ARTICLES| VOLUME 10, ISSUE 11, P1074-1085, NOVEMBER 01, 2022 Daily use of lateral flow devices by contacts of confirmed COVID-19 cases to enable exemption from isolation compared with standard self-isolation to reduce onward transmission of SARS-CoV-2 in England: a randomised, controlled, non-inferiority trial Nicola K Love, Derren R Ready, Charlie Turner, et al. Lancet Respir Med 2022; 10: 1074-1085 DOI:https://doi.org/10.1016/S2213-2600(22)002...

ORIGINAL ARTICLE Liquefied Petroleum Gas or Biomass for Cooking and Effects on Birth Weight Thomas F. Clasen, Howard H. Chang, Lisa M. Thompson, et al N Engl J Med 2022; 387:1735-1746DOI: 10.1056/NEJMoa2206734 Abstract BACKGROUND Exposure during pregnancy to household air pollution caused by the burning of solid biomass fuel is associated with adverse health outcomes, including low birth weight. Whether the replacement of a biomass cookstove with a lique...

Sleep Assessment in Critically Ill Adults Sleep in adult patients in the ICU is severely disturbed and typically short, light and fragmented. In addition, interventions in the ICU such as sedation, ventilation and illness can alter sleep characteristics. Some of the most common causes of sleep disruption include environmental factors such as noise and light; physiologic factors, such as pain, immobility, discomfort and coughing; care-related factors, such as nursin...

ORIGINAL ARTICLE Lifting Universal Masking in Schools — Covid-19 Incidence among Students and Staff Tori L. Cowger, Eleanor J. Murray, Jaylen Clarke, et al N Engl J Med 2022; 387:1935-1946DOI: 10.1056/NEJMoa2211029 Abstract BACKGROUND In February 2022, Massachusetts rescinded a statewide universal masking policy in public schools, and many Massachusetts school districts lifted masking requirements during the subsequent weeks. In the greater Boston a...

ORIGINAL ARTICLE Progression of Atrial Fibrillation after Cryoablation or Drug Therapy Jason G. Andrade, Marc W. Deyell, Laurent Macle, et al N Engl J Med November 7, 2022DOI: 10.1056/NEJMoa2212540 Abstract BACKGROUND Atrial fibrillation is a chronic, progressive disorder, and persistent forms of atrial fibrillation are associated with increased risks of thromboembolism and heart failure. Catheter ablation as initial therapy may modify the pathogenic mec...

Clinical Outcomes With and Without Direct Discharge Home ICUs are an important part of an acute care system and provide life-sustaining treatment to critically ill patients. The level and complexity of care delivered in ICUs can vary. For example, some ICUs provide support for multiple organ failure, while others may focus on single-system support or might be a point of transition between the ward and the highest level of care. Patient care pathways, in general, fu...

ORIGINAL ARTICLE Defibrillation Strategies for Refractory Ventricular Fibrillation Sheldon Cheskes, P. Richard Verbeek, Ian R. Drennan, et al N Engl J Med November 6, 2022DOI: 10.1056/NEJMoa2207304 Abstract BACKGROUND Despite advances in defibrillation technology, shock-refractory ventricular fibrillation remains common during out-of-hospital cardiac arrest. Double sequential external defibrillation (DSED; rapid sequential shocks from two defibrillators)...

ORIGINAL ARTICLE Once-Weekly Semaglutide in Adolescents with Obesity Daniel Weghuber, Timothy Barrett, Margarita Barrientos-Pérez, et al N Engl J Med November 2, 2022DOI: 10.1056/NEJMoa2208601 Abstract BACKGROUND A once-weekly, 2.4-mg dose of subcutaneous semaglutide, a glucagon-like peptide-1 receptor agonist, is used to treat obesity in adults, but assessment of the drug in adolescents has been lacking. METHODS In this double-blind, parallel-grou...

ORIGINAL ARTICLE Trial of an Intervention to Improve Acute Heart Failure Outcomes Douglas S. Lee, Sharon E. Straus, Michael E. Farkouh, et al N Engl J Med November 5, 2022DOI: 10.1056/NEJMoa2211680 Abstract BACKGROUND Patients with acute heart failure are frequently or systematically hospitalized, often because the risk of adverse events is uncertain and the options for rapid follow-up are inadequate. Whether the use of a strategy to support clinicians i...

ICU vs High-Dependency Care Unit for Septic Shock Sepsis is a life-threatening disease with high mortality. More than 10,000 people die from sepsis every year in Japan. Septic shock is when sepsis is associated with circulatory and cellular metabolic abnormalities. International guidelines recommend the use of antimicrobial therapy and source control with drainage or surgery, intensive care with fluid resuscitation and vasopressors for septic shock. However, there ...