Patient falls are a serious safety concern in any setting. This article discusses the evolution of fall prevention strategies for postoperative surgical patients in acute care over a span of 10 years. The authors outline the features of fall prevention that have remained relevant over time, including during and after the COVID-19 pandemic, for consideration of applicability in other settings.

A 65-year-old female patient presented to the emergency department with a history of progressive bilateral leg weakness. Her medical background included arterial hypertension, morbid obesity, and nicotine abuse.On clinical examination, the patient exhibited flaccid paraparesis without palpable foot pulses. Subsequently, the patient developed acute hypoxemia. CT angiography revealed an acute Leriche- syndrome with complete occlusion of the abdominal aorta and iliacal vessels, along with bilateral pulmonary embolisms.Therapeutic anticoagulation was administered and emergency thrombectomy performed. The patient was managed in the intensive care unit due to cardiogenic and hypovolemic shock resulting from reperfusion syndrome and pulmonary embolism. Despite, she died from subsequent complications.Acute Leriche syndrome refers to occlusion of the aortoiliac segment. The clinical mnemonic "the 6 P's" (paresthesia, pulselessness, pallor, pain, paralysis, and prostration) aid in recognizing acute limb ischemia. Notably, a sensomotor deficit may be the sole initial symptom. Prompt revascularization is essential; however, mortality remains high due to associated complications.

This study aims to analyze the clinical and microbiologic characteristics of febrile episodes in pediatric oncology patients undergoing chemotherapy, with and without neutropenia.

A retrospective analysis was conducted on 212 febrile episodes in 94 pediatric cancer patients hospitalized between January 2015 and December 2018. Patients with fever ≥38°C were included. Data were extracted from electronic health records. Infection diagnoses were established based on clinical examination and microbiologic studies.

Among the 212 febrile episodes, 117 (55.1%) were classified as febrile neutropenia. Infection foci were identified in 51.4% of cases, with catheter infections being the most common (18.4%), followed by viral upper respiratory tract infections (16%). Microbiologic analysis identified bacterial agents in 69 cases. The most frequently identified bacteria were Coagulase-negative Staphylococcus and Escherichia coli. Septic shock occurred in 7 febrile episodes (3.3%), all in neutropenic patients. There was no statistically significant difference in infection rates between neutropenic and non-neutropenic groups (P>0.05), except for septic shock, which was significantly higher in neutropenic patients (P=0.02).

Our data suggest that infections remain a major cause of morbidity in pediatric oncology patients regardless of neutropenic status. We believe that prospective and multicenter studies are also necessary to optimize infection management strategies in non-neutropenic patients with fever as well as neutropenic ones.

This study aims to explore the pharmacodynamic material basis of Jinbei Oral Liquid(JBOL) against idiopathic pulmonary fibrosis(IPF) based on serum pharmacochemistry and network pharmacology. The ultra-high performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry(UHPLC-Q-TOF-MS/MS) technology was employed to analyze and identify the components absorbed into rat blood after oral administration of JBOL. Combined with network pharmacology, the study explored the pharmacodynamic material basis and potential mechanism of JBOL against IPF through protein-protein interaction(PPI) network construction, "component-target-pathway" analysis, Gene Ontology(GO) functional enrichment, and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analysis. First, a total of 114 compounds were rapidly identified in JBOL extract according to the exact relative molecular mass, fragment ions, and other information of the compounds with the use of reference substances and a self-built compound database. Second, on this basis, 70 prototype components in blood were recognized by comparing blank serum with drug-containing serum samples, including 28 flavonoids, 25 organic acids, 4 saponins, 4 alkaloids, and 9 others. Finally, using these components absorbed into blood as candidates, the study obtained 212 potential targets of JBOL against IPF. The anti-IPF mechanism might involve the action of active ingredients such as glycyrrhetinic acid, cryptotanshinone, salvianolic acid B, and forsythoside A on core targets like AKT1, TNF, and ALB and thereby the regulation of multiple signaling pathways including PI3K/AKT, HIF-1, and TNF. In conclusion, JBOL exerts the anti-IPF effect through multiple components, targets, and pathways. The results would provide a reference for further study on pharmacodynamic material basis and pharmacological mechanism of JBOL.

