Breaking the Cycle of Nurse Manager Presenteeism: A Convergent Mixed-Methods Study.

Objective: The aim was to describe the factors leading to, and explore the coping strategies and the consequences of, nurse manager presenteeism.

Background: Presenteeism, or presence at work while not fully performing, is prevalent among direct-care nurses, yet no studies have explored nurse manager presenteeism.

Methods: This study used a convergent mixed-methods design with 1:1 interviews, a demographic questionnaire, mental/physical health and work situation questions, and the Job Stress-Related Presenteeism Scale (JSPS).

A Patient Case of Malan Syndrome Involving 19p13.2 Deletion of with Longitudinal Follow-Up and Future Prospectives.

Malan syndrome is a rare overgrowth syndrome resulting from haploinsufficiency due to heterozygous loss-of-function mutations or microdeletions of on chromosome 19 at p13.2. Phenotypic presentation can vary but is characterized by macrocephaly, long and slender body habitus, skeletal abnormalities, and intellectual disability.

Machine Learning Identifies Arrhythmogenic Features of QRS Fragmentation in Human Cardiomyopathy: Implications for Improving Risk Stratification.

Background: Heterogeneous ventricular activation can provide the substrate for ventricular arrhythmias (VA), but its manifestation on the electrocardiogram (ECG) as a risk stratifier is not well-defined.

Objective: To characterize the spatiotemporal features of QRS peaks that best predict VA in patients with cardiomyopathy (CM) using machine learning (ML).

Methods: Prospectively enrolled CM patients with prophylactic defibrillators (n=95) underwent digital, high-resolution ECG recordings during intrinsic rhythm and ventricular pacing at 100 to 120 beats/min.

Machine learning automated treatment planning for online magnetic resonance guided adaptive radiotherapy of prostate cancer.

Background And Purpose: No best practices currently exist for achieving high quality radiation therapy (RT) treatment plan adaptation during magnetic resonance (MR) guided RT of prostate cancer. This study validates the use of machine learning (ML) automated RT treatment plan adaptation and benchmarks it against current clinical RT plan adaptation methods.

Materials And Methods: We trained an atlas-based ML automated treatment planning model using reference MR RT treatment plans (42.

Wound cleansing solutions versus normal saline in the treatment of diabetic foot ulcers - A systematic review.

Diabetic foot ulcers (DFUs) are a major complication of diabetes mellitus, defined as infection, ulceration and/or destruction of deep tissues and/or peripheral artery disease in the lower extremities. Efficient cleansing is essential for the treatment of wounds, as it removes debris and necrotic tissue and decreases the burden of wound-colonizing microorganisms. The objective was to conduct a systematic review of the literature to investigate the effects of wound cleansing agents commonly used in DFU care, compared to the use of normal saline for DFU management.

Down syndrome and DYRK1A overexpression: relationships and future therapeutic directions.

Down syndrome is a genetic-based disorder that results from the triplication of chromosome 21, leading to an overexpression of many triplicated genes, including the gene encoding Dual-Specificity Tyrosine Phosphorylation-Regulated Kinase 1A (DYRK1A). This protein has been observed to regulate numerous cellular processes, including cell proliferation, cell functioning, differentiation, and apoptosis. Consequently, an overexpression of has been reported to result in cognitive impairment, a key phenotype of individuals with Down syndrome.

Unlocking Tomorrow's Health Care: Expanding the Clinical Scope of Wearables by Applying Artificial Intelligence.

As an integral aspect of health care, digital technology has enabled modelling of complex relationships to detect, screen, diagnose, and predict patient outcomes. With massive data sets, artificial intelligence (AI) can have marked effects on 3 levels: for patients, clinicians, and health systems. In this review, we discuss contemporary AI-enabled wearable devices undergoing research in the field of cardiovascular medicine.

The impact of COVID-19 on the care of diabetic foot ulcers: A scoping review.

Aim: The aims and objectives of this scoping review were to conduct a systematic search of the literature to identify the nature and extent of the research evidence to which the COVID-19 pandemic impacted and disrupted the care of Diabetic Foot Ulcers (DFU) and the subsequent impact on patient outcomes. Secondly, to identify transformation in models of care and service delivery, adoption of innovative technologies and new models of service innovations, including modalities such as telehealth that were adopted during the pandemic.

