Standardized Consent Forms for Surgical Procedures: An Intervention to Improve the Resident-led Informed Consent Process

Objectives and Goals: To provide high quality, consistent consent forms for common surgical procedures and improve resident workflow by creating and implementing standardized printed consents for common surgical procedures. These consents will be used by residents consenting patients in the ED or inpatient setting. Consents shall include standardized procedure descriptions, risks and benefits of the procedure, and alternative treatment option descriptions, risks and benefitshttps://jdc.jefferson.edu/patientsafetyposters/1057/thumbnail.jp

Exploring the Chemical Composition and Double Horizontal Branch of the Bulge Globular Cluster NGC 6569

Photometric and spectroscopic analyses have shown that the Galactic bulge cluster Terzan 5 hosts several populations with different metallicities and ages that manifest as a double red horizontal branch (HB). A recent investigation of the massive bulge cluster NGC 6569 revealed a similar, though less extended, HB luminosity split, but little is known about the cluster's detailed chemical composition. Therefore, we have used high-resolution spectra from the Magellan-M2FS and VLT-FLAMES spectrographs to investigate the chemical compositions and radial velocity distributions of red giant branch and HB stars in NGC 6569. We found the cluster to have a mean heliocentric radial velocity of -48.8 km/s (sigma = 5.3 km/s; 148 stars) and a mean [Fe/H] =-0.87 dex (19 stars), but the cluster's 0.05 dex [Fe/H] dispersion precludes a significant metallicity spread. NGC 6569 exhibits light- and heavy-element distributions that are common among old bulge/inner Galaxy globular clusters, including clear (anti)correlations between [O/Fe], [Na/Fe], and [Al/Fe]. The light-element data suggest that NGC 6569 may be composed of at least two distinct populations, and the cluster's low mean [La/Eu] = -0.11 dex indicates significant pollution with r-process material. We confirm that both HBs contain cluster members, but metallicity and light-element variations are largely ruled out as sources for the luminosity difference. However, He mass fraction differences as small as delta Y ~ 0.02 cannot be ruled out and may be sufficient to reproduce the double HB.Comment: 72 pages, 14 figures, 8 tables; published in The Astronomical Journal; electronic versions of all tables are available in the published versio

<em>Cryptococcus neoformans</em>-Host Interactions Determine Disease Outcomes

The fungal pathogen Cryptococcus neoformans can infect the central nervous system (CNS) and cause fatal meningoencephalitis, which accounts for an estimated 180,000 deaths per year. Cryptococcal meningoencephalitis (CM) occurs mainly in the individuals with compromised immune systems. Thus, cryptococcal disease in the CNS has been predominantly attributed to insufficient immune responses and subsequent uncontrolled fungal growth. However, evidence has emerged that an inappropriate immune response, as much as an insufficient response, may promote clinical deterioration and pathogenesis. In this chapter, we will review the different types of immune responses to C. neoformans and their contribution to tissue damage and diseases

A Chemical Composition Survey of the Iron-Complex Globular Cluster NGC 6273 (M 19)

Recent observations have shown that a growing number of the most massive Galactic globular clusters contain multiple populations of stars with different [Fe/H] and neutron-capture element abundances. NGC 6273 has only recently been recognized as a member of this "iron-complex" cluster class, and we provide here a chemical and kinematic analysis of > 300 red giant branch (RGB) and asymptotic giant branch (AGB) member stars using high resolution spectra obtained with the Magellan-M2FS and VLT-FLAMES instruments. Multiple lines of evidence indicate that NGC 6273 possesses an intrinsic metallicity spread that ranges from about [Fe/H] = -2 to -1 dex, and may include at least three populations with different [Fe/H] values. The three populations identified here contain separate first (Na/Al-poor) and second (Na/Al-rich) generation stars, but a Mg-Al anti-correlation may only be present in stars with [Fe/H] > -1.65. The strong correlation between [La/Eu] and [Fe/H] suggests that the s-process must have dominated the heavy element enrichment at higher metallicities. A small group of stars with low [alpha/Fe] is identified and may have been accreted from a former surrounding field star population. The cluster's large abundance variations are coupled with a complex, extended, and multimodal blue horizontal branch (HB). The HB morphology and chemical abundances suggest that NGC 6273 may have an origin that is similar to omega Cen and M 54.Comment: Accepted for Publication in The Astrophysical Journal; 50 pages; 18 figures; 8 tables; higher resolution figures are available upon request or in the published journal articl

Gesture use in children with autism spectrum disorder: a scoping review

Purpose This study reviewed the literature examining type and frequency of gesture use in children diagnosed with autism spectrum disorder (ASD) in comparison to other populations. The findings can inform future studies and programs targeting the use of gestures as an early indicator of ASD. Methods A six step search procedure was utilized to identify all articles exploring gesture use in children with ASD in comparison to other populations. Articles meeting inclusion criteria were double coded by the investigators with 97% agreement. Results examining type and frequency of gesture were synthesized and three common themes were identified: comparison group(s), age of participants with ASD, and gesture terminology. Results A total of 32 studies met inclusion criteria for this study. Of these studies, nine exclusively measured type of gesture, 17 exclusively measured frequency, and 6 measured both type and frequency. Results indicate that children with ASD used different types and frequency of gesture in comparison to other populations. The most studied age range was 4–5 years and most studies used typically developing children as the comparison group. Gesture terminology and definition were extremely variable. Conclusions Children with ASD are using different types and frequencies of gesture when compared to other populations. More research including younger and more diverse populations is needed to translate these findings into clinical practice. Additionally, there is a need for more consistent use of gesture terminology and definition