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First responder

Bishnu P Joshi, Joseph Hardie, Michelle E Farkas
The accumulation of therapeutic and imaging agents at sites of interest is critical to their efficacy. Similarly, off-target effects (especially toxicity) are a major liability for these agents. For this reason, the use of delivery vehicles to improve the distribution characteristics of bio-active agents has become ubiquitous in the field. However, the majority of traditionally employed, cargo-bearing entities rely on passive accumulation. Even in cases where 'targeting' functionalities are used, the agents must first reach the site in order for the ligand-receptor interaction to occur...
March 15, 2018: Chemistry: a European Journal
Rafael E de la Hoz, Jonathan Weber, Dongming Xu, John T Doucette, Xiaoyu Liu, Deborah A Carson, Juan C Celedón
We examined the chest CT scans of 1,453 WTC responders using the International Classification of High-resolution CT for Occupational and Environmental Respiratory Diseases. Univariate and bivariate analyses of potential work-related pleural abnormalities were performed with pre-WTC and WTC-related occupational exposure data, spirometry, demographics and quantitative CT measurements. Logistic regression was used to evaluate occupational predictors of those abnormalities. Chest CT scans were performed first at a median of 6...
March 15, 2018: Archives of Environmental & Occupational Health
Vijay A Patel, Laila Siddique, Lauren Stahl, Michele M Carr
BACKGROUND: The objective of this work was to assess resident education regarding contemporary management of hereditary angioedema using a web-based survey. METHODS: An 11-item, multiple-choice, electronic questionnaire was sent to all 106 accredited otolaryngology training programs in November 2016. Questions focused on resident education, management principles, and formalized assessment. RESULTS: A total of 34 program directors responded, representing 32% of otolaryngology residences...
March 15, 2018: International Forum of Allergy & Rhinology
Haley Adams, Gayathri Narasimham, John Rieser, Sarah Creem-Regehr, Jeanine Stefanucci, Bobby Bodenheimer
As virtual reality expands in popularity, an increasingly diverse audience is gaining exposure to immersive virtual environments (IVEs). A significant body of research has demonstrated how perception and action work in such environments, but most of this work has been done studying adults. Less is known about how physical and cognitive development affect perception and action in IVEs, particularly as applied to preteen and teenage children. Accordingly, in the current study we assess how preteens (children aged 8-12 years) and teenagers (children aged 15-18 years) respond to mismatches between their motor behavior and the visual information presented by an IVE...
April 2018: IEEE Transactions on Visualization and Computer Graphics
Gladstone C McDowell, Joseph Winchell
OBJECTIVES: The majority of patients seeking medical care for chronic pain consult a primary care physician (PCP). Because systemic opioids are commonly prescribed to patients with chronic pain, PCPs are attempting to balance the competing priorities of providing adequate pain relief while reducing risks for opioid misuse and overdose. It is important for PCPs to be aware of pain management strategies other than systemic opioid dose escalation when patients with chronic pain fail to respond to conservative therapies and to initiate a multimodal treatment plan...
March 15, 2018: Postgraduate Medicine
Peter A Nigrovic, Timothy Beukelman, George Tomlinson, Brian M Feldman, Laura E Schanberg, Yukiko Kimura
BACKGROUND: Systemic juvenile idiopathic arthritis is a rare febrile arthritis of childhood characterized by a potentially severe course, including prolonged glucocorticoid exposure, growth failure, destructive arthritis, and life-threatening macrophage activation syndrome. Early cytokine-blocking biologic therapy may improve long-term outcomes, although some systemic juvenile idiopathic arthritis patients respond well to non-biologic treatment, leaving optimal management undefined. Consequently, treatment of new-onset systemic juvenile idiopathic arthritis by expert clinicians varies widely...
March 1, 2018: Clinical Trials: Journal of the Society for Clinical Trials
Randy McCamey, Jennifer Yeager
During natural disasters, communications can be disrupted, which negatively impacts response time of first responders thus diminishing the level of care provided to disaster victims. In the fall of 2014, as part of a larger community-based participatory research study, the Tarleton Area Amateur Radio Club (TAARC) joined the Department of Nursing, Tarleton State University, and provided amateur radio communications during a disaster preparedness simulation. The simulation was conducted to determine the ability of the university to provide rapid response and render quality, acute healthcare to its neighbors during a natural disaster...
