ICU Liberation: Early Mobility and Exercise

ICU Liberation: The Society of Critical Care Medicine’s (SCCM) Intensive Care Unit (ICU) Liberation Bundle was created to reduce the harmful effects of events that occur in the ICU setting. Early mobility and exercise is part “E” of the ICU Liberation Bundle; goals are to reduce ICU and hospital length of stay (LOS), prevent readmissions, reduce discharges to long term care facilities, reduce delirium and coma days, and reduce likelihood of hospital mortality (SCCM, 2021)https://digitalcommons.centracare.com/nursing_posters/1130/thumbnail.jp

Effects of Inhaled Brevetoxins in Allergic Airways: Toxin–Allergen Interactions and Pharmacologic Intervention

During a Florida red tide, brevetoxins produced by the dinoflagellate Karenia brevis become aerosolized and cause airway symptoms in humans, especially in those with pre-existing airway disease (e.g., asthma). To understand these toxin-induced airway effects, we used sheep with airway hypersensitivity to Ascaris suum antigen as a surrogate for asthmatic patients and studied changes in pulmonary airflow resistance (R(L)) after inhalation challenge with lysed cultures of K. brevis (crude brevetoxins). Studies were done without and with clinically available drugs to determine which might prevent/reverse these effects. Crude brevetoxins (20 breaths at 100 pg/mL; n = 5) increased R (L) 128 ± 6% (mean ± SE) over baseline. This bronchoconstriction was significantly reduced (% inhibition) after pretreatment with the glucocorticosteroid budesonide (49%), the β (2) adrenergic agent albuterol (71%), the anticholinergic agent atropine (58%), and the histamine H(1)-antagonist diphenhydramine (47%). The protection afforded by atropine and diphenhydramine suggests that both cholinergic (vagal) and H(1)-mediated pathways contribute to the bronchoconstriction. The response to cutaneous toxin injection was also histamine mediated. Thus, the airway and skin data support the hypothesis that toxin activates mast cells in vivo. Albuterol given immediately after toxin challenge rapidly reversed the bronchoconstriction. Toxin inhalation increased airway kinins, and the response to inhaled toxin was enhanced after allergen challenge. Both factors could contribute to the increased sensitivity of asthmatic patients to toxin exposure. We conclude that K. brevis aerosols are potent airway constrictors. Clinically available drugs may be used to prevent or provide therapeutic relief for affected individuals

A bio-plausible design for visual attitude stabilization

We consider the problem of attitude stabilization using exclusively visual sensory input, and we look for a solution which can satisfy the constraints of a "bio-plausible" computation. We obtain a PD controller which is a bilinear form of the goal image, and the current and delayed visual input. Moreover, this controller can be learned using classic neural networks algorithms. The structure of the resulting computation, derived from general principles by imposing a bilinear computation, has striking resemblances with existing models for visual information processing in insects (Reichardt Correlators and lobula plate tangential cells). We validate the algorithms using faithful simulations of the fruit fly visual input

Generating Caenorhabditis elegans UNC-33 antigens to be used for the Synthesis of Polyclonal Antibodies

UNC-33 and its human homolog, CRMP2 (Collapsin Response Mediator Protein-2), have been demonstrated to be involved in neurodevelopment as well as neurodegenerative disorders, primarily Alzheimer’s Disease. However, the physiology and interactions of these associations are vague. In order to further understand UNC-33/CRMP2, our group decided to use molecular biology and work toward the production of polyclonal antibodies specific to C. elegans UNC-33. To do this, we utilized the GST tag Gene Fusion System and produced two antigens- UNC-33 amino acid 48 to 212 and UNC-33 amino acid 48 to131 (UNC-3348-212 and UNC-3348-131). During this process, parameters were developed for the efficient expression and purification of these polypeptides. Once an effective protocol was established, GST fused UNC-3348-212 and UNC-3348-131 were expressed, purified, and tested for purity multiple times. Overall, these procedures resulted in the production of 3.72 mg and 2.10 mg of GST fused to UNC-3348-212 and GST fused to UNC-3348-131, respectively. Currently, these purified polypeptides are being injected into laboratory animals for the generation of polyclonal antibodies for UNC-33 research

Sirtuin-1 mediates the obesity induced risk of common degenerative diseases: Alzheimer\u27s disease, coronary artery disease and type 2 diabetes

Obesity, especially at mid-life, is a major risk factor for atherosclerosis, insulin resistance and the metabolic syndrome, which in turn contrib- ute to coronary artery disease (CAD), Type 2 diabetes and Alzheimer’s disease (AD). The rise in overweight and obesity in all societies is prompting intense research into the causes and effects of the condition. Obesity disrupts many body systems including glucose and lipid me- tabolism, circadian rhythms and liver function. It also causes or increases inflammation and oxi- dative stress. Within cells, the endoplasmic re- ticulum (ER) appears to be particularly suscep- tible to such metabolic disruption. Sirtuin 1 (Sirt1) and leptin have received attention recently as they are central regulatory factors for the body’s metabolic pathways which interact at particular levels, for example lipid and Abeta metabolism. This mini-review discusses recent findings con- cerning obesity, lipid metabolism and the role of Sirtuin 1 and how all influence the ER. A greater understanding of obesity and its effects on me- tabolic control systems of the body are required, to develop pharmacological, dietary and lifestyle changes that will reduce the incidence of CAD, Type 2 diabetes and AD

