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xis, it may be appropriate to treat for those conditions. Any patient with suspected ACE-I-AE should immediately discontinue that medication.

Iatrogenic pulmonary air embolism is a fairly common and sometimes deadly complication of i.v. contrast injection.

We present the case of a 33-year-old man with a symptomatic iatrogenic injection air embolism and resolution within 5 h. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS? Given the importance of computed tomography imaging in emergency medicine, clinicians should be aware of the risk for injection air embolism from i.v. contrast injection.

We present the case of a 33-year-old man with a symptomatic iatrogenic injection air embolism and resolution within 5 h. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS? Given the importance of computed tomography imaging in emergency medicine, clinicians should be aware of the risk for injection air embolism from i.v. contrast injection.

Integrating medical scribes with clinicians has been suggested to improve access, quality of care, enhance patient/clinician satisfaction, and increase productivity revenue.

Conduct a systematic review to evaluate the effects of medical scribes in emergency departments.

Electronic databases from 2010 through December 2019. Two individuals independently reviewed study eligibility, rated risk of bias, and determined overall certainty of evidence. Data abstracted included study and population characteristics, outcomes (efficiency, patient or clinician satisfaction, financial productivity, documentation quality, cost, and training time), and the effect of compensation structure, qualifications, duties, and setting on outcomes.

Twenty studies (18 observational) were included; 12 from two institutions. All utilized in-person rather than virtual scribes. Fifteen were rated as serious or critical risk of bias; five were rated moderate. CC-885 chemical structure Findings indicate that scribes may increase patients seen per day and decrefficiency and financial productivity. There was no information on virtual scribes. There was little information on patient or clinician satisfaction, scribe documentation quality, or whether results vary by in-house vs. contracted hiring and training.

Iron deficiency (IDef) is a prevalent condition in patients with heart disease and in those with heart failure (HF). Evidence has shown that this deficit is associated with a worse prognosis. There is only a small amount of data in the literature regarding the prognostic impact of IDef in acute coronary syndromes (ACS), which is the main objective of this study.

Observational, retrospective study which included 817 patients admitted for ACS. Two groups were defined according to the presence (n = 298) or absence of IDeF (n = 519) on admission. The clinical event under study was the occurrence of death or severe HF in long term. Independent predictors of prognosis were determined with logistic regression analysis.

36% of patients had IDef. These patients had a higher mortality rate (p = 0.004), higher incidence of HF (p = 0.011) during follow-up and a higher rate of hospital readmissions (p = 0.048). IDef was an independent predictor of death or severe HF in follow-up, along with anemia, left ventricular dysfunction, renal dysfunction and the absence of revascularization. IDef also enabled us to further stratify the prognosis of patients without anemia based on the occurrence of death or severe HF and those with lower Killip classes (≤2) based on the occurrence of death.

IDef was an independent predictor of death or severe HF in patients admitted with ACS and enabled additional stratification for those without anemia on admission and in those with Killip classes ≤2.

IDef was an independent predictor of death or severe HF in patients admitted with ACS and enabled additional stratification for those without anemia on admission and in those with Killip classes ≤2.Ferroptosis is a form of regulated cell death modality associated with disturbed iron-homeostasis and unrestricted lipid peroxidation. Ample evidence has depicted an essential role for ferroptosis as either the cause or consequence for human diseases, denoting the likely therapeutic promises for targeting ferroptosis in the preservation of human health. Ferritinophagy, a selective form of autophagy, contributes to the initiation of ferroptosis through degradation of ferritin, which triggers labile iron overload (IO), lipid peroxidation, membrane damage, and cell death. In this review, we will delineate the role of ferritinophagy in ferroptosis, and its underlying regulatory mechanisms, to unveil the therapeutic value of ferritinophagy as a target in the combat of ferroptosis to manage metabolic diseases.The application of single-cell analytic techniques to the study of stem/progenitor cell niches supports the emerging view that pancreatic cell lineages are in a state of flux between differentiation stages. For all their value, however, such analyses merely offer a snapshot of the cellular palette of the tissue at any given time point. Conclusions about potential developmental/regeneration paths are solely based on bioinformatics inferences. In this context, the advent of new techniques for the long-term culture and lineage tracing of human pancreatic slices offers a virtual window into the native organ and presents the field with a unique opportunity to serially resolve pancreatic regeneration dynamics at the single-cell level.

To assess validity of Laser Speckle Contrast Imaging (LSCI) for the measurement of burn wound healing potential (HP) in a burn centre patient population, based on Laser Doppler Imaging (LDI) as reference standard.

A single-centre prospective observational cohort study was performed between September-December 2019. A total of 50 burns in 14 patients were included. Imaging and data collection were standardized. Correlation between LSCI and LDI flux values was tested. ROC curves were developed to test the discriminative ability of LSCI between LDI HP categories.

