Kompetenzen und Aufgabenbereiche von Advanced Practice Nurses auf der Notfallstation : ein Internationaler Literaturreview

Aufgrund von demografischen Veränderungen hin zu mehr älteren multimorbideren Menschen in der Schweiz, sowie einem zunehmenden Anstieg an Notfallkonsultationen, bedarf es der Definition von Kompetenzen und Aufgabenbereichen von Advanced Practice Nurses (APNs) auf Schweizer Notfallstationen. Dies fordern Gesundheitsfachpersonen, sowie das Bundesamt für Gesundheit, um weiterhin eine hohe Versorgungsqualität im Schweizer Gesundheitssystem gewährleisten zu können. Daraus ergibt sich folgende Fragestellung: Welche weltweiten Kompetenzen und Aufgabenbereiche haben Advanced Practice Nurses in Notfallstationen? Das Ziel dieser Bachelorarbeit ist es, weltweite Kompetenzen und Aufgabenbereiche von APNs in Notfallstationen zu identifizieren und daraus einen Praxistransfer für Schweizer Notfallstationen abzuleiten. Die systematische Literaturrecherche wird in den Datenbanken CINAHL, Cochrane und PubMed durchgeführt und die Ergebnisse im Rahmen des APN-Modells von Ann Hamric illustriert. Die Ergebnisse der inkludierten Studien zeigen, dass die Hauptkompetenzen und Aufgabenbereiche von APNs im Bereich der Triage, des klinischen Assessments, im Medikamentenverordnen und im Austrittsmanagement angesiedelt sind

Effect of Neutralizing Monoclonal Antibody Treatment on Early Trajectories of Virologic and Immunologic Biomarkers in Patients Hospitalized With COVID-19

BACKGROUND: Neutralizing monoclonal antibodies (nmAbs) failed to show clear benefit for hospitalized patients with coronavirus disease 2019 (COVID-19). Dynamics of virologic and immunologic biomarkers remain poorly understood. METHODS: Participants enrolled in the Therapeutics for Inpatients with COVID-19 trials were randomized to nmAb versus placebo. Longitudinal differences between treatment and placebo groups in levels of plasma nucleocapsid antigen (N-Ag), anti-nucleocapsid antibody, C-reactive protein, interleukin-6, and D-dimer at enrollment, day 1, 3, and 5 were estimated using linear mixed models. A 7-point pulmonary ordinal scale assessed at day 5 was compared using proportional odds models. RESULTS: Analysis included 2149 participants enrolled between August 2020 and September 2021. Treatment resulted in 20% lower levels of plasma N-Ag compared with placebo (95% confidence interval, 12%-27%; P \u3c .001), and a steeper rate of decline through the first 5 days (P \u3c .001). The treatment difference did not vary between subgroups, and no difference was observed in trajectories of other biomarkers or the day 5 pulmonary ordinal scale. CONCLUSIONS: Our study suggests that nmAb has an antiviral effect assessed by plasma N-Ag among hospitalized patients with COVID-19, with no blunting of the endogenous anti-nucleocapsid antibody response. No effect on systemic inflammation or day 5 clinical status was observed. CLINICAL TRIALS REGISTRATION: NCT04501978

A novel interaction between complement inhibitor C4b-binding protein and plasminogen that enhances plasminogen activation.

The complement, coagulation and fibrinolytic systems are crucial for the maintenance of tissue homeostasis. To date numerous interactions and cross talks have been identified between these cascades. In line with this, here we propose a novel, hitherto unknown interaction between the complement inhibitor C4b-binding protein (C4BP) and plasminogen of the fibrinolytic pathway. Binding of C4BP to S. pneumoniae is a known virulence mechanism of this pathogen and it was increased in the presence of plasminogen. Interestingly, the acute phase variant of C4BP lacking the β-chain and protein S binds plasminogen much stronger than the main isoform containing the β-chain and protein S. Indeed, the complement control protein (CCP) 8 domain of C4BP, which would otherwise be sterically hindered by the β-chain, primarily mediates this interaction. Moreover, the lysine-binding sites in plasminogen kringle domains facilitate the C4BP-plasminogen interaction. Furthermore, C4BP readily forms complexes with plasminogen in fluid phase and such complexes are present in human serum and plasma. Importantly, while the presence of plasminogen did not affect the factor I cofactor activity of C4BP, the activation of plasminogen by urokinase-type plasminogen activator to active plasmin was significantly augmented in the presence of C4BP. Taken together, our data demonstrate a novel interaction between two proteins of the complement and fibrinolytic system. Most complexes might be formed during the acute phase of inflammation and have an effect on the homeostasis at the site of injury or acute inflammation

EVI1 Promotes the Proliferation and Invasive Properties of Human Head and Neck Squamous Cell Carcinoma Cells

