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BackgroundExtracorporeal membrane oxygenation (ECMO) represents an important but limited treatment for patients with severe COVID-19. We assessed the effects of an educational intervention on a person's ECMO care preference and examined whether patients and providers had similar ECMO preferences.MethodsIn the Video+Survey group, patients watched an educational video about ECMO's purpose, benefits, and risks followed by an assessment of ECMO knowledge and care preferences in seven scenarios varying by hypothetical patient age, function, and comorbidities. Patients in the Survey Only group and providers didn't watch the video. Logistic regression was used to estimate the probability of agreement for each ECMO scenario between the two patient groups and then between all patients and providers.ResultsVideo+Survey patients were more likely (64% vs. 17%; p = 0.02) to correctly answer all ECMO knowledge questions than Survey Only patients. Patients in both groups agreed that ECMO should be considered across all hypothetical scenarios, with predicted agreement above 65%. In adjusted analyses, patients and providers had similar predicted agreement for ECMO consideration across six of the seven scenarios, but patients showed greater preference (84% vs. 41%, p = 0.003) for the scenario of a functionally dependent 65-year-old with comorbidities than providers.Discussion and conclusionsAn educational video increased a person's ECMO knowledge but did not change their ECMO preferences. Clinicians were less likely than patients to recommend ECMO for older adults, so advanced care planning discussion between patients and providers about treatment options in critically ill patients with COVID-19 is critical.

Presents a study that probed the inhomogeneities of diamond crystallites grown with an oxygen-acetylene flame on a scratched silicon surface. Use of micro-Raman spectroscopy; Surface temperature profile; Comparison of the profile with the observed inhomogeneities in the crystallites; Dominant factor contributing to the diamond crystallite inhomogeneities.

The article discusses the history of the medico-legal system from the mid-1970s and forensic malfeasance and its breakdown role in justice of death investigation system in Mississippi. It informs that the Mississippi legislature had refused to adapt medico-legal's forensic science in its courtrooms. It presents suggestions from the Mississippi legislature to reform the system and also make further recommendations for its improvement.