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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/28549169/regulatory-dynamics-of-11p13-suggest-a-role-for-ehf-in-modifying-cf-lung-disease-severity
#2
Lindsay R Stolzenburg, Rui Yang, Jenny L Kerschner, Sara Fossum, Matthew Xu, Andrew Hoffmann, Kay-Marie Lamar, Sujana Ghosh, Sarah Wachtel, Shih-Hsing Leir, Ann Harris
Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene cause cystic fibrosis (CF), but are not good predictors of lung phenotype. Genome-wide association studies (GWAS) previously identified additional genomic sites associated with CF lung disease severity. One of these, at chromosome 11p13, is an intergenic region between Ets homologous factor (EHF) and Apaf-1 interacting protein (APIP). Our goal was to determine the functional significance of this region, which being intergenic is probably regulatory...
May 26, 2017: Nucleic Acids Research
https://www.readbyqxmd.com/read/28549132/selective-impairment-of-goal-directed-decision-making-following-lesions-to-the-human-ventromedial-prefrontal-cortex
#3
Justin Reber, Justin S Feinstein, John P O'Doherty, Mimi Liljeholm, Ralph Adolphs, Daniel Tranel
HASH(0x36e5290)
June 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28549125/transfemoral-transapical-and-transcatheter-aortic-valve-implantation-and-surgical-aortic-valve-replacement-a-meta-analysis-of-direct-and-adjusted-indirect-comparisons-of-early-and-mid-term-deaths
#4
Tomo Ando, Hisato Takagi, Cindy L Grines
Clinical outcomes of transfemoral-transcatheter aortic valve implantation (TF-TAVI) versus surgical aortic valve replacement (SAVR) or transapical (TA)-TAVI are limited to a few randomized clinical trials (RCTs). Because previous meta-analyses only included a limited number of adjusted studies or several non-adjusted studies, our goal was to compare and summarize the outcomes of TF-TAVI vs SAVR and TF-TAVI vs TA-TAVI exclusively with the RCT and propensity-matched cohort studies with direct and adjusted indirect comparisons to reach more precise conclusions...
May 26, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28549033/estrogen-receptor-progesterone-receptor-and-human-epidermal-growth-factor-receptor-2-testing-in-breast-cancer-assessing-the-value-of-repeated-centralized-testing-in-excision-specimens
#5
Nosaibah Hariri, Farnaz Hasteh, Vighnesh Walavalkar, Andres A Roma, Oluwole Fadare
At some tertiary breast care centers, where many patients are referred from other institutions, it is routine to repeat testing for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2/neu) in excision specimens if these tests were performed on the preceding biopsy at the referring facility. The goal of this study is to assess the value of this practice. We documented results from ER, PR, and HER2 testing in 541 consecutive invasive breast cancers excised over a 2...
May 25, 2017: Applied Immunohistochemistry & Molecular Morphology: AIMM
https://www.readbyqxmd.com/read/28548613/recommendations-for-research-on-suicide-loss-a-commentary
#6
Robert A Neimeyer, Julie Cerel, Myfanwy Maple
As detailed in the lead article in this Special Issue, the Survivors of Suicide Loss Task Force of the National Action Alliance for Suicide Prevention in the United States has recently worked to formulate national guidelines to mitigate the harmful after-effects of suicide in social and family systems. In the present article, we elaborate on one of four strategic directions addressed by the Task Force, namely the development of goals and objectives for surveillance, research and evaluation of the impact of suicide loss...
May 26, 2017: Death Studies
https://www.readbyqxmd.com/read/28547995/adsorption-induced-deformation-of-hierarchically-structured-mesoporous-silica-effect-of-pore-level-anisotropy
#7
Christian Balzer, Anna M Waag, Stefan Gehret, Gudrun Reichenauer, Florian Putz, Nicola Hüsing, Oskar Paris, Noam Bernstein, Gennady Y Gor, Alexander V Neimark
The goal of this work is to understand adsorption-induced deformation of hierarchically structured porous silica exhibiting well-defined cylindrical mesopores. For this purpose, we performed an in situ dilatometry measurement on a calcined and sintered monolithic silica sample during the adsorption of N2 at 77 K. To analyze the experimental data, we extended the adsorption stress model to account for the anisotropy of cylindrical mesopores, i.e., we explicitly derived the adsorption stress tensor components in the axial and radial direction of the pore...
May 26, 2017: Langmuir: the ACS Journal of Surfaces and Colloids
https://www.readbyqxmd.com/read/28545739/-health-impact-assessment-methodology-for-urban-planning-projects-in-andalusia-spain
#8
Luis A Moya-Ruano, Ana Candau-Bejarano, Francisco J Rodríguez-Rasero, Josefa Ruiz-Fernández, José Vela-Ríos
OBJECTIVE: To describe the tool developed in Andalusia (Spain) to conduct an analysis and prospective assessment of health impacts from urban planning projects as well as the process followed to design it. METHOD: On the one hand, direct and indirect relationships between urban setting and health were identified in light of the best scientific evidence available; and, on the other hand, methods and tools in impact assessment were reviewed. After the design of the tool, it was tested via both internal and external validation processes (meetings, workshops and interviews with key informants)...
