Pediatric Resuscitation: Evaluation of a Clinical Curriculum

Objective: To assess the impact of a 6-hour pediatric resuscitation curriculum on the comfort levels of resident physicians’ evaluation and treatment of critically ill pediatric patients. Methods: An evaluation instrument assessed resident comfort levels, measured on a seven digit Likert scale ranging from significantly uncomfortable to significantly comfortable, in 13 areas of pediatric resuscitation. To complete the curriculum, residents had to demonstrate proficiency in knowledge and procedural skills during mock resuscitation scenarios and on both written and oral examinations. Results: Thirty-one residents participated in the study: 51.6% were pediatric, 12.9% were medicine/pediatric and 35.5% were emergency medicine residents. Participants in the curriculum had little previous experience with pediatric resuscitation (83% had been involved in five or fewer pediatric resuscitations). In all 13 areas of pediatric resuscitation tested, residents reported improvement in comfort levels following the course (p<0.002; Wilcoxon Signed Rank Tests). The most significant changes were observed for the following items: resuscitation of pulseless arrest, performance of cardioversion and defibrillation, performance of intraosseous needle insertion, and drug selection and dosing for rapid sequence intubation. Fewer than 48% of learners rated themselves as comfortable in these areas prior to training, but after completion, more than 80% rated themselves in the comfortable range. All residents but one received passing scores on their written examinations (97%). During the mock resuscitation scenarios and oral examination, 100% of the residents were assessed to have ‘completely’ met the learning objectives and critical actions Conclusion: Implementation of a pediatric resuscitation curriculum improves pediatric and emergency medicine residents’ comfort with the evaluation and treatment of critically ill pediatric patients. This curriculum can be used in residency training to document the acquisition of core competencies, knowledge and procedural skills needed for the evaluation and treatment of the critically ill child. The results reported in this study support using this model of instructional design to implement educational strategies, which will meet the requirements of graduate education

Attentional biases in eating disorders: a meta-analytic review of Stroop performance.

The Stroop task has been adapted from cognitive psychology to be able to examine attentional biases in various forms of psychopathology, including the eating disorders. This paper reviews the research on the Stroop task in the eating disorders research area in both descriptive and meta-analytic fashions. Twenty-eight empirical studies are identified, which predominantly examine food and body/weight stimuli in bulimic, anorexic, or dieting/food-restricted samples. It is concluded that there is evidence of an attentional bias in bulimia for a range of stimuli but that the effect seems to be limited to body/weight stimuli in anorexia. The evidence to date is that there is no attentional bias in dieting samples. Limitations of the methodology employed in the extant literature include small sample sizes, unstandardized Stroop methodology, restricted gender, and a general lack of consideration of individual differences variables. Recommendations for future research are provided

Cognitive and cognitive-behavioral therapies

In this chapter we will provide a brief review of some of the major historical forces that lead to the development of the cognitive behavioral therapies. We will then define what are the common characteristics among this increasingly diverse set of interventions, and in doing so also attempt to differentiate the cognitive-behavioral therapies from related approaches to psychotherapy. We will then turn our primary focus to a description of the major models within the cognitive-behavioral paradigm, and to discussing their current empirical status. The chapter will conclude with a discussion of current issues related to the cognitive-behavioral therapies, and with predictions and suggestions for the future development of the approach

Leishmania sexual reproductive strategies as resolved through computational methods designed for aneuploid genomes

A cryptic sexual reproductive cycle i

Larval Survival of Fuller's Rose Weevil, Naupactus cervinus, on Common Groundcover Species in Orchards of New Zealand Kiwifruit

Fuller's rose weevil, Naupactus cervinus (Boheman) (Curculionidae: Entiminae), is an important quarantine pest of New Zealand kiwifruit exported to Asian markets. Both adults and larvae are considered to be polyphagous. In this study, the survival of larval N. cervinus was estimated on common groundcover species of kiwifruit (Actinidia spp.) in the Bay of Plenty, the main region in New Zealand where kiwifruit is grown. The botanical composition of groundcover in commercial kiwifruit orchards, characterised by survey, was dominated by ryegrass (Lolium perenne), with white clover (Trifolium repens), creeping buttercup (Ranunculus repens), wild strawberry (Duchesnea indica) and broadleaf dock (Rumex obtusifolius) in lower abundance. Survival to mature larvae or adult was relatively low (·11%) for N. cervinus introduced as neonates to field plots or potted ryegrass, white clover and broadleaf dock. White clover was a more favourable host for survival to adults than ryegrass. This study suggests that increased survival of N. cervinus larvae may occur where white clover and large dock plants are abundant, but that survival is likely to be highly variable because of the heterogeneous availability of preferred host plants and host plant quality. These data suggest that larval polyphagy is a strategy that enables N. cervinus to persist at low densities in kiwifruit orchards despite variation in the quality and diversity of groundcover

Letters To The Editor.

