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BACKGROUND: Research demonstrates that Point-of-care ultrasound (POCUS) improves clinical outcomes for patients. Improving clinician satisfaction with POCUS should promote utilization into everyday practice, leading to improved clinical outcomes. Despite this benefit, there are still barriers to use including POCUS workflow. This project was undertaken to improve the functionality of the existing POCUS workflow and move toward an encounter-based system by automating worklist generation. It aimed to streamline the POCUS workflow, primarily determine if there was improved clinician satisfaction with the new workflow, and secondarily determine the change in revenue generation from decreased errors in data entry. METHODS: A new workflow was created which automatically populated every registered Emergency Department (ED) patient into the worklist upon patient registration. Clinician feedback on their use of the new workflow was sought via survey after implementation. The number of medical record number (MRN) entry errors prior to and following implementation was manually reviewed and calculated. RESULTS: There was a strong preference for the new workflow, with 36 of 38 (94.7%) clinicians finding it to be more convenient and 37 of 38 (97.4%) finding it to be preferable to use compared to the old workflow. Implementation also resulted in a 36% reduction in database studies containing an MRN data entry error. CONCLUSIONS: An encounter-based workflow is strongly preferred over manual data entry for POCUS workflow among clinicians. Additionally, there was no cost to the intervention and the total data entry errors were significantly reduced, allowing for improved quality review and increased revenue.

Abstract Background Research demonstrates that Point-of-care ultrasound (POCUS) improves clinical outcomes for patients. Improving clinician satisfaction with POCUS should promote utilization into everyday practice, leading to improved clinical outcomes. Despite this benefit, there are still barriers to use including POCUS workflow. This project was undertaken to improve the functionality of the existing POCUS workflow and move toward an “encounter-based” system by automating worklist generation. It aimed to streamline the POCUS workflow, primarily determine if there was improved clinician satisfaction with the new workflow, and secondarily determine the change in revenue generation from decreased errors in data entry. Methods A new workflow was created which automatically populated every registered Emergency Department (ED) patient into the worklist upon patient registration. Clinician feedback on their use of the new workflow was sought via survey after implementation. The number of medical record number (MRN) entry errors prior to and following implementation was manually reviewed and calculated. Results There was a strong preference for the new workflow, with 36 of 38 (94.7%) clinicians finding it to be more convenient and 37 of 38 (97.4%) finding it to be preferable to use compared to the old workflow. Implementation also resulted in a 36% reduction in database studies containing an MRN data entry error. Conclusions An “encounter-based” workflow is strongly preferred over manual data entry for POCUS workflow among clinicians. Additionally, there was no cost to the intervention and the total data entry errors were significantly reduced, allowing for improved quality review and increased revenue.

Introduction: Peritonsillar abscesses form between the tonsillar capsule, the superior constrictor, and palatopharyngeus muscles. Physicians traditionally make this diagnosis clinically; however, ultrasound allows clinicians to further identify and differentiate between peritonsillitis, peritonsillar abscess, and phlegmon formation. By increasing both the sensitivity and specificity, ultrasound improves the diagnostic accuracy for patients with peritonsillar abscesses. This case demonstrates the utilization of ultrasound in peritonsillar abscesses and the application of point-of-care ultrasound (POCUS) in identifying complications of procedures used for treatment in the emergency department (ED).Case Report: A 19-year-old male presented to the ED with complaints of severe sore throat and fever for the prior five days. A POCUS using an endocavitary probe with sterile cover demonstrated hypoechoic debris with a “swirl sign.” Ultrasound was used to successfully guide needle aspiration by using in-plane needle guidance. The patient had significant bleeding after needle aspiration, and repeat POCUS clearly identified a new pocket of blood that had formed and was contained in the soft tissue. We monitored the size of the hematoma in real time with ultrasound to ensure the hematoma had no rapid expansion and was stable.Conclusion: Among the differential diagnoses for sore throat, the diagnosis of peritonsillar abscess is particularly concerning as it is both common and generally requires swift intervention. Presentations can range from a mild infection to a life-threatening emergency with potential airway compromise. The two primary avenues for treatment include either needle aspiration or incision and drainage. Ultrasound can successfully identify the abscess and other landmarks for safe and successful drainage, as well as early identification of complications.

The study investigated the effectiveness of a multicultural project implemented for the purpose of infusing multicultural instruction into a graduate level infant language disorders class in a speech-language pathology graduate program. The participants were 24 graduate students who ranged in age from 23-32, 20 were white, 4 were Black. A pretest and posttest survey were implemented along with journal entry thematic analysis to evaluate qualitative changes in learning. The results of the survey indicate that this experiential learning project can promote increased understanding, awareness and confidence in students related to multicultural issues. The journal analysis revealed that students were provided an opportunity to understand the impact of structural inequities related to intersectionality.

