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Knotted ureteral stent is rare yet tedious complication that might represent a treatment challenge to the endourologist. Only twelve cases of knotted stent have been reported. Different management options have been reported, including simple traction, ureteroscopy, percutaneous removal, and open surgery. In this paper, we present the successful untying of the knot using ureteroscopy with holmium laser.

This paper examines how Stanford Hospital, a Level I trauma centre serving the metropolitan region of California's Bay Area, manages an acute surge of patients from a mass casualty incident, specifically within the context of the crowded and overburdened US emergency medicine system. The authors offer practical considerations for the rapid creation of space and bandwidth during an acute surge of injured patients as well as best practices for reorganising daily systems to care for those patients efficiently. The study also discusses how past mass casualty incidents were examined for lessons learned in order to build and refine the response plan at Stanford Hospital, with input from a multidisciplinary committee. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) can negatively affect health and well-being. This study aimed to assess quality of life, use of self-management strategies, stress, anxiety, and depression in people with PCOS, and the effect of body mass index (BMI) on these factors. An online survey was distributed on PCOS social media sites and email listservs. Categorical data were analyzed as counts and percentages. Relationships between BMI and scores for PCOS quality of life (PCOSQ), use of diet and physical activity self-management strategies, perceived stress scale, and hospital anxiety and depression scale were analyzed using simple linear regression analyses. Significance was set at p < 0.05. The median BMI of participants (n = 101) was 33.12 kg/m2. PCOSQ scores were similar across BMI groups for many domains. Linear regression analyses revealed that BMI predicted variation in weight and hirsutism scores. Self-management scores were low for all BMI groups. Linear regression analyses revealed no significant relationships between BMI and scores for self-management strategy categories. Most participants had moderate stress (n = 55, 59.8%), abnormal anxiety (n = 50, 56.2%), and normal depression (n = 48, 53.9%) levels. Linear regression analyses revealed no significant relationships between BMI and these scores. Individuals of all body sizes with PCOS may experience quality of life disruptions and mental health concerns and may utilize dietary and physical activity self-management strategies at a low level. In PCOS, quality of life and mental health concerns should be assessed, in addition to metabolic impacts, and an individualized approach to increasing the use of self-management strategies should be implemented.

To help students develop an understanding of the proper use and function of spectrographs and monochromators we describe a student-assembled spectrograph using a "webcam" detector. The apparatus also works well as a low-cost demonstration, helping students make connections between an atomic spectrum observed by eye and a plot of the relative intensity versus wavelength. It also allows students to observe the internal components of a spectrograph. (Contains 3 footnotes and 3 figures.)

The exponential function model of radioactive decay and the concept of a half-life are used in nuclear experiments that appear in introductory and intermediate laboratories. In our interactions with students, we have found that students at all levels have significant confusion about both the term exponential and what is meant by a half-life as well as fundamental misconceptions regarding curve fitting.

Allison P Pack,1 Mary Clare Masters,2 Rachel O’Conor,1 Kenya Alcantara,1 Sophia Svoboda,1 Reneaki Smith,1 Fangyu Yeh,1 Guisselle Wismer,1 Amisha Wallia,2,3 Stacy C Bailey1 1Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; 2Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; 3Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USACorrespondence: Allison P Pack, Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA, Email allison.pack@northwestern.eduBackground: People living with HIV (PLWH) are at higher risk of developing type 2 diabetes (T2DM). Both chronic conditions require individuals to adhere to medication regimens, yet few studies have sought to explore medication-taking behaviors among individuals with comorbid HIV and T2DM (HIV+T2DM).Objective: This qualitative study sought to: 1) identify and compare perceived determinants of medication adherence for HIV and, separately, for T2DM, and 2) explore how participants prioritize conditions.Methods: Between October 2022 and January 2023, we conducted in-depth interviews with individuals aged 50 or older, living with comorbid HIV+T2DM. Participants were prescribed oral medications to treat their conditions and had recent clinical measures indicating probable challenges with medication adherence. Interviews with consented participants from a large academic health center in the Midwest were conducted remotely. Questions largely drew from the Theoretical Domains Framework (TDF), a widely used implementation science framework. Additional questions explored the prioritization of conditions. Analysis employed the Framework Method and a side-by-side comparison of key determinants of medication adherence by condition.Results: A total of 19 interviews were audio recorded, transcribed, and analyzed. Participants were an average age of 61, mostly male (89.5%), and Non-Hispanic White (47.4%). Although results revealed many commonalities between perceived determinants of medication adherence for HIV and for T2DM, differences relating to two TDF domains were noted: nature of the behavior (taking medications as prescribed), and motivations and goals. Many participants viewed their conditions as equally important, though they suggested T2DM was more difficult to manage, largely due to lifestyle modifications.Conclusion: As individuals with HIV develop chronic conditions, such as T2DM, they may require additional medication adherence support. Attention should be paid to offering support early. Disease perceptions may differ by condition, and as such, one’s motivations to take medication as prescribed may also differ by condition.Keywords: qualitative, HIV, type 2 diabetes, medication adherence

