Efficacy of Smart Infusion Pumps from a Nursing Perspective

In today’s healthcare, intravenous (IV) therapy-related errors have become rampant and are responsible for a substantial portion of hospital injuries and deaths. In the last decade, however, since the development and implementation of “smart” IV pumps, a significant number of these IV medication errors have allegedly been reduced. The purpose of this paper is to discuss research surrounding an evaluation of the efficacy of smart IV pumps from a nursing perspective

The DELVE Quadruple Quasar Search I. A Lensed Low Luminosity AGN

A quadruply lensed source, J125856.3-031944, has been discovered using the DELVE survey and WISE W1 - W2 colors. Followup direct imaging carried out with the MPIA 2.2 m and the Baade 6.5 m telescopes is analyzed, as is spectroscopy from the 2.5 m Nordic Optical Telescope. The lensed image configuration is kite-like, with the faintest image 2 magnitudes fainter than the other three. Redward of 6000 AA that image is badly blended with the lensing galaxy, which is elongated along the symmetry axis of the kite. Magellan direct imaging carried out in Sloan g permits better deblending. As the lensed image configuration is nearly circular, simple models give individual magnifications of at least 25 for the 3 brighter images. The source's narrow emission lines and low intrinsic luminosity qualify it as a type 2 AGN.Comment: 8 pages, 5 figures, submitted to AJ, comments welcom

Identification of Galaxy-Galaxy Strong Lens Candidates in the DECam Local Volume Exploration Survey Using Machine Learning

We perform a search for galaxy-galaxy strong lens systems using a convolutional neural network (CNN) applied to imaging data from the first public data release of the DECam Local Volume Exploration Survey, which contains 1/4520 million astronomical sources covering 1/44000 deg2 of the southern sky to a 5σ point-source depth of g = 24.3, r = 23.9, i = 23.3, and z = 22.8 mag. Following the methodology of similar searches using Dark Energy Camera data, we apply color and magnitude cuts to select a catalog of 1/411 million extended astronomical sources. After scoring with our CNN, the highest-scoring 50,000 images were visually inspected and assigned a score on a scale from 0 (not a lens) to 3 (very probable lens). We present a list of 581 strong lens candidates, 562 of which are previously unreported. We categorize our candidates using their human-assigned scores, resulting in 55 Grade A candidates, 149 Grade B candidates, and 377 Grade C candidates. We additionally highlight eight potential quadruply lensed quasars from this sample. Due to the location of our search footprint in the northern Galactic cap (b > 10 deg) and southern celestial hemisphere (decl. < 0 deg), our candidate list has little overlap with other existing ground-based searches. Where our search footprint does overlap with other searches, we find a significant number of high-quality candidates that were previously unidentified, indicating a degree of orthogonality in our methodology. We report properties of our candidates including apparent magnitude and Einstein radius estimated from the image separation

The DECam Local Volume Exploration Survey Data Release 2

We present the second public data release (DR2) from the DECam Local Volume Exploration survey (DELVE). DELVE DR2 combines new DECam observations with archival DECam data from the Dark Energy Survey, the DECam Legacy Survey, and other DECam community programs. DELVE DR2 consists of similar to 160,000 exposures that cover >21,000 deg(2) of the high-Galactic-latitude ( divide b divide > 10 degrees) sky in four broadband optical/near-infrared filters (g, r, i, z). DELVE DR2 provides point-source and automatic aperture photometry for similar to 2.5 billion astronomical sources with a median 5 sigma point-source depth of g = 24.3, r = 23.9, i = 23.5, and z = 22.8 mag. A region of similar to 17,000 deg(2) has been imaged in all four filters, providing four-band photometric measurements for similar to 618 million astronomical sources. DELVE DR2 covers more than 4 times the area of the previous DELVE data release and contains roughly 5 times as many astronomical objects. DELVE DR2 is publicly available via the NOIRLab Astro Data Lab science platform

Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review.

The incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer. Within the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts. The clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes

RNA delivery by extracellular vesicles in mammalian cells and its applications.

