Characteristics and outcomes of prehospital and emergency department surgical airways.

Objectives: The surgical airway is a high acuity, low occurrence procedure. Data on the complications and outcomes of surgical airways are limited. Our primary objective was to describe immediate complications, late complications, and clinical outcomes of patients who underwent a surgical airway procedure in the prehospital or emergency department (ED) setting. Methods: We conducted a retrospective chart review of patients ≥14 years at an academic medical center who underwent a surgical airway procedure in the ED, the prehospital setting, or at a referring ED prior to interfacility transfer. We identified cases from keyword searches of prehospital text pages and hospital electronic medical records from June 1, 2008 to July 1, 2022. Manual chart review was used to confirm inclusion and determine patient and procedure characteristics. Outcomes included immediate complications, delayed in-hospital complications, and neurologic disability as defined by Modified Rankin Score (mRS) at discharge. Results: We identified 63 patients (34 prehospital, 11 ED, and 18 referring ED). Immediate complications included mainstem intubation (46.0%) and bleeding that required direct pressure (23.4%). Overall, 29 patients (46%) died after arrival to the hospital. Of the patients surviving to hospital admission, 25 (48%) had an airway-related complication. Nine complications were deemed directly related to technical components of the procedure. Of the patients who survived to discharge, 18 (52.9%) had poor neurologic function (mRS 4-5). Conclusion: Procedural complications, mortality, and poor neurologic function were common following a surgical airway procedure in the prehospital or ED setting. Most patients surviving to discharge had a moderate to severe neurologic disability.

Preparing Future Foodservice Managers: Operational and Educational Characteristics of Student-Operated Restaurants.

OBJECTIVE: To study operational, management, and educational experiences of student-operated restaurants (SOR) through the perspective of SOR managers across the US. METHODS: Qualitative semistructured interviews were conducted with 19 SOR managers. Qualitative case study procedures were used for analysis. RESULTS: Three themes emerged: (1) objectives and processes in SORs, (2) support received by SORs, and (3) individual experiences in SORs. Within these themes, participants described various methods and designs used to operate SORs. However, participants ultimately perceived that SORs were successful in helping students gain foodservice management skills and be better prepared to be future foodservice managers. CONCLUSIONS AND IMPLICATIONS: Foodservice managers can connect nutrition principles to practice for consumers. Strong foodservice education through SORs can play a role in students being more competent and prepared for foodservice management careers. Findings provide ideas for foodservice educators as they initiate or refine the use of SORs.

Fast and Accurate Electric Field Gradient Calculations in Molecular Solids With Density Functional Theory.

Modern approaches for calculating electric field gradient (EFF) tensors in molecular solids rely upon plane-wave calculations employing periodic boundary conditions (PBC). In practice, models employing PBCs are limited to generalized gradient approximation (GGA) density functionals. Hybrid density functionals applied in the context of gauge-including atomic orbital (GIAO) calculations have been shown to substantially improve the accuracy of predicted NMR parameters. Here we propose an efficient method that effectively combines the benefits of both periodic calculations and single-molecule techniques for predicting electric field gradient tensors in molecular solids. Periodic calculations using plane-wave basis sets were used to model the crystalline environment. We then introduce a molecular correction to the periodic result obtained from a single-molecule calculation performed with a hybrid density functional. Single-molecule calculations performed using hybrid density functionals were found to significantly improve the agreement of predicted 17O quadrupolar coupling constants (C q ) with experiment. We demonstrate a 31% reduction in the RMS error for the predicted 17O C q values relative to standard plane-wave methods using a carefully constructed test set comprised of 22 oxygen-containing molecular crystals. We show comparable improvements in accuracy using five different hybrid density functionals and find predicted C q values to be relatively insensitive to the choice of basis set used in the single molecule calculation. Finally, the utility of high-accuracy 17O C q predictions is demonstrated by examining the disordered 4-Nitrobenzaldehyde crystal structure.

Accurate fragment-based 51-V chemical shift predictions in molecular crystals.

Nuclear magnetic resonance (NMR) spectroscopy plays a crucial role in determining molecular structure for complex biological and pharmaceutical compounds. NMR investigations are increasingly reliant on computation for mapping spectral features to chemical structures. Here we benchmark the accuracy of fragment-based 51V chemical shielding tensor calculations using a training set comprised of 10 biologically and pharmaceutically relevant oxovanadium complexes. Using our self-consistent reproduction of the Madelung potential (SCRMP) electrostatic embedding model, we demonstrate comparable performance between fragment methods and computationally demanding cluster-based techniques. Specifically, fragment methods employing hybrid density functionals are capable of reproducing the experimental 51V isotropic chemical shifts with a training set rms error of ~9 â€‹ppm, representing a 20% improvement over traditional plane wave techniques. We provide training set-derived linear regression models for mapping the absolute shieldings obtained from computation to the experimentally determined chemical shifts using four common density functionals; PBE0, B3LYP, PBE, and BLYP. Finally, we establish the utility of fragment methods and the reported regression parameters examining four oxovanadium structures excluded from the training set including the tetracoordinate oxovanadium silicate [Formula: see text] , VO15NGlySalbz which contains redox-active ligands, and the solid-state form of the common 51V NMR reference compound VOCl3.

Foodservice Management Educators' Perspectives on Nutrition and Menu Planning in Student-Operated Restaurants.

OBJECTIVE: Explore how student-operated restaurant (SOR) managers consider and apply nutrition principles and menu planning in SORs. DESIGN: Nineteen SOR managers in the US were recruited to complete an online survey and participate in a 30-60-minute interview. Interviews were conducted via video conference and explored the menu and nutritional characteristics of the SOR at each facility. SETTING: SORs across the US. PARTICIPANTS: Managers of SORs. PHENOMENON OF INTEREST: Menu and nutrition characteristics and their use in SORs. ANALYSIS: Demographic data were analyzed using SPSS. Thematic analysis was conducted using NVivo software. RESULTS: Thematic analysis revealed nutrition in practice, nutrition philosophy, and menu planning as the 3 major themes. Nutrition in practice captured the role of nutrition in menu planning, special diets, and healthy options. Nutrition philosophy subthemes explored issues such as the purpose of the SOR experience and instructor perspective on nutrition. Menu planning subthemes addressed issues regarding the menu development process, including menu planning that was student-driven and faculty-driven. CONCLUSIONS AND APPLICATIONS: Approaches to menu planning had varying degrees of student involvement. Although nutrition was stated as a consideration in menu planning, most programs did not include formalized nutrition criteria as part of the SOR curriculum.