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Complex special needs

Albert Yen, Yilong Cheng, Meilyn Sylvestre, Heather Herd Gustafson, Sanyogitta Puri, Suzie H Pun
Messenger RNA (mRNA) is a biomolecule with a wide range of promising clinical applications. However, the unstable nature of mRNA and its susceptibility to degradation by ribonucleases necessitate the use of specialized formulations for delivery. Polycations are an emerging class of synthetic carriers capable of packaging nucleic acids, and may serve as suitable ribonuclease-resistant formulations for mRNA administration. Here, we explore the application of VIPER and sunflower polycations, two polycations previously synthesized by our group, for the delivery of mRNA in comparison to branched poly(ethylenimine); all three polycations have been shown to efficiently deliver plasmid DNA (pDNA) to cultured cells...
April 19, 2018: Molecular Pharmaceutics
Eileen Sutton, Georgia Herbert, Sorrel Burden, Stephen Lewis, Steve Thomas, Andy Ness, Charlotte Atkinson
INTRODUCTION: The Enhanced Recovery After Surgery programme (ERAS) is an approach to the perioperative care of patients encompassing multiple interventions and involving a wide range of different actors. It can thus be defined as a complex intervention. Despite the strength of the evidence-base in its support, the implementation of ERAS has been slow. This paper specifically explores the utility of Normalization Process Theory (NPT) as a methodological framework to aid exploration of ERAS implementation, with a focus on the core NPT construct coherence...
2018: PloS One
Ursula Creutzig, Matthew A Kutny, Ronald Barr, Richard F Schlenk, Raul C Ribeiro
The incidence of acute myelogenous leukemia (AML) increases progressively with age. Favorable genetic mutations are most prevalent in children, and unfavorable profiles increase proportionately in adolescents and young adults (AYA) and into later adulthood. Survival rates of AYA have improved over recent decades to 50-60%, but their accrual to clinical trials remains poor. In contrast to AYA with acute lymphoblastic leukemia, the prognostic benefit for AYA with AML enrolled in pediatric compared with adult trials is minor and only seen when different protocols are used...
April 18, 2018: Pediatric Blood & Cancer
Mohammad Rezaei, David M Warsinger, John H Lienhard V, Mikel C Duke, Takeshi Matsuura, Wolfgang M Samhaber
Membrane distillation (MD) is a rapidly emerging water treatment technology; however, membrane pore wetting is a primary barrier to widespread industrial use of MD. The primary causes of membrane wetting are exceedance of liquid entry pressure and membrane fouling. Developments in membrane design and the use of pretreatment have provided significant advancement toward wetting prevention in membrane distillation, but further progress is needed. In this study, a broad review is carried out on wetting incidence in membrane distillation processes...
March 30, 2018: Water Research
Matthew Weeks, Brandon Cole, Eric Flake, Daniel Roy
Introduction: This study aims to describe the quantity and satisfaction current residents and experienced pediatricians have with graduate medical education on transitioning medically complex patients to adult care. There is an increasing need for transitioning medically complex adolescents to adult care. Over 90% now live into adulthood and require transition to adult healthcare providers. The 2010 National Survey of Children with Special Health Care Needs found that only 40% of youth 12-17 yr receive the necessary services to appropriately transition to adult care...
April 11, 2018: Military Medicine
Meghan M Galligan, Tara W Bamat, Annique K Hogan, Joseph Piccione
Children with special healthcare needs have been identified nationally as a population whose health care is associated with unmet needs; increased morbidity; fragmentation of care and medical errors; caregiver dissatisfaction; and disproportionately high costs. A subset of these children are medically fragile, with medical complexity that requires a reliance on tertiary care-based services-including subspecialty appointments, surgical procedures, and care coordination resources. For medically complex patients affected by upper and lower respiratory tract and gastrointestinal disorders, multidisciplinary aerodigestive centers have emerged at tertiary care centers across the United States to facilitate coordinated, high-quality, and high value care...
