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Depression and anxiety have been associated with cigarette use among young people. Higher impulsivity has also been associated with increased smoking behavior. However, relatively less is known about the associations between depression, anxiety, impulsivity and e-cigarette use and how these associations compare with the associations between depression, anxiety, impulsivity and cigarette smoking. In addition, little is known about how impulsivity influences the relationships between depression, anxiety, cigarette, and e-cigarette use. This study tested the hypothesis that higher depression and anxiety symptoms are associated with higher e-cigarette use and cigarette smoking in a similar way, and that these associations would be stronger among those with higher impulsivity. A sample of 2,622 young adults (18-25 year olds; 54% women) enrolled in 4-year and 2-year colleges in Hawai'i participated in a cross-sectional survey. Approximately 68% of the sample reported no use of either e-cigarettes or cigarettes, 13% reported only e-cigarette use, 9% reported only cigarette smoking, and 11% reported use of both. The study found that higher depressive and anxiety symptoms and higher impulsivity were significantly associated with current cigarette and e-cigarette use. For example, one unit increases in depression, anxiety, and impulsivity were associated with 34%, 17%, and 38% increased odds of e-cigarette use versus non-use, respectively. Impulsivity was found to significantly moderate the association between higher anxiety and higher cigarette smoking, such that the association was stronger among those with higher impulsivity. Impulsivity was not found to moderate any other association. Results suggest that tobacco product use prevention education should target children and young adults with higher internalizing symptoms, with particular attention to those who show higher impulsivity.There is little current research comparing stress, burnout, and resilience in pediatric and adult intensive care practitioners. This article analyzes data derived from a 2018 qualitative study of burnout and resilience among ICU providers to explore differences that may exist between the pediatric and adult domains of practice.

This study represents a thematic subanalysis of textual data derived from a larger qualitative study of ICU provider burnout and resilience.

Six international critical care units (Australia, Israel, United States).

Physicians working at the above sites who had been practicing as intensivists for a minimum period of 4 years.

None.

Data were collected using a semistructured interview process, and resulting transcripts were analyzed using postpositivist framework analysis. A secondary analysis was then performed separately on pediatric and adult datasets using the initial coding framework as a template. Three themes related to perceived differences were noted differences in the pintensive care clinicians.

Although similar stressors exist within each group, meaningful differences in how these are perceived and personally processed by individual clinicians exist. Better understanding of these differences will assist attempts to enhance the resilience and provide career guidance to aspiring intensive care clinicians.The third wave of COVID-19 is unique in that vaccines have been widely available; however, the highly transmissible Delta variant has been the predominant strain. Temporal changes of hospitalized patient characteristics should continue to be analyzed as COVID-19 progresses.

Compare the demographics and outcomes of hospitalized patients during New York City's third wave of COVID-19 to the first two waves.

Retrospective cohort study across five hospitals within Mount Sinai Health System, a quaternary academic medical system in New York City. Participants were adult inpatients admitted with COVID-19 identified by positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction at admission or clinical documentation of infection during the three waves of COVID-19.

Patient demographics, comorbidities, vaccination status, and outcomes of COVID-19 patients hospitalized at Mount Sinai Health System were examined. Patients admitted during the third wave were notably younger than the first two, wed patients which may be expected given their lower age and burden of comorbidities.

We continue to see improved outcomes in hospitalized COVID-19 patients. Patients that are unvaccinated against COVID-19 are younger and have less reported comorbidities.

We continue to see improved outcomes in hospitalized COVID-19 patients. Patients that are unvaccinated against COVID-19 are younger and have less reported comorbidities.Hypoalbuminemia has been associated with poor outcome in critically ill population including sepsis and COVID-19. The observational study by Su et al showed a favorable albumin kinetics, with an initial downwards trend followed by recovery back to the predicted albumin levels, in survivors of COVID-19 and sepsis-induced acute respiratory distress syndrome (ARDS). However, nonsurvivors in COVID-19 group did not have an upwards recovery slope, while those in sepsis group did not follow any sort of albumin kinetics. Thus, authors concluded that the pattern of albumin kinetics may be predictive of outcome in COVID-19 and sepsis-induced ARDS. Here, we would like to highlight a few more points in this letter.Symptoms of posttraumatic stress disorder (PTSD) are common among surrogate decision makers of patients with chronic critical illness (CCI). PTSD symptoms can be categorized into clusters including intrusion, avoidance, and hyperarousal, each of which has been associated with distinct outcomes and treatment responses. Our objective was to determine which symptom cluster was predominant among surrogates of patients with CCI.

Secondary analysis of data from a clinical trial of a communication intervention.

The original trial was conducted in medical intensive care units at three tertiary-care centers and one community hospital.

