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  • Womble Jonassen posted an update 6 days, 12 hours ago

    BACKGROUND Mapped with the guiding principles of academic-practice partnerships (APPs) outlined by the American Association of Colleges of Nursing and the American Organization for Nursing Leadership, a joint nurse scientist role between a nursing school and acute care facility at a large academic health center was developed and characterized by a PhD-prepared nurse appointed in a research role across organizations. To date, eight faculty are now appointed across the School and four health systems. PURPOSE Describe outcomes, facilitators and vulnerabilities of the joint nurse scientist role. METHODS Review of administrative records. DISCUSSION Outcomes include the 1) conduct and dissemination of joint research, 2) translation of evidence into practice, 3) development of educational programs for health system nurses, 4) scholarly activities among health system nurses, and 5) improved visibility and valuation of the PhD-prepared nurse. Role facilitators include those previously reported for APPs, the joint nurse scientists’ ability to broker opportunities across settings, and the evolving nature of the role. Role vulnerabilities pertain to the negotiation of workload, promotion, and institutional priorities. CONCLUSION The joint nurse scientist role fosters shared scholarly successes across academia and service. BACKGROUND AND OBJECTIVE Extramammary Paget disease (EMPD) has seldom been studied in Mediterranean populations. We aimed to review the characteristics of our patients with EMPD, the presence of a neoplasm in continuity, and the long-term course of the disease. PATIENTS AND METHODS Retrospective observational study of 27 patients diagnosed with EMPD between 1990 and 2015. All clinical and pathology findings related to clinical course and outcomes were retrieved for analysis. RESULTS Twenty patients were women and 7 were men. Ages ranged from 42 to 88 years (median, 76 years). Lesions were in the following locations vulva (16 cases), pubis-groin (5), perianal region (4), and axilla (2). Time from onset to diagnosis ranged from 1 to 60 months (median, 12 months) and maximum lesion diameter from 20 to 140mm (median, 55mm). In 3 cases (11.1%) EMPD was a secondary condition. None of the lesions developed on a previous cutaneous adnexal adenocarcinoma. Ten of the 24 primary EMPDs (41.7%) invaded the dermis. Eight of the 27 patients (29.6%) experienced local recurrence after the initial surgical treatment.Three patients (11.1%) died as a consequence of metastasis from the EMPD. CONCLUSIONS The presence of an underlying cutaneous adnexal adenocarcinoma is uncommon, but it is not unusual to find an extracutaneous adenocarcinoma in continuity. Although EMPD is a slow-growing tumor, dermal invasion is frequent and metastasis is not uncommon. Local recurrence is common even after excision with wide margins and may be delated, so long term follow-up is essential. L.U.BACKGROUND Myocardial infarction (MI) complicated by cardiogenic shock (CS) is associated with high mortality. Early coronary revascularization improves survival, but the optimal mode of revascularization remains uncertain. We sought to characterize practice patterns and outcomes of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in patients with MI complicated by CS. METHODS Patients hospitalized for MI with CS between 2002 and 2014 were identified from the United States National Inpatient Sample. Trends in management were evaluated over time. Propensity score matching was performed to identify cohorts with similar baseline characteristics and MI presentations who underwent PCI and CABG. The primary outcome was in-hospital all-cause mortality. RESULTS A total of 386,811 hospitalizations for MI with CS were identified; 67% were STEMI. Overall, 62.4% of patients underwent revascularization, with PCI in 44.9%, CABG in 14.1%, and a hybrid approach in 3.4%. Coronary revascularization for MI and CS increased over time, from 51.5% in 2002 to 67.4% in 2014 (P for trend less then .001). Patients who underwent CABG were more likely to have diabetes mellitus (35.5% vs. 29.2%, P  less then  .001) and less likely to present with STEMI (48.7% vs. 80.9%, P  less then  .001) than those who underwent PCI. CABG (without PCI) was associated with lower mortality than PCI (without CABG) overall (18.9% vs. 29.0%, P  less then  .001) and in a propensity-matched subgroup of 19,882 patients (19.0% vs. 27.0%, P  less then  .001). CONCLUSIONS CABG was associated with lower in-hospital mortality than PCI among patients with MI complicated by CS. Due to the likelihood of residual confounding, a randomized trial of PCI versus CABG in patients with MI, CS, and multi-vessel coronary disease is warranted. Published by Elsevier Inc.In living cells, cysteine (Cys) and bisulfite are involved in many important physiological processes. Their unbalance in vivo would lead to multiple diseases. So, it is vital to develop difuntional sensor for Cys and bisulfite. As we known, cysteine could metabolized into bisulfite by the metabolic processes of cysteine in the animal level. Therefore, we designed and synthesized a mitochondria-targeted long-wavelength ratio fluorescence sensor Z2 for Cys and bisulfite simultaneous detection. Z2 exhibitted excellent selectivity, good anti-interference, fast response and low detection limit. The sensor exhibited obviously two channels fluorescence response for Cys and bisulfite orderly. Z2 is widely used for imaging Cys and bisulfite in MCF-7 cells, zebrafish, and mice, and successfully imaging Cys metabolism in these livings. We hope this bifunctional ratio fluorescence sensor Z2 will be a useful tool to monitor Cys and SO2 levels in living systems. A luminescent metal-organic framework Eu3+ functionalized Hf-MOF (Eu3+@1) is designed through post-synthesis modification (PSM) and utilized as a probe for detecting p-nitrophenol (PNP, the urinary metabolite of parathion, methyl-parathion and EPN) and 3-methyl-4-nitrophenol (PNMC, the urinary metabolite of fenitrothion). The apparent quenching effect in urine is observed from the Eu3+@1 with the addition of organophosphorus metabolites. TJ-M2010-5 The fluorescent probe has several appealing merits, such as high selectivity, excellent sensitivity (0.36 μg mL-1 for PNP, 0.41 μg mL-1 for PNMC), fast response time (less than 1 min) and easy preparation. Linear correlation between the fluorescence intensity of Eu3+@1 and the concentration of PNP and PNMC are from 0.005 to 0.15 mg mL-1 and 0.005-0.30 mg mL-1, respectively. Furthermore, this fluorescent material also demonstrated the possibility for recycling. It is a prominent candidate for potential application in personalized monitoring the internal dose of human exposure to some organophosphorus pesticides.

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