Assessment of adherence to American Diabetes Association guidelines and evaluation of social determinants of health and interventions in patients with type 2 diabetes mellitus in a nurse practitioner-owned clinic.

Background: This was an ongoing quality-improvement (QI) project that aimed to assess the quality of nurse practitioner (NP)-driven diabetes care based on the 2023 American Diabetes Association (ADA) Standards of Care (SOC) at a NP-owned primary care practice. In addition, a more recent focus was the assessment of and intervention on social determinants of health (SDOH). Nationally, 47.

Acute and Critical Care Nurses' Roles in Mass Shootings: An Integrative Review.

Background: From 2018 to 2022, mass shooting incidents in the United States increased by 67.7%. Health care-associated shootings also increased.

Evaluating adherence to American Diabetes Association standards of care in diabetes and impacts of social determinants of health on patients at two nurse practitioner-owned clinics.

Background: The COVID-19 pandemic created barriers in the management of type 2 diabetes mellitus (T2DM) and worsened social determinants of health (SDOH). A New Hampshire primary care office worked to adhere to T2DM standards of care and began screening for SDOH. This project assessed adherence to quality metrics, hemoglobin A1C, and SDOH screening as telehealth utilization decreased.

Diffusely invasive supratentorial rosette-forming glioneuronal tumor: illustrative case.

Background: Rosette-forming glioneuronal tumors (RGNTs) are rare tumors composed of mixed glial and neurocytic components. Most lesions are confined to the posterior fossa, especially in the region of the fourth ventricle, in young adults. In few instances, diffuse involvement of the supratentorial region is identified, thereby creating significant challenges in diagnosis, surgical intervention, and prognostication.

Identifying multimodal misinformation leveraging novelty detection and emotion recognition.

With the growing presence of multimodal content on the web, a specific category of fake news is rampant on popular social media outlets. In this category of fake online information, real multimedia contents (images, videos) are used in different but related contexts with manipulated texts to mislead the readers. The presence of seemingly non-manipulated multimedia content reinforces the belief in the associated fabricated textual content.

Bradycardia-Induced Torsades de Pointes in Atrioventricular Block.

Bradycardia is known to prolong QT interval. Persistent bradycardia and high-grade atrioventricular (AV) block may lead to persistently prolonged QTc interval with a risk for life-threatening ventricular arrhythmias, which needs addressing the underlying cause. We present the case of a patient with persistent sinus bradycardia with a high-grade AV block leading to persistently prolonged QTc without any reversible etiology that resulted in torsades de pointes.

Predictors and outcomes of spinal cord injury following complex branched/fenestrated endovascular aortic repair in the US Aortic Research Consortium.

Objective: Spinal cord ischemia (SCI) is a well-known complication of thoracoabdominal aortic aneurysm repair and is associated with profound morbidity and mortality. The purpose of this study was to describe predictors for the development of SCI, as well as outcomes for patients who develop SCI, after branched/fenestrated endovascular aortic repair in a large cohort of centers with adjudicated physician-sponsored investigational device exemption studies.

Methods: We used a pooled dataset from nine US Aortic Research Consortium centers involved in investigational device exemption trials for treatment of suprarenal and thoracoabdominal aortic aneurysms.

Original Research: Nurses' Self-Assessed Knowledge, Attitudes, and Educational Needs Regarding Patients with Substance Use Disorder.

Background: Substance use disorder (SUD) is a chronic illness, but it's often seen as an intentional choice rather than as a disease. People with SUD are frequently stigmatized, leading to disparate care. Findings from previous studies have indicated that nurses feel inadequately prepared to care for, and tend to have negative attitudes toward, patients with SUD.

Atrioventricular Block: An Unusual Presentation of Overactive Thyroid.

The clinical features of hyperthyroidism are varied, but bradyarrhythmia and atrioventricular (AV) block are typically not reported in hyperthyroid patients. We present here a case of primary hyperthyroidism with symptomatic high-grade AV block as the sole presenting feature of hyperthyroidism without any obvious precipitating factors for thyroid disease or AV block. This case highlights a rare presentation of high-grade AV block with the risk of progression to complete AV block as a complication of an untreated overactive thyroid.

The Association of Frailty With Long-Term Outcomes in Patients With Acute Respiratory Failure Treated With Noninvasive Ventilation.

The objective of this study was to investigate the prevalence and impact of frailty on mortality in patients with acute respiratory failure (ARF) treated with noninvasive ventilation (NIV). This was a single-center, prospective study of patients who developed ARF (irrespective of etiology) and were treated with NIV support. Frailty was assessed using the Clinical Frailty Scale (CFS).

Left Main Coronary Artery Disease: The Forgotten Lead of Electrocardiogram Is Predictive.

An ST segment depression in eight or more leads along with ST segment elevation in lead aVR or V1, especially occurring during ischemic symptoms, has a very high predictive accuracy of left main or three-vessel disease, or tight proximal left anterior descending (LAD) coronary artery stenosis. We describe a classic case of a patient who presented with ST elevation in the lead aVR with diffuse ST segment depression during anginal symptoms and was found to have severe disease in the distal left main, ostial circumflex, and left anterior descending artery on an emergent coronary angiogram.

Evaluating the effect of COVID-19 on quality measures of patients with type 2 diabetes in two family nurse practitioner-owned clinics.

