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https://www.readbyqxmd.com/read/28724143/potentially-avoidable-surgical-intensive-care-unit-admissions-and-disposition-delays
#1
Navpreet K Dhillon, Ara Ko, Eric J T Smith, Mayumi Kharabi, Joseph Castongia, Michael Nurok, Bruce L Gewertz, Eric J Ley
Importance: High health care costs encourage initiatives that avoid overuse of resources and identify opportunities to promote appropriate care. Objective: To investigate the causes of potentially avoidable surgical intensive care unit (SICU) admissions and disposition delays to determine whether targeted interventions could decrease these stays. Design, Setting, and Participants: This prospective, observational study focused on potentially avoidable SICU days, as determined by observers with input from the rounding intensivists at a 24-bed open SICU at an urban, academic hospital...
July 19, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28723703/management-of-chest-pain-in-the-french-emergency-healthcare-system-the-prospective-observational-epidoultho-study
#2
Sandrine Charpentier, Sebastien Beaune, Luc Marie Joly, Abdo Khoury, François-Xavier Duchateau, Raphael Briot, Bertrand Renaud, François-Xavier Ageron
OBJECTIVE: The aim of this paper was to describe the epidemiology, and diagnostic and therapeutic strategies that emergency physicians use to manage patients presenting with chest pain at all three levels of the French emergency medical system - that is, dispatch centres (SAMUs: the medical emergency system), which operate the mobile intensive care units (MICUs), and hospitals' emergency departments (EDs), with a focus on acute coronary syndrome (ACS). PATIENTS AND METHODS: All patients with chest pain who contacted a SAMU and/or were managed by a MICU and/or were admitted into an ED were included in a 1-day multicentre prospective study carried out in January 2013...
July 18, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28721643/the-scientific-self-reclaiming-its-place-in-the-history-of-research-ethics
#3
Herman Paul
How can the history of research ethics be expanded beyond the standard narrative of codification-a story that does not reach back beyond World War II-without becoming so broad as to lose all distinctiveness? This article proposes a history of research ethics focused on the "scientific self," that is, the role-specific identity of scientists as typically described in terms of skills, competencies, qualities, or dispositions. Drawing on three agenda-setting texts from nineteenth-century history, biology, and sociology, the article argues that the "revolutions" these books sought to unleash were, among other things, revolts against inherited conceptions of scientific selfhood...
July 18, 2017: Science and Engineering Ethics
https://www.readbyqxmd.com/read/28719834/the-exon3-deleted-growth-hormone-receptor-gene-polymorphism-d3-ghr-is-associated-with-insulin-and-spontaneous-growth-in-short-sga-children-nesgas
#4
Mathilde Gersel Wegmann, Ajay Thankamony, Edna Roche, Hilary Hoey, Jeremy Kirk, Guftar Shaikh, Sten-A Ivarsson, Olle Söder, David B Dunger, Anders Juul, Rikke Beck Jensen
OBJECTIVE: The effect of a common polymorphism in the Growth Hormone (GH) receptor (d3-GHR) gene on growth, metabolism and body composition was examined in short children born small for gestational age (SGA) on GH treatment. DESIGN: In 96 prepubertal, short SGA children treated with high-dose GH (67μg/kg/day) in the NESGAS study, insulin sensitivity (IS), insulin secretion and disposition index (DI) were determined during the first year of treatment. Body composition was analysed by DXA...
July 12, 2017: Growth Hormone & IGF Research
https://www.readbyqxmd.com/read/28718757/the-impact-of-dispositional-variables-of-elders-relatives-and-paid-caregivers-on-elders-empowerment-and-life-satisfaction
#5
Manuela Tomai, Lina Pezzuti, Minou Mebane, Maura Benedetti, Annalisa Moro
Background/Study Context: The impact of dispositional characteristic of elders' closest network members on elders' life satisfaction and empowerment has remained largely unexplored. This innovative study aimed to assess the impact of dispositional variables of elders, relatives, and paid caregivers on life satisfaction and empowerment of elders. METHODS: One hundred forty-three triads (one elder, one paid caregiver, and one relative) completed six scales measuring modifiable personality characteristics (loneliness, optimism, regulation of positive and negative emotions), life satisfaction, and sense of empowerment...
