Acquisition and Handling of Endobronchial Ultrasound Transbronchial Needle Samples: An American College of Chest Physicians Clinical Practice Guideline.

Background: Endobronchial ultrasound-guided transbronchial aspiration (EBUS-TBNA) has become the standard for initial lung cancer diagnosis and staging. Previous guidelines have generally focused on the "when" and "how" of EBUS-TBNA; however, little guidance is available on handling and processing specimens during and after acquisition to help optimize both diagnostic yield and tissue integrity for ancillary studies. This document examines the available literature on EBUS-TBNA specimen processing and handling.

ACR Appropriateness Criteria® Pulmonary Arteriovenous Malformation (PAVM): 2023 Update.

Pulmonary arteriovenous malformations (PAVMs) occur in 30% to 50% of patients with hereditary hemorrhagic telangiectasia. Clinical presentations vary from asymptomatic disease to complications resulting from the right to left shunting of blood through the PAVM such as paradoxical stroke, brain abscesses, hypoxemia, and cardiac failure. Radiology plays an important role both in the diagnosis and treatment of PAVM.

Recommendations for Medical and Mental Health Care in Assisted Living Based on an Expert Delphi Consensus Panel: A Consensus Statement.

Importance: Assisted living (AL) is the largest provider of residential long-term care in the US, and the morbidity of AL residents has been rising. However, AL is not a health care setting, and concern has been growing about residents' medical and mental health needs. No guidance exists to inform this care.

The Imperative to Reimagine Assisted Living.

Assisted living (AL) has existed in the United States for decades, evolving in response to older adults' need for supportive care and distaste for nursing homes and older models of congregate care. AL is state-regulated, provides at least 2 meals a day, around-the-clock supervision, and help with personal care, but is not licensed as a nursing home. The key constructs of AL as originally conceived were to provide person-centered care and promote quality of life through supportive and responsive services to meet scheduled and unscheduled needs for assistance, an operating philosophy emphasizing resident choice, and a residential environment with homelike features.

Discussing End-of-Life Care Preferences With Family: Role of Race and Ethnicity.

This study examined racial, ethnic, and other factors associated with whether older adults discussed their end-of-life (EOL) care wishes with family. A sample of 223 White, 95 African American, and 46 Hispanic adults aged 50 and older from a five-county area of Florida answered questions about sociodemographics, health, and preferences for involving family/friends in health-care decision-making. Analyses describe associations between whether discussions occurred and race/ethnicity and other factors, including preferences for family/friend involvement in health care.

A Raman-Based Imaging Method for Characterizing the Molecular Adsorption and Spatial Distribution of Silver Nanoparticles on Hydrated Mineral Surfaces.

Although minerals are known to affect the environmental fate and transformation of heavy-metal ions, little is known about their interaction with the heavily exploited silver nanoparticles (AgNPs). Proposed here is a combination of hitherto under-utilized micro-Raman-based mapping and chemometric methods for imaging the distribution of AgNPs on various mineral surfaces and their molecular interaction mechanisms. The feasibility of the Raman-based imaging method was tested on two macro- and microsized mineral models, muscovite [KAl(AlSiO)(OH)] and corundum (α-AlO), under key environmental conditions (ionic strength and pH).

Sharing End-of-Life Care Preferences with Family Members: Who Has the Discussion and Who Does Not.

Background: Research suggests that greater engagement in family discussions concerning end-of-life (EOL) care preferences could improve advance care planning and EOL outcomes. However, a substantial number of people have not had such discussions.

Objective: The study's objective was to understand attitudes and experiences influencing engagement in discussions of EOL care preferences with family members, including the role of healthcare providers in such discussions.

Pain Management in Long-Term Care Communities: A Quality Improvement Initiative.

Pain is underrecognized and undertreated in the long-term care (LTC) setting. To improve the management of pain for LTC residents, the authors implemented a quality improvement (QI) initiative at one LTC facility. They conducted a needs assessment to identify areas for improvement and designed a 2-hour educational workshop for facility staff and local clinicians.

Age at immigration and the incomes of older immigrants, 1994-2010.

Objectives: Seniors comprise a growing proportion of new U.S. immigrants.

Improving diabetes care and patient outcomes in skilled-care communities: successes and lessons from a quality improvement initiative.

Objective: To improve the quality of care for residents of long term care (LTC) facilities who have diabetes by (1) improving glycemic control, (2) increasing comprehensive diabetes management, (3) reducing fragmented care, and (4) empowering patient-care teams to educate patients and families regarding this disease.

Design: Based on the Plan-Do-Study-Act principles of effective change, a baseline evaluation of contemporary care for residents with diabetes was conducted through focus-group interviews, a confidence survey, and chart review. Three live educational workshops provided guideline-recommended information addressing educational desires and needs of clinical staff, a tool for improving performance in key areas of need, and an opportunity for care teams to engage in dialogue about advances in diabetes with a national diabetes expert.

