Exploring power building capacity at the ecosystem level: A case study of a justice-oriented organizational network.

Community organizing and base building groups operate as part of a larger ecosystem of organizations, each with complementary capacities necessary to build power and achieve social change. Analytic approaches to assessing power in organizational networks can generate data to inform strategy, identify gaps, and help nurture organizational ecosystems that support communities in building and exercising power. This article uses a network of 43 justice-focused organizations in the Bay Area, California and their 267 reported connections as a case study to assess the feasibility of measuring power building capacities using social network analyses. We evaluated network capacity for different power-building capacities and explored the relationships between organizations\u27 positions in the network and their access to capacity. We found that justice-focused organizations were more likely than their connections to have mature capacity for creating alliances and coalitions and for research/legal strategies, whereas their connections were more likely to report mature capacity for community organizing. Most participants in the network were connected within one degree to an organization that was mature in organizing and base building. These results highlight the potential to assess community power building capacities within networks of organizations to identify ecosystem strengths and weaknesses and opportunities for strategic development

Exploring the complexities of pain phenotypes: OMERACT 2023 chronic pain working group workshop.

OBJECTIVE: To educate and discuss pain mechanisms (nociceptive, neuropathic, nociplastic) illuminating its possible impact when measuring different outcomes, which may modify, confound and potentially bias the outcome measures applied across various aspects of Rheumatic Musculoskeletal Diseases (RMDs) clinical trials. METHODS: In the plenary presentations, PM lectured on different pain mechanisms and impact on disease activity assessment. Data from two data sets of RMDs patients, which assessed the prevalence and impact of nociplastic pain were presented and reviewed. Audience breakout group sessions and polling were conducted. RESULTS: Mixed pain etiologies may differentially influence disease activity assessment and therapeutic decision-making. Polling demonstrated a consensus on the need to assess different types of pain as a phenotype, as it constitutes an important contextual factor (a variable that is not an outcome of the trial, but needs to be recognized [and measured] to understand the study results), and to standardize across RMDs. CONCLUSION: There is need for a standardized pain measure that can differentiate underlying pain mechanisms

Nurse Perceptions of Providing Continuous Blood Glucose Data for a Research Study

Abstract: Title: Nurse Perceptions of Providing Continuous Blood Glucose Data for a Research Study Background: Acute care nurses are essential to preserve quality and quantity of life of hospitalized patients. However, nurses present with a higher risk of type II diabetes compared to other licensed healthcare providers, especially if assigned to night shifts, despite controlling for modifiable lifestyle factors such as diet and exercise. Laboratory studies suggest that eating during the night hours may cause an aberrant glucose response. It is hypothesized that consistently eating a meal during night hours may provide one mechanism for increased risk of type II diabetes development among night shift workers, yet field studies confirming these relationships are lacking. Studies collecting accurate blood glucose measures may help inform innovative strategies to preserve the health of registered nurses. Purpose: To describe nurse perceptions of participation in a continuous blood glucose study. Methods: Frontline, 12-hour shift nurses who were not pregnant/breastfeeding or suffering pre/diabetes and working on one of two adult intensive care units at a large medical center in the Pacific Northwest were invited to participate in this observational study. Interested nurses were directed to complete an online screening form, with the option to e-consent if eligibility criteria were met. Once consented, nurses were instructed to meet with research staff on the last off-duty day before working 3, consecutive shifts followed by 4 off-duty days. During onboarding, research staff inserted a continuous glucose monitor (CGM) on the participant as well as an activity monitor and provided a printed “to-do list” to ensure protocol compliance. Participants returned the activity monitor and had CGM data uploaded at the end of the 4th off-duty day and completed a questionnaire on experiences participating in the study. Results: Out of approximately 152 nurses on the units, 62 (40.8%) self-screened, 61 were eligible, and 49 provided consent. In all, 12-night shift and 10-day shift nurses coordinated the correct schedule and completed the protocol. Participants unanimously rated the CGM as extremely easy to use and 19 out of 20 (95%) reported they would be willing to participate in a similar study in the future. Open-ended feedback from participants were very positive toward the study, with quotes such as: “Devices were comfortable and did not interfere with clothing or exercise.” “It (the study) was easy and didn\u27t require a lot of work.” “I’m excited to find out what my glucose was throughout the study.” “The activity monitor and CGM were set it and forget it.” Conclusion: Frontline nurses demonstrated substantial interest in a study collecting CGM data. Most study participants rated the device as extremely easy to use and would participate in another similar study. A barrier to this study was the required shift schedule of 3 consecutive shifts, followed by 4 off-duty days. Future studies should consider allowing variable shift sequences. Implications for Practice: Understanding the impact of night shift work on acute and chronic changes to blood glucose is imperative to mitigate risk for diabetes. Our study suggests that collecting these data from frontline, critical care nurses using a subcutaneously-attached CGM is feasible, simple, and reproducible

One Sheet: Special Pathogens Program Region 10 Emerging Special Pathogens Treatment Center (RESPTC) • Spokane, WA

https://digitalcommons.providence.org/special_pathogens_resources/1000/thumbnail.jp

Pemphigus vulgaris presenting with epigastric pain.

