35 (31- 34) min, P = 0.000]. After operation, ventilation times [19 (16 - 24) h vs. 24 (17 - 43) h, P = 0.046] and ICU stay [41 (34 - 58) h vs. 54 (42 - 85) h, P = 0.002] were significantly shorter in the MI group compared with the MO group. Total arch replacement combined with FET at mild hypothermia circulatory arrest with lower body antegrade perfusion via single upper hemisternotomy approach is safe and feasible with significantly shorter time of circulatory arrest compared with no LBP.Total arch replacement combined with FET at mild hypothermia circulatory arrest with lower body antegrade perfusion via single upper hemisternotomy approach is safe and feasible with significantly shorter time of circulatory arrest compared with no LBP.While some have claimed that a median sternotomy is an 'unkind cut,' when this incision is performed, closed, and managed optimally, it can be one of the 'most kind cuts' used for major operations. The median sternotomy is the most commonly used incision for coronary artery bypass surgery, which is the most common operation performed in the United States at the current time. This approach is, of course, used for many other cardiac and thoracic operations, as well. It is, however, also one of the most misunderstood procedures in Surgery. Because it is an incision that even a novice surgical resident can perform, with proper supervision, the subtleties and nuances of not only opening but also of closing sternotomies are not often conveyed optimally to our trainees. In this treatise we will attempt to comprehensively address these subtleties, nuances, and misunderstandings, both for the benefit of our younger learners, but also, and more importantly, for the benefit of our patients.Septic shock and disseminated intravascular coagulation (DIC) are knowingly characterized by an endothelial cell dysfunction. The molecular mechanisms underlying this relationship are, however, poorly understood. In this work, me aimed at investigating human circulating interferon-α (IFN-α) in septic shock-induced DIC patients and tested the potential role of endothelial Stat1 as a therapeutic target in a mouse model of sepsis. For this, circulating type I, II and III IFNs and procoagulant microvesicles were quantified in a prospective cohort of septic shock patients. Next, we used a septic shock model induced by cecal ligation and puncture (CLP) in wild-type (WT) mice, in Ifnar1 (type I IFN receptor subunit 1)-knockout (KO) mice, as well as in Stat1 (Signal transducer and activator of transcription 1) conditional KO mice. In humans samples, we observed higher levels of circulating IFN-α and IFN-α1 in DIC compared to non-DIC patients, while levels of IFN-β, IFN-γ, IFN-λ1, IFN-λ2, IFN-λ3 were not different. IFN-α level was positively correlated with CD105-microvesicle levels, reflecting endothelial injury. In Ifnar1-/- mice, CLP did not induce septic shock and was characterized by lesser endothelial cell injury, with lower aortic inflammatory cytokine expression, endothelial inflammatory-related genes expression and fibrinolysis. In mice in which Stat1 was specifically ablated in endothelial cells, a marked protection against sepsis was also observed, suggesting the relevance of an endothelium-targeted strategy. Our work highlights the key roles of type I interferons as pathogenic players in septic shock-induced DIC and the potential pertinence of endothelial STAT1 as a therapeutic target. Patients with pulmonary hypertension admitted to pediatric cardiac intensive care units are at high risk of mortality. We identified factors associated with mortality in cardiac critical care admissions with pulmonary hypertension. We evaluated pulmonary hypertension medical admissions to Pediatric Cardiac Critical Care Consortium (PC4) institutions over five years. Pulmonary hypertension was standardly defined in the clinical registry by diagnosis and/or receipt of intensive care-level pulmonary vasodilator therapy. Multivariable logistic regression identified independent associations with mortality. We analyzed 2,602 admissions; mortality was 10% versus 3.9% for all other medical admissions. Covariates most strongly associated with mortality included invasive ventilation (adjusted odds ratio 44.8, 95% confidence interval 6.2-323), non-invasive ventilation (19.7, 2.8-140), cardiopulmonary resuscitation (8.9, 5.6-14.1), and vasoactive infusions (4.8, 2.6-8.8). Patients receiving both invasive ventilatity compared to those who did not. These data highlight the illness severity of pulmonary hypertension patients in this setting and could help inform conversations with families regarding prognosis.Buprenorphine is one of the gold standard medication treatments for opioid use disorder (OUD), with proven effectiveness in preventing overdose, increasing abstinence, and improving quality of life. In the United States, buprenorphine can be legally prescribed and administered in office-based settings from clinicians who are specially credentialed to provide that care under the X-waiver. We believe the X-waiver will ultimately be repealed, but there is a need for a variety of strategies to create a new treatment system after the X-waiver. Building a new tier of treatment capacity will require educational outreach, systems strategies, and enhanced payments.Purpose We assessed the feasibility and acceptability of a 12-week telehealth behavior change intervention to promote physical activity and fruit and vegetable consumption among rural-living young adult cancer survivors.Methods Participants met with a health coach once a week for 60 minutes for 12 weeks. 2-Cl-IB-MECA Feasibility measures included rates of recruitment, enrollment, attrition, retention, adherence, and missing data. Acceptability was assessed using semi-structured interviews.Findings Over 1-year, 18 individuals self-referred, 9 were eligible and consented to participate, and 2 dropped out. Retention was 74% and adherence was 95%. Participants considered the length of the intervention, synchronous communication with the health coach, and the distance-based delivery mode to be acceptable. Moreover, participants described key behavior change techniques and recommended minor changes.Implications Findings provide information that can help refine future trials seeking to increase access to behavior change interventions and optimize participation in health-promoting behaviors for underserved populations.