high transmissibility and morbidity. Healthcare workers (HCWs) are at risk of contracting COVID-19, but this risk has been mitigated through the use of personal protective equipment such as N95 Filtering Facepiece Respirators (FFRs). At times the high demand for FFRs has exceeded supply, placing HCWs at increased exposure risk. Read More

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A survey of US hospitals on platelet inventory management, transfusion practice, and platelet availability.

Transfusion 2021 Jul 19. Epub 2021 Jul 19.

Medical Affairs, OneBlood, Orlando, Florida, USA.

Background: A survey of US hospitals was conducted to increase our understanding of the current state of platelet (PLT) practice and supply. The survey captures information on transfusion practice and inventory management, including stock levels, outdate rates, ability to return or transfer PLTs, and low dose PLTs. Notably, the survey also elucidates PLT availability challenges and impact to patient care. Read More

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What can we learn from supermarkets? An application of the Poisson distribution (order-up-to) model to improve blood culture bottle supplies.

Future Healthc J 2021 Jul;8(2):e283-e287

St George's University Hospitals NHS Foundation Trust, London, UK.

Background: The order-up-to inventory model is a method for identifying and maintaining the optimal product level for items that that hold value over time and have recurring demand. Typically, supermarkets utilise it to manage stock-levels of non-perishable goods.

Local Problem: This project aimed to improve blood culture bottle supplies following reports by junior doctors of shortages when dealing with septic/unwell patients. Read More

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Considerations for development of pharmacy support models for COVID-19 alternate care sites.

Am J Health Syst Pharm 2020 09;77(19):1592-1597

Department of Pharmacy and Intermountain Precision Genomics, Intermountain Healthcare, Salt Lake City, UT.

Purpose: Guidance on alternate care site planning based on the experience of a health-system pharmacy department in preparing for an expected surge in coronavirus disease 2019 (COVID-19) cases is provided.

Summary: In disaster response situations such as the COVID-19 pandemic, healthcare institutions may be compelled to transition to a contingency care model in which staffing and supply levels are no longer consistent with daily practice norms and, while usual patient care practices are maintained, establishment of alternate care sites (eg, a convention center) may be necessitated by high patient volumes. Available resources to assist hospitals and health systems in alternate care site planning include online guidance posted within the COVID-19 resources section of the US Army Corps of Engineers website, which provides recommended medication and supply lists; and the Federal Healthcare Resilience Task Force's alternate care site toolkit, a comprehensive resource for all aspects of alternate care site planning, including pharmacy services. Read More

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September 2020

Relative efficiency of demand creation strategies to increase voluntary medical male circumcision uptake: a study conducted as part of a randomised controlled trial in Zimbabwe.

BMJ Glob Health 2021 Jul;6(Suppl 4)

Division of Health Economics and Health Systems Innovations, Instituto Nacional de Salud Publica, Cuernavaca, Mexico.

Background: Supply and demand-side factors continue to undermine voluntary medical male circumcision (VMMC) uptake. We assessed relative economic costs of four VMMC demand creation/service-delivery modalities as part of a randomised controlled trial in Zimbabwe.

Methods: Interpersonal communication agents were trained and incentivised to generate VMMC demand across five districts using four demand creation modalities (standard demand creation (SDC), demand creation plus offer of HIV self-testing (HIVST), human-centred design (HCD)-informed approach, HCD-informed demand creation approach plus offer of HIVST). Read More

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Clinical and Angioarchitectural Features of Hemorrhagic Brain Arterio-Venous Malformations in Adults and Children: Contrasts and Implications on Outcome.

Neurosurgery 2021 Jul 16. Epub 2021 Jul 16.

Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Canada.

Background: Hemorrhage from brain arteriovenous malformations (bAVMs) is estimated at 3% per annum. Features influencing risk of hemorrhage include perforator/posterior circulation supply, associated aneurysms, and deep drainage. Children are more likely to present with bAVM bleeds. Read More

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Promise and Perils of Telehealth in the Current Era.

Curr Cardiol Rep 2021 07 16;23(9):115. Epub 2021 Jul 16.

Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd, Houston, TX, USA.

Purpose Of Review: The concept of telehealth has been around since the early twentieth century and has been used in different healthcare specialties. However, with the recent COVID-19 pandemic necessitating physical distancing, there has been an increased emphasis and utilization of this mode of healthcare delivery. With increasing reliance on telehealth services, data from investigator groups have brought to light several merits as well as failings of telehealth. Read More

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Long splenic flexure carcinoma requiring laparoscopic extended left hemicolectomy with CME and transverse-rectal anastomosis: technique for a modified partial Deloyers in 5 steps to achieve enough reach and preserving middle colic vessels.

Langenbecks Arch Surg 2021 Jul 16. Epub 2021 Jul 16.

University Hospital 'Gregorio Marañón', Madrid, Spain.

Introduction: This How-I-Do-It article presents a modified Deloyers procedure by mean of the case of a 67-year-old female with adenocarcinoma extending for a long segment and involving the splenic flexure and proximal descending colon who underwent a laparoscopic left extended hemicolectomy (LELC) with derotation of the right colon and primary colorectal anastomosis.

Background: While laparoscopic extended right colectomy is a well-established procedure, LELC is rarely used (mainly for distal transverse or proximal descending colon carcinomas extending to the area of the splenic flexure). LELC presents several technical challenges which are demonstrated in this How-I-Do-It article. Read More

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Implementation of an open-source robotic platform for SARS-CoV-2 testing by real-time RT-PCR.

PLoS One 2021 14;16(7):e0252509. Epub 2021 Jul 14.

Molecular Biology CORE (CDB), Hospital Clínic de Barcelona, Barcelona, Spain.

The current global pandemic due to the SARS-CoV-2 has pushed the limits of global health systems across all aspects of clinical care, including laboratory diagnostics. Supply chain disruptions and rapidly-shifting markets have resulted in flash-scarcity of commercial laboratory reagents; this has motivated health care providers to search for alternative workflows to cope with the international increase in demand for SARS-CoV-2 testing. The aim of this study is to present a reproducible workflow for real time RT-PCR SARS-CoV-2 testing using OT-2 open-source liquid-handling robots (Opentrons, NY). Read More

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A Nationwide Survey on the Facilities and Personnel for Endoscopic Sedation: Results from 50 Qualified Endoscopy Units of Teaching Hospitals Accredited by the Korean Society of Gastrointestinal Endoscopy (KSGE).

Clin Endosc 2021 Jul 14. Epub 2021 Jul 14.

Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.

Background/aims: This study aimed to determine the current status of facilities, equipment, and personnel for endoscopic sedation from endoscopy units of representative hospitals in South Korea.

Methods: A questionnaire survey was conducted on 50 qualified endoscopy units accredited by the Korean Society of Gastrointestinal Endoscopy.

Results: All included endoscopy units had regulations and educational programs regarding sedation training for endoscopists and nursing personnel. Read More

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Optimal SARS-CoV-2 vaccine allocation using real-time attack-rate estimates in Rhode Island and Massachusetts.

BMC Med 2021 07 13;19(1):162. Epub 2021 Jul 13.

Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, University Park, PA, USA.

Background: When three SARS-CoV-2 vaccines came to market in Europe and North America in the winter of 2020-2021, distribution networks were in a race against a major epidemiological wave of SARS-CoV-2 that began in autumn 2020. Rapid and optimized vaccine allocation was critical during this time. With 95% efficacy reported for two of the vaccines, near-term public health needs likely require that distribution is prioritized to the elderly, health care workers, teachers, essential workers, and individuals with comorbidities putting them at risk of severe clinical progression. Read More

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Nutritional intake and bone health.

Lancet Diabetes Endocrinol 2021 Jul 6. Epub 2021 Jul 6.

School of Medical Sciences and School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.

