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Introducción : La Organización Mundial de la Salud (OMS) efectuó recomendaciones en relación con la recopilación y notificación de datos agregados semanales de COVID-19. Objetivo : Investigar el grado de cumplimiento de las recomendaciones elaboradas por la OMS para la notificación de casos y muertes de COVID-19 en la Argentina durante el año 2020 a 2022, y comparar la notificación de muertes con el número de defunciones por COVID-19 consolidadas en el registro de estadísticas vitales del país. Materiales y métodos : Estudio cuantitativo descriptivo, basado en revisión documental y en fuentes de datos secundarias. Se utilizó los reportes diarios de información epidemiológica y la base de datos Dataset, COVID-19 casos registrados en la República Argentina. Adicionalmente, para estimar la omisión en los registros epidemiológicos de fallecimientos por COVID-19 en los años 2020 y 2021, se cotejaron los resultados de las bases de datos Dataset COVID-19 con la base de las Estadísticas vitales de mortalidad por causa de defunción, proporcionadas por la Dirección de Estadísticas e Información en Salud (DEIS). Se analizaron las variables recomendadas por la OMS para la notificación de casos y muertes por COVID-19. En cuanto a las consideraciones éticas relacionadas con el uso de la información utilizada en este trabajo, las bases de datos cumplen con lo estipulado por la Ley Nacional N° 17.622 de Resguardo del Secreto Estadístico, garantizando que la información mantiene el carácter confidencial y reservado del informante. Resultados: Del análisis de los reportes diarios, durante 2020 se observó que, de los 13 indicadores recomendados, 9 presentan datos algunos meses y los 4 restantes no se relevaron; en 2021 solo 7 indicadores presentaron datos algunos meses, y en 2022 solo 3 indicadores se continuaron informando. Respecto al análisis de la base de datos Dataset COVID-19, la mayoría fueron captadas. Respecto a la comparación de los valores de las defunciones registradas por el sistema de vigilancia epidemiológica y por la DEIS para los años 2020 y 2021, las muertes registradas fueron superiores en el registro de la DEIS (9,6% y 14,2%). Conclusiones : El Estado argentino cumplió con gran parte de las recomendaciones que establece la OMS para la notificación de los casos de COVID-19. Estudios posteriores deberían analizar otros componentes de la calidad de los datos, así como la oportunidad de los registros de defunciones, característica necesaria para la toma de decisiones en salud pública.

Introduction : The World Health Organization (WHO) establishes recommendations regarding the collection and reporting of weekly aggregated data on COVID-19. Objective : To investigate the degree of compliance with the recommendations made by the WHO for the reporting of COVID-19 cases and deaths in Argentina during the years 2020 to 2022, and to compare death notifications with the number of COVID-19 deaths recorded in the country's vital statistics registry. Materials and methods : Descriptive quantitative study, based on a documentary review and secondary data sources. Daily reports of epidemiological information and the Dataset database containing registered COVID-19 cases in the Argentine Republic were used. Additionally, to estimate the omission in the epidemiological records of COVID-19 deaths in the years 2020 and 2021, the results of the Dataset COVID-19 databases were compared with the vital statistics death registry on cause of death, provided by the Directorate of Statistics and Health Information (DEIS, by its acronym in Spanish). The variables recommended by the WHO for the reporting of COVID-19 cases and deaths were analyzed. As for the ethical considerations related to the use of the information in this study, the databases comply with the provisions of National Law 17,622 on the Protection of Statistical Secrecy, ensuring that the information remains confidential and reserved for the informant. Results : From the analysis of daily reports, it was observed that in 2020, out of the 13 recommended indicators, 9 had data for some months, and the remaining 4 were not reported. In 2021 only 7 indicators had data for some months, and in 2022 only 3 indicators continued to be reported. Regarding the analysis of the Dataset COVID-19 database, most data were captured. In comparing the values of deaths recorded by the epidemiological surveillance system and by the DEIS for the years 2020 and 2021, the deaths recorded were higher in the DEIS registry (9.6% and 14.2%). Conclusions : The Argentine state largely complied with the recommendations established by the WHO for the reporting of COVID-19 cases. Subsequent studies should analyze other components of data quality, as well as the timeliness of death records, a necessary characteristic for public health decision-making.