April 12, 2018: Current Problems in Pediatric and Adolescent Health Care
Monika Lemke, Rachel Kappel, Robert McCarter, Lawrence D'Angelo, Lisa K Tuchman
OBJECTIVES: Expert consensus jointly authored in 2011 by the American Academy of Pediatrics, American Academy of Family Physicians, and American College of Physicians supports the use of health care transition (HCT) care coordination (CC). Although gaps in care are addressed in these practice-based implementation recommendations, such recommendations have never undergone rigorous assessment. We assessed the effectiveness of implementation on quality of chronic illness care and CC during HCT for adolescents and young adults...
April 12, 2018: Pediatrics
Elizabeth Grier, Dara Abells, Ian Casson, Meg Gemmill, Jessica Ladouceur, Amanda Lepp, Ullanda Niel, Samantha Sacks, Kyle Sue
OBJECTIVE: To delineate the factors inherent in caring for patients with intellectual and developmental disabilities (IDD) that lead to complexity and to provide perspectives and techniques mapped to the phases of the clinical encounter. SOURCES OF INFORMATION: The authors of the physical health section of the 2018 Canadian consensus guidelines on the primary care of adults with IDD consisted of family physicians, all of whom practise comprehensive family medicine with additional clinical experience in care of adults with IDD...
April 2018: Canadian Family Physician Médecin de Famille Canadien
Claudia Bausewein
Palliative medicine has become an integral part of the German healthcare system in recent years. However, patients with non-malignant diseases have less access to palliative care than patients with oncological diseases. These patients comprise a heterogeneous group of chronic lung and heart diseases, neurological and geriatric diseases. Their symptom burden and their palliative care needs are similar to those of oncological patients, but earlier in the disease process. Physical aspects of the disease process are different from psychological, social and spiritual aspects...
April 2018: Deutsche Medizinische Wochenschrift
Wendy Nicholls, Linda A Selvey, Craig Harper, Martin Persson, Suzanne Robinson
BACKGROUND: Management of a cleft of the lip and/or palate (CL/P) involves a multidisciplinary team approach lasting from birth to potentially postskeletal maturity. This condition is complex, with both medical and psychosocial implications that may place individuals with a cleft at higher risk of developing psychosocial problems. METHODOLOGY: A self-administered questionnaire was completed by a sample from the Western Australian cleft population comprising 3 age groups: child (n = 100), adolescent (n = 101), and adult (n = 158)...
January 1, 2018: Cleft Palate-craniofacial Journal
Holly Barone, Eli Eliav
No abstract text is available yet for this article.
2018: Quintessence International
Rita C Pessotti, Bridget L Hansen, Matthew F Traxler
Microbes occupy diverse habitats, forming interconnected, dynamic communities. Elucidating the principles of microbial community function is a grand challenge for microbiology, and it will entail experiments that engage microbiomes across multiple levels of complexity. For example, community-level hypotheses often require testing at the mechanistic and/or genetic levels, while mechanistic relationships require community-level evaluation to understand their importance in context. In this Perspective, we articulate the need for model microbiome systems that enable experimentation in both community and reductionist frameworks, with an emphasis on understanding the role of specialized metabolites in microbial communities...
March 2018: MSystems
Ryan M Mizumoto, Burak Yilmaz
STATEMENT OF PROBLEM: Intraoral scan body (ISB) design is highly variable and its role in the digital workflow and accuracy of digital impressions is not well understood. PURPOSE: The purpose of this systematic review was to determine the relevant reports pertaining to ISBs with regard to design and accuracy and to describe their evolution and role in the digital dentistry workflow. Special attention was placed on their key features in relation to intraoral scanning technology and the digitization process...
April 5, 2018: Journal of Prosthetic Dentistry
Marcos Caballero-Molada, María D Planes, Helena Benlloch, Sergio Atares, Miguel A Naranjo, Ramón Serrano
In eukaryotic cells amino acid biosynthesis is feedback inhibited by amino acids through inhibition of conserved protein kinase Gcn2. This decreases phosphorylation of initiation factor eIF2a resulting in general activation of translation but inhibition of translation of mRNA for transcription factor (TF) Gcn4 in yeast or ATF4 in mammals. These TFs are positive regulators of amino acid biosynthetic genes. As several enzymes of amino acid biosynthesis contain iron-sulfur clusters and iron excess is toxic, iron and amino acid homeostasis should be coordinated...
