Spanish Translation and Cultural Adaptation of the Intensive Care Unit Delirium Playbook.

Background: A lack of high-quality provider education hinders the delivery of standard-of-care delirium detection and prevention practices in the intensive care unit (ICU). To fill this gap, we developed and validated an e-learning ICU Delirium Playbook consisting of eight videos and a 44-question knowledge assessment quiz. Given the increasing Spanish-speaking population worldwide, we translated and cross-culturally adapted the playbook from English into Spanish.

Integrated platform for multiscale molecular imaging and phenotyping of the human brain.

Understanding cellular architectures and their connectivity is essential for interrogating system function and dysfunction. However, we lack technologies for mapping the multiscale details of individual cells and their connectivity in the human organ-scale system. We developed a platform that simultaneously extracts spatial, molecular, morphological, and connectivity information of individual cells from the same human brain.

New insights and novel perspectives in bileaflet mechanical heart valve prostheses thromboresistance.

Background: Although well-known for their thromboresistance, bileaflet mechanical heart valves (BMHV) require lifelong anti-thrombotic therapy. This must be associated with a certain level of thrombogenicity. Since both thromboresistance and thrombogenicity are explained by the blood-artificial surface or liquid-solid interactions, the aim of the present study was to explore BMHV thromboresistance from new perspectives.

Correlation of microscopic tumor extension with tumor microenvironment in esophageal cancer patients.

Objective: In the era of image-guided adaptive radiotherapy, definition of the clinical target volume (CTV) is a challenge in various solid tumors, including esophageal cancer (EC). Many tumor microenvironmental factors, e.g.

Proteolytic stability and aggregation in a key metabolic enzyme of bacteria.

Proteins that are kinetically stable are thought to be less prone to both aggregation and proteolysis. We demonstrate that the classical system of can be leveraged as a model system to study this relation. β-galactosidase (LacZ) plays a critical role in lactose metabolism and is an extremely stable protein that can persist in growing cells for multiple generations after expression has stopped.

Using a Flipped Classroom Model to Deliver Cardiovascular Nursing Education: A Continuous Quality Improvement Study.

The COVID-19 pandemic served as a catalyst to change a didactic class training series consisting of passive lecture-based learning to a flipped classroom model with active learning techniques for newly hired nurses to a cardiovascular center. The purpose of this quality improvement project is to measure if utilizing a flipped classroom model to teach new cardiovascular nurses elicits the same class evaluation measurements compared to a traditional in-person didactic learning model.

Development and Validation of an ICU Delirium Playbook for Provider Education.

Unlabelled: Although delirium detection and prevention practices are recommended in critical care guidelines, there remains a persistent lack of effective delirium education for ICU providers. To address this knowledge-practice gap, we developed an "ICU Delirium Playbook" to educate providers on delirium detection (using the Confusion Assessment Method for the ICU) and prevention.

Design: Building on our previous ICU Delirium Video Series, our interdisciplinary team developed a corresponding quiz to form a digital "ICU Delirium Playbook.

Development and Evaluation of an Intensive Care Unit Video Series to Educate Staff on Delirium Detection.

Background: Delirium affects up to 80% of patients who are mechanically ventilated in the intensive care unit (ICU) but often goes undetected because of incomplete and/or inaccurate clinician evaluation and documentation. A lack of effective, feasible, and sustainable educational methods represents a key barrier to efforts to optimize, scale, and sustain delirium detection competencies. Progress with such barriers may be addressed with asynchronous video-based education.

Comparing Patient Perspectives on Diabetes Management to the Deficit-Based Literature in an Ethnic Minority Population: A Mixed-Methods Study.

Marginalized racial/ethnic minorities have disproportionately high rates of type 2 diabetes prevalence, complications and mortality. Researchers and policymakers have typically addressed these disparities using a deficit-based discourse focused on individual/cultural deficiencies or failure. A mixed-methods study was used to compare the deficit discourse to the perspectives of adults with diabetes in the Arab minority in Israel, using data from 10 focus groups (5 men's, 5 women's) and 296 quantitative in-person surveys.

Axon Tracing and Centerline Detection using Topologically-Aware 3D U-Nets.

As advances in microscopy imaging provide an ever clearer window into the human brain, accurate reconstruction of neural connectivity can yield valuable insight into the relationship between brain structure and function. However, human manual tracing is a slow and laborious task, and requires domain expertise. Automated methods are thus needed to enable rapid and accurate analysis at scale.

Emotion processing in depression with and without comorbid anxiety disorder.

Background: Among mental disorders, major depressive disorder (MDD) is highly prevalent and associated with emotional dysfunctions linked to activity alterations in the brain, mainly in prefrontal regions, the insula, the anterior cingulate cortex and the amygdala. However, this evidence is heterogeneous, perhaps because magnetic resonance imaging (MRI) studies on MDD tend to neglect comorbid anxiety (COM-A).

Methods: To address this, here a sample of age- and sex-matched patients, n = 90 and n = 85, underwent functional MRI to assess neurofunctional group differences during a negative emotional face-matching task using a hypothesis-driven region of interest approach (dorsolateral prefrontal cortex, insula, anterior cingulate cortex, amygdala) and an explorative whole-brain approach.

