Using the parameterized susceptible-exposed-infectious-recovered model, we simulated the spread dynamics of coronavirus disease 2019 (COVID-19) outbreak and impact of different control measures, conducted the sensitivity analysis to identify the key factor, plotted the trend curve of effective reproductive number (R), and performed data fitting after the simulation. By simulation and data fitting, the model showed the peak existing confirmed cases of 59 769 arriving on 15 February 2020, with the coefficient of determination close to 1 and the fitting bias 3.02%, suggesting high precision of the data-fitting results. More rigorous government control policies were associated with a slower increase in the infected population. Isolation and protective procedures would be less effective as more cases accrue, so the optimization of the treatment plan and the development of specific drugs would be of more importance. There was an upward trend of R in the beginning, followed by a downward trend, a temporary rebound, and another continuous decline. The feature of high infectiousness for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) led to an upward trend, and government measures contributed to the temporary rebound and declines. The declines of R could be exploited as strong evidence for the effectiveness of the interventions. Evidence from the four-phase stringent measures showed that it was significant to ensure early detection, early isolation, early treatment, adequate medical supplies, patients' being admitted to designated hospitals, and comprehensive therapeutic strategy. Collaborative efforts are required to combat the novel coronavirus, focusing on both persistent strict domestic interventions and vigilance against exogenous imported cases.

The period of disrupted human activity caused by the COVID\19 pandemic, coined the anthropause, altered the nature of interactions between humans and ecosystems. It is uncertain how the anthropause has changed ecosystem states, functions, and feedback to human systems through shifts in ecosystem services. Here, we used an existing disturbance framework to propose new investigation pathways for coordinated studies of distributed, long\term social\ecological research to capture effects of the anthropause. Although it is still too early to comprehensively evaluate effects due to pandemic\related delays in data availability and ecological response lags, we detail three case studies that show how long\term data can be used to document and interpret changes in air and water quality and wildlife populations and behavior coinciding with the anthropause. These early findings may guide interpretations of effects of the anthropause as it interacts with other ongoing environmental changes in the future, particularly highlighting the importance of long\term data in separating disturbance impacts from natural variation and long\term trends. Effects of this global disturbance have local to global effects on ecosystems with feedback to social systems that may be detectable at spatial scales captured by nationally to globally distributed research networks.

(1) Objective: The objective of this study was to evaluate the effect of enforcement capabilities on the efficacy of two public interventions to improve occupational safety in olive mills. (2) Method: The difference in efficacy was evaluated by comparing the risks detected in two groups in an initial assessment (with visits in the 2006-2008 period) to the risks detected in a later assessment, either after an intervention by Authorized Technicians with enforcement capabilities or after an intervention by Technical Advisors without enforcement capabilities (2011-2013). The assessments identified risks in the companies, according to a specific risk map for olive oil mill enterprises. (3) Results: Statistically significant differences were observed in the comparison of the risk reductions of the two groups, with regard to the initial assessment. The greatest reductions in risk were found in the companies that received interventions by Authorized Technicians with enforcement capabilities, in the sections of individual protection equipment and the storage of dangerous products. (4) Conclusion: Interventions by Authorized Technicians with enforcement capabilities are more effective than interventions by Technical Advisors without enforcement capabilities.

During the 2019 novel coronavirus (SARS-CoV-2) outbreak in China (from January 24 to March 11, 2020), our center performed 16 organ transplants (10 kidney, 4 liver, and 2 lung transplants) harvested from deceased donors. Regarding the strategies to prevent infections of SARS-CoV-2, we implemented specific measures for the donor and recipient management, as well as prevention of hospital-acquired infections. All 16 organ recipients had a favorable outcome without SARS-CoV-2 infection. Our approaches aiming to interrupt the spread of SARS-CoV-2 within the transplantation wards were successful, and allowed us to maintain the transplantation program for deceased liver, kidney, and lung organ recipients.

Mental health condition is including depression and anxiety, and they may impact wellbeing, personal relationships and productivity of both genders. Herbal medicines have been used to treatment of anxiety and depression symptoms for centuries. SARS, MERS and COVID-19 are related to coronavirus types. SARS (sever acute respiratory syndrome, China, 2002), MERS (Middle East respiratory syndrome, Saudi Arabia, 2012), and SARS-CoV-2 (2019-2020) are the main coronavirus outbreaks. Both anxiety and depression are more serious to be considered and improved for all general public during fight with these diseases. In this mini-review article, we have mentioned the key role some of the most important plants and herbs for treatment of stress and anxiety and improve mental health against SARS and SARS-CoV-2 on the basis of traditional Asian medicine, especially traditional Chinese and Persian medicine.

