JAMA network open
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Multiple organ dysfunction syndrome (MODS) is a dynamic and heterogeneous process associated with high morbidity and mortality in critically ill children. ⋯ In this study, data-driven phenotyping in critically ill children with MODS uncovered 4 distinct and reproducible phenotypes with prognostic relevance and possible therapeutic relevance. Further validation and characterization of these phenotypes is warranted.
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Women who experience imprisonment have high morbidity and an increased risk of adverse pregnancy outcomes. Antenatal care could modify pregnancy-related risks, but there is a lack of evidence regarding antenatal care in this population. ⋯ This study found that women who experienced imprisonment were substantially less likely to receive adequate antenatal care than were women in the general population whether or not they were in prison during pregnancy. Efforts are needed to improve antenatal care for this population both in prison and in the community.
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Mindfulness-based interventions (MBIs), grounded in mindfulness, focus on purposely paying attention to experiences occurring at the present moment without judgment. MBIs are increasingly used by patients with cancer for the reduction of anxiety, but it remains unclear if MBIs reduce anxiety in patients with cancer. ⋯ In this study, MBIs were associated with reductions in anxiety and depression up to 6 months postintervention in adults with cancer. Future trials should explore the long-term association of mindfulness with anxiety and depression in adults with cancer and determine its efficacy in more diverse cancer populations using active controls.
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Multicenter Study
Internal and External Validation of a Machine Learning Risk Score for Acute Kidney Injury.
Acute kidney injury (AKI) is associated with increased morbidity and mortality in hospitalized patients. Current methods to identify patients at high risk of AKI are limited, and few prediction models have been externally validated. ⋯ In this study, the machine learning algorithm demonstrated excellent discrimination in both internal and external validation, supporting its generalizability and potential as a clinical decision support tool to improve AKI detection and outcomes.
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Observational Study
Projected Estimates of African American Medical Graduates of Closed Historically Black Medical Schools.
There continue to be low numbers of underrepresented minorities, including African Americans, in academic medicine. Historically Black medical colleges and universities are major sources of training for medical school graduates who are African American or who belong to other underrepresented minority groups. Several historically Black medical schools were closed during the period surrounding the 1910 Flexner report. The implications of these school closures with regard to the number of African American medical school graduates have not been fully examined. ⋯ To increase the number of African American medical school graduates, consideration should be given to creating medical education programs at historically Black colleges and universities. Such programs may start with small enrollment but could have positive consequences for the diversity of the physician workforce.