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In Reply to the Letter to the Editor Regarding: The Association of Bone Mineral Density with Distal Junctional Kyphosis and Distal Junctional Failure After Multilevel Spine Fusions: A Systematic Review and Meta-Analysis .
No full textEvery Patient Every Time: HAPI Bundle Implementation on MICU and NSICU
No full texthttps://digitalcommons.providence.org/covenant_nurses_week_2025/1012/thumbnail.jp
Does Medication Administration by Rapid Response Team Members Decrease Mortality: A Research Review
No full texthttps://digitalcommons.providence.org/covenant_nurses_week_2025/1006/thumbnail.jp
Patient Satisfaction Survey – Every Patient Matters
No full texthttps://digitalcommons.providence.org/covenant_nurses_week_2025/1002/thumbnail.jp
Candida albicans: A Comprehensive View of the Proteome
No full textWe describe a new release of the Candida albicans PeptideAtlas proteomics spectral resource (build 2024-03), providing a sequence coverage of 79.5% at the canonical protein level, matched mass spectrometry spectra, and experimental evidence identifying 3382 and 536 phosphorylated serine and threonine sites with false localization rates of 1% and 5.3%, respectively. We provide a tutorial on how to use the PeptideAtlas and associated tools to access this information. The C. albicans PeptideAtlas summary web page provides Build overview , PTM coverage , Experiment contribution , and Data set contribution information. The protein and peptide information can also be accessed via the Candida Genome Database via hyperlinks on each protein page. This allows users to peruse identified peptides, protein coverage, post-translational modifications (PTMs), and experiments that identify each protein. Given the value of understanding the PTM landscape in the sequence of each protein, a more detailed explanation of how to interpret and analyze PTM results is provided in the PeptideAtlas of this important pathogen. Candida albicans PeptideAtlas web page: https://db.systemsbiology.net/sbeams/cgi/PeptideAtlas/buildDetails?atlas_build_id=578
Worsening Renal Function Is Common and Is Associated With Higher Mortality Rates in Cardiogenic Shock: A Cardiogenic Shock Working Group Report.
No full textBACKGROUND: Outcomes associated with worsening renal function (WRF) in cardiogenic shock (CS) remain poorly understood.
OBJECTIVES: To study the incidence of WRF in heart failure-CS (HF-CS) and acute myocardial infarction CS (AMI-CS), examine its association with in-hospital mortality (IHM) rates, define the trajectory of renal function in CS, and identify independent predictors of WRF in HF-CS vs AMI-CS.
METHODS: Patients in the Cardiogenic Shock Working Group registry (CSWG) from 2021-2024 were analyzed; those with baseline end-stage renal disease were excluded. WRF was defined as an increase in creatinine ≥ 0.3 mg/dL, a decrease in estimated glomerular filtration rate (eGFR) \u3e 25%, or initiation of renal replacement therapy (RRT) within 72 hours of CS diagnosis.
RESULTS: Of 6269 patients with CS, 35% developed WRF, including 32% of patients with HF-CS and 41% of patients with AMI-CS. Patients who developed WRF were more likely to have been transferred from other hospitals (63% vs 50%; P \u3c 0.001). Baseline right atrial pressure (RAP) was higher in patients with both HF-CS (15 mmHg vs 12 mmHg; P \u3c 0.001) and AMI-CS (13 mmHg vs 11 mmHg; P = 0.02) and with WRF compared to patients without WRF. The incidence of WRF was higher in patients exposed to both tMCS and vasoactive agents as compared to vasoactive drugs alone (46% vs 29%; P \u3c 0.001). The overall rate of RRT initiation was 20% throughout admission, with higher rates in patients with acute on chronic vs de novo HF-CS and in patients with ST-elevation myocardial infarction (STEMI)-CS vs NSTEMI-CS in the first 24 hours. IHM was higher in patients with WRF (41% vs 21%; P \u3c 0.001). In patients with WRF, median eGFRs declined steadily throughout the first 72 hours after diagnosis of CS. Key independent predictors of WRF included RAP, lactate levels and transfer status in patients with HF-CS and CKD and lactate and transfer status in patients with AMI-CS.