Patients with CCI (≥7 d of mechanical ventilation and not expected to die or to be weaned from the ventilator in the subsequent 72 hr) and their surrogates.

None.

Surrogate PTSD symptoms were measured 90 days after onset of patient CCI using the Impact of Events Scale-Revised (IES-R). selleck inhibitor The IES-R includes a total score (range, 0-88, higher scores indicate severe symptoms) as well most severe PTSD symptom in surrogates of patients experiencing CCI, with intensified symptoms among surrogates of patients who died. These results have the potential to inform tailored treatment strategies to reduce PTSD symptoms in this population.Acute respiratory failure is a common reason for ICU admission and imposes significant strain on patients and the healthcare system. Noninvasive positive-pressure ventilation and high-flow nasal oxygen are increasingly used as an alternative to invasive mechanical ventilation to treat acute respiratory failure. As such, there is a need to accurately cohort patients using large, routinely collected, clinical data to better understand utilization patterns and patient outcomes. The primary objective of this retrospective observational study was to externally validate our computable phenotyping algorithm for patients with acute respiratory failure requiring various sequences of respiratory support in real-world data from a large healthcare delivery network.

This is a cross-sectional observational study to validate our algorithm for phenotyping acute respiratory patients by method of respiratory support. We randomly selected 5% (

= 4,319) from each phenotype for manual validation. We calculated the algorithm peodalities of respiratory support.

The electronic phenotyping algorithm is robust and provides a necessary tool for retrospective research for characterizing patients with acute respiratory failure across modalities of respiratory support.Approximately one in 30 patients with acute respiratory failure (ARF) undergoes an inter-ICU transfer. Our objectives are to describe inter-ICU transfer patterns and evaluate the impact of timing of transfer on patient-centered outcomes.

Retrospective, quasi-experimental study.

We used the Healthcare Cost and Utilization Project State Inpatient Databases in five states (Florida, Maryland, Mississippi, New York, and Washington) during 2015-2017.

We selected patients with

, 9th and 10th Revision codes of respiratory failure and mechanical ventilation who underwent an inter-ICU transfer (

= 6,718), grouping as early (≤ 2 d) and later transfers (3+ d). To control for potential selection bias, we propensity score matched patients (11) to model propensity for early transfer using a priori defined patient demographic, clinical, and hospital variables.

Inhospital mortality, hospital length of stay (HLOS), and cumulative charges related to inter-ICU transfer.

Six-thousand seven-hundred eighteen patients w. Our findings of favorable outcomes with early transfer are vital in designing future prospective studies evaluating evidence-based transfer procedures and policies.

Our study is the first to use a large, multistate sample to evaluate the practice of inter-ICU transfers in ARF and also define early and later transfers. Our findings of favorable outcomes with early transfer are vital in designing future prospective studies evaluating evidence-based transfer procedures and policies.The structure-function relationship between white matter microstructure and episodic memory (EM) has been poorly studied in the developing brain, particularly in early childhood. Previous studies in adolescents and adults have shown that episodic memory recall is associated with prefrontal-limbic white matter microstructure. It is unknown whether this association is also observed during early ontogeny. Here, we investigated the association between prefrontal-limbic tract microstructure and EM performance in a cross-sectional sample of children aged 4 to 12 years. We used a multivariate partial least squares correlation approach to extract tract-specific latent variables representing shared information between age and diffusion parameters describing tract microstructure. Individual projections onto these latent variables describe patterns of interindividual differences in tract maturation that can be interpreted as scores of white matter tract microstructural maturity. Using these estimates of microstructural maturity, we showed that maturity scores of the uncinate fasciculus and dorsal cingulum bundle correlated with distinct measures of EM recall. Furthermore, the association between tract maturity scores and EM recall was comparable between younger and older children. Our results provide new evidence on the relation between white matter maturity and EM performance during development.

Elderly patients with glioblastoma are perceived to face a poor prognosis with perceptions surrounding older age and a relative lack of randomized data contributing. This study evaluated survival prognosticators in elderly glioblastoma patients to more accurately guide their treatment.

The records of 169 elderly (≥70 years) patients with a new diagnosis of glioblastoma who had undergone neurosurgical intervention were retrospectively examined for patient sex, age, performance status, comorbidities, MGMT promoter methylation, surgical intervention, and chemoradiation regime. The adjusted survival impact of these factors was determined using Cox proportional hazards model and used to devise a two-stage scoring system to estimate patient survival at the stage of surgical (Elderly Glioblastoma Surgical Score, EGSS) and oncological management (Elderly Glioblastoma Oncological Score, EGOS).

The median overall survival (mOS) of the cohort was 28.8 weeks. Gross-total and subtotal resection were associated with improved survival compared to biopsy alone (respective mOS 65.