A simple method requiring minimal tools and mechanical ability, is presented for making a spherical air bearing. The air bearings are used for an exploration of precession. Results of test measurements are presented. [DOI: 10.1119/1.3050161]

Objective: The purpose of this study was to examine the attitudes and behaviors of emergency medical technicians (EMTs) and Paramedics when faced with the decision to care for patients with suspected Ebola Virus Disease (EVD) and to illicit suggestions for improvement of infectious disease (ID) preparedness. Methods: A convenience sample of 22 EMT/Paramedics were recruited from an emergency department at one of the designated Ebola centers. Each provider participated in one of three on-site focus groups. Participants answered questions about how they gained their knowledge, felt about caring for EVD patients, made decisions about caring for EVD patients, and suggestions for improvement of ID preparedness. Focus groups were recorded, transcribed, and coded using inductive content analysis. Results: Analysis revealed five prominent themes: reactions to scare, education/training, danger, decision making, and suggestions for future responses. Overall, first responders were excited to be a part of the response to EVD. They were more comfortable caring for EVD patients if they received adequate education and transparency from the administration. This resulted in a decreased perceived danger of the disease and decreased hesitancy when caring for EVD patients. However, those that expressed the most hesitancy also expressed the most emotional distress. Suggestions for improvement of ID preparedness included continuing education, tiered training models, peer training models, collaboration between emergency medical services (EMS) systems, better communication between departments, and the development of an infectious disease response team. Conclusions: Although first responders were excited to be a part of the response to EVD, this did not come without hesitation and emotional distress. Some of these concerns may be mitigated by first providing a clear definition of "duty to care," followed by interventions such as the development of clear and consistent ID preparedness training and interventions that address the emotional distress experienced by these providers. [ABSTRACT FROM AUTHOR]

Focuses on a study which presented the time-resolved observation of krypton second continuum excimer emission from a pulsed-discharge excited gas jet. Description of the temporal behavior of the excimer emission as a function of gas pressure, discharge energy, and positron within the cathode-anode gap; Cause of the temporal and spatial characteristics of the excimer emission during discharge.

We report the observation of bound–free emission corresponding to the lowest triplet transition 1 3Π→1 3Σ+ of the NaK molecule. In the experiment, specific levels of the upper triplet state were populated directly from the ground state by virtue of spin–orbit induced perturbations between the 1 3Π0 and 2 1Σ+ states. Oscillations in the fluorescence spectra between 1.1 and 1.6 μm reflect the probability distribution (wave function squared) in the bound upper state. We have also carried out quantum mechanical simulations of the fluorescence spectra, based on recent ab initio calculations of the relevant potential curves. These simulations verify the identification of this near-infrared emission and provide a critical test for the calculated potentials. [ABSTRACT FROM AUTHOR]

Rayleigh scattering is presented as evidence for the presence of large argon clusters formed in a planar expansion. Based on the observed scattering signal, the dependence of mean cluster size on stagnation pressure is ∝P03.38. This is in contrast to the dependence of the mean cluster size on stagnation pressure for a symmetric expansion of ∝P02.29. [ABSTRACT FROM AUTHOR]