Advanced practice nurse attitudes toward sex offender patients

Purpose: To determine advanced practice nurses\u27 (APNs\u27) attitudes and behaviors toward patients in their practices who are registered sex offenders. Data sources: An online survey of 300 APN members of a local APN organization asking respondents to identify the behavioral actions they were likely to agree or disagree with when faced with a scenario of realizing that a sex offender was a patient in their practice. Sixty-nine respondents submitted completed surveys. Conclusions: There was an ambiguity of behavioral responses and no consensus among APNs on how to respond to the issue of a sex offender patient in a healthcare practice. There was also a lack of awareness of whether sex offenders were patients in their practice. Implications for practice: The modest number of respondents and their demographic homogeneity limit the ability to draw any conclusions or generalizations from this study. While awareness of a known sex offender in a practice is unlikely to alter direct patient care, it may have an impact on office policies and procedures and should be a consideration of all involved staff, including providers, ancillary team members, and administrative personnel. © 2007 American Academy of Nurse Practitioners

The mechanisms of catalysis and ligand binding for the SARS-CoV-2 NSP3 macrodomain from neutron and x-ray diffraction at room temperature.

The nonstructural protein 3 (NSP3) macrodomain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Mac1) removes adenosine diphosphate (ADP) ribosylation posttranslational modifications, playing a key role in the immune evasion capabilities of the virus responsible for the coronavirus disease 2019 pandemic. Here, we determined neutron and x-ray crystal structures of the SARS-CoV-2 NSP3 macrodomain using multiple crystal forms, temperatures, and pHs, across the apo and ADP-ribose-bound states. We characterize extensive solvation in the Mac1 active site and visualize how water networks reorganize upon binding of ADP-ribose and non-native ligands, inspiring strategies for displacing waters to increase the potency of Mac1 inhibitors. Determining the precise orientations of active site water molecules and the protonation states of key catalytic site residues by neutron crystallography suggests a catalytic mechanism for coronavirus macrodomains distinct from the substrate-assisted mechanism proposed for human MacroD2. These data provoke a reevaluation of macrodomain catalytic mechanisms and will guide the optimization of Mac1 inhibitors