Pharmacist Avoidance or Reductions in Medical Costs in Critically and Emergently Ill Pediatrics: PHARM-PEDS Study.

Objectives: To comprehensively classify interventions performed by pediatric critical care clinical pharmacists and quantify cost avoidance (CA) generated through their accepted interventions.

Design: A multicenter, prospective, observational study performed between August 2018 and January 2019.

Setting: Academic and community hospitals in the United States with pediatric critical care units.

Within-person changes in aversive reactivity predict session-to-session reductions in anxiety and depression in the unified protocol.

The Unified Protocol (UP) theoretically leads to reductions in emotional disorder symptoms by reducing aversive reactions to emotions. However, aversive reactions can take many forms (e.g.

Psychopathy and antisocial personality disorder in the fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders: An attempted replication of Wygant et al. (2016).

The fifth edition of the American Psychiatric Association's (APA) Section III Alternative Model of Personality Disorder (AMPD) was developed to ameliorate some of the concerns of the Section II categorical model by moving away from the discrete boundaries of behaviorally specific criteria to a hybridized dimensional trait-based approach. Wygant et al. (2016) examined the extent to which the AMPD improved the operationalization of antisocial personality disorder to more closely align with psychopathy, a notable weakness of DSM-5 Section II (Crego & Widiger, 2015; Lynam & Vachon, 2012; Strickland et al.

Experimental Manipulation of the BFI-2, IPIP-NEO-120, and the IPC-5.

Research assessing the relationship of the five-factor model (FFM) to personality disorder symptomatology has generally been confirmatory, with three exceptions. The exceptions have been failures to confirm associations of conscientiousness with the obsessive-compulsive personality disorder, agreeableness with dependent, and openness with schizotypal. Haigler and Widiger demonstrated empirically years ago that this was occurring because the predominant FFM measure at that time, the NEO Personality Inventory-Revised, does not include a sufficient representation of maladaptive variants of the respective FFM personality trait domains.

Dissemination of a Novel Framework to Improve Blood Culture Use in Pediatric Critical Care.

Introduction: Single center work demonstrated a safe reduction in unnecessary blood culture use in critically ill children. Our objective was to develop and implement a customizable quality improvement framework to reduce unnecessary blood culture testing in critically ill children across diverse clinical settings and various institutions.

Methods: Three pediatric intensive care units (14 bed medical/cardiac; 28 bed medical; 22 bed cardiac) in 2 institutions adapted and implemented a 5-part Blood Culture Improvement Framework, supported by a coordinating multidisciplinary team.

Is high fidelity simulation the most effective method for the development of non-technical skills in nursing? A review of the current evidence.

Aim: To review the literature on the use of simulation in the development of non-technical skills in nursing

Background: The potential risks to patients associated with learning 'at the bedside' are becoming increasingly unacceptable, and the search for innovative education and training methods that do not expose the patient to preventable errors continues. All the evidence shows that a significant proportion of adverse events in health care is caused by problems relating to the application of the 'non-technical' skills of communication, teamwork, leadership and decision-making.

Results: Simulation is positively associated with significantly improved interpersonal communication skills at patient handover, and it has also been clearly shown to improve team behaviours in a wide variety of clinical contexts and clinical personnel, associated with improved team performance in the management of crisis situations.

Cyanoximes as effective and selective co-crystallizing agents.

The ability of cyanoxime-based synthons to act as versatile synthetic tools for the construction of co-crystals is demonstrated through the preparation and structural characterization of seven co-crystals. Cyanoximes can bind effectively to both five-membered and six-membered N-heterocyclic hydrogen-bond acceptors, and they also display selectivity towards the best acceptor (as determined using semi-empirical AM1 calculations) in ditopic compounds.

Establishing amide...amide reliability and synthon transferability in the supramolecular assembly of metal-containing one-dimensional architectures.

On the basis of a combination of new structural data (eleven single-crystal structure determinations are presented) and information from the Cambridge Structural Database, it has been shown that self-complementary hydrogen-bond based amide...

Constructing, deconstructing, and reconstructing ternary supermolecules.

A hypothesis-driven protocol comprising precise and predictable molecular recognition events based upon an electrostatic view of competing hydrogen-bond interactions is proposed and subsequently employed in the construction of ternary co-crystals.

[(Benzimidazol-1-yl)methyl]benzamides as bifunctional reagents for reliable inorganic-organic supramolecular synthesis.

