Electronic health record system use and documentation burden of acute and critical care nurse clinicians: a mixed-methods study.

Objectives: Examine electronic health record (EHR) use and factors contributing to documentation burden in acute and critical care nurses.

Materials And Methods: A mixed-methods design was used guided by Unified Theory of Acceptance and Use of Technology. Key EHR components included, Flowsheets, Medication Administration Records (MAR), Care Plan, Notes, and Navigators.

A program for real-time surveillance of SARS-CoV-2 genetics.

The COVID-19 pandemic brought forth an urgent need for widespread genomic surveillance for rapid detection and monitoring of emerging SARS-CoV-2 variants. It necessitated design, development, and deployment of a nationwide infrastructure designed for sequestration, consolidation, and characterization of patient samples that disseminates de-identified information to public authorities in tight turnaround times. Here, we describe our development of such an infrastructure, which sequenced 594,832 high coverage SARS-CoV-2 genomes from isolates we collected in the United States (U.

Consistent metacognitive efficiency and variable response biases in peripheral vision.

Across the visual periphery, perceptual and metacognitive abilities differ depending on the locus of visual attention, the location of peripheral stimulus presentation, the task design, and many other factors. In this investigation, we aimed to illuminate the relationship between attention and eccentricity in the visual periphery by estimating perceptual sensitivity, metacognitive sensitivity, and response biases across the visual field. In a 2AFC detection task, participants were asked to determine whether a signal was present or absent at one of eight peripheral locations (±10°, 20°, 30°, and 40°), using either a valid or invalid attentional cue.

Use of Electronic Health Records and Documentation Burden Among Nurses in Acute and Critical Care.

Nurses who provide the majority of hands-on care for hospitalized patients are disproportionately affected by the current state of electronic health records (EHRs), and little is known about their lived perception of EHR use. Using a mixed-methods research design, we conducted an in-depth analysis and synthesis of data from EHR usage log files, interviews, and surveys and assessed factors contributing to the nurse documentation burden in acute and critical at a large academic medical center. There remain substantial spaces where we can develop viable solutions for enhancing the usability of multi-component EHR systems.

SARS-CoV-2 variant introduction following spring break travel and transmission mitigation strategies.

Background: University spring break carries a two-pronged SARS-CoV-2 variant transmission risk. Circulating variants from universities can spread to spring break destinations, and variants from spring break destinations can spread to universities and surrounding communities. Therefore, it is critical to implement SARS-CoV-2 variant surveillance and testing strategies to limit community spread before and after spring break to mitigate virus transmission and facilitate universities safely returning to in-person teaching.

Effects of Social Determinants and Pharmacogenetic Medication Interactions on 90-Day Hospital Readmissions.

Context: The present study builds on our prior work that demonstrated an association between pharmacogenetic interactions and 90-day readmission. Objective: Evaluate aggregate contribution of social determinants, comorbidity, and gene-x-drug interactions to moderate 90-day hospital readmission. Study Design and Analysis: Non-concurrent cohort study; Multivariable logistic regression Setting: Hospital/integrated healthcare delivery system in northern Illinois Population Studied: 19,999 adults tracked from 2010 through 2020 who underwent testing with a 13-gene pharmacogenetic panel Outcome Measure: 90-day hospital readmission (primary outcome) Results: Univariate logistic regression analyses demonstrated that strongest associations with 90 day hospital readmissions were the number of medications prescribed within 30 days of a first hospital admission that had Clinical Pharmacogenomics Implementation Consortium (CPIC) guidance (CPIC medications) (5+ CPIC medications, odds ratio (OR) = 7.

Oral Care in Critically Ill Infants and the Potential Effect on Infant Health: An Integrative Review.

Background: Critically ill infants admitted to the neonatal intensive care unit are at risk for ventilator-associated pneumonia and abnormal oral colonization. Adherence to evidence-based guidelines for oral care in critically ill adults is associated with improved short- and long-term health outcomes. However, oral care guidelines for critically ill infants admitted to the neonatal intensive care unit have not been established, possibly increasing their risk of ventilator-associated pneumonia and other health complications.

Effects of neurofeedback training on performance in laboratory tasks: A systematic review.

Neurofeedback procedures are attracting increasing attention in the neuroscience community. Based on the principle that participants, through suitable feedback, may learn to affect specific aspects of their brain activity, neurofeedback interventions have been applied to basic research, translational, and clinical science. A large segment of the available empirical research as well as review articles have focused on the extent to which neurofeedback interventions affect mental health outcomes, cognitive capacity, aging, and other complex behaviors.

Effect Modification by Social Determinants of Pharmacogenetic Medication Interactions on 90-Day Hospital Readmissions within an Integrated U.S. Healthcare System.

The present study builds on our prior work that demonstrated an association between pharmacogenetic interactions and 90-day readmission. In a substantially larger, more diverse study population of 19,999 adults tracked from 2010 through 2020 who underwent testing with a 13-gene pharmacogenetic panel, we included additional covariates to evaluate aggregate contribution of social determinants and medical comorbidity with the presence of identified gene-x-drug interactions to moderate 90-day hospital readmission (primary outcome). Univariate logistic regression analyses demonstrated that strongest associations with 90 day hospital readmissions were the number of medications prescribed within 30 days of a first hospital admission that had Clinical Pharmacogenomics Implementation Consortium (CPIC) guidance (CPIC medications) (5+ CPIC medications, odds ratio (OR) = 7.