Osteoporotic or fragility fractures affect one in two women and one in five men who are older than 50. These events are associated with substantial morbidity, increased mortality, and an impaired quality of life. Recommended general measures for fragility fracture prevention include a balanced diet with an optimal protein and calcium intake and vitamin D sufficiency, together with regular weight-bearing physical exercise. Read More

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Perceptions of health-care professionals about quality of care and barriers to management of war injuries in Gaza Strip: a qualitative analysis.

Lancet 2021 Jul;398 Suppl 1:S37

Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.

Background: War-related injury is a growing clinical and public health concern in occupied Palestinian territory, especially in the Gaza Strip. However, little research has been done into the quality of care and management of war injuries in public hospitals. We explored the perceptions of health-care workers about these factors in Palestinian health-care facilities in Gaza. Read More

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Exploring pharmacist involvement in the discharge medicines reconciliation process and information transfer to primary care: an observational study.

Int J Clin Pharm 2021 Jul 5. Epub 2021 Jul 5.

Principal Pharmacist Prescribing Support Unit, Royal Cornwall Hospitals NHS Trust, Truro, , TR1 3LJ, Cornwall, UK.

Background Medication errors can occur because of incomplete or poorly communicated information at the transition from hospital to community. Following an audit in 2016, a project was undertaken to determine if pharmacists could improve the quality of medication information in discharge summaries by introducing a discharge medication reconciliation process. Pharmacists recorded any changes to the patient's medication in the electronic prescribing system during their inpatient stay and summarised these changes on discharge. Read More

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Comparison of direct surgical cost for humeral shaft fracture fixation: open reduction internal fixation versus intramedullary nailing.

JSES Int 2021 Jul 30;5(4):734-738. Epub 2021 Apr 30.

Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA.

Background And/or Hypothesis: Prior literature has supported similar complication rates and outcomes for humeral shaft fractures treated with open reduction internal fixation (ORIF) with a plate/screw construct versus intramedullary nailing (IMN). The purpose of this study is to determine whether surgical encounter total direct costs (SETDCs) differ between ORIF and IMN for these fractures.

Methods: Adult patients (≥ 18 years) treated for isolated humeral shaft fractures by ORIF or IMN between June 18, 2014 and June 17, 2019 at a single tertiary academic center were available for inclusion. Read More

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Beyond the Outbreak of COVID-19: Factors Affecting Burnout in Nurses in Iran.

Ann Glob Health 2021 06 24;87(1):51. Epub 2021 Jun 24.

Centre for Occupational and Health Psychology, School of Psychology, Cardiff University, Cardiff, UK.

Background: Nurses working in treating patients with COVID-19 are exposed to various stressors, such as fear of COVID-19, stress, and high workload, leading to burnout.

Objectives: This study aimed to identify the level of burnout and its predictors in nurses working in hospitals for COVID-19 patients.

Methods: Participants in this study were nurses working in 11 hospitals for COVID-19 patients in the Fars province of Iran. Read More

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Descriptive assessment of graduates' perceptions of pharmacy-related competencies based on the Lebanese pharmacy core competencies framework.

Pharm Pract (Granada) 2021 Apr-Jun;19(2):2320. Epub 2021 Jun 22.

PharmD, PhD. Medical School, University of Nicosia. Nicosia (Cyprus).

Background: Pharmacists possess a unique and complex body of knowledge, skills, attitudes, and behaviors necessary to enable them to optimize health outcomes. Pharmacy organizations publish routinely updated versions of professional competencies that help pharmacy schools integrate advances into their curricula. In Lebanon, no national framework for pharmacy education is officially adopted yet. Read More

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Sustainable waste management of medical waste in African developing countries: A narrative review.

Waste Manag Res 2021 Jul 3:734242X211029175. Epub 2021 Jul 3.

Department of Engineering, College of Engineering, Mathematics, and Physical Sciences, University of Exeter, Exeter, UK.

Africa is the second populous continent, and its population has the fastest growing rate. Some African countries are still plagued by poverty, poor sanitary conditions and limited resources, such as clean drinking water, food supply, electricity, and effective waste management systems. Underfunded healthcare systems, poor training and lack of awareness of policies and legislations on handling medical waste have led to increased improper handling of waste within hospitals, healthcare facilities and transportation and storage of medical waste. Read More

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Direct oral anticoagulant-related medication incidents and pharmacists' interventions in hospital in-patients: evaluation using reason's accident causation theory.

