Milder disease with Omicron: is it the virus or the pre-existing immunity?

At the population level we are seeing milder disease during the Omicron wave of the SARS-CoV-2 pandemic. Is this due to the virus or pre-existing immunity, and what should we expect next

Availability and use of hemostatic agents in prehospital trauma patients in Pennsylvania translation from the military to the civilian setting

Adam Sigal,1 Anthony Martin,1 Adrian Ong2 1Department of Emergency Medicine, 2Department of Surgery, Trauma Section, The Reading Hospital, West Reading, PA, USA Objective: To understand the translation of one innovation in trauma care from the military to the civilian setting, the adoption of topical hemostatic agents in the Emergency Medical Services (EMS) community and in Trauma Centers in Pennsylvania. Method: We utilized an anonymous electronic survey of EMS Agency Administrative Officers and Trauma Center Coordinators. Results: We received responses from 23% (93/402) Advanced Life Support and Air Medical agencies in the State. Of the EMS agencies that responded, 46.6% (61/131) stock hemostatic products, with 55.5% (44/79) carrying QuickClot® Combat Gauze®. Of the agencies that carried hemostatic products, 50% utilized them at least once in the prior 6 months and 59% over the past 12 months. Despite the infrequent number of applications, prehospital providers ranked themselves as somewhat skilled and comfortable both with the application of the products and the indications for their use. Conclusion: Our survey found that 46.6% of the respondents indicated they carry hemostatic products, a much greater number than found on prior surveys of EMS agencies. There is a steady acceptance by EMS of new innovations in trauma care although more work is needed in translating the exact role of hemostatic agents in the civilian setting. Keywords: hemostatic, dressing, trauma, prehospital, trauma care, EM

Multilevel Language and Vision Integration for Text-to-Clip Retrieval

We address the problem of text-based activity retrieval in video. Given a sentence describing an activity, our task is to retrieve matching clips from an untrimmed video. To capture the inherent structures present in both text and video, we introduce a multilevel model that integrates vision and language features earlier and more tightly than prior work. First, we inject text features early on when generating clip proposals, to help eliminate unlikely clips and thus speed up processing and boost performance. Second, to learn a fine-grained similarity metric for retrieval, we use visual features to modulate the processing of query sentences at the word level in a recurrent neural network. A multi-task loss is also employed by adding query re-generation as an auxiliary task. Our approach significantly outperforms prior work on two challenging benchmarks: Charades-STA and ActivityNet Captions.Comment: AAAI 201

Informal Peer Interaction and Practice Type as Predictors of Physician Performance on Maintenance of Certification Examinations

Importance Physicians can demonstrate mastery of the knowledge that supports continued clinical competence by passing a maintenance of certification examination (MOCEX). Performance depends on professional learning and development, which may be enhanced by informal routine interactions with colleagues. Some physicians, such as those in solo practice, may have less opportunity for peer interaction, thus negatively influencing their examination performance. Objective To determine the relationship among level of peer interaction, group and solo practice, and MOCEX performance. Design, Setting, and Participants Longitudinal cohort study of 568 surgeons taking the 2008 MOCEX. Survey responses reporting the level of physicians’ peer interactions and their practice type were related to MOCEX scores, controlling for initial qualifying examination scores, practice type, and personal characteristics. Exposures Solo practice and amount of peer interaction. Main Outcomes and Measures Scores on the MOCEX and pass-fail status. Results Of the 568 surgeons in the study sample, 557 (98.1%) passed the examination. Higher levels of peer interaction were associated with a higher score (β = 0.91 [95% CI, 0.31-1.52]) and higher likelihood of passing the examination (odds ratio, 2.58 [1.08-6.16]). Physicians in solo (vs group) practice had fewer peer interactions (β = −0.49 [95% CI, −0.64 to −0.33), received lower scores (β = −1.82 [−2.94 to −0.82]), and were less likely to pass the examination (odds ratio, 0.22 [0.06-0.77]). Level of peer interaction moderated the relationship between solo practice and MOCEX score; solo practitioners with high levels of peer interaction achieved an MOCEX performance on a par with that of group practitioners. Conclusions and Relevance Physicians in solo practice had poorer MOCEX performance. However, solo practitioners who reported high levels of peer interaction performed as well as those in group practice. Peer interaction is important for professional learning and quality of care

THE PROMISED CONSTITUTION OF THE PROMISED LAND:THE ISRAELI CONSTITUTIONAL EXPERIENCE

THE PROMISED CONSTITUTION OF THE PROMISED LAND:THE ISRAELI CONSTITUTIONAL EXPERIENC