Trident Technical College

39 Background: Prostate cancer is a leading cause of cancer-related death among men in the United States (U.S). Despite therapeutic advances, racial disparities persist, with African American men experiencing higher incidence and poorer survival. Data on racial differences in inpatient outcomes, particularly in-hospital mortality, remain limited. This study evaluated racial and ethnic variations in in-hospital mortality among patients hospitalized with malignant prostate cancer (MPC) in the U.S. Methods: The U.S National Inpatient Sample (NIS) from 2016 to 2020 was queried for patients diagnosed with MPC. We used International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) code “C61” to identify patients who were hospitalized for MPC. The study was exempt from institutional review board approval as the NIS database contains deidentified patient information. Multivariable regression analysis was performed to determine the odds of in-hospital mortality among patients with MPC. Multivariable logistic regression followed by marginal effects was used to plot yearly trends in in-hospital mortality. All the outcomes were adjusted for age, gender, Charlson comorbidity index (CCI) and hospital characteristics. All Statistical analyses were conducted using STATA 19 software. Results: The current retrospective study analyzed 98,000 patients hospitalized for MPC between 2016 to 2020. The racial distribution among study patients included: Whites (68,000; 69.4%), African Americans (17,738; 18.1%), Hispanics (7,154; 7.3%), and other minorities (5,098; 5.2%). African Americans were more likely to be hospitalized at a relatively younger age, and with a higher co-morbidity burden (mean age: 69.4 years; mean CCI: 5.5; p<0.01) when compared to Whites (mean age: 73 years; mean CCI: 4.8), Hispanics (mean age: 71.1 years; mean CCI: 5.1) and other minorities (mean age: 71.5 years; mean CCI: 5.0). A total of 3,626 (3.7%) patients died during the study period. On multivariable analysis, a higher absolute in-hospital mortality was observed in African Americans (OR: 1.14, 95% CI: 1.07 – 1.22, p <0.01) and other minorities (OR: 1.19, 95% CI: 1.06 – 1.34, p <0.01), when compared to Whites (OR: reference). Similarly, an increasing trend of in-hospital mortality was observed in African Americans (from 1.6% mortality per annum in 2016 to 2.0% in 2020; trend p <0.01) and Hispanics (from 1.1% mortality per annum in 2016 to 1.6% in 2020; trend p = 0.02). No change in mortality was observed among Whites (trend p = 0.171) and other minorities (trend p = 0.479) during the study period. Conclusions: Racial disparities persist in in-hospital outcomes among patients with MPC in the U.S. African American and Hispanic patients experienced increasing in-hospital mortality over time, highlighting the need for targeted interventions to address inequities in access, comorbidity management, and inpatient care.

The RUMERTIME Process (RP) is a five-step culturally responsive social-emotional, problem-solving, prevention-intervention strategy used to educate, equip, and empower students, educators, and families. The RP equips individuals with the abilities to recognize, understand, manage, express, and reflect on their thoughts, interactions, mindsets, and emotions (RUMERTIME) in relation to themselves, others, and the daily life challenges they face within multiple systems and settings. The RP is embedded within the Cultivating SEEDS System framework (CSS) and is utilized to equip culturally diverse communities, inclusive of students, family members, educators, and administrators, with the social-emotional skills to effectively solve student attendance problems (SAPs). The data shared in this practice intervention article are descriptive in nature and highlight the RP as a protective factor and explain its three goals. The paper consists of three parts: (a) introduction of the RP, which is embedded in the CSS framework; (b) description of implementation of the RP as integral to the Daytime Intervention Room (DIR) program; and (c) discussion of risk factors that qualified students to receive services through the DIR program as well as data that demonstrated how the RP performed as a protective factor. The DIR program was aimed at creating an alternative to out-of-school suspension (OSS) and the traditional punitive in-school suspension (ISS). The program was established in each of the four schools in an urban high-needs school district in the midwest region of the United States. The DIR program was intentionally designed to include multiple levels, stakeholders, and delivery support, thus creating a solid base for the holistic development of students, educators, and parents. In conjunction with the CSS framework, the DIR program sought to increase academic performance, decrease the number of behavior referrals, and improve attendance rates in this high-needs urban school district.

Identifying misconceptions in student learning is a valuable practice for evaluating student learning gains and directing educational interventions. By accurately identifying students’ knowledge and misconceptions about microbiology concepts, instructors can design effective classroom practices centered on student understanding. Following the development of ASM’s Curriculum Guidelines in 2012, we developed a concept inventory, the Microbiology for Health Sciences Concept Inventory (MHSCI), that measures learning gains and identifies student misconceptions in health sciences microbiology classrooms. The 23-question MHSCI was delivered to a wide variety of students at multiple institution types. Psychometric analysis identified that the MHSCI instrument is both discriminatory and reliable in measuring student learning gains. The MHSCI results correlated with course outcomes, showing the value of using the instrument alongside course level assessments to measure student learning. The MHSCI is a reliable and efficient way to measure student learning in microbiology and can be used both as a faculty development tool and an effective student assessment tool.

Septic shock is a rare, potentially life-threatening complication of bacterial dysentery. The clinical presentation of septic shock includes hypotension, bleeding, hypoxia, acidosis, and jaundice. Historically gram-negative organisms were the most frequent cause of nosocomial bloodstream infections. However isolation of gram-positive organisms has become increasingly frequent with Staphylococcus species accounting for over one half of all nosocomial bloodstream pathogens. Bacterial dysentery is an acute diarrheal illness characterized by abdominal cramping, fever, and the production of mucoid, bloody stools. Laboratory findings include positive stool culture and increased leukocytes in direct fecal exam. Chemistry and hematology values may be abnormal. The disease is usually self-limiting but administration of antibiotics and rehydration therapy may be warranted in severe cases. This case study describes a 53 year old male who presented with diarrhea and diabetic acidosis and subsequently developed respiratory distress and renal failure due to shigellosis. Discussion of disease pathogenesis and treatment are provided.

Abstract Several 2′‐phenylphenylacetohydrazides were polylithiated with excess lithium diisopropylamide, and the resulting intermediates were condensed with several aromatic esters to afford C‐acylated intermediates that were not usually isolated, but acid cyclized directly to 1,4,5‐trisubstituted, 1,2‐dihydro‐3H‐pyrazol‐3‐ones.

Effective communication with hospital administrators, with medical staff, with the media, and with peers in healthcare epidemiology is a vital skill for hospital epidemiologists. This article will describe a number of practical ways to improve such communication based on the author's experience, on interviews with senior SHEA members, and on relevant articles from the literature.