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The Internet of Things (IoT) is expected to have a positive impact on various sectors, such as manufacturing, users, and operators. Due to the capabilities of smart objects to share their contents and interact with their social networks, the combined Social Internet of Educational Things (SIoET) for smart education is expected to provide users with more efficient services. The primary objective of this paper is to provide an efficient resource management by adopting edge intelligence technique for higher education system workloads on next-generation networks. As the number of tasks handled by these interconnected devices continues to rise, there is an escalating concern regarding resource competition and power consumption within the network. To mitigate these challenges, we propose an innovative edge intelligence-based resource allocation approach to intelligently allocate resources while minimizing latency and optimizing power consumption with increasing task volumes. The problem is dissected into two core sub-problems: computation resource optimization and power optimization. Leveraging the concept of Lagrangian and Bisection methods, our proposed algorithm, implemented within a Device-to-Device (D2D) -assisted edge intelligence network, demonstrates remarkable performance improvements. Network latency and energy consumption is reduced by up to 57.9 % and 82.3 % compared to the benchmark schemes. These findings hold promising implications for the integration of this work into higher education systems driven by SIoET. Furthermore, simulations indicate that the system maintains robust performance even in dynamic urban environments characterized by random device movement.

BackgroundThe rapid expansion of telehealth services, driven by the COVID-19 pandemic, necessitates systematic evaluation to guarantee the quality, effectiveness, and cost-effectiveness of telehealth services and programs in the United States. While numerous evaluation frameworks have emerged, crafted by various stakeholders, their comprehensiveness is limited, and the overall state of telehealth evaluation remains unclear. ObjectiveThe overarching goal of this scoping review is to create a comprehensive overview of telehealth evaluation, incorporating perspectives from multiple stakeholder categories. Specifically, we aim to (1) map the existing landscape of telehealth evaluation, (2) identify key concepts for evaluation, (3) synthesize existing evaluation frameworks, and (4) identify measurements and assessments considered in the United States. MethodsWe will conduct this scoping review in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews and in line with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). This scoping review will consider documents, including reviews, reports, and white papers, published since January 1, 2019. It will focus on evaluation frameworks and associated measurements of telehealth services and programs in the US health care system, developed by telehealth stakeholders, professional organizations, and authoritative sources, excluding those developed by individual researchers, to collect data that reflect the collective expertise and consensus of experts within the respective professional group. ResultsThe data extracted from selected documents will be synthesized using tools such as tables and figures. Visual aids like Venn diagrams will be used to illustrate the relationships between the evaluation frameworks from various sources. A narrative summary will be crafted to further describe how the results align with the review objectives, facilitating a comprehensive overview of the findings. This scoping review is expected to conclude by August 2024. ConclusionsBy addressing critical gaps in telehealth evaluation, this scoping review protocol lays the foundation for a comprehensive and multistakeholder assessment of telehealth services and programs. Its findings will inform policy makers, health care providers, researchers, and other stakeholders in advancing the quality, effectiveness, and cost-effectiveness of telehealth in the US health care system. Trial RegistrationOSF Registries osf.io/aytus; https://osf.io/aytus International Registered Report Identifier (IRRID)DERR1-10.2196/55209

Abstract Localization in underwater wireless sensor network (UWSN) faces an imminent threat when the triangulating anchor node starts to malfunction. Traditional geometric approaches are insufficient to cope with the survivability of UWSN topology. To address these issues, this paper presents a symplectic geometry for identification of the malicious anchor node. Consequently, a geodesic search algorithm (GSA) based Target localization is proposed which reduces the positioning error by exploiting the phase-space constancy of the underwater acoustic sensor network topology to effectively triangulate the target node despite its mobility. First, a malicious anchor node model is presented. The node movement is expressed in the form of “ripple region”. GSA is then proposed which effectively frees the node metastasis from anchor node geometry, thereby making the underwater system more survivable and resilient. Simulation results evaluate the survivability of the geodesic formalism in terms of the reduced penalty incurred by node movement, as well as the reduced impact of anchor node malfunction. An improvement of 13.46% and 9.26% reveals the utility of the geodesic technique in aquamarine sensor deployments, which would be beneficial in underwater resource exploration and defense planning.

