Elevated inbreeding in Heliconia tortuosa is determined by tropical forest stand age, isolation and loss of hummingbird functional diversity.

Forest conversion and habitat loss are major threats to biological diversity. Forest regeneration can mitigate the negative effects of old-growth forest loss on species diversity, but less is known about the extent to which forest loss reduces genetic diversity in remnant populations and whether secondary forests play a role in the maintenance of genetic diversity. We quantified genetic diversity in a tropical hummingbird-pollinated understorey herb, Heliconia tortuosa, across a landscape mosaic of primary and secondary forest regrowth.

Current Utilization of Antifungal Agents for Intra-abdominal Infections Categorized by Patient Risk Factors During Surgical Procedures: A Literature Review.

The high morbidity and mortality rates associated with invasive fungal infections have led to the overutilization of empiric antifungal therapies. With increasing antibiotic resistance, the careful consideration of prophylactic or empiric antifungal use is critical. The purpose of this review is to evaluate the available literature regarding the current practice of utilizing antifungal agents for intra-abdominal infections based on specific surgical procedures and patient risk factors.

Formulation and Characterization of Raloxifene Nanostructured Lipid Carriers for Permeability and Uptake Enhancement Applications.

Raloxifene (RLX), a biopharmaceutical classification system (BCS) class II drug, is a selective estrogen receptor modulator (SERM) having an estrogenic effect on the bone and an antiestrogenic effect on the endometrium and breast. Low solubility, high permeability, high metabolism, and low bioavailability are the characteristics of raloxifene. Although 60% is absorbed orally, raloxifene shows extremely poor bioavailability (2%) owing to its low solubility and extensive (>90%) intestinal/hepatic first-pass metabolism.

BarberED then screened: Disrupting the colorectal cancer disparity in urban Black men.

Background: Colorectal cancer (CRC) is the third most common diagnosed cancer among non-Hispanic Black people in the United States. Alarmingly, this population is also 40% more likely to succumb to the disease. Black men get diagnosed younger, present with late-stage disease, and have poor 5-year survival rates.

An Exploratory Study of a New Vancomycin Eye Drops Formulation for Extemporaneous Compounding.

Purpose: Compounded eye drop solutions of vancomycin hydrochloride have important clinical applications, such as postoperative antimicrobial prophylaxis and bacterial keratitis. There exists a plethora of data to support the use of various liquid vehicles to compound vancomycin hydrochloride eye drops. However, there are a number of limitations for implementation, especially the frequent shortage or discontinuation of the vehicle products.

Medications Associated With Geriatric Syndromes (MAGS) and Hospitalization Risk in Home Health Care Patients.

Objectives: Polypharmacy is common in home health care (HHC). This study examined the prevalence of medications associated with geriatric syndromes (MAGS), its predictors, and association with subsequent hospitalization in HHC.

Design: Analysis of HHC electronic medical records, the Outcome and Assessment Information Set (OASIS), and Medicare HHC claims.

An Introductory Over-the-Counter Simulation for First-Year Pharmacy Students Using a Virtual Pharmacy.

First-year pharmacy students at two institutions were required to complete a virtual over-the-counter (OTC) simulation during their community pharmacy practice skills laboratory course. The simulation was designed to introduce first-year pharmacy students to OTC product selection and consultation prior to didactic coursework and community introductory pharmacy practice experiences. The objective of this study was to assess the impact of the OTC simulation on students' knowledge and confidence of OTC medications and overall perceptions of the activity.

Multicenter Retrospective Review of Ketamine Use in the ICU.

Unlabelled: The response of ICU patients to continuously infused ketamine when it is used for analgesia and/or sedation remains poorly established.

Objectives: To describe continuous infusion (CI) ketamine use in critically ill patients, including indications, dose and duration, adverse effects, patient outcomes, time in goal pain/sedation score range, exposure to analgesics/sedatives, and delirium.

Design Setting And Participants: Multicenter, retrospective, observational study from twenty-five diverse institutions in the United States.

A qualitative exploration of nurse-physician collaboration in intensive care units.

Background: Effective nurse-physician collaboration is associated with superior patient outcomes and improved job satisfaction for both nurses and physicians.

Objectives: This qualitative study explored factors that contribute to nurse-physician collaboration in critical care. Using a qualitative descriptive design, in-depth interviews were conducted with intensive care unit physicians and nurses.

Does Accreditation by the Association of Zoos and Aquariums Correlate with Animal Welfare Act Compliance?

The Association of Zoos and Aquariums (AZA) promotes itself as the "gold standard" for animal welfare in zoos and aquariums; however, no objective evaluation of this claim has been performed. As the only statute providing protection to individual animals in the United States, the Animal Welfare Act (AWA) also seeks to assure animal welfare at facilities exhibiting animals to the public. In this study, the incidences of AWA noncompliant items (NCIs) at AZA-accredited facilities were evaluated and compared to non-accredited facilities licensed as exhibitors by the United States Department of Agriculture (USDA).