Patients’ and consumers’ perceptions of and involvement in safety and quality in Australian general practice

The importance of patient safety and quality research is renowned worldwide, but research outlining the interventions, intended outcomes, measurement and effectiveness are few and far between. Most of the research surrounding patient safety has focused on measurement and identifying what constitutes a risk, analysing, evaluating and managing risks effectively. Identifying practices and process of successful quality improvement can lead to effective results through greater understanding of the development, design and evaluation of complex interventions. Davidoff & Batalden (2005) point out that health care safety and quality research adds to scientific discovery and experiential learning, and that disseminating knowledge leads to better performance.However, there is still lack of relevant, timely, appropriate, accurate and transparent studies on this topic. Research on safety in primary care is just beginning to emerge as much of the literature has focussed on secondary care settings. Furthermore, research involving patients and carers is in its infancy and there has been a call to engage and partner with patients more effectively to improve the safety and quality of care they receive. Patients and carers have an important role to play when preventing errors and reducing harm. They have firsthand experience of their care, and are often able to provide detailed information about the processes, systems and structures that have led to the occurrence of an adverse event. Although there are many well-recognised benefits for involving patients to improve the safety of their care, there are still some unresolved contentions regarding the effectiveness of interventions, the roles and responsibilities for both patients and health professionals, and the kind of health care culture and organisational governance required for patient involvement in safety to occur successfully. A systematic review of the effectiveness of interventions designed to improve the delivery of patient centred care has shown that there are some promising approaches. This mainly includes improving patient education, health literacy, self-management skills, and capacity for making decisions, as well as developing partnerships with physicians, and contributing to safety and quality of care. There is also a growing evidence base centred on how health professionals can better support patient engagement in care. Patient involvement in health care has been proposed as a promising approach to achieving better quality of care, greater cost efficiency, and improved population health. Much of the literature on patient involvement in safety has focussed on partnering with patients to reduce harm in hospital settings. Hand hygiene interventions and speaking up campaigns dominate the evidence base in this area. However, research that has been conducted in general practice is scarce. A tool to measure patient involvement in decision making in general practice has been developed by Elwyn and collegues (2003), Sanders et al (2013) have found that interventions aiming to increase patient participation as a means to improve health outcomes in general practice are non-conclusive, and Flink et al (2012) have investigated patient activation during handover between primary and secondary care. Apart from these studies little else has been undertaken in this setting. To the authors knowledge only one study conducted in Australian general practice found that patient directed questioning improved information provision by physicians and patient involvement in safety. While there are some examples of partnering with patients to improve the safety of primary care, there is no evidence of how patients and carers view safety. Having an in depth understanding of patients and carers perceptions of safety is the starting point for designing and implementing effective and appropriate interventions that can help to reduce harm in the primary care setting.The research reported in this paper is a project of the Australian Primary Health Care Research Institute which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research Evaluation and Development Strategy

Field dynamics as context – a multi-perspective combined analysis of the effects of context on entrepreneurship.

Addressing the growing need for nuanced understandings of entrepreneurial contexts, this article presents a multifaceted pragmatic framework for scrutinising the ‘field of entrepreneurship’ and its associated dynamics. Drawing on Bourdieu's theory of practice and the institutional logics perspective, we introduce the concept of the field as a mid-level analytical lens—positioned between micro and macro perspectives—that captures the complex interplay of agency and structure in entrepreneurial activity. Our conceptualisation of the field enables the dissection of structural logics and actor dispositions, alongside the institutional processes that shape the entrepreneurial landscape. In response to calls for innovative methodologies in entrepreneurship research, we propose a combined analytical approach to unpack the layered complexities of entrepreneurial contexts, from individual actors to broader institutional influences. The utilisation of this ‘field of entrepreneurship’ concept, with a particular focus on field dynamics, serves as a pragmatic analytical unit, contributing to the broader discourse by balancing simplicity, accuracy, and generalisability. This research consequently offers a novel methodological avenue for exploring what facilitates or impedes entrepreneurial activity within varying contexts

Field dynamics as context – a multi-perspective combined analysis of the effects of context on entrepreneurship

Addressing the growing need for nuanced understandings of entrepreneurial contexts, this article presents a multifaceted pragmatic framework for scrutinising the ‘field of entrepreneurship’ and its associated dynamics. Drawing on Bourdieu's theory of practice and the institutional logics perspective, we introduce the concept of the field as a mid-level analytical lens—positioned between micro and macro perspectives—that captures the complex interplay of agency and structure in entrepreneurial activity. Our conceptualisation of the field enables the dissection of structural logics and actor dispositions, alongside the institutional processes that shape the entrepreneurial landscape. In response to calls for innovative methodologies in entrepreneurship research, we propose a combined analytical approach to unpack the layered complexities of entrepreneurial contexts, from individual actors to broader institutional influences. The utilisation of this ‘field of entrepreneurship’ concept, with a particular focus on field dynamics, serves as a pragmatic analytical unit, contributing to the broader discourse by balancing simplicity, accuracy, and generalisability. This research consequently offers a novel methodological avenue for exploring what facilitates or impedes entrepreneurial activity within varying contexts

Assessment and comparison of physician-reported staging using the AJCC staging system in Head and Neck Cancer

https://openworks.mdanderson.org/sumexp21/1183/thumbnail.jp