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Recent empirical evidence suggests that gut dysbiosis is one of the negative health outcomes potentially associated with chronic consumption of some food additives. In this context, the present study aimed at analyzing the disclosure of food additives associated with gut dysbiosis in the labels of products commercialized in the Uruguayan market. A cross-sectional survey of packaged products commercialized in nine supermarkets was conducted between August and September 2021. All packaged processed and ultra-processed products available in each data collection site were surveyed using a cellphone app. The information available on the labels was manually extracted and the disclosure of food additives was analyzed using a computer assisted approach. Results showed that 38.1% of the products disclosed at least one food additive associated with gut dysbiosis. Disclosure was most frequent in ice-cream and popsicles, beverages, meat products and analogues, desserts, and fats, oils and fat and oil emulsions. Potassium sorbate was the individual additive associated with gut dysbiosis most frequently disclosed on the labels, followed by mono- and di-glycerides of fatty acid, sucralose, carboxymethylcellulose, acesulphame potassium, carrageenan, and sodium benzoate. These food additives frequently co-occurred and network analysis enabled the identification of patterns of co-occurrence. Taken together, results from the present work suggest the need to conduct additional research to assess the intake of food additives associated with gut dysbiosis at the population level, as well as to evaluate potential synergistic effects of food additives.

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The bovine Major Histocompatibility Complex (MHC), also known as the Bovine Leucocyte Antigen (BoLA) complex, is the genomic region that encodes the most important molecules for antigen presentation to initiate immune responses. The first evidence of MHC in bovines pointed to a locus containing 2 antigens, one detected by cytotoxic antiserum (MHC class I) and another studied by mixed lymphocyte culture tests (MHC class II). The most studied gene in the BoLA region is the highly polymorphic BoLA-DRB3, which encodes a ß chain with a peptide groove domain involved in antigen presentation for T cells that will develop and co-stimulate cellular and humoral effector responses. BoLA-DRB3 alleles have been associated with outcomes in infectious diseases such as mastitis, trypanosomiasis, and tick loads, and with production traits. To catalog these alleles, 2 nomenclature methods were proposed, and the current use of both systems makes it difficult to list, comprehend and apply these data effectively. In this review we have organized the knowledge available in all of the reports on the frequencies of BoLA-DRB3 alleles. It covers information from studies made in at least 26 countries on more than 30 breeds; studies are lacking in countries that are important producers of cattle livestock. We highlight practical applications of BoLA studies for identification of markers associated with resistance to infectious and parasitic diseases, increased production traits and T cell epitope mapping, in addition to genetic diversity and conservation studies of commercial and creole and locally adapted breeds. Finally, we provide support for the need of studies to discover new BoLA alleles and uncover unknown roles of this locus in production traits.

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OBJECTIVES: Using Texas STAR (seeking transparency in application to residency), we aimed to 1) examine predictors of matching success in integrated plastic surgery residency programs and 2) assess the reliability of the tool. DESIGN, SETTING, AND PARTICIPANTS: A retrospective analysis of self-reported nationwide data of plastic surgery residency applicants between 2021 and 2023 across 146 participating medical schools were included. A comparison analysis was performed between matched and unmatched applicants using chi-squared tests, t-tests, and logistic regression models. NRMP data and literature were referenced to determine reliability. RESULTS: Of the 209 plastic surgery resident applications, 147 matched (70.3%) and 62 went unmatched (29.7%). Average United States Medical Licensing Examination (USMLE) Step 1 and 2 scores were 248 and 257, respectively. Between matched and unmatched cohorts, no significant differences were observed in Alpha Omega Alpha (AOA) status, Gold Humanism Honor Society (GHHS) status, mean number of research experiences/presentations, volunteer experiences, leadership positions, and programs applied. Significant predictors of matching included taking a research year (OR 2.07, CI 0.99-4.34, p= 0.052), 8+ peer-reviewed publications (OR 2.29, CI 1.22-4.30, p = 0.009), geographic connection (p = 0.02), and 13+ interviews attended (OR 2.94, CI 1.56 -5.51, p < 0.001). These findings are consistent with current literature and the NRMP. Upon analysis of the qualitative free text responses on general recommendations for prospective applicants by users, subinternships, connections, interviews, research, letter of recommendation quality, home advantage, and mentorship were prominent themes of advice provided by both matched and unmatched cohorts. CONCLUSIONS: Texas STAR is a resourceful and reliable tool. We conclude that a research year and geographic connections are strong predictors of matching in plastic surgery. However, more factors (e.g., applicants' home medical school, number of sub internships, and number of mentors) should be considered to make a well-informed decision on determining their own competitiveness, away rotations and residency programs.