Correspondence to Dr Bryndis Eva Birgisdottir, Unit for Nutrition Research, Faculty of Food Science and Nutrition and Landspitali-University Hospital, Haskoli Islands, Reykjavik, Iceland;[email protected] Healthful food of good quality is our first line of defence against diseases,1 including immune defences against pathogenic organisms.2 3 In the current worldwide concern of coronavirus SARS-CoV-2, resulting in the COVID-19 disease, a sturdy immune system is considered central.4 This inevitably puts focus on the saga of the harmonious concert between nutrition and the immune system, unfolding over the last century.2 Big pandemics and resourceful pathogens have shaken the world before, with devastating death tolls of often young people, such as through the Spanish influenza and tuberculosis.5 6 Although biological processes or mechanisms were less understood at the time, it was simply considered common sense that those who had access to enough quality food had a better chance against diseases. Later, or mid-century, the extended and cyclical relations between malnutrition and infections were elegantly described,2 and diabetes was also early identified as a condition making people especially vulnerable to pathogens.7 An interwoven world Today, however, the increasing diversity of reliable quality tools that are available to assess immune function have facilitated the remarkable increases in our comprehension of the design of both the innate and adaptive immune system.2 Scientific advances have also brought with them an emerging understanding of the web of genes, the immune system and nutritional status, including energy metabolism and the gut microbiota, although many puzzles still remain to be solved.3 8 The current challenge is to capture the complexity of this multidimensional relationship, interacting via multiple direct and indirect pathways,3 while at the same time tracing and understanding the effect of single nutrients of special importance.9 10 As the immune system develops and forms from conception to adulthood,3 a natural decline in immune function is usually inevitable with age.4 However, this decline may be slowed through optimal nutrition, as well as optimisation of other lifestyle factors such as physical activity and sedentariness, stressors and sleep, throughout the life course.9 All are of great importance. The importance of these are bluntly reflected in food-based dietary guidelines (FBDGs), represented as recommendations for a variety and diversity of whole vegetables, fruits, berries, nuts, seeds, grains and pulses, along with some meats, eggs, dairy products and fish, if selected, as discussed in the paper by Calder.4 This type of healthy diet is a tactical aproach to build a healthy body and a strong immune system, as emphasised by the WHO and other organisations during the pandemic,18 especially when eaten at the expense of more ultraprocessed food items.19 Nutrition is a balancing act Furthermore, the diet described previously would for most people provide ample amount of the micronutrients that have been suggested to be of special importance for the immune system.4 However, vitamin D as one of the key micronutrients for the immune system has been given special focus by several papers in the collection.12 13 The vitamin is found in only an handful of foods and populations with low sun exposure have been found to be prone to low status, especially during the winter months. Special conditions: clinical setting However, with advancing age and for high-risk groups, a nutrient-rich diet is not always enough to meet needs for micronutrients.4 14 While high intakes should be avoided, there may be a a role for immune-targeted supplements that might be necessary to achieve the intake of nutrients needed for an optimally functioning immune system.4 Furthermore, there is one thing to enhance the public health nutritional status, through preventive actions, while the clinical situation of an active disease is another situation altogether.

The objective of the article were to discuss the implementation of infection prevention and control strategies in health facilities in South Sudan These strategies were: ensuring triage, early recognition, and source control, applying standard precautions for all patients, implementing empiric additional precautions for suspected cases of COVID-19, issuing new guidance, policies and protocols for IPC as appropriate, and using environmental and engineering controls (e g , reorganizing health facilities to create isolation rooms, improving airflow in existing rooms)

