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In recent years, medical journals have emphasized the increasingly critical role that social media plays in the dissemination of public health information and disease prevention guidelines. However, platforms such as Facebook and Twitter continue to pose unique challenges for clinical health care providers and public health officials alike. In order to effectively communicate during public health emergencies, such as the COVID-19 pandemic, it is increasingly critical for health care providers and public health officials to understand how patients gather health-related information on the internet and adjudicate the merits of such information. With that goal in mind, we conducted a survey of 1003 US-based adults to better understand how health consumers have used social media to learn and stay informed about the COVID-19 pandemic, the extent to which they have relied on credible scientific information sources, and how they have gone about fact-checking pandemic-related information. A web-based survey was conducted with a sample that was purchased through an industry-leading market research provider. The results were reported with a 95% confidence level and a margin of error of 3. Participants included 1003 US-based adults (aged ≥18 years). Participants were selected via a stratified quota sampling approach to ensure that the sample was representative of the US population. Balanced quotas were determined (by region of the country) for gender, age, race, and ethnicity. The results showed a heavy reliance on social media during the COVID-19 pandemic; more than three-quarters of respondents (762/1003, 76%) reported that they have relied on social media at least \"a little,\" and 59.2% (594/1003) of respondents indicated that they read information about COVID-19 on social media at least once per week. According to the findings, most social media users (638/1003, 63.6%) were unlikely to fact-check what they see on the internet with a health professional, despite the high levels of mistrust in the accuracy of COVID-19-related information on social media. We also found a greater likelihood of undergoing vaccination among those following more credible scientific sources on social media during the pandemic (χ =50.790; φ=0.258; P<.001). The findings suggest that health professionals will need to be both strategic and proactive when engaging with health consumers on social media if they hope to counteract the deleterious effects of misinformation and disinformation. Effective training, institutional support, and proactive collaboration can help health professionals adapt to the evolving patterns of health information seeking.

Serum prostate-specific antigen (PSA) concentrations after radical prostatectomy typically become undetectable with the use of current immunometric assay methods. Despite modern surgical techniques, 15%-30% of prostate cancer patients undergoing radical prostatectomy develop a biochemical recurrence during follow-up. Unfortunately, poor analytical sensitivity of standard PSA assays delays biochemical recurrence detection, and because of day-to-day assay imprecision ultrasensitive PSA assays cannot assess PSA kinetics. We developed an immuno-PCR assay for total PSA that has a limit of quantification >10 times lower than current ultrasensitive assays. The 2-site immunometric assay for total PSA employed 2 monoclonal antibodies, one conjugated to a double-stranded DNA label and the other bound to paramagnetic microparticles. After several washing steps, quantification cycles were determined and values were converted to PSA concentrations. We characterized analytical performance and compared accuracy with a commercially available total PSA assay. The limit of quantification was 0.65 ng/L and the assay was linear in the range of 0.25-152.0 ng/L. Total imprecision estimates at PSA concentrations of 3.8, 24.1, and 69.1 ng/L were <15.2%, <9.4%, and <10.6%, respectively. Recovery of supplemented PSA ranged from 87.5% to 119.2% (mean 100.3%). Dilution recovery ranged from 96.4% to 115.3% (mean 102.3%). There was no high-dose hook effect up to 50 000 ng/L of PSA. Comparison with the commercial PSA assay showed a regression slope of 1.06 and a correlation coefficient of 0.996. The analytical characteristics of the assay support the use of this assay for the accurate and precise measurement of serum PSA, even at sub-nanogram-per-liter concentrations.

IntroductionChildren with CHD and acquired heart disease have unique, high-risk physiology. They may have a higher risk of adverse tracheal-intubation-associated events, as compared with children with non-cardiac disease.Materials and methodsWe sought to evaluate the occurrence of adverse tracheal-intubation-associated events in children with cardiac disease compared to children with non-cardiac disease. A retrospective analysis of tracheal intubations from 38 international paediatric ICUs was performed using the National Emergency Airway Registry for Children (NEAR4KIDS) quality improvement registry. The primary outcome was the occurrence of any tracheal-intubation-associated event. Secondary outcomes included the occurrence of severe tracheal-intubation-associated events, multiple intubation attempts, and oxygen desaturation. A total of 8851 intubations were reported between July, 2012 and March, 2016. Cardiac patients were younger, more likely to have haemodynamic instability, and less likely to have respiratory failure as an indication. The overall frequency of tracheal-intubation-associated events was not different (cardiac: 17% versus non-cardiac: 16%, p=0.13), nor was the rate of severe tracheal-intubation-associated events (cardiac: 7% versus non-cardiac: 6%, p=0.11). Tracheal-intubation-associated cardiac arrest occurred more often in cardiac patients (2.80 versus 1.28%; p<0.001), even after adjusting for patient and provider differences (adjusted odds ratio 1.79; p=0.03). Multiple intubation attempts occurred less often in cardiac patients (p=0.04), and oxygen desaturations occurred more often, even after excluding patients with cyanotic heart disease. The overall incidence of adverse tracheal-intubation-associated events in cardiac patients was not different from that in non-cardiac patients. However, the presence of a cardiac diagnosis was associated with a higher occurrence of both tracheal-intubation-associated cardiac arrest and oxygen desaturation.

Few things are more complicated than federal acquisition regulations (maybe the Internal Revenue Code or US civil service rules), yet the goods and services they help purchase add up to a significant portion of the national economy. Indeed, nearly $1 of every $2 of the discretionary portion of the federal budget goes out through a contract. So like them or not, those pesky acquisition regulations -- and the professionals who administer them -- likely affect just about every public manager. People can't get their jobs done without them, but it can sometimes be quite challenging to reconcile those arcane regulatory requirements with the imperative to achieve results.

As public managers, they live in a world that increasingly depends on collaboration -- between an agency and its workforce, among agencies and levels of government, between public and private sectors, and even among nations -- to do the people's work. Read any morning's headlines, almost everything government does requires collaboration. More importantly, almost everything government does requires collaborative leaders. That's why this publication devoted an entire Forum to this topic last summer. Their first Forum adopted a rather eclectic approach to the term, essentially leaving it to the eye of the beholder. But there is a danger that the word collaboration becomes too vague and all-encompassing, especially if it is used to describe almost every positive interaction. Bottom line: they have a lot to learn about collaboration. It is fast becoming the \"new normal\" for public managers, although whether they're any good at it is another matter altogether.

There's a growing realization in today's federal government: The challenges that managers and frontline employees face -- from the drama of disaster to the routine of meat inspection -- can no longer be addressed by individual agencies, each myopically focusing on its own specialized mission. Rather, as those challenges become increasingly complex, they require the myriad federal agencies that have expertise, jurisdiction, or stake in the matter to collaborate in a seamless and integrated way. All must work toward the common goal or mission, acting as a single, collaborative \"enterprise\" to get the job done. For purposes of this article, enterprise is defined as the constellation of public and private organizations -- federal, state, and local government departments and agencies (as well as their subordinate bureaus and divisions), tribal governments, private and not-for-profit organizations, non-governmental organizations, and even such international organizations as the United Nations or Interpol -- that must collectively address a particular cross-cutting national or international challenge.