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Anita A Vashi, Farnoosh H Sheikhi, Lisa A Nashton, Jennifer Ellman, Priya Rajagopal, Steven M Asch
Introduction: We describe the use of Lean quality improvement methodologies at a Veterans Affairs (VA) medical facility to redesign Emergency Department (ED) front-end operations and improve ED flow, specifically to reduce time from Veteran arrival to provider evaluation. Materials and Methods: The intervention, a Rapid Process Improvement Workshop (RPIW), took place during January 2014 at the VA Palo Alto Health Care System (VAPAHCS). Key changes made as a result of the RPIW included standardizing and streamlining evaluation and hand-off processes, better-delineating roles for RNs and MDs, more efficiently utilizing beds and improving team communication...
July 11, 2018: Military Medicine
Andrew Zikic, Holger Schünemann, Teodora Wi, Ornella Lincetto, Nathalie Broutet, Nancy Santesso
Background: With the continued high prevalence of chlamydia worldwide and high risk of transfer from mothers to their infant during delivery, a need for safe and effective therapies for infants who acquire a chlamydial infection remains. We conducted a systematic review and meta-analysis of antibiotic treatments, including oral erythromycin, azithromycin, and trimethoprim, for neonatal chlamydial conjunctivitis. Methods: We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) from their inception to July 14, 2017...
July 10, 2018: Journal of the Pediatric Infectious Diseases Society
Jinshan Jin, Ying-Hsin Hsieh, Arpana S Chaudhary, Jianmei Cui, John E Houghton, Sen-Fang Sui, Binghe Wang, Phang C Tai
Sec-dependent protein translocation is an essential process in bacteria. SecA is a key component of the translocation machinery and has multiple domains that interact with various ligands. SecA acts as an ATPase motor to drive the precursor protein/peptide through the SecYEG protein translocation channels. As SecA is unique to bacteria and there is no mammalian counterpart, it is an ideal target for the development of new antimicrobials. Several reviews detail the assays for ATPase and protein translocation, as well as the search for SecA inhibitors...
August 1, 2018: FEMS Microbiology Letters
Loredana Tarraran, Roberto Mazzoli
Lactic acid bacteria (LAB) have a long history in industrial processes as food starters and biocontrol agents, and also as producers of high-value compounds. Lactic acid, their main product, is among the most requested chemicals because of its multiple applications, including the synthesis of biodegradable plastic polymers. Moreover, LAB are attractive candidates for the production of ethanol, polyhydroalkanoates, sweeteners and exopolysaccharides. LAB generally have complex nutritional requirements. Furthermore, they cannot directly ferment inexpensive feedstocks such as lignocellulose...
August 1, 2018: FEMS Microbiology Letters
Andrea Agostinelli, Davide Carino, Bruno Borrello, Carla Marcato, Annalisa Volpi, Tiziano Gherli, Francesco Nicolini
OBJECTIVES: Blunt thoracic aortic injury can be treated with thoracic endovascular aortic repair (TEVAR) with excellent short and mid-term outcomes. However, few data are available about the long-term results. Our goal was to report our single-centre, 20-year experience using TEVAR to treat blunt thoracic aortic injury. METHODS: We retrospectively reviewed our institutional database to identify all patients treated with TEVAR for traumatic lesions of the aortic isthmus...
July 10, 2018: Interactive Cardiovascular and Thoracic Surgery
Enny S Paixão, Laura C Rodrigues, Maria da Conceição N Costa, Martha Itaparica, Florisneide Barreto, Patrick Gérardin, Maria Glória Teixeira
Background: Chikungunya is a mosquito-borne disease caused by an arthritogenic alphavirus, with four genotypes: East Central South African (ECSA), West African, ECSA-diverged or Indian Ocean Lineage (IOL) and Asian lineage. Overall, the disease is self-limited; however, in some patients, joint pain and other non-specific symptoms can last for months or years. This systematic review and meta-analysis aims to estimate the proportion of people that self-report chikungunya-related chronic non-specific symptoms...
