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https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#1
David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
https://www.readbyqxmd.com/read/27935782/wet-or-dry-a-review-of-intravenous-fluid-administration-in-anesthesia-practice
#2
Matthew D'Angelo, R Kyle Hodgen
Fluid therapy has dramatically changed since its early inception nearly 200 years ago. Administration of intravenous fluid (IVF) has evolved from a "drip" technique to the algorithmic approach of the anesthetic fluid plan, and is now moving toward Goal-Directed Fluid Therapy. As the science and culture of fluid management evolves, anesthetists must remain focused on "why" anesthetic fluid matters. The purpose of IVF administration is to support tissue perfusion and maintain euvolemia. As the evidence underlying perioperative practice matures and the science of anesthesia races to meet the evolving demands of surgery, anesthetists must align knowledge generation with the individualized needs of the patient...
January 2017: Annual Review of Nursing Research
https://www.readbyqxmd.com/read/27935206/developmental-transcriptional-regulation-by-sumoylation-an-evolving-field
#3
REVIEW
Juan Monribot-Villanueva, Mario Zurita, Martha Vázquez
SUMOylation is a reversible post-translational protein modification that affects the intracellular localization, stability, activity and interactions of its protein targets. The SUMOylation pathway influences several nuclear and cytoplasmic processes. The expression of many genes, in particular those involved in development is finely tuned in space and time by several groups of proteins. There is growing evidence that transcriptional regulation mechanisms involve direct SUMOylation of transcriptional-related proteins such as initiation and elongation factors, and subunits of chromatin modifier and remodeling complexes originally described as members of the trithorax and Polycomb groups in Drosophila...
December 9, 2016: Genesis: the Journal of Genetics and Development
https://www.readbyqxmd.com/read/27934977/real-time-observation-of-protein-aggregates-in-pharmaceutical-formulations-using-liquid-cell-electron-microscopy
#4
Lynn M DiMemmo, A Cameron Varano, Jonathan Haulenbeek, Yanping Liang, Kaya Patel, Madeline J Dukes, Songyan Zheng, Mario Hubert, Steven P Piccoli, Deborah F Kelly
Understanding the properties of protein-based therapeutics is a common goal of biologists and physicians. Technical barriers in the direct observation of small proteins or therapeutic agents can limit our knowledge of how they function in solution and in the body. Electron microscopy (EM) imaging performed in a liquid environment permits us to peer into the active world of cells and molecules at the nanoscale. Here, we employ liquid cell EM to directly visualize a protein-based therapeutic in its native conformation and aggregate state in a time-resolved manner...
December 9, 2016: Lab on a Chip
https://www.readbyqxmd.com/read/27934891/structure-determination-of-molecules-in-an-alignment-laser-field-by-femtosecond-photoelectron-diffraction-using-an-x-ray-free-electron-laser
#5
Shinichirou Minemoto, Takahiro Teramoto, Hiroshi Akagi, Takashi Fujikawa, Takuya Majima, Kyo Nakajima, Kaori Niki, Shigeki Owada, Hirofumi Sakai, Tadashi Togashi, Kensuke Tono, Shota Tsuru, Ken Wada, Makina Yabashi, Shintaro Yoshida, Akira Yagishita
We have successfully determined the internuclear distance of I2 molecules in an alignment laser field by applying our molecular structure determination methodology to an I 2p X-ray photoelectron diffraction profile observed with femtosecond X-ray free electron laser pulses. Using this methodology, we have found that the internuclear distance of the sample I2 molecules in an alignment Nd:YAG laser field of 6 × 10(11) W/cm(2) is elongated by from 0.18 to 0.30 Å "in average" relatively to the equilibrium internuclear distance of 2...
December 9, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27934789/a-3d-map-of-the-hindlimb-motor-representation-in-the-lumbar-spinal-cord-in-sprague-dawley-rats
#6
Jordan A Borrell, Shawn B Frost, Jeremy Peterson, Randolph J Nudo
OBJECTIVE: Spinal cord injury (SCI) is a devastating neurological trauma with a prevalence of about 282 000 people living with an SCI in the United States in 2016. Advances in neuromodulatory devices hold promise for restoring function by incorporating the delivery of electrical current directly into the spinal cord grey matter via intraspinal microstimulation (ISMS). In such designs, detailed topographic maps of spinal cord outputs are needed to determine ISMS locations for eliciting hindlimb movements...
December 9, 2016: Journal of Neural Engineering
https://www.readbyqxmd.com/read/27934763/selective-modulation-of-cortical-state-during-spatial-attention
#7
Tatiana A Engel, Nicholas A Steinmetz, Marc A Gieselmann, Alexander Thiele, Tirin Moore, Kwabena Boahen
Neocortical activity is permeated with endogenously generated fluctuations, but how these dynamics affect goal-directed behavior remains a mystery. We found that ensemble neural activity in primate visual cortex spontaneously fluctuated between phases of vigorous (On) and faint (Off) spiking synchronously across cortical layers. These On-Off dynamics, reflecting global changes in cortical state, were also modulated at a local scale during selective attention. Moreover, the momentary phase of local ensemble activity predicted behavioral performance...
December 2, 2016: Science
https://www.readbyqxmd.com/read/27934240/modeling-the-endogenous-sunlight-inactivation-rates-of-laboratory-strain-and-wastewater-e-coli-and-enterococci-using-biological-weighting-functions
#8
Andrea I Silverman, Kara L Nelson
Models that predict sunlight inactivation rates of bacteria are valuable tools for predicting the fate of pathogens in recreational waters and designing natural wastewater treatment systems to meet disinfection goals. We developed biological weighting function (BWF)-based numerical models to estimate the endogenous sunlight inactivation rates of E. coli and enterococci. BWF-based models allow the prediction of inactivation rates under a range of environmental conditions that shift the magnitude or spectral distribution of sunlight irradiance (e...
November 15, 2016: Environmental Science & Technology
https://www.readbyqxmd.com/read/27934019/experimental-and-computational-analysis-of-protein-stabilization-by-gly-to-d-ala-substitution-a-convolution-of-native-state-and-unfolded-state-effects
#9
Junjie Zou, Benben Song, Carlos Simmerling, Daniel Raleigh
The rational and predictable enhancement of protein stability is an important goal in protein design. Most efforts target the folded state, however stability is the free energy difference between the folded and unfolded states thus both are suitable targets. Strategies directed at the unfolded state usually seek to decrease chain entropy by introducing cross-links or by replacing glycines. Cross-linking has led to mixed results. Replacement of glycine with an l-amino acid, while reducing the entropy of the unfolded state, can introduce unfavorable steric interactions in the folded state, since glycine is often found in conformations that require a positive φ angle such as helical C-capping motifs or type I' and II″ β-turns...
December 7, 2016: Journal of the American Chemical Society
https://www.readbyqxmd.com/read/27933281/pet-imaging-of-urokinase-type-plasminogen-activator-receptor-upar-in-prostate-cancer-current-status-and-future-perspectives
#10
REVIEW
Dorthe Skovgaard, Morten Persson, Andreas Kjaer
Overexpression of urokinase-type plasminogen activator receptors (uPAR) represents an important biomarker for aggressiveness in most common malignant diseases, including prostate cancer (PC). Accordingly, uPAR expression either assessed directly in malignant PC tissue or assessed directly in plasma (intact/cleaved forms)-provides independent additional clinical information to that contributed by PSA, Gleason score, and other relevant pathological and clinical parameters. In this respect, non-invasive molecular imaging by positron emission tomography (PET) offers a very attractive technology platform, which can provide the required quantitative information on the uPAR expression profile, without the need for invasive procedures and the risk of missing the target due to tumor heterogeneity...
2016: Clinical and Translational Imaging: Reviews in Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/27932895/are-patients-and-doctors-accounts-of-the-first-specialist-consultation-for-chronic-back-pain-in-agreement
#11
Kathy B White, John Lee, Amanda C de C Williams
INTRODUCTION: The first consultation at a specialist pain clinic is potentially a pivotal event in a patient's pain history, affecting treatment adherence and engagement with longer term self-management. What doctors communicate to patients about their chronic pain and how patients interpret doctors' messages and explanations in pain consultations are under-investigated, particularly in specialist care. Yet, patients value personalized information about their pain problem. PATIENTS AND METHODS: Sixteen patients in their first specialist pain clinic consultation and the doctors they consulted were interviewed shortly after the consultation...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27931834/treatments-for-colorectal-liver-metastases-a-new-focus-on-a-familiar-concept
#12
REVIEW
M G Zampino, E Magni, P S Ravenda, C A Cella, G Bonomo, P Della Vigna, S Galdy, F Spada, G M Varano, G Mauri, N Fazio, F Orsi
A major challenge for the management of advanced-colorectal-cancer is the multidisciplinary approach required for the treatment of liver metastases. Reducing the burden of liver metastases with liver-directed therapy has an important impact on both survival and health-related quality of life. This paper debates the rationale and current liver-directed approaches for colorectal liver metastases based on the evidence of literature and new clinical trials. Surgery is the gold standard, when feasible, and it's the main treatment goal for patients with potentially-resectable disease as a means of prolonging progression-free survival...
December 2016: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/27931648/haemodynamic-coherence-in-perioperative-setting
#13
REVIEW
Andrea Carsetti, Ximena Watson, Maurizio Cecconi
Over the last decade, there has been an increased interest in the use of goal-directed therapy (GDT) in patients undergoing high-risk surgery, and various haemodynamic monitoring tools have been developed to guide perioperative care. Both the complexity of the patient and surgical procedure need to be considered when deciding whether GDT will be beneficial. Ensuring optimum tissue perfusion is paramount in the perioperative period and relies on the coherence between both macrovascular and microvascular circulations...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27931595/transcatheter-closure-of-patent%C3%A2-ductus%C3%A2-arteriosus-in-extremely%C3%A2-premature%C3%A2-newborns-early-results-and-midterm-follow-up
#14
Evan M Zahn, Daniel Peck, Alistair Phillips, Phillip Nevin, Kaylan Basaker, Charles Simmons, Marion E McRae, Tracy Early, Ruchira Garg
OBJECTIVES: The goal of this study was to describe early and midterm outcomes of extremely premature newborns (EPNs) who underwent transcatheter echocardiographically guided patent ductus arteriosus (PDA) closure. BACKGROUND: Surgical ligation of PDA in EPNs confers significant risk for procedural morbidity and adverse long-term outcomes. METHODS: The Amplatzer Vascular Plug II was used in all cases. Post-ligation syndrome was defined using previously published parameters...
December 12, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27931263/extracellular-matrix-components-and-culture-regimen-selectively-regulate-cartilage-formation-by-self-assembling-human-mesenchymal-stem-cells-in-vitro-and-in-vivo
#15
Johnathan Ng, Yiyong Wei, Bin Zhou, Aonnicha Burapachaisri, Edward Guo, Gordana Vunjak-Novakovic
BACKGROUND: Cartilage formation from self-assembling mesenchymal stem cells (MSCs) in vitro recapitulate important cellular events during mesenchymal condensation that precedes native cartilage development. The goal of this study was to investigate the effects of cartilaginous extracellular matrix (ECM) components and culture regimen on cartilage formation by self-assembling human MSCs in vitro and in vivo. METHODS: Human bone marrow-derived MSCs (hMSCs) were seeded and compacted in 6...
December 9, 2016: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/27930608/effective-interpersonal-health-communication-for-linkage-to-care-after-hiv-diagnosis-in-south-africa
#16
Tonderai Mabuto, Salome Charalambous, Christopher J Hoffmann
BACKGROUND: Early in the global response to HIV, health communication was focused toward HIV prevention. More recently, the role of health communication along the entire HIV care continuum has been highlighted. We sought to describe how a strategy of interpersonal communication allows for precision health communication to influence behavior regarding care engagement. METHODS: We analyzed 1 to 5 transcripts from clients participating in longitudinal counseling sessions from a communication strategy arm of a randomized trial to accelerate entry into care in South Africa...
