An Open-Access Review to Determine Best Evidence-Based Practice for COPD

Background: The manifestation of Chronic Obstructive Pulmonary Disease (COPD) can have an enormous impact on individuals’ areas of occupation, specifically activities of daily living. Occupational therapy (OT) practitioners have the ability to efficiently treat these clients using evidence-based interventions to achieve optimal functioning and quality of life. The purpose of this research study was to identify specific interventions supported by evidence for consumers with COPD using an open-access database for OT. Method: A thematic synthesis of 102 articles available on COPD via the open-access database OTseeker was used in this study. A constant comparison approach revealed seven descriptive themes for intervention including exercise, education, self-management, cognitive-behavioral therapy, complementary and alternative medicine therapy, breathing technique training, and nutrition. Results: For each theme, sub-themes were discussed and components of effective interventions were identified. Aspects of an evidence-based intervention program for individuals with COPD were outlined. Conclusion: Occupational therapists can use this evidence to thoroughly design well-rounded effective evidence-based intervention programs to enable individuals with COPD to live life to its fullest

Men's perceptions of the impact of the physical consequences of radical prostatectomy on their quality of life: a qualitative systematic review protocol

The objective of this review is to explore men’s perceptions of the impact of the physical consequences of radical prostatectomy on their quality of lif

Enhancing the clinical supervision experience of staff members working within primary and community care: a best practice implementation project

Objectives: The project aimed to assess compliance with evidence-based criteria regarding the use of clinical supervision amongst district nurses and to improve knowledge and engagement in clinical supervision activities within the workplace. Introduction: It is important to provide clinical support to all healthcare workers that provide opportunities to develop and be listened to in a supervised environment. Clinical supervision is seen as a key element to provide this support. It provides a professional working relationship between two or more members of staff where the reflection of practice and personal emotion can be discussed, which is outlined in many policies and guidelines. Methods: A baseline audit was carried out using the JBI Practical Application of Clinical Evidence System program involving 16 participants in one district nursing team in South Wales. The first step involved the development of the project and generating the evidence. Following this, a baseline audit was conducted, and educational training on clinical supervision was undertaken followed by clinical supervision sessions. A postimplementation re-audit was conducted following implementation. Results: A total of 16 participants enrolled on the project. Receiving basic training and participating in clinical supervision was much higher than the baseline audit with both increasing to 100% compliance. Furthermore, 94% of participants were aware of clinical supervision activities and 88% knew of existing records on clinical supervision. The project results show a large increase in compliance with all of the criteria. Conclusion: Overall the implementation project achieved an improvement in evidence-based practice regarding clinical supervision in primary care

Development of a Human Physiologically Based Pharmacokinetic (PBPK) Toolkit for Environmental Pollutants

Physiologically Based Pharmacokinetic (PBPK) models can be used to determine the internal dose and strengthen exposure assessment. Many PBPK models are available, but they are not easily accessible for field use. The Agency for Toxic Substances and Disease Registry (ATSDR) has conducted translational research to develop a human PBPK model toolkit by recoding published PBPK models. This toolkit, when fully developed, will provide a platform that consists of a series of priority PBPK models of environmental pollutants. Presented here is work on recoded PBPK models for volatile organic compounds (VOCs) and metals. Good agreement was generally obtained between the original and the recoded models. This toolkit will be available for ATSDR scientists and public health assessors to perform simulations of exposures from contaminated environmental media at sites of concern and to help interpret biomonitoring data. It can be used as screening tools that can provide useful information for the protection of the public

The use of ketamine as an antidepressant: : A systematic review and meta-analysis

This is the peer reviewed version of the following article: Caoimhe M. Coyle, and Keith R. Laws, ‘The use of ketamine as an antidepressant: a systematic review and meta-analysis’, Human Psychopharmacology, Vol. 30 (3): 152-163, May 2015, which has been published in final form at https://doi.org/10.1002/hup.2475. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.Objective The current meta-analysis examines the effects of ketamine infusion on depressive symptoms over time in major depressive disorder (MDD) and bipolar disorder (BD). Methods Following a systematic review of the literature, data were extracted from 21 studies (n = 437 receiving ketamine) and analysed at four post-infusion time points (4 h, 24 h, 7 days and 12-14 days). The moderating effects of several factors were assessed including: repeat/single infusion, diagnosis, open-label/participant-blind infusion, pre-post/placebo-controlled design and the sex of patients. Results Effect sizes were significantly larger for repeat than single infusion at 4 h, 24 h and 7 days. For single infusion studies, effect sizes were large and significant at 4 h, 24 h and 7 days. The percentage of males was a predictor of antidepressant response at 7 days. Effect sizes for open-label and participant-blind infusions were not significantly different at any time point. Conclusions Single ketamine infusions elicit a significant antidepressant effect from 4 h to 7 days; the small number of studies at 12-14 days post infusion failed to reach significance. Results suggest a discrepancy in peak response time depending upon primary diagnosis - 24 h for MDD and 7 days for BD. The majority of published studies have used pre-post comparison; further placebo-controlled studies would help to clarify the effect of ketamine over time.Peer reviewedFinal Accepted Versio

Local Sensitivity Analysis of Kinetic Models for Cellulose Pyrolysis

Abstract: The first and nth order kinetic models are usually used to describe cellulose pyrolysis. In this work, the local sensitivities of the conversion and derivative conversion with respect to the frequency factor, the logarithm of the frequency factor, the activation energy and the reaction order for the first and nth order kinetic models are calculated by using the finite difference method. The results show that the sensitivities of the first and nth order kinetic models with respect to the activation energy and the logarithm of the frequency factor are significant, while the frequency factor and the reaction order affect the nth order kinetic model slightly. Compared with the frequency factor, the natural logarithm of the frequency factor is a better choice in the parameter estimation of the first and nth order kinetic models. Graphical Abstract: [Figure not available: see fulltext.

