Sha, T., Zhang, Y., Li, C., Lei, G., Wu, J., Li, X., Yang, Z., Zeng, C. and Wei, J., 2022. Association of metformin use with risk of venous thromboembolism in adults with type 2 diabetes: a general-population–based cohort study. American Journal of Epidemiology, 191(5), pp.856-866. Study Abstract (Modified) Metformin is hypothesized to protect against the risk of venous thromboembolism (VTE); however, there is a paucity of data supporting this hypothesis. Among individuals aged 40–90 years with a diagnosis of type 2 diabetes in the Health Improvement Network database (2000–2019), we compared [outcomes of] VTE, pulmonary embolism, and deep vein thrombosis among metformin initiators with those among sulfonylurea initiators. Individuals were followed from their first prescription refill to an incident VTE, drug discontinuation, switching or augmenting, plan disenrollment, or the end of the study, whichever occurred first… Question 1a: What was the purpose of the study conducted by Sha et al?

Wu, K., Feskanich, D., Fuchs, C.S., Willett, W.C., Hollis, B.W. and Giovannucci, E.L., 2007. A nested case–control study of plasma 25-hydroxyvitamin D concentrations and risk of colorectal cancer. Journal of the National Cancer Institute, 99(14), pp.1120-1129. Study Purpose and Design (Modified): Wu et al conducted a study to investigate the relationship between low vitamin D status (25-hydroxyvitamin D level 90%) were confirmed through medical records; the remaining cases were confirmed by corroborating information on cancer diagnosis from participants (i.e., through consent forms sent by participants). Participants without cancer were identified by the year (same year) and month (within 1 month) of blood donation. Results (Modified) Vitamin D Status Colorectal Cancer No Colorectal Cancer Total Deficient 103 167 270 Not Deficient 76 189 265 Total 179 356 535 Question 2a. Calculate the appropriate relative measure of association for this study comparing those who are not vitamin D deficient (exposed) to those who are vitamin D deficient (unexposed). Show your calculations in the free-text space provided. Round your final answer to two decimal places (i.e., 0.00). 

Question 2b: Provide an interpretation of the measure of association you calculated in Question 2a. 

During the VFSS, which of the following best describes the SLP’s primary role for this patient?  

The still frame from a videofluoroscopic swallow study (VFSS) is shown below. Which of the following impression statements most appropriately reflects management based on the observed pharyngoesophageal segment (PES) findings?

Most traditional oral motor exercises have strong evidence supporting their effectiveness for improving swallowing physiology.  

The NMES observed in this case uses electrodes placed on the skin over the muscles. This differs from direct muscle stimulation because:

Which additional finding would most strongly indicate the need for urgent (expedited) gastroenterology evaluation in this patient?  

When building a decision tree, we need to decide on which feature makes a better split. We often do this by measuring the impurity. Why? Mark all that apply.

During inspection of a 60-year-old client, the nurse observes dimpling of the nipple and skin surrounding the breast when the client raises their arms overhead. What is the nurse’s priority interpretation of this finding?