Introduction of the Development Nurse Role to Advance Critical Thinking Skills of New Nurses.

This article explores the development and implementation of an innovative method for advancing critical thinking and skill development among new nurses after initial orientation. By creating a development nurse role, this pediatric intensive care unit was able to better train and retain its staff. Features of this program are generalizable to nursing units across various settings.

Utility of angiotensin-converting enzyme and serum calcium levels in cutaneous sarcoidosis.

Background: Sarcoidosis is a granulomatous disease of unknown etiology but is theorized to result from immune overactivity in the setting of an environmental or genetic trigger. It most commonly affects the lungs and lymph nodes but can affect other organ systems, with cutaneous involvement in 30% of patients. The granulomas associated with sarcoidosis lead to increased activity of angiotensin-converting enzyme (ACE) and 1α-hydroxylase resulting in an uncontrolled synthesis of 1,25-dihydroxyvitamin D3 by macrophages, along with elevated serum ACE and calcium levels.

Implementation of an Intensive Telehealth Intervention for Rural Patients with Clinic-Refractory Diabetes.

Background: Rural patients with type 2 diabetes (T2D) may experience poor glycemic control due to limited access to T2D specialty care and self-management support. Telehealth can facilitate delivery of comprehensive T2D care to rural patients, but implementation in clinical practice is challenging.

Objective: To examine the implementation of Advanced Comprehensive Diabetes Care (ACDC), an evidence-based, comprehensive telehealth intervention for clinic-refractory, uncontrolled T2D.

Automatic wide complex tachycardia differentiation using mathematically synthesized vectorcardiogram signals.

Background: Automated wide complex tachycardia (WCT) differentiation into ventricular tachycardia (VT) and supraventricular wide complex tachycardia (SWCT) may be accomplished using novel calculations that quantify the extent of mean electrical vector changes between the WCT and baseline electrocardiogram (ECG). At present, it is unknown whether quantifying mean electrical vector changes within three orthogonal vectorcardiogram (VCG) leads (X, Y, and Z leads) can improve automated VT and SWCT classification.

Methods: A derivation cohort of paired WCT and baseline ECGs was used to derive five logistic regression models: (i) one novel WCT differentiation model (i.

Differentiating wide complex tachycardias: A historical perspective.

One of the most critical and challenging skills is the distinction of wide complex tachycardias into ventricular tachycardia or supraventricular wide complex tachycardia. Prompt and accurate differentiation of wide complex tachycardias naturally influences short- and long-term management decisions and may directly affect patient outcomes. Currently, there are many useful electrocardiographic criteria and algorithms designed to distinguish ventricular tachycardia and supraventricular wide complex tachycardia accurately; however, no single approach guarantees diagnostic certainty.

Conceptual and literature basis for wide complex tachycardia and baseline ECG comparison.

Accurate wide QRS complex tachycardia (WCT) differentiation into either ventricular tachycardia or supraventricular wide complex tachycardia using 12‑lead electrocardiogram (ECG) interpretation is essential for diagnostic, therapeutic, and prognostic reasons. There is an ever-expanding variety of WCT differentiation methods and criteria available to clinicians. However, only a few make use of the diagnostic value of comparing the ECG during WCT to that of the patient's baseline ECG.

Increased risk of hematoma with uninterrupted warfarin in patients undergoing implantation of subcutaneous implantable cardioverter defibrillator.

Background: The perioperative management of anticoagulation with the use of subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation is still evolving.

Objective: The purpose of this study was to assess whether it is safe to perform S-ICD implantation with uninterrupted warfarin.

Methods: This is a multi-center retrospective review of patients undergoing S-ICD implantation between October 1, 2012 and June 30, 2017.

Perioperative management of oral anticoagulation in patients undergoing implantation of subcutaneous implantable cardioverter-defibrillator.

Background: The perioperative anticoagulation management during subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation is still evolving.

Objective: The purpose of this study was to assess whether it is safe to perform S-ICD implantation with uninterrupted warfarin.

Methods: This is a single-center retrospective review of patients undergoing S-ICD implantation between October 1, 2012 and June 30, 2017.

Role of exercise electrocardiogram to screen for T-wave oversensing after implantation of subcutaneous implantable cardioverter-defibrillator.

Background: During early experience with subcutaneous implantable cardioverter-defibrillators (S-ICD), several patients had inappropriate shocks from T-wave oversensing (TWOS) during exercise. This prompted some operators to perform routine treadmill exercise tests after implantation of S-ICD to screen for TWOS. Meanwhile, improvements have been made in the detection algorithms by the manufacturer.