Aim Despite the regular heart damage in patients with coronavirus pneumonia caused by SARS-Cov-2, a possibility of developing lymphocytic myocarditis as a part of COVID-19 remains unsubstantiated. The aim of this study was to demonstrate a possibility of lymphocytic myocarditis and to study its morphological features in patients with the novel coronavirus infection (COVID-19) with a severe course.Material and methods Postmortem data were studied for 5 elderly patients (74.84.4 years; 3 men and 2 women) with the novel coronavirus infection and bilateral, severe polysegmental pneumonia (stage 3-4 by computed tomography). COVID-19 was diagnosed based on the typical clinical presentation and positive polymerase chain reaction test in nasopharyngeal swabs. All patients were treated in different hospitals repurposed for the treatment of patients with COVID-19. A standard histological study was performed with hematoxylin and eosin, toluidine blue, and van Gieson staining. Serial paraffin slices were studied immunohistochemically with antibodies to CD3, D68, CD20, perforin, and toll-like receptors (TLR) 4 and 9.Results In none of the cases, myocarditis was suspected clinically, added to the diagnosis or indicated as a possible cause of death. IHD and acute myocardial infarction were mentioned as error diagnoses not confirmed by the postmortem examination. The morphological examination of the heart identified signs of lymphocytic myocarditis consistent with Dallas criteria for this diagnosis. Myocardial infiltrate was characterized in detail, and a combined inflammatory damage of endocardium and pericardium was described. The immunohistochemical study with cell infiltrate typing confirmed the presence of CD3-positive lymphocytes and the increased expression of TLR-4. A picture of coronaritis, including that with microvascular thrombosis, was found in all cases.Conclusion A possibility for development of lymphocytic viral myocarditis in COVID-19 was confirmed morphologically and immunohistochemically. Specific features of myocarditis in COVID-19 include the presence of coronaritis and a possible combination of myocarditis with lymphocytic endo- and pericarditis.

We conducted a mixed-methods outcome evaluation to examine student experiences and learning in the University of Manitobas Queen Elizabeth II Diamond Jubilee Scholarship Program in Global and Indigenous Health. Our scholarship program is a bi-directional, 3-month international experiential learning program, including both undergraduate and graduate students, with associated online course focused on community engagement. Students completed a semi-structured narrative report at the conclusion of their funding related to their experience and learning. The Likert questions were analyzed descriptively and student responses to the open-ended questions were utilized for thematic analysis. Also included in this paper is a summary of our lessons learned through program administration. A total of 38 students completed the program between 2016 and 2018, with 95% reporting that they either met or exceeded their goals in the program. Three overarching and inter-related themes emerged in our thematic-analysis of students narrative reports, including success through relationships and new perspectives, challenges of the unfamiliar, and personal growth through strong emotions. Many students reported personal growth as their greatest success and linked this with new perspectives and awareness of how different contexts shaped their understanding of health issues. Overcoming challenges in their placements contributed to students confidence in their ability to problem-solve. Overall, students reported value in their experiential learning, which further supports the growing trend to incorporate both experiential learning and formal education in community engagement in public health pedagogy. However, international experiential learning requires considerable financial and human resource commitments to ensure its success.