No abstract available

Next generation organofluorine containing blockbuster drugs

Funding: the National Natural Science Foundation of China (No. 21761132021), the Hungarian Research Foundation (NKFIH No. K 119282), and Ministry of Human Capacities, Hungary grant 20391-3/2018/FEKUSTRAT. The Qinlan Project of Jiangsu Province, and IKERBASQUE, the Basque Foundation for Science are also acknowledged.The role of organo-fluorine compounds in modern health, food and energy related industries is widely-appreciated. The unique properties that fluorine imparts to organic molecules, stemming from its high electronegativity and stability when bound to carbon, finds it increasing being used in the development of new bioactivities. Around 25% of the current blockbuster drugs contain fluorine and this number is increasing to well above 30% for recent FDA approvals. In this Review we highlight a selection of the most successful organo-fluorine drugs, that have achieved blockbuster status, namely, sitagliptin (diabetes), sofosbuvir (hepatitis C), emtricitabine (HIV), glecaprevir/pibrentasvir (hepatitis C), elvitegravir (HIV), dolutegravir (HIV), bictegravir (HIV), efavirenz (HIV), enzalutamide (prostate cancer), aubagio (immunomodulatory) and paliperidone palmitate (schizophrenia). For each compound we discuss their discovery, their relevant disease state and how they are made, emphasizing the source of fluorine-containing moieties, and where known, their mode of action.PostprintPeer reviewe

Tractable non-local correlation density functionals for flat surfaces and slabs

A systematic approach for the construction of a density functional for van der Waals interactions that also accounts for saturation effects is described, i.e. one that is applicable at short distances. A very efficient method to calculate the resulting expressions in the case of flat surfaces, a method leading to an order reduction in computational complexity, is presented. Results for the interaction of two parallel jellium slabs are shown to agree with those of a recent RPA calculation (J.F. Dobson and J. Wang, Phys. Rev. Lett. 82, 2123 1999). The method is easy to use; its input consists of the electron density of the system, and we show that it can be successfully approximated by the electron densities of the interacting fragments. Results for the surface correlation energy of jellium compare very well with those of other studies. The correlation-interaction energy between two parallel jellia is calculated for all separations d, and substantial saturation effects are predicted.Comment: 10 pages, 6 figure

Structure of a single-chain Fv bound to the 17 N-terminal residues of huntingtin provides insights into pathogenic amyloid formation and suppression.

Huntington's disease is triggered by misfolding of fragments of mutant forms of the huntingtin protein (mHTT) with aberrant polyglutamine expansions. The C4 single-chain Fv antibody (scFv) binds to the first 17 residues of huntingtin [HTT(1-17)] and generates substantial protection against multiple phenotypic pathologies in situ and in vivo. We show in this paper that C4 scFv inhibits amyloid formation by exon1 fragments of huntingtin in vitro and elucidate the structural basis for this inhibition and protection by determining the crystal structure of the complex of C4 scFv and HTT(1-17). The peptide binds with residues 3-11 forming an amphipathic helix that makes contact with the antibody fragment in such a way that the hydrophobic face of this helix is shielded from the solvent. Residues 12-17 of the peptide are in an extended conformation and interact with the same region of another C4 scFv:HTT(1-17) complex in the asymmetric unit, resulting in a β-sheet interface within a dimeric C4 scFv:HTT(1-17) complex. The nature of this scFv-peptide complex was further explored in solution by high-resolution NMR and physicochemical analysis of species in solution. The results provide insights into the manner in which C4 scFv inhibits the aggregation of HTT, and hence into its therapeutic potential, and suggests a structural basis for the initial interactions that underlie the formation of disease-associated amyloid fibrils by HTT.E.D.G. and C.M.D. are grateful for support by the Medical Research Council (G1002272). We also thank the Hereditary Disease Foundation (A.M.). D.Y.C. is supported by the Crystallographic X-ray Facility at the Department of Biochemistry, University of Cambridge. We would like to acknowledge Dr. Katherine Stott at the Biophysics Facility at the Department of Biochemistry, University of Cambridge, for her help with the ultracentrifugation experiments and Prof. Weiss and Dr. Desplancq at the Ecole Supérieure de Biotechnologie de Strasbourg for the kind gift of the gankyrin-specific scFv, scFvR19 as a control for our in vitro aggregation experiments.This is the final published version. It first appeared at http://www.sciencedirect.com/science/article/pii/S002228361500217X#