Improving Handovers Between Emergency Department and In Patient Cardiac Units

https://digitalcommons.psjhealth.org/stvincent-bootcamp/1037/thumbnail.jp

Examining Antibody to Sin Nombre Virus in Rodents Associated with Peridomestic Habitats in North East Montana

Hantaviruses are rodent-borne pathogens that produce chronic persistent infections in their reservoir hosts.  Sin Nombre virus (SNV) is a type of hantavirus carried by deer mice (Peromyscus maniculatus).  Infected deer mice shed virus in urine, saliva, or feces, and human contact with the virus can lead to a serious illness called hantavirus cardiopulmonary syndrome. Most studies examining SNV in the rodent host have been conducted in natural settings where human contact with the virus is unlikely.  This study, performed in a peridomestic setting (in and around buildings), where contact with the virus is more likely, adds data to a previous study in west central Montana.  Mice were live trapped for 3 consecutive nights every two weeks from May to August 2014, at 2 sites in NE Montana.  Captured individuals were ear tagged,and species, body mass, sex, reproductive condition, presence of scars or wounds, and location of capture were recorded into a field journal.  Blood samples were collected from the retro-orbital sinus of each captured animal.  These blood samples were frozen until they could be analyzed.  Blood samples were analyzed for antibodies (IgM) to SNV.  Deer mice were the most common species captured at both study sites and antibody positive deer mice were detected at both study sites.  Antibody prevalence was found to be variable both spatially and temporally with highest prevalence in the middle of the summer

The Providence St. Vincent Emergency Department implementation of a standardized communication tool in patient’s rooms

https://digitalcommons.psjhealth.org/stvincent-bootcamp/1018/thumbnail.jp

PSVMC Nursing Reducing Anxiety With the Use of Aromatherapy Essential Oil Blends in Patients Awaiting Pre-scheduled Cesarean Section

https://digitalcommons.psjhealth.org/stvincent-bootcamp/1016/thumbnail.jp

Autistic and Schizotypal Traits and Global Functioning in Bipolar I Disorder

Objective: To determine the expression of autistic and positive schizotypal traits in a large sample of adults with bipolar I disorder (BD-I), and the effect of co-occurring autistic and positive schizotypal traits on global functioning in BD-I. Method: Autistic and positive schizotypal traits were self-assessed in 797 individuals with BD-I recruited by the Bipolar Disorder Research Network. Differences in global functioning (rated using the Global Assessment Scale) during lifetime worst depressive and manic episodes (GASD and GASM respectively) were calculated in groups with high/low autistic and positive schizotypal traits. Regression analyses assessed the interactive effect of autistic and positive schizotypal traits on global functioning. Results: 47.2% (CI=43.7-50.7%) showed clinically significant levels of autistic traits, and 23.22% (95% CI=20.29-26.14) showed clinically significant levels of positive schizotypal traits. In the worst episode of mania, the high autistic, high positive schizotypal group had better global functioning compared to the other groups. Individual differences analyses showed that high levels of co-occurring traits were associated with better global functioning in both mood states. Limitations: Autistic and schizotypal traits were assessed using self-rated questionnaires. Conclusions: Expression of autistic and schizotypal traits in adults with BD-I is prevalent, and may be important to predict illness aetiology, prognosis, and diagnostic practices in this population. Future work should focus on replicating these findings in independent samples, and on the biological and/or psychosocial mechanisms underlying better global functioning in those who have high levels of both autistic and positive schizotypal traits

Genome-wide association and Mendelian randomisation analysis provide insights into the pathogenesis of heart failure