Discriminant analysis of fecal bacterial species composition for use as a phenotypic microbial source tracking method.

A rapidly growing method to identify origins of nonpoint source (NPS) pollution is microbial source tracking (MST). Current MST research utilizes either an organism's genetic or physiological traits to establish source identification. To determine if an MST method based on fecal bacterial species composition can be used to determine sources of NPS pollution, samples from known NPS contributors (human, cattle, poultry, and swine) were collected and analyzed for fecal coliform (FC) and fecal streptococci (FS).

Signs of resilience: assets that support deaf adults' success in bridging the deaf and hearing worlds.

A multiple-case exploratory study is used to describe intrapersonal, behavioral, and environmental assets that may build bridges for Deaf adults between the Deaf and hearing worlds. A study of three exemplary former community college students provides new information about internal resources that may empower Deaf individuals to achieve work and social success in interaction with environmental support, despite the vulnerabilities associated with their deafness. This study identifies 15 assets that may support resilience in Deaf adults, including authenticity and comfort with solitude.

Thiophosphate phase diagrams developed in conjunction with the synthesis of the new compounds KLaP(2)S(6), K(2)La(P(2)S(6))(1/2)(PS(4)), K(3)La(PS(4))(2), K(4)La(0.67)(PS(4))(2), K(9-)(x)La(1+x/3)(Ps(4))(4) (x = 0.5), K(4)Eu(PS(4))(2), and KEuPS(4).

An alkali-metal sulfur reactive flux has been used to synthesize a series of quaternary rare-earth metal compounds. These include KLaP(2)S(6) (I), K(2)La(P(2)S(6))(1/2)(PS(4)) (II), K(3)La(PS(4))(2) (III), K(4)La(0.67)(PS(4))(2) (IV), K(9-x)La(1+x/3)(PS(4))(4) (x = 0.

Selenophosphate phase diagrams developed in conjunction with the synthesis of the new compounds K(2)La(P(2)Se(6))(1/2)(PSe(4)), K(3)La(PSe(4))(2), K(4)La(0.67)(PSe(4))(2), K(9-x)La(1+x/3)(PSe(4))(4) (x = 0.5), and KEuPSe(4).

Five new rare-earth metal polyselenophosphates have been synthesized by the reactive flux method and characterized by single-crystal X-ray diffraction: K(2)La(P(2)Se(6))(1/2)(PSe(4)) (I), K(3)La(PSe(4))(2) (II), K(4)La(0.67)(PSe(4))(2) (III), K(9-x)()La(1+)(x/3)(PSe(4))(4) (x = 0.5) (IV), and KEuPSe(4) (V).

Synthesis and characterization of four new europium group XIV chalcogenides: K(2)EuTSe(5) and KEuTS(4) (T = Si, Ge).

Four europium group XIV chalcogenides have been synthesized using the reactive flux method: K(2)EuTSe(5) (I, II) and KEuTS(4) (III, IV) where T = Si, Ge. K(2)EuSiSe(5), I, crystallizes in the monoclinic space group P2(1)/c with cell parameters a = 11.669(3) A, b = 9.

Nutrient conversions by photosynthetic bacteria in a concentrated animal feeding operation lagoon system.

A diurnal examination was conducted to determine the effect of photosynthetic bacteria on nutrient conversions in a two-stage concentrated animal feeding operation (CAFO) lagoon system in west-central Oklahoma. Changes in nutrients, microbial populations, and physical parameters were examined at three depths (0, 1.5, and 3.

Hepatic export of glutathione and uptake of constituent amino acids, glutamate and cysteine, in broilers in vivo.

This study was conducted to document the glutathione (GSH) cycle (interorgan circulation of GSH) in broilers in vivo. Two experiments were conducted on 36 anesthetized male broilers (n = 6 per treatment) implanted with cannulae in the carotid artery, hepatic portal, and hepatic veins. Plasma GSH, glutamate, cysteine, cystine, and cysteinylglycine levels in each vessel were monitored following a bolus injection [Experiment (Exp.

The magnitude of reproductive wastage to lamb marking in 30 Merino flocks in south-west Queensland.

Thirty groups of Merino ewes in 6 districts of south-west Queensland were studied between 1976 and 1985 to determine the magnitude of reproductive wastage to lamb making. Relatively high pregnancy rates (77 to 100%, mean 93%) and a wide range of lamb marking percentages (10 to 115%, mean 78%) were recorded. The mean reproductive wastage due to failure to mate and failure to lamb was low (1.