Morsecombs5378

78-47.99, p = .0033] and serum MMP-1 levels >6.81 (OR = 2.67, CI = 1.21-6.08, p = .0165). Factors associated with ML current CD4 ≤ 350 (OR = 5.59, CI = 1.69-20.39, p = .006); with LH number of antiretroviral regimens used 2 (OR = 2.06, CI = 1.01-4.20, p = .0460) and 3+ (OR = 2.09, CI = 1.00-4.35, p = .0477), and current CD4 ≤ 350 (OR = 2.08, CI = 1.00-4.24, p = .0461); and with LA current viral load >40 (OR = 2.52, CI = 1.03-5.91, p = .0372) and current use of zidovudine (OR = 2.97, CI = 1.32-6.54, p = .0074). Higher levels of MMP-1 were associated with genotypes 1G/2G+1G/1G and with LD. Other individual risk factors were independently associated with LD, and its subtypes, suggesting that the pathogenesis itself is differently manifested for each type of LD.Background Medications for Opioid Use Disorder (MOUD) are recognized as successful treatments for Opioid Use Disorder (OUD). The Emergency Department is well situated to initiate MOUD and begin the referral process. Unfortunately, uptake of this practice among Emergency Medicine (EM) physicians has been slow. EM physicians may feel inadequately prepared to provide MOUD and addiction referral services due to lack of previous training and experience. The goal of this pilot study was to create, implement, and evaluate an OUD management curriculum for EM residents and measure impact on knowledge, practice, and empathy. Methods A 4.5-hour curriculum was developed, incorporating the Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment mission statement as well as the Accreditation Council for Graduate Medical Education and the American Board of Emergency Medicine resident physician milestones. The curriculum was inserted into an existing EM residency didactic block at an urban, tertiary care, residency program. Surveys were obtained pre- and post-intervention. Results Post curriculum surveys demonstrated improved knowledge of buprenorphine/naloxone including indications, clinical effects and side-effects (p  less then  0.05). Surveys also noted increased comfort prescribing buprenorphine/naloxone for opioid withdrawal and misuse and instructing patients on home induction (p  less then  0.05). Additionally, residents responded positively regarding the impact of the curriculum on their understanding of the topic and their subsequent confidence in managing patients with OUD in the ED setting. Conclusion A dedicated brief MOUD and referral curriculum can be effectively integrated into EM resident education to provide valuable clinical knowledge that may affect clinical practice.

Coronary ectasia (CE) is defined as dilation of the coronary artery, 1.5 times that of the surrounding vessel. Outcomes of percutaneous intervention (PCI) in patients with CE presenting as ST-elevated myocardial infarction (STEMI) remain a topic of debate.

Studies comparing outcomes of PCI in CE versus no-ectasia (NE) STEMI patients were identified. Baseline angiographic characteristics include thrombolysis in myocardial infarction (TIMI) 0-1 flow, right coronary artery (RCA) involvement, and primary outcomes including thrombus aspiration, no-reflow, mortality, and TIMI-3 post-PCI. Odds ratio (OR) and 95% confidence interval (CI) were calculated.

Six studies (n = 5746, CE-340 and NE-5406) qualified for the analysis. RCA involvement was more common in CE than NE, OR-1.39 (95%CI1.06-1.82, p-0.02). Pre-procedure TIMI-0-1 was of comparable results between the groups (p-1.13). Higher thrombus aspiration for CE (OR 2.18, 95%CI1.44-3.32;p-<0.001). Tofacitinib CE had higher incidence of no-reflow (OR 4.07, 95%CI2.42-6.84;p-<0.001). TIMI-3 flow post-PCI was achieved less commonly in the CE group (OR-0.64, 95%CI-0.48-0.86;p-<0.001). Mortality on follow-up was comparable (0.83, 95%CI0.39-1.78;p-0.63). Metaregression analysis did not show confounding effects from comorbidities.

Coronary ectasia patients with STEMI had higher rates of PCI failure and no-reflow than NE; however, mortality during follow-up was comparable.

Coronary ectasia patients with STEMI had higher rates of PCI failure and no-reflow than NE; however, mortality during follow-up was comparable.Barriers to effective interprofessional collaboration may include insufficient knowledge of other professional roles and inexperience using effective communication skills. Improving self-efficacy for interprofessional collaboration may enhance the ability to practice expertly within the interprofessional environment of healthcare. This article examines the results of a multiple methods pretest/posttest study that used the Self-Efficacy for Interprofessional Experiential Learning (SEIEL) scale to determine self-reported perceptions of self-efficacy development following participation in a trauma simulation. Participants included 74 undergraduate nursing students and nine undergraduate social work students. Findings included a significant increase in perceived self-efficacy from pretest to posttest for both groups. Nursing majors and participants who reported previous interaction with a member of another profession scored significantly higher on the posttest. Qualitative data were analyzed through thematic content analysis which produced three themes an improved understanding of the importance of communication and the interconnection of interprofessional roles; a realistic simulation which challenged the students; and an increased appreciation for teamwork. These findings suggest that challenging simulations with pre-licensure students can increase undergraduate students' perceived self-efficacy for interprofessional collaboration and contribute to an improved understanding of interprofessional team roles and communication.

Prior research has individually linked rumination, anxiety, and emotion dysregulation to alcohol misuse, but limited research has examined a comprehensive model linking these variables together. The present study tested a moderated-mediation model to examine whether emotion dysregulation moderated the indirect association of anxiety symptoms on alcohol-related problems

ruminative thinking styles.

Participants were 448 college students who consumed alcohol in the previous month. A plurality of participants identified as being White, non-Hispanic (40.6%), female (68.6%), and reported a mean age of 22.75 (Median = 20.00;

 = 6.84) years.

Brooding and reflection subtypes of ruminative thinking mediated the association between anxiety symptoms and alcohol-related problems with higher rates of anxiety symptoms associated with higher ruminative thinking, which in turn was associated with more alcohol-related problems. Further, the indirect effect of anxiety symptoms on alcohol-related problems through ruminative thinking was stronger for individuals who reported high levels of emotion dysregulation compared to those with average and low levels of emotion dysregulation.