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BACKGROUND: Physical therapists use diagnostic tests in a variety of settings. Choosing the best diagnostic test to apply in a particular situation can be difficult. The choice of diagnostic test should be informed, at least in part, by evidence of test accuracy. Finding evidence of diagnostic test accuracy has, until recently, been challenging. Ideally, there would exist a database that comprehensively indexes evidence on diagnostic tests relevant to physical therapy practice, is free to access, and is easy to use. OBJECTIVE: This Masterclass will describe the DiTA (Diagnostic Test Accuracy) database (dita.org.au) including its development and search interface, and provide advice on how to search and retrieve records. DISCUSSION: DiTA indexes more than 2400 primary studies and systematic reviews of diagnostic test accuracy relevant to physical therapy practice. Users can search DiTA using text fields and dropdown lists to find evidence of diagnostic test accuracy. The database is freely accessible on the internet. Since its launch, DiTA has been accessed from almost every country in the world, the largest number of searches having been conducted from Brazil.

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Compound databases (DBs) are essential tools for drug discovery. The number of DBs in public domain is increasing, so it is important to analyze these DBs. In this article, the main characteristics of 64 DBs will be presented. The methodological strategy used was a literature search. To analyze the characteristics obtained in the review, the DBs were categorized into two subsections: Open Access and Commercial DBs. Open access includes generalist DBs (containing compounds of diverse origins), DBs with specific applicability, DBs exclusive to natural products and those containing compounds with specific pharmacological action. The literature review showed that there are challenges to making these repositories available, such as standardizing information curation practices and funding to maintain and sustain them.

[Box: see text].

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OBJECTIVE: To investigate the extent of extraskeletal manifestations along with inpatient outcomes and complications associated with osteogenesis imperfecta (OI). STUDY DESIGN: This cross-sectional study utilized the Kids' Inpatient Database as a part of the Healthcare Cost and Utilization Project to investigate inpatient hospital outcomes and management in patients with OI from 1997 through 2016. Data regarding hospital characteristics, cost of treatment, inpatient outcomes, and procedures were collected and analyzed. RESULTS: There were 7291 admissions that listed OI as a diagnosis in the Kids' Inpatient Database from 1997 through 2016. Unexpectedly, more than one-third of all admissions in these children with OI presented with an extraskeletal manifestation. The rate of major complications was 3.85%. The rate of minor complications was 19.4%, most commonly respiratory problems. The mortality rate was 18.2% in the neonatal period and 1.0% in all other admissions. Total charges of hospital stay increased over the years. CONCLUSIONS: We identified a striking prevalence of extraskeletal manifestations in OI along with inpatient outcomes and complications associated with OI, of which respiratory complications were predominant. We observed a significant financial burden for patients with OI and identified additional risks for financial crisis, in addition to disparities in care identified among socioeconomic groups. These data contribute to a more holistic understanding of OI from diagnosis to management.

