There is a global shortage of health care providers needed to address all levels of primary and specialty care. The recent COVID-19 pandemic also highlights the importance and added value of health professionals with specialty training in infectious diseases. In the United States, advanced practice providers (APPs) are being engaged to meet the expanding demand for generalist and specialist patient care. The history and development of advanced practice registered nurses (APRNs) and physician assistants (PAs), are discussed as collaborative healthcare providers to promote better understanding of the ways they can be incorporated into a healthcare system. An example of how APPs are utilized to provide both inpatient and outpatient care of persons with infectious diseases is illustrated at our midwestern United States regional medical center. Especially relevant for regions of the world where both nurses and physicians are in short supply, this paper identifies ways that healthcare leaders can support, develop and strategically utilize APPs to provide critically necessary functions and achieve excellent outcomes. Challenges to future healthcare administration are articulated and compared with World Health Organization roadmap objectives for nursing that can be expanded to better utilize all APPS as valuable healthcare professionals.
Most drugs undergo some metabolism in the liver before excretion by the kidneys or bile. Thus, it is not surprising that liver injury may be provoked due to its exposure to various drugs and compounds. Drug-induced cholestatic liver injury may occur particularly under conditions of increased drug concentrations, genetic alterations in expression of enzymes or transporters. Additionally, the drug-induced cholestasis can be caused by direct toxic effects of drugs or their metabolites on different hepatic cell types or through an immune-mediated process. Amoxicillin/ clavulanic acid, an antibiotic that is therapeutically utilized for the treatment of a number of bacterial infections. Omega-3 fatty acids are unsaturated fatty acids that have ro
... Show MoreIn the recent decade, injection of nanoparticles (NPs) into underground formation as liquid nanodispersions has been suggested as a smart alternative for conventional methods in tertiary oil recovery projects from mature oil reservoirs. Such reservoirs, however, are strong candidates for carbon geo-sequestration (CGS) projects, and the presence of nanoparticles (NPs) after nanofluid-flooding can add more complexity to carbon geo-storage projects. Despite studies investigating CO2 injection and nanofluid-flooding for EOR projects, no information was reported about the potential synergistic effects of CO2 and NPs on enhanced oil recovery (EOR) and CGS concerning the interfacial tension (γ) of CO2-oil system. This study thus extensively inves
... Show MoreIn this work, Titanium oxide thin films doped with different concentration of CuO (0,5,10, 15,20) %wt were prepared by pulse laser deposition(PLD) technique on glass substrates at room temperature with constant deposition parameter such as : pulse (Nd:YAG), laser with λ=1064 nm, constant energy 800 mJ , repetition rate 6 Hz and No. of pulse (500). The structure , optical and electrical properties were studied . The results of X-ray diffraction( XRD) confirmed that the film grown by this technique have good crystalline tetragonal mixed anatase and rutile phase structure, The preferred orientation was along (110) direction for Rutile phase. The optical properties of the films were studied by UV-VIS spectrum in the range of (360-1100)
... Show MoreSome structures such as tall buildings, offshore platforms, and bridge bents are subjected to lateral loads of considerable magnitude due to wind and wave actions, ship impacts, or high-speed vehicles. Significant torsional forces can be transferred to the foundation piles by virtue of eccentric lateral loading. The testing program of this study includes one group consists of 3 piles, four percentages of allowable vertical load were used (0%, 25%, 50%, and 100%) with two L/D ratios 20 and 30, vertical allowable load 110 N for L/D = 20 and 156 N for L/D = 30. The results obtained indicate that the torsional capacity for pile group increases with increasing the percentage of allowable vertical load, when the percentage of allowable vertica
... Show MoreAbstract: Objectives: To investigate the effect of temperature elevation on the bonding strength of resin cement to the zirconia ceramic using fractional CO2 laser. Background: Fractional CO2 laser is an effective surface treatment of zirconia ceramic, as it increases the bonding strength of zirconia to resin cement. Methods: Thirty sintered zirconia discs (10 mm diameter, 2 mm thickness) were prepared and divided to three groups (N=10) and five diffident pulse durations were used in each group (0.1, 0.5, 1, 5 and 10 ms). Group A was treated with 10 W power setting, group B with 20 W and group C with 30 W. During laser irradiation, temperature elevation measurement was recorded for each specimen. Luting cement was bonded to the treated z
... Show MoreCadmium sulfide (CdS) nanocrystalline thin films have been prepared by chemical bath deposition (CBD) technique on commercial glass substrates at 70ºC temperature. Cadmium chloride (CdCl2) as a source of cadmium (Cd), thiourea (CS(NH2)2) as a source of sulfur and ammonia solution (NH4OH) were added to maintain the pH value of the solution at 10. The characterization of thin films was carried out through the structural and optical properties by X-ray diffraction (XRD) and UV-VIS spectroscopy. A UV-VIS optical spectroscopy study was carried out to determine the band gap of the nanocrystalline CdS thin film and it showed a blue shift with respect to the bulk value (from 3.9 - 2.4eV). In present w
... Show MoreObjective(s): The world of dentistry is constantly evolving, and with the advent of 3D printing technology, the possibilities are endless. However, little is known about the effects of adding ZrO2 NPs to the denture base resin of 3D additive manufacturing technique.Aim of this study is to evaluate the behavior of resin which is used to 3D printing of denture base with the addition of ZrO2 NPs on denture adaptation property and diametral compression strength.Methods: 60 samples were printed, 30 disks for diametral compressive test and 30 denture base for denture adaptation test. Three groups per test (n=10). The control group for each test included unreinforced 3Dprinted denture base resin, and the other groups were reinforced with (2&
... Show MoreObliquely deposited (70o) Bi, Sb, and Bi-Sb alloy thin films have been prepared by thermal
resistive technique. Structural properties of these films were studied using XRD. Their resistance and
voltage responsivity for Nd:YAG and CO2 laser pulses have been recorded as function of operating
temperature between 10 oC and 120 oC. It was found that the maximum responsivity for these detectors
can be obtained at 75 oC. On the other hand, the dependence of responsivity on the width of detectors was
investigated.
Botnet is a malicious activity that tries to disrupt traffic of service in a server or network and causes great harm to the network. In modern years, Botnets became one of the threads that constantly evolving. IDS (intrusion detection system) is one type of solutions used to detect anomalies of networks and played an increasing role in the computer security and information systems. It follows different events in computer to decide to occur an intrusion or not, and it used to build a strategic decision for security purposes. The current paper
In this search, Ep/SiO2 at (3, 6, 9, 12 %) composites is prepared by hand Lay-up method, to measure the change in the thermal conductivity and Impact Strength of epoxy resin before and after immersion in H2SO4 Solution with a 0.3N for 10 days. The results before immersion decreases with the increase of the weight ratios of the reinforcement material (SiO2), It changed from (82.6×10-2 to 38.7×10-2 W/m.°C) with change weight ratios from (3 to 12) % respectively, but after immersion time in the chemical solution where it was (65.6×10-2 W/m.°C) at the weight ratios (6 %) and became (46.6 × 10-2 W/m.°C) after immersion in sulfuric acid. The results of the Impact strength decreased by increasing the percentage weight ratio, it changed f
... Show More