The existing literature on device-to-device (D2D) architecture suffers from a dearth of analysis under imperfect channel conditions. There is a need for rigorous analyses on the policy improvement and evaluation of network performance. Accordingly, a two-stage transmit power control approach (named QSPCA) is proposed: First, a reinforcement Q-learning based power control technique and; second, a supervised learning based support vector machine (SVM) model. This model replaces the unified communication model of the conventional D2D setup with a distributed one, thereby requiring lower resources, such as D2D throughput, transmit power, and signal-to-interference-plus-noise ratio as compared to existing algorithms. Results confirm that the QSPCA technique is better than existing models by at least 15.31% and 19.5% in terms of throughput as compared to SVM and Q-learning techniques, respectively. The customizability of the QSPCA technique opens up multiple avenues and industrial communication technologies in 5G networks, such as factory automation.

Malicious anchor node is a serious issue in underwater sensor networks. This problem gets compounded under sparse deployment scenario. To overcome this issue, the authors present a Compressed Sensing for Malicious node Compensation theorem (abbreviated as CS-MC Theorem) which would be applicable to underwater localization. To counter malicious node behavior, CS-MC Theorem is justified through three lemmas. For underwater acoustic propagation, a specific L1-norm minimization method is derived. It describes the condition for unique localization of target by discretizing the target search space. Malicious node is identified by inserting the anchor nodes into the discretized grid. An insertion vector concept is introduced to determine the extent of node metastasis. Derivations are performed to prove the mathematical basis of the proposed algorithm under acoustically stratified and unstratified scenarios. Numerical results establish the feasibility of CS-MC algorithm for sparse underwater acoustic sensor network.

Objectives:. Implement a connected network between two Tele-ICU programs to support staffing and rounding during the first wave of the coronavirus disease 2019 pandemic in the United States. Design:. Proof of Concept model. Setting:. Northwell Health; a 23 Hospital, 40 ICU (500 ICU beds) healthcare organization serving the downstate NY area. During the initial coronavirus disease 2019 pandemic, Northwell Health rapidly expanded to greater than 1,000 ICU beds. The surge in patients required redeployment of noncritical care providers to the ICU bedside. The Tele-ICU program expanded from covering 176 beds pre pandemic to assisting with care for patients in approximately 450 beds via deployment of Wi-Fi-enabled mobile telehealth carts to the newly formed ICUs. Patients:. Critically ill coronavirus disease 2019 patients hospitalized at Northwell Health, NY, at any point from March 2020 to June 2020. Interventions:. To offset the shortage of critical care physicians, Northwell Health established a collaboration with the Tele-ICU program of Providence, St. Joseph Health in the state of Washington, which enabled the critical care physicians of Providence, St. Joseph Health to participate in virtual rounding on critically ill coronavirus disease 2019 patients at Northwell Health. Main Results:. We developed an innovative hybrid model that allowed for virtual rounding on an additional 40–60 patients per day by a remote critical care physician at Providence, St. Joseph Health. This was accomplished in approximately 3 weeks and provided remote care to complex patients. Conclusions:. Our findings demonstrate the proof of concept of establishing a network of connected Tele-ICU programs as a rapidly scalable and sustainable paradigm for the provision of support from critical care physicians for noncritical care teams at the bedside.

We discuss the complete invariance property with respect to homeomorphism (CIPH) over various sets of wavelets containing all orthonormal multiwavelets, all tight frame multiwavelets, all super-wavelets of length n, and all normalized tight super frame wavelets of length n.

In this paper, we establish the pathconnectedness of H-wavelet sets in a reducing subspace H of L²(R). [ABSTRACT FROM AUTHOR]

Objective: Investigate the association between Telemental Health (TMH) uptake and sociodemographic characteristics, and how TMH uptake relates to health care resource utilization and Medicaid expenditures among Mississippi Medicaid enrollees with major depression. Methods: A retrospective cohort study was conducted (2019–2020), comparing those who utilized TMH and those who did not. Results: Among the 21,239 identified enrollees, 806 (3.79%) utilized TMH. The TMH cohort was more likely to be of older age, non-Hispanic White, comprehensive managed care organization enrollees, rural residents, and from areas with a higher area deprivation index, and have higher Charlson comorbidity index scores. The TMH cohort also exhibited higher mental health-related and all-cause outpatient and emergency department utilization, along with higher Medicaid expenditures. Conclusion: As the first study investigating telehealth utilization among Mississippi Medicaid enrollees, this study highlights sociodemographic disparities in telehealth adoption. Addressing barriers hindering telehealth adoption among vulnerable populations and ensuring the availability of quality data are vital for future research. [ABSTRACT FROM AUTHOR]