Methods: This systematic scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping reviews (PRISMA-ScR).

Shortcut learning in medical AI hinders generalization: method for estimating AI model generalization without external data.

Healthcare datasets are becoming larger and more complex, necessitating the development of accurate and generalizable AI models for medical applications. Unstructured datasets, including medical imaging, electrocardiograms, and natural language data, are gaining attention with advancements in deep convolutional neural networks and large language models. However, estimating the generalizability of these models to new healthcare settings without extensive validation on external data remains challenging.

Hemostatic Evaluation of Refrigerated Whole Blood Stored 7 Days Post-Expiration.

Introduction: The United States Army has shifted doctrine to focus on large-scale combat operations against peer to near-peer adversaries. Future conflicts could result in a limited supply chain, leaving medical providers with only expired blood products for treatment of hemorrhagic shock. This study evaluated quality, function, and safety metrics of whole blood stored for 1 week past regulated expiration (i.

The Quadrangular Cartilage in Rhinoplasty: A Surgically Focused CT Dimensional Analysis of Black African and Caucasian Populations.

The apparent lack of quadrangular cartilage in Black African noses is commonly observed both from a radiological and clinical point of view. To the best of our knowledge, only a few research papers have been conducted on the facial proportions and structural anatomy of black people of Southern and Eastern Africa. The aim of this retrospective comparative study is a radiological assessment of the total amount of septal quadrangular cartilage by measuring its area in sagittal CT views, in two selected Black South African and Caucasian (CA) samples and the comparison with the literature in our hands.

Empirical modeling of agricultural climate risk.

Effective policies for adaptation to climate change require understanding how impacts are related to exposures and vulnerability, the dimensions of the climate system that will change most and where human impacts will be most draconian, and the institutions best suited to respond. Here, we propose a simple method for more credibly pairing empirical statistical damage estimates derived from recent weather and outcome observations with projected future climate changes and proposed responses. We first analyze agricultural production and loan repayment data from Brazil to understand vulnerability to historical variation in the more predictable components of temperature and rainfall (trend and seasonality) as well as to shocks (both local and over larger spatial scales).

Evaluating the effects of hypoxic storage on platelet function and health using a novel storage system.

Background: Thousands of units of whole blood (WB) and blood components are transfused daily to treat trauma patients. Improved methods for blood storage are critical to support trauma-related care. The Hemanext ONE® system offers a unique method for hypoxic storage of WB, with successfully demonstrated storage of clinically viable RBCs.

Effectiveness of interventions to enhance healing of chronic foot ulcers in diabetes: A systematic review.

Background: It is critical that interventions used to enhance the healing of chronic foot ulcers in diabetes are backed by high-quality evidence and cost-effectiveness. In previous years, the systematic review accompanying guidelines published by the International Working Group of the Diabetic Foot performed 4-yearly updates of previous searches, including trials of prospective, cross-sectional and case-control design.

Aims: Due to a need to re-evaluate older studies against newer standards of reporting and assessment of risk of bias, we performed a whole new search from conception, but limiting studies to randomised control trials only.

Selection of positive controls and their impact on anti-drug antibody assay performance.

Development of assays to reliably identify and characterize anti-drug antibodies (ADAs) depends on positive control anti-idiotype (anti-id) reagents, which are used to demonstrate that the standards recommended by regulatory authorities are met. This work employs a set of therapeutic antibodies under clinical development and their corresponding anti-ids to investigate how different positive control reagent properties impact ADA assay development. Positive controls exhibited different response profiles and apparent assay analytical sensitivity values depending on assay format.

A Prospective Study of Machine Learning-Assisted Radiation Therapy Planning for Patients Receiving 54 Gy to the Brain.

Purpose: The capacity for machine learning (ML) to facilitate radiation therapy (RT) planning for primary brain tumors has not been described. We evaluated ML-assisted RT planning with regard to clinical acceptability, dosimetric outcomes, and planning efficiency for adults and children with primary brain tumors.

Methods And Materials: In this prospective study, children and adults receiving 54 Gy fractionated RT for a primary brain tumor were enrolled.