Attention-deficit/hyperactivity disorder (ADHD) and anxiety during the COVID-19 pandemic: Implications for internalizing behaviors in college students.

The purpose of this study was to delineate the moderating roles of negative experiences related to the coronavirus disease 2019 (COVID-19) on the association between Attention-Deficit/Hyperactivity Disorder symptoms and anxiety symptoms and internalizing behaviors during Fall 2020. Participants were 200 college students. Using a moderated moderation model, researchers found that attention-deficit/hyperactivity disorder symptoms predicted anxiety symptoms for those who internalized behaviors and experienced COVID-19 more negatively.

Contained rupture of a sinus of Valsalva aneurysm: Is it just a matter of luck?

Background: Contained rupture of the ascending aorta is a rare condition, but the severity of this complication enforces strict guidelines for its prevention and a prompt diagnosis, once already occurred.

Case Presentation: A 66-year-old man with a history of type 2 diabetes, longstanding aortic valve stenosis and aortic root aneurysm of 47 mm was hospital admitted for elective surgery. A Bentall-De Bono procedure was performed in order to replace the stenotic bicuspid aortic valve and exclude the dilated portion of the aortic wall.

A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study.

Indigenous and other marginalized racial/ethnic minorities have poorer health status than majority populations, including higher rates of type 2 diabetes. These disparities have typically been addressed using a 'deficit-based' discourse that isolates disease management from the broader social, economic, political context and does not incorporate patient perspectives. We aimed to explore factors affecting glycemic control among Indigenous Arabs with diabetes in Israel using a strengths-based approach that centered participants' knowledge of their context, needs, resources and strengths.

Doxycycline-Induced Gastric Perforation.

Esophageal and gastric mucosal injuries are well-documented adverse effects of doxycycline leading to odynophagia, chest pain, and abdominal pain. There are no clear diagnostic criteria for such adverse effects; hence, the diagnosis depends heavily on thorough history. There is a paucity of literature describing life-threatening complications from doxycycline-induced mucosal injury, such as hemorrhage and perforation.

Laser texturing of a St. Jude Medical RegentTM mechanical heart valve prosthesis: the proof of concept.

Objectives: The liquid-solid interactions have attracted broad interest since solid surfaces can either repel or attract fluids, configuring a wide spectrum of wetting states (from superhydrophilicity to superhydrophobicity). Since the blood-artificial surface interaction of bileaflet mechanical heart valves essentially represents a liquid-solid interaction, we analysed the thrombogenicity of mechanical heart valve prostheses from innovative perspectives. The aim of the present study was to modify the surface wettability of standard St.

The Bipartite Medial Cuneiform.

This report discusses an unusual case of a 23-year-old woman with a painful bipartite medial cuneiform and severe arthritic and cystic changes at the partition with no history of trauma. Magnetic resonance imaging confirmed a large cyst with subchondral erosions at the dorsal and plantar segments with significant bone marrow edema. Definitive treatment consisted of arthrodesis on the dorsal to plantar segments using one lag screw, demineralized bone matrix grafting, and a bone stimulator.

Extending the Lifetime of Organic Flow Batteries via Redox State Management.

Redox flow batteries based on quinone-bearing aqueous electrolytes have emerged as promising systems for energy storage from intermittent renewable sources. The lifetime of these batteries is limited by quinone stability. Here, we confirm that 2,6-dihydroxyanthrahydroquinone tends to form an anthrone intermediate that is vulnerable to subsequent irreversible dimerization.

A Two-Stage Foot Repair in a 55-Year-Old Man with Poliomyelitis.

A 55-year-old man with poliomyelitis presented with a plantarflexed foot and painful ulceration of the sub-first metatarsophalangeal joint present for many years. A two-stage procedure was performed to bring the foot to 90°, perpendicular to the leg, and resolve the ulceration. The first stage corrected only soft-tissue components.

Atypical Melanocytic Proliferation in a Pediatric Patient with Double Advancement Flap Repair.

This report highlights an unusual case of an atypical melanocytic proliferation in a pediatric patient and the surgical method used to repair the defect. I describe a 10-year-old boy with hallux irregular discoloration that was present from birth and rapidly enlarging. A biopsy led to the diagnosis of atypical melanocytic proliferation, which may represent an unusual manifestation of early melanoma in situ.

Peroneus Quartus Muscle Autograft.

This case report highlights a novel approach to strengthening the repair of a split peroneus brevis tendon tear with a peroneus quartus muscle autograft. We describe a 51-year-old woman with a longitudinal split tear of the peroneus brevis tendon confirmed by magnetic resonance imaging. Intraoperatively, a peroneus quartus muscle was appreciated, resected, and used as an autograft in the repair of the peroneus brevis tendon.

Toxin-Antitoxin systems eliminate defective cells and preserve symmetry in Bacillus subtilis biofilms.

Toxin-antitoxin modules are gene pairs encoding a toxin and its antitoxin, and are found on the chromosomes of many bacteria, including pathogens. Here, we characterize the specific contribution of the TxpA and YqcG toxins in elimination of defective cells from developing Bacillus subtilis biofilms. On nutrient limitation, defective cells accumulated in the biofilm breaking its symmetry.