Assessing outcomes of intravenous insulin therapy in non-intensive care patients.

Objectives: The aim of this study was to compare outcomes of using intravenous insulin infusion (IVII) therapy for managing hyperglycemia in a non-intensive care unit (ICU) versus an ICU setting.

Methods: We conducted a retrospective analysis on patients who received IVII for hyperglycemia. The analysis compared variables associated with hypoglycemic events while on IVII, and point-of-care blood glucose control and insulin regimens at discharge.

Investigating the role of preference variation in the perceptions of railway passengers in Great Britain.

This study explores the factors associated with passenger satisfaction on the UK railways. To uncover taste variation, the data was segmented into three homogeneous groups of passengers through a latent class ordered logit model, whereby the class allocation was based on observed personal and trip characteristics. The findings suggest that there is significant variation in the impact of service attributes on overall satisfaction across the segments, 'class a', 'class b' and 'class c'.

Synthesis of Quaternary and Tertiary Carbon-Substituted Arenes by Lewis Base Promoted Site-Selective Coupling with Allylic Nucleophiles.

A practical method for the preparation of quaternary and tertiary allyl-substituted heteroarenes by site-selective couplings of heteroaryl nitriles and allylic nucleophiles is disclosed. Transformations utilize readily accessible stable reagents, proceed in the presence of a Lewis base activator, and undergo aryl-C(sp ) quaternary and tertiary carbon formation with high γ-selectivity (up to >98 : 2 γ : α).

Improving outcomes for children with malaria, diarrhoea and pneumonia in Mozambique: A cluster randomised controlled trial of the inSCALE technology innovation.

Background: The majority of post-neonatal deaths in children under 5 are due to malaria, diarrhoea and pneumonia (MDP). The WHO recommends integrated community case management (iCCM) of these conditions using community-based health workers (CHW). However iCCM programmes have suffered from poor implementation and mixed outcomes.

Improving community health worker treatment for malaria, diarrhoea, and pneumonia in Uganda through inSCALE community and mHealth innovations: A cluster randomised controlled trial.

The inSCALE cluster randomised controlled trial in Uganda evaluated two interventions, mHealth and Village Health Clubs (VHCs) which aimed to improve Community Health Worker (CHW) treatment for malaria, diarrhoea, and pneumonia within the national Integrated Community Case Management (iCCM) programme. The interventions were compared with standard care in a control arm. In a cluster randomised trial, 39 sub-counties in Midwest Uganda, covering 3167 CHWs, were randomly allocated to mHealth; VHC or usual care (control) arms.

An online learning algorithm for adapting leg stiffness and stride angle for efficient quadruped robot trotting.

Animals adjust their leg stiffness and stride angle in response to changing ground conditions and gait parameters, resulting in improved stability and reduced energy consumption. This paper presents an online learning algorithm that attempts to mimic such animal behavior by maximizing energy efficiency on the fly or equivalently, minimizing the cost of transport of legged robots by adaptively changing the leg stiffness and stride angle while the robot is traversing on grounds with unknown characteristics. The algorithm employs an approximate stochastic gradient method to change the parameters in real-time, and has the following advantages: (1) the algorithm is computationally efficient and suitable for real-time operation; (2) it does not require training; (3) it is model-free, implying that precise modeling of the robot is not required for good performance; and (4) the algorithm is generally applicable and can be easily incorporated into a variety of legged robots with adaptable parameters and gaits beyond those implemented in this paper.

The association between age at breast cancer diagnosis and prevalence of pathogenic variants.

Purpose: Young age at breast cancer (BC) diagnosis and family history of BC are strongly associated with high prevalence of pathogenic variants (PVs) in BRCA1 and BRCA2 genes. There is limited evidence for such associations with moderate/high penetrance BC-risk genes such as ATM, CHEK2, and PALB2.

Methods: We analyzed multi-gene panel testing results (09/2013-12/2019) for women unaffected by any cancer (N = 371,594) and those affected with BC (N = 130,151) ascertained for suspicion of hereditary breast and/or ovarian cancer.

Reducing Infection Rates with Enhanced Preoperative Diabetes Mellitus Diagnosis and Optimization Processes.

Objectives: Hyperglycemia and increased preoperative hemoglobin A1c (HbA1c) are associated with perioperative morbidity and death. For nonurgent operations, adequate glycemic control before surgery is recommended. Our surgical practice needed a process for preoperative diabetes mellitus (DM) diagnosis and glycemic optimization.

A Catalytic Method for the Enantioselective Synthesis of α-Quaternary Ketones, α-Ketoesters and Aldehydes.

A practical method for the efficient and enantioselective preparation of versatile ketones and aldehydes that contain an α-quaternary stereocenter is described. Reactions utilize simple carboxylic acid or ester starting materials, a monodentate chiral phosphine, and afford a variety of aryl, alkenyl, alkynyl, and alkyl-substituted ketone and aldehyde products in 25-94 % yield and 90 : 10 to >99 : 1 enantiomeric ratio. Reactions proceed by acyl substitution with in situ formed chiral allylic nucleophiles, and display selectivity and conversion dependence on a protic additive.

