Heart Failure with Reduced Ejection Fraction

Heart failure (HF) is a complex disease the requires a high-level understanding of pathophysiology and physics. Heart failure is an umbrella term with multiple subsets beneath it. Heart failure with reduced ejection fraction relates to a failing left ventricle with an ejection fraction (EF) of less than 40%. Inability to push fluid forward causes the heart rate to increase, neurohormonal changes and creates a backup of flow into the lungs creating dyspnea. Applied physics plays a large role in understand heart failure. Frank-starling’s curve, Ohm’s, Poiseulle’s and Laplace’s laws all apply to the physiological principles behind preload, afterload, and contractility. Medications continue to improve side effects however the gold standard in treatment is a heart transplant. Nurses need to have a full understanding of hemodynamics, physics, and pathophysiology of heart failure in order to recognize and intervene with deteriorating heart failure conditions. Heart failure is never going to be eradicated; however, the understanding of the disease process, prescribed treatments, and interventions need to continue to improve to save more lives. Keywords: Heart Failure with Reduced EF, pathophysiology of heart failure, physics in heart failure, HFrEF, Left sided Heart failur

Standardized Handoffs For Anesthesia Students

Communication between healthcare providers is an essential aspect of caring for patients. Effective communication is vital during the patient handoff process. The patient handoff process involves exchanging patient’s medical information between a provider currently caring for the patient and the provider assuming care of the patient. If the information exchanged during the handoff process is inaccurate or essential information is omitted, that could potentially lead to harmful consequences for the patient. Currently, no standardized handoff tool exists for student registered nurse anesthesia students (SRNAs) in clinical practicum at the local level one trauma center. The lack of a standardized handoff tool at this facility suggests an increased likelihood of communication errors during the handoff process. The purpose of this quality improvement project is to implement a standardized handoff tool called the AneSBAR tool that SRNA students can utilize in their practice to ensure proper and effective handoffs in the post-anesthesia care unit (PACU) and the intensive care unit (ICU). The inclusion criteria for the project are 2nd or 3rd-year SRNA students currently enrolled full-time in the local Certified Registered Nurse Anesthetist (CRNA) program. The quality improvement project will follow a Plan-Do-Study-Act (PDSA) model. Both qualitative and quantitative data will be collected to determine the impact of the standardized handoff tool. Data collected from surveys and simulations will determine if the PDSA cycle needs repeated or if the QI measure is ready for implementation

Actin cytoskeleton: Setting the pace of cell movement

AbstractEukaryotic cells have many proteins that cap the barbed ends of actin filaments. Manipulation of their cellular concentration leads to changes in cell motility rates, actin dynamics and signal transduction reactions

Ionization Chambers for Radioactivity Oil Well Logging

Electrical Engineerin

α-Adducin dissociates from F-actin and spectrin during platelet activation

Aspectrin-based skeleton uniformly underlies and supports the plasma membrane of the resting platelet, but remodels and centralizes in the activated platelet. α-Adducin, a phosphoprotein that forms a ternary complex with F-actin and spectrin, is dephosphorylated and mostly bound to spectrin in the membrane skeleton of the resting platelet at sites where actin filaments attach to the ends of spectrin molecules. Platelets activated through protease-activated receptor 1, FcγRIIA, or by treatment with PMA phosphorylate adducin at Ser726. Phosphoadducin releases from the membrane skeleton concomitant with its dissociation from spectrin and actin. Inhibition of PKC blunts adducin phosphorylation and release from spectrin and actin, preventing the centralization of spectrin that normally follows cell activation. We conclude that adducin targets actin filament ends to spectrin to complete the assembly of the resting membrane skeleton. Dissociation of phosphoadducin releases spectrin from actin, facilitating centralization of spectrin, and leads to the exposure of barbed actin filament ends that may then participate in converting the resting platelet's disc shape into its active form