Clinical impacts of utilizing ceftriaxone and metronidazole versus piperacillin/tazobactam in patients diagnosed with complicated diverticulitis.

Background: The optimal antibiotic regimen to empirically treat complicated diverticulitis has not been well established in guidelines.

Methods: A 5-year retrospective cohort study was conducted with 322 patients admitted to Mayo Clinic hospitals for complicated diverticulitis. Outcomes for 89 patients treated with ceftriaxone and metronidazole were compared to 233 patients treated with piperacillin/tazobactam.

Hypertension and cerebral blood flow in the development of Alzheimer's disease.

Introduction: We investigated the interactive associations between amyloid and hypertension on the entorhinal cortex (EC) tau and atrophy and the role of cerebral blood flow (CBF) as a shared mechanism by which amyloid and hypertension contribute to EC tau and regional white matter hyperintensities (WMHs).

Methods: We analyzed data from older adults without dementia participating in the Add-Tau study (NCT02958670, n = 138) or Alzheimer's Disease Neuroimaging Initiative (ADNI) (n = 523) who had available amyloid-positron emission tomography (PET), tau-PET, fluid-attenuated inversion recovery (FLAIR), and T1-weighted magnetic resonance imaging (MRI). A subsample in both cohorts had available arterial spin labeling (ASL) MRI (Add-Tau: n = 78; ADNI: n = 89).

Perspectives of pediatric oncologists on referral for CAR-T therapy: a mixed methods pilot study.

Background: Receipt of chimeric antigen receptor T-cell (CAR-T) therapy at an institution different from the primary oncologist's institution is a complex, multistep process. Referral by oncologists plays an important role in the process but may be susceptible to bias.

Methods: Oncologists who previously referred patients for CAR-T therapy at 5 pediatric hospitals were sent surveys by email exploring their CAR-T referral practices.

Formation of Doubly and Triply Charged Fullerene Dimers in Superfluid Helium Nanodroplets.

Sequential ionization of fullerene cluster ions (C_{60})_{n}^{+} within multiply charged helium nanodroplets leads to the intriguing phenomenon of forming and stabilizing doubly and triply charged fullerene oligomers. While the formation of doubly charged dimers (C_{60})_{2}^{2+} has been predicted in earlier studies, the observation of even triply charged ones (C_{60})_{2}^{3+} is highly surprising. This remarkable resilience against Coulomb explosion is achieved through efficient cooling within the superfluid environment of helium nanodroplets and a sequential ionization scheme that populates covalently bound or physisorbed fullerene dimers.

Screening for oncogenic AF1q expression predicts disease recurrence in gastric cancer patients.

AF1q associates with tumor progression and metastases upon WNT signaling. The downstream WNT target CD44 has demonstrated prognostic significance in gastric cancer (GC). This study evaluates the impact of AF1q on tumor stage and survival in GC patients.

Barriers and facilitators to screen for and address social needs in primary care practices in Maryland: a qualitative study.

Background: Social needs screening can help modify care delivery to meet patient needs and address non-medical barriers to optimal health. However, there is a need to understand how factors that exist at multiple levels of the healthcare ecosystem influence the collection of these data in primary care settings.

Methods: We conducted 20 semi-structured interviews involving healthcare providers and primary care clinic staff who represented 16 primary care practices.

Task-induced deactivation dysfunction during reward processing is associated with low self-esteem in a possible subtype of major depression.

Introduction: Low self-esteem is a frequent symptom in major depressive disorder (MDD). This functional magnetic resonance imaging study investigated whether MDD patients with low self-esteem show a distinct neural pathophysiology. Previous studies linked low self-esteem to reduced task-induced deactivation of the pregenual anterior cingulate cortex (pgACC) as a part of the default mode network, and to reduced connectivity between pgACC and reward system.

Age-Friendly Health Systems and Meeting the Principles of High Reliability Organizations in the VHA.