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Natural product databases are an integral part of chemoinformatics and computer-aided drug design. Despite their pivotal role, a distinct scarcity of projects in Latin America, particularly in Mexico, provides accessible tools of this nature. Herein, we introduce BIOMX-DB, an open and freely accessible web-based database designed to address this gap. BIOMX-DB enhances the features of the existing Mexican natural product database, BIOFACQUIM, by incorporating advanced search, filtering, and download capabilities. The user-friendly interface of BIOMX-DB aims to provide an intuitive experience for researchers. For seamless access, BIOMX-DB is freely available at www.biomx-db.com.

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INTRODUCTION: Atrial fibrillation is the main complication in the postoperative period of cardiovascular surgery. Its genesis is multifactorial, so its rapid identification to mitigate the associated risks is essential. OBJECTIVE: To evaluate the incidence of atrial fibrillation in patients undergoing coronary artery bypass grafting (CABG) and its relationship with other complications in our setting. METHODS: This is a multicenter, observational study involving patients undergoing isolated CABG between 2017 and 2019 with data from the Registro Paulista de Cirurgia Cardiovascular (or REPLICCAR II). Variables were prospectively collected in REDCap following the definitions given by version 2.73 of the Society of Thoracic Surgeons Adult Cardiac Surgery Database. Data were collected with prior authorization from the local ethics committee and analyses performed in R software. RESULTS: A total of 3,803 patients were included, of these 605 had postoperative atrial fibrillation (POAF). In order to adjust the groups, propensity score matching was used. Such analyses resulted in 605 patients in each group (without POAF vs. with POAF). Among patients with POAF, the mean age was 67.56 years, with a prevalence of males (73.6%, 445 patients). Patients belonging to the group with POAF had a mortality rate of 9.26% (P=0.007), longer ventilation time (P<0.001), pneumonia (P<0.001), and sepsis (P<0.001). In multiple analysis, acute renal dysfunction (P=0.032) and longer intensive care unit stay (P<0,001) were associated with the presence of POAF. CONCLUSION: POAF in CABG is associated with longer intensive care unit and hospital stay, as well as renal dysfunction, pneumonia, and in-hospital mortality.

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BACKGROUND: This study aimed to identify potential subtypes of hepatocellular carcinoma (HCC) associated with cirrhosis and to investigate key markers using bioinformatic analysis of gene expression datasets-0. METHODS: Three data sets (GSE17548, GSE56140, and GSE87630) were extracted from the Gene Expression Omnibus (GEO) database and normalized using the Limma package in R. Principal component analysis (PCA) and cluster analysis was performed to examine data distribution and identify subtypes. Differential gene expression analysis was performed using the Limma software package. Protein-protein interaction analysis and functional annotation were performed using the STRING database and Cytoscape software. Important signaling pathways and processes were identified using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) Pathway Analysis. RESULTS: The analysis revealed different subtypes of HCC associated with cirrhosis and identified several key genes, including CCNB2, MCM4, and CDC20, with strong binding power and prognostic value. Functional annotation indicated involvement in cell cycle regulation and metabolic pathways. ROC analysis showed high sensitivity and specificity of these genes in predicting HCC prognosis. CONCLUSION: These results suggest that CCNB2, MCM4, and CDC20 may serve as potential biomarkers for predicting HCC prognosis in patients with cirrhosis and provide insights into the molecular mechanisms of HCC progression.

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Colonoscopy is the choice procedure to diagnose, screening, and treat the colon and rectum cancer, from early detection of small precancerous lesions (polyps), to confirmation of malign masses. However, the high variability of the organ appearance and the complex shape of both the colon wall and structures of interest make this exploration difficult. Learned visuospatial and perceptual abilities mitigate technical limitations in clinical practice by proper estimation of the intestinal depth. This work introduces a novel methodology to estimate colon depth maps in single frames from monocular colonoscopy videos. The generated depth map is inferred from the shading variation of the colon wall with respect to the light source, as learned from a realistic synthetic database. Briefly, a classic convolutional neural network architecture is trained from scratch to estimate the depth map, improving sharp depth estimations in haustral folds and polyps by a custom loss function that minimizes the estimation error in edges and curvatures. The network was trained by a custom synthetic colonoscopy database herein constructed and released, composed of 248400 frames (47 videos), with depth annotations at the level of pixels. This collection comprehends 5 subsets of videos with progressively higher levels of visual complexity. Evaluation of the depth estimation with the synthetic database reached a threshold accuracy of 95.65%, and a mean-RMSE of 0.451cm, while a qualitative assessment with a real database showed consistent depth estimations, visually evaluated by the expert gastroenterologist coauthoring this paper. Finally, the method achieved competitive performance with respect to another state-of-the-art method using a public synthetic database and comparable results in a set of images with other five state-of-the-art methods. Additionally, three-dimensional reconstructions demonstrated useful approximations of the gastrointestinal tract geometry. Code for reproducing the reported results and the dataset are available at https://github.com/Cimalab-unal/ColonDepthEstimation.