Continuous Glucose Monitoring for Patients with COVID-19 Pneumonia: Initial Experience at a Tertiary Care Center.

Objective: Patients hospitalized with COVID-19 and hyperglycemia require frequent glucose monitoring, usually performed with glucometers. Continuous glucose monitors (CGMs) are common in the outpatient setting but not yet approved for hospital use. We evaluated CGM accuracy, safety for insulin dosing, and CGM clinical reliability in 20 adult patients hospitalized with COVID-19 and hyperglycemia.

Eleven-Year Experience with Selective Adrenal Vein Sampling in Management of Primary Adrenal Hormonal Hypersecretion.

Nearly half of the adult population in the United States has been diagnosed with hypertension. Adrenal hormonal hypersecretion is a leading cause of secondary hypertension. Adrenal vein sampling (AVS) may assist in differentiating between unilateral and bilateral adrenal hormonal hypersecretion to identify patients who are candidates for adrenalectomy.

Efficient Enantio-, Diastereo, /-, and Site-Selective Nickel-Catalyzed Fragment Couplings of Aldehydes, Dienes, and Organoborons.

The enantioselective synthesis of bis-homoallylic alcohols through nickel-catalyzed three-component fragment couplings of simple aldehydes, dienes, and aryl organoborons is disclosed. The reactions proceed through diene dicarbofunctionalization that concurrently forms two C-C bonds and two stereogenic centers. The transformations are promoted by a 5.

Considerations in the Care of Athletes With Type 1 Diabetes Mellitus.

Type 1 diabetes mellitus is an autoimmune disease caused by affected individuals' autoimmune response to their own pancreatic beta-cell. It affects millions of people worldwide. Exercise has numerous health and social benefits for patients with type 1 diabetes mellitus; however, careful management of blood glucose is crucial to minimize the risk of hypoglycemia and hyperglycemia.

Development and validation of a cell cycle progression signature for decentralized testing of men with prostate cancer.

The 46-gene Prolaris cell cycle progression test provides information on the risk of prostate cancer progression. Here we developed and validated a 16-gene kit-based version. RNA was extracted from prostate cancer biopsy tissue.

Stability and Control of a Pacing Quadruped Using Stabilizing Switching Design.

In this paper we present a method for control and stabilizing a pacing quadruped robot using state feedback switching. In the pacing gait, a quadruped cycles between the left and right pairs of legs to achieve locomotion. This results in two discrete stance configurations, each being unstable.

Hereditary cancer risk assessment and genetic testing in the community urology practice setting.

Objectives: To evaluate the feasibility of integrating a hereditary cancer risk assessment (HCRA) process in the community urology practice setting for patients with prostate cancer (PCa).

Methods: In this prospective intervention, an HCRA process was implemented across six different community urology clinics between May 2019 and April 2020. The intervention included a process integration during which the workflow at each site was refined, a post-integration period during which HCRA was conducted in all patients with PCa, and a follow-up period during which healthcare providers and patients reported their satisfaction with the HCRA and genetic testing process.

Enhancing graduates' enterprise capabilities through work-integrated learning in co-working spaces.

Complex and rapidly evolving work contexts augment industry calls for future-capable graduates that can demonstrate enterprise capabilities such as critical thinking, problem-solving, collaboration, and value creation. Gaps between employers' expectations and evaluations of higher education (HE) graduates' enterprise capabilities continue to drive university curriculum renewal. There is a particular focus on work-integrated learning (WIL), a spectrum of industry-student engagement activities which provide valuable opportunities for developing and applying skills and knowledge, including enterprise capabilities.

Back to nature: herbal treatment, environmental enrichment, and social play can protect against unpredictable chronic stress in Long-Evans rats (Rattus norvegicus).

The importance of integrative biobehavioral responses to complex challenges cannot be overlooked. In this study, the synergetic effects of icariin (a flavonoid present in the plant Epimedium brevicornum), natural enrichment (NaEn), and play behavior were investigated. Rats (n = 60) were assigned to standard housing or NaEn; these two groups were subsequently divided into controls, rats receiving icariin treatments, and rats receiving icariin and allowed to play with an individual from another cage.

Comprehensive Breast Cancer Risk Assessment for and Pathogenic Variant Carriers Incorporating a Polygenic Risk Score and the Tyrer-Cuzick Model.

Purpose: Breast cancer risks for and pathogenic variant (PV) carriers are modified by an 86-single nucleotide polymorphism polygenic risk score (PRS) and individual clinical factors. Here, we describe comprehensive risk prediction models for women of European ancestry combining PV status, PRS, and individual clinical variables.

Materials And Methods: This study included deidentified clinical records from 358,095 women of European ancestry who received testing with a multigene panel (September 2013 to November 2019).