Expedited transfer from the scene for refractory out-of-hospital cardiac arrest in Australia: a prospective, multicentre, parallel, open label, randomised clinical trial.

Background: The benefit of expedited intra-arrest transport with ongoing resuscitation versus more extended on-scene resuscitation for refractory out of hospital cardiac arrest (OHCA) is uncertain. We aimed to determine whether expedited intra-arrest transfer to hospital in adults with refractory OHCA improves favourable neurological outcomes.

Methods: We conducted a prospective, parallel, multi-centre, open-label randomised, superiority trial across greater Sydney, NSW, Australia.

Long-term Outcomes of COVID-19 in Patients Receiving Maintenance Dialysis: A Propensity Score Matched Population-Based Cohort Study.

Background: There is concern regarding the long-term impact of COVID-19 on the maintenance dialysis population. This study describes the long-term morbidity and mortality of COVID-19 among patients receiving maintenance dialysis in comparison to uninfected controls.

Methods: We conducted a population-based cohort study of patients receiving maintenance dialysis in Ontario, Canada, between March 14, 2020, and December 1, 2021 (pre-Omicron), with follow-up until March 31, 2023.

Clinical Outcomes and Health Care Utilization in Patients with Advanced Chronic Kidney Disease not on Dialysis After the Onset of the COVID-19 Pandemic in Ontario, Canada.

Background: The COVID-19 pandemic caused considerable disruption to health care services. Limited data exist on its impacts on clinical outcomes and health care utilization in patients with advanced chronic kidney disease (CKD).

Objective: To compare the rates of all-cause mortality, cardiovascular-related hospitalizations, kidney-related outcomes, and health care utilization in patients with advanced CKD before and during the first 21 months of the COVID-19 pandemic.

The role of oceanographic scales in shaping highly mobile marine predator distributions.

Marine animals live in a dynamic environment, where a wide range of drivers and processes impact their movements and distributions. These processes occur over multiple spatio-temporal scales, from fine scale phytoplankton blooms and zooplankton patches to larger scale climatic events such as El Niño or climate change. In a dynamic ocean, the predictability of ocean features and processes vary across multiple scales.

The Impact of Suctioning on Oxygenation During Rapid Sequence Intubation in the Emergency Department: A Multi-Center Pilot Randomized Controlled Trial.

Background: Recent trends in emergency airway management encourage longer periods of suction, and the use of more powerful suction devices. Whether the intensity of oropharyngeal suction during laryngoscopy causes more rapid desaturation is unknown.

Study Objective: This study aimed to determine whether longer duration of suction leads to more significant desaturation in Emergency Department patients undergoing Rapid Sequence Intubation (RSI).

The effect of intrawound vancomycin powder on surgical site infection in inguinal lymph node dissection: a randomized controlled trial pilot study.

Background: Inguinal lymph node dissections are morbid surgeries with high rates of postoperative wound infections. The primary objective of this pilot study was to assess the feasibility of implementing a randomized controlled trial to assess the impact of intrawound vancomycin powder on postoperative complications after inguinal lymph node dissection in patients with vulvar cancer. Secondary objectives included 1) 30-day composite postoperative complication rate, and 2) adverse effects.

Suspended detrital particles support a distinct microbial ecosystem in Palmer Canyon, Antarctica, a coastal biological hotspot.

Unlabelled: The coastal region of the Western Antarctic Peninsula is considered a biological hotspot with high levels of phytoplankton productivity and krill biomass. Recent in situ observations and particle modeling studies of Palmer Canyon, a deep bathymetric feature in the region, demonstrated the presence of a recirculating eddy that traps particles, retaining a distinct particle layer over the summer season. We applied metagenomic sequencing and Imaging Flow Cytobot (IFCB) analysis to characterize the microbial community in the particle layer.

Clinical Outcomes and Healthcare Utilization in Patients Receiving Maintenance Dialysis After the Onset of the COVID-19 Pandemic in Ontario, Canada.

Background: The impact of the COVID-19 pandemic on clinical outcomes and healthcare utilization in patients receiving maintenance dialysis is unclear.

Objective: To compare the rates of clinical outcomes and healthcare utilization in patients receiving maintenance dialysis (in-center and home modalities) before and during the COVID-19 pandemic.

Design: Population-based, repeated cross-sectional study.

Distribution and concordance of HER2 scores in endometrial and ovarian cancer.

Objectives: Although multiple HER2 scoring criteria exist, the optimal strategy to identify patients with gynecologic malignancies who may benefit from HER2-directed therapies remains unknown. The objectives of this study were to assess the distribution and concordance of HER2 scores in endometrial and ovarian cancer.

Methods: One hundred five tumor specimens from 94 patients with endometrial or epithelial ovarian cancer (EOC) who underwent Caris tumor profiling from 11/2022 to 01/2025 were identified from a retrospective database.

Predictive models on patients' eligibility for peritoneal dialysis.

Background: Peritoneal dialysis (PD) is being promoted because it is cost-effective and has equivalent outcomes to facility-based hemodialysis (HD). Determining PD eligibility is critical but subjective, with high variability among renal programs. This study aimed to establish a predictive model for PD eligibility among individuals who started treatment with HD.

Measurement of interfacial thermal resistance in high-energy-density matter.

Heat transport across interfaces is a ubiquitous phenomenon with many unresolved aspects. In particular, it is unknown if an interfacial thermal resistance (ITR) occurs in matter with high-energy-density where free electrons dominate the heat conduction. Here, we report on the first experimental evidence that a significant heat barrier is present between two different regions of high-energy-density matter: a strongly heated tungsten wire and a surrounding plastic layer that stays relatively cold.

COVID-19 infection and the progression of kidney disease in British Columbia, Canada.