July 11, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
Raf Aerts, Olivier Honnay, An Van Nieuwenhuyse
Introduction: Natural environments and green spaces provide ecosystem services that enhance human health and well-being. They improve mental health, mitigate allergies and reduce all-cause, respiratory, cardiovascular and cancer mortality. The presence, accessibility, proximity and greenness of green spaces determine the magnitude of their positive health effects, but the role of biodiversity (including species and ecosystem diversity) within green spaces remains underexplored. This review describes mechanisms and evidence of effects of biodiversity in nature and green spaces on human health...
July 10, 2018: British Medical Bulletin
Christie Jackson, Brandon J Weiss, Marylene Cloitre
Introduction: Group Skills Training in Affective and Interpersonal Regulation (STAIR) is an evidence-based, manualized treatment for individuals with post-traumatic stress symptoms, that focuses on improving functioning through mood management (e.g., emotion regulation) and relationship skills development. To date, no study has evaluated the potential benefit of group STAIR among Veterans. Feasibility of delivering STAIR in a mixed-gender group format and the potential impact of gender on outcome were examined...
July 11, 2018: Military Medicine
Teresa M Seccia, Brasilina Caroccia, Elise P Gomez-Sanchez, Celso E Gomez-Sanchez, Gian Paolo Rossi
The identification of several germline and somatic ion channel mutations in aldosterone-producing adenomas (APA) and detection of cell clusters that can be responsible for excess aldosterone production, as well as the isolation of autoantibodies activating the angiotensin II type 1 receptor, have rapidly advanced the understanding of the biology of primary aldosteronism (PA), in particular that of APA. Hence, the main purpose of this review is to discuss how discoveries of the last decade could impact on histopathology analysis and clinical practice...
July 10, 2018: Endocrine Reviews
Esther J van Zuuren, Zbys Fedorowicz, Ton Kuijpers, Hanno Pijl
Background: It remains uncertain which diet is best for people with type 2 diabetes (T2D). Objective: We compared the effects of dietary carbohydrate restriction with fat restriction on markers of metabolic syndrome and quality of life in people with T2D. Design: This systematic review of randomized controlled trials (RCTs) and controlled clinical trials (CCTs) compares the effects of a low-carbohydrate [≤40% of energy (%)] diet with those of a low-fat (≤30%) diet over a period of ≥4 wk in patients with T2D...
July 11, 2018: American Journal of Clinical Nutrition
F Salamanna, V Borsari, D Contartese, N Nicoli Aldini, M Fini
Different fields of cancer management consider bone health to be of increasing clinical importance for patients: 1) presence of bone metastases in many solid tumors, 2) use of bone-targeted treatments in the reduction of bone metastasis, 3) effects of cancer treatment on reproductive hormones, critical for normal bone remodeling maintenance. Additionally, bone microenvironment is further complicated by the decline of ovarian sex steroid production and by the related increase in inflammatory factors linked to menopause, which result in accelerated bone loss and increased risk of osteoporosis (OP)...
June 22, 2018: Breast: Official Journal of the European Society of Mastology
Esther Gil-Barrionuevo, José Maria Balibrea, Enric Caubet, Oscar Gonzalez, Ramón Vilallonga, José Manuel Fort, Andrea Ciudin, Manel Armengol
INTRODUCTION: Pheochromocytomas are infrequent tumors arised from the chromaphine cells of the adrenal sympathetic system. The excess of circulating catecholamines may lead to different cardiovascular disorders from silent alterations of the myocardial conduction to different forms of cardiomyopathy. The onset as cardiogenic shock is exceptional. PRESENTATION OF CASE: A 35-year-old male, with a known history of acute myopericarditis of unknown origin which debuted as acute pulmonary edema, was admitted with dyspnea in the context of a new heart failure episode with pulmonary edema...
June 27, 2018: International Journal of Surgery Case Reports
G J Waring, S Shawer, K Hinshaw
O-ring retractors (Alexis/Mobius) have been shown to reduce the risk of Surgical site infection (SSI) following general abdominal surgery. The benefit at caesarean section (CS) remains to be established given the relatively high cost. OBJECTIVES: To assess the efficacy of O-ring retractors when used at CS. STUDY DESIGN: Systematic review and meta-analysis. Electronic databases were searched from inception of each database until January 2018. No language restrictions were applied...
