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This study describes nurses' perceptions about how and why medication errors occur and their personal experiences with medication errors. A survey was mailed to a random sample of registered nurses. Two hundred and two responded. Of those, 158 (78%) nurses admitted making medication errors and provided details about these errors. This study, by providing the perspective of frontline nurses, contributes to the body of knowledge on medication errors. [ABSTRACT FROM AUTHOR]

This article addresses a recent change in the health care delivery system: the concierge medical practice, where doctors provide an array of special services by limiting practice to a small number of patients willing to pay a membership fee. The purpose of this article is to document this trend and to situate it within the health care system. Although beneficial for patients who can afford it, concierge medicine leads to increasing health care inequalities and disparities in the United States. The implications for nurse practitioners include caring for a larger and sicker population of underserved patients. [ABSTRACT FROM AUTHOR]

After intravenous administration of [7α-³H]dehydroepiandrosterone [35S]sulfate (³H/35S = 2.88) to a normal male subject various ³H-labeled C19- and C18-steroid metabolites could be isolated from the fractions of free steroids and double-labeled sulfoconjugates (³H/35S = 3.16) in skin extracts, containing a total of 1.36% of the injected ³H-activity. The specific activity of ³H-labeled steroids in skin extracts was found to be significantly lower than that of corresponding compounds in the 24-hour urine. Whereas in skin extracts up to 95% of steroids present were isolated from the fractions of sulfoconjugates, more than 90% of steroids in sweat extracts could be detected in the fraction of free steroids. From such data, as well as from the qualitative and quantitative composition of steroid fractions in skin and sweat it was concluded, that under in vivo conditions endogenous sulfo-conjugated dehydroepiandrosterone undergoes a direct metabolism in human skin tissue. Subsequently, sulfoconjugated metabolites probably suffer hydrolysis prior to excretion in sweat. [ABSTRACT FROM AUTHOR]

Photoexcitation of atoms solvated inside superfluid helium nanodroplets is investigated with femtosecond photoelectron spectroscopy. Expansion of the solvation shell within about 600 fs is observed as transient photoelectron peak shift. For larger photoexcitation energies within the blue-shifted absorption band, more energy is transferred to the He droplet and the expansion proceeds faster.

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A convergent total synthesis of bacterial gyrase B/topoisomerase IV inhibitor kibdelomycin (a.k.a. amycolamicin) (1) was devised starting from inexpensive d-mannose and l-rhamnose, which were converted in new efficient ways to an N -acylated amycolose and an amykitanose derivative as late building blocks. For the former, we developed an expeditious, general method for the introduction of an α-aminoalkyl linkage into sugars via 3-Grignardation. The decalin core was built up in seven steps via an intramolecular Diels-Alder reaction. These building blocks could be assembled as published previously, making for a formal total synthesis of 1 in 2.8% overall yield. An alternative order of connecting the essential fragments was also made possible by the first protocol for the direct N -glycosylation of a 3-acyltetramic acid., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Laser-assisted electron scattering (LAES) is a fundamental three body interaction process that enables energy transfer between electrons and photons in the presence of matter. Here, we focus on the multiscattering regime of electrons generated by above-threshold ionization (ATI) of In atoms inside a high-density nanostructure, helium nanodroplets (He N ) of ∼40 Å radius. The stochastic nature of the multiscattering regime results in photoelectron spectra independent of laser polarization. Numerical simulations via tunnel-type ionization followed by applying the Kroll-Watson approximation for LAES are in agreement with experimental spectra and yield a mechanistic description of electron generation and the LAES energy modulation processes. We find a negligible influence of the electron start position inside the helium droplet on the simulated electron energy spectrum. Further, our simulations shine light on the interplay of electron time of birth, number of LAES gain/loss events, and final kinetic energy; early ionization leads to the largest number of scattering events and thereby the highest electron kinetic energy.

