Recurrent Cerebral Embolic Infarcts in a Patient With a Mechanical Valve: A Rare Case of Infective Endocarditis Caused by Parvimonas micra.

We present the case of a 60-year-old man with a history of mechanical mitral valve replacement and atrial fibrillation who developed infective endocarditis (IE) caused by (), resulting in recurrent cerebral infarctions. Despite increasing the intensity of anticoagulation therapy with warfarin and adding aspirin, the patient experienced four embolic cerebral infarctions. Following a single fever spike, blood cultures identified , although no other systemic features of IE were present.

The prescription and monitoring of conventional synthetic disease-modifying anti-rheumatic drugs: British Society for Rheumatology guideline scope.

This guideline will provide up-to-date, evidence-based recommendations on the safe use of non-biologic DMARDs, also called conventional synthetic DMARDs (csDMARD), across the full spectrum of autoimmune rheumatic diseases. The guideline will update the guideline published in 2017 and will be expanded to include people of all ages. Updated information on the monitoring of DMARDs and vaccinations will be included.

Smartphones and Learning: Evaluating the Focus of Recent Research.

The smartphone has become integral to most aspects of students' lives and is the primary conduit for accessing the internet. Objective research into the promise and dangers of this device is critical. While educational uses of the smartphone with young adults hold promise, the potential for harm is also present.

Public Perceptions About Smart Cities: Governance and Quality-of-Life in Hong Kong.

This study analyzes public perceptions about the impact of 'smart cities' programs on governance and quality-of-life. With smart city scholarship focusing primarily on technical and managerial issues, political legitimacy remains relatively underexplored-particularly in non-Western contexts. Drawing on a Hong Kong-based survey of over 800 residents conducted in 2019, this study analyzes the results of probit regressions on dependent variables for governance (participation, transparency, public services, communication, and fairness) and quality-of-life (buildings, energy-environment, mobility-transportation, education, and health).

Understanding Connections between Nature and Stress among Conservation-Engaged Adolescents Using Photovoice Methodology.

While the literature supports positive associations between nature and adolescent mental health, mechanisms are not well understood, and assessment of nature varies widely among existing studies. To partner with the most insightful informants, we enrolled eight adolescent participants from a conservation-informed summer volunteer program, applying qualitative photovoice methodology to understand their use of nature to relieve stress. Across five group sessions, participants identified four themes: (1) Nature shows us different aspects of beauty; (2) nature helps us relieve stressful experiences by balancing our senses; (3) nature gives us space to find solutions; and (4) we want to find time to enjoy nature.

Residential greenness, asthma, and lung function among children at high risk of allergic sensitization: a prospective cohort study.

Background: While benefits of greenness to health have been reported, findings specific to child respiratory health are inconsistent.

Methods: We utilized a prospective birth cohort followed from birth to age 7 years (n = 617). Residential surrounding greenness was quantified via Normalized Difference Vegetation Index (NDVI) within 200, 400, and 800 m distances from geocoded home addresses at birth, age 7 years, and across childhood.

Three-Year Nursing PhD Model Recommendations from the RWJF Future of Nursing Scholars.

Background: In response to the 2011 report, the Robert Wood Johnson Foundation created the Future of Nursing Scholars (FNS) Program in partnership with select schools of nursing to increase the number of PhD-prepared nurses using a 3-year curriculum.

Method: A group of scholars and FNS administrative leaders reflect on lessons learned for stakeholders planning to pursue a 3-year PhD model using personal experiences and extant literature.

Results: Several factors should be considered prior to engaging in a 3-year PhD timeline, including mentorship, data collection approaches, methodological choices, and the need to balance multiple personal and professional loyalties.

Gestational exposure to polybrominated diphenyl ethers and social skills and problem behaviors in adolescents: The HOME study.

Background: Polybrominated diphenyl ethers (PBDEs) are persistent environmental pollutants used as flame retardants. Gestational PBDE exposure has been associated with a variety of behavior problems in children, but little is known about its impact into adolescence, particularly on social skills, which are important for achieving social competence, establishing identity, and forming lasting relationships.

Objective: We investigated associations between gestational exposure to PBDEs and social skills and problem behaviors in early adolescence in a longitudinal pregnancy and birth cohort in Cincinnati, Ohio (recruited 2003-2006).

Digital transformation in community nursing.

Digital transformation has been making its mark on organisations in healthcare and beyond over the last few years, with no signs of stopping. In the NHS, much of the focus has been on acute services until recently, but this focus is now shifting towards community services, with Sussex Community Foundation Trust (SCFT) being named as the first community Digital Aspirant Trust by NHSx. This article explores what digital transformation is and uses SCFT's experiences to illustrate how this can provide benefits for community nurses.

Community Pharmacist Telephonic Medication Reviews with Uncontrolled Asthma Patients: A Pilot Study.

This study reports the process of telephonic medication reviews conducted by community pharmacists for patients with asthma. The study occurred at an independent community chain in association with a Missouri Medicaid consulting group. Participants were identified utilizing claims data and met the National Quality Forum criteria for uncontrolled moderate-to-severe persistent asthma.

Residential surrounding greenness and self-reported symptoms of anxiety and depression in adolescents.

Background: Evidence on the relationship between exposure to greenness and adolescent mental health is limited. The purpose of this study was to examine the association between greenness throughout childhood and mental health at age 12 years.