July 2017: Experimental Aging Research
https://www.readbyqxmd.com/read/28717776/a-retrospective-study-of-emergency-department-potassium-disturbances-severity-treatment-and-outcomes
#6
Adam J Singer, Henry C Thode, W Frank Peacock
OBJECTIVE: Disturbances in potassium (K) levels are relatively common and may be associated with significant morbidity and mortality; however, treatments vary. Our purpose was to determine the incidence, treatments, and outcomes associated with hyperkalemia and hypokalemia in emergency department (ED) patients. METHODS: We performed a structured, retrospective review of electronic medical records of consecutive adult ED patients with K measured while in the ED. Demographic, clinical, and laboratory data as well as treatments, disposition, and in-hospital complications were collected...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28717420/comprehensive-toxicity-and-immunogenicity-studies-reveal-minimal-effects-in-mice-following-sustained-dosing-of-extracellular-vesicles-derived-from-hek293t-cells
#7
Xiaohua Zhu, Mohamed Badawi, Steven Pomeroy, Dhruvitkumar S Sutaria, Zhiliang Xie, Alice Baek, Jinmai Jiang, Ola A Elgamal, Xiaokui Mo, Krista La Perle, Jeffrey Chalmers, Thomas D Schmittgen, Mitch A Phelps
Extracellular vesicles (EVs) are under evaluation as therapeutics or as vehicles for drug delivery. Preclinical studies of EVs often use mice or other animal models to assess efficacy and disposition. However, as most EVs under evaluation are derived from human cells, they may elicit immune responses which may contribute to toxicities or enhanced EV clearance. Furthermore, EVs from different cell sources or EVs comprising various cargo may differ with respect to immunogenicity or toxicity. To assess EV-induced immune response and toxicity, we dosed C57BL/6 mice with EVs intravenously and intraperitoneally for 3 weeks...
2017: Journal of Extracellular Vesicles
https://www.readbyqxmd.com/read/28717260/faculty-motivation-to-mentor-students-through-undergraduate-research-programs-a-study-of-enabling-and-constraining-factors
#8
Danielle X Morales, Sara E Grineski, Timothy W Collins
Undergraduate research experiences are a "high impact" educational practice that confer benefits to students. However, little attention has been paid to understanding faculty motivation to mentor undergraduate students through research training programs, even as the number of programs has grown, requiring increasing numbers of faculty mentors. To address this, we introduce a conceptual model for understanding faculty motivation to mentor and test it by using empirical data to identify factors that enable and constrain faculty engagement in an undergraduate research program...
August 2017: Research in Higher Education
https://www.readbyqxmd.com/read/28716967/contextual-and-developmental-differences-in-the-neural-architecture-of-cognitive-control
#9
Raluca Petrican, Cheryl L Grady
Since both development and context impact functional brain architecture, the neural connectivity signature of a cognitive or affective predisposition may similarly vary across different ages and circumstances. To test this hypothesis, we investigated the effects of age and cognitive versus social-affective context on the stable and time-varying neural architecture of inhibition, the putative core cognitive control component, in a subsample (N= 359 [22-36 yrs], 174 men) of the Human Connectome Project. Among younger individuals, a neural signature of superior inhibition emerged in both stable and dynamic connectivity analyses...
July 17, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28716928/support-for-redistribution-is-shaped-by-compassion-envy-and-self-interest-but-not-a-taste-for-fairness
#10
Daniel Sznycer, Maria Florencia Lopez Seal, Aaron Sell, Julian Lim, Roni Porat, Shaul Shalvi, Eran Halperin, Leda Cosmides, John Tooby
Why do people support economic redistribution? Hypotheses include inequity aversion, a moral sense that inequality is intrinsically unfair, and cultural explanations such as exposure to and assimilation of culturally transmitted ideologies. However, humans have been interacting with worse-off and better-off individuals over evolutionary time, and our motivational systems may have been naturally selected to navigate the opportunities and challenges posed by such recurrent interactions. We hypothesize that modern redistribution is perceived as an ancestral scene involving three notional players: the needy other, the better-off other, and the actor herself...
