219 research outputs found
Management Strategies in Cardiac Surgery for Postoperative Atrial Fibrillation: Contemporary Prophylaxis and Futuristic Anticoagulant Possibilities
With more than a third of patients expected to endure the arrhythmia at any given time point, atrial fibrillation after cardiac surgery becomes a vexing problem in the postoperative care of cardiac surgery patients. The impact on patient care covers a spectrum from the more common clinically insignificant sequelae to debilitating embolic events. Despite this, postoperative atrial fibrillation generally masquerades as being insignificant, or at most as an anticipated inherent risk, merely extending one's hospital stay by a few days. As an independent risk factor for stroke, early and late mortality, and being a multibillion dollar strain on the healthcare system annually, postoperative atrial fibrillation is far more flagrant than a mere inherent risk. It is a serious medical quandary, which is not recognized as such. Though complete prevention is unrealistic, a step-wise treatment strategy that incorporates multiple preventative modalities can significantly reduce the impact of postoperative atrial fibrillation on patient care. The aims of this review are to present a brief overview of the arrhythmia's etiology, risk factors, and preventative strategies to reduce associated morbidities. Newer anticoagulants and the potential role of these drugs on future treatment paradigms are also discussed
The Wick in the Candle of Learning: Epistemic Curiosity Activates Reward Circuitry and Enhances Memory
Curiosity has been described as a desire for
learning and knowledge, but its underlying mechanisms
are not well understood. We scanned subjects with functional
magnetic resonance imaging while they read trivia
questions. The level of curiosity when reading questions
was correlated with activity in caudate regions previously
suggested to be involved in anticipated reward. This
finding led to a behavioral study, which showed that subjects
spent more scarce resources (either limited tokens or
waiting time) to find out answers when they were more
curious. The functional imaging also showed that curiosity
increased activity in memory areas when subjects guessed
incorrectly, which suggests that curiosity may enhance
memory for surprising new information. This prediction
about memory enhancement was confirmed in a behavioral
study: Higher curiosity in an initial session was correlated
with better recall of surprising answers 1 to 2 weeks later
Ernst Freund as Precursor of the Rational Study of Corporate Law
Gindis, David, Ernst Freund as Precursor of the Rational Study of Corporate Law (October 27, 2017). Journal of Institutional Economics, Forthcoming. Available at SSRN: https://ssrn.com/abstract=2905547, doi: https://dx.doi.org/10.2139/ssrn.2905547The rise of large business corporations in the late 19th century compelled many American observers to admit that the nature of the corporation had yet to be understood. Published in this context, Ernst Freund's little-known The Legal Nature of Corporations (1897) was an original attempt to come to terms with a new legal and economic reality. But it can also be described, to paraphrase Oliver Wendell Holmes, as the earliest example of the rational study of corporate law. The paper shows that Freund had the intuitions of an institutional economist, and engaged in what today would be called comparative institutional analysis. Remarkably, his argument that the corporate form secures property against insider defection and against outsiders anticipated recent work on entity shielding and capital lock-in, and can be read as an early contribution to what today would be called the theory of the firm.Peer reviewe
Demonstration of quantum volume 64 on a superconducting quantum computing system
We improve the quality of quantum circuits on superconducting quantum
computing systems, as measured by the quantum volume, with a combination of
dynamical decoupling, compiler optimizations, shorter two-qubit gates, and
excited state promoted readout. This result shows that the path to larger
quantum volume systems requires the simultaneous increase of coherence, control
gate fidelities, measurement fidelities, and smarter software which takes into
account hardware details, thereby demonstrating the need to continue to
co-design the software and hardware stack for the foreseeable future.Comment: Fixed typo in author list. Added references [38], [49] and [52
Lipid analogs reveal features critical for hemolysis and diminish granadaene mediated Group B Streptococcus infection
Although certain microbial lipids are toxins, the structural features important for cytotoxicity
remain unknown. Increased functional understanding is essential for developing therapeutics
against toxic microbial lipids. Group B Streptococci (GBS) are bacteria associated with preterm
births, stillbirths, and severe infections in neonates and adults. GBS produce a pigmented,
cytotoxic lipid, known as granadaene. Despite its importance to all manifestations of
GBS disease, studies towards understanding granadaene’s toxic activity are hindered by its
instability and insolubility in purified form. Here, we report the synthesis and screening of
lipid derivatives inspired by granadaene, which reveal features central to toxin function,
namely the polyene chain length. Furthermore, we show that vaccination with a non-toxic
synthetic analog confers the production of antibodies that inhibit granadaene-mediated
hemolysis ex vivo and diminish GBS infection in vivo. This work provides unique structural
and functional insight into granadaene and a strategy to mitigate GBS infection, which will be
relevant to other toxic lipids encoded by human pathogens.This work was supported by funding from the National Institutes of Health
Grants R01AI112619, R01AI133976, R01AI100989, and R21AI125907 and seed funds
from Seattle Childrens Research Institute to L.