Dentin dysplasia is a rare genetic condition with autosomal inheritance. In this case study, we report a male and female patient who are siblings, diagnosed with dentin dysplasia type I. They were the first affected generations in their family. The diagnosis of dentin dysplasia type I was confirmed based on the clinical and radiographic features. Dentin dysplasia I has distinctive radiographic features that differentiate it from other dentin developmental disorders. Since periodontitis and root morphology can cause early exfoliation of teeth, the goal is to provide preventive treatment for optimal oral function. [ABSTRACT FROM AUTHOR]

The present paper analyzes the Rabinowitsch fluid (RF) behavior on a pivoted curved slider with surface roughness (SR) with the aid of the perturbation technique. In order to account for the random roughness of the bearing surfaces, a stochastic random variable with a nonzero mean, variance, and skewness was taken into consideration. The averaged Reynolds equation (RE) was developed using a stochastic random variable. The load carrying capacity (LCC) and centre of pressure (COP) were obtained by solving the relevant stochastically averaged RE with appropriate boundary conditions. Bearing performance was observed to suffer as a result of transverse SR; nevertheless, the bearing system's efficiency can be increased in the case of negatively-skewed SR. It was demonstrated that, unlike a traditional lubricant, the bearing can withstand a LCC even in the absence of flow. The outcomes of the current paper can be helpful in various modern mathematical physics engineering applications. [ABSTRACT FROM AUTHOR]

The hydroperoxyalkyl radicals (˙QOOH) are known to play a significant role in combustion and tropospheric processes, yet their direct spectroscopic detection remains challenging. In this study, we investigate molecular stereo-electronic effects influencing the kinetic and thermodynamic stability of a ˙QOOH along its formation path from the precursor, alkylperoxyl radical (ROO˙), and the depletion path resulting in the formation of cyclic ether + ˙OH. We focus on reactive intermediates encountered in the oxidation of acyclic hydrocarbon radicals: ethyl, isopropyl, isobutyl, tert-butyl, neopentyl, and their alicyclic counterparts: cyclohexyl, cyclohexenyl, and cyclohexadienyl. We report reaction energies and barriers calculated with the highly accurate method Weizmann-1 (W1) for the channels: ROO˙ ˙QOOH, ROO˙ alkene + ˙OOH, ˙QOOH alkene + ˙OOH, and ˙QOOH cyclic ether + ˙OH. Using W1 results as a reference, we have systematically benchmarked the accuracy of popular density functional theory (DFT), composite thermochemistry methods, and an explicitly correlated coupled-cluster method. We ascertain inductive, resonance, and steric effects on the overall stability of ˙QOOH and computationally investigate the possibility of forming more stable species. With new reactions as test cases, we probe the capacity of various ab initio methods to yield quantitative insights on the elementary steps of combustion. [ABSTRACT FROM AUTHOR]

Importance:Given the rapid increase in telehealth utilization since the onset of the COVID-19 pandemic, it has become essential to examining the vast amount of available data on telehealth encounters to conduct more cogent, robust, and large-scope research studies to examine the utility, cost-impact, and effect on clinical outcomes that telehealth can potentially provide. However, the diversity of data collected by numerous telehealth organizations has made that type of analysis difficult. Objective:The University of Mississippi Medical Center (UMMC), a Telehealth Center of Excellence designated by the Health Resources and Services Administration, is creating a National Telehealth Data Warehouse. Design:UMMC will develop the data warehouse in Microsoft Azure and will use a data dictionary that was created by the Center for Telehealth and eHealth Law (CTeL) to support their national cost-benefit study on the use of telehealth during COVID-19. Impact:The data warehouse will provide unparalleled opportunities to conduct cost-benefit and cost-effectiveness analyses on telehealth, to develop and test quality measures specific to telehealth, and to understand how telehealth and reduce disparities in health care and expand access to care for everyone. The warehouse is expected to go live in the Summer of 2023. [ABSTRACT FROM AUTHOR]