July 17, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28715978/the-role-of-efflux-pumps-in-tuberculosis-treatment-and-their-promise-as-a-target-in-drug-development-unraveling-the-black-box
#11
Lindsey H M Te Brake, Gerjo J de Knegt, Jurriaan E de Steenwinkel, Teunis J P van Dam, David M Burger, Frans G M Russel, Reinout van Crevel, Jan B Koenderink, Rob E Aarnoutse
Insight into drug transport mechanisms is highly relevant to the efficacious treatment of tuberculosis (TB). Major problems in TB treatment are related to the transport of antituberculosis (anti-TB) drugs across human and mycobacterial membranes, affecting the concentrations of these drugs systemically and locally. Firstly, transporters located in the intestines, liver, and kidneys all determine the pharmacokinetics and pharmacodynamics of anti-TB drugs, with a high risk of drug-drug interactions in the setting of concurrent use of antimycobacterial, antiretroviral, and antidiabetic agents...
July 17, 2017: Annual Review of Pharmacology and Toxicology
https://www.readbyqxmd.com/read/28715810/population-pharmacokinetics-of-diazoxide-in-children-with-hyperinsulinemic-hypoglycemia
#12
Rika Kizu, Kazuko Nishimura, Reiko Sato, Kenjiro Kosaki, Toshiaki Tanaka, Yusuke Tanigawara, Tomonobu Hasegawa
BACKGROUND: Diazoxide is the first-line treatment for pediatric hyperinsulinemic hypoglycemia (HI). This study aimed to elucidate the pharmacokinetics of diazoxide in children with HI. METHODS: We obtained 81 blood samples from 22 children with HI. Measured serum diazoxide concentrations were used for population pharmacokinetic analysis. Patient factors influencing pharmacokinetics were estimated using nonlinear mixed-effects model analysis. Relationships between drug exposure and adverse drug reactions were also investigated...
July 14, 2017: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/28715363/decompressive-craniectomy-vs-craniotomy-only-for-intracranial-hemorrhage-evacuation-a-propensity-matched-study
#13
Faisal Jehan, Asad Azim, Peter Rhee, Muhammad Khan, Lynn Gries, Terence OʼKeeffe, Narong Kulvatunyou, Andrew Tang, Bellal Joseph
BACKGROUND: Decompressive craniectomy (DC) is often performed in conjunction with evacuation of intracranial hemorrhage (ICH) to control intracranial pressure (ICP) in patients with a traumatic brain injury (TBI). The efficacy of DC in lowering ICP is well established, however, its effect on clinical outcomes remains controversial. The aim of our study is to assess outcomes in TBI patients undergoing decompressive craniectomy (DC) vs. craniotomy only (CO) for the evacuation of intracranial hemorrhage...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28715155/asteroid-hyalosis-masquerading-as-vitreous-hemorrhage-on-point-of-care-sonography
#14
Penelope C Lema, Daniel Mantuani, Arun Nagdev, Srikar Adhikari
Point-of-care ocular sonography is frequently used in the emergency department to evaluate patients with vision disorders. We describe a case series of 3 patients who ultimately had a diagnosis of asteroid hyalosis, a lesser-known condition that on point-of-care sonography may be mistaken for vitreous hemorrhage. Asteroid hyalosis is considered a benign degenerative condition. In contrast, vitreous hemorrhage may be an ocular emergency that warrants an urgent ophthalmologic consultation if there is an underlying retinal tear or detachment...
July 17, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28714883/nmr-insights-into-the-structure-function-relationships-in-the-binding-of-melanocortin-analogues-to-the-mc1r-receptor
#15
Maurício Morais, Héctor Zamora-Carreras, Paula D Raposinho, Maria Cristina Oliveira, David Pantoja-Uceda, João D G Correia, M Angeles Jiménez
Linear and cyclic analogues of the α-melanocyte stimulating hormone (α-MSH) targeting the human melanocortin receptor 1 (MC1R) are of pharmacological interest for detecting and treating melanoma. The central sequence of α-MSH (His-Phe-Arg-Trp) has been identified as being essential for receptor binding. To deepen current knowledge on the molecular basis for α-MSH bioactivity, we aimed to understand the effect of cycle size on receptor binding. To that end, we synthesised two macrocyclic isomeric α-MSH analogues, c[NH-NO₂-C₆H₃-CO-His-DPhe-Arg-Trp-Lys]-Lys-NH₂ (CycN-K6) and c[NH-NO₂-C₆H₃-CO-His-DPhe-Arg-Trp-Lys-Lys]-NH₂ (CycN-K7)...
