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Emergency critical

Ji She, Jiangtao Guo, Qingfeng Chen, Weizhong Zeng, Youxing Jiang, Xiao-Chen Bai
The organellar two-pore channel (TPC) functions as a homodimer, in which each subunit contains two homologous Shaker-like six-transmembrane (6-TM)-domain repeats. TPCs belong to the voltage-gated ion channel superfamily and are ubiquitously expressed in animals and plants. Mammalian TPC1 and TPC2 are localized at the endolysosomal membrane, and have critical roles in regulating the physiological functions of these acidic organelles. Here we present electron cryo-microscopy structures of mouse TPC1 (MmTPC1)-a voltage-dependent, phosphatidylinositol 3,5-bisphosphate (PtdIns(3,5)P2 )-activated Na+ -selective channel-in both the apo closed state and ligand-bound open state...
March 21, 2018: Nature
Yasir Mohamud, Junyan Shi, Junyan Qu, Tak Poon, Yuan Chao Xue, Haoyu Deng, Jingchun Zhang, Honglin Luo
Picornaviruses have evolved to hijack host cellular machinery, including the autophagic pathway. However, the mechanisms remain largely unclear. We use coxsackievirus B3 (CVB3) as a model organism to explore the possible role of picornavirus subversion of the autophagic pathway in viral infection. Our in vivo and in vitro experiments demonstrate that CVB3 infection causes a significant, albeit incomplete, inhibition of autophagic flux by limiting the fusion of autophagosomes with lysosomes and/or late endosomes...
March 20, 2018: Cell Reports
Robert Campbell, Geoffrey Chong, Eliza A Hawkes
Bruton's tyrosine kinase (BTK) is a critical terminal enzyme in the B-cell antigen receptor (BCR) pathway. BTK activation has been implicated in the pathogenesis of certain B-cell malignancies. Targeting this pathway has emerged as a novel target in B-cell malignancies, of which ibrutinib is the first-in-class agent. A few other BTK inhibitors (BTKi) are also under development (e.g., acalabrutinib). While the predominant action of BTKi is the blockade of B-cell receptor pathway within malignant B-cells, increasing the knowledge of off-target effects as well as a potential role for B-cells in proliferation of solid malignancies is expanding the indication of BTKi into non-hematological malignancies...
March 21, 2018: Journal of Clinical Medicine
Cheng-Yu Shih, René Streubel, Johannes Heberle, Alexander Letzel, Maxim V Shugaev, Chengping Wu, Michael Schmidt, Bilal Gökce, Stephan Barcikowski, Leonid V Zhigilei
The synthesis of chemically clean and environmentally friendly nanoparticles through pulsed laser ablation in liquids has shown a number of advantages over conventional chemical synthesis methods and has evolved into a thriving research field attracting laboratory and industrial applications. The fundamental understanding of processes leading to the nanoparticle generation, however, still remains elusive. In particular, the origin of bimodal nanoparticle size distributions in femto- and picosecond laser ablation in liquids, where small nanoparticles (several nanometers) with narrow size distribution are commonly observed to coexist with larger (tens to hundreds of nanometers) ones, has not been explained so far...
March 21, 2018: Nanoscale
Patrick Gogognon, Béatrice Godard
Research in health occupies a central place in the elaboration of public policies and the interventions that aim to reduce inequality and make the right to health effective. However, research in health remains marked by inequalities which particularly affect developing countries. The objective of this critical recension of the international normative frameworks and the scientific literature is to present a summary of the assessment, underline the challenges and identify the main recommendations as well as the ethical principles that aim to reduce inequalities in the field of health research...
May 22, 2017: Journal International de Bioéthique et D'éthique des Sciences
Jamal Seidi, Fatemeh Alhani, Farasat Ardalan
Background: Clinical judgment of nurses to conduct medication orders is based on patient assessment, medication knowledge, observation, and interpretation of the data collected. This process is influenced by many factors. Objective: This study aims to explore nurses' experience about facilitating factors in medication administration based on clinical judgment of nurses. Methods: This qualitative study was part of an approved project research of the Iranian National Institute of Health Research, which was conducted in Kurdistan University of Medical Sciences in 2015...
