he literature. More implementation science research is needed to explore audit and feedback reports in nursing. This article adds to the literature by highlighting a significant lack of consistent and compelling positive results from the well-established quality improvement strategy of audit and feedback in the nursing population. The absence of good data is as telling as its presence.
Human soluble epoxide hydrolase plays a major role in cardiovascular homoeostasis. Genetic variants in the EPHX2 gene among different ethnic groups are associated with cardiovascular complications, such as hypertension. However, no reports regarding the association of EPHX2 genotype with hypertension among type II diabetic (T2D) patients of Middle Eastern Jordanian origin exist.
The current study aimed to elucidate the association of the EPHX2 allele, genotype and haplotype with T2D, hypertension and parameters of lipid profile parameters among Jordanian T2D patients.
Ninety-three genomic DNA samples of non-diabetic controls and 97 samples from T2D patients were genotyped for EPHX2 rs4149243, rs2234914 and rs751142 genetic variants. The DNA samples were amplified using polymerase chain reaction (PCR) and then sequenced using Applied Biosystems Model (ABI3730x1). The functionality of intronic EPHX2 variants was predicted using the in silico Berkely Drosophila Genome Project software.
We found no signifants with cardiovascular diseases among T2D patients in Jordan.
It can be concluded from this study that EPHX2 rs4149243, rs2234914 and rs751142 genetic variants do not play a role in the development of T2D and hypertension among Jordanian T2D patients. Further genetic studies with larger sample sizes are needed to find out the association of other functional EPHX2 variants with cardiovascular diseases among T2D patients in Jordan.
Clinical decision-making is complex and requires the integration of multiple sources of information. Physicians tend to over-rely on objective measures, despite the lack of supportive evidence in many cases. We sought to test if pediatricians over-rely on C-reactive protein (CRP) results when managing a child with suspected pneumonia.
A nationwide decision-making experiment was conducted among 337 pediatricians in Israel. Each participant was presented with two detailed vignettes of a child with suspected pneumonia, each with a chest X-ray (CXR) taken from a real-life case of viral pneumonia. Participants were randomly assigned to one of three groups Controls-where no lab tests were provided, and two intervention groups where the vignettes also noted a high or a low CRP value, in varying orders. Between-participant and within-participant analyses were conducted to study the effect of CRP on CXR interpretation. The three groups were presented with identical medical history, vital signs, findings on physical examination, blood count, and CXR.
Three-hundred and one pediatricians (89.3% of those approached) completed the study. Pediatricians were 60%-90% more likely to diagnose viral pneumonia as bacterial when presented with high CRP levels versus low CRP levels, despite the identical clinical data and CXR (62% vs. 39% and 58% vs. 31% of physicians; p = .002). Accordingly, they were 60%-90% more likely to prescribe antibiotics in these cases (86% vs. 53% and 78% vs. 41% of physicians; p < .001).
CRP by itself may modify the way in which pediatricians interpret a CXR, leading to the overprescription of antibiotics.
CRP by itself may modify the way in which pediatricians interpret a CXR, leading to the overprescription of antibiotics.Laser noninvasive methods for assessment of a tissue blood flow (BF), for example, the Laser Doppler Flowmetry (LDF), are well-known today. However, in such methods, low-frequency fluctuations (LFFs) in the registered optical signal caused by blood volume changes inside a tissue have not been studied in details until now. The aim of this study is to investigate the LFFs formation and to justify the LFFs-based diagnostic technique for cutaneous BF assessment. LFFs are theoretically described and experimentally shown in the input LDF signal inside the frequency range 0 to 10 Hz. They are substantiated as the basis of the new diagnostic method, in which BF is defined as the magnitude of blood volume changes in a tissue per unit time. read more The hand-made prototype of the promising diagnostic tool with light emitted diodes is used to validate the technique in experiments in vivo on 16 healthy volunteers in comparison with the LDF method. Experimental results show a good similarity of the recorded BF for both coherent and incoherent method. The proposed technique makes it possible the creation of inexpensive diagnostic equipment for assessment of cutaneous BF without using lasers and coherent light, completely and functionally comparable to LDF devices.Phosphorene-the monolayered material of the element allotrope black phosphorus (Pblack )-and SnIP are 2D and 1D semiconductors with intriguing physical properties. Pblack and SnIP have in common that they can be synthesized via short way transport or mineralization using tin, tin(IV) iodide and amorphous red phosphorus. This top-down approach is the most important access route to phosphorene. The two preparation routes are closely connected and differ mainly in reaction temperature and molar ratios of starting materials. Many speculative intermediates or activator side phases have been postulated especially for top-down Pblack /phosphorene synthesis, such as Hittorf's phosphorus or Sn24 P19.3 I8 clathrate. The importance of phosphorus-based 2D and 1D materials for energy conversion, storage, and catalysis inspired us to elucidate the formation mechanisms of these two compounds. Herein, we report on the reaction mechanisms of Pblack /phosphorene and SnIP from P4 and SnI2 via direct gas phase formation.Severe intrusion injuries of primary teeth are frequently associated with serious developmental disorders. This report describes the diagnostic procedures and the multidisciplinary approach for multiple sequelae to permanent incisors due to a severe intrusive injury of the primary maxillary anterior teeth at the age of 18 months in a 7-year-old girl. Clinical examination revealed hypoplasia of tooth 22, and radiographic examination showed crown-root malformation of tooth 21, impaction of tooth 11, and the presence of an odontoma-like malformation on tooth 12. The affected tooth 12 had a poor prognosis, as highlighted by CBCT, and it was extracted. While for the impacted 11, a surgical extraction followed by an orthodontic treatment is scheduled. Aesthetic and functional problems were solved by a functional space maintainer using a removable partial denture. The occurrence of multiple abnormalities in permanent teeth as a result of intrusive injuries in the primary dentition enhances the need for creating awareness among dentists not only of the importance of appropriate immediate management of trauma but also of the importance of establishing a long-term follow up and subsequent management of any sequelae.read more
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