(1,3)-β-D-glucan (BD) assays were developed as a method to rapidly diagnose invasive candidiasis (IC). The incidence of fungal infections and the demands for BD assay are gradually increasing in patients with severe trauma and under intensive care. However, the ideal BD cut-off value to predict IC has not been clarified. In this study, we evaluate the predictability of the BD assay and investigate the optimal cut-off value in patients with severe burn injuries.
 
  From July to December 2018, 134 samples from 86 patients with severe burns were analyzed. Serum BD levels were measured utilizing a Fungitell (Cape Cod Inc.) assay. A receiver operator characteristic (ROC) curve was generated, and the cumulative progression of IC was studied using a Cox proportional hazards model. Partial dependence plots (PDP) was applied to predict the risk of IC.
 
  Eleven patients were diagnosed with IC. BD over 120pg/mL (HR=5.11; P=0.001) was found to be independent predictor of the occurrence of IC, when the multivariable Cox model was adjusted for age, total body surface area, and inhalation injury. The area under the ROC curve was 0.658 (95% CI, 0.513-0.803), at an optimal cut-off value of 124.7pg/mL. PDP analysis showed the higher predicted IC occurrence at a BD level of ∼120-150pg/mL and TBSA over 60%.
 
  Our findings suggest that BD is an independent predictor for IC, and that a BD level between 120 and 150pg/mL could be utilized for IC prediction.
 Our findings suggest that BD is an independent predictor for IC, and that a BD level between 120 and 150 pg/mL could be utilized for IC prediction.
  Pharmacists who are integrated into the ward team are involved in initial decision making, therefore pre-empting pharmaceutical problems and optimising therapy from the outset. Identifying the barriers and facilitators (determinants) to successful pharmacist integration within a multidisciplinary ward team will facilitate design of strategies to support integration.
 
  The study aimed to identify the modifiable barriers and facilitators to pharmacist integration into the ward-based multidisciplinary team.
 
  Searches were conducted in May 2018 across 5 databases MEDLINE, Embase, CINAHL, PsychINFO and ASSIA, combined with grey literature and manual searches. Qualitative and mixed-methods studies using a qualitative method of data collection and analysis were eligible if reporting at least 1 modifiable determinant. Framework synthesis using the Theoretical Domains Framework (TDF) as the a priori coding framework was undertaken. Behaviour change techniques for addressing the identified determinants were selectedr knowledge and skills being valued and through demonstrating effective interpersonal skills. Re-structuring pharmacist responsibilities and working patterns to align with those of multidisciplinary team members also promotes integration.
 The identified determinants within TDF domains and their associated behaviour change techniques now enable researchers to design theory- and evidence-based interventions to facilitate pharmacist integration into the ward-based multidisciplinary team. Pharmacist integration is facilitated by their knowledge and skills being valued and through demonstrating effective interpersonal skills. Re-structuring pharmacist responsibilities and working patterns to align with those of multidisciplinary team members also promotes integration.
  Thyroidectomy techniques using extracervical approaches have grown in popularity for about 20 years and their feasibility has now been demonstrated. We wanted to evaluate one of these new approaches the anterior vestibular endoscopic approach (TOETVA). The aim of this study was to evaluate the results of an initial series patients who underwent an anterior trans-vestibular endoscopic oral thyroidectomy.
 
  From February 2018 to September 2020, this technique was offered to patients aged 18 to 70, ASA I or II, who presented with an indication for thyroid surgery and who wished to avoid cervical scars. The approach was through the anterior vestibule of the mouth and the specimen was extracted either transorally or via the axilla depending on its size. Apart from the first ten cases, all patients underwent recurrent nerve neuromonitoring. The patients were operated on by two surgeons experienced in thyroid surgery. All the patients had follow-up visits on D15, D30 and at 2 months. The pre- and intra-operative dransient and two permanent, one skin burn and 26 cases of transient chin numbness related to the electrocautery (29%). Ten patients (11%) presented with transient post-operative skin ecchymosis that resolved within 7-10 days. A spontaneous pneumo-mediastinum was observed on chest CT in three patients and evolved favorably.  https://www.selleckchem.com/products/vorapaxar.html  No hematoma, or surgical site infection, or complications related to axillary extraction were observed. All the patients declared themselves satisfied post-operatively and at the end of the follow-up.
 
  The TOETVA route of entry is a safe and reliable technique in well-selected patients wishing to avoid a cervical scar.
 The TOETVA route of entry is a safe and reliable technique in well-selected patients wishing to avoid a cervical scar.
  The opioid epidemic continues to be a serious public health crisis in the United States. One way to address this issue is to effectively educate future healthcare providers, especially nurses, who play a key role in managing pain and improving opioid-related outcomes.
 
  A 34-item electronic survey was administered to traditional baccalaureate student nurses at a large, public University School of Nursing. The survey was used to assess participant demographics, general knowledge, and attitudes regarding opioids and the opioid epidemic, and relevant personal and professional experiences. Quantitative responses were analyzed using descriptive statistics, ANOVAs, and logistic regression; free-text responses were categorized by frequency of keywords.
 
  In all, 134 students (response rate 42.3%) completed the survey. Increases in student opioid knowledge and confidence scores over the 4 years were statistically significant (p< .001). General opioid attitudes were primarily negative (n=70; 52.5%) or neutral (n=54; 40.