The present investigation deals with the formulation, optimization and evaluation of sodium alginate based in situ gel of Loratadine. Sodium alginate is used as polymer and calcium carbonate was used as a cross linking agent. In situ forming polymeric formulation drug delivery systems is in sol form before administration in the body, but once administered, undergoes gelation In-Situ to form a gel. The formulation of gel depends upon factors like temperature, pH, presence of ions and ultra-violet irradiation, from which drug gets released in sustained and controlled manner. The objective of this study to develop a novel In-Situ gel system for sustained drug delivery using natural polymer. The system utilizes polymers that exhibit sol-to-gel phase transition due to change in specific physico-chemical parameters. In- Situ gel was formed at a biological pH. In vitro release studies were conducted in simulated gastric fluid and cumulative amount of drug release was analyzed by spectrophotometry. From designed set of experiments, it was evident that formulation containing 1.5% of sodium alginate control the release of drug for longer duration. The In-Situ gel exhibited the expected viscosity, pH, drug content, in-vitro gelling capacity, in-vitro floating ability, water uptake ability and sustained drug release. [ABSTRACT FROM AUTHOR]

Background Baseline diaphragmatic dysfunction (DD) at the initiation of non-invasive ventilation (NIV) correlates positively with subsequent intubation. We investigated the utility of DD detected 2 hours after NIV initiation in estimating NIV failure in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients. Methods In a prospective-cohort design, we enrolled 60 consecutive patients with AECOPD initiated on NIV at intensive care unit admission, and NIV failure events were noted. The DD was assessed at baseline (T1 timepoint) and 2 hours after initiating NIV (T2 timepoint). We defined DD as ultrasound-assessed change in diaphragmatic thickness (ΔTDI)

This paper examines the impact of silicon in the AlCrFeMnNi high-entropy alloy system, focusing on both its microstructural and mechanical properties. Alloys with varying silicon content (x = 0, 0.3, 0.6, 0.9 atomic ratio) were synthesized using vacuum arc melting. The phase formation of these high-entropy alloys was analyzed using x-ray diffraction to comprehend the alloying process behaviour. The findings revealed that the solidification of the AlCrFeMnNi alloy occurred in dendritically, with dendrite cores containing Cr, Fe, and Ni, while interdendritic regions were enriched in Al and Ni after adding Silicon. Increasing the silicon content from 0 to 0.9 led to significant improvements in microhardness and wear resistance. This improvement is attributed to the reinforcement of grain boundaries provided by silicon. The formation of an Al and Ni rich B2 phase is crucial in resisting dislocation motion and preventing further deformation. Additionally, the addition of silicon led to improved corrosion resistance, as demonstrated by potentiodynamic polarization measurements. However, a trade-off was observed between compressive strength and ductility: compressive strength increased with higher silicon concentrations, but at the expense of ductility.

Lumbar hernias are rarely encountered as compared to other ventral abdominal wall hernias and are often misdiagnosed and overlooked. They account for less than 1.5% of all abdominal hernias. Fewer than 300 cases have been reported over the past 300 years. A lumbar hernia is defined as a protrusion of intra-abdominal contents through a weakness or rupture in the posterior abdominal wall. It must be distinguished from a lipoma, cold (tuberculous) abscess or a pseudo-hernia due to local muscular paralysis. Presenting a case of 65-year-old female who came to surgery OPD with complaint of a swelling in the right lumbar area since 5 years. On examination, a smooth and non-tender swelling measuring approximately 4 x 3 cm was evident in right lumbar region. We proceeded with a lumbar ultrasound which confirmed the presence of the hernia in posterior abdominal wall. Later, the patient was admitted for surgery under spinal anaesthesia. An open approach was performed and intraoperative findings revealed retroperitoneal fat, intermuscular lipoma and a small hernia sac as contents of swelling. It is very unusual to find lumbar hernias presenting with a lipoma, as in our case, the clinical findings alone can be very confusing and increase the chances of incorrect diagnosis and subsequent treatment. Inability of clinical examination and ultrasonography alone in making an adequate diagnosis of lumbar hernia in preoperative setting mandates a routine CT/MRI for all such patients, to ensure surgeons have a correct diagnosis before proceeding for surgery. Ideal management is just like other hernias, i.e., with mesh hernioplasty either laparoscopically or through an open approach.

Abstract: The concept of super‐wavelet was introduced by Balan, and Han and Larson over the field of real numbers which has many applications not only in engineering branches but also in different areas of mathematics. To develop this notion on local fields having positive characteristic we obtain characterizations of super‐wavelets of finite length as well as Parseval frame multiwavelet sets of finite order in this setup. Using the group theoretical approach based on coset representatives, further we establish Shannon type multiwavelet in this perspective while providing examples of Parseval frame (multi)wavelets and (Parseval frame) super‐wavelets. In addition, we obtain necessary conditions for decomposable and extendable Parseval frame wavelets associated to Parseval frame super‐wavelets. [ABSTRACT FROM AUTHOR]