Noise resistant synchronization and collective rhythm switching in a model of animal group locomotion.

Biology is suffused with rhythmic behaviour, and interacting biological oscillators often synchronize their rhythms with one another. Colonies of some ant species are able to synchronize their activity to fall into coherent bursts, but models of this phenomenon have neglected the potential effects of intrinsic noise and interspecific differences in individual-level behaviour. We investigated the individual and collective activity patterns of two ant species.

Occipital Nerve Stimulation: An Alternative Treatment of Chronic Migraine.

Purpose Of Review: This paper will examine the efficacy and safety of occipital nerve stimulation as a non-pharmacological alternative treatment for migraine.

Recent Findings: Migraine is characterized as a primary headache disorder with possible premonitory and aura phases, both of which vary greatly in symptomatology. The most common treatments for chronic migraine are pharmacological and are aimed at both acute relief (e.

The Contribution of Pharmacogenetic Drug Interactions to 90-Day Hospital Readmissions: Preliminary Results from a Real-World Healthcare System.

Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines exist for many medications commonly prescribed prior to hospital discharge, yet there are limited data regarding the contribution of gene-x-drug interactions to hospital readmissions. The present study evaluated the relationship between prescription of CPIC medications prescribed within 30 days of hospital admission and 90-day hospital readmission from 2010 to 2020 in a study population (N = 10,104) who underwent sequencing with a 14-gene pharmacogenetic panel. The presence of at least one pharmacogenetic indicator for a medication prescribed within 30 days of hospital admission was considered a gene-x-drug interaction.

Distance From Critical Pelvic Structures: Radiographic Comparison of High Submuscular and Space of Retzius IPP Reservoir Placement Techniques.

Objective: To evaluate the distance from critical pelvic structures (CPS, defined as bladder and iliac vessels) among inflatable penile prosthesis (IPP) reservoirs placed into the space of Retzius (SOR) and high submuscular (HSM) locations using cross-sectional imaging. IPP reservoir placement into the HSM location has been proposed as a strategy to prevent injury due to greater distance from CPS.

Methods: Our institutional database was retrospectively reviewed to identify men who underwent IPP insertion between 2007 and 2020 and had available cross-sectional abdominopelvic imaging after the time of surgery.

Radiographic Assessment of Inflatable Penile Prosthesis Reservoir Location Variability in Contemporary Practice.

Background: Inflatable penile prosthesis (IPP) reservoirs are typically placed into the Space of Retzius (SOR) or alternative locations including the High Submuscular (HSM) space via transinguinal (TI) or counter incision (CI) techniques. A cadaver study showed variability in reservoir location after TI-HSM placement.

Aim: To evaluate reservoir location using cross-sectional imaging following IPP insertion.

The Antisense Oligonucleotide Nusinersen for Treatment of Spinal Muscular Atrophy.

Spinal muscular atrophy (SMA) is a rare, autosomal recessive neuromuscular degenerative disease characterized by loss of spinal cord motor neurons leading to progressive muscle wasting. The most common pathology results from a homozygous disruption in the survival motor neuron 1 (SMN1) gene on chromosome 5q13 via deletion, conversion, or mutation. SMN2 is a near duplicate of SMN1 that can produce full-length SMN mRNA transcripts, but its overall production capability of these mRNA transcripts is lower than that seen in SMN1.

Spatial proximity and prey vibratory cues influence collective hunting in social spiders.

Social spiders are thought to predominantly receive information about their environment through vibrational cues. Thus, group living introduces the challenge of distinguishing useful vibrational information from the background noise of nestmates. Here we investigate whether spatial proximity between colony-mates may allow social spiders () to reduce background noise that might obstruct vibrational information from prey.

Costs Associated With Imaging Surveillance After Treatment for Head and Neck Cancer.

Importance: The National Comprehensive Cancer Network recommends imaging within 6 months after treatment for head and neck cancer (HNC). Further imaging is recommended only if the patient has symptoms or abnormal findings on physical examination. However, in many instances, asymptomatic patients continue to have imaging evaluations.

Surface characterization of a silicone hydrogel contact lens having bioinspired 2-methacryloyloxyethyl phosphorylcholine polymer layer in hydrated state.

A silicone hydrogel contact lens material, with a unique chemical and physical structure has been designed for long-term ocular performance. Enhancement of this silicone hydrogel contact lens material was achieved through surface modification using a cross-linkable bioinspired 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer, which creates a soft surface gel layer on the silicone hydrogel base material. The surface properties of this MPC polymer-modified lens were characterized under hydrated condition revealing, inter alia, its unique polymer structure, excellent hydrophilicity, lubricity, and flexibility.

Predator-induced selection on urchin activity level depends on urchin body size.

Temporally consistent individual differences in behavior impact many ecological processes. We simultaneously examined the effects of individual variation in prey activity level, covering behavior, and body size on prey survival with predators using an urchin-lobster system. Specifically, we tested the hypothesis that slow-moving purple sea urchins () and urchins who deploy extensive substrate (pebbles and stones) covering behavior will out-survive active urchins that deploy little to no covering behavior when pitted against a predator, the California spiny lobster ().