Reducing Hospital-Acquired Pressure Injuries through Measure-vention

The Braden scale may be outdated in the critical care setting to prevent hospital acquired pressure injuries (HAPIs). Applying evidence from the literature on Braden subscales and using “Measure-vention” for quality improvement, a quality improvement project using Braden subscales implemented in a 30-bed ICU reduced HAPIs by 63.5 percent

Resolved Imaging of the HD191089 Debris Disc

Two thirds of the F star members of the 12 Myr old Beta Pictoris Moving Group (BPMG) show significant excess emission in the mid-infrared, several million years after the expected dispersal of the protoplanetary disc. Theoretical models of planet formation suggest that this peak in the mid-infrared emission could be due to the formation of Pluto-sized bodies in the disc, which ignite the collisional cascade and enhance the production of small dust. Here we present resolved mid-infrared imaging of the disc of HD191089 (F5V in the BPMG) and consider its implications for the state of planet formation in this system. HD191089 was observed at 18.3 microns using T-ReCS on Gemini South and the images were compared to models of the disc to constrain the radial distribution of the dust. The emission observed at 18.3 microns is shown to be significantly extended beyond the PSF at a position angle of 80 degrees. This is the first time dust emission has been resolved around HD191089. Modelling indicates that the emission arises from a dust belt from 28-90 AU, inclined at 35 degrees from edge on with very little emission from the inner 28AU of the disc, indicating the presence of an inner cavity. The steep slope of the inner edge is more consistent with truncation by a planet than with ongoing stirring. A tentative brightness asymmetry F(W)/F(E)=0.80+/-0.12 (1.8 sigma) between the two sides of the disc could be evidence for perturbations from a massive body on an eccentric orbit in the system.Comment: 11 Pages Accepted to MNRA

Successfully Spreading Improvement Work Using a Proven Framework

Background: Hospital-acquired pressure injuries (HAPIs) are rising in the United States, increasing six percent between 2014 and 2017 alone (Agency for Healthcare Research and Quality [AHRQ], 2019). Approximately 60,000 patients die from complications related to HAPI annually (Padula & Delarmente, 2019). Local Problem: In a Northern California Level II Trauma acute care hospital, HAPIs increased by 422% over two years, 2016-2018, with most of the HAPIs occurring in the Intensive Care Unit (ICU). Context: This project sought to spread the Interventions by Braden Subscale protocol to seven medical-surgical units in the hospital using the Institute for Healthcare Improvement’s (IHI) Framework for Spread and Lewin’s Change Management Theory. Interventions: A baseline survey was disseminated to ascertain the level of knowledge on the IHI Framework for Spread, and education was subsequently developed based on the results. The Interventions by Braden Subscale protocol was spread utilizing the framework to multiple medical-surgical units with the goal of reducing HAPIs. Outcome Measures: Improve the level of knowledge among nurse leaders by 30% on the IHI Framework for Spread and reduce HAPIs in the medical-surgical units by 30%. Results: The successful spread led to a net reduction of 34% in the incidence of all-stage HAPIs. No improvement was seen in the level of knowledge among nursing leaders on the IHI Framework for Spread. Results were analyzed from the pre-and post-education surveys and were found to not be statistically significant and may have been impacted by the SARS-COV-2 pandemic. Conclusions: Using a structured framework to spread improvement work demonstrated benefit in this project and became the platform for the development of a committee where improvement work could be reported in a standardized way, monitored for performance, spread, and sustained over time

Interview with Jean Wyatt

Jean Wyatt talks about her involvement with the County Fairhttps://digital.kenyon.edu/ps_interviews/1022/thumbnail.jp

What is the evidence base for integrating health and environmental approaches into the school context to nurture healthy and environmentally aware young people? A systematic scoping review of global evidence

This scoping review collates empirical and grey literature that examines how schools are acting to nurture healthier and more environmentally aware young people through integrated approaches. Over the last twenty years, integration has been increasing within school contexts. Approaches include teaching and learning, physical environmental adaptations, developing ecologically focused policy, and reorienting wider school culture. We noted a developing discourse around what constitutes evidence in this emerging interdisciplinary field. Developing a better understanding of integrated approaches, and an evidence base of what works and how, could inform interdisciplinary collaboration and enable a clearer message to be communicated to stakeholders about how the school context can nurture healthier and more environmentally aware young people.PostprintPeer reviewe

Learning health systems need to bridge the ‘two cultures’ of clinical informatics and data science