Eight analogues of the bioherbicides macrocidin A ( 1 ) and Z ( 2 ) with structural variance in the size of the macrocycle, its para - or meta -cyclophane character, and its functional groups were synthesized on two modular routes and tested for herbicidal, antibiotic, and antibiofilm activities. Apart from the lead compounds 1 and 2 , the structurally simplified dihydromacrocidin Z ( 3 ) and normacrocidin Z ( 4 ) showed high herbicidal activity in either thistles, dandelions or in both. The derivatives 2 , 3 , and dibromide 9 also inhibited the growth of Staphylococcus aureus biofilms by ca 70% when applied at subtoxic concentrations as low as ca 20 µM, which are unlikely to induce bacterial resistance. They also led to the dispersion of preformed biofilms of S. aureus , exceeding a similar effect by microporenic acid A, a known biofilm inhibitor. Compounds 3 and 9 showed no noticeable cytotoxicity against human cancer and endothelial cells at concentrations below 50 µM, making them conceivable candidates for application as anti-biofilm agents in a medicinal context.

Laser-assisted electron scattering (LAES), a light-matter interaction process that facilitates energy transfer between strong light fields and free electrons, has so far been observed only in gas phase. Here we report on the observation of LAES at condensed phase particle densities, for which we create nano-structured systems consisting of a single atom or molecule surrounded by a superfluid He shell of variable thickness (32-340 Å). We observe that free electrons, generated by femtosecond strong-field ionization of the core particle, can gain several tens of photon energies due to multiple LAES processes within the liquid He shell. Supported by Monte Carlo 3D LAES and elastic scattering simulations, these results provide the first insight into the interplay of LAES energy gain/loss and dissipative electron movement in a liquid. Condensed-phase LAES creates new possibilities for space-time studies of solids and for real-time tracing of free electrons in liquids., (© 2021. The Author(s).)

For the realm of visual cues, it has been well documented that attention is preferentially oriented toward emotionally relevant cues. Preliminary evidence suggests that emotional cues from other sensory modalities may also steer visual attention toward emotional pictures. However, more research is needed to elucidate the mechanisms that are involved. Therefore, a novel design was used to investigate whether emotional sounds promote attentional orientation toward emotional pictures. To this end, 48 participants viewed pairs of pictures with either neutral or unpleasant content in a free-viewing paradigm. In addition, neutral or unpleasant sounds were presented either on the left-hand or on the right-hand side of the monitor. Eye movements were recorded as an index of visual spatial attention toward the pictures. Most interestingly, position and valence of the sounds independently modulated visual orienting towards unpleasant pictures. For initial capture and sustained attention, orienting towards unpleasant pictures was significantly enhanced when any sound was heard on the same side as the unpleasant picture. In addition, unpleasant sounds (irrespective of the side) boosted leftward bias of initial attention toward emotionally congruent pictures. Taken together, this study clearly shows that emotional auditory cues guide visual spatial allocation of attention specifically to emotionally congruent pictures. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

In our ongoing search for new bioactive fungal metabolites, four previously undescribed oxazole carboxylic acid derivatives ( 1 - 4 ) for which we proposed the trivial names macrooxazoles A-D together with two known tetramic acids ( 5 - 6 ) were isolated from the plant pathogenic fungus Phoma macrostoma . Their structures were elucidated based on high-resolution mass spectrometry (HR-MS) and nuclear magnetic resonance (NMR) spectroscopy. The hitherto unclear structure of macrocidin Z ( 6 ) was also confirmed by its first total synthesis. The isolated compounds were evaluated for their antimicrobial activities against a panel of bacteria and fungi. Cytotoxic and anti-biofilm activities of the isolates are also reported herein. The new compound 3 exhibited weak-to-moderate antimicrobial activity as well as the known macrocidins 5 and 6 . Only the mixture of compounds 2 and 4 (ratio 1:2) showed weak cytotoxic activity against the tested cancer cell lines with an IC 50 of 23 µg/mL. Moreover, the new compounds 2 and 3 , as well as the known compounds 5 and 6 , interfered with the biofilm formation of Staphylococcus aureus , inhibiting 65%, 75%, 79%, and 76% of biofilm at 250 µg/mL, respectively. Compounds 5 and 6 also exhibited moderate activity against S. aureus preformed biofilm with the highest inhibition percentage of 75% and 73% at 250 µg/mL, respectively.