Background: The Veterans Health Administration (VHA) is the largest integrated health care system in the US, providing care to more than 9 million enrolled veterans. In February 2019, the VHA identified key actionable steps to become a high reliability organization (HRO), transforming how employees think about patient safety and care quality. The VHA is also working toward becoming the largest age-friendly health system in the US to be recognized by the Institute for Healthcare Improvement for its commitment to providing care guided by the 4Ms (what matters, medication, mentation, and mobility), causing no harm, and aligning care with what matters to older veterans.

[Factors in the implementation of expert standards in nursing: A qualitative study].

Factors in the implementation of expert standards in nursing: A qualitative study Many German health and long-term care facilities face the challenge of implementing expert standards in practice. Implementation models, such as the Consolidated Framework for Implementation Research (CFIR), support the implementation process by identifying the relevant influencing factors that can determine the success of an implementation. Aim: The aim was to identify the factors influencing the implementation of expert standards in nursing care and their interactions.

Size limits and fission channels of doubly charged noble gas clusters.

Small, highly charged liquid droplets are unstable with respect to spontaneous charge separation when their size drops below the Rayleigh limit or, in other words, their fissility parameter exceeds the value 1. The absence of small doubly charged atomic cluster ions in mass spectra below an element-specific appearance size has sometimes been attributed to the onset of barrierless fission at = 1. However, more realistic models suggest that marks the size below which the rate of fission surpasses that of competing dissociative channels, and the Rayleigh limit of doubly charged van der Waals clusters has remained unchartered.

Liraglutide 3.0 mg once daily for the treatment of overweight and obesity in patients hospitalised at a forensic psychiatric department: A 26-week open-label feasibility study.

Introduction: Overweight and obesity constitute a major concern among patients treated at forensic psychiatric departments. The present clinical feasibility study aimed at investigating the extent to which glucagon-like peptide 1 receptor agonist (GLP-1RA) treatment with once-daily liraglutide 3.0 mg could be a feasible pharmacological treatment of these conditions in patients with schizophrenia spectrum disorders hospitalised in forensic psychiatry.

Understanding social needs screening and demographic data collection in primary care practices serving Maryland Medicare patients.

Background: Health outcomes are strongly impacted by social determinants of health, including social risk factors and patient demographics, due to structural inequities and discrimination. Primary care is viewed as a potential medical setting to assess and address individual health-related social needs and to collect detailed patient demographics to assess and advance health equity, but limited literature evaluates such processes.

Methods: We conducted an analysis of cross-sectional survey data collected from n = 507 Maryland Primary Care Program (MDPCP) practices through Care Transformation Requirements (CTR) reporting in 2022.

White matter hyperintensity patterns: associations with comorbidities, amyloid, and cognition.

Background: White matter hyperintensities (WMHs) are often measured globally, but spatial patterns of WMHs could underlie different risk factors and neuropathological and clinical correlates. We investigated the spatial heterogeneity of WMHs and their association with comorbidities, Alzheimer's disease (AD) risk factors, and cognition.

Methods: In this cross-sectional study, we studied 171 cognitively unimpaired (CU; median age: 65 years, range: 50 to 89) and 51 mildly cognitively impaired (MCI; median age: 72, range: 53 to 89) individuals with available amyloid (18F-flutementamol) PET and FLAIR-weighted images.

Doubly charged dimers and trimers of heavy noble gases.

Many doubly charged heteronuclear dimers are metastable or even thermodynamically stable with respect to charge separation. Homonuclear dicationic dimers, however, are more difficult to form. He was the first noble gas dimer predicted to be metastable and, decades later, observed.

Encephalocraniocutaneous Lipomatosis: A Case Report.

Encephalocraniocutaneous lipomatosis (ECCL) is a rare congenital syndrome and subclassification of oculoectodermal syndrome. Encephalocraniocutaneous lipomatosis may be associated with postzygotic mutations. However, absence of an identifiable mutation does not preclude a diagnosis of ECCL.

Explaining variability in early stages of [18F]-flortaucipir tau-PET binding: Focus on sex differences.