Objetivo: apresentar atualiza??es para a ressuscita??o cardiopulmonar em pacientes suspeitos e confirmados com COVID-19 Mtodo: revis?o compreensiva da literatura, com sntese narrativa das evidncias de diretrizes e recomenda??es da Organiza??o Mundial de Sade, Associa??o de Medicina Intensiva Brasileira, American Heart Association, Resuscitation Council UK, American College of Surgions Committee on Trauma e National Association of Emergency Medical Technicians Resultados: as principais atualiza??es trazem informa??es sobre especificidades das manobras de ressuscita??o cardiopulmonar;prepara??o do ambiente, recursos humanos e materiais, reconhecimento da parada cardiorrespiratria e a??es iniciais;estratgias de ventila??o e acesso invasivo da via area;ajustes do ventilador mecanico e manobras de ressuscita??o cardiopulmonar em pacientes pronados Considera??es finais: profissionais de sade envolvidos no atendimento parada cardiorrespiratria de pacientes suspeitos e/ou confirmados com COVID-19 podem encontrar inmeros desafios, portanto devem seguir com rigor o protocolo estabelecido para maximizar a efetividade das manobras de ressuscita??o e minimizar o risco de contgio pelo vrus e sua dissemina??o Objective: to present updates for cardiopulmonary resuscitation in suspected and confirmed patients with COVID-19 Method: comprehensive literature review with narrative synthesis of the evidence of guidelines and recommendations from World Health Organization, Associa??o de Medicina Intensiva Brasileira, American Heart Association, Resuscitation Council UK, American College of Surgions Committee on Trauma and National Association of Emergency Medical Technicians Results: the main updates bring information about the specifics of cardiopulmonary resuscitation maneuvers;preparation of the environment and human and material resources, recognition of cardiorespiratory arrest and initial actions;ventilation and invasive airway access strategies;mechanical ventilator adjustments and cardiopulmonary resuscitation maneuvers in patients in the prone position Final considerations: health professionals involved in the care of cardiorespiratory arrest of suspected and/or confirmed patients with COVID-19 can face numerous challenges, so they must strictly follow the protocol established to maximize the effectiveness of resuscitation maneuvers and minimize the risk of contagion by the virus and its spread Objetivo: apresentar actualizaciones para la reanimacin cardiopulmonar en pacientes sospechos os y confirmados con COVID-19 Mtodo: revisin exhaustiva de la literatura con sntesis narrativa de la evidencia de guas y recomendaciones de la Organizacin Mundial de la Salud, Associa??o de Medicina Intensiva Brasileira, American Heart Association, Resuscitation Council UK, American College of Surgions Committee on Trauma and National Association of Emergency Medical Technicians Resultados: las principales actualizaciones aportan informacin sobre los detalles de las maniobras de reanimacin cardiopulmonar;preparacin del medio ambiente y recursos humanos y materiales, reconocimiento de paro cardiorrespiratorio y acciones iniciales;estrategias de ventilacin y acceso invasivo a las vas areas;ajustes del ventilador mecnico y maniobras de reanimacin cardiopulmonar en pacientes en decbito prono Consideraciones finales: los profesionales de la salud involucrados en la atencin del paro cardiorrespiratorio de pacientes sospechosos y/o confirmados con COVID-19 pueden enfrentar numerosos desafos, por lo que deben seguir estrictamente el protocolo establecido para maximizar la efectividad de las maniobras de reanimacin y minimizar el riesgo de contagio por el virus y supropagacin

OBJECTIVES: To investigate functioning, activity and disability in people with post-COVID syndrome. DESIGN: Cross-sectional. SUBJECTS/PATIENTS: Participants were recruited online via Facebook and a stakeholders organization for post-COVID syndrome in Sweden. METHODS: Sociodemographic data and International Classification of Functioning, Disability and Health (ICF)-based questionnaire were collected via an online platform and analysed. RESULTS: A total of 100 participants were included (mean age 44.5 years, 82% women, 61% with higher education, and 56% working full- or part-time). For the ICF component Body Functions, the most impaired functions were: fatigability and energy drive (98C99%); higher cognitive functions (74C94%); sleep functions (98%); muscle functions (93%); respiratory functions (92%); heart functions (82%); emotional functions (80%); sexual functions (77%); pain problems (56C90%); and thermoregulatory functions (68%). For the component Activity, the most frequent limitations were: handling stressful situations (98%); remunerative employment (95%); recreation and leisure (94%); climbing the stairs (94%); doing housework (84%); and informal socializing (64%). The most frequent degrees of impairment/limitations were light and moderate, except for severe-complete for fatigue, higher cognitive functions, multitasking, handling stressful situations; and recreation and leisure activities. CONCLUSION: Post-COVID syndrome following a mild COVID-19 infection can result in impaired body functions and activities. These results support the importance of a multidisciplinary rehabilitation approach for these patients.

Over the last 25 years, the human endocannabinoid system (ECS) has come into the limelight as an imperative neuro-modulatory system. It is mainly comprised of endogenous cannabinoid (endocannabinoid), cannabinoid receptors and the associated enzymes accountable for its synthesis and deterioration. The ECS plays a proven role in the management of several neurological, cardiovascular, immunological, and other relevant chronic conditions. Endocannabinoid or endogenous cannabinoid are endogenous lipid molecules which connect with cannabinoid receptors and impose a fashionable impact on the behavior and physiological processes of the individual. Arachidonoyl ethanolamide or Anandamide and 2-arachidonoyl glycerol or 2-AG were the endocannabinoid molecules that were first characterized and discovered. The presence of lipid membranes in the precursor molecules is the characteristic feature of endocannabinoids. The endocannabinoids are released upon rapid enzymatic reactions into the extracellular space via activation through G-protein coupled receptors, which is contradictory to other neurotransmitter that are synthesized beforehand, and stock up into the synaptic vesicles. The current review highlights the functioning, synthesis, and degradation of endocannabinoid, and explains its functioning in biological systems.