January 2018: Journal of Emergency Management: JEM
Holger Joswig, Armin Neff, Christina Ruppert, Gerhard Hildebrandt, Martin Nikolaus Stienen
BACKGROUND: The predictive value of short-term arm pain relief after 'indirect' cervical epidural steroid injection (ESI) for the 1-month treatment response has been previously demonstrated. It remained to be answered whether the long-term response could be estimated by the early post-interventional pain course as well. METHODS: Prospective observational study, following a cohort of n = 45 patients for a period of 24 months after 'indirect' ESI for radiculopathy secondary to a single-level cervical disk herniation (CDH)...
March 14, 2018: Acta Neurochirurgica
Thierry Almont, Corinne Couteau, Hélène Etienne, Pierre Bondil, Rosine Guimbaud, Leslie Schover, Éric Huyghe
PURPOSE: To assess sexual health and needs for sexology care of cancer patients during chemotherapy. METHODS: We performed a 4-month cross-sectional study in cancer patients treated by chemotherapy in the digestive cancer department of a regional university hospital. Patients were asked to fill out a self-administered questionnaire about their sexual health, Sexual Quality of Life Questionnaire for Male (SQoL-M) or Female (SQoL-F), and their needs for sexology care...
March 14, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Natalie Herold, Barbara Wappenschmidt, Birgid Markiefka, Katharina Keupp, Sandra Kröber, Eric Hahnen, Rita Schmutzler, Kerstin Rhiem
Non-small cell neuroendocrine carcinomas (NSCNEC) account for 2% of gynecological cancer cases and are associated with a poor prognosis due to delayed diagnosis and aggressive tumor behavior. BRCA2 -associated ovarian carcinomas predominantly possess a high-grade serous phenotype, which respond to platinum and targeted therapy with PARP inhibitors. Presented here is the case of an adult patient with NSCNEC of the ovaries associated with a deleterious BRCA2 germline mutation. The pathogenic mutation was also confirmed on the somatic level, while the wild-type allele had a high variant fraction, suggesting loss of heterozygosity...
April 2018: Oncology Letters
Saloni Sharma, Prosper A Fiave, Koen Nelissen
Neurophysiological data obtained in primates suggests that merely observing others' actions can modulate activity in the observer's motor cortices. In humans, it has been suggested that these multimodal vicarious responses extend well beyond the motor cortices, including somatosensory and insular brain regions, that seem to yield vicarious responses when witnessing others' actions, sensations or emotions (Gazzola and Keysers, 2009). Despite the wealth of data with respect to shared action responses in the monkey motor system, whether the somatosensory and insular cortices also yield vicarious responses during observation of touch remains largely unknown...
March 14, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Uri Hamiel, Idan Hecht, Achia Nemet, Liron Pe'er, Vitaly Man, Assaf Hilely, Asaf Achiron
AIMS: Abbreviations are common in the medical record. Their inappropriate use may ultimately lead to patient harm, yet little is known regarding the extent of their use and their comprehension. Our aim was to assess the extent of their use, their comprehension and physicians' attitudes towards them, using ophthalmology consults in a tertiary hospital as a model. METHODS: We first mapped the frequency with which English abbreviations were used in the departments' computerised databases...
March 14, 2018: Postgraduate Medical Journal
Roman Hari, Michael Harris, Peter Frey, Sven Streit
BACKGROUND: Exposure to a broad spectrum of patient cases is a mainstay of undergraduate medical education. This study aimed to assess how many primary care-specific clinical pictures final-year medical students in traditional block rotations had encountered, and how this changed after a curricular change that included the implementation of a four-year longitudinal clerkship in primary care. METHODS: Final-year students before, and after, implementation of the clerkship were asked which of the clinical pictures most relevant to primary care they had seen...