Int J Clin Pharm 2021 Jul 2. Epub 2021 Jul 2.

School of Pharmacy, College of Medical and Dental Sciences, Sir Robert Aitken Institute for Medical Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.

Background Direct oral anticoagulants (DOACs) have revolutionised anticoagulant pharmacotherapy. However, DOAC-related medication incidents are known to be common. Objective To assess medication incidents associated with DOACs using an error theory and to analyse pharmacists' contributions in minimising medication incidents in hospital in-patients. Read More

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Triboelectric Energy Harvester Based on Stainless Steel/MoS and PET/ITO/PDMS for Potential Smart Healthcare Devices.

Nanomaterials (Basel) 2021 Jun 10;11(6). Epub 2021 Jun 10.

Maestría en Ingeniería Aplicada, Facultad de Ingeniería de la Construcción y el Hábitat, Universidad Veracruzana, Boca del Río 94294, Veracruz, Mexico.

The smart healthcare devices connected with the internet of things (IoT) for medical services can obtain physiological data of risk patients and communicate these data in real-time to doctors and hospitals. These devices require power sources with a sufficient lifetime to supply them energy, limiting the conventional electrochemical batteries. Additionally, these batteries may contain toxic materials that damage the health of patients and environment. Read More

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Investigation and Analysis of Sharp Injuries among Health Care Workers from 36 Hospitals in Shandong Province, China.

Biomed Res Int 2021 11;2021:5698483. Epub 2021 Jun 11.

Department of Infection Control, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China.

Background: This study investigated and analyzed the current situation of sharp injuries among health care workers (HCWs) in China's Shandong Province.

Methods: By means of questionnaire survey, the incidence of sharp injuries among HCWs from 36 hospitals in China's Shandong Province in October 2019 was investigated, and the results of this survey were compared with those of October 2012.

Results: A total of 48165 HCWs were investigated. Read More

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Unraveling the Mystery of Polyvalent Immunoglobulins in Belgium: Do We Have an Indication?

Int Arch Allergy Immunol 2021 Jun 30:1-8. Epub 2021 Jun 30.

Belgian Health Care Knowledge Center (KCE), Brussels, Belgium.

Introduction: Worldwide, polyvalent immunoglobulin (Ig) use is rising. Together with the limited supply, this puts pressure on Ig availability. A clear overview on a country's usage pattern helps in forecasting future needs. Read More

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Lingual-Artery Thromboembolism.

N Engl J Med 2021 Jul;385(1):65

Cambridge University Hospitals, Cambridge, United Kingdom

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CTSA pharmacies: Contribution to research and public health during the COVID-19 pandemic.

J Clin Transl Sci 2021 Feb 18;5(1):e108. Epub 2021 Feb 18.

Allen and Frances Adler Laboratory of Blood and Vascular Biology, The Rockefeller University, New York, NY, USA.

Introduction: In March 2020, academic medical center (AMC) pharmacies were compelled to implement practice changes in response to the COVID-19 pandemic. These changes were described by survey data collected by the Clinical and Translational Science Awards (CTSA) program which were interpreted by a multi-institutional team of AMC pharmacists and physician investigators.

Methods: The CTSA program surveyed 60 AMC pharmacy departments. Read More

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February 2021

Assessing emergency healthcare accessibility in the Salton Sea region of Imperial County, California.

Preeti Juturu

PLoS One 2021 30;16(6):e0253301. Epub 2021 Jun 30.

School of Public Policy and Department of Economics, University of California, Riverside, California, United States of America.

The area surrounding California's Salton Sea, which lies within Riverside and Imperial counties, has particularly negative health outcomes. Imperial County, a primarily rural region that encompasses the lake, has pediatric asthma-related emergency healthcare visits that double the state average. This paper seeks to assess the level of emergency healthcare access in the Salton Sea region of Imperial County, drawing from spatial science methods. Read More

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