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Background: Fractional excretion of urea (FEUrea) is often used to understand the etiology of acute kidney injury (AKI) in patients receiving diuretics. Although FEUrea demonstrates diagnostic superiority over fractional excretion of sodium (FENa), clinicians often assume FEUrea is not affected by diuretics., Objective: To assess the intravenous loop diuretic effect on FEUrea., Methods: We analyzed a prospective cohort (n=297) hospitalized with hypervolemic heart failure at Yale New Haven Hospital System. FENa and FEUrea were calculated at baseline and serially after diuretics. The change in FEUrea at peak diuresis was compared with the pre-diuretic baseline., Results: Mean baseline FEUrea was 35.2% ± 10.5% and increased by a mean 5.6% ± 10.5% following 80 mg (40-160 mg) of furosemide equivalents (P < .001). The magnitude of change in FEUrea was clinically important as the distribution of change in FEUrea was similar to the overall distribution of baseline FEUrea. Change in FEUrea was related to the diuretic response (r = 0.61, P < .001), with a larger FEUrea increase in diuretic responders (8.8%, interquartile range [IQR]: 1.8-16.9) than non-responders (1.2%, IQR: -3.2 to 5.5; P < .001). Diuretic administration reclassified 27% of patients between low and high FEUrea groups across a 35% threshold. Neither change in FEUrea nor percentage reclassified out of a low FEUrea category differed between patients with and without AKI (P > .63 for both)., Conclusions: FEUrea is meaningfully affected by loop diuretics. The degree of change in FEUrea is highly variable between patients and commonly of a magnitude that could reclassify across categories of FEUrea., (Copyright © 2020 Elsevier Inc. All rights reserved.)

We assessed the prevalence of high body mass index (BMI) in a large cohort of military children. We compared BMI data from electronic medical records of military children aged 2 to 18 years with BMI data from the National Health and Nutrition Examination Survey (NHANES). The 23,778 military children studied were significantly less likely than the NHANES children to be overweight (27.1% vs 31.8%) or obese (11.9% vs 16.9%). Even though military parents are required to maintain fitness and weight standards, the absolute difference between military and civilian children was small.

If sales and service organizations are to improve, they must learn to measure and manage the quality of the employee-customer encounter. Quality improvement methodologies such as Six Sigma are extremely useful in manufacturing contexts, but they're less useful when it comes to human interactions. To address this problem, the authors have developed a quality improvement approach they refer to as Human Sigma. It weaves together a consistent method for assessing the employee-customer encounter and a disciplined process for managing and improving it. There are several core principles for measuring and managing the employee-customer encounter: It's important not to think like an economist or an engineer when assessing interactions because emotions inform both sides' judgments and behavior. The employee-customer encounter must be measured and managed locally, because there are enormous variations in quality at the work-group and individual levels. And to improve the quality of the employee-customer interaction, organizations must conduct both short-term, transactional interventions and long-term, transformational ones. Employee engagement and customer engagement are intimately connected--and, taken together, they have an outsized effect on financial performance. They therefore need to be managed holistically. That is, the responsibility for measuring and monitoring the health of employee-customer relationships must reside within a single organizational structure, with an executive champion who has the authority to initiate and manage change. Nevertheless, the local manager remains the single most important factor in local group performance. A local manager whose work group shows suboptimal performance should be encouraged to conduct interventions, such as targeted training, performance reviews, action learning, and individual coaching.

Examined how communicators send mixed messages containing an explicit surface content and a covert hidden content. In Study 1, Ss wrote constrained essays presenting either an introverted or extraverted personality. Although authors reported manipulating essay credibility and readers reported relying on credibility to make their judgments, readers succumbed to correspondence bias. In Studies 2 and 3, Ss again prepared either constrained essays (Study 2) or constrained videotapes (Study 3) and included in them a hidden message that would be understood by only their friends but not by strangers. Observers then read these essays or watched these videotapes. Friends detected and decoded the hidden messages, whereas strangers did not. We discuss these findings in terms of social perception and strategic communication.

Pattern reversal visual evoked potentials were recorded in a dentist who had abused nitrous oxide while he showed neurologic impairment and during recovery. The latency of the major positive peak (P100) remained constant during both phases. However, the amplitude of this peak was markedly reduced during the stage of neurologic involvement, and increased during recovery after withdrawal. The clinical significance of this is discussed.

Each year approximately 290,000 workmen are injured on duty, 24,000 of whom will suffer some permanent disability and will merit financial compensation for their injuries. An accurate doctor's report is the single most important factor in ensuring that a workman receives fair compensation.

We examined how features of the situation and the target's behavior in the attitude-attribution paradigm may lead observers to infer that the behavior was performed purposefully and how these perceptions may contribute to correspondence bias. Experiment 1 demonstrated that cues suggesting that essay assignment resulted from the target's purposeful action lead to correspondent inferences. When these cues were absent, observers' inferences were not correspondent. Experiment 2 demonstrated that observers are sensitive to cues emitted by the target (facial expressions of delight and disappointment) and that those cues' meaning depends on the context in which they take place. When the essay was freely chosen, the expression had little effect; observers judged that the essay accurately reflected the target's attitudes. When the essay assignment was constrained, observers used the expressions to discount the essay when judging the target's attitudes. We discuss the implications of these findings for the study of correspondent inferences and correspondence bias.