A series of ligands that utilize five-membered N-heterocycles as coordination sites, and the self-complementarity of the carboxamide functionality, have been employed in the supramolecular synthesis of Ag(I)-based extended networks. The crystal structures of eight compounds are reported: bis[4-(2-methylbenzimidazol-1-yl)methylbenzamide]silver(I) tetrafluoroborate hydrate methanol, 1; bis[3-(2-methylbenzimidazol-1-yl)methylbenzamide]silver(I) tetrafluoroborate, 2; bis[4-(5,6-dimethylbenzimidazol-1-yl)methylbenzamide]silver(I) tetrafluoroborate, 3; bis[4-(2-methylbenzimidazol-1-yl)methylbenzamide]silver(I) hexafluoroarsenate methanol, 4; bis[3-(2-methylbenzimidazol-1-yl)methylbenzamide]silver(I) hexafluoroarsenate methanol(0.5), 5; bis[4-(5,6-dimethylbenzimidazol-1-yl) methylbenzamide]silver(I) hexafluoroarsenate, 6; bis[4-(2-methylbenzimidazol-1-yl)methylbenzamide]silver(I) hexafluoroantimonate, 7; and bis[3-(2-methylbenzimidazol-1-yl)methylbenzamide]silver(I) hexafluoroantimonate, 8.

Enlarged vomeronasal organ in a child: imaging findings.

The vomeronasal organ is a special sensory organ that exists in both animals and humans. It is located on the sides of nasal septum and although it involutes with age, occasionally it may be seen in humans. We present the imaging findings in a child with an enlarged nasal septum whose features we believe are compatible with a vomeronasal organ.

Calcification of the olfactory bulbs in three patients with hyposmia.

An estimated two million Americans suffer from chemosensory disorders. We present the clinical and imaging findings in three hyposmic patients with bilateral olfactory bulb calcification detected by CT. To our knowledge, these are the first cases of olfactory bulb calcification reported in the literature.

Meningitis due to Enterobacter aerogenes subsequent to resection of acoustic neuroma and percutaneous endoscopic gastrostomy tube placement: a rare nosocomial event.

We present a case of meningitis after percutaneous endoscopic gastrostomy (PEG) tube placement subsequent to acoustic neuroma resection and cranioplasty. Four days following PEG tube placement, the patient developed Enterobacter aerogenes meningitis, requiring explantation of infected cranioplasty material. His condition subsequently improved.

Coronal computed tomography analysis of frontal cells.

Background: Described by Schaefer in 1916, frontal cells have been implicated as a cause of frontal recess obstruction. In this cross-sectional study, we determine the prevalence of frontal cells and other anatomic variants and examine their relationships.

Methods: Coronal computed tomography scans of the sinuses performed from January 2000 to June 2001 were evaluated for frontal cells, other anatomic variants, and sinus disease.

External auditory canal eccrine spiradenocarcinoma: a case report and review of literature.

Background: Eccrine spiradenocarcinoma is a rare dermal appendage carcinoma believed to arise from transformation of a long-standing benign spiradenoma. This tumor demonstrates highly malignant biologic behavior with a high recurrence rate, frequent lymph node metastases, and overall poor survival.

Methods: We report the first case of eccrine spiradenocarcinoma arising in the external auditory canal.

Hemangioma of the sphenoid and ethmoid sinuses: two case reports.

Hemangiomas of the paranasal sinuses are rare, particularly those of the sphenoid and ethmoid sinuses. Although imaging of the sinuses is key to determining the extent of involvement, the diagnosis is based on the lesion's histologic appearance. Obtaining an adequate biopsy can be difficult in light of the risk of bleeding and the relative inaccessibility of lesions in this region.

Oral cancer treatment.

Oral cancer is the sixth most common cancer in the world, and it continues to represent a serious public health problem. Oral cancer is a preventable disease, related to behavioral and lifestyle factors, including tobacco and alcohol. Prevention and early detection of oral cancer remain the goals of national efforts to reduce the impact of this disease on the public.

Evaluation and surgical management of isolated sphenoid sinus disease.

Objectives: To evaluate the pathologic conditions, preoperative evaluation, treatment, and clinical outcomes associated with sphenoid sinus disease.

Design: Retrospective study.

Setting: Tertiary university-based referral center.

The ascending pharyngeal artery: branches, anastomoses, and clinical significance.

Neuroradiologists generally do not fully appreciate the importance of the territory of the ascending pharyngeal artery. The ascending pharyngeal artery is a small but important artery that supplies multiple cranial nerves and anastomotic channels to the anterior and posterior cerebral circulations. Several disease processes in the head and neck involve the ascending pharyngeal artery.