The term 'extracellular vesicles' refers to a heterogeneous population of vesicular bodies of cellular origin that derive either from the endosomal compartment (exosomes) or as a result of shedding from the plasma membrane (microvesicles, oncosomes and apoptotic bodies). Extracellular vesicles carry a variety of cargo, including RNAs, proteins, lipids and DNA, which can be taken up by other cells, both in the direct vicinity of the source cell and at distant sites in the body via biofluids, and elicit a variety of phenotypic responses. Owing to their unique biology and roles in cell-cell communication, extracellular vesicles have attracted strong interest, which is further enhanced by their potential clinical utility. Because extracellular vesicles derive their cargo from the contents of the cells that produce them, they are attractive sources of biomarkers for a variety of diseases. Furthermore, studies demonstrating phenotypic effects of specific extracellular vesicle-associated cargo on target cells have stoked interest in extracellular vesicles as therapeutic vehicles. There is particularly strong evidence that the RNA cargo of extracellular vesicles can alter recipient cell gene expression and function. During the past decade, extracellular vesicles and their RNA cargo have become better defined, but many aspects of extracellular vesicle biology remain to be elucidated. These include selective cargo loading resulting in substantial differences between the composition of extracellular vesicles and source cells; heterogeneity in extracellular vesicle size and composition; and undefined mechanisms for the uptake of extracellular vesicles into recipient cells and the fates of their cargo. Further progress in unravelling the basic mechanisms of extracellular vesicle biogenesis, transport, and cargo delivery and function is needed for successful clinical implementation. This Review focuses on the current state of knowledge pertaining to packaging, transport and function of RNAs in extracellular vesicles and outlines the progress made thus far towards their clinical applications

Post-Operative Functional Outcomes in Early Age Onset Rectal Cancer

Background: Impairment of bowel, urogenital and fertility-related function in patients treated for rectal cancer is common. While the rate of rectal cancer in the young (&lt;50 years) is rising, there is little data on functional outcomes in this group. Methods: The REACCT international collaborative database was reviewed and data on eligible patients analysed. Inclusion criteria comprised patients with a histologically confirmed rectal cancer, &lt;50 years of age at time of diagnosis and with documented follow-up including functional outcomes. Results: A total of 1428 (n=1428) patients met the eligibility criteria and were included in the final analysis. Metastatic disease was present at diagnosis in 13%. Of these, 40% received neoadjuvant therapy and 50% adjuvant chemotherapy. The incidence of post-operative major morbidity was 10%. A defunctioning stoma was placed for 621 patients (43%); 534 of these proceeded to elective restoration of bowel continuity. The median follow-up time was 42 months. Of this cohort, a total of 415 (29%) reported persistent impairment of functional outcomes, the most frequent of which was bowel dysfunction (16%), followed by bladder dysfunction (7%), sexual dysfunction (4.5%) and infertility (1%). Conclusion: A substantial proportion of patients with early-onset rectal cancer who undergo surgery report persistent impairment of functional status. Patients should be involved in the discussion regarding their treatment options and potential impact on quality of life. Functional outcomes should be routinely recorded as part of follow up alongside oncological parameters

COOL-LAMPS VIII: Known wide-separation lensed quasars and their host galaxies reveal a lack of evolution in MBH/M⋆M_{\rm{BH}}/M_\star since z∼3z\sim 3

Wide-separation lensed quasars (WSLQs) are a rare class of strongly lensed quasars, magnified by foreground massive galaxy clusters, with typically large magnifications of the multiple quasar images. They are a relatively unexplored opportunity for detailed study of quasar host galaxies. The current small sample of known WSLQs has a median redshift of $z\approx 2.1$, larger than most other samples of quasar host galaxies studied to date. Here, we derive precise constraints on the properties of six WSLQs and their host galaxies, using parametric surface brightness fitting, measurements of quasar emission lines, and stellar population synthesis of host galaxies in six WSLQ systems. Our results, with significant uncertainty, indicate that these six hosts are a mixture of star-forming and quiescent galaxies. To probe for co-evolution between AGNs and host galaxies, we model the offset from the `local\u27 ($z=0$) M_{\rm{BH}}\unicode{x2013}M_\star relation as a simple power-law in redshift. Accounting for selection effects, a WSLQ-based model for evolution in the M_{\rm{BH}}\unicode{x2013}M_\star relation has a power-law index of $γ_M=-0.42\pm0.31$, consistent with no evolution. Compared to several literature samples, which mostly probe unlensed quasars at $z<2$, the WSLQ sample shows less evolution from the local relation, at $\sim 4σ$. We find that selection affects and choices of $M_{\rm{BH}}$ calibration are the most important systematics in these comparisons. Given that we resolve host galaxy flux confidently even from the ground in some instances, our work demonstrates that WSLQs and highly magnified AGNs are exceptional systems for future AGN\unicode{x2013}host co-evolution studies.Submitted to ApJ. 25 pages + 7-page appendix, 12+4 figures. Key results are shown starting with Figure 6. Comments welcom