Securing clinical locations for Bachelor of Nursing Science (BSN) programs is always a complex challenge, particularly when clinical experiences are focused on vulnerable populations such as pediatric psychiatric patients. To provide students with a meaningful clinical experience during the first weeks of the COVID-19 pandemic, we developed a telehealth simulation centered on a pediatric psychiatric patient with unfolding adolescent depression and suicidal ideation. This case study uses qualitative data analysis of student debriefing sessions as well as a pre/posttest design to explore the effectiveness of the simulation. Results suggest that simulations can be useful for presenting unique patient scenarios focused on therapeutic communication in psychiatric assessment, particularly for vulnerable patient populations. Quantitative data analysis showed BSN students improved their understanding of communication needs of adolescents and retained their knowledge over time; qualitative comments showed that students felt the simulation was a valuable learning experience and achieved key learning outcomes.

Significant efforts have been made to characterize the biophysical properties of proteins. Small proteins have received less attention because their annotation has historically been less reliable. However, recent improvements in sequencing, proteomics, and bioinformatics techniques have led to the high-confidence annotation of small open reading frames (smORFs) that encode for functional proteins, producing smORF-encoded proteins (SEPs). SEPs have been found to perform critical functions in several species, including humans. While significant efforts have been made to annotate SEPs, less attention has been given to the biophysical properties of these proteins. We characterized the distributions of predicted and curated biophysical properties, including sequence composition, structure, localization, function, and disease association of a conservative list of previously identified human SEPs. We found significant differences between SEPs and both larger proteins and control sets. In addition, we provide an example of how our characterization of biophysical properties can contribute to distinguishing protein-coding smORFs from noncoding ones in otherwise ambiguous cases.

In this study, the length-weight relationship (LWR) was determined for the marine gastropod and commercial fisheries species, Kellet's whelk (Kelletia kelletii), and possible site- and sex-based differences in the LWR were assessed. Data were collected from 761 Kellet's whelks (1.6-15.5cm shell length, 0.51-404g total weight) that were brought to port by commercial fishermen or collected using SCUBA from three regions across the US geographic distribution of the species: San Diego, Santa Barbara, including the Northern Channel Islands, and Monterey. Model fitting revealed a cubic function to represent the LWR of the entire dataset with strong explanatory power. The fitted model suggested the species demonstrates slightly negative allometric growth, indicating that shell length grows faster than the width of the organism. Whelk sex and collection site did not impact the LWR. The information from this study can be used to inform management decisions for Kellet's whelk conservation, aquaculture, and fisheries harvest and guide future research. KEY WORDS: Kellet's whelk, Kelletia kelletii, length-weight relationship, fisheries, management, California, INTRODUCTION Kellet's whelk (Kelletia kelletii, Forbes, 1850) is a large (up to 17.5 cm), predatory gastropod found primarily in subtidal kelp forests at depths of 2-70 m (Rosenthal 1970). Following [...]

Introduction: Peritonsillar abscesses form between the tonsillar capsule, the superior constrictor, and palatopharyngeus muscles. Physicians traditionally make this diagnosis clinically; however, ultrasound allows clinicians to further identify and differentiate between peritonsillitis, peritonsillar abscess, and phlegmon formation. By increasing both the sensitivity and specificity, ultrasound improves the diagnostic accuracy for patients with peritonsillar abscesses. This case demonstrates the utilization of ultrasound in peritonsillar abscesses and the application of point-of-care ultrasound (POCUS) in identifying complications of procedures used for treatment in the emergency department (ED). Case Report: A 19-year-old male presented to the ED with complaints of severe sore throat and fever for the prior five days. A POCUS using an endocavitary probe with sterile cover demonstrated hypoechoic debris with a “swirl sign.” Ultrasound was used to successfully guide needle aspiration by using in-plane needle guidance. The patient had significant bleeding after needle aspiration, and repeat POCUS clearly identified a new pocket of blood that had formed and was contained in the soft tissue. We monitored the size of the hematoma in real time with ultrasound to ensure the hematoma had no rapid expansion and was stable. Conclusion: Among the differential diagnoses for sore throat, the diagnosis of peritonsillar abscess is particularly concerning as it is both common and generally requires swift intervention. Presentations can range from a mild infection to a life-threatening emergency with potential airway compromise. The two primary avenues for treatment include either needle aspiration or incision and drainage. Ultrasound can successfully identify the abscess and other landmarks for safe and successful drainage, as well as early identification of complications.