Improving the Early Identification of Acute Appendicitis Using Ultrasound in Pediatric Patients

Purpose: The purpose of this evidence-based practice project was to improve early identification using ultrasound in pediatric patients who met the diagnostic criteria for acute appendicitis in the emergency department. Background: One of the most common diagnoses of pediatric patients seen in the emergency department with an abdominal complaint is an acute appendicitis (Mostbeck et al., 2016). Methodology: A quality improvement program in an emergency department was led by a nurse practitioner. Retrospective baseline data was collected for 12 months and 8 weeks post intervention. Results: An increased utilization of ultrasound by 18.2% and a decrease utilization of computed tomography (CT) by 32.56% were noted. Conclusions: This project demonstrated improved early identification of acute appendicitis via ultrasound while reducing the use of ionizing radiation of CTs. Barriers identified were the initial attitudes and beliefs about the use of ultrasound vs. CT. The nurse practitioner will provide sustainability to this ongoing program by coordinating an instructional program to improve ultrasound technician technique

Analyzing the video popularity characteristics of large-scale user generated content systems

Abstract—User generated content (UGC), now with millions of video producers and consumers, is re-shaping the way people watch video and TV. In particular, UGC sites are creating new viewing patterns and social interactions, empowering users to be more creative, and generating new business opportunities. Compared to traditional video-on-demand (VoD) systems, UGC services allow users to request videos from a potentially unlimited selection in an asynchronous fashion. To better understand the impact of UGC services, we have analyzed the world’s largest UGC VoD system, YouTube, and a popular similar system in Korea, Daum Videos. In this paper, we first empirically show how UGC services are fundamentally different from traditional VoD services. We then analyze the intrinsic statistical properties of UGC popularity distributions and discuss opportunities to leverage the latent demand for niche videos (or the so-called “the Long Tail ” potential), which is not reached today due to informa-tion filtering or other system scarcity distortions. Based on traces collected across multiple days, we study the popularity lifetime of UGC videos and the relationship between requests and video age. Finally, we measure the level of content aliasing and illegal content in the system and show the problems aliasing creates in ranking the video popularity accurately. The results presented in this paper are crucial to understanding UGC VoD systems and may have major commercial and technical implications for site administrators and content owners. Index Terms—Interactive TV, human factors, exponential distri-butions, log normal distributions, pareto distributions, probability, copyright protection. I

Effects of solvent used for fabrication on drug loading and release kinetics of electrosprayed temozolomide-loaded PLGA microparticles for the treatment of glioblastoma

Glioblastoma multiforme (GBM) is the most common and invasive form of malignant brain tumors and despite advances in surgery, radiotherapy, and chemotherapy, the survival of patients with GBM still remains poor. Temozolomide (TMZ) is the chemotherapy drug that is most commonly given orally after surgical resection of these tumors. In this study, the effects of solvents (i.e., dichloromethane and acetonitrile) used for the fabrication of electrosprayed TMZ-loaded poly(lactic-co-glycolic acid) (PLGA) on drug loading, loading efficiency, drug release kinetics, surface morphology, and particle size were investigated. The results from this study demonstrated that by using a larger volume of a solvent with higher polarity (i.e., acetonitrile) which allows for a higher amount of hydrophilic TMZ to dissolve into the polymer solution, higher drug loading could be achieved. However, the particles fabricated with high amount of acetonitrile, which has a lower vapor pressure, had large pores and a smaller diameter which led to an initial burst release and high cumulative release at the end of the study. An optimal combination of the two solvents is needed to result in particles with a good amount of loading and minimal initial burst release. The electrosprayed microparticles were able to illicit a cytotoxic response in U-87 MG glioblastoma cells at a lower concentration of drug compared to the free drug. This work indicated that electrospraying is a promising method for the fabrication of TMZ-loaded PLGA microparticles for the treatment of GBM and solvent composition can be altered to control drug loading and release kinetics

Sibling relationship quality and Mexican-origin adolescents\u27 and young adults\u27 familism values and adjustment

We examined profiles of sibling relationship qualities in 246 Mexican-origin families living in the United States using latent profile analyses. Three profiles were identified: Positive, Negative and Affect-Intense. Links between profiles and youths’ familism values and adjustment were assessed using longitudinal data. Siblings in the Positive profile reported the highest familism values, followed by siblings in the Affect-Intense profile and, finally, siblings in the Negative profile. Older siblings in the Positive and Affect-Intense profiles reported fewer depressive symptoms than siblings in the Negative profile. Further, in the Positive and Negative profiles, older siblings reported less involvement in risky behaviors than younger siblings. In the Negative profile, younger siblings reported greater sexual risk behaviors in late adolescence than older siblings; siblings in opposite-sex dyads, as compared to same-sex dyads, engaged in riskier sexual behaviors. Our findings highlight sibling relationship quality as promotive and risky, depending on sibling characteristics and adjustment outcomes

Mexican-Origin Youth\u27s Risk Behavior from Adolescence to Young Adulthood: The Role of Familism Values

Engagement in risk behavior has implications for individuals\u27 academic achievement, health, and well-being, yet there is a paucity of developmental research on the role of culturally-relevant strengths in individual and family differences in risk behavior involvement among ethnic minority youth. In this study, we used a longitudinal cohort-sequential design to chart intraindividual trajectories of risk behavior and test variation by gender and familism values in 492 youth from 12 to 22 years of age. Participants were older and younger siblings from 246 Mexican-origin families who reported on their risk behaviors in interviews spaced over eight years. Multilevel cohort-sequential growth models revealed that youth reported an increase in risk behavior from 12 to 18 years of age, and then a decline to age 22. Male youth reported greater overall levels and a steeper increase in risk behavior from ages 12 to 18, compared to female youth. For familism values, on occasions when youth reported higher levels, they also reported lower levels of risk behavior (i.e., within-person effect). For sibling dyads characterized by higher average levels of familism values, youth reported lower average levels of risk behavior (i.e., between-family effect). Findings provide unique insights into risk behavior from adolescence to young adulthood among Mexican-origin youth