July 15, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28714036/pharmacokinetics-of-intravenous-pan-class-i-phosphatidylinositol-3-kinase-pi3k-inhibitor-14-c-copanlisib-bay-80-6946-in-a-mass-balance-study-in-healthy-male-volunteers
#16
Michael Gerisch, Thomas Schwarz, Dieter Lang, Gabriele Rohde, Stefanie Reif, Isabelle Genvresse, Susanne Reschke, Dorina van der Mey, Camille Granvil
PURPOSE: To determine the pharmacokinetics of radiolabeled copanlisib (BAY 80-6946) in healthy male volunteers and to investigate the disposition and biotransformation of copanlisib. METHODS: A single dose of 12 mg copanlisib containing 2.76 MBq [(14)C]copanlisib was administered as a 1-h intravenous infusion to 6 volunteers with subsequent sampling up to 34 days. Blood, plasma, urine and feces were collected to monitor total radioactivity, parent compound and metabolites...
July 11, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28713332/childhood-maltreatment-is-an-independent-risk-factor-for-prediabetic-disturbances-in-glucose-regulation
#17
Li Li, W Timothy Garvey, Barbara A Gower
AIMS: Childhood maltreatment (CM) is shown to be associated with obesity and depression. However, the relationship of CM to prediabetic state is much less studied. We tested the hypothesis that CM increases the risk for prediabetic state due to glucose intolerance, reduced insulin sensitivity, and beta cell function. METHODS: Oral glucose tolerance test (OGTT)-derived metabolic parameters of glucose tolerance, insulin sensitivity, and beta cell function were measured in 121 participants aged 19-60 years...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28712798/region-and-insurance-plan-type-influence-discharge-disposition-after-hip-and-knee-arthroplasty-evidence-from-the-privately-insured-us-population
#18
Marina Soley-Bori, Rene Soria-Saucedo, Bora Youn, Alex B Haynes, Ryan Macht, Colleen M Ryan, Jeffrey C Schneider, Lewis E Kazis
BACKGROUND: Little is known about regional variation in the use of postacute care services after elective procedures, such as total hip or knee arthroplasty (THA/TKA), and how insurance type may influence it. The goal of this study is to assess the influence of region and insurance arrangements on discharge disposition. METHODS: A representative sample of the privately insured US population with THA or TKA in 2009 or 2010 was obtained from the MarketScan database applying individual-level weights from the Medical Expenditure Panel Survey...
June 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28712608/a-custom-developed-emergency-department-provider-electronic-documentation-system-reduces-operational-efficiency
#19
Joshua Feblowitz, Sukhjit S Takhar, Michael J Ward, Ryan Ribeira, Adam B Landman
STUDY OBJECTIVE: Electronic health record implementation can improve care, but may also adversely affect emergency department (ED) efficiency. We examine how a custom, ED provider, electronic documentation system (eDoc), which replaced paper documentation, affects operational performance. METHODS: We analyzed retrospective operational data for 1-year periods before and after eDoc implementation in a single ED. We computed daily operational statistics, reflecting 60,870 pre- and 59,337 postimplementation patient encounters...
July 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28712417/holding-the-body-in-mind-interoceptive-awareness-dispositional-mindfulness-and-psychological-well-being
#20
Adam W Hanley, Wolf E Mehling, Eric L Garland
Objective Recent dialogue between Western and Eastern traditions has stimulated novel explorations of the relationship between mind and body. Many of these cross-cultural, mind-body dialogues have proven productive in identifying more adaptive forms of embodiment. Prior studies suggest that dispositional mindfulness (DM) and interoceptive awareness (IA) are associated but distinct, key constructs in mind-body approaches that are conceptualized in a variety of ways with imprecisely characterized relationship...
August 2017: Journal of Psychosomatic Research
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