A Tale of Two Counties: Natives' Opinions Toward Immigration in North Carolina.

This paper compares native residents' opinions and perceptions regarding immigration using a representative survey from a pair of matched North Carolina counties-one that experienced recent growth of its foreign-born population and one that did not. Drawing from several theoretical perspectives, including group threat, contact theory, and symbolic politics, we formulate and empirically evaluate several hypotheses. Results provide limited evidence that competition and threat influence formation of opinions about immigration, with modest support for claims that parents with school-aged children harbor more negative views of immigration than their childless counterparts.

Central configurations of identical masses lying along curves.

A central configuration is an arrangement of point masses in which the net gravitational accelerations are proportional to the displacements from the center of mass. Here several families of central configurations are described consisting of a large number of identical masses that occupy one or more curves. The families are found numerically.

Continuing medical education effect on physician knowledge application and psychomotor skills: effectiveness of continuing medical education: American College of Chest Physicians Evidence-Based Educational Guidelines.

Background: Recommendations for optimizing continuing medical education (CME) effectiveness in improving physician application of knowledge and psychomotor skills are needed to guide the development of processes that effect physician change and improve patient care.

Methods: The guideline panel reviewed evidence tables and a comprehensive review of the effectiveness of CME developed by The Johns Hopkins Evidence-based Practice Center for the Agency for Healthcare Research and Quality (AHRQ Evidence Report). The panel considered studies relevant to the effect of CME on physician knowledge application and psychomotor skill development.

On the origin of mesoscopic inhomogeneity of conducting polymers.

The mesoscopic inhomogeneity of conducting polymer films obtained by electropolymerization and spin-coating was studied using Kelvin probe force microscopy (KFM) and current-sensing atomic-force microscopy (CS-AFM). A well-pronounced correlation was established between the polymer morphology, on the one hand, and its local work function (which is related to the polymer oxidation degree) as well as polymer conductivity, on the other. The most conducting regions were associated with the tops of the polymer grains and showed Ohmic behavior.

The pulmonary status of patients with limited-stage small cell lung cancer 15 years after treatment with chemotherapy and chest irradiation.

Study Objectives: To describe pulmonary symptoms, signs, pulmonary function, and lung imaging studies in patients with limited-stage small cell lung cancer (SCLC) 2 to 15 years after receiving treatment with chemotherapy and chest radiotherapy.

Design: Retrospective review of clinical records and radiographic studies of patients treated in three different prospective combined-modality studies.

Setting: Federal hospital.

Prospective study of the airways and pulmonary parenchyma of patients at risk for a second lung cancer.

Purpose: We conducted our study to compare the number of preneoplastic lesions in the airways and nodules in the pulmonary parenchyma of patients with resected non-small cell lung cancer with the patients whose treatment included chest radiotherapy.

Experimental Design: Patients were eligible if they had successfully resected stage I and II non-small cell lung cancer or advanced stage non-small cell or small cell lung cancer treated with chest radiotherapy with or without chemotherapy and were free of cancer for >2 years. Patients underwent a history and physical examination, white light and fluorescence bronchoscopy, and computerized tomography of the chest.

Web-based research: methodological variables' effects on dropout and sample characteristics.

Previous research has made a beginning in addressing the importance of methodological differences in Web-based research. The present paper presents four studies investigating whether sample type, financial incentives, time when personal information is requested, table design, and method of obtaining informed consent influence dropout and sample characteristics (both demographics and measured attitudes). Undergraduates were less likely to drop out than nonstudents, and nonstudents offered a financial incentive were less likely to drop out than those offered no incentive.

Augmentation therapy with alpha1-antitrypsin: patterns of use and adverse events.

Study Objectives: To describe patterns of prescribing augmentation therapy, and types and rates of adverse events in the National Heart, Lung, and Blood Institute Registry for Individuals with Severe Deficiency of Alpha(1)-Antitrypsin.

Design: Observational cohort study with follow-up visits every 6 to 12 months for up to 7 years.

Measurements: The rate and dosing frequency with which Registry participants were prescribed to receive augmentation therapy by their managing physicians, and the type and frequency of adverse events, classified in two ways: severity of self-reported symptoms, and actions taken as a consequence of the symptom.

t(11;19)(q21;p13) translocation in mucoepidermoid carcinoma creates a novel fusion product that disrupts a Notch signaling pathway.

Truncation of Notch1 has been shown to cause a subtype of acute leukemia, and activation of Notch4 has been associated with mammary and salivary gland carcinomas of mice. Here we identify a new mechanism for disrupting Notch signaling in human tumorigenesis, characterized by altered function of a new ortholog of the Drosophila melanogaster Notch co-activator molecule Mastermind. We cloned the t(11;19) translocation that underlies the most common type of human malignant salivary gland tumor.