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Abstract Objectives To determine the diagnostic accuracy of a rapid host‐protein test for differentiating bacterial from viral infections in patients who presented to the emergency department (ED) or urgent care center (UCC). Methods This was a prospective multicenter, blinded study. MeMed BV (MMBV), a test based on tumor necrosis factor‐related apoptosis‐inducing ligand (TRAIL), interferon gamma‐inducible protein‐10 (IP‐10), and C‐reactive protein (CRP), was measured using a rapid measurement platform. Patients were enrolled from 9 EDs and 3 UCCs in the United States and Israel. Patients >3 months of age presenting with fever and clinical suspicion of acute infection were considered eligible. MMBV results were not provided to the treating clinician. MMBV results (bacterial/viral/equivocal) were compared against a reference standard method for classification of infection etiology determined by expert panel adjudication. Experts were blinded to MMBV results. They were provided with comprehensive patient data, including laboratory, microbiological, radiological and follow‐up. Results Of 563 adults and children enrolled, 476 comprised the study population (314 adults, 162 children). The predominant clinical syndrome was respiratory tract infection (60.5% upper, 11.3% lower). MMBV demonstrated sensitivity of 90.0% (95% confidence interval [CI]: 80.3–99.7), specificity of 92.8% (90.0%–95.5%), and negative predictive value of 98.8% (96.8%–99.6%) for bacterial infections. Only 7.2% of cases yielded equivocal MMBV scores. Area under the curve for MMBV was 0.95 (0.90–0.99). Conclusions MMBV had a high sensitivity and specificity relative to reference standard for differentiating bacterial from viral infections. Future implementation of MMBV for patients with suspected acute infections could potentially aid with appropriate antibiotic decision‐making.

Habitat management can directly impact Setophaga discolor (Prairie Warbler) abundance and distribution. Despite regional declines, Prairie Warbler populations at Camp Edwards (Bourne, MA) have increased. To investigate habitat-management effects on Prairie Warbler populations at Camp Edwards, we used a dynamic-occupancy model to analyze a long-term monitoring dataset collected across 84 point-count sites from 2013 to 2022. The model results indicated that Prairie Warbler colonization and extinction probabilities were impacted by management (measured in years since disturbance). Colonization probability was highest initially after disturbance, then subsequently decreased for ∼50 years, and extinction probability also decreased for ∼25 years. Both probabilities remained low before increasing at ∼75 years since disturbance. The increase in colonization probability >75 years since disturbance may have been an artifact of our study design and incomplete disturbance records. We also found that latitude and longitude significantly affected colonization probability, likely a result of how habitat types are distributed across the base. These results inform how Prairie Warblers respond to long-term management, suggesting that habitat management could improve colonization rates and sustain Prairie Warbler populations. [ABSTRACT FROM AUTHOR]

Current measures of student success fall short in capturing the nuanced and multiplicitous ways that underrepresented and misrepresented students (e.g., Latinx, first-generation college students) who are navigating the intersection of multiple contexts important to their identities (e.g., home communities and university), define and understand success. For students, success includes individual and collective desires for well-being, or the desire to acquire an education to improve one's life and to pursue social justice in their home communities. In this study, we used Chicana feminist Gloria Anzaldúa's concept of the Borderlands (1999) as a conceptual framework to develop a Borderlands scale as a new measure of student success. For the psychometric validation of the scale, we surveyed 250 college students who were enrolled in a Hispanic Serving Research Institution. On a random half sample of the data, we performed an exploratory factor analysis (EFA) to determine a good fitting model. On the other half of the sample, we performed a confirmatory factor analysis (CFA) to assess evidence of validity. For the purposes of assessing convergent and discriminant validity, we provide correlations between the Borderlands scale and three thriving quotient subscales: academic determination, social connection, and diverse citizenship (Schreiner, 2010a), as well as high school grade point average (GPA) and composite Scholastic Aptitude Test (SAT) scores. We end the article with implications for the college student success literature, and for universities, especially Hispanic Serving Institutions. [ABSTRACT FROM AUTHOR]

This study sought to investigate the influence of a preexisting overweight condition (body mass index [BMI], 25–29.9 kg/m2) on functional outcomes after arthroscopic rotator cuff repair surgery. A retrospective review was performed examining the outcomes of arthroscopic rotator cuff repair in a normal-weight (BMI, 18.5–24.9 kg/m2) and an overweight (BMI, 25–29.9 kg/m2) population. Functional outcomes were assessed to include the American Shoulder and Elbow Surgeons (ASES) score, the Single Assessment Numeric Evaluation score, and the visual analog scale (VAS) pain score, as well as range of motion in forward flexion, external rotation, and internal rotation. A total of 52 normal-weight patients (mean BMI, 23.7±2.1 kg/m2) and 57 overweight patients (mean BMI, 28.4±1.4 kg/m2) were included. Both groups demonstrated statistically and clinically significant improvements in VAS score, Single Assessment Numeric Evaluation score, and ASES score at final follow-up (P<.0001), with no difference in range of motion (P>.05). Overall, when comparing outcomes between the groups, there were significantly better outcomes in the normal-weight group's VAS scores (mean, 0.56±0.96 vs 1.3±1.7; P=.0064), ASES scores (mean, 96.1±5.8 vs 92.4±9.7; P=.0187), and internal rotation (mean thoracic vertebrae, 9.2±3.0 vs 10.4±2.6; P=.0289). However, these differences did not reach clinical significance regarding the threshold of patients meeting standard minimal clinically important difference, substantial clinical benefit, and patient-acceptable symptomatic state for rotator cuff repairs. Over-weight patients have improved outcomes after arthroscopic rotator cuff repair surgery with noninferior clinical results when compared with normal-weight patients. More data regarding outcomes of overweight patients will help physicians make better-informed decisions when considering rotator cuff repair. [Orthopedics. 2023;46(4):242–249.] [ABSTRACT FROM AUTHOR]

Introduction: Describe the lived experience of a grassroots, nongovernmental disaster medical team (DMT) through a research lens and share practical lessons learned based on the DMT's experience to support and inform future response teams. Method: Forty-five days after Hurricane Maria, a nongovernmental DMT provided primary medical care by means of community-based pop-up clinics and home visitations in 5 different areas of Puerto Rico. Observational data, photo images, and debriefing notes were collected and documented in the response team's daily activity log. Field notes were coded using a descriptive coding method and then categorized into 2 domains specific to public health and medical diagnosis. Results: Medical aid was provided to nearly 300 (N = 296) residents. Field note observations identified exhaustion related to living conditions and the exacerbation of underlying conditions, such as reactive airway diseases, diabetes, hypertension, and depression due to the compounding effects of multiple post-disaster triggers. During home visitations, feelings of sadness and helplessness were identified secondary to natural disaster trauma and current living conditions. Conclusion: Our nongovernmental DMT displayed similar characteristics demonstrated by federal DMTs post-natural disaster. Several strategic lessons learned emerged from the public health intervention important to future nongovernmental DMTs. [ABSTRACT FROM AUTHOR]