A Practice Improvement Project to Improve Knowledge and Perceptions of Palliative Care among Patients with Heart Failure and Cancer in the Acute Setting Using Video Enhanced Education

Background: Clear communication of the purpose and benefits of palliative care can reduce barriers to acceptance of such services for patients and families. The purpose of this practice improvement project was to assess and improve knowledge and perceptions of palliative care among patients with a diagnosis of heart failure and cancer in the acute setting using a video enhanced education intervention. Methods: This practice improvement project took place at a 555 bed teaching hospital. 18 patients referred to an inpatient palliative care consult service in the acute care setting with a diagnosis of either heart failure or cancer participated. Result: Paired sample t-tests were conducted to examine the effectiveness of the intervention in patients’ scores assessing level of palliative care awareness (Table 2). There was a significant positive difference in the scores for level of palliative care awareness before (M = 2.56, SD = 1.25) and after (M = 3.72, SD = 1.179) a five-minute video describing palliative care; t(17) = 3.82 p = .001. Discussion: Video interventions delivered at the point of care in the acute setting may be an effective tool for improving knowledge and perceptions of palliative care among patient with diagnoses of heart failure or cancer. Conclusion: The benefits of video education may be enhanced when delivered with the addition of face to face interaction by a member of the healthcare team versus a video self-administered by the patient. Further evaluation is needed

Regulatory networks and connected components of the neutral space

The functioning of a living cell is largely determined by the structure of its regulatory network, comprising non-linear interactions between regulatory genes. An important factor for the stability and evolvability of such regulatory systems is neutrality - typically a large number of alternative network structures give rise to the necessary dynamics. Here we study the discretized regulatory dynamics of the yeast cell cycle [Li et al., PNAS, 2004] and the set of networks capable of reproducing it, which we call functional. Among these, the empirical yeast wildtype network is close to optimal with respect to sparse wiring. Under point mutations, which establish or delete single interactions, the neutral space of functional networks is fragmented into 4.7 * 10^8 components. One of the smaller ones contains the wildtype network. On average, functional networks reachable from the wildtype by mutations are sparser, have higher noise resilience and fewer fixed point attractors as compared with networks outside of this wildtype component.Comment: 6 pages, 5 figure

Can\u27t You See? : You Were Made For Me

https://digitalcommons.library.umaine.edu/mmb-vp/3854/thumbnail.jp

Modelling time course gene expression data with finite mixtures of linear additive models

Summary: A model class of finite mixtures of linear additive models is presented. The component-specific parameters in the regression models are estimated using regularized likelihood methods. The advantages of the regularization are that (i) the pre-specified maximum degrees of freedom for the splines is less crucial than for unregularized estimation and that (ii) for each component individually a suitable degree of freedom is selected in an automatic way. The performance is evaluated in a simulation study with artificial data as well as on a yeast cell cycle dataset of gene expression levels over time

Heat Transfer Model of Hyporthermic Intracarotid Infusion of Cold Saline for Stroke Therapy

A 3-dimensional hemispheric computational brain model is developed to simulate infusion of cold saline in the carotid arteries in terms of brain cooling for stroke therapy. The model is based on the Pennes bioheat equation, with four tissue layers: white matter, gray matter, skull, and scalp. The stroke lesion is simulated by reducing blood flow to a selected volume of the brain by a factor of one-third, and brain metabolism by 50%. A stroke penumbra was also generated surrounding the core lesion (blood volume reduction 25%, metabolism reduction 20%). The finite difference method was employed to solve the system of partial differential equations. This model demonstrated a reduction in brain temperature, at the stroke lesion, to 32°C in less than 10 minutes