Helium nanodroplets can serve as reaction containers for photoinduced time-resolved studies of cold, isolated molecular systems that are otherwise inaccessible. Recently, three different dynamical processes, triggered by photoexcitation of a single atom inside a droplet, were observed in their natural time scale: Expansion of the He solvation shell (He bubble) within 600 fs initiates a collective bubble oscillation with a ∼30 ps oscillation period, followed by dopant ejection after ∼60 ps. Here, we present a systematic investigation of these processes by combining time-resolved photoelectron and photoion spectroscopy with time-dependent He density functional theory simulations. By variation of the photoexcitation energy, we find that the full excess excitation energy, represented by the blue-shifted in-droplet excitation band, is completely transferred to the He environment during the bubble expansion. Surprisingly, we find that variation of the droplet size has only a minor influence on the ejection time, providing insight into the spatial distribution of the ground-state atoms before photoexcitation. Simulated particle trajectories after photoexcitation are in agreement with experimental observations and suggest that the majority of ground-state atoms are located at around 16 Å below the droplet surface. Bubble expansion and oscillation are purely local effects, depending only on the ultimate dopant environment. These solvation-induced dynamics will be superimposed on intramolecular dynamics of molecular systems, and a mechanistic description is fundamental for the interpretation of future experiments.

The observation of chemical reactions on the time scale of the motion of electrons and nuclei has been made possible by lasers with ever shortened pulse lengths. Superfluid helium represents a special solvent that permits the synthesis of novel classes of molecules that have eluded dynamical studies so far. However, photoexcitation inside this quantum solvent triggers a pronounced response of the solvation shell, which is not well understood. Here, we present a mechanistic description of the solvent response to photoexcitation of indium (In) dopant atoms inside helium nanodroplets (He N ), obtained from femtosecond pump-probe spectroscopy and time-dependent density functional theory simulations. For the In-He N system, part of the excited state electronic energy leads to expansion of the solvation shell within 600 fs, initiating a collective shell oscillation with a period of about 30 ps. These coupled electronic and nuclear dynamics will be superimposed on intrinsic photoinduced processes of molecular systems inside helium droplets.

Aim: To report the results of a community-based screening program associated with Project DIRECT, a multiyear diabetes mellitus prevention and control project targeting African-American residents of southeast Raleigh, NC., Methods: Between December 1996 and June 1999, 183 screening events took place in community settings. Screening was by capillary glucose concentration. Participants with a positive screen were referred for confirmatory testing and physician follow-up., Main Results: Risk factors for diabetes were prevalent, including ethnic minority race (88.2%), obesity (45.6%), and family history of diabetes (41.7%). In all, 197 personshad an elevated screening result; the prevalence of diabetes in the screened population that underwent follow-up testiing was 1.7%. Despite persistent tracking efforts, 28% of the persons with a high screening test received no final diagnosis, Conclusions: In this community-based screening program targeted to high-risk African Americans, risk factors for diabetes were common, but new cases of undiagnosed diabetes among participants were uncommon. Intensive follow-up for persons with high screening values is necessary but difficult to achieve. Our results support national recommendations against community-based screening; opportunistic screening for diabetes in clinical settings is likely a more effective use of resources.

This paper discusses a novel technique for studying the inherent sensitivity of materials toward oxygen and the utility of quantitative thin-layer chromatography, as a tool in such studies. The degradation generally followed first order kinetics up to about 60% decomposition, indicating that the usual kinetic treatment applied to homogeneous systems can be used. The method can also detect degradation products, in many cases adding a considerable diagnostic element to its predictive value. Among the model compounds tested testosterone was the most stable with ca. 95% recovery following a 190-h exposure to air on standard silica gel plates. The half-life time of the other model substances under similar experimental conditions was estimated by means of direct measurements or by extrapolation, and found to range from approximately 300 h to 1 h 10 min with cortisone marking the upper value and cholesta-3,5-diene the lower one.

A method has been developed that consists of one-dimensional thin-layer chromatography of the samples on pre-coated silica gel 60F254 plates followed by an in situ spectrophotometric evaluation of the chromatograms at 273 nm. Statistical evaluations showed a linear calibration (r2 greater than 0.999) for the range of 0.2-20 microgram/spot. The relative standard deviations for broth samples containing 1.505 and 12.47 microgram Cephamycin C per spot were 3.61 and 1.07%, respectively. The recovery was virtually quantitative: 97.6%. The correlation with a liquid chromatographic method was quite acceptable with r2 = 0.99124 and b = 0.998 (slope).