Methods: We assessed greenness using the satellite-based measure of Normalized Difference Vegetation Index (NDVI) within 200m, 400m, and 800m of home address at birth, age 12 years, and across childhood (averaged for each year from birth to age 12) among the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS) cohort.

Fighting fake news in the COVID-19 era: policy insights from an equilibrium model.

The COVID-19 crisis has revealed structural failures in governance and coordination on a global scale. With related policy interventions dependent on verifiable evidence, pandemics require governments to not only consider the input of experts but also ensure that science is translated for public understanding. However, misinformation and fake news, including content shared through social media, compromise the efficacy of evidence-based policy interventions and undermine the credibility of scientific expertise with potentially longer-term consequences.

Association of smoking with abdominal adipose deposition and muscle composition in Coronary Artery Risk Development in Young Adults (CARDIA) participants at mid-life: A population-based cohort study.

Background: Smokers have lower risk of obesity, which some consider a "beneficial" side effect of smoking. However, some studies suggest that smoking is simultaneously associated with higher central adiposity and, more specifically, ectopic adipose deposition. Little is known about the association of smoking with intermuscular adipose tissue (IMAT), an ectopic adipose depot associated with cardiovascular disease (CVD) risk and a key determinant of muscle quality and function.

Policymaking in a low-trust state: legitimacy, state capacity, and responses to COVID-19 in Hong Kong.

With indiscriminate geographic and socio-economic reach, COVID-19 has visited destruction of life and livelihoods on a largely unprepared world and can arguably be declared the new millennium's most trying test of state capacity. Governments are facing an urgent mandate to mobilize quickly and comprehensively in response, drawing not only on public resources and coordination capabilities but also on the cooperation and buy-in of civil society. Political and institutional legitimacy are crucial determinants of effective crisis management, and low-trust states lacking such legitimacy suffer a profound disadvantage.

MCLENA-1: A Phase II Clinical Trial for the Assessment of Safety, Tolerability, and Efficacy of Lenalidomide in Patients with Mild Cognitive Impairment Due to Alzheimer's Disease.

With the general population reaching higher ages, a surge in Alzheimer's disease (AD) incidence will happen in the coming decades, putting a heavy burden on families and healthcare systems Worldwide. This emphasizes the pressing need for AD therapeutic interventions. Accumulating evidence indicates that inflammation is prominent both in the blood and central nervous system of AD sufferers.

Effect of greenness on asthma in children: A systematic review.

Greenness such as trees, plants, and shrubs may positively influence mental and physical health, but the relationship between greenness and asthma is poorly understood. Because asthma is the most prevalent child respiratory disease internationally, elucidating the role of greenness may substantially benefit public health. The purpose of this systematic review was to synthesize findings related to effects of greenness on asthma in children.

A formal model concerning policy strategies to build public acceptance of potable water reuse.

Water stress is an increasing burden in regions with arid climates, aquifer vulnerability, and erratic rainfall. Population growth and competing domestic, industrial, and agricultural uses are also stretching the capacity of water supply systems. Beyond groundwater extraction, surface water overuse, and inter-basin transfers, governments are exploring alternative sources amidst looming supply threats.

Automated Characterization of Body Composition and Frailty with Clinically Acquired CT.

Quantification of fat and muscle on clinically acquired CT scans is critical for determination of body composition, a key component of health. Manual tracing has been regarded as the gold standard method of body segmentation; however, manual tracing is time-consuming. Many semi-automated/automated algorithms have been proposed to avoid the manual efforts.

Early Comparative Outcomes of Carbon Fiber-Reinforced Polymer Plate in the Fixation of Distal Femur Fractures.

Objective: To evaluate the early clinical results of distal femur fractures treated with carbon fiber-reinforced polyetheretherketone (CFR-PEEK) plates compared with stainless steel (SS) lateral locking plates.

Design: Retrospective comparative cohort study.

Setting: ACS Level I trauma center.

Lymphedema evaluation using noninvasive 3T MR lymphangiography.

Purpose: To exploit the long 3.0T relaxation times and low flow velocity of lymphatic fluid to develop a noninvasive 3.0T lymphangiography sequence and evaluate its relevance in patients with lymphedema.

Bikini versus traditional incision direct anterior approach: is there any difference in soft tissue damage?

Introduction: The direct anterior approach for total hip replacements has reported advantages of improved early function and muscle preservation. In an effort to improve healing and cosmesis, a change in the orientation of the incision has been proposed. Traditionally, the skin incision is in-line with the tensor fasciae latae muscle belly.

Untangling approaches to management and leadership across systems of medical education.

Aims: How future doctors might be educated and trained in order to meet the population and system needs of countries is currently being debated. Incorporation of a broad range of capabilities, encompassed within categories of management and, increasingly, leadership, form part of this discussion. The purpose of this paper is to outline a framework by which countries' progress in this area might be assessed and compared.

Medicine and management in European hospitals: a comparative overview.

Background: Since the early 1980s all European countries have given priority to reforming the management of health services. A distinctive feature of these reforms has also been the drive to co-opt professionals themselves into the management of services, taking on full time or part time (hybrid) management or leadership roles. However, although these trends are well documented in the literature, our understanding of the nature and impact of reforms and how they are re-shaping the relationship between medicine and management remains limited.