Pemphigus vulgaris is an autoimmune mucocutaneous disease with an involvement in gastrointestinal tract especially in oral cavity and esophagus. Ulcers can be the initial presentation even before visible mucosal or cutaneous lesions. The presenting symptoms will be in accordance with the affected organ such as throat pain, hoarseness, dysphagia, odynophagia, or even bleeding. Here, we report a case of undiagnosed pemphigus vulgaris presenting with epigastric pain whose endoscopy showed oropharyngeal involvement and isolate esophageal ulcer, which failed proton pump inhibitor treatment

Overall survival with adjuvant atezolizumab after chemotherapy in resected stage II-IIIA non-small-cell lung cancer (IMpower010): a randomised, multicentre, open-label, phase III trial.

BACKGROUND: IMpower010 (NCT02486718) demonstrated significantly improved disease-free survival (DFS) with adjuvant atezolizumab versus best supportive care (BSC) following platinum-based chemotherapy in the programmed death-ligand 1 (PD-L1)-positive and all stage II-IIIA non-small-cell lung cancer (NSCLC) populations, at the DFS interim analysis. Results of the first interim analysis of overall survival (OS) are reported here. PATIENT AND METHODS: The design, participants, and primary-endpoint DFS outcomes have been reported for this phase III, open-label, 1 : 1 randomised study of atezolizumab (1200 mg q3w; 16 cycles) versus BSC after adjuvant platinum-based chemotherapy (1-4 cycles) in adults with completely resected stage IB (≥4 cm)-IIIA NSCLC (per the Union Internationale Contre le Cancer and American Joint Committee on Cancer staging system, 7th edition). Key secondary endpoints included OS in the stage IB-IIIA intent-to-treat (ITT) population and safety in randomised treated patients. The first pre-specified interim analysis of OS was conducted after 251 deaths in the ITT population. Exploratory analyses included OS by baseline PD-L1 expression level (SP263 assay). RESULTS: At a median of 45.3 months\u27 follow-up on 18 April 2022, 127 of 507 patients (25%) in the atezolizumab arm and 124 of 498 (24.9%) in the BSC arm had died. The median OS in the ITT population was not estimable; the stratified hazard ratio (HR) was 0.995 [95% confidence interval (CI) 0.78-1.28]. The stratified OS HRs (95% CI) were 0.95 (0.74-1.24) in the stage II-IIIA (n = 882), 0.71 (0.49-1.03) in the stage II-IIIA PD-L1 tumour cell (TC) ≥1% (n = 476), and 0.43 (95% CI 0.24-0.78) in the stage II-IIIA PD-L1 TC ≥50% (n = 229) populations. Atezolizumab-related adverse event incidences remained unchanged since the previous analysis [grade 3/4 in 53 (10.7%) and grade 5 in 4 (0.8%) of 495 patients, respectively]. CONCLUSIONS: Although OS remains immature for the ITT population, these data indicate a positive trend favouring atezolizumab in PD-L1 subgroup analyses, primarily driven by the PD-L1 TC ≥50% stage II-IIIA subgroup. No new safety signals were observed after 13 months\u27 additional follow-up. Together, these findings support the positive benefit-risk profile of adjuvant atezolizumab in this setting

Prolonged Survival of NUT Midline Carcinoma and Current Approaches to Treatment.

NUT midline carcinoma is a rare malignancy most commonly seen in adolescents and young adults. The disease presents most often in the lung or head and neck area but can be seen occasionally elsewhere. The diagnosis can be difficult and requires a high degree of suspicion with demonstration of the classic fusion rearrangement mutation of the NUTM1 gene with one of a variety of partners by immunohistochemistry, fluorescent in situ hybridization, or genomic analysis. Survival is usually only a number of months with few long-term survivors. Here we report one of the longest-known survivors of this disease treated with surgery and radiation without additional therapy. Systemic treatment approaches including the use of chemotherapy and BET and histone deacetylase inhibitors have yielded modest results. Further studies of these, as well as p300 and CDK9 inhibitors and combinations of BET inhibitors with chemotherapy or CDK 4/6 inhibitors, are being evaluated. Recent reports suggest there may be a role for immune checkpoint inhibitors, even in the absence of high tumor mutation burden or PD-L1 positivity. RNA sequencing of this patient\u27s tumor demonstrated overexpression of multiple potentially targetable genes. Given the altered transcription that results from the causative mutation multi-omic evaluation of these tumors may uncover druggable targets for treatment