April 6, 2018: Biochemical Journal
Andréa D Furlan, Emma Irvin, Claire Munhall, Mario Giraldo-Prieto, Laura Fullerton, Robert McMaster, Shivang Danak, Alicia Costante, Kristen B Pitzul, Rohit P Bhide, Stanislav Marchenko, Quenby Mahood, Judy A David, John F Flannery, Mark Bayley
OBJECTIVE: To compare models of rehabilitation services for people with mental and/or physical disability in order to determine optimal models for therapy and interventions in low- to middle-income countries. DATA SOURCES: CINAHL, EMBASE, MEDLINE, CENTRAL, PsycINFO, Business Source Premier, HINARI, CEBHA and PubMed. STUDY SELECTION: Systematic reviews, randomized control trials and observational studies comparing >2 models of rehabilitation care in any language...
April 3, 2018: Journal of Rehabilitation Medicine
Rebecca Freilich, Taylor Arhar, Jennifer L Abrams, Jason E Gestwicki
Molecular chaperones play a central role in protein homeostasis (a.k.a. proteostasis) by balancing protein folding, quality control, and turnover. To perform these diverse tasks, chaperones need the malleability to bind nearly any "client" protein and the fidelity to detect when it is misfolded. Remarkably, these activities are carried out by only ∼180 dedicated chaperones in humans. How do a relatively small number of chaperones maintain cellular and organismal proteostasis for an entire proteome? Furthermore, once a chaperone binds a client, how does it "decide" what to do with it? One clue comes from observations that individual chaperones engage in protein-protein interactions (PPIs)-both with each other and with their clients...
April 3, 2018: Accounts of Chemical Research
Valentina Leandri, Quentin Daniel, Hong Chen, Licheng Sun, James M Gardner, Lars Kloo
The reaction of CuCl2 with 2,9-dimethyl-1,10-phenanthroline (dmp) does not lead to the formation of [Cu(dmp)2 ](Cl)2 but instead to [Cu(dmp)2 Cl]Cl, a 5-coordinated complex, in which one chloride is directly coordinated to the metal center. Attempts at removing the coordinated chloride by changing the counterion by metathesis were unsuccessful and resulted only in the exchange of the noncoordinated chloride, as confirmed from a crystal structure analysis. Complex [Cu(dmp)2 Cl]PF6 exhibits a reversible cyclic voltammogram characterized by a significant peak splitting between the reductive and oxidative waves (0...
April 2, 2018: Inorganic Chemistry
Gregory S Orf, Christopher Gisriel, Kevin E Redding
The proliferation of phototrophy within early-branching prokaryotes represented a significant step forward in metabolic evolution. All available evidence supports the hypothesis that the photosynthetic reaction center (RC)-the pigment-protein complex in which electromagnetic energy (i.e., photons of visible or near-infrared light) is converted to chemical energy usable by an organism-arose once in Earth's history. This event took place over 3 billion years ago and the basic architecture of the RC has diversified into the distinct versions that now exist...
March 30, 2018: Photosynthesis Research
Elisenda Feliu, Daniele Cappelletti, Carsten Wiuf
We introduce a unifying and generalizing framework for complex and detailed balanced steady states in chemical reaction network theory. To this end, we generalize the graph commonly used to represent a reaction network. Specifically, we introduce a graph, called a reaction graph, that has one edge for each reaction but potentially multiple nodes for each complex. A special class of steady states, called node balanced steady states, is naturally associated with such a reaction graph. We show that complex and detailed balanced steady states are special cases of node balanced steady states by choosing appropriate reaction graphs...
March 27, 2018: Mathematical Biosciences
Yanfen Chang, Atsushi Ebihara, Shugang Lu, Hongmei Liu, Harald Schneider
The Asplenium normale D. Don complex comprises several taxa that are either diploid or tetraploid. The tetraploids are assumed to have originated from diploid ancestors by relatively recent autopolyploidization or allopolyploidization. Some of the diploids are readily recognized morphologically but most of the taxa have until now been placed into a single species. However, phylogenetic studies have challenged this treatment and emphasized the notion that the taxonomic treatment of this complex needs to be revised...
March 29, 2018: Journal of Plant Research
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