Introduction: Female sex is associated with increased [18F]-flortaucipir signal, which may be affected by amyloid pathology, age, and off-target binding in skull and meninges.

Methods: In this cross-sectional study comprising 52 females and 52 matched males, we examined sex-related differences in regional tau-positron emission tomography (PET) with and without considering off-target binding. We assessed the respective contributions of sex, age, amyloid-PET burden, and off-target binding to tau-PET signal.

Prolonged critical avalanche burial for nearly 23 h with severe hypothermia and severe frostbite with good recovery: a case report.

Background: Accidental hypothermia with severe frostbite is a rare combination of injuries with a high risk for long-term sequelae. There are widely accepted recommendations for the management of avalanche victims and for frostbite treatment, but no recommendation exists for the treatment of frostbite in severe hypothermic patients, specifically for the management of hypothermic avalanche victims presenting with frostbite.

Case Presentation: We present a case of a previously healthy, 53-year-old male skier who was critically buried by an avalanche at 2300 m of altitude at an ambient temperature of - 8 °C for nearly 23 h.

Diagnostic utility of the total nucleated cell count for differentiation of septic and sterile peritoneal effusions in dogs.

Background: Rapid and accurate diagnosis of septic peritonitis is critical for initiating appropriate medical and surgical management.

Objectives: The aim of this study was to determine the diagnostic utility of the total nucleated cell count (TNCC), absolute neutrophil count, neutrophil percentage, and total protein (TP) to distinguish septic versus non-septic peritoneal effusions in dogs.

Methods: Electronic medical records were retrospectively searched for peritoneal fluid samples from 2008 to 2018 and classified as septic or non-septic based on bacterial culture and/or cytology results.

Change motivation and mindfulness in individual psychotherapy: Examining a sample of adult outpatients with depression and/or anxiety.

Objectives: Existing literature has demonstrated that both motivation to change and mindfulness are associated with therapy outcomes in samples with mental disorders. Between the constructs of mindfulness and motivation to change occurs some theoretical-related and empirical overlap. However, it is still little known about the association of these two constructs.

Artificial light at night reduces earthworm activity but increases growth of invasive ragweed.

Background: Artificial light at night, also referred to as light pollution (LP), has been shown to affect many organisms. However, little is known about the extent to which ecological interactions between earthworms and plants are altered by LP. We investigated the effects of LP on anecic earthworms (Lumbricus terrestris) that come to the surface at night to forage and mate, and on the germination and growth of the invasive and allergenic ragweed (Ambrosia artemisiifolia).

Gas-Phase Electronic Structure of Phthalocyanine Ions: A Study of Symmetry and Solvation Effects.

Research into and applications of phthalocyanines (Pc) are mostly connected to their intriguing electronic properties. Here, messenger-type UV-vis spectroscopy of two metal-free ions from the phthalocyanine family, cationic HPc and HPcD, along with their hydrates is performed. They show that the electronic properties of both ions can be traced to those in the conjugate base, Pc, however, they are affected by state splitting due to the reduced symmetry; in the HPc radical cation, a new band appears due to excitations into the singly-occupied molecular orbital.

Spectroscopy of C60+ and C120+ in the mid-infrared.

Infrared spectra of C60+ and C120+, obtained via helium messenger spectroscopy, are reported. For C60+, new absorption features have been found just above the discrete vibrational spectrum of the ion. The absorption profile, which is broad and contains little structure, is assigned to one or more electronic absorption transitions and is in good agreement with predictions from time-dependent density functional theory.

Maryland's Integration of Public Health and Primary Care During the COVID-19 Pandemic: Case Study and Lessons Learned.

The Maryland Primary Care Program is a statewide advanced primary care program that works directly with practices to transform healthcare delivery by managing chronic disease, preventing unnecessary hospital utilization, and integrating with the public health system. The Maryland Primary Care Program has demonstrated how linking the public health system to primary care practices, paired with strategic financial and resource investments in primary care, can enable the delivery of high-value care and reduce acute hospital utilization. Such a system is especially prudent when responding to crises.