Explore the vast range of titles available.

\"In an era where the foundational elements of business are being disrupted, Essential: How Distributed Teams, Generative AI, and Global Shifts are Creating a New Human-Powered Leadership emerges as a crucial guide for leaders navigating the profound changes reshaping industries and markets worldwide. This book, penned by a team of seasoned business and leadership strategists, offers a radical and necessary perspective on management transformation, emphasizing the importance of human-centered leadership in meeting the full potential of the technology age\"-- Provided by publisher.

We describe an epidemiologic investigation and successful control measures for the first reported outbreak of bla NDM-1 -carrying Pseudomonas aeruginosa in Texas occurring in a veteran with transmission of the same organism and a bla NDM-5 -carrying Escherichia coli , respectively, to two roommates and bla NDM -carrying organism/s to a patient cared for by common staff.

The armor is familiar, but the man inside isn't who you'd expect! He's Arno Stark, the cold and hard-hitting Iron Man of the future - and Tony Stark's descendant has quite a legacy to live up to. Catch all the futuristic action as Arno battles Spider-Man and Blizzard in a time-traveling adventure to stop a nuclear terrorist; faces Machine Man at the behest of Tony's old foe Sunset Bain; and clashes with the original Death's Head, industrial saboteur Wellington Marcus and the high-flying Commodore Q! Can Arno overcome his foes - and himself - to become the hero he's modeled himself after?

The increase in severe acute respiratory coronavirus virus 2 (SARS-CoV-2) cases due to the omicron strain led to reduced acute care hospital beds at the Veterans Administration (VA) Hospital, North Texas; veterans with non-severe coronavirus disease 2019 (COVID-19) disease were managed at a community living center (CLC), a VA nursing home. The management of non-severe COVID-19 in VA nursing homes has not been extensively described. We describe resident characteristics and outcomes, and infection control practices implemented during 2 COVID-19 outbreak periods (January 12-February 15, 2022, June 28-July 14, 2023). Serial testing of all CLC residents was conducted, and residents with polymerase chain reaction-confirmed SARS-CoV-2 (COVID-19) infection were included in the analysis. Resident data were ascertained from the COVID-19 facility dashboard and medical record system. From January 12 to February 15, 2022, and June 28-July 14, 2023, 62 adults residing at the CLC were diagnosed with COVID-19. Overall, the median age was 75 years [interquartile range, 71-80], and 57 (91.9%) were men. Residents were cohorted by COVID-19 test results. A multidisciplinary team was convened, and staff were fit tested for appropriate personal protective equipment (PPE) and received refresher training on hand hygiene, donning, and doffing of PPE. Thirty-seven (59.7%) residents were symptomatic. Overall, 55 (88.7%) residents were documented to have received the SARS-CoV-2 primary vaccination series. Most residents were managed at the CLC, while 12 (19.3%) were hospitalized in acute care. It is feasible to manage high-risk residents with non-severe COVID-19 disease in a CLC utilizing a multidisciplinary approach and implementing Infection Prevention and Control strategies.

(1) Background: Neurodynamic tests are recommended for the diagnosis of entrapment neuropathies such as carpal tunnel syndrome (CTS). However, their association with clinical variables in severe patients or patients with associated comorbidities is poorly documented. This study aims to analyze the association between the mechanosensitivity of the median nerve and symptoms, function and psycho-social variables in moderate and severe carpal tunnel syndrome patients with comorbidities; (2) Methods: Correlational study. In total, 42 pre-surgical patients (24 females; 59.1 ± 12.7 years) included in the Spanish Public Healthcare System with an electrodiagnostic of CTS were selected. Sociodemographic variables and clinical features (symptoms, function, sensitivity and quality of life evaluated with the 36-item Short Form Survey (SF-36) and the Medical Outcomes Study Sleep Scale (MOS-sleep) were recorded. Upper Limb Neurodynamic Test 1 was used to evaluate neural mechanosensitivity; (3) Results: The 81% had a severe CTS and 78.6% had some comorbidity. The average time from the first medical visit to the surgeon’s visit was 365.5 days. Median nerve mechanosensitivity correlated weakly with the SF-36 subscale, General Health, (Spearman’s rho = 0.367) and MOS sleep scale, Awaken Short of Breath or with headache dimension (Spearman’s rho = −0.353) and moderately with SF-36 subscale, Social Functioning (Spearman’s rho = 0.553); (4) Conclusions: No associations were observed for median nerve mechanosensitivity, except for quality of life and sleep. Both social determinants and clinical variables should be considered when examining and treating these patients.