A Retrospective Characterization of Dexmedetomidine-Suspected Fever and Its Consequences in Adult Critically Ill Patients.

Background: Current evidence for dexmedetomidine-suspected fever (DSF) is limited. Lack of recognition may lead to costly or potentially harmful interventions for critically ill patients.

Objective: The primary objective was to characterize escalations of care related to DSF.

The Use of Neuromuscular Blockers to Prevent Shivering in the Setting of Postcardiac Arrest Targeted Temperature Management: A Narrative Review of an Off-Label Indication.

Targeted temperature management (TTM) has become a standard of care over the past two decades for the improvement in neurologic function and mortality in postcardiac arrest patients. There are various mechanisms by which hypothermia helps to improve these outcomes, one of which is by reducing oxygen requirements. Less established is the use of nondepolarizing neuromuscular blockers (NMBs) to prevent shivering during TTM.

Combined oral contraceptive use in rheumatoid arthritis for the purpose of pregnancy prevention and additional benefits: A narrative review.

Combined oral contraceptives are a common method of contraception and many females prefer them regardless of their medical history. The use in patients with rheumatoid and autoimmune disorders has not been extensively studied with previous reviews focusing on the safety component. This review seeks to address the effectiveness and benefits of utilizing combined oral contraceptives in females with rheumatoid arthritis (RA).

Stinging Nettle (Urtica dioica): An Unusual Case of Galactorrhea.

BACKGROUND The increasing popularity and availability of herbal supplements among patients necessitates a better understanding of their mechanism of action and the effects they have on the body, both intended and unintended. Stinging nettle (Urtica dioica) is an herbaceous shrub found throughout the world that has been used for medicinal purposes for centuries. CASE REPORT A 30-year-old woman with obesity and GERD presented to a primary care clinic with new-onset galactorrhea.

The Psychology of COVID-19 Economic Impact Payment Use.

Unlabelled: This study investigates how American adults' personality and financial self-efficacy (FSE) beliefs contributed to how they used their COVID-19 CARES Act Economic Impact Payment (EIP) for spending needs, spending wants, and financial transactions (save, invest, debt repayment). The results from a sample of 1172 Amazon MTurk users collected in July 2020 suggest that both personality traits and FSE beliefs were associated with EIP use. Specifically, this study finds that FSE and conscientiousness emerged as the most robust predictors of EIP use across all categories of financial behavior with a greater allocation of EIP funds to saving and less to spending needs and debt repayment.

The association between commuting, mood and job performance: the structural equation modelling approach.

Commuting demands a considerable amount of time from a worker's daytime. Numerous studies have shown the relationship between commuting and mood, and even job performance. Contradictory findings are also present in the literature regarding the association between commuting, mood and job performance.

An Outreach Phone Call Project: Using Home Health to Reach Isolated Community Dwelling Adults During the COVID 19 Lockdown.

Home health care (HHC) focuses on delivering skilled health care services to patients in their homes. Over 82% of HHC patients are 65 and older, and living with chronic health conditions. In an effort to respond to the risk the COVID-19 pandemic presented for patients, a HHC agency designed "The Outreach Phone Call Project".

Development and optimization of paclitaxel loaded Eudragit/PLGA nanoparticles by simplex lattice mixture design: Exploration of improved hemocompatibility and in vivo kinetics.

Anemia is the most common hematological abnormality of chemotherapy, which is responsible for poor clinical outcomes. To overcome this complication, the present study was aimed for developing a Eudragit/polylactic-co-glycolic acid (PLGA) based nanoparticulate system for a model drug paclitaxel (PTX). The study was planned using a simplex lattice mixture design.

Filling the Gaps on the Institute for Safe Medication Practices (ISMP) Do Not Crush List for Immediate-release Products.

The Institute for Safe Medication Practices (ISMP) Do Not Crush List is a common resource for healthcare providers to determine whether an oral solid drug product can be manipulated. However, evidence is weak or missing for a number of immediate-release products. The purpose of this study was to perform an in-depth analysis of these products on the ISMP Do Not Crush List with the goal of removing unnecessary restrictions and providing conditional recommendations if needed.

The Beacon Collaborative: A Journey to Excellence.

Topic: The development of the Critical Care Beacon Collaborative to achieve meaningful recognition.

Clinical Relevance: Recognizing nurses for contributions to their work environment and care delivery is important for their professional and personal fulfillment, job satisfaction, and retention; such recognition can occur at the individual, unit, or organizational level. The American Nurses Credentialing Center's Magnet Recognition Program acknowledges nursing excellence at the organizational level.

Ghrelin Immunoreactive Cell Amounts in the Abomasum in 4-Month-Old Calves by Feeding Different Amounts of Prebiotics and New Synbiotics.

The study aim was to determine prebiotic (inulin) and new synbiotic (inulin and varied dosage effects, during food breakdown-abomasum immunoreactive (IR) cell amount and cold carcass weight. Ghrelin is synthesized in the fundus region of the stomach. In the gastrointestinal system, ghrelin affects multiple functions, including secretion of gastric acid, gastric motility, and pancreatic protein output.