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Global assessments of mycorrhizal symbiosis present large sampling gaps in rich biodiversity regions. Filling these gaps is necessary to build large-scale, unbiased mycorrhizal databases to obtain reliable analyses and prevent misleading generalizations. Underrepresented regions in mycorrhizal research are mainly in Africa, Asia, and South America. Despite the high biodiversity and endemism in these regions, many groups of organisms remain understudied, especially mycorrhizal fungi. In this Viewpoint, we emphasize the importance of inclusive and collaborative continental efforts in integrating perspectives for comprehensive trait database development and propose a conceptual framework that can help build large mycorrhizal databases in underrepresented regions. Based on the four Vs of big data (volume, variety, veracity, and velocity), we identify the main challenges of constructing a large mycorrhizal dataset and propose solutions for each challenge. We share our collaborative methodology, which involves employing open calls and working groups to engage all mycorrhizal researchers in the region to build a South American Mycorrhizal Database. By fostering interdisciplinary collaborations and embracing a continental-scale approach, we can create robust mycorrhizal trait databases that provide valuable insights into the evolution, ecology, and functioning of mycorrhizal associations, reducing the geographical biases that are so common in large-scale ecological studies.

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This project addresses the global challenge of breast cancer, particularly in low-resource settings, by creating a pioneering mammography database. Breast cancer, identified by the World Health Organization as a leading cause of cancer death among women, often faces diagnostic and treatment resource constraints in low- and middle-income countries. To enhance early diagnosis and address educational setbacks, the project focuses on leveraging artificial intelligence (AI) technologies through a comprehensive database. Developed in collaboration with Ambra Health, a cloud-based medical image management software, the database comprises 941 mammography images from 100 anonymized cases, with 62 % including 3D images. Accessible through http://mamografia.unifesp.br, the platform facilitates a simple registration process and an advanced search system based on 169 clinical and imaging variables. The website, customizable to the user's native language, ensures data security through an automatic anonymization system. By providing high-resolution, 3D digital images and supplementary clinical information, the platform aims to promote education and research in breast cancer diagnosis, representing a significant advancement in resource-constrained healthcare environments.

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Worldwide, some of the largest hydrocarbon reservoirs are located in tropical neritic carbonate deposits. Biostratigraphic and paleoenvironmental analyzes of these sedimentary records are often based on the study of foraminiferal assemblage. Foraminifera-based biozones are widely employed in the oil industry to support drilling processes that, alongside petrophysical prospecting, define interval favorable for exploiting hydrocarbon resources. Both scientific research and the petroleum industry, however, usually apply traditional petrographical and paleontological methods to analyze microfossil assemblages, especially for large benthic foraminifera. New, faster, and more accurate methods based on microCT analyzes have emerged as a valuable high-output tool to obtain high-resolution microfossil records for biostratigraphy and paleoenvironmental reconstructions. This method is also useful for the development of digital databases for artificial intelligence applications. MicroCT analyzes, therefore, lead to faster identification of foraminifera assemblage and support digital access to international foraminifera repositories and reference collections, introducing a new dimension in micropaleontological research.