Objective: To study the spectrum and outcome of severe scrub typhus in adult patients and to predict the hospital mortality by organ failure on admission. Methods: This was a prospective observational cohort study conducted between July 2017 and October 2020 at the medical emergency centre of PGIMER, Chandigarh, India. One hundred and twenty-six patients aged ≥13 years were diagnosed with scrub typhus. Severe disease was defined as the presence of organ failure based on the Sequential Organ Failure Assessment (SOFA) score on admission. Results: About two-thirds of the patients were from geographic regions outside the endemic sub-Himalayan belt. Fever (99.21%) and dyspnea (79.36%) were the most frequent complaints. Respiratory failure (81.75%) was the most common organ failure, followed by hepatic (52.38%), coagulative (47.62%), circulatory (33.33%), renal (21.43%), and cerebral dysfunction (13.49%). The median (Q1, Q3) SOFA score was 8 (6, 9), and 48.41% of the patients had a quick-SOFA score ≥2. Organ supports with invasive ventilation (40.48%), vasopressors (36.51%), and renal replacement therapy (7.14%) were frequently required. The in-hospital mortality was 11.90% and was independently predicted by circulatory and hepatic failures on multivariate logistic regression (OR 11.12, 95% CI 1.73-71.31 and OR 8.49, 95% CI 1.18-61.41, respectively). Conclusions: Most patients had pulmonary dysfunction; circulatory or hepatic failure on admission strongly predicts death.

PROTEIN l-ISOASPARTYL O-METHYLTRANSFERASE (PIMT) is a protein-repairing enzyme involved in seed vigor and longevity. However, the regulation of PIMT isoforms during seed development and the mechanism of PIMT-mediated improvement of seed vigor and longevity are largely unknown., In this study in rice ( Oryza sativa), we demonstrate the dynamics and correlation of isoaspartyl (isoAsp)-repairing demands and PIMT activity, and their implications, during seed development, germination and aging, through biochemical, molecular and genetic studies., Molecular and biochemical analyses revealed that rice possesses various biochemically active and inactive PIMT isoforms. Transcript and western blot analyses clearly showed the seed development stage and tissue-specific accumulation of active isoforms. Immunolocalization studies revealed distinct isoform expression in embryo and aleurone layers. Further analyses of transgenic lines for each OsPIMT isoform revealed a clear role in the restriction of deleterious isoAsp and age-induced reactive oxygen species (ROS) accumulation to improve seed vigor and longevity., Collectively, our data suggest that a PIMT-mediated, protein repair mechanism is initiated during seed development in rice, with each isoform playing a distinct, yet coordinated, role. Our results also raise the intriguing possibility that PIMT repairs antioxidative enzymes and proteins which restrict ROS accumulation, lipid peroxidation, etc. in seed, particularly during aging, thus contributing to seed vigor and longevity. [ABSTRACT FROM AUTHOR]

In this paper it is investigated as to when a nonempty invariant closed subset A of a S1-space X containing the set of stationary points (S) can be the fixed point set of an equivariant continuous selfmap on X and such space X is said to possess the S- equivariant complete invariance property (S-ECIP). It is also shown that if X is a metric space and S1 acts on X × S1 by the action (x, p) · q = (x, p · q), where p, q ∈ S1 and x ∈ X, then the hyperspace 2X×S1 of all nonempty compact subsets of X × S1 has the S-ECIP. [ABSTRACT FROM AUTHOR]

The contamination of surface- and groundwater by the leaching of solid wastes generated by industrial activities as a result of water runoff and rainfall is a matter of great concern. The leachates from tannery solid waste (TSW), a major environmental pollutant, were examined for their possible genotoxic effects on the somatic cells of Vicia faba. Leachates were prepared from solid wastes procured from leather-tanning industrial sites, and V. faba seedlings were exposed to three test concentrations, 2.5%, 5%, and 10%, through soil and aqueous media for 5 days. The root tips examined for cytogenetic damage revealed that leachate of TSW significantly inhibited the mitotic index and induced significantly frequent chromosomal and mitotic aberrations (CA/MA) in a dose-dependent manner. The chemical analysis of TSW samples revealed that the chief constituents were chromium and nickel, which may cause genetic abnormalities. The frequency of aberrations was found to be higher in the root meristematic cells of Vicia faba exposed through the aqueous medium than those exposed through the soil medium. The results of the present study indicated that contamination of potable water bodies by leachates of TSW may cause genotoxicity. For the biomonitoring of complex mixtures of toxicants with the V. faba bioassay, the use of the aqueous medium seems to be a more promising method than the use of the soil medium. © 2004 Wiley Periodicals, Inc. Environ Toxicol 19: 129–133, 2004. [ABSTRACT FROM AUTHOR]

