Incidence of drug-resistant pathogens in community-acquired pneumonia at a safety net hospital.

The 2019 Infectious Diseases Society of America guideline for the management of community-acquired pneumonia (CAP) emphasizes the need for clinician to understand local epidemiological data to guide selection of appropriate treatment. Currently, the local distribution of causative pathogens and their associated resistance patterns in CAP is unknown. A retrospective observational study was performed of patients admitted to an 870-bed safety net hospital between March 2016 and March 2021 who received a diagnosis of CAP or healthcare-associated pneumonia within the first 48 hours of admission.

Analyzing the effectiveness of environmental impact assessment in Paraná, Brazil and California, United States with fuzzy-set qualitative comparative analysis and the analytical hierarchy process.

Environmental impact assessment (EIA) has become one of the most widespread environmental management instruments. Despite this, EIA is routinely criticized for being ineffective at impacting decision-making. This study compared the EIA systems of Paraná, Brazil and California, United States using the effectiveness dimensions from the EIA literature.

Technology-enhanced community forest management in tropical regions: A state of the art.

Tropical forests provide ecosystem services to around 2.7 billion people. Yet they are reaching tipping points due to social, economic, and environmental pressures.

Elements of the water - food - environment nexus for integrated sustainability analysis.

Water and food security are constantly on the sustainable development agenda since they are interrelated with anthropogenic and ecosystemic issues present in the economic, environmental, and social spheres. The non-integrative management of these issues points to unsustainable futures. In this context, nexus approaches deserve considerable attention in the search for integrative management solutions capable of contributing to leveraging synergies that increase agricultural productivity, while simultaneously reducing environmental impacts, including water resources.

Medication Deprescribing Among Patients With Type 2 Diabetes: A Qualitative Case Series of Lifestyle Medicine Practitioner Protocols.

This study is a qualitative case series of lifestyle medicine practitioners' protocols for medication de-escalation in the context of reduced need for glucose-lowering medications due to lifestyle modifications. Increasing numbers of lifestyle medicine practitioners report achieving reductions in medications among patients with type 2 diabetes, and in some cases remission, but limited data exist on the clinical decision-making process used to determine when and how medications are deprescribed. Practitioners interviewed here provide accounts of their deprescribing protocols.

A naturally occurring membrane-anchored Gα variant, XLα, activates phospholipase Cβ4.

Extra-large stimulatory Gα (XLα) is a large variant of G protein α subunit (Gα) that uses an alternative promoter and thus differs from Gα at the first exon. XLα activation by G protein-coupled receptors mediates cAMP generation, similarly to Gα; however, Gα and XLα have been shown to have distinct cellular and physiological functions. For example, previous work suggests that XLα can stimulate inositol phosphate production in renal proximal tubules and thereby regulate serum phosphate levels.

Demographic disparities of penile cancer in Appalachian Kentucky.

Introduction: Appalachian Kentucky is a region characterized by poor healthcare literacy and access. We investigate the disparities in demographic distribution and outcomes of penile squamous cell carcinoma (pSCC) in rural Kentucky.

Materials And Methods: Data were retrieved for patients with pSCC from 1995-2015 from the Kentucky Cancer Registry and the Surveillance, Epidemiology and End Results Program (SEER) and were used to investigate differences between Appalachian Kentucky and the remainder of the state and country.

Advances in Diagnostic Imaging in Pediatric Gastroenterology.

Purpose Of Review: The purpose is to provide a review of cross-sectional imaging updates in the assessment of gastrointestinal diseases, relevant to clinical practice and research.

Recent Findings: New magnetic resonance imaging contrast agents (Eovist) are taken up by hepatocytes and excreted via the biliary tree. As such, a lesion will retain contrast only if hepatocytes are present, which aids in refining the differential diagnosis.

Normal size of the fetal adrenal gland on prenatal magnetic resonance imaging.

Background: The adrenal gland plays a vital role in fetal growth. Many disease states such as congenital adrenal hyperplasia, hemorrhage and tumors can lead to morphological changes in the gland. Ultrasound measurements of normal adrenal sizes in the fetus reported in the literature have shown a trend of increasing size with gestational age.

Open Radical Nephrectomy for Suspected Renal Malignancy-Tips and Tricks.

Objective: To present the surgical approach to a cystic renal mass suspicious for malignancy in a 22-month-old female.

Materials: The patient was a healthy female was found to have an abdominal mass by her parents. Her mother underwent a nephrectomy as a child for unknown pathology.

Music to One's Ears: Familiarity and Music Engagement in People With Parkinson's Disease.

Parkinson's disease (PD) is a complex diagnosis commonly associated with motor dysfunction, but known to comprise cognitive, psychiatric, and mood disturbances as well. Music has been successfully used to address motor and non-motor symptoms of PD. Still, little is known about the nature of an individual with PD's experience and relationship with music on conceptual and emotional levels, which may factor into their engagement in music-based techniques to ameliorate impairments.