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Background: To examine the longitudinal association between frailty criteria and depression (DEP) in a large sample of older Europeans using decision tree models, and to examine complex relationships between frailty criteria and DEP symptomatology. Methods: Data come from waves six and eight of the Population Survey of Health, Ageing and Retirement in Europe. DEP was assessed using the EURO-D scale (wave 8) and frailty (wave 6). We included 27,122 people (56.9% women), aged 50 or over. Results: Women indicated a higher rate of DEP (29.0%), as well as a higher prevalence of pre-frailty (21.6%) and frailty (10.8%) than men. For both sexes, fatigue, weight loss, and slowness indicated an increased chance of DEP 5 years later. MPA (moderate physical activity) and grip strength were considered longitudinally protective factors for DEP. The highest prevalence of DEP symptomatology 5 years later was 50.3%, pointing to those with fatigue and slowness. Among women, the highest incidence of DEP was 66.8%, identified through fatigue, slowness, and low MPA. Conclusions: Strategies to reduce frailty and DEP in older European adults may include the creation of policies that encourage the promotion of physical capacity to reach MPA levels, as well as an improvement in muscular strength.

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Purpose was to study 3-dimensional choroidal contour at choroidal inner boundary (CIB) and choroidal outer boundary (COB) in healthy eyes. Healthy eyes imaged on wide field swept-source optical coherence tomography were included. Delineation of CIB and COB was done based on our previously reported methods. Quantitative analysis of the surfaces of CIB and COB was based on analyzing best fit spherical radius (R) (overall and sectoral). One hundred and seven eyes of 74 subjects with a mean age of 46.4 ± 19.3 years were evaluated. Overall, R COB (mean ± SD: 22.5 ± 4.8 mm) < R CIB (32.4 ± 9.4 mm). Central sector had the least R at COB (7.2 ± 5.9 mm) as well as CIB (25.1 ± 14.3 mm) across all age groups. Regression analysis between R (CIB) and age (r = -0.31, r2 = 0.09) showed negative correlation (P < 0.001) and that between R (COB) and age was positive (r = 0.26, r2 = 0.07) (P = 0.01). To conclude, central sector is the steepest sector in comparison to all the other sectors. This is indicative of a prolate shape of choroidal contour at CIB and COB. Outer boundary of choroid is steeper than inner boundary across all age groups. However, with ageing, outer boundary becomes flatter and inner boundary becomes steeper.

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From 1990 to 2024, this study presents a groundbreaking bibliometric and sentiment analysis of nanocomposite literature, distinguishing itself from existing reviews through its unique computational methodology. Developed by our research group, this novel approach systematically investigates the evolution of nanocomposites, focusing on microstructural characterization, electrical properties, and mechanical behaviors. By deploying advanced Boolean search strategies within the Scopus database, we achieve a meticulous extraction and in-depth exploration of thematic content, a methodological advancement in the field. Our analysis uniquely identifies critical trends and insights concerning nanocomposite microstructure, electrical attributes, and mechanical performance. The paper goes beyond traditional textual analytics and bibliometric evaluation, offering new interpretations of data and highlighting significant collaborative efforts and influential studies within the nanocomposite domain. Our findings uncover the evolution of research language, thematic shifts, and global contributions, providing a distinct and comprehensive view of the dynamic evolution of nanocomposite research. A critical component of this study is the "State-of-the-Art and Gaps Extracted from Results and Discussions" section, which delves into the latest advancements in nanocomposite research. This section details various nanocomposite types and their properties and introduces novel interpretations of their applications, especially in nanocomposite films. By tracing historical progress and identifying emerging trends, this analysis emphasizes the significance of collaboration and influential studies in molding the field. Moreover, the "Literature Review Guided by Artificial Intelligence" section showcases an innovative AI-guided approach to nanocomposite research, a first in this domain. Focusing on articles from 2023, selected based on citation frequency, this method offers a new perspective on the interplay between nanocomposites and their electrical properties. It highlights the composition, structure, and functionality of various systems, integrating recent findings for a comprehensive overview of current knowledge. The sentiment analysis, with an average score of 0.638771, reflects a positive trend in academic discourse and an increasing recognition of the potential of nanocomposites. Our bibliometric analysis, another methodological novelty, maps the intellectual domain, emphasizing pivotal research themes and the influence of crosslinking time on nanocomposite attributes. While acknowledging its limitations, this study exemplifies the indispensable role of our innovative computational tools in synthesizing and understanding the extensive body of nanocomposite literature. This work not only elucidates prevailing trends but also contributes a unique perspective and novel insights, enhancing our understanding of the nanocomposite research field.

