Proper Placement of Tubes on Chest Radiographs.

A variety of tubes are placed by the advanced practice provider including endotracheal tubes, nasogastric tubes, feeding tubes, and chest tubes. Recognizing the proper placement of these tubes is critical to prevent complications and allow for intended use including ventilation, nasogastric drainage, providing enteral nutrition, and drainage of air or fluid from the pleural space. The advanced practice provider must be aware of the anatomical landmarks that help indicate correct positioning for safe use and proper functioning of these tubes.

Clinical and economic strategies in outpatient medical care during the COVID-19 pandemic.

The COVID-19 pandemic has resulted in significant clinical and economic consequences for medical practices of all specialties across the nation. Although the clinical implications are of the utmost importance, the economic consequences have also been serious and resulted in substantial damage to the US healthcare system, including pain practices. Outpatient pain practices have had to significantly change their clinical care pathways, including the incorporation of telemedicine.

Controlling interdependent meso-nanosecond dynamics and defect generation in metal 3D printing.

State-of-the-art metal 3D printers promise to revolutionize manufacturing, yet they have not reached optimal operational reliability. The challenge is to control complex laser-powder-melt pool interdependency (dependent upon each other) dynamics. We used high-fidelity simulations, coupled with synchrotron experiments, to capture fast multitransient dynamics at the meso-nanosecond scale and discovered new spatter-induced defect formation mechanisms that depend on the scan strategy and a competition between laser shadowing and expulsion.

Vaping: What Every Emergency Nurse Practitioner Should Know!

As of December 10, 2019, according to the Centers for Disease Control and Prevention (CDC), more than 2,668 hospitalized cases of lung injury and 60 deaths associated with use of electronic nicotine delivery systems, or "vaping." In many cases, patients required multiple health care visits prior to diagnosis. Recognition of the risk factors, symptoms, and examination findings that have been consistently reported is critical to making the diagnosis and initiating treatment early in the progression of disease.

Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of low back pain.

Background Context: The North American Spine Society's (NASS) Evidence Based Clinical Guideline for the Diagnosis and Treatment of Low Back Pain features evidence-based recommendations for diagnosing and treating adult patients with nonspecific low back pain. The guideline is intended to reflect contemporary treatment concepts for nonspecific low back pain as reflected in the highest quality clinical literature available on this subject as of February 2016.

Purpose: The purpose of the guideline is to provide an evidence-based educational tool to assist spine specialists when making clinical decisions for adult patients with nonspecific low back pain.

Model Predictive Control of a Feedback-Linearized Hybrid Neuroprosthetic System With a Barrier Penalty.

Functional electrical stimulation (FES) is prescribed as a treatment to restore motor function in individuals with neurological impairments. However, the rapid onset of FES-induced muscle fatigue significantly limits its duration of use and limb movement quality. In this paper, an electric motor-assist is proposed to alleviate the fatigue effects by sharing work load with FES.

Caring for patients with pain during the COVID-19 pandemic: consensus recommendations from an international expert panel.

Chronic pain causes significant suffering, limitation of daily activities and reduced quality of life. Infection from COVID-19 is responsible for an ongoing pandemic that causes severe acute respiratory syndrome, leading to systemic complications and death. Led by the World Health Organization, healthcare systems across the world are engaged in limiting the spread of infection.

Consensus practice guidelines on interventions for lumbar facet joint pain from a multispecialty, international working group.

Background: The past two decades have witnessed a surge in the use of lumbar facet blocks and radiofrequency ablation (RFA) to treat low back pain (LBP), yet nearly all aspects of the procedures remain controversial.

Methods: After approval by the Board of Directors of the American Society of Regional Anesthesia and Pain Medicine, letters were sent to a dozen pain societies, as well as representatives from the US Departments of Veterans Affairs and Defense. A steering committee was convened to select preliminary questions, which were revised by the full committee.

A Systematic Literature Review of Spine Neurostimulation Therapies for the Treatment of Pain.

Objective: To conduct a systematic literature review of spinal cord stimulation (SCS) for pain.

Design: Grade the evidence for SCS.

Methods: An international, interdisciplinary work group conducted literature searches, reviewed abstracts, and selected studies for grading.

Options: A Prospective, Open-Label Study of High-Dose Spinal Cord Stimulation in Patients with Chronic Back and Leg Pain.

Background: Therapeutic approaches to spinal cord stimulation (SCS) continue to evolve and improve patient outcomes in patients receiving SCS therapy secondary to failed back surgery syndrome.

Objectives: The aim of this study was to evaluate pain relief and other patient outcomes of SCS using selected high-dose programming parameters.

Study Design: This was a prospective cohort study.

Implementation of the North American Neuromodulation Society Mentorship Program: Recommendations and Survey Results of Participants.