June 25, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Laura Avanzino, Giovanna Lagravinese, Giovanni Abbruzzese, Elisa Pelosin
BACKGROUND: Disturbance of gait is a key feature of Parkinson's disease (PD) and has a negative impact on quality of life. Deficits in cognition and sensorimotor processing impair the ability of people with PD to walk quickly, efficiently and safely. Recent evidence suggests that emotional disturbances may also affect gait in PD. RESEARCH QUESTION: We explored if there were relationships between walking ability, emotion and cognitive impairment in people with PD...
June 28, 2018: Gait & Posture
Abdelkader Zebda, Jean-Pierre Alcaraz, Pankaj Vadgama, Sergey Shleev, Shelley D Minteer, François Boucher, Philippe Cinquin, Donald K Martin
There is a growing interest in the design and engineering of operational biofuel cells that can be implanted. This review highlights the recent progress in the electrochemistry of biofuel cell technologies, but with a particular emphasis on the medical and physiological aspects that impact the biocompatibility of biofuel cells operating inside a living body. We discuss the challenge of supplying power to implantable medical devices, with regard to the limitations of lithium battery technology and why implantable biofuel cells can be a promising alternative to provide the levels of power required for medical devices...
June 18, 2018: Bioelectrochemistry
Chen Zhou, Haimin Zou, Chengjun Sun, Dongxia Ren, Jing Chen, Yongxin Li
DNA has well-defined ability to recognize a wide variety of targets, such as small biological molecules, proteins, inorganic ions and small organic molecules. As molecular recognition elements, DNA can be used to build simple, rapid and sensitive biosensors for detection of these targets. DNA-based SPR sensors are considered to be a real-time and label-free tool. We present a systematical and critical review on DNA-based SPR biosensors and their signal amplification via various strategies, focusing on recent advances in nanomaterials, novel DNA amplifications, redox reactions on surface, enzyme amplifications, as well as promising multiplex amplification strategies...
June 30, 2018: Biosensors & Bioelectronics
Cai Zhang, Xian Zheng, Hui Ni, Ping Li, Hui-Jun Li
Quality control (QC) is crucial for ensuring the safety and effectiveness of traditional Chinese medicines (TCMs). Due to extremely complicated phytochemical matrices and characteristic mode of "multi-component, multi-target, integrated adjustment", discovering of QC markers from TCMs is a big challenge. Fingerprint-efficacy (FE) modeling method is currently proposed as an effective and reasonable attempt. This review summarizes the methodologies of FE modeling and applications in screening QC markers, meanwhile the future perspectives are also briefly discussed so as to provide inspiration and reference for follow-up study of FE relationship for TCMs...
July 8, 2018: Journal of Pharmaceutical and Biomedical Analysis
Andrea Cockett, Carole Jackson
OBJECTIVE: To explore the literature relating to the use of rubrics in Higher Education. DESIGN: A systematic search using three databases was undertaken, the question used to guide the search strategy was: What are the benefits and challenges of using rubrics as part of the assessment process in Higher Education? DATA SOURCES: Three electronic databases were searched: British Education Index, Education Resources Information Centre and the Cumulative Index to Nursing and Allied Health Literature...
June 30, 2018: Nurse Education Today
Karpagam Chakkaravarthy, Norzihan Ibrahim, Mardiah Mahmud, Munikumar Ramasamy Venkatasalu
AIM: To systematically review the existing evidence on predictors for nurses and midwives' readiness towards Self-directed Learning (SDL). BACKGROUND: Increased complexities in healthcare settings demand that nurses and midwives become involved in lifelong learning by means of self-directed learning (SDL) for delivering quality healthcare. More evidence is available for the self-directed learning readiness (SDLR) of nursing and midwifery students, less is systematically derived on predictors for nurses and midwives' readiness to SDL...
July 5, 2018: Nurse Education Today
Maree Johnson, Tracy Levett-Jones, R Langdon, Gabrielle Weidemann, Elizabeth Manias, Bronwyn Everett
OBJECTIVES: We sought to evaluate the perceptions of nurses of an e-learning educational program to encourage the use of behavioural strategies-blocking, engaging, mediating, multitasking, and preventing-to reduce the negative effects of interruptions during medication administration. DESIGN: A qualitative design was used to evaluate the impact of this e-learning educational intervention on nurses' behaviour. SETTINGS: Two wards (palliative care and aged care) from two different hospitals within a large local health service within Sydney Australia, were included in the study...
June 30, 2018: Nurse Education Today
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