Head and neck squamous cell carcinoma (HNSCC) is a frequent malignancy with a poor prognosis. So far, the EGFR inhibitor cetuximab is the only approved targeted therapy. A deeper understanding of the molecular and genetic basis of HNSCC is needed to identify additional targets for rationally designed, personalized therapeutics. The transcription factor EVI1, the major product of the MECOM locus, is an oncoprotein with roles in both hematological and solid tumors. In HNSCC, high EVI1 expression was associated with an increased propensity to form lymph node metastases, but its effects in this tumor entity have not yet been determined experimentally. We therefore overexpressed or knocked down EVI1 in several HNSCC cell lines and determined the impact of these manipulations on parameters relevant to tumor growth and invasiveness, and on gene expression patterns. Our results revealed that EVI1 promoted the proliferation and migration of HNSCC cells. Furthermore, it augmented tumor spheroid formation and the ability of tumor spheroids to displace an endothelial cell layer. Finally, EVI1 altered the expression of numerous genes in HNSCC cells, which were enriched for Gene Ontology terms related to its cellular functions. In summary, EVI1 represents a novel oncogene in HNSCC that contributes to cellular proliferation and invasiveness

Generation and characterization of native and sialic acid-deficient IgE

Efficient characterization of IgE antibodies and their glycan structures is required for understanding their function in allergy and in the emerging AllergoOncology field for antibody immunotherapy. We report the generation, glyco-profiling and functional analysis of native and sialic acid-deficient glyco-engineered human IgE. The antibodies produced from human embryonic kidney cells were purified via a human IgE class-specific affinity matrix and structural integrity was confirmed by SDS-PAGE and size-exclusion chromatography (SEC). Purified IgEs specific for the tumor-associated antigens Chondroitin Sulfate Proteoglycan 4 (CSPG4-IgE) and Human Epidermal Growth Factor Receptor 2 (HER2-IgE) were devoid of by-products such as free light chains. Using neuraminidase-A, we generated sialic acid-deficient CSPG4-IgE as example glyco-engineered antibody. Comparative glycan analyses of native and glyco-engineered IgEs by Hydrophilic interaction liquid chromatography (HILIC)-high performance liquid chromatography (HPLC) indicated loss of sialic acid terminal residues and differential glycan profiles. Native and glyco-engineered CSPG4-IgEs recognized Fc receptors on the surface of human FcεRI-expressing rat basophilic leukemia RBL-SX38 cells, and of CD23/FcεRII-expressing human RPMI-8866 B-lymphocytes and bound to CSPG4-expressing A2058 human melanoma cells, confirming Fab-mediated recognition. When cross-linked on the cell surface, both IgEs triggered RBL-SX38 degranulation. We demonstrate efficient generation and functional competence of recombinant native and sialic acid-deficient IgEs

Kinship and Social Security (KASS)

To work with this survey you need to visit our Secure Data Center in Cologne, Germany (unless you are a former member of the KASS research team, in which case special rules apply)! Family structures, kinship networks, general circumstances of life and patterns of mutual support. Income; intra-family transfer benefits. Practical support from state and officially supported social insurance. Topics: recording of the genealogical links of all relatives by descent or marriage, including deceased ancestors and distant links through descent or marriage. For each member of the network the following information was asked: place of birth and current residence, economic situation, level of education, general state of health, an indicator of living standard. Similar information on the respondents themselves, including their own economic and health situation, information on the frequency and type of social contacts with each member of the network of known kin (including ritual relations such as godparenthood). Information on the scope and network of support relations, help for third parties, or of help persons themselves received from members of the network of friends and kin; specific information on the type of help, e.g. help with shopping, childcare, leaving an inheritance, covering health or education costs. Similar information was asked on neighbours and friends, with whom the respondents had support relations. For major items of support, help patterns were recorded for the entire life. The influence of parents and relatives and friends on decisions concerning the choice of life partners and family size planning.Diese Studie kann nur vor Ort in unserem Secure Data Center in Köln bearbeitet werden! (Für ehemalige Mitglieder des KASS Forschungsteams gibt es eine eigene Regelung.) Familienformen, Verwandtschaftsnetzwerke. Allgemeine Lebensumstände und Muster der gegenseitigen Unterstützung. Einkommen; Innerfamiliäre Transferleistungen. Praktische Unterstützung von staatlichen und offiziel anerkannten Versicherungen. Themen: Erfassung von genealogischen Verbindungen von allen Verwandten durch Abstammung oder Heirat, darunter nicht mehr lebende Vorfahren und entfernte Verbindungen durch Abstammung oder Heirat. Für jedes Mitglied in diesem Netzwerk wurde erfragt: Geburtsort und derzeitiger Wohnort, wirtschaftliche Lage, Bildungsniveau, allgemeiner Gesundheitszustand, Indikator des Lebensstandards. Ähnliche Informationen über die Befragten selbst, einschließlich der eigenen wirtschaftlichen und gesundheitlichen Umstände, Informationen über die Häufigkeit und Art der sozialen Kontakte mit jedem Mitglied des Netzes der bekannten Verwandten (darunter rituelle Beziehungen wie Patenschaften). Informationen über Umfang und Geflecht helfender Beziehungen, Hilfe für Dritte oder selbst empfangene Hilfe von Mitgliedern des Netzwerks von Bekannten und Verwandten; konkrete Angabe der Arten von Hilfe, z.B. Hilfe beim Einkaufen, Kinderbetreuung, Hinterlassen eines Vermächtnisses, die Zahlung von Gesundheitskosten oder Bildungskosten. Vergleichbare Informationen wurden erfragt über Nachbarn und Freunde, mit denen der Befragte helfende Beziehungen hat. Bei wesentlichen Unterstützungsleistungen wurde das Muster der Hilfe über das ganze Leben erfasst. Die Rolle der Eltern und von Verwandten und Freunden bei Entscheidungen über die Auswahl der Partner und die Planung der Familiengröße