December 2017: Electronic Physician
Fareen Zaver, Nicole Battaglioli, William Denq, Anne Messman, Arlene Chung, Michelle Lin, Emberlynn L Liu
Introduction: Burnout, depression, and suicidality among residents of all specialties have become a critical focus for the medical education community, especially among learners in graduate medical education. In 2017 the Accreditation Council for Graduate Medical Education (ACGME) updated the Common Program Requirements to focus more on resident wellbeing. To address this issue, one working group from the 2017 Resident Wellness Consensus Summit (RWCS) focused on wellness program innovations and initiatives in emergency medicine (EM) residency programs...
March 2018: Western Journal of Emergency Medicine
Ashley Haubert, Matt Walsh, Rachel Boyd, Megan Morris, Megan Wiedbusch, Mike Krusmark, Glenn Gunzelmann
Cognitive fatigue emerges in wide-ranging tasks and domains, but traditional vigilance tasks provide a well-studied context in which to explore the mechanisms underlying it. Though a variety of experimental methodologies have been used to investigate cognitive fatigue in vigilance, relatively little research has utilized electroencephalography (EEG), specifically event-related potentials (ERPs), to explore the nature of cognitive fatigue, also known as the vigilance decrement. Moreover, much of the research that has been done on vigilance and ERPs uses non-traditional vigilance paradigms, limiting generalizability to the established body of behavioral results and corresponding theories...
2018: Frontiers in Psychology
Jason W Shapiro, Catherine Putonti
Bacteriophages are the most abundant and diverse biological entities on the planet, and new phage genomes are being discovered at a rapid pace. As more phage genomes are published, new methods are needed for placing these genomes in an ecological and evolutionary context. Phages are difficult to study by phylogenetic methods, because they exchange genes regularly, and no single gene is conserved across all phages. Here, we demonstrate how gene-level networks can provide a high-resolution view of phage genetic diversity and offer a novel perspective on virus ecology...
March 20, 2018: MBio
Lauren D Aarreberg, Courtney Wilkins, Hilario J Ramos, Richard Green, Michael A Davis, Kwan Chow, Michael Gale
Induction of interferon beta (IFN-β), IFN-stimulated genes (ISGs), and inflammatory responses is critical for control of viral infection. We recently identified an essential linkage of stimulation of the inflammatory cytokine interleukin-1β (IL-1β) and induction of ISGs that function as host restriction pathways against the emerging flavivirus West Nile virus (WNV) in vivo Here we utilized ex vivo global transcriptome analysis of primary dendritic cells, known targets of WNV replication, to define gene signatures required for this IL-1β-driven antiviral response...
March 20, 2018: MBio
Jared Brazg, Phyllis Huang, Corey Weiner, Guneet Singh, Antonios Likourezos, Linda Salem, Eitan Dickman, John Marshall
IMPORTANCE: Emergency Physicians often rely on Lactic Acid (LA) values to make important clinical decisions. Accuracy of LA values improve when blood gas analysis is performed in the emergency department (ED) as opposed to a satellite laboratory (SL). OBJECTIVE: To investigate an association between blood gas laboratory location and accuracy of ED lactic acid samples. METHODS: The study team evaluated lactic acid values from venous and arterial blood gas samples drawn between June 1, 2015 and September 30, 2016...
March 12, 2018: American Journal of Emergency Medicine
Jean-Louis Trouillet, Olivier Collange, Fouad Belafia, François Blot, Gilles Capellier, Eric Cesareo, Jean-Michel Constantin, Alexandre Demoule, Jean-Luc Diehl, Pierre-Grégoire Guinot, Franck Jegoux, Erwan L'Her, Charles-Edouard Luyt, Yazine Mahjoub, Julien Mayaux, Hervé Quintard, François Ravat, Sébastien Vergez, Julien Amour, Max Guillot
Tracheotomy is widely used in intensive care units, albeit with great disparities between medical teams in terms of frequency and modality. Indications and techniques are, however, associated with variable levels of evidence based on inhomogeneous or even contradictory literature. Our aim was to conduct a systematic analysis of the published data in order to provide guidelines. We present herein recommendations for the use of tracheotomy in adult critically ill patients developed using the grading of recommendations assessment, development and evaluation (GRADE) method...
March 17, 2018: Anaesthesia, Critical Care & Pain Medicine
Dawn Perez, Kath Peters, Lesley Wilkes, Gillian Murphy
BACKGROUND: Physical restraints (PRs) are commonly used in intensive care units (ICUs) worldwide for the prevention of treatment interference. While PRs are fundamentally used to maintain patient safety, they can negatively impact the experiences of patients and their families and cause moral and ethical dilemmas for ICU nurses. OBJECTIVES: The aim of this integrative review was to explore the current literature on the use of PR in intensive care. METHODS: This article used an integrative review framework to explore the current literature available on the experiences of PR in ICU...