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La utilización de herramientas tecnológicas en la docencia condiciona el desarrollo de nuevas destrezas intelectuales en los estudiantes, lo que les facilita la aplicación de estrategias de investigación, mejora sus capacidades de una forma integral, les ayuda a enfrentar las dificultades y exigencias del mundo y les permite adquirir un aprendizaje más significativo para poder desenvolverse en el ámbito socioeducativo. Con vistas a cumplir lo anterior, se desarrolló un repositorio institucional de recursos educativos abiertos para la Universidad Virtual de Salud, a partir del empleo de herramientas tecnológicas libres y de código abierto que permiten la estandarización e interoperabilidad entre cada uno de los repositorios establecidos en el Sistema Nacional de Salud, con lo cual se garantizará una lógica de organización académica.

The use of digital technologies in teaching determines the development of new intellectual skills in students, which facilitates the application of investigation strategies, improves their capabilities in an integral way, helps them face the difficulties and demands of the current world and allows them to acquire more significant learning to have a good performance in the socio-educational environment. With a view to fulfilling the above, an institutional repository of open educational resources was developed for the Virtual Health University, based on the use of free and open-source technology tools that allow the standardization and interoperability among each of the repositories established in the National Health System, which will guarantee logic of academic organization.

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OBJECTIVE: To assess rates of cardiac surgery and the clinical and demographic features that influence surgical vs nonsurgical treatment of congenital heart disease (CHD) in patients with trisomy 13 (T13) and trisomy 18 (T18) in the United States. STUDY DESIGN: A retrospective study was performed using the Pediatric Health Information System. All hospital admissions of children (<18 years of age) with T13 and T18 in the United States were identified from 2003 through 2022. International Classifications of Disease (ICD) codes were used to identify presence of CHD, extracardiac comorbidities/malformations, and performance of cardiac surgery. RESULTS: Seven thousand one hundred thirteen patients were identified. CHD was present in 62% (1625/2610) of patients with T13 and 73% (3288/4503) of patients with T18. The most common CHD morphologies were isolated atrial/ventricular septal defects (T13 40%, T18 42%) and aortic hypoplasia/coarctation (T13 21%, T18 23%). Single-ventricle morphologies comprised 6% (100/1625) of the T13 and 5% (167/3288) of the T18 CHD cohorts. Surgery was performed in 12% of patients with T13 plus CHD and 17% of patients with T18 plus CHD. For all cardiac diagnoses, <50% of patients received surgery. Nonsurgical patients were more likely to be born prematurely (P < .05 for T13 and T18). The number of extracardiac comorbidities was similar between surgical/nonsurgical patients with T13 (median 2 vs 2, P = .215) and greater in surgical vs nonsurgical patients with T18 (median 3 vs 2, P < .001). Hospital mortality was <10% for both surgical cohorts. CONCLUSIONS: Patients with T13 or T18 and CHD receive surgical palliation, but at a low prevalence (≤17%) nationally. Given operative mortality <10%, opportunity exists perhaps for quality improvement in the performance of cardiac surgery for these vulnerable patient populations.

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Drug information tools help avoid medication errors, a common cause of avoidable harm in health care systems. We sought to describe the design, development process and architecture of an electronic drug information tool, as well as its overall use by health professionals. We developed a tool that can be accessed by all health professionals in a tertiary level university hospital. The functionalities of eDrugs are organized into two main parts: Drug Summary sheet, and Prescription Simulator. Most users accessed eDrugs to use the Drug summary sheet. Clinical information and antimicrobial drugs were the most accessed drug information and drug group. The analysis of log data provides insights into the information priorities of health professionals.

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