Retinal ischemia is a common cause of many retinal diseases, leading to irreversible vision impairment and blindness. Excessive neuroinflammation, including microglial activation and T-cell responses, has been identified as a critical factor associated with neurodegeneration in retinal ischemia. Baicalein is a natural flavonoid reported to have broad anti-inflammatory and neuroprotective bioactivities. Herein, the effects of baicalein on microglia activation in vitro and in vivo were investigated. We found that baicalein exhibited robust anti-inflammatory effect on cultured human and mouse microglia, as demonstrated by decreased induction of pro-inflammatory cytokines and the phosphorylation of phosphoinositide 3-kinase (PI3K) and nuclear factor kappa B (NFB). Proteomic analysis further unraveled baicaleins effect on modulating IL-17 signaling pathways and its upstream regulator IL-1. Intravitreal administration of baicalein in the mouse model of retinal ischemia/reperfusion (I/R) injury attenuated microglial activation and retinal T-cell infiltration, particularly the T helper 17 cells. Additionally, baicalein was shown to exert neuroprotective effects by significantly reducing the retinal ganglion cell (RGC) loss after I/R injury, leading to an improved retinal function and spatial vision. These results suggest that baicalein, a natural flavonoid, acts as a negative regulator of activated microglia and immune responses both in vitro and in vivo, effectively alleviating neurodegeneration in retinal I/R injury. This finding indicates that baicalein could be a potential therapeutic agent against currently incurable degenerative retinal diseases.

Crimean-Congo hemorrhagic fever (CCHF) is a severe tick-borne febrile illness with wide geographic distribution. In humans, the disease follows infection by the Crimean-Congo hemorrhagic fever virus (CCHFV) and begins as flu-like symptoms that can rapidly progress to hemorrhaging and death. Case fatality rates can be as high as 30%. An important gap in our understanding of CCHF are the host immune responses necessary to control the infection. A better understanding of these responses is needed to direct therapeutic strategies to limit the often-severe morbidity and mortality seen in humans. In this report, we have utilized a mouse model in which mice develop severe disease but ultimately recover. T-cells were robustly activated, differentiated to produce antiviral cytokines, and were critical for survival following CCHFV infection. We further identified a key role for interferon gamma (IFN) in survival following CCHFV infection. These results significantly improve our understanding of the host adaptive immune response to severe CCHFV infection.

The present study aimed to present and validate the Workers Healthcare Assistance Model (WHAM), which includes an interdisciplinary approach to health risk management in search of integral and integrated health, considering economic sustainability Through the integration of distinct methodological strategies, WHAM was developed in the period from 2011 to 2018, in a workers occupational health centre in the oil industry in Bahia, Brazil The study included a sample of 965 workers, 91 7% of which were men, with a mean age of 44 9 years (age ranged from 23 to 73 years) The Kendall rank correlation coefficient and hierarchical multiple regression analysis were used for the validation of WHAM The assessment of sustainable return on investment (S-ROI) was made using the WELLCAST ROI? decision support tool, covering workers with heart disease and diabetes WHAM can be considered an innovative healthcare model, as there is no available comparative model WHAM is considered robust, with 86% health risk explanatory capacity and with an 85 5% S-ROI It can be concluded that WHAM is a model capable of enhancing the level of workers health in companies, reducing costs for employers and improving the quality of life within the organization

OBJECTIVE: To investigate whether the use of diffusing capacity of the lungs for carbon monoxide (DLCO) and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) could be used to predict bleomycin-induced pulmonary toxicity in patients with testicular cancer (TCa). STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Ankara Oncology Training and Research Hospital, Turkey, between 2017 and 2020. METHODOLOGY: Data of 40 patients with TCa, who were followed at cancer centre from 2017-2020 and received 3-4 cycles of BEP protocol were retrospectively screened and included who met the criteria for inclusion in the study. All patients with TCa, who were older than 18 years of age and had no secondary malignancy and comorbidity, were included in this study. RESULTS: A statistically significant negative correlation was found between DLCO change and NLR, PLR (r:-0.558, p:0.002 for NLR; r:-0.462 p:0.012 for PLR). A statistically significant positive correlation was found between DLCO change and lymphocyte level (r:0.436, p:0.018). The NLR and PLR were statistically higher in the group with a decrease of 10% in DLCO compared to the group with no decrease or a decrease of 10% in DLCO (for NLR; 3.03 1.45 and 1.68 0.73, respectively, p = 0.005; for PLR 187.72 66.90 and 124.72 47.99, respectively, p = 0.008). Multivariate regression analysis showed a statistically significant relationship between PLR increase and a decrease of 10% in DLCO. CONCLUSION: PLR and LDH could be used as independent predictive biomarkers for DLCO decline which is used to identify bleomycin-induced pulmonary toxicity. Key Words: Bleomycin, Markers of inflammation, Platelet-to-lymphocyte ratio (PLR), Pulmonary diffusing capacity, Testicular cancer.