Introduction: Despite Accredited Counsel of Graduate Medical Education (ACGME) guidance and criteria, there remains variability in training both within each specialty and across the specialties involved in the delivery of neuromodulation. NANS advocates for the efficacious and safe the implementation of neuromodulation and therefore an educational mentoring program with a defined educational platform is needed.

Materials And Methods: This is a structured, patient centered, and evidence-based approach mentorship program performed more than one year.

THE INFLUENCE OF HEEL HEIGHT ON MUSCLE ELECTROMYOGRAPHY OF THE LOWER EXTREMITY DURING LANDING TASKS IN RECREATIONALLY ACTIVE FEMALES: A WITHIN SUBJECTS RANDOMIZED TRIAL.

Background: An increased risk of ACL injury has been shown in female athletes who land from jumping maneuvers with knee angles close to extension and in those who demonstrate a hamstring-to-quadriceps muscle recruitment imbalance.

Hypothesis/purpose: The purpose of this study was to determine if added heel lift height would alter electromyography (EMG) magnitude and timing of the quadriceps (vastus medialis, vastus lateralis), hamstrings (semitendinosus, biceps femoris) and gastroc (medial gastroc, lateral gastroc) musculature during forward jump and drop-rebound jump landing tasks in females. The authors hypothesized increased heel lift height would promote recruitment of the hamstring and gastrocnemius muscles and increase the time to peak muscle activity in the quadriceps muscles.

An expanded toxicological profile of tetramethyl bisphenol F (TMBPF), a precursor for a new food-contact metal packaging coating.

Tetramethyl bisphenol F (TMBPF) has been shown to impart unique physical properties critical for high performance of epoxy can coatings without the estrogenic activity concerns associated with other bisphenols. To further characterize the toxicological profile of TMBPF, additional endocrine-related endpoints including in vitro aromatase inhibition and steroidogenesis assays, and in vivo androgen agonism/antagonism were performed. Systemic toxicity was also assessed by a repeat dose 90-day dietary toxicity study followed by 28-day recovery period.

A framework for integrating information resources for chemical emergency management and response.

Effective emergency management and response require appropriate utilization of various resources as an incident evolves. This manuscript describes the information resources used in chemical emergency management and operations and how their utility evolves from the initial response phase to recovery to event close out. The authors address chemical hazard guidance in the context of four different phases of emergency response: preparedness, emergency response (both initial and ongoing), recovery, and mitigation.

Impact of a Telehealth-Based Antimicrobial Stewardship Program in a Community Hospital Health System.

Background: Data on antimicrobial stewardship programs (ASPs) facilitated via telehealth in the community hospital setting are limited.

Methods: A telehealth-based ASP was implemented in 2 community hospitals (285 and 176 beds). Local pharmacists without residency or prior antimicrobial stewardship training were trained to conduct prospective audit and feedback.

Prevention and treatment of dilator injuries during central venous catheter placement.

Backround: Misuse of vascular dilators during the placement of central venous catheters has been infrequently reported and can lead to devastating intrathoracic hemorrhage and death. These injuries should be preventable in most cases. If a major intrathoracic vascular injury is recognized intraoperatively, less invasive treatment options are available to minimize the consequences.

A framework for integrating information resources for chemical emergency management and response.

Effective emergency management and response require appropriate utilization of various resources as an incident evolves. This manuscript describes the information resources used in chemical emergency management and operations and how their utility evolves from the initial response phase to recovery to event close out. The authors address chemical hazard guidance in the context of four different phases of emergency response: preparedness, emergency response (both initial and ongoing), recovery, and mitigation.

Mine drainage: Treatment technologies and rare earth elements.

The recent research and development on mine drainage published in 2018 was summarized in this annual review. In particular, this review was focused on two main aspects of mine drainage: (a) advances in treatment technologies and (b) rare earth elements in mine drainage and its recovery. The first section covers passive treatment technologies and active treatment options, including physiochemical treatment and biological treatment.

Fatal gadolinium-induced encephalopathy following accidental intrathecal administration: a case report and a comprehensive evidence-based review.

Gadolinium-based contrast agents (GBCAs) have been suggested as off-label alternatives to iodine-based contrast agents for fluoroscopic imaging during interventional pain procedures. We report a case of accidental intrathecal administration of a GBCA during a neuraxial interventional pain procedure leading to acute gadolinium neurotoxicity, which resulted in encephalopathy and ultimately death. To our knowledge, it is the first published case of fatal intrathecal gadolinium-induced encephalopathy and the first published case of intrathecal gadoteridol causing serious neurologic complications.

Spinal Cord Stimulation Infection Rate and Incremental Annual Expenditures: Results From a United States Payer Database.

Objectives: Surgical site infections (SSIs) result in significant negative clinical and economic outcomes. The objective of this study is to estimate annual health expenditures associated with spinal cord stimulation (SCS)-related infections.

Materials And Methods: Data from the Truven MarketScan® databases were used to identify patients with an SCS implant (2009-2014) and a continuous health plan enrollment for at least 12-months before and after implant (index date).