DESCRIPTION A 46-year-old man was transferred from an outside hospital for evaluation of acute renal failure and non-ST-segment elevation myocardial infarction. During his initial presentation at the outside hospital, the patient was profoundly hypotensive with signs of respiratory failure. Owing to the perceived urgency, he was started on norepinephrine for haemodynamic support through a perip...

We performed a retrospective chart review for 149 randomly selected well-child encounters to evaluate the frequency with which clinicians plot growth measurements and document growth abnormalities during health maintenance visits. Providers failed to plot at least one measurement of height, weight, and/or head circumference in 31 of 149 encounters (21%, 95% CI = 14.5% to 27.5%). Growth abnormal...

Supernumerary teeth or hyperdontia are defined as the teeth that exceeds the normal dental formula, regardless of their location and morphology. A supernumerary tooth is a developmental anomaly and it has been argued to arise from multiple aetiologies. Supernumerary teeth with orthodox shapes and sizes, that resemble the normal dentition are called 'supplemental teeth'. The supplemental teeth a...

increases in incidents involving so-called confused persons have brought attention to the potential costs of recent changes to public mental health (pmh) services in the netherlands. decentralized under the (community) participation act (2014), local governments must find resources to compensate for reduced central funding to such services or “innovate.” but innovation, even when pressure for c...

For complex systems of systems, such as those required to perform maritime security, system architects have numerous choices they may select from, both in the components and in the way the system operates. Component choices, such as the length of a wing or the number of ground control stations, are often considered in tradespace studies, but this paper highlights the operational choices that ar...