Ansiedad y agresividad en estudiantes universitarios de un programa de una organización no gubernamental de Lima Metropolitana y Callao, 2021

El objetivo fue determinar la relación entre ansiedad y agresividad en estudiantes universitarios de un programa de una Organización No Gubernamental de Lima Metropolitana y Callao, 2021. Para ello, se utilizó el alcance metodológico de tipo correlacional, de corte transversal, diseño no experimental con enfoque cuantitativo. Para medir la variable ansiedad, se aplicó la “Escala de Ansiedad de Lima DE 20 ítems” (EAL-20), de Lozano Vargas Antonio y Vega Dienstmaier Johann (2017); por otro lado, para medir la variable agresividad, se utilizó el “Cuestionario de Agresión” (AQ) de Buss y Perry, adaptado a nuestra localidad por Matalinares et al. (2012). Se evaluaron a 331 estudiantes, con edades entre 18 y 30 años (M=23.63, DS= 3.360, 51.7% mujeres) los cuales fueron elegidos mediante el muestreo no probabilístico. En los resultados, se evidenció que existe relación entre ambas variables presentando estadísticamente una correlación positiva (directa) moderada de Spearman (rho=.607), muy significativa (p<.01) y con tamaño del efecto grande (r2 = .37). Por lo que se concluye, que, a mayor ansiedad, mayor será la probabilidad de aparición de conductas agresivas

Mexican-origin Youths’ Trajectories of Depressive Symptoms: The Role of Familism Values

Purpose—To describe Mexican-origin youths’ trajectories of depressive symptoms from early to late adolescence and examine the role of three aspects of familism values: supportive, obligation, and referent familism. Methods—Mexican-origin adolescents (N = 492) participated in home interviews and provided self-reports of depressive symptoms and cultural values at four assessments across an 8-year span. Using a cohort sequential design and accounting for the nesting within the 246 families (2 youth per family), we examined depressive symptoms from ages 12 to 22 years and the within-person, between-sibling, and between-family effects of familism values. Results—Mexican-origin males’ depressive symptoms decreased across adolescence, while females’ symptoms exhibited a cubic pattern of change. Results revealed that increases in supportive and referent familism values within individuals and across families related to lower levels of depressive symptoms. Findings were most pronounced for referent familism values, as a between-sibling effect also emerged. Obligation familism values were not associated with depressive symptoms. Conclusions—Our findings provide important descriptive information about Mexican-origin youths’ depressive symptoms and highlight the promotive role of familism values

Closing the gap on causal processes of infection risk from cross-sectional data:structural equation models to understand infection and co-infection

BACKGROUND: Epidemiological studies of disease exposure risk are frequently based on observational, cross-sectional data, and use statistical approaches as crucial tools for formalising causal processes and making predictions of exposure risks. However, an acknowledged limitation of traditional models is that the inferred relationships are correlational, cannot easily distinguish direct from indirect determinants of disease risk, and are often considerable simplifications of complex interrelationships. This may be particularly important when attempting to infer causality in patterns of co-infection through pathogen-facilitation. METHODS: We describe analyses of cross-sectional data using structural equation models (SEMs), a contemporary advancement on traditional regression approaches, based on our study system of feline gammaherpesvirus (FcaGHV1) in domestic cats. RESULTS: SEMs strongly supported a latent (host phenotype) variable associated with FcaGHV1 exposure and co-infection risk, suggesting these individuals are simply more likely to become infected with multiple pathogens. However, indications of pathogen-covariance (potential facilitation) were also variably detected: potentially among FcaGHV1, Bartonella spp and Mycoplasma spp. CONCLUSIONS: Our models suggest multiple exposures are primarily driven by host phenotypic traits, such as aggressive male phenotypes, and secondarily by pathogen-pathogen interactions. The results of this study demonstrate the application of SEMs to understanding epidemiological processes using observational data, and could be used more widely as a complementary tool to understand complex cross-sectional information in a wide variety of disciplines

Mexican American Adolescents’ Gender Role Attitude Development: The Role of Adolescents’ Gender and Nativity and Parents’ Gender Role Attitudes

Gender development has long term implications for education and career endeavors and family formation behaviors, but we know very little about the role of sociocultural factors in developmental and individual differences. In this study, we investigated one domain of gender development, gender role attitudes, in Mexican American adolescents (N = 246; 51% female), using four phases of longitudinal data across eight years. Data were collected when adolescents averaged 12.51 years (SD = 0.58), 14.64 years (SD = 0.59), 17.72 years (SD = 0.57), and 19.60 years of age (SD = 0.66). Mothers’ and fathers’ gender role attitudes also were assessed in Phases 1, 3, and 4. Findings revealed that gender attitude development varied as a function of the interaction between adolescents’ nativity and gender. Among Mexico-born adolescents, females exhibited significant declines in traditional attitudes from early to late adolescence, but males’ attitudes were stable over time. U.S.-born females and males, in contrast, did not differ in their gender attitude trajectories. Examining the links between mothers’, fathers’, and adolescents’ gender role attitudes revealed within-person associations between mothers’ and adolescents’ gender role attitudes: on occasions when mothers reported more traditional attitudes relative to their own cross-time average, adolescents also reported more traditional attitudes than usual. In addition, fathers’ more traditional gender role attitudes were associated with daughters’, but not sons’, more traditional gender role attitudes at the between-person level. The discussion focuses on the interpretation of Mexican American adolescents’ gender role attitude development from a cultural ecological perspective