The Rapid ASKAP Continuum Survey I: Design and First Results
The Rapid ASKAP Continuum Survey (RACS) is the first large-area survey to be
conducted with the full 36-antenna Australian Square Kilometre Array Pathfinder
(ASKAP) telescope. RACS will provide a shallow model of the ASKAP sky that will
aid the calibration of future deep ASKAP surveys. RACS will cover the whole sky
visible from the ASKAP site in Western Australia, and will cover the full ASKAP
band of MHz. The RACS images are generally deeper than the existing
NRAO VLA Sky Survey (NVSS) and Sydney University Molonglo Sky Survey (SUMSS)
radio surveys and have better spatial resolution. All RACS survey products will
be public, including radio images (with arcsecond resolution) and
catalogues of about three million source components with spectral index and
polarisation information. In this paper, we present a description of the RACS
survey and the first data release of 903 images covering the sky south of
declination made over a 288 MHz band centred at 887.5 MHz.Comment: 24 pages, 17 figures, 4 tables. For associated data see
https://data.csiro.au/collections/domain/casdaObservation/results/PRAS110%20-%20The%20Rapid%20ASKAP%20Continuu
Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups
BACKGROUND: Conventional systematic review techniques have limitations when the aim of a review is to construct a critical analysis of a complex body of literature. This article offers a reflexive account of an attempt to conduct an interpretive review of the literature on access to healthcare by vulnerable groups in the UK METHODS: This project involved the development and use of the method of Critical Interpretive Synthesis (CIS). This approach is sensitised to the processes of conventional systematic review methodology and draws on recent advances in methods for interpretive synthesis. RESULTS: Many analyses of equity of access have rested on measures of utilisation of health services, but these are problematic both methodologically and conceptually. A more useful means of understanding access is offered by the synthetic construct of candidacy. Candidacy describes how people's eligibility for healthcare is determined between themselves and health services. It is a continually negotiated property of individuals, subject to multiple influences arising both from people and their social contexts and from macro-level influences on allocation of resources and configuration of services. Health services are continually constituting and seeking to define the appropriate objects of medical attention and intervention, while at the same time people are engaged in constituting and defining what they understand to be the appropriate objects of medical attention and intervention. Access represents a dynamic interplay between these simultaneous, iterative and mutually reinforcing processes. By attending to how vulnerabilities arise in relation to candidacy, the phenomenon of access can be better understood, and more appropriate recommendations made for policy, practice and future research. DISCUSSION: By innovating with existing methods for interpretive synthesis, it was possible to produce not only new methods for conducting what we have termed critical interpretive synthesis, but also a new theoretical conceptualisation of access to healthcare. This theoretical account of access is distinct from models already extant in the literature, and is the result of combining diverse constructs and evidence into a coherent whole. Both the method and the model should be evaluated in other contexts
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