The results provide the factors associated health literacy as well as health-related QOL. Nurses should understand the health literacy among survivors with breast cancer and improve health literacy to optimize their quality of life.
  The subcutaneous implantable cardioverter-defibrillator (S-ICD) has a larger generator and its implantation involves more dissection and tunneling compared to traditional transvenous defibrillator system. Liposomal bupivacaine, an extended-release bupivacaine with 72h of duration has been used for postoperative pain management in patients undergoing S-ICD implantation. Our aim was to compare postoperative pain and opioid prescription patterns among patients undergoing S-ICD implantation who received intraprocedural liposomal bupivacaine and those who did not.
 
  We performed a retrospective analysis of all patients who underwent subcutaneous ICD implantation from January 1, 2013 to March 30, 2018 at the Mayo Clinic in Rochester, Minnesota. Patients were categorized into those who received liposomal bupivacaine and those who did not. Data on inpatient pain score, outpatient opioid prescription rates at discharge, and doses based on oral morphine equivalents (OME) were collected.
 
  A total of 104 patients underwent S-ICD implantation.  https://www.selleckchem.com/products/hydroxychloroquine-sulfate.html  Intraprocedural liposomal bupivacaine was used in 69% of patients. Patients who received intraprocedural liposomal bupivacaine had similar mean inpatient pain scores (2.9vs. 2.9, p=.786). There was also no difference in the rate of inpatient opioid administration (79.2%vs. 87.5%, p=.4139), outpatient opioid prescription (23.6%vs. 12.5%, p=.29), or mean OME (41.7-mg vs. 16.6-mg, p=.188) when comparing patients those who received intraprocedural liposomal bupivacaine and those who did not.
 
  Intraprocedural liposomal bupivacaine administration was not associated with any significant impact on postoperative pain scores, inpatient opioid administration, and outpatient opioid prescription rates or OME amounts at discharge.
 Intraprocedural liposomal bupivacaine administration was not associated with any significant impact on postoperative pain scores, inpatient opioid administration, and outpatient opioid prescription rates or OME amounts at discharge.
  Gait impairment implies subtle cognitive impairment (CI) and is associated with severity of white matter hyperintensities (WMHs). However, cognitive differences in such an association are not yet fully understood. This study examined the association between WMHs and gait performance among three cognitively different older groups.
 
  Gait performance and WMHs were assessed in 150 community-dwelling older adults, comprising 53 with CI (Mini-Mental State Examination [MMSE] score <24), 63 with mild CI (MMSE score ≥24 and Montreal Cognitive Assessment [MoCA] score <25), and 34 who were cognitively normal or preserved (MMSE ≥24 and MoCA score ≥25). Gait velocity and variability were assessed on a 5-m electronic walkway. Furthermore, WMH volume was derived by automated segmentation using 1.5 T magnetic resonance imaging.
 
  Adjusted multiple regression analyses showed that greater WMHs were associated with slower gait velocity and greater temporal (stride time) and spatial (stride and step lengths) variabilities among older adults with CI. In contrast, WMH was only associated with spatial variability in older adults with mild CI and in cognitively normal or preserved older adults.
 
  Our findings suggest that gait variability measures are more sensitive to subtle underlying neurological pathologies including WMHs in older adults. The cognitive-dependent differences found in the association between WMHs and gait performance suggests that the level of cognitive function interferes with the association between WMH and gait performance. Geriatr Gerontol Int 2021; •• ••-••.
 Our findings suggest that gait variability measures are more sensitive to subtle underlying neurological pathologies including WMHs in older adults. The cognitive-dependent differences found in the association between WMHs and gait performance suggests that the level of cognitive function interferes with the association between WMH and gait performance. Geriatr Gerontol Int 2021; •• ••-••.
  To identify the efficacy of a design thinking and health care innovation course in improving medical students' self-awareness regarding design thinking metrics.
 
  The assessment of the design thinking mindset was measured pre- and post-course. The target population included medical students at our institution participating in the Innovation & Design Thinking (IDT) course. A paired t-test was used to compare scores from before and after taking the course with p-value set at <0.05.
 
  Students reported significantly improvements in the domains of tolerance for uncertainty, embracing risk, human-centeredness, mindfulness and awareness of process, team knowledge, experimentation, transforming in something tangible, abductive thinking, envisioning new things, and creative confidence (p<0.05). The greatest improvements were in tolerance for uncertainty (0.48), mindfulness and awareness of process (0.47), and creative confidence (0.40). No significant change was observed in constructs such as empathy, problem reframing, team member's interaction, multidisciplinary collaborative teams, openness to diversity, being learning oriented, learning from mistakes, bias for action, critical thinking, desire to make a difference, and optimism to have an impact.
 
  Instructing medical students on the principles of design thinking and their applications in health care improves their self-awareness regarding the design thinking mindset.
 Instructing medical students on the principles of design thinking and their applications in health care improves their self-awareness regarding the design thinking mindset.The SARS-CoV-2 pandemic has affected millions across the world. Significant patient surges have caused severe resource allocation challenges in personal protective equipment, medications, and staffing. The virus produces bilateral lung infiltrates causing significant oxygen depletion and respiratory failure thus increasing the need for ventilators. The patients who require ventilation are often requiring prolonged ventilation and depleting hospital resources. Tracheostomy is often utilized in patients requiring prolonged ventilation, and early tracheostomy in critical care patients has been shown in some studies to improve a variety of factors including intensive care unit (ICU) length of stay, ventilation weaning, and decreased sedation medication utilization. In a patient surge setting, as long as adequate personal protective equipment (PPE) is available to minimize spread to healthcare workers, early tracheostomy may be a beneficial management of these patients. Decreasing sedative medication utilization may help prevent shortages in future waves of infection and improve patient-provider communication as patients are more alert.