CALIBRATING LEGAL JUDGMENTS

Objective: to study the notion and essence of legal judgments calibration, the possibilities of using it in the law-enforcement activity; to explore the expenses and advantages of using it.Methods: dialectic approach to the cognition of social phenomena, which enables to analyze them in historical development and functioning in the context of the integrity of objective and subjective factors; it determined the choice of the following research methods: formal-legal, comparative legal, sociological, methods of cognitive psychology and philosophy.Results: In ordinary life, people who assess other people›s judgments typically take into account the other judgments of those they are assessing in order to calibrate the judgment presently being assessed. The restaurant and hotel rating website TripAdvisor is exemplary, because it facilitates calibration by providing access to a rater›s previous ratings. Such information allows a user to see whether a particular rating comes from a rater who is enthusiastic about every place she patronizes, or instead from someone who is incessantly hard to please. And even when less systematized, as in assessing a letter of recommendation or college transcript, calibration by recourse to the decisional history of those whose judgments are being assessed is ubiquitous. Yet despite the ubiquity and utility of such calibration, the legal system seems perversely to reject it. Appellate courts do not openly adjust their standard of review based on the previous judgments of the judge whose decision they are reviewing, nor do judges in reviewing legislative or administrative decisions, magistrates in evaluating search warrant representations, or jurors in assessing witness perception. In most legal domains, calibration by reference to the prior decisions of the reviewee is invisible, either because it does not exist or because reviewing bodies are unwilling to admit using what they in fact know and employ. Scientific novelty: for the first time, the work substantiates that law is reluctant to take account of the past decisions of the individuals and institutions they are reviewing. By looking only at the particular decision under review, and not calibrating the posture of review on the basis of a history of decisions, reviewing courts and other reviewing institutions embody the particularism that is a large part of the American legal tradition.Practical significance: the main provisions and conclusions of the article can be used in scientific and educational activity when viewing the issues of legal judgments calibration

Sequential Acquisition and Processing of Perfusion and Diffusion MRI Data for a Porcine Stroke Model

An automated data processing pipeline, designed for handling a large throughput of sequentially acquired MRI brain data, is described. The system takes as input multiple diffusion weighted (DWI) and perfusion weighted imaging (PWI) volumes acquired at different temporal points, automatically segments and registers them, and ultimately outputs a database used to track various perfusion and diffusion parameters through time at individual brain voxels. This pipeline has been utilized to successfully process two pig brains from an induced stroke experiment

Treatment of tumours with the combination of WR-2721 and cis-dichlorodiammineplatinum (II) or cyclophosphamide.

The ability of WR-2721 [S-2(3-aminopropylamino)ethyl-phosporothioic acid] to selectively protect the host against the toxic effects of multiple doses of cis-dichlorodiammineplatinum [cis-Pt] or cyclophosphamide [CY] has been studied in mice and rats bearing 3 different tumours. Selective protection against cis-Pt induced nephrotoxicity has been demonstrated under all conditions studied, with the extent of protection being inversely related to the size of the cis-Pt dose. For example, pre-treatment with 200 mg/kg of WR-2721 30 min before each weekly dose of 2 mg/kg of cis-Pt allows the administration of this cytotoxic agent for 3 times longer before nephrotoxic injury. In none of these studies was there tumour protection. The same pattern was observed with CY, but quantitation of the extent of marrow protection was not possible for the multiple treatment studies, due to the longer latent period between induced and observed death with this drug. We conclude, therefore, that for both of these drugs, selective protection of the kidney and marrow is not only maintained under conditions of multiple treatment, but actually enhanced due to the need for smaller doses of cytotoxic agents in these protocols

Non-Insertive Acupuncture and Neonatal Abstinence Syndrome: A Case Series from an Inner City Safety Net Hospital

OBJECTIVE: We report on the safety of non-insertive acupuncture (NIA) in 54 newborns diagnosed with Neonatal Abstinence Syndrome (NAS) in a busy inner city hospital. METHODS: For this case series, a retrospective chart review was conducted. Data on participant demographics, number of NIA treatments, provider referrals, and outcomes of interest (sleeping, feeding, and adverse events) were collected. RESULTS: Of the 54 newborns receiving NIA, 86% were non-Hispanic White; 87% were on Medicaid, and gestational age ranged from 33.2 to 42.1 weeks. Out of 54 chart reviews, a total of 92 NIA sessions were documented ranging from 1 to 6 sessions per infant. Of the total number of treatments (n = 92), 73% were requested by a physician. Chart reviews reported restless infants calmed down during NIA, babies slept through or fell asleep immediately following NIA, and better feeding was noted following NIA. There were no adverse events noted in the medical records. CONCLUSIONS: This retrospective chart review shows potential for the use of NIA as an adjunctive treatment in newborns with NAS symptoms during hospitalization. More research is necessary to study whether the incorporation of NIA can result in positive outcomes in newborns withdrawing from narcotics