May 22, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/28545542/recognition-and-treatment-of-sleep-disordered-breathing-an-important-component-of-chronic-disease-management
#9
REVIEW
Peter C Farrell, Glenn Richards
Sleep-disordered breathing (SDB) is a highly prevalent condition, and is associated with many debilitating chronic diseases. The role of untreated obstructive sleep apnea (OSA) in arterial hypertension has been recognized in international guidelines. Treatment with continuous positive airway pressure (CPAP) is associated with clinically-relevant reductions in blood pressure. In heart failure (HF), SDB is associated with worse prognosis and increased mortality. Major HF guidelines recommend that patients should be treated for sleep apnea to improve their HF status...
May 25, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28544860/behavioral-processes-in-long-lag-intervention-studies
#10
Dale T Miller, Jennifer E Dannals, Julian J Zlatev
We argue that psychologists who conduct experiments with long lags between the manipulation and the outcome measure should pay more attention to behavioral processes that intervene between the manipulation and the outcome measure. Neglect of such processes, we contend, stems from psychology's long tradition of short-lag lab experiments where there is little scope for intervening behavioral processes. Studying process in the lab invariably involves studying psychological processes, but in long-lag field experiments it is important to study causally relevant behavioral processes as well as psychological ones...
May 2017: Perspectives on Psychological Science: a Journal of the Association for Psychological Science
https://www.readbyqxmd.com/read/28544432/are-10-khz-stimulation-and-burst-stimulation-fundamentally-the-same
#11
REVIEW
Dirk De Ridder, Sanjaya Perera, Sven Vanneste
BACKGROUND: Spinal cord stimulation (SCS) is routinely used for intractable pain syndromes. For SCS to be efficacious the painful area needs to be covered by SCS induced paresthesia symptoms. Recently, novel stimulation designs have been developed for spinal cord stimulation (SCS) that are superior to classical spinal cord stimulation and exert their effects without the mandatory paresthesia. Two such stimulation designs are burst stimulation and 10 kHz stimulation. OBJECTIVE: Whereas the mechanism of action of burst SCS has been partly elucidated, in that it modulates the medial pain pathway in contrast to tonic stimulation, the mechanism of action of 10 kHz SCS is still enigmatic...
May 25, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28544221/single-atom-electrocatalysts
#12
Chengzhou Zhu, Shaofang Fu, Qiurong Shi, Dan Du, Yuehe Lin
Recent years have witnessed the increasing production of the sustainable and renewable energy. The limitations of electrochemical performances are closely associated with the search for highly efficient electrocatalysts with more rational control of size, shape, composition and structure. Specifically, the rapidly emerging studies on single-atom catalysts (SACs) have sparked new interests in electrocatalysis because of the unique properties such as high catalytic activity, selectivity and 100% atom utilization...
May 23, 2017: Angewandte Chemie
https://www.readbyqxmd.com/read/28543410/the-diagnosis-of-equine-insulin-dysregulation
#13
REVIEW
F R Bertin, M A de Laat
Insulin dysregulation is the hallmark of Equine Metabolic Syndrome and has received attention because of its direct association with laminitis. In the absence of an adequate treatment for laminitis, a focus on prophylaxis is needed, making early detection of individuals at risk of developing laminitis one of the main challenges in equine endocrinology. Recent studies have shown that insulin dysregulation goes beyond tissue insulin resistance and it is now demonstrated that the equine enteroinsular axis plays a major role in insulin secretion and equine hyperinsulinaemia...
May 22, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28543369/directing-clinical-care-using-lower-extremity-biomechanics-in-patients-with-ankle-osteoarthritis-and-ankle-arthroplasty
#14
REVIEW
Robin Queen
Ankle osteoarthritis is a debilitating disease with approximately 50,000 new cases per year leading to skeletal deformity, severe and recurrent pain, cartilage breakdown, and gait dysfunction limiting patient mobility and well-being. Although many treatments (total ankle arthroplasty (TAA), ankle fusion (arthrodesis), and ankle distraction arthroplasty) relieve pain, it is not clear that these procedures significantly improve patient mobility. The goal of the research presented here is to summarize what is presently known about lower extremity gait mechanics and outcomes and to quantify the impact of ankle osteoarthritis and TAA have on these measures using an explicitly holistic and mechanistic approach...
