Assessing Real-World Spot Urine Sodium Values During Continuous Intravenous Infusion of Loop Diuretics

The use of spot urine sodium (UNa)\u3e60 mmol/L as an objective measure to guide diuretic therapy in patients receiving bolus intravenous loop diuretics has been associated with increased weight loss and decreased length of stay. There is limited published data evaluating UNa use in patients receiving continuous intravenous loop diuretic infusions.https://digitalcommons.centracare.com/pharmacy_posters/1004/thumbnail.jp

Complex humans: Quality care and a spirity of inquiry

As human life becomes more complex and the speed of life increases, everyone needs quality care for health promotion, disease promotion, and management based on current, emerging evidence. All nurses, novice or expert, must be lifelong learners and researchers who translate evidence into their practice. In this webinar, the presenters will discuss the value of nursing research and inspire attendees to engage in evidence-based practice for better patient care. Learning Outcomes: - Discuss the need for clinical research to impact patient outcomes - Develop a desire to mentor or be mentored in research-related activities - Identify barriers to engaging in research and develop strategies to overcome the

Using an Experiential Learning Design to Teach Photography in Agricultural Communications

Photography is an important competency of agricultural communications graduates and is a core skill taught in the discipline’s curriculum. The [department] at [university] offers an undergraduate photography course twice yearly in two semester formats: a traditional spring semester where photography principles are taught in the classroom and a 12-day experiential intersession semester that allows for flexibility in how and where the course is taught. Both semesters utilize the same instructor, assignments, and grading rubric. While much agricultural communications research has focused on photography as a needed skill, few studies examine photography teaching methods. The purpose of this study was to compare student performance in an agricultural communications digital photography course taught with an experiential learning approach to a traditional classroom approach during the 2016 and 2017 academic calendar years. Kolb’s (1984) experiential learning theory was used as the theoretical framework for this study. Independent-samples t-tests were conducted to compare students’ cumulative mean assignment scores, individual assignment mean scores, and rubric criteria mean scores within the two instruction formats. The results suggest instruction method has an effect on student performance in agricultural communications digital photography courses. Students in the experiential intersession course had significantly higher mean cumulative assignment scores compared to students in the traditional course. While individual assignment performance was less affected by instruction format, students’ understanding of specific photography skills (rubric criteria), especially composition and clarity was higher when in the experiential intersession format

Building First‑Year Medical Students’ Skills in Finding, Evaluating, and Visualizing Health Information Through a “Debunking Medical Myths” Curricular Module

To provide an online service learning opportunity for medical students during the COVID-19 pandemic, medical faculty and librarians developed and implemented a “Debunking Medical Myths” module in which students learned to search for emerging medical literature, evaluate evidence, and use that evidence to create an infographics debunking a COVID-19-related myth for a non-medical audience. The resultant infographics are visually appealing and designed to make complex health information easy to understand. The module was well-received by students, who demonstrated a nuanced understanding of the use of infographics to convey health information, and students’ work was evaluated highly by community members

Shedding light on humanitarian sanitation

Lighting should be provided for WASH facilities in Humanitarian contexts according to several standards. Evidence for this and the practical budget, operational and management responsibilities are less clear. A three-country research project looking at the impact of lighting on WASH use and Gender- Based Violence (GBV) required a multi-disciplinary approach, combining OXFAM’s practical implementing expertise with WEDC’s research-orientated approach. The research showed how much more is needed for safe sanitation than just building latrines. Lack of usage of latrines had implications for environmental health. A reason for not using latrines was due to fear of many things, including GBV. The location of the facility was a common concern, but simple lessons are not easy to distil as the context varies between settlements and changes rapidly overtime. The provision of lighting was welcomed by a wide range of stakeholders, but other factors still affect both GBV and WASH outcomes

Evidence-Based Assessment of Congenital Heart Disease Genes to Enable Returning Results in a Genomic Study

Background: Congenital heart disease (CHD) is the most common major congenital anomaly and causes significant morbidity and mortality. Epidemiologic evidence supports a role of genetics in the development of CHD. Genetic diagnoses can inform prognosis and clinical management. However, genetic testing is not standardized among individuals with CHD. We sought to develop a list of validated CHD genes using established methods and to evaluate the process of returning genetic results to research participants in a large genomic study. Methods: Two-hundred ninety-five candidate CHD genes were evaluated using a ClinGen framework. Sequence and copy number variants involving genes in the CHD gene list were analyzed in Pediatric Cardiac Genomics Consortium participants. Pathogenic/likely pathogenic results were confirmed on a new sample in a clinical laboratory improvement amendments-certified laboratory and disclosed to eligible participants. Adult probands and parents of probands who received results were asked to complete a post-disclosure survey. Results: A total of 99 genes had a strong or definitive clinical validity classification. Diagnostic yields for copy number variants and exome sequencing were 1.8% and 3.8%, respectively. Thirty-one probands completed clinical laboratory improvement amendments-confirmation and received results. Participants who completed postdisclosure surveys reported high personal utility and no decision regret after receiving genetic results. Conclusions: The application of ClinGen criteria to CHD candidate genes yielded a list that can be used to interpret clinical genetic testing for CHD. Applying this gene list to one of the largest research cohorts of CHD participants provides a lower bound for the yield of genetic testing in CHD

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

In-flight performance of Spider's 280-GHz receivers

Spider is a balloon-borne instrument designed to map the cosmic microwave background at degree-angular scales in the presence of Galactic foregrounds. Spider has mapped a large sky area in the Southern Hemisphere using more than 2000 transition-edge sensors (TESs) during two NASA Long Duration Balloon flights above the Antarctic continent. During its first flight in January 2015, Spider was observed in the 95- and 150-GHz frequency bands, setting constraints on the B-mode signature of primordial gravitational waves. Its second flight in the 2022–2023 season added new receivers at 280 GHz, each using an array of TESs coupled to the sky through feedhorns formed from stacks of silicon wafers. These receivers are optimized to produce deep maps of polarized Galactic dust emission over a large sky area, providing a unique data set with lasting value to the field. We describe the instrument’s performance during Spider’s second flight, focusing on the performance of the 280-GHz receivers. We include details on the flight, in-band optical loading at float, and an early analysis of detector noise

Reducing the Negative Impact of Social Distancing Through Intentional Connectedness

Social distancing during the COVID-19 pandemic resulted in both positive and negative effects. Nursing education was significantly impacted by the necessity of remote learning and absence of clinical experiences. The purpose of this article is to discuss how intentionality in social connectedness can combat the negative impact of social distancing in nursing education. Lessons learned and strategies employed by nursing educators during the intentional application of social connectedness are presented