This review explores the intercontinental disparities in endovascular treatment for aortic diseases, focusing on North America, Europe, Africa and Asia with special focus Southeast Asia(India). It highlights device availability, cost, accessibility, patient outcomes, and the necessity for improved healthcare equity.

The management of aortic diseases such as aneurysms and dissections has improved with endovascular techniques like thoracic endovascular aortic repair and fenestrated-branched repair. These minimally invasive procedures offer benefits over traditional surgery, including lower morbidity and mortality rates, reduced hospital stays, faster recovery times, and generally higher patient satisfaction. However, their adoption varies across continents due to differences in healthcare infrastructure, economic resources, regulatory environments, and physician expertise. By examining the current landscape of endovascular aortic treatment globally, we can better understand the challenges and opportunities for enhancing aortic care and ensuring equitable access for all patients, regardless of their geographic location and socioeconomic status.

Polygenic scores (PGSs) for body mass index (BMI) may guide early prevention and targeted treatment of obesity. Using genetic data from up to 5.1 million people (4.6% African ancestry, 14.4% American ancestry, 8.4% East Asian ancestry, 71.1% European ancestry and 1.5% South Asian ancestry) from the GIANT consortium and 23andMe, Inc., we developed ancestry-specific and multi-ancestry PGSs. The multi-ancestry score explained 17.6% of BMI variation among UK Biobank participants of European ancestry. For other populations, this ranged from 16% in East Asian-Americans to 2.2% in rural Ugandans. In the ALSPAC study, children with higher PGSs showed accelerated BMI gain from age 2.5 years to adolescence, with earlier adiposity rebound. Adding the PGS to predictors available at birth nearly doubled explained variance for BMI from age 5 onward (for example, from 11% to 21% at age 8). Up to age 5, adding the PGS to early-life BMI improved prediction of BMI at age 18 (for example, from 22% to 35% at age 5). Higher PGSs were associated with greater adult weight gain. In intensive lifestyle intervention trials, individuals with higher PGSs lost modestly more weight in the first year (0.55 kg per s.d.) but were more likely to regain it. Overall, these data show that PGSs have the potential to improve obesity prediction, particularly when implemented early in life.

Most pediatric patients with valve reconstruction require reoperation after discharge, primarily due to valve structural degeneration or infective endocarditis, which is caused by valve leaflet material problems. Previous studies generally believe that glutaraldehyde-solidified autologous pericardial tissue is superior to other biological tissues; however, it is regrettable that it lacks growth potential. It is urgent to develop new valve materials with certain growth potential, without anticoagulation and rejection. The right atrial appendage tissue is a native tissue and can be used immediately without any chemical fixation. This tissue is stretchable, elastic, and relatively thin. It has many benefits such as easy access, low price, safe and effective, short learning curve, strong reproducibility, no need for anticoagulation, no immunogenicity, and certain growth potential, which are worthy of promotion in many developing countries with limited medical resources. This review summarizes the pathophysiological mechanism, past and current status of right atrial appendage tissue for valve reconstruction in children, and prospects it, provides the evidence-based medical basis for the surgical treatment of valve diseases in children, and opens up another direction for the surgical repair of valve diseases in children.

Stroke has become a leading cause of death and disability worldwide, resulting in a significant loss of healthy life years and imposing a considerable economic burden on patients, their families, and caregivers. However, despite the growing role of online videos as an emerging source of health information, the credibility and quality of stroke prevention education videos, especially those in Chinese, remain unclear.

This study aims to assess the basic characteristics, overall quality, and reliability of Chinese-language online videos related to public health education on stroke prevention.

We systematically searched and screened stroke prevention-related video resources from 4 popular Chinese domestic video platforms (Bilibili, Douyin, Haokan, and Xigua). General information, including upload date, duration, views, likes, comments, and shares, was extracted and recorded. Two validated evaluation tools were used: the modified DISCERN questionnaire to assess content reliability and the Global Quality Scale (GQS) to evaluate overall quality. Finally, Spearman correlation analysis was conducted to examine potential associations between general video metrics and their quality and reliability.