March 17, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Nikolaos P Daskalakis, Allison C Provost, Richard G Hunter, Guia Guffanti
Posttraumatic stress disorder (PTSD) is a pathologic response to trauma that impacts ∼8% of the population and is highly comorbid with other disorders, such as traumatic brain injury. PTSD affects multiple biological systems throughout the body, including the hypothalamic-pituitary-adrenal axis, cortical function, and the immune system, and while the study of the biological underpinnings of PTSD and related disorders are numerous, the roles of noncoding RNAs (ncRNAs) are just emerging. Moreover, deep sequencing has revealed that ncRNAs represent most of the transcribed mammalian genome...
January 31, 2018: Biological Psychiatry
Anna Hall, Laurence W Busse, Marlies Ostermann
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2018. Other selected articles can be found online at . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from .
March 20, 2018: Critical Care: the Official Journal of the Critical Care Forum
Nick Kerman, John Sylvestre, Tim Aubry, Jino Distasio
BACKGROUND: Housing First is an effective intervention to stably house and alter service use patterns in a large proportion of homeless people with mental illness. However, it is unknown whether there are differences in the patterns of service use over time among those who do or do not become stably housed and what effect, if any, Housing First has on these differing service use patterns. This study explored changes in the service use of people with mental illness who received Housing First compared to standard care, and how patterns of use differed among people who did and did not become stably housed...
March 20, 2018: BMC Health Services Research
Carlos Rumbo, Juan Antonio Tamayo-Ramos, M Federica Caso, Antonio Rinaldi, Lorena Romero-Santacreu, Roberto Quesada, Santiago Cuesta
Electrospun biodegradable polymers have emerged as promising materials for their applications in several fields, including biomedicine and food industry. For this reason, the susceptibility of these materials to be colonized by different pathogens is a critical issue for public health, and their study can provide future knowledge to develop new strategies against bacterial infections. In this work, the ability of three pathogenic bacterial species ( Pseudomonas aeruginosa, Acinetobacter baumannii and Listeria monocytogenes) to adhere and form biofilm in electrospun polycaprolactone (PCL) microfibrous meshes was investigated...
March 20, 2018: ACS Applied Materials & Interfaces
Rachael Piltch-Loeb, Elena Savoia, Nasandra Wright, Rahul Gupta, Michael A Stoto
To demonstrate how public health emergency systems can use health systems tools to analyze and learn from critical incidents, we employed a facilitated look-back approach to review the public response to a chemical spill in Charleston, West Virginia. We reviewed official reports, news articles, and other documents; conducted in-person interviews with key public health and emergency response officials and local community stakeholders; and organized a facilitated look-back meeting to identify root causes of the problems that were encountered...
March 19, 2018: Journal of Public Health Management and Practice: JPHMP
Neill Storrar, David Hope, Helen Cameron
PURPOSE: Competency-based medical education (CBME) seeks to prepare undergraduate and postgraduate trainees for clinical practice. Its major emphasis is on outcomes, but questions about how best to reach these remain. One key issue is the need to integrate what matters most to students when setting educational goals: this is crucial if we are to design curricula that trainees understand and engage with, and that promote successful achievement of competencies. METHOD: We interviewed medical students in years 4 and 6 of a 6-year medical degree and used thematic analysis to understand their main educational priorities and how these fit with the aims of CBME...
March 20, 2018: Medical Teacher
Jenna L Gollihue, Samir P Patel, Alexander G Rabchevsky
Mitochondria are essential cellular organelles critical for generating adenosine triphosphate for cellular homeostasis, as well as various mechanisms that can lead to both necrosis and apoptosis. The field of "mitochondrial medicine" is emerging in which injury/disease states are targeted therapeutically at the level of the mitochondrion, including specific antioxidants, bioenergetic substrate additions, and membrane uncoupling agents. Consequently, novel mitochondrial transplantation strategies represent a potentially multifactorial therapy leading to increased adenosine triphosphate production, decreased oxidative stress, mitochondrial DNA replacement, improved bioenergetics and tissue sparing...
February 2018: Neural Regeneration Research
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