5,566 research outputs found
Role and Importance of Alfalfa in WKU Teaching/Research/Farm Programs
Alfalfa is the oldest and most widely grown forage legume in the world and in Kentucky, where approximately 250,000 acres are produced. It has gained this top position through producing forage suitable for most classes of livestock, by being drought tolerant, and by fixing atmosphere nitrogen
ROCURONIUM-INDUCED ANAPHYLAXIS: ANY EVIDENCE FOR SUGAMMADEX?
INTRODUCTION: Anaphylaxis during general anesthesia is estimated to occur around 1 in 3,500 cases. 90% of these cases occur at induction of anesthesia. Neuromuscular blocking drugs are thought to be the most responsible trigger, with Rocuronium being the most implicated drug. Sugammadex is a synthetic modified gamma-cyclodextrin derivative that will incompletely encapsulate Rocuronium, preventing the rocuronium epitope from binding IgE; hence it was thought that its use could decrease anaphylaxis severity. The use of sugammadex in suspected rocuronium-induced anaphylaxis (RIA) is based