Background: We investigated the long-term effect of COVID-19 on estimated glomerular filtration rate (eGFR) trajectory and the association with progression to kidney failure in patients with CKD.

Methods: Patients living with non-dialysis-dependent CKD from British Columbia, Canada infected with COVID-19 (cases) were matched 1:2 to non-COVID-19-infected controls on variables including pre-COVID-19 annual rate of eGFR decline. Patients were followed from 90 days from the date of COVID-19 diagnosis.

Rethinking the pan scan in stable trauma: A comparison of whole-body computed tomography and selective imaging in clinically stable blunt force trauma.

Objective: To compare the frequency of clinically significant missed injuries in clinically stable trauma patients undergoing initial whole-body computed tomography (WBCT) versus selective imaging. Secondary objectives include comparisons of radiation exposure, incidental findings, ED length of stay (LOS), hospital LOS and mortality.

Methods: We performed a retrospective cohort study of trauma activations at a tertiary trauma centre in patients with normal vital signs from 1st January 2022 to 31st December 2022.

Effects of a Virtual Trauma Clinic on admissions and length of stay for minor to moderate trauma.

Objective: To investigate the feasibility of a Virtual Trauma Clinic (VTC) for patients with minor to moderate trauma, and evaluate patient satisfaction and outcomes.

Methods: One hundred VTC patients were matched 1:1 with historical patients from the hospital trauma registry who received conventional care. Matching was based on age ± 5 years, sex, mechanism of injury, Injury Severity Score ± 2, trauma team activation and day of week of presentation.

Recent advances in peritoneal dialysis catheter placement: the association between method of insertion, operator, and prior abdominal surgery and outcomes.

Purpose Of Review: Peritoneal dialysis (PD) is associated with comparable outcomes to hemodialysis and is much less expensive to provide in most parts of the world. A well functioning PD catheter is required, but complications are frequent, and while there are guidelines for the placement and care of a PD access, they are based on low-quality evidence.

Recent Findings: Data reporting the outcomes of percutaneous, as compared to surgical pathways for placement of catheters and the role of operator type in determining outcomes are examined.

Anticoagulation for Patients with Atrial Fibrillation Receiving Dialysis: A Pilot Randomized Controlled Trial.

Key Points: Is performing a large definitive trial to establish the optimal anticoagulation strategy in dialysis recipients with atrial fibrillation feasible? One hundred fifty-one patients at 28 dialysis centers were enrolled and randomized to apixaban (=51), warfarin (=52), or no oral anticoagulation (=48). Despite coronavirus disease–related pauses, recruitment was completed in 30 months, with 83% of participants completing follow-up in their assigned treatment arm.

Background: Atrial fibrillation is common in individuals receiving dialysis.

Long-Term Morbidity and Mortality of Coronavirus Disease 2019 in Patients Receiving Maintenance Dialysis: A Multicenter Population-Based Cohort Study.

Key Points: The rates of long-term mortality, reinfection, cardiovascular outcomes, and hospitalization were high among coronavirus disease 2019 (COVID-19) survivors on maintenance dialysis. Several risk factors, including intensive care unit admission related to COVID-19 and reinfection, were found to have a prolonged effect on survival. This study shows that the burden of COVID-19 remains high after the period of acute infection in the population receiving maintenance dialysis.

Long-term trends in incidence and outcomes of rib fractures: A population-based data linkage study from New South Wales, Australia.

Objective: Determine long-term trends in population-based incidence and outcomes of rib fracture hospitalisations.

Methods: This was a data linkage study of rib fracture cases identified between 2015 and 2022 in New South Wales, Australia. Routinely collected health data were linked between ED, admitted patient and death registry data collection.

Implementing enhanced extracorporeal membrane oxygenation for CPR (ECPR) in the emergency department.

Refractory out-of-hospital cardiac arrest (OHCA) has a very poor prognosis, with survival rates at around 10%. Extracorporeal membrane oxygenation (ECMO) for patients in refractory arrest, known as ECPR, aims to provide perfusion to the patient whilst the underlying cause of arrest can be addressed. ECPR use has increased substantially, with varying survival rates to hospital discharge.

Derivation and Validation of a Machine Learning Model for the Prevention of Unplanned Dialysis.

Key Points: Nearly half of all patients with CKD who progress to kidney failure initiate dialysis in an unplanned fashion, which is associated with poor outcomes. Machine learning models using routinely collected data can accurately predict 6- to 12-month kidney failure risk among the population with advanced CKD. These machine learning models retrospectively deliver advanced warning on a substantial proportion of unplanned dialysis events.

Serratus Anterior Plane Blocks for Early Rib Fracture Pain Management: The SABRE Randomized Clinical Trial.

Importance: Rib fractures secondary to blunt thoracic trauma typically result in severe pain that is notoriously difficult to manage. The serratus anterior plane block (SAPB) is a regional anesthesia technique that provides analgesia to most of the hemithorax; however, SAPB has limited evidence for analgesic benefits in rib fractures.

Objective: To determine whether the addition of an SAPB to protocolized care bundles increases the likelihood of early favorable analgesic outcomes and reduces opioid requirements in patients with rib fractures.

Perceptions and Information-Seeking Behavior Regarding COVID-19 Vaccination Among Patients With Chronic Kidney Disease in 2023: A Cross-Sectional Survey.

Background: People living with chronic kidney disease (CKD) face an increased risk of severe outcomes such as hospitalization or death from COVID-19. COVID-19 vaccination is a vital approach to mitigate the risk and severity of infection in patients with CKD. Limited information exists regarding the factors that shape COVID-19 vaccine uptake, including health information-seeking behavior and perceptions, within the CKD population.