Abstract: Heart failure (HF) is a leading cause of morbidity and mortality worldwide. A small proportion of HF cases are attributable to monogenic cardiomyopathies and existing genome-wide association studies (GWAS) have yielded only limited insights, leaving the observed heritability of HF largely unexplained. We report results from a GWAS meta-analysis of HF comprising 47,309 cases and 930,014 controls. Twelve independent variants at 11 genomic loci are associated with HF, all of which demonstrate one or more associations with coronary artery disease (CAD), atrial fibrillation, or reduced left ventricular function, suggesting shared genetic aetiology. Functional analysis of non-CAD-associated loci implicate genes involved in cardiac development (MYOZ1, SYNPO2L), protein homoeostasis (BAG3), and cellular senescence (CDKN1A). Mendelian randomisation analysis supports causal roles for several HF risk factors, and demonstrates CAD-independent effects for atrial fibrillation, body mass index, and hypertension. These findings extend our knowledge of the pathways underlying HF and may inform new therapeutic strategies

Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden

Stroke genetics informs drug discovery and risk prediction across ancestries

Previous genome-wide association studies (GWASs) of stroke — the second leading cause of death worldwide — were conducted predominantly in populations of European ancestry1,2. Here, in cross-ancestry GWAS meta-analyses of 110,182 patients who have had a stroke (five ancestries, 33% non-European) and 1,503,898 control individuals, we identify association signals for stroke and its subtypes at 89 (61 new) independent loci: 60 in primary inverse-variance-weighted analyses and 29 in secondary meta-regression and multitrait analyses. On the basis of internal cross-ancestry validation and an independent follow-up in 89,084 additional cases of stroke (30% non-European) and 1,013,843 control individuals, 87% of the primary stroke risk loci and 60% of the secondary stroke risk loci were replicated (P < 0.05). Effect sizes were highly correlated across ancestries. Cross-ancestry fine-mapping, in silico mutagenesis analysis3, and transcriptome-wide and proteome-wide association analyses revealed putative causal genes (such as SH3PXD2A and FURIN) and variants (such as at GRK5 and NOS3). Using a three-pronged approach4, we provide genetic evidence for putative drug effects, highlighting F11, KLKB1, PROC, GP1BA, LAMC2 and VCAM1 as possible targets, with drugs already under investigation for stroke for F11 and PROC. A polygenic score integrating cross-ancestry and ancestry-specific stroke GWASs with vascular-risk factor GWASs (integrative polygenic scores) strongly predicted ischaemic stroke in populations of European, East Asian and African ancestry5. Stroke genetic risk scores were predictive of ischaemic stroke independent of clinical risk factors in 52,600 clinical-trial participants with cardiometabolic disease. Our results provide insights to inform biology, reveal potential drug targets and derive genetic risk prediction tools across ancestries

Characterization of Stormwater Runoff in Residential Catchments

Engstrom will discuss stormwater runoff from residential catchments. She will describe a study that monitored natural drainage systems in Seattle. She will consider construction, performance, and application of knowledge toward future projects

Characterizing Water Quality of Urban Stormwater Runoff: Interactions of Heavy Metals and Solids in Seattle Residential Catchments

Stormwater quality and quantity were investigated in urbanized catchments in the Pipers Creek watershed in North Seattle in order to characterize existing rates and processes of stormwater runoff in areas of moderate-density residential development. Hydrologic monitoring and water-quality sampling during storm events were performed as part of this project from fall 2002 through spring 2004. Results of the sampling program indicate that concentrations of total and dissolved metals, total suspended solids, nutrients, total petroleum hydrocarbons, pesticides, herbicides, and E. coli and fecal coliform bacteria present in the runoff from these areas are significant, especially because they represent only a fraction of the total pollutant loading experienced by the receiving stream. Detailed analysis of heavy metal concentrations, total suspended solids concentrations, and concentrations of solids in the clay and silt size ranges has allowed for better understanding of how solids and metals interact in an urban stormwater environment. This research highlights the importance of mitigating the impacts that urban development has had on the runoff from these catchments, given the regional goal of improved instream aquatic conditions for native biota, particularly salmon. This research is part of the City of Seattle's Natural Drainage Systems project, which has been responsible for several stormwater management projects already constructed within the Pipers Creek watershed. As additional projects are implemented in the coming years, results from this research will allow for a comparison of pre- and post-improvement stormwater runoff conditions. This should document the effectiveness of these various stormwater management techniques on alleviating the effects of urbanization, both in the catchments themselves and on downstream natural systems