β-hydroxybutyrate recapitulates the beneficial effects of ketogenic metabolic therapy in polycystic kidney disease.

Autosomal-dominant polycystic kidney disease (ADPKD) is a common monogenic disease characterized by the formation of fluid-filled renal cysts, loss of mitochondrial function, decreased fatty acid oxidation, increased glycolysis, and likely renal failure. We previously demonstrated that inducing a state of ketosis ameliorates or reverses PKD progression in multiple animal models. In this study, we compare time-restricted feeding and 48-h periodic fasting regimens in both juvenile and adult Cy/+ rats.

Using Assigned Peer Discussants to Enhance Engagement and Feedback for Student Presentations.

Nursing students are frequently assigned to provide case or topical presentations in class. They are often nervous about presenting, which can distract them from learning from peers. Faculty introduced the role of the assigned discussant to enhance engagement and enable peer feedback in real time.

Implementation of a Standardized Red Blood Cell Transfusion Policy in a Level IV Neonatal Intensive Care Unit: A Quality Improvement Project.

Background: Within the neonatal intensive care unit (NICU), infants frequently receive packed red blood cell (PRBC) transfusions. Although medically necessary, potential negative long- and short-term outcomes exist following PRBC transfusions in very low birth-weight (VLBW) infants (<1500 g). Synthesis of the literature demonstrates that the use of a restrictive PRBC transfusion policy can lead to a decreased number of transfusions administered with no increase in long-term neurodevelopmental outcomes.

Preceptors and the New Neonatal Nurse Practitioner Educational World.

The need for neonatal nurse practitioner (NNP) preceptors has never been greater. Precepting is a professional responsibility with both rewards and challenges. The recent pandemic has brought about new challenges, not the least of which is burnout from clinical, learner, and environmental demands.

Preservative-Free versus Benzalkonium Chloride-Preserved Latanoprost Ophthalmic Solution in Patients with Primary Open-Angle Glaucoma or Ocular Hypertension: A Phase 3 US Clinical Trial.

Purpose: To evaluate the safety and efficacy of a preservative-free latanoprost 0.005% formulation (T2345) in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT) compared to benzalkonium chloride-preserved latanoprost 0.005% (BPL) formulation in the United States (US).

Cleavage fragments of the C-terminal tail of polycystin-1 are regulated by oxidative stress and induce mitochondrial dysfunction.

Mutations in the gene encoding polycystin-1 (PC1) are the most common cause of autosomal dominant polycystic kidney disease (ADPKD). Cysts in ADPKD exhibit a Warburg-like metabolism characterized by dysfunctional mitochondria and aerobic glycolysis. PC1 is an integral membrane protein with a large extracellular domain, a short C-terminal cytoplasmic tail and shares structural and functional similarities with G protein-coupled receptors.

A Rare Case of Neonatal Disseminated Herpes Simplex Virus (HSV) With Concomitant Methicillin-Sensitive Staphylococcus aureus (MSSA) Bacteremia.

Background: Neonatal herpes simplex virus (HSV) infections can be challenging to diagnose and often occur without maternal history of infection. Routine initial pharmacologic management when a neonate presents with signs of sepsis in the first weeks of life typically targets antibiotic therapies. This case illustrates the importance of the addition of antiviral coverage, especially when a neonate demonstrates temperature instability and neurologic changes.

Virtual Interprofessional Learning Due to COVID-19.

Background: The COVID-19 pandemic necessitated sweeping changes in a neonatal nurse practitioner (NNP) program's approach to distance-accessible learning. Prioritizing student learning and safety, we developed a new alternative model for individualized simulation.

Method: The scenario created for a student to deliver an unexpected diagnosis of trisomy 21, or Down syndrome, to a postpartum mother was redesigned to take place using web-conference technology.

Innovative Approach to Procedure Skills: A Nurse Practitioner Educator's Response to COVID-19.

Background: The The Neonatal Nurse Practitioner program at The Ohio State University transitioned from a traditional face-to-face program to a distance-enhanced hybrid model providing course content online with campus visits for procedural skills and simulation in 2017. Although the 2020 COVID-19 pandemic necessitated cancellation of all in-person events across the university, the neonatal nurse practitioner students' learning needs remained the same.

Method: The onsite experience was redesigned for virtual delivery.