Background UK health research policy and plans for population health management are predicated upon transformative knowledge discovery from operational 'Big Data'. Learning health systems require not only data, but feedback loops of knowledge into changed practice. This depends on knowledge management and application, which in turn depends upon effective system design and implementation. Biomedical informatics is the interdisciplinary field at the intersection of health science, social science and information science and technology that spans this entire scope. Issues In the UK, the separate worlds of health data science (bioinformatics, 'Big Data') and effective healthcare system design and implementation (clinical informatics, 'Digital Health') have operated as 'two cultures'. Much National Health Service and social care data is of very poor quality. Substantial research funding is wasted on 'data cleansing' or by producing very weak evidence. There is not yet a sufficiently powerful professional community or evidence base of best practice to influence the practitioner community or the digital health industry. Recommendation The UK needs increased clinical informatics research and education capacity and capability at much greater scale and ambition to be able to meet policy expectations, address the fundamental gaps in the discipline's evidence base and mitigate the absence of regulation. Independent evaluation of digital health interventions should be the norm, not the exception. Conclusions Policy makers and research funders need to acknowledge the existing gap between the 'two cultures' and recognise that the full social and economic benefits of digital health and data science can only be realised by accepting the interdisciplinary nature of biomedical informatics and supporting a significant expansion of clinical informatics capacity and capability.</p

Oncogenic Ras deregulates cell-substrate interactions during mitotic rounding and respreading to alter cell division orientation

Oncogenic Ras has been shown to change the way cancer cells divide by increasing the forces generated during mitotic rounding. In this way, RasV12 enables cancer cells to divide across a wider range of mechanical environments than normal cells. Here, we identify a further role for oncogenic Ras-ERK signaling in division by showing that RasV12 expression alters the shape, division orientation, and respreading dynamics of cells as they exit mitosis. Many of these effects appear to result from the impact of RasV12 signaling on actomyosin contractility, because RasV12 induces the severing of retraction fibers that normally guide spindle positioning and provide a memory of the interphase cell shape. In support of this idea, the RasV12 phenotype is reversed by inhibition of actomyosin contractility and can be mimicked by the loss of cell-substrate adhesion during mitosis. Finally, we show that RasV12 activation also perturbs division orientation in cells cultured in 2D epithelial monolayers and 3D spheroids. Thus, the induction of oncogenic Ras-ERK signaling leads to rapid changes in division orientation that, along with the effects of RasV12 on cell growth and cell-cycle progression, are likely to disrupt epithelial tissue organization and contribute to cancer dissemination

High-quality genomes of Paenibacillus spp. RC334 and RC343, isolated from a long-term forest soil warming experiment

Paenibacillus spp. RC334 and RC343 were isolated from heated soil in a long-term soil warming experiment. Both genomes were 5.98 Mb and assembled as a single contig. We describe the assembly and annotation of the two high-quality draft genomes for these isolates here

Impact of a Reduced Nicotine Standard on Young Adult Appeal for Menthol and Non-Menthol Cigarettes

Introduction The Food and Drug Administration (FDA) announced its intention to reduce the nicotine content in cigarettes as a strategy to promote cessation and reduce smoking-related harm. A low nicotine product standard will apply to all cigarettes on the market, including menthol cigarettes. In December 2021, the FDA approved a modified risk tobacco product application for menthol and non-menthol flavoured very low nicotine cigarettes (VLNC) from the 22nd Century Group. Notably, experimentation with menthol cigarettes is linked to smoking progression, as well as greater nicotine dependence relative to non-menthol cigarette use. If menthol VLNCs are perceived as more appealing than non-menthol VLNCs, this would indicate that some aspect of menthol may maintain smoking even in the absence of nicotine and FDA’s regulatory authority to ban or restrict the sale of menthol cigarettes should apply to reduced nicotine content of cigarettes. In April 2022, the FDA announced proposed rulemaking to prohibit menthol cigarettes, however it is unclear if a menthol prohibition would apply to VLNCs. Methods and analysis This study will recruit 172 young adult menthol smokers (with a specific subsample of n=40 sexual and gender minority young adults) and measure appeal for smoking experimental menthol and non-menthol VLNCs, and the impact of proposed product standards on tobacco product purchasing behaviour using an Experimental Tobacco Marketplace. Appeal across product standards will be assessed in a controlled laboratory and using ecological momentary assessment. Ethics and dissemination The protocol was approved by the University of Oklahoma Health Sciences Center Institutional Review Board (#11865). Findings will examine the effects of a reduced nicotine standard and a menthol ban on young adult smoking and will be disseminated through peer-reviewed journal articles and presentations at scientific conferences. Trial registration number NCT04340947