Background: New Delhi metallo-β-lactamases impart resistance to carbapenems. Enterobacteriaceae carrying New Delhi metallo-β-lactamases have been reported before. However, only 7 cases of bla NDM-carrying Pseudomonas aeruginosa has been reported from 4 states in the United States as of January 1, 2018, according to the CDC. We describe an epidemiologic investigation of the first reported case of bla NDM-carrying Pseudomonas aeruginosa in Texas and the measures that controlled the spread of the organisms carrying this gene at a 30-bed spinal cord injury unit (SCI) and the acute-care hospital within the Veterans’ Affairs North Texas Health Care System. Methods: After identification of bla NDM-1–carrying P. aeruginosa from a urine culture in an SCI patient who received medical treatment in Thailand prior to transfer, we performed a rectal screen for the presence of bla NDM in the index patient’s hospital roommates. Based on the results, we expanded the investigation to other patient care units that had provided care to the patient. We initiated universal contact isolation precautions, 1:1 nursing care, restricted movement, phased point-prevalence testing, and intense environmental cleaning until the threat of bla NDM was mitigated. Whole-genome sequencing (WGS) was performed on clinical isolates from the index patient and the roommates by the CDC. Results: Of the 2 roommates of the index, 1 patient had a urine culture positive for bla NDM-5-carrying Escherichia coli . The second roommate has subsequently grown bla NDM-1-carrying P. aeruginosa from a clinical culture. A third patient who was in the same unit as the index patient but not in the same room in an acute-care unit tested positive for bla NDM in a rectal screen. Of the 54 patients who were hospitalized in the same unit as the index patient, 26 refused to get the test and 28 tested negative. In addition, point-prevalence rectal screening was conducted in the SCI in 3 phases that were 3 to 4 weeks apart. All of these screening tests were negative. WGS revealed that the index patient and roommate 2 had bla NDM-1–carrying P. aeruginosa , whereas the roommate 1 had bla NDM-5–carrying E. coli . No further spread occurred. Conclusions: Our aggressive efforts quickly mitigated further spread of bla NDM. Our epidemiologic investigation indicates that an intergenus transfer of bla NDM from P. aeruginosa to E. coli likely took place. In addition, it appears there was an evolution of NDM-1 to NDM-5, which differs from the former by 2 amino acid substitutions at positions 88 (Val→Leu) and 154 (Met→Leu). This type of evolution has been shown by prior studies to confer increased antibiotic resistance in certain resource limited settings. Funding: None Disclosures: None

In these eighteen illuminating essays, some of Colorado's most accomplished novelists, essayists, and poets write in intimate detail about their most poignant experiences in the Colorado wilderness. Readers are given access -- both physically and spiritually -- to settings that inspire reverence for and contemplation about one's relationship to the land. From above tree line in the Rawah Mountains down into the broad San Luis Valley, from the Western Slope to the high plains in the east, the reader is taken on a vivid journey through a rich assortment of Colorado's awe-inspiring landscapes. The book belongs on the bookshelves of tourists, outdoor enthusiasts, and Coloradoans -- both long-time residents and newcomers -- who seek to apprehend something in nature that is larger than themselves.

Co-Winner of the 2004 Colorado Endowment for the Humanities Publication Prize. In these eighteen illuminating essays, some of Colorado's most accomplished novelists, essayists, and poets write in intimate detail about their most poignant experiences in the Colorado wilderness. Readers are given access - both physically and spiritually - to settings that inspire reverence for and contemplation about one's relationship to the land. From above tree line in the Rawah Mountains down into the broad San Luis Valley, from the Western Slope to the high plains in the east, the reader is taken on a vivid journey through a rich assortment of Colorado's awe-inspiring landscapes. Essays by Tom Noel, Fred Baca, Kristen Iversen, and Reyes Garcia are historical in makeup, while those by Sangeeta Reddy, Merrill Gilfillan, and Amy England feature engaging spiritual and philosophical explorations, even epiphanies. Reg Saner and Nick Sutcliffe share experiences of pitting themselves against nature. And in the tradition of Thoreau, John Muir, and Annie Dillard, all of these essayists explore the intense and vibrant relationships people have with the wilderness.Sites of Insightbelongs on the bookshelves of tourists, outdoor enthusiasts, and Coloradoans - both longtime residents and newcomers - who seek to apprehend something in nature that is larger than themselves.

Introduction Nasoalveolar molding (NAM) is a treatment option available for early cleft care. Despite the growing debate about the efficacy of nasoalveolar molding, questions remain regarding its prevalence and the demographic characteristics of families undergoing this technique prior to traditional cleft surgery. Objectives To determine the number of teams currently offering nasoalveolar molding and to identify salient clinical and sociodemographic variables in infants and families who choose nasoalveolar molding compared with those who choose traditional cleft care across three well-established cleft centers. Results Via phone surveys, 89% of the U.S. cleft teams contacted revealed that nasoalveolar molding is available at 37% of these centers. Chart reviews and phone correspondence with caregivers indicate that the average distance to the cleft center was 65.5 miles and caregiver age averaged 30.9 ± 5.7 years. Of families who chose nasoalveolar molding, 85% received total or partial insurance coverage. No difference in caregiver education, income, or distance to the clinic between treatment groups was found. On average, infants receiving nasoalveolar molding and cleft surgery had larger clefts and had more clinic visits than infants receiving traditional cleft surgery. Infants who were firstborn and those who did not have other siblings were more likely to receive nasoalveolar molding than were infants who were residing with other siblings. Conclusions Currently more than one-third of U.S. cleft centers offer nasoalveolar molding. Although the cleft size was larger in the nasoalveolar molding group, no treatment group differences in education, income, and distance to the clinic were found.