CONCLUSION: WRF is common and deleterious in both HF- and AMI-CS. Given the early association with worse outcomes, WRF may be not only prognostic but may also represent a potential therapeutic target in future studies of CS
Community-Based Lung Cancer Screening Program Structure, Quality, and Barriers: The Struggle for Implementation.
No full textObjectives: Recommendations for programmatic components for lung cancer screening programs (LCSPs) have been published; however, adoption within LCSPs has not been mandated and implementation requires resources. We aimed to determine the presence of recommended structural and quality elements within LCSPs and determine barriers to performing LCS within a community-based, multistate healthcare network. Methods: We conducted a cross-sectional study using two structured interviews within a community-based healthcare network between 1 June 2018 and 31 July 2020. Two separate interviews were created, one delivered to LCSP navigators to determine the presence of recommended structural and quality elements within LCSPs and one delivered to imaging center administrators to determine barriers to LCS implementation. Results: Of the 22 LCSPs, 20 (91%) were decentralized and 2 (9%) centralized. Three (14%) utilized standardized shared decision-making tools and 13 (59%) a multidisciplinary nodule review. Of the 21 (95%) LCSPs who collected information for external purposes, 9 (43%) collected it manually. Ten (45%) utilized a standard procedure for smoking cessation, and 5 (23%) had Certified Tobacco Treatment Specialists. Of the 31 affiliated imaging sites not associated with a LCSP, 8 (26%) were performing LCS. While 19 (61%) sites had the resources to fulfill or maintain an increase in LCS orders, lack of resources was the predominant (11, 35%) barrier to implementing a LCSP. Conclusions: A wide variation in the structure, quality, and resource allocation was identified within the network of LCSPs. Further research identifying the implications this variation has on outcomes, operational cost, and experience may shed light on whether stringent program quality control is needed
Updates in Management of Locally and Regionally Advanced Basal Cell Carcinoma.
No full textBasal cell carcinoma (BCC) is a slow-growing skin cancer that tends to remain localized but that can occasionally grow extensively and penetrate deeper tissues (locally advanced BCC [laBCC]). The first line of treatment for laBCC is surgical excision, but when resection is not possible systemic therapies such as Hedgehog pathway inhibitors or immune checkpoint inhibitors are indicated. The management of laBCC relies on a multidisciplinary team approach; the goals of treatment include local control, palliation of symptoms, achieving acceptable cosmetic results, and reduce the risk of recurrence
Spy Quest: Gamifying Quality and Patient Safety Education
No full texthttps://digitalcommons.providence.org/swedish_fish_2025/1005/thumbnail.jp
The NLS3 Motif in TPX2 Regulates Spindle Architecture in Xenopus Egg Extracts.
No full textA bipolar spindle composed of microtubules and many associated proteins functions to segregate chromosomes during cell division in all eukaryotes, yet both spindle size and architecture vary dramatically across different species and cell types. Targeting protein for Xklp2 (TPX2) is one candidate factor for modulating spindle microtubule organization through its roles in branching microtubule nucleation, activation of the mitotic kinase Aurora A, and association with the kinesin-5 (Eg5) motor. Here we characterize a conserved nuclear localization sequence (NLS) motif, 123KKLK126 in Xenopus laevis TPX2, which regulates astral microtubule formation and spindle pole morphology in Xenopus egg extracts. Addition of recombinant TPX2 with this sequence mutated to AALA stimulated spontaneous formation of microtubule asters and increased recruitment of phosphorylated Aurora A, pericentrin, and Eg5 to meiotic spindle poles while still binding to the regulatory transport factor importin α. We propose that TPX2 is a linchpin spindle assembly factor whose regulation contributes to the activation of multiple microtubule polymerizing and organizing proteins, generating distinct spindle architectures