Visual control of steering in curve driving.

This pair of studies investigated steering in the absence of continuous visual information. In a driving simulator, participants steered a curving path that was displayed either continuously or intermittently. Optic flow conditions were manipulated to alter the nature of the heading information with respect to the path being steered.

Assessment of Radiation Safety Knowledge Among Urology Residents in the United States.

Urologists are increasingly exposed to fluoroscopy, which can cause cellular damage. Appropriate awareness and safety precautions concerning fluoroscopy are necessary and likely should be a focus during training. We sought to assess radiation safety knowledge among Urology residents in the United States.

Nanostructured polymer films with metal-like thermal conductivity.

Due to their unique properties, polymers - typically thermal insulators - can open up opportunities for advanced thermal management when they are transformed into thermal conductors. Recent studies have shown polymers can achieve high thermal conductivity, but the transport mechanisms have yet to be elucidated. Here we report polyethylene films with a high thermal conductivity of 62 Wm K, over two orders-of-magnitude greater than that of typical polymers (~0.

Assessment of Radiation Safety Knowledge among House Staff Exposed to Fluoroscopic Radiation.

Introduction: Urologists are increasingly exposed to fluoroscopy as minimally invasive techniques continue to proliferate. Fluoroscopy, or electromagnetic radiation, can cause cellular damage. Appropriate knowledge of safety precautions for fluoroscopy are necessary and ideally should be taught to physicians in training.

Plant-Based Diets for Cardiovascular Safety and Performance in Endurance Sports.

Studies suggest that endurance athletes are at higher-than-average risk for atherosclerosis and myocardial damage. The ability of plant-based regimens to reduce risk and affect performance was reviewed. The effect of plant-based diets on cardiovascular risk factors, particularly plasma lipid concentrations, body weight, and blood pressure, and, as part of a healthful lifestyle, reversing existing atherosclerotic lesions, may provide a substantial measure of cardiovascular protection.

A Culturally Sensitive Approach to Cervical Cancer Prevention in the Latina Population Using the Promotora Model.

Latina women of low socioeconomic status are particularly vulnerable to morbidity and mortality from cervical cancer. Lower rates of screening are associated with increased mortality rates in this population. Community health workers known as promotoras de salud can be an effective part of the health care team to help improve health care access in this population.

Willingness to Pay for Conservation of Transborder Migratory Species: A Case Study of the Mexican Free-Tailed Bat in the United States and Mexico.

We estimated U.S. and Mexican citizens' willingness to pay (WTP) for protecting habitat for a transborder migratory species, the Mexican free-tailed bat (Tadarida brasiliensis mexicana), using the contingent valuation method.

Ecosystem service flows from a migratory species: Spatial subsidies of the northern pintail.

Migratory species provide important benefits to society, but their cross-border conservation poses serious challenges. By quantifying the economic value of ecosystem services (ESs) provided across a species' range and ecological data on a species' habitat dependence, we estimate spatial subsidies-how different regions support ESs provided by a species across its range. We illustrate this method for migratory northern pintail ducks in North America.

Electrochemical Measurement of Dopamine Release and Uptake in Zebrafish Following Treatment with Carboplatin.

Post-chemotherapy cognitive impairment, also known as 'chemobrain,' is a neurological condition in which cognitive function is impaired as a result of cancer chemotherapy treatment. In this work, we used fast-scan cyclic voltammetry (FSCV) to measure electrically evoked dopamine release and uptake in whole brain preparations from zebrafish that have been treated with carboplatin, an agent associated with chemobrain. We administered carboplatin by addition to the fish's tank water or their food.

Recreation economics to inform migratory species conservation: Case study of the northern pintail.

Quantification of the economic value provided by migratory species can aid in targeting management efforts and funding to locations yielding the greatest benefits to society and species conservation. Here we illustrate a key step in this process by estimating hunting and birding values of the northern pintail (Anas acuta) within primary breeding and wintering habitats used during the species' annual migratory cycle in North America. We used published information on user expenditures and net economic values (consumer surplus) for recreational viewing and hunting to determine the economic value of pintail-based recreation in three primary breeding areas and two primary wintering areas.

The STEADI toolkit: Incorporating a fall prevention guideline into the primary care setting.

Falls are a growing problem in the older adult population, leading to debilitating and traumatic consequences. The CDC's STEADI toolkit was created to assist providers in screening and managing falls. This article introduces the toolkit and examines the process and importance of adopting it into routine clinical practice.

Spatial updating of multiple targets: Comparison of younger and older adults.

When walking without vision, people mentally keep track of the directions and distances of previously viewed objects, a process called spatial updating. The current experiment indicates that while people across a large age range are able to update multiple targets in memory without perceptual support, aging negatively affects accuracy, precision, and decision time. Participants (20 to 80 years of age) viewed one, three, or six targets (colored lights) on the floor of a dimly lit room.