Background: The COVID-19 pandemic necessitated lockdowns resulting in the disruption of access to primary care. A family nurse practitioner (NP)-owned practice shifted many visits to telehealth to provide care to all their patients including those with chronic illness . The purpose of this project was to evaluate the impact of the pandemic on selected diabetes quality measures and adherence to national diabetes guidelines in two previously well-performing NP-owned primary care clinics.

Nitrous Oxide/Whippits-Induced Thoracic Spinal Cord Myelopathy and Cognitive Decline With Normal Serum Vitamin B₁₂.

Abuse of nitrous oxide leads to irreversible neurologic deficits. Nitrous oxide is commonly abused through the inhalation of whipped cream canisters. These whipped cream chargers, also known as "whippits," are widely available in the United States and their sale is unregulated.

Patterns of high-risk drinking among medical students: A web-based survey with machine learning.

Background: Prior studies have found increased rates of alcohol consumption among physicians and medical students. The present study aims to build machine learning (ML) models to identify patterns of high-risk drinking (HRD), including alcohol use disorder, within this population.

Methods: We analyzed data collected through a web-based survey among Brazilian medical students.

Highly efficient and selective antimicrobial isonicotinylhydrazide-coated polyoxometalate-functionalized silver nanoparticles.

With the rapidly approaching post-antibiotic era, new and effective combinations of antibiotics are imperative to combat multiple drug resistance (MDR). We have synthesized multimodal antimicrobials that integrate the antibiotic isonicotinylhydrazide (INH), silver nanoparticles (AgNPs), and two different polyoxometalates (POMs) namely, phosphotungstic acid (PTA) and phosphomolybdic acid (PMA) to prepare AgNPs and AgNPs, respectively. AgNPs have peroxidase-like (nanozyme) activity and very high antibacterial potential toward S.

Coronary disease is not associated with robust alterations in inflammatory gene expression in human epicardial fat.

Epicardial adipose tissue (EAT) is the visceral fat depot of the heart. Inflammation of EAT is thought to contribute to coronary artery disease (CAD). Therefore, we hypothesized that the EAT of patients with CAD would have increased inflammatory gene expression compared with controls without CAD.

Current trends and challenges in cancer management and therapy using designer nanomaterials.

Nanotechnology has the potential to circumvent several drawbacks of conventional therapeutic formulations. In fact, significant strides have been made towards the application of engineered nanomaterials for the treatment of cancer with high specificity, sensitivity and efficacy. Tailor-made nanomaterials functionalized with specific ligands can target cancer cells in a predictable manner and deliver encapsulated payloads effectively.

Attachment and Concord of Temporal Adverbs: Evidence From Eye Movements.

The present study examined the processing of temporal adverbial phrases such as "last week," which must agree in temporal features with the verb they modify. We investigated readers' sensitivity to this feature match or mismatch in two eye-tracking studies. The main aim of this study was to expand the range of concord phenomena which have been investigated in real-time processing in order to understand how linguistic dependencies are formed during sentence comprehension (Felser et al.

Cationic Silver Nanoclusters as Potent Antimicrobials against Multidrug-Resistant Bacteria.

Bacterial multidrug resistance (MDR) is a serious healthcare issue caused by the long-term subtherapeutic clinical treatment of infectious diseases. Nanoscale engineering of metal nanoparticles has great potential to address this issue by tuning the nano-bio interface to target bacteria. Herein, we report the use of branched polyethylenimine-functionalized silver nanoclusters (bPEI-Ag NCs) to selectively kill MDR pathogenic bacteria by combining the antimicrobial activity of silver with the selective toxicity of bPEI toward bacteria.

Physical abrasion method using submerged spike balls to remove algal biofilm from photobioreactors.

Objective: A major factor in practical application of photobioreactors (PBR) is the adhesion of algal cells onto their inner walls. Optimized algal growth requires an adequate sunlight for the photosynthesis and cell growth. Limitation in light exposure adversely affects the algal biomass yield.

Knot integrity using different suture types and different knot-tying techniques for reconstructive pelvic floor procedures.

Introduction And Hypothesis: Surgeons use a variety of sutures and knot-tying methods during pelvic reconstructive procedures. We hypothesized that knot-strength integrity will be similar with regards to type of knot, type of suture, and the knot-tying process.

Methods: Using six different suture materials, flat square knots and slip knots were tied robotically and by hand by two surgeons.

Voiding Function After Midurethral Slings With and Without Local Anesthetic: Randomized Controlled Trial.

Objectives: This study aimed to compare the effect of periurethral infiltration of bupivacaine versus normal saline on postoperative voiding function and pain in patients undergoing retropubic midurethral sling METHODS: A randomized double-blind placebo-controlled study was performed at the University of Massachusetts from March 2012 to June 2015. Ninety patients were randomized to receive 0.5% bupivacaine with epinephrine or normal saline with epinephrine solution for periurethral hydrodissection.

Gray zone lymphoma with features intermediate between classical Hodgkin lymphoma and diffuse large B-cell lymphoma: characteristics, outcomes, and prognostication among a large multicenter cohort.

Gray zone lymphoma (GZL) with features between classical Hodgkin lymphoma and diffuse large B-cell lymphoma (DLBCL) is a recently recognized entity reported to present primarily with mediastinal disease (MGZL). We examined detailed clinical features, outcomes, and prognostic factors among 112 GZL patients recently treated across 19 North American centers. Forty-three percent of patients presented with MGZL, whereas 57% had non-MGZL (NMGZL).