Correlation Between Heart Rate Characteristic Index Score and Severity of Brain Injury in Neonates With Hypoxic-Ischemic Encephalopathy.

Background: Hypoxic-ischemic encephalopathy (HIE) remains devastating for neonates despite widespread treatment with therapeutic hypothermia (TH). The heart rate characteristic (HRC) index score, a measure of heart rate variability, could prove useful in the management of neonates with HIE as new therapies emerge or when withdrawal-of-support decisions are being considered.

Purpose: The main purpose was to describe correlation between HRC index scores and brain magnetic resonance imaging (MRI) severity of injury for neonates with HIE.

The Effect of Education on Chlorhexidine Use in the NICU.

Background: Neonates are at greater risk for central line-associated bloodstream infection (CLABSI) because of prolonged vascular access for nutrition and medications. Skin antisepsis using chlorhexidine gluconate (CHG), particularly the formulation with alcohol (CHG/alcohol), during central line insertion and maintenance activities is a key clinical care process associated with CLABSI reduction. One area of ongoing confusion for many clinicians is whether to adhere to the manufacturer's recommendations that CHG remain on the skin following the procedure to promote persistent microbicidal effects or to foster product removal in hopes of preventing skin-related complications.

Neonatal Peripherally Inserted Central Catheter Practices and Providers: Results From the Neonatal PICC1 Survey.

Background: Neonatal intensive care units (NICUs) commonly utilize peripherally inserted central catheters (PICCs) to provide nutrition and long-term medications to premature and full-term infants. However, little is known about PICC practices in these settings.

Purpose: To assess PICC practices, policies, and providers in NICUs.

Comparison of Outcomes of Resident-performed Ahmed Valve Implantation vs Trabeculectomy.

Aims: To compare outcomes of resident-performed Ahmed valve surgery vs trabeculectomy in a Veteran Affairs medical facility.

Materials And Methods: A retrospective cohort of 103 eyes in 91 patients receiving Ahmed valve (valve) or trabeculectomy (trab) performed at a Veterans Administration Medical Center by residents in their third year of training. The primary outcomes included intraocular pressure (IOP), treatment failure, and complications over 1 year.

Neonatal peripherally inserted central catheter practices and their association with demographics, training, and radiographic monitoring: results from a national survey.

The goal of this secondary analysis of results from a national survey of peripherally inserted central catheters (PICCs) practices in neonates was to determine whether demographics and types of training were associated with differing radiographic confirmation practices of these catheters. Correlational analyses were performed on the 2010 national database of neonatal PICC practices. The sample consisted of 187 respondents, representing 25% of the level III neonatal intensive care units (NICUs) of more than 20 beds in the United States.

A national survey of neonatal peripherally inserted central catheter (PICC) practices.

Purpose: The purpose of this study was to assess and describe the practices involved in the insertion and maintenance of peripherally inserted central catheters (PICCs) in neonates in level III neonatal intensive care units (NICUs) in the United States and to compare the findings with current recommendations and evidence.

Subjects: The study included responses from 187 nurses, nurse practitioners, and neonatologists who place PICCs in NICUs representing 43 states.

Methods: A 90-question, multiple-choice survey of a variety of PICC practices was sent to NICU directors and nursing staff responsible for PICC insertion.

Association of strength of religious adherence with attitudes regarding glaucoma or ocular hypertension.

Background: To evaluate the impact of religious adherence on a patient's outlook on disease in a glaucoma population.

Methods: A prospective survey analysis of patients with open-angle glaucoma or ocular hypertension evaluating self-reported global religious adherence, adherence to specific basic activities and knowledge of faith ('maturity') and 'comfort' (ability to cope, attitude toward glaucoma, motivation to take medication and God's concern). This specific analysis was limited to self-professed Christians.

Repositioning techniques for malpositioned neonatal peripherally inserted central catheters.

The utilization of Peripherally Inserted Central Catheters (PICCs) has grown to become a common practice in neonatal care. Proper placement of the catheter in the superior vena cava (SVC) is essential to support safe delivery of care and minimize complications. This article describes three cases of patients whose catheters were malpositioned on initial placement or while in situ, that were successfully guided to appropriate tip location in the superior vena cava by implementing a combination of non-invasive catheter repositioning techniques.