Number of adults and children were equal. Mean total body surface area burnt was 5.5%. Main burn causes were scalds (64%) and flame burns (36%). LSCI set-up and imaging duration was 3 min and 10 s, respectively. LSCI was able to discriminate between wounds with early versus delayed HP (<14 versus ≥14 days) with sensitivity 71% and specificity 95% (p < 0.001). For HP ≤21 versus >21 days, similar sensitivity (74%) and specificity (95%) were found (p < 0.001). Correlations between LSCI and LDI flux values were moderate (<14 days) to absent (>21 days).

LSCI shows good validity for the prediction of burn wound HP. It is a highly feasible, patient and physician friendly tool.

LSCI shows good validity for the prediction of burn wound HP. It is a highly feasible, patient and physician friendly tool.

Recently, emergence of a higher proportion of serotype 3 in children with parapneumonic pleural effusion/empyema (PPE/PE) were observed in Germany despite general immunization with 13-valent pneumococcal conjugate vaccine (PCV13) since 2009. The impact of PCV13 on the overall incidence of PPE/PE in children is unclear.

Annual incidence of PPE/PE in children were determined using secondary health care data for 2009-2018, provided by the Barmer statutory health insurer, serving about 11% of the German population. Temporal trends of the annual incidence were modelled applying generalized additive models.

Overall incidence of PPE/PE in children ( ≤18years) in the ten-year observation period was 18.17 per 100,000. The 0-1year olds showed the highest incidence (43.09 per 100 000). PPE/PE incidence decreased from 2009 until 2013 (nadir 2013 was 15.36; 95% CI 13.41-17.31). Since 2013, the data show an annual increase. The nadir of incidence for the 2-5year olds (15.85; 95% CI 11.27-20.43) and the 6-18year olds cases generated during the same observation period.

The objective of this study is to assess cases of thrombocytopenia, including immune thrombocytopenia (ITP), reported to the Vaccine Adverse Event Reporting System (VAERS) following vaccination with mRNA COVID-19 vaccines.

This case-series study analyzed VAERS reports of thrombocytopenia after vaccination with Pfizer-BioNTech COVID-19 Vaccine or Moderna COVID-19 Vaccine.

Fifteen cases of thrombocytopenia were identified among 18,841,309 doses of Pfizer-BioNTech COVID-19 Vaccine and 13 cases among 16,260,102 doses of Moderna COVID-19 Vaccine. The reporting rate of thrombocytopenia was 0.80 per million doses for both vaccines. Based on an annual incidence rate of 3.3 ITP cases per 100,000 adults, the observed number of all thrombocytopenia cases, which includes ITP, following administration of mRNA COVID-19 vaccines is not greater than the number of ITP cases expected.

The number of thrombocytopenia cases reported to VAERS does not suggest a safety concern attributable to mRNA COVID-19 vaccines at this time.

The number of thrombocytopenia cases reported to VAERS does not suggest a safety concern attributable to mRNA COVID-19 vaccines at this time.

Hearing aid amplification rationales have typically been developed by using global averages of the long-term average speech spectrum (LTASS) from Western European languages. However, there are few reports on hearing-aid amplification based on acoustic-phonetic characteristics of the Japanese language. This study's objective is to investigate the LTASS for Japanese, and to compare a typical amplification rationale originally developed mainly for Western European languages with an amplification rationale specifically adjusted to the LTASS for Japanese.

LTASS for two speech materials provided by four Japanese talkers were analyzed using 1/3 octave bandwidth filters. The speech was recorded with different levels of vocal effort, yielding three LTASS for "soft", "moderate" and "loud" speech. From these results, a gain offset of the hearing-aid amplification for Japanese was obtained as compared to ANSI S3.5. Speech intelligibility for an amplification rationale for Western European languages and the newly-deveuropean Languages could be made. This preserved speech intelligibility at the same level as the original amplification rationale, suggesting that there was no need to consider differences in phonetics of Japanese to optimize speech understanding.

It was shown that for hearing-aid amplification for Japanese, adjustments based on LTASS differences for Western European Languages could be made. This preserved speech intelligibility at the same level as the original amplification rationale, suggesting that there was no need to consider differences in phonetics of Japanese to optimize speech understanding.

Children represent a significant percentage of casualties in modern conflict. Yet, the epidemiology of conflict-related injury among children is poorly understood. A comprehensive analysis of injuries sustained by children in 21

-century armed conflict is necessary to inform planning of local, military, and humanitarian health responses.

We conducted a systematic search of databases including PubMed, Embase, Web of Science, World Health Organization Catalog, and Google Scholar to identify records that described conflict-related injuries sustained by children since 2001.

The search returned 5,264 records. 9 eligible reports without potentially duplicative data were included in analysis, representing 5,100 pediatric patients injured in 5 conflicts. Blast injury was the most frequent mechanism (57%), compared to 24.8% in adults. Mortality was only slightly higher among children (11.0% compared to 9.8% among adults; p <0.05). Non-uniform reporting prevented pooled analysis and limited the conclusions that could be drawn.