A comprehensive description of the factors associated with job satisfaction among occupational therapy practitioners is needed to promote their work well-being. This systematic review aimed to describe occupational therapy practitioners' job satisfaction and the related intra-, inter-, and extra-personal factors. Original peer-reviewed studies published between 2010 and 2019 were retrieved from four databases with the review including fourteen studies. The review was conducted according to the Joanna Briggs Institute guideline. The data were analyzed by narrative synthesis. Occupational therapy practitioners experienced high job satisfaction. Job satisfaction was found to be associated with significantly lower rates of turnover intention and higher rates of rewards. The relationships between job satisfaction, professional identity, exhaustion, and social environment showed conflicting results.

ABSTRACT The impact of the COVID-19 pandemic on adolescent and young adult chlamydial infection is unknown. Patient testing data were extracted from the electronic health records of ten family planning clinics. Pre-pandemic and pandemic comparisons revealed an increase in observed chlamydial infection, with greater positivity among Black/African American female adolescent patients.

In response to the recent pandemic, vaccines have been developed for large-scale immunization. Despite safety and efficacy verified by health authorities, Guillain-Barre syndrome (GBS) remains a risk of unexpected adverse reactions. Since COVID-19-related GBS cases have largely been reported in Europe, vaccines involving viral genetic materials can potentially trigger GBS, as demonstrated in clinical trials in the Americas. Therefore, medical professionals should be aware of GBS as a potential adverse reaction in SARS-CoV-2 vaccination. Consultation with a neurologist may be needed. Nevertheless, this is not to say that the use of vaccines against SARS-CoV-2 should be suspended and that the association between GBS and the vaccine is confirmed or excluded. The benefits of vaccine still outweigh potential adverse effects.

OBJECTIVES: Physiological decompensation of hospitalized patients is common and is associated with substantial morbidity and mortality. Research surrounding patient decompensation has been hampered by the absence of a robust definition of decompensation and lack of standardized clinical criteria with which to identify patients who have decompensated. We aimed to: 1) develop a consensus definition of physiological decompensation and 2) to develop clinical criteria to identify patients who have decompensated. DESIGN: We utilized a three-phase, modified electronic Delphi (eDelphi) process, followed by a discussion round to generate consensus on the definition of physiological decompensation and on criteria to identify decompensation. We then validated the criteria using a retrospective cohort study of adult patients admitted to the Hospital of the University of Pennsylvania. SETTING: Quaternary academic medical center. PATIENTS: Adult patients admitted to the Hospital of the University of Pennsylvania who had triggered a rapid response team (RRT) response between January 1, 2019, and December 31, 2020. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Sixty-nine experts participated in the eDelphi. Participation was high across the three survey rounds (first round: 93%, second round: 94%, and third round: 98%). The expert panel arrived at a consensus definition of physiological decompensation, An acute worsening of a patients clinical status that poses a substantial increase to an individuals short-term risk of death or serious harm. Consensus was also reached on criteria for physiological decompensation. Invasive mechanical ventilation, severe hypoxemia, and use of vasopressor or inotrope medication were bundled as criteria for our novel decompensation metric: the adult inpatient decompensation event (AIDE). Patients who met greater than one AIDE criteria within 24 hours of an RRT call had increased adjusted odds of 7-day mortality (adjusted odds ratio [aOR], 4.1 [95% CI, 2.5C6.7]) and intensive care unit transfer (aOR, 20.6 [95% CI, 14.2C30.0]). CONCLUSIONS: Through the eDelphi process, we have reached a consensus definition of physiological decompensation and proposed clinical criteria with which to identify patients who have decompensated using data easily available from the electronic medical record, the AIDE criteria.