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33%; 95% CI, -3.21% to -1.44%; P  less then  .001). Accordingly, the proportion of men presenting with high-risk disease decreased in expansion states relative to nonexpansion states (DID, -1.25%; 95% CI, -2.26% to 0.25%; P = .015). A similar statistically significant decrease in PSA levels ≥20 ng/mL was noted among black men (DID, -3.11%; 95% CI, -5.25% to 0.96%; P = .005). CONCLUSIONS In Medicaid expansion states, there was an associated decrease in the proportion of young men presenting with PSA ≥20 ng/mL at the time of PCa diagnosis. These results suggest that Medicaid expansion improved access to PCa screening. Longer term data should assess oncologic outcomes. © 2020 American Cancer Society.OBJECTIVES For patients who require frequent and intensive therapy services after hospitalization, rehabilitation is predominantly provided in skilled nursing facilities (SNFs). Delivering post-acute rehabilitation in patients' homes offers a potential alternative. Our aim was to describe and evaluate services and functional outcomes and then identify factors associated with the provision of a 30-day post-acute care (PAC) bundle of rehabilitation, medical, and social services provided via the Rehabilitation at Home (RaH) program. DESIGN Single-arm retrospective review of patients participating in the RaH program. SETTING Multidisciplinary home-based delivery of PAC in Manhattan. PARTICIPANTS Individuals 18 years or older residing in a specified catchment area and qualifying for SNF-based rehabilitation services from October 2015 to September 2017. RESULTS A total of 237 patients participated in RaH over 264 episodes of care. Participants were predominantly older than 85 years (57%; mean = 84.2; standard devia of diagnoses is feasible and associated with functional improvement. This approach may help older adults maintain living status in the community. © 2020 The American Geriatrics Society.Gluten-free (GF) products are on the rise due to their perceived healthiness. Hypoallergenic rice flour is typically used in GF products. New rice varieties with greater protein were recently developed. Physicochemical and sensory properties of white and brown high-protein rice flours (HPRFs) and muffins were compared to commercial rice flours. Sensory color of white high-protein rice muffin was favored. Other attributes were not statistically different between samples. HPRF muffins had greater frequencies of "just about right" levels for muffin crumbliness, moistness, and softness than the commercial control. Purchase intent was greater for both HPRF muffins than commercial brown rice muffins. Purchase intent increased further by 9% to 12%, after information that the products were gluten free and made with naturally higher protein rice flour was displayed. This information could be used to market GF food products if increased protein ingredient claims are included. PRACTICAL APPLICATION This study shows that greater protein content rice flour can be used to make gluten-free (GF) muffins that are acceptable to consumers. Analysis and application of higher protein rice flours could contribute to a large-scale use in GF baked goods that may aim to naturally increase nutritional value. This research also shows that purchase intent increases when the greater protein content and gluten free is stated. This information can be used for GF product development and marketing of these products. © 2020 Institute of Food Technologists®.BACKGROUND This is an updated version of the Cochrane Review previously published in 2018. The incidence of seizures following supratentorial craniotomy for non-traumatic pathology has been estimated to be between 15% to 20%; however, the risk of experiencing a seizure appears to vary from 3% to 92% over a five-year period. Postoperative seizures can precipitate the development of epilepsy; seizures are most likely to occur within the first month of cranial surgery. The use of antiepileptic drugs (AEDs) administered pre- or postoperatively to prevent seizures following cranial surgery has been investigated in a number of randomised controlled trials (RCTs). OBJECTIVES To determine the efficacy and safety of AEDs when used prophylactically in people undergoing craniotomy and to examine which AEDs are most effective. SEARCH METHODS For the latest update we searched the following databases on 29 September 2019 Cochrane Epilepsy Group Specialized Register, CENTRAL, MEDLINE, ClinicalTrials.gov, and the WHO Internamy (early or late) seizures. The current evidence base is limited due to the different methodologies employed in the trials and inconsistencies in the reporting of outcomes including deaths and adverse events. Further evidence from good-quality, contemporary trials is required in order to assess the clinical effectiveness of prophylactic AED treatment compared to placebo or no treatment, or other AEDs in preventing postcraniotomy seizures in this select group of patients. Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.BACKGROUND AND PURPOSE Identifying safe and effective compounds that target to mitophagy to eliminate impaired mitochondria may be an attractive therapeutic strategy for NAFLD. Here, we investigated the effects of cyanidin-3-O-glucoside (C3G) on NAFLD and the underlying mechanism. EXPERIMENTAL APPROACH NAFLD was induced by a high-fat diet (HFD) for 16 weeks. buy Obeticholic C3G was administered during the last 4 weeks. In vivo, recombinant adenoviruses and AAV8 were used for overexpression and knockdown of PTEN-induced kinase 1 (PINK1), respectively. AML-12 and HepG2 cells were used for the mechanism study. KEY RESULTS C3G administration suppressed hepatic oxidative stress, NLR family pyrin domain containing 3 (NLRP3) inflammasome activation, steatosis and improve systemic glucose metabolism in mice with NAFLD. These effects of C3G also observed in palmitic acid-treated AML-12 cells and hepatocytes from NAFLD patients. Mechanistic investigations revealed that C3G increased PTEN-induced kinase 1 (PINK1)/Parkin expression and mitochondrial localization, promotes PINK1-mediated mitophagy to clear damaged mitochondria. Knockdown of hepatic PINK1 abolished the mitophagy-inducing effect of C3G, which blunted the beneficial effects of C3G on oxidative stress, NLRP3 inflammasome activation, hepatic steatosis and glucose metabolism. CONCLUSION AND IMPLICATIONS These results demonstrate that PINK1-mediated mitophagy plays an essential role in the ability of C3G to alleviate NAFLD and suggest that C3G may be a potential drug candidate for NAFLD treatment. This article is protected by copyright. All rights reserved.This study developed a composite machine learning algorithm for attribution of materials of forensic interest (like ammonium nitrate) to original sources. k-nearest neighbor and random forest models were used for source elimination and classification, respectively, in a two-step, composite algorithm based on particle color, size/shape, and trace element concentration features. Novel approaches for simulation to supplement within-source reference features based on empirically measured multi-lot analyses, an improved hold-one-lot-out method for cross-validation, an assessment of the likelihood of the presence of a reference sample, fusion of the source probabilities from the respective classification models, and the calculation of metrics for assessing ensemble sourcing performance are described. Excellent sourcing predictions were obtained; the sourcing algorithm identified the correct source as the top choice 89% of the time, and the correct source was identified to be an average of 2.7 times more likely than the most likely incorrect source. © 2020 American Academy of Forensic Sciences.Using Failure Modes and Effects Analysis to improve special-order implant procurement Key words Failure Modes and Effects Analysis (FMEA), implant procurement, special-order implant, risk profile number (RPN), interdisciplinary teamwork. Heat stress among perioperative personnel Key words heat stress, environmental conditions, task performance, surgical tasks, OR temperature. Venous thromboembolism prevention for bariatric surgery patients Key words venous thromboembolism (VTE), prophylactic measures, bariatric surgery, risk factors, prevention protocol. Disinfecting case carts using ultraviolet light systems Key words environmental cleaning, decontamination, case cart, ultraviolet (UV) light system, pulsed xenon. © AORN, Inc, 2020.Cleaning cannulated medical devices can be challenging for perioperative and sterile processing department personnel. We performed a laboratory experimental study to evaluate differences in cleaning effectiveness using either a back-and-forth or helical spinning brushing motion and the effect of rinsing the bristles at each reintroduction of the brush in the lumen. We also tested the lumen cleanliness after high-pressure water cleansing without brushing. We inspected the devices to determine whether visible soil remained, and we measured the amount of residual organic matter using adenosine triphosphate testing to determine cleaning method effectiveness. The results showed that rinsing the brush during cleaning decreased the amount of organic material that remained in the lumen. A helical spinning motion with brush rinsing at each reintroduction of the brush may be more effective than back-and-forth brushing with rinsing, but additional testing with a larger sample size is required to determine whether this result is replicable. © AORN, Inc, 2020.Surgeons use irrigation during open cavity procedures to improve their view of the patient's anatomy and to reduce the patient's risk of infection. However, there are no standard guidelines that recommend a specific type of fluid, additive, or volume of irrigation to use during open procedures. Intraoperative hypothermia can occur if irrigation fluids have not been warmed or have cooled before use, causing adverse patient outcomes. In addition, failing to manage (eg, measure and document) fluid volume accurately may affect clinical decision making and cause other complications. Perioperative personnel should evaluate new technologies that may improve the efficiency and accuracy of irrigation temperature and volume measurements. More research is needed to develop standardized practice guidelines for intraoperative irrigation and fluid management. © AORN, Inc, 2020.The accelerated pace of change in health care and the call for a radical transformation in prelicensure nursing education will require changes in baccalaureate nursing programs to ensure nurses are adequately prepared for practice. At one Midwestern university, academic nurse educators developed an innovative multilevel interprofessional and intradisciplinary education opportunity using a Lean Healthcare quality improvement (QI) process to improve systems, strengthen academic-practice partnerships, and bridge the education-to-practice gap. During one 16-week semester, one group of sophomore and junior clinical nursing students worked collaboratively with personnel at a local health care organization on a QI project on sequential compression devices. The students identified practice barriers related to sequential compression device compliance when medication prophylaxis was contraindicated. Using a Lean QI framework, the students developed and implemented a comprehensive, evidence-based venous thromboembolism prophylaxis policy, including tools and strategies for educating employees and patients.