American Society of Hematology 2021 guidelines for management of venous thromboembolism: prevention and treatment in patients with cancer

Background: Venous thromboembolism (VTE) is a common complication among patients with cancer. Patients with cancer and VTE are at a markedly increased risk for morbidity and mortality. Objective: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in their decisions about the prevention and treatment of VTE in patients with cancer. Methods: ASH formed a multidisciplinary guideline panel balanced to minimize potential bias from conflicts of interest. The guideline development process was supported by updated or new systematic evidence reviews. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess evidence and make recommendations. Results: Recommendations address mechanical and pharmacological prophylaxis in hospitalized medical patients with cancer, those undergoing a surgical procedure, and ambulatory patients receiving cancer chemotherapy. The recommendations also address the use of anticoagulation for the initial, short-term, and long-term treatment of VTE in patients with cancer. Conclusions: Strong recommendations include not using thromboprophylaxis in ambulatory patients receiving cancer chemotherapy at low risk of VTE and to use low-molecular-weight heparin (LMWH) for initial treatment of VTE in patients with cancer. Conditional recommendations include using thromboprophylaxis in hospitalized medical patients with cancer, LMWH or fondaparinux for surgical patients with cancer, LMWH or direct oral anticoagulants (DOAC) in ambulatory patients with cancer receiving systemic therapy at high risk of VTE and LMWH or DOAC for initial treatment of VTE, DOAC for the short-term treatment of VTE, and LMWH or DOAC for the long-term treatment of VTE in patients with cancer

The radius and other fundamental parameters of the F9 V star beta Virginis

We have used the Sydney University Stellar Interferometer (SUSI) to measure the angular diameter of the F9 V star beta Virginis. After correcting for limb darkening and combining with the revised Hipparcos parallax, we derive a radius of 1.703 +/- 0.022 R_sun (1.3%). We have also calculated the bolometric flux from published measurements which, combined with the angular diameter, implies an effective temperature of 6059 +/- 49 K (0.8%). We also derived the luminosity of beta Vir to be L = 3.51 +/- 0.08 L_sun (2.1%). Solar-like oscillations were measured in this star by Carrier et al. (2005) and using their value for the large frequency separation yields the mean stellar density with an uncertainty of about 2%. Our constraints on the fundamental parameters of beta Vir will be important to test theoretical models of this star and its oscillations.Comment: accepted for publication in MNRAS. Updated reference

A Guide to Conscious Editing at Wilson Special Collections Library

This is the final version of The Guide to Conscious Editing for Wilson Special Collections Library. The work was created by the Conscious Editing Steering Committee for the University Libraries of the University of North Carolina at Chapel Hill. Between September 2019 and April 2022, more than twenty archivists, librarians, and humanities scholars contributed to the Guide

HNF4alpha Dysfunction as a Molecular Rational for Cyclosporine Induced Hypertension

Induction of tolerance against grafted organs is achieved by the immunosuppressive agent cyclosporine, a prominent member of the calcineurin inhibitors. Unfortunately, its lifetime use is associated with hypertension and nephrotoxicity. Several mechanism for cyclosporine induced hypertension have been proposed, i.e. activation of the sympathetic nervous system, endothelin-mediated systemic vasoconstriction, impaired vasodilatation secondary to reduction in prostaglandin and nitric oxide, altered cytosolic calcium translocation, and activation of the renin-angiotensin system (RAS). In this regard the molecular basis for undue RAS activation and an increased signaling of the vasoactive oligopeptide angiotensin II (AngII) remain elusive. Notably, angiotensinogen (AGT) is the precursor of AngII and transcriptional regulation of AGT is controlled by the hepatic nuclear factor HNF4alpha. To better understand the molecular events associated with cyclosporine induced hypertension, we investigated the effect of cyclosporine on HNF4alpha expression and activity and searched for novel HNF4alpha target genes among members of the RAS cascade. Using bioinformatic algorithm and EMSA bandshift assays we identified angiotensin II receptor type 1 (AGTR1), angiotensin I converting enzyme (ACE), and angiotensin I converting enzyme 2 (ACE2) as genes targeted by HNF4alpha. Notably, cyclosporine represses HNF4alpha gene and protein expression and its DNA-binding activity at consensus sequences to AGT, AGTR1, ACE, and ACE2. Consequently, the gene expression of AGT, AGTR1, and ACE2 was significantly reduced as evidenced by quantitative real-time RT-PCR. While RAS is composed of a sophisticated interplay between multiple factors we propose a decrease of ACE2 to enforce AngII signaling via AGTR1 to ultimately result in vasoconstriction and hypertension. Taken collectively we demonstrate cyclosporine to repress HNF4alpha activity through calcineurin inhibitor mediated inhibition of nuclear factor of activation of T-cells (NFAT) which in turn represses HNF4alpha that leads to a disturbed balance of RAS