Integrating lesbian, gay, bisexual, transgender, and queer (LGBTQ) competency into the dental school curriculum.

Background: Decreasing healthcare disparities in marginalized communities requires healthcare providers who understand and appreciate social, economic, and cultural backgrounds. This includes care and education focused on individuals who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ).

Methods: This study examined dental students' and residents' self-reported clinical preparedness, prejudicial attitudes (implicit and explicit), and knowledge of health disparities that exist in the LGBTQ community using the Lesbian, Gay, Bisexual, Transgender Development of Clinical Skills Scale (LGBT-DOCSS) prior to and after the presentation of an LGBTQ competency course.

Expression and Purification of Cp3GT: Structural Analysis and Modeling of a Key Plant Flavonol-3-O Glucosyltransferase from .

Glycosyltransferases (GTs) are pivotal enzymes in the biosynthesis of various biological molecules. This study focuses on the scale-up, expression, and purification of a plant flavonol-specific 3-O glucosyltransferase (Cp3GT), a key enzyme from , for structural analysis and modeling. The challenges associated with recombinant protein production in , such as proteolytic degradation, were addressed through the optimization of culture conditions and purification processes.

Impact of the COVID-19 related border restrictions on influenza and other common respiratory viral infections in New Zealand.

Background: New Zealand's (NZ) complete absence of community transmission of influenza and respiratory syncytial virus (RSV) after May 2020, likely due to COVID-19 elimination measures, provided a rare opportunity to assess the impact of border restrictions on common respiratory viral infections over the ensuing 2 years.

Methods: We collected the data from multiple surveillance systems, including hospital-based severe acute respiratory infection surveillance, SHIVERS-II, -III and -IV community cohorts for acute respiratory infection (ARI) surveillance, HealthStat sentinel general practice (GP) based influenza-like illness surveillance and SHIVERS-V sentinel GP-based ARI surveillance, SHIVERS-V traveller ARI surveillance and laboratory-based surveillance. We described the data on influenza, RSV and other respiratory viral infections in NZ before, during and after various stages of the COVID related border restrictions.

A review of the risks and relationships between oral health and chronic diseases.

Advances in medical science and in preventive dentistry have changed the context of oral health. The American population is living longer with numerous complex chronic diseases. This paper is to raise awareness about the impact of multiple chronic diseases and their associations with oral diseases.

Low-affinity CD8 T cells provide interclonal help to high-affinity CD8 T cells to augment alloimmunity.

Following solid organ transplantation, small precursor populations of polyclonal CD8 T cells specific for any graft-expressed antigen preferentially expand their high-affinity clones. This phenomenon, termed "avidity maturation," results in a larger population of CD8 T cells with increased sensitivity to alloantigen, posing a greater risk for graft rejection. Using a mouse model of minor-mismatched skin transplantation, coupled with the tracking of 2 skin graft-reactive CD8 T cell receptor-transgenic tracer populations with high and low affinity for the same peptide-major histocompatibility complex, we explored the conventional paradigm that CD8 T cell avidity maturation occurs through T cell receptor affinity-based competition for cognate antigen.

Lipidomic-Based Approach to 10 s Classification of Major Pediatric Brain Cancer Types with Picosecond Infrared Laser Mass Spectrometry.

Picosecond infrared laser mass spectrometry (PIRL-MS) is shown, through a retrospective patient tissue study, to differentiate medulloblastoma cancers from pilocytic astrocytoma and two molecular subtypes of ependymoma (PF-EPN-A, ST-EPN-RELA) using laser-extracted lipids profiled with PIRL-MS in 10 s of sampling and analysis time. The average sensitivity and specificity values for this classification, taking genomic profiling data as standard, were 96.41 and 99.

Nasal Dorsum Anatomy of Major Different Ethnicities-Surgical Implications: A Multicenter Radiologic Study.

Background: The heterogeneity of nasal features across different racial and ethnic groups is evident. This large-scale multicenter study was performed to evaluate the dorsal keystone area and its relation to superficial nasal anatomy through computed tomography (CT) scans.

Methods: Six populations were included: South Caucasian, Middle Eastern, Black South African, Eastern Asian, Mestizo, and Eastern European.