After searching and screening, a total of 313 eligible videos were included for analysis: 68 from Bilibili, 74 from Douyin, 86 from Haokan, and 85 from Xigua. Among these, 113 (36.1%) were created by health care professionals, followed by news agencies (n=95, 30.4%) and general individual users (n=40, 12.8%). The median scores for the modified DISCERN and GQS were 2 and 3, respectively, suggesting that the included stroke prevention-related videos were relatively unreliable and of moderate quality. Most videos focused on primary stroke prevention and commonly recommended adopting a healthy diet; engaging in physical activity; and managing blood pressure, glucose, and lipid levels. Additionally, videos with longer durations and more comments tended to be more reliable and of higher quality. A positive association was also observed between video quality and reliability.

Overall, the quality and reliability of Chinese-language online videos as a source of stroke prevention information remain unsatisfactory and should be approached with caution by viewers. To address this issue, several measures should be implemented, including establishing an online monitoring and correction system, strengthening the video review process through collaboration with health care professionals, and encouraging more selective and cautious sharing of controversial content. These steps are essential to help curb the spread of online misinformation and minimize its ongoing impact.

Climate change, a global crisis, affects health through changes such as more intense and longer lasting heatwaves. Some populations are more vulnerable to such events, including those with certain medical conditions, like heart failure. This study aimed to improve understanding of heat-related vulnerabilities and opportunities to enhance adaptive capacity of patients within an ambulatory heart failure clinic.

Heart failure clinic patients at the Clement J. Zablocki VA Medical Center in Milwaukee, Wisconsin, voluntarily completed a 25-question multiple-choice survey. We present descriptive statistics of the survey responses with count and percentage for categorical responses.

We found that out of 60 survey respondents, 46.55% agreed or strongly agreed they would benefit from discussing heat illness risks with their physician, and 31.58% were not aware their heat illness risk is higher on days hotter than 90 °F (32.2 °C). Several vulnerability factors were common: 70.69% follow a prescribed fluid restriction, 33.33% live alone, 20.34% lack a car with air conditioning, and 20.00% worry about their ability to pay electric bills. Notable knowledge gaps included 65% do not check forecasted temperatures, 60% do not plan activities for the coolest times of day, 43.10% lacked awareness of cooling centers, 33.33% were unsure of heat illness symptoms, and 27.12% lacked awareness of Wisconsin's Focus on Energy program.

A sizable portion of survey respondents indicated they would benefit from discussing their heat illness risk with their clinicians, and many underestimated their personal risk of heat illness. Additionally, multiple vulnerability factors were highly prevalent and knowledge gaps were demonstrated in this population. Our findings support adaptive capacity opportunities through heat illness education, anticipatory guidance, and increased resource awareness for patients with heart failure in an ambulatory setting.

This review aims to examine the rationale, development, and implications of the newly developed Predicting Risk of CVD EVENTs (PREVENT) equations for cardiovascular disease (CVD) risk assessment.

The PREVENT equations were developed from diverse, contemporary, real-world datasets and offer accurate discrimination for predicting risk of total CVD and separately, atherosclerotic CVD (ASCVD) and heart failure (HF). It addresses the nearly twofold overprediction of ASCVD risk with PCEs and includes risk factors related to cardiovascular-kidney-metabolic (CKM) syndrome (body mass index and estimated glomerular filtration rate, with the option to include albumin-creatinine ratio and haemoglobin A1C). Unlike PCEs, PREVENT did not include race as a predictor. PREVENT provides an option to add Social Deprivation Index (SDI) as variable in risk prediction which allows incorporation of social determinants of health. Studies indicate that PREVENT estimates for 10-year ASCVD risk are significantly lower than those obtained using PCEs. PREVENT also has potential to assess HF risk and guide potential therapies in the future for the prevention of HF. The PREVENT equations represent a crucial step forward in personalized CVD risk assessment, addressing limitations of PCEs by incorporating a broader range of CKM risk factors and accounting for social determinants of health. While promising for guiding future preventive strategies and public health initiatives, endorsement by guidelines and effective implementation into clinical workflows will be essential to realize its full potential in reducing the burden of CVD.