March 14, 2018: BMC Medical Education
Tatjana Barišić, Vjekoslav Mandić, Anja Vasilj, Dejan Tiric
OBJECTIVE: To determine the frequency of subclinical hypothyroidism in women with pathological pregnancies and the association between elevated thyroid-stimulating hormone (TSH) and pregnancy outcome. SUBJECTS AND METHODS: A cross-sectional prospective study investigated value of TSH and free thyroxine (FT4) in: 1. pregnant women with hypertension (HTA) (N = 62) or preeclampsia (PE) (N = 50), 2.women with gestational diabetes mellitus (GDM) (N = 92) in pregnancy and 3...
March 14, 2018: Journal of Maternal-fetal & Neonatal Medicine
Anthony Banks, Sanbo Qin, Kevin L Weiss, Christopher B Stanley, Huan-Xiang Zhou
Conformational malleability allows intrinsically disordered proteins (IDPs) to respond agilely to their environments, such as nonspecifically interacting with in vivo bystander macromolecules (or crowders). Previous studies have emphasized conformational compaction of IDPs due to steric repulsion by macromolecular crowders, but effects of soft attraction are largely unexplored. Here we studied the conformational ensembles of the IDP FlgM in both polymer and protein crowders by small-angle neutron scattering...
March 13, 2018: Biophysical Journal
Stephanie M Topp, Chanda Mwamba, Anjali Sharma, Njekwa Mukamba, Laura K Beres, Elvin Geng, Charles B Holmes, Izukanji Sikazwe
BACKGROUND: Failure to keep people living with HIV engaged in life-long care and treatment has serious implications for individual and population-level health. Nested within a four-province study of HIV care and treatment outcomes, we explored the dynamic role of social and service-related factors influencing retention in HIV care in Zambia. METHODS: From a stratified random sample of 31 facilities, eight clinics were selected, one urban and one rural from each province...
2018: PloS One
Tomohiro Morita, Shuhei Nomura, Tomoyuki Furutani, Claire Leppold, Masaharu Tsubokura, Akihiko Ozaki, Sae Ochi, Masahiro Kami, Shigeaki Kato, Tomoyoshi Oikawa
INTRODUCTION: Demographic changes as a result of evacuation in the acute phase of the 2011 Fukushima nuclear disaster are not well evaluated. We estimated post-disaster demographic transitions in Minamisoma City-located 14-38 km north of the nuclear plant-in the first month of the disaster; and identified demographic factors associated with the population remaining in the affected areas. MATERIALS AND METHODS: We extracted data from the evacuation behavior survey administered to participants in the city between July 11, 2011 and April 30, 2013...
2018: PloS One
Samuel Ofei-Dodoo, Cassie Scripter, Rick Kellerman
BACKGROUND AND OBJECTIVES: Research into the rates of burnout among nonclinical workers is nonexistent at medical education centers (MECs). The first goal of this study was to explore the prevalence of burnout among nonclinical faculty and staff working at a local MEC. The second goal was to identify predictors of burnout using job satisfaction dimensions-supervision, coworkers, contingency rewards, and nature of work. METHODS: The study included a convenience sample of 95 nonclinical faculty and staff working at a local MEC...
March 2018: Family Medicine
Raza Aly, Tate Winter, Steve Hall, Tracey Vlahovic
Dermatophytoma is a little-known, difficult to treat fungal infection that complicates onychomycosis. First described by Roberts and Evans in the late 1990's, dermatophytoma presents as a dense concentration of fungal hyphae within or under the nail plate and is generally white or yellow/brown in color, and linear (streaks) or round (patches) in shape; primary etiologic organisms are dermatophytes. Oral antifungals have limited success in treating dermatophytoma owing to difficulties accessing and penetrating what is hypothesized to be a fungal biofilm...
March 1, 2018: Journal of Drugs in Dermatology: JDD
Nicholas Alipui, Nicole Gerke
We are currently facing one of the largest and most complex refugee crises in modern times. Conflict and natural disasters have resulted in 22.5 million refugees worldwide, more than half are children. As the world struggles to respond to this massive displacement of people, how is this affecting child refugees' development and what is being done about it? In this commentary, we explore answers to these central questions. First, we review the situation of child refugees in numbers, exploring their geographic concentration...
March 2018: New Directions for Child and Adolescent Development
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