Latest Articles
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Numerous, sometimes conflicting, changes in brain functional connectivity have been associated with the transition from wakefulness to unresponsiveness at induction of general anesthesia. However, relatively few studies have looked at the detailed time evolution of the transition, for different electroencephalogram (EEG) frequency bands, and in the clinical scenario of surgical patients undergoing general anesthesia. ⋯ Propofol-induced loss of consciousness in surgical patients is associated with a global breakdown in low-frequency directed functional connectivity, coupled with a high-frequency increase between closely located brain regions. At loss of consciousness, Granger causality shows more pronounced changes than coherence.
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J Pain Symptom Manage · Jan 2025
Improving hospital palliative care between COVID-19 waves: A retrospective cohort study.
A specialist palliative care service in an acute hospital characterized care patterns during the first wave of the COVID-19 pandemic. There were delayed referrals for minoritized ethnic groups. COVID-19 treatments (dexamethasone, anticoagulation, remdesivir) alongside service changes were introduced in the second wave. ⋯ Our findings have the potential to inform strategies that improve palliative care response and equity beyond COVID-19, and in future pandemics or crises.
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This is a retrospective study that examines the risk of non-COVID-19 respiratory infection (RI)-related emergency department (ED) visits and hospitalizations among autistic adults. The study compares these findings to non-autistic adults using the 2018 Healthcare Cost and Utilization Project Nationwide Emergency Department Sample. ⋯ Individuals with autism were more likely to experience emergency department visits and hospitalizations because of respiratory infections than individuals without autism. Amid growing evidence of the disproportionate impact of COVID-19 on the autistic population, the study findings highlight a broader, pre-existing burden of respiratory infections among adults with autism in the U.S. that extend beyond the recent pandemic.
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To review the current state of research training during surgical residency and make recommendations commensurate with current surgical training and academic environment. ⋯ We recommend incorporating a minimum standard for all trainees and flexibility in dedicated scholarly training to meet the needs of future academic surgeons.
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Chronic pain is a serious and prevalent condition that can affect many facets of life. However, uncertainty remains regarding the strength of the association between chronic pain and death and whether the association is causal. We investigate the pain-mortality relationship using data from 19,971 participants aged 51+ years in the 1998 wave of the U. ⋯ This attenuation highlights the role of confounders of the pain-mortality relationship as potentially modifiable upstream risk factors for mortality. Posing the depressive symptoms variable as a mediator rather than a confounder of the pain-mortality relationship resulted in stronger evidence of a modest causal effect of pain on mortality (eg, HR: 1.08, 95% CI: 1.01-1.15). Future work is required to model exposure-confounder feedback loops and investigate the potentially cumulative causal effect of chronic pain at multiple time points on mortality.