Background: Supraglottic airway devices now have an established place in pediatric anesthesia practice. The laryngeal tube suction (LTS) II, a recent revision of the LTS, has very few studies evaluating its use in pediatric patients. The aim of this study was to compare insertion and ventilation profiles of the LTS-II size 2 and the ProSeal™ Laryngeal Mask Airway (PLMA) size 2 in pediatric patients undergoing elective surgeries. Materials and Methods: A randomized prospective study was conducted in 100 children aged 2–5 years between 12 and 25 kg weight, of the American Society of Anesthesiologists physical status I and II scheduled for routine elective surgeries of

Objective: Investigate the association between Telemental Health (TMH) uptake and sociodemographic characteristics, and how TMH uptake relates to health care resource utilization and Medicaid expenditures among Mississippi Medicaid enrollees with major depression. Methods: A retrospective cohort study was conducted (2019-2020), comparing those who utilized TMH and those who did not. Results: Among the 21,239 identified enrollees, 806 (3.79%) utilized TMH. The TMH cohort was more likely to be of older age, non-Hispanic White, comprehensive managed care organization enrollees, rural residents, and from areas with a higher area deprivation index, and have higher Charlson comorbidity index scores. The TMH cohort also exhibited higher mental health-related and all-cause outpatient and emergency department utilization, along with higher Medicaid expenditures. Conclusion: As the first study investigating telehealth utilization among Mississippi Medicaid enrollees, this study highlights sociodemographic disparities in telehealth adoption. Addressing barriers hindering telehealth adoption among vulnerable populations and ensuring the availability of quality data are vital for future research.

Importance: Given the rapid increase in telehealth utilization since the onset of the COVID-19 pandemic, it has become essential to examining the vast amount of available data on telehealth encounters to conduct more cogent, robust, and large-scope research studies to examine the utility, cost-impact, and effect on clinical outcomes that telehealth can potentially provide. However, the diversity of data collected by numerous telehealth organizations has made that type of analysis difficult. Objective: The University of Mississippi Medical Center (UMMC), a Telehealth Center of Excellence designated by the Health Resources and Services Administration, is creating a National Telehealth Data Warehouse. Design: UMMC will develop the data warehouse in Microsoft Azure and will use a data dictionary that was created by the Center for Telehealth and eHealth Law (CTeL) to support their national cost-benefit study on the use of telehealth during COVID-19. Impact: The data warehouse will provide unparalleled opportunities to conduct cost-benefit and cost-effectiveness analyses on telehealth, to develop and test quality measures specific to telehealth, and to understand how telehealth and reduce disparities in health care and expand access to care for everyone. The warehouse is expected to go live in the Summer of 2023.

Background: Delirium affects up to 80% of patients in the intensive care unit (ICU) but is missed in up to 75% of cases. Telehealth in the ICU (tele-ICU) has become the standard for providing timely, expert care to remotely located ICUs., Objectives: This pilot study assessed the feasibility and acceptability of using tele-ICU to increase the accuracy of delirium screening and recognition by ICU nurses., Methods: The pilot sites included 4 ICUs across 3 hospitals. A geriatrician with delirium expertise remotely observed 13 bedside ICU nurses administering the Confusion Assessment Method for the ICU (CAM-ICU) to patients in real time via the tele-ICU platform and subsequently provided training on CAM-ICU performance and delirium management. Training evaluation consisted of a validated spot check form, a 2-item satisfaction/change-of-practice survey, and a qualitative question on acceptability., Results: Thirteen ICU nurses were observed performing 26 bedside delirium assessments. The top observed barriers to accurate delirium screening were CAM-ICU knowledge deficits, establishment of baseline cognition, and inappropriate use of the "unable to assess" designation. The mean percentage of correct observations improved from 40% (first observation) to 90% (second observation) (P < .001). All 13 nurses strongly agreed that the training was beneficial and practice changing., Conclusions: The use of tele-ICU to improve the accuracy of delirium screening by ICU nurses appears to be feasible and efficient for leveraging delirium expertise across multiple ICUs. Future studies should evaluate the effects of tele-ICU delirium training on patient-centered outcomes., (©2022 American Association of Critical-Care Nurses.)