January 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27929582/liquid-biopsy-on-chip-a-paradigm-shift-towards-the-understanding-of-cancer-metastasis
#17
REVIEW
Amogha Tadimety, Abeer Syed, Yuan Nie, Christina R Long, Kasia M Kready, John X J Zhang
This comprehensive review serves as a guide for developing scalable and robust liquid biopsies on chip for capture, detection, and analysis of circulating tumor cells (CTCs). Liquid biopsy, the detection of biomarkers from body fluids, has proven challenging because of CTC rarity and the heterogeneity of CTCs shed from tumors. The review starts with the underlying biological mechanisms that make liquid biopsy a challenge before moving into an evaluation of current technological progress. Then, a framework for evaluation of the technologies is presented with special attention to throughput, capture rate, and cell viability for analysis...
December 8, 2016: Integrative Biology: Quantitative Biosciences From Nano to Macro
https://www.readbyqxmd.com/read/27927938/transcranial-direct-current-stimulation-for-children-with-perinatal-stroke-and-hemiparesis
#18
Adam Kirton, Patrick Ciechanski, Ephrem Zewdie, John Andersen, Alberto Nettel-Aguirre, Helen Carlson, Lisa Carsolio, Mia Herrero, Jillian Quigley, Aleksandra Mineyko, Jacquie Hodge, Michael Hill
OBJECTIVE: To determine whether the addition of transcranial direct current stimulation (tDCS) to intensive therapy increases motor function in children with perinatal stroke and hemiparetic cerebral palsy. METHODS: This was a randomized, controlled, double-blind clinical trial. Participants were recruited from a population-based cohort with MRI-classified unilateral perinatal stroke, age of 6 to 18 years, and disabling hemiparesis. All completed a goal-directed, peer-supported, 2-week after-school motor learning camp (32 hours of therapy)...
December 7, 2016: Neurology
https://www.readbyqxmd.com/read/27927703/pharmacokinetics-and-pharmacodynamics-of-oral-mecamylamine-development-of-a-nicotinic-acetylcholine-receptor-antagonist-cognitive-challenge-test-using-modelling-and-simulation
#19
Ricardo Alvarez-Jimenez, Anne Catrien Baakman, Jasper Stevens, Sebastiaan C Goulooze, Ellen P Hart, Robert Rissmann, Joop Ma van Gerven, Geert Jan Groeneveld
A pharmacologic challenge model with a nicotinic antagonist could be an important tool not only to understand the complex role of the nicotinic cholinergic system in cognition, but also to develop novel compounds acting on the nicotinic acetylcholine receptor. The objective was to develop a pharmacokinetic-pharmacodynamic (PKPD) model using nonlinear mixed effects (NLME) methods to quantitate the pharmacokinetics of three oral mecamylamine doses (10, 20 and 30 mg) and correlate the plasma concentrations to the pharmacodynamic effects on a cognitive and neurophysiologic battery of tests in healthy subjects...
December 7, 2016: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/27926758/association-between-surgeon-scorecard-use-and-operating-room-costs
#20
Corinna C Zygourakis, Victoria Valencia, Christopher Moriates, Christy K Boscardin, Sereina Catschegn, Alvin Rajkomar, Kevin J Bozic, Kent Soo Hoo, Andrew N Goldberg, Lawrence Pitts, Michael T Lawton, R Adams Dudley, Ralph Gonzales
Importance: Despite the significant contribution of surgical spending to health care costs, most surgeons are unaware of their operating room costs. Objective: To examine the association between providing surgeons with individualized cost feedback and surgical supply costs in the operating room. Design, Setting, and Participants: The OR Surgical Cost Reduction (OR SCORE) project was a single-health system, multihospital, multidepartmental prospective controlled study in an urban academic setting...
December 7, 2016: JAMA Surgery
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