May 19, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28543041/the-added-value-of-cardiac-index-and-pulse-pressure-variation-monitoring-to-mean-arterial-pressure-guided-volume-therapy-in-moderate-risk-abdominal-surgery-coguide-a-pragmatic-multicentre-randomised-controlled-trial
#15
J Stens, J-P Hering, C W P van der Hoeven, A Boom, H S Traast, L E Garmers, S A Loer, C Boer
There is disagreement regarding the benefits of goal-directed therapy in moderate-risk abdominal surgery. Therefore, we tested the hypothesis that the addition of non-invasive cardiac index and pulse pressure variation monitoring to mean arterial pressure-based goal-directed therapy would reduce the incidence of postoperative complications in patients having moderate-risk abdominal surgery. In this pragmatic multicentre randomised controlled trial, we randomly allocated 244 patients by envelope drawing in a 1:1 fashion, stratified per centre...
May 25, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28542848/change-of-transfusion-and-treatment-paradigm-in-major-trauma-patients
#16
P Stein, A Kaserer, K Sprengel, G A Wanner, B Seifert, O M Theusinger, D R Spahn
Trauma promotes trauma-induced coagulopathy, which requires urgent treatment with fixed-ratio transfusions of red blood cells, fresh frozen plasma and platelet concentrates, or goal-directed administration of coagulation factors based on viscoelastic testing. This retrospective observational study compared two time periods before (2005-2007) and after (2012-2014) the implementation of changes in trauma management protocols which included: use of goal-directed coagulation management; admission of patients to designated trauma centres; whole-body computed tomography scanning on admission; damage control surgery; permissive hypotension; restrictive fluid resuscitation; and administration of tranexamic acid...
May 23, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28542004/do-dynamic-fat-and-fat-free-mass-changes-follow-theoretical-driven-rules-in-athletes
#17
Analiza M Silva, Catarina N Matias, Diana A Santos, Paulo M Rocha, Cláudia S Minderico, Diana Thomas, Steven B Heymsfield, Luís B Sardinha
INTRODUCTION: Maximizing fat mass (FM) loss while preserving or increasing fat-free mass (FFM) is a central goal for athletic performance but the composition of body weight (BW) changes over time with training are largely unknown. PURPOSE: We aimed to analyze FM and FFM contributions to BW changes and to test if these contributions follow established rules and predictions over one athletic season. METHODS: 70 athletes (42 males; handball, volleyball, basketball, triathlon, and swimming) were evaluated from the beginning to the competitive stage of the season and were empirically divided into those who lost (n=20) or gained >1...
May 23, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28541924/characterizing-highly-benefited-patients-in-randomized-clinical-trials
#18
Vivek Charu, Paul B Rosenberg, Lon S Schneider, Lea T Drye, Lisa Rein, David Shade, Constantine G Lyketsos, Constantine E Frangakis
Physicians and patients may choose a certain treatment only if it is predicted to have a large effect for the profile of that patient. We consider randomized controlled trials in which the clinical goal is to identify as many patients as possible that can highly benefit from the treatment. This is challenging with large numbers of covariate profiles, first, because the theoretical, exact method is not feasible, and, second, because usual model-based methods typically give incorrect results. Better, more recent methods use a two-stage approach, where a first stage estimates a working model to produce a scalar predictor of the treatment effect for each covariate profile; and a second stage estimates empirically a high-benefit group based on the first-stage predictor...
May 20, 2017: International Journal of Biostatistics
https://www.readbyqxmd.com/read/28541407/insular-and-ventrolateral-orbitofrontal-cortices-differentially-contribute-to-goal-directed-behavior-in-rodents
#19
Shauna L Parkes, Pascal M Ravassard, Juan-Carlos Cerpa, Mathieu Wolff, Guillaume Ferreira, Etienne Coutureau
The medial prefrontal cortex (mPFC) has long been considered a critical site in action control. However, recent evidence indicates that the contribution of cortical areas to goal-directed behavior likely extends beyond mPFC. Here, we examine the function of both insular (IC) and ventrolateral orbitofrontal (vlOFC) cortices in action-dependent learning. We used chemogenetics to study the consequences of IC or vlOFC inhibition on acquisition and performance of instrumental actions using the outcome devaluation task...
May 25, 2017: Cerebral Cortex
https://www.readbyqxmd.com/read/28541287/the-geography-of-measles-vaccination-in-the-african-great-lakes-region
#20
Saki Takahashi, C Jessica E Metcalf, Matthew J Ferrari, Andrew J Tatem, Justin Lessler
Expanded access to measles vaccination was among the most successful public health interventions of recent decades. All WHO regions currently target measles elimination by 2020, yet continued measles circulation makes that goal seem elusive. Using Demographic and Health Surveys with generalized additive models, we quantify spatial patterns of measles vaccination in ten contiguous countries in the African Great Lakes region between 2009-2014. Seven countries have 'coldspots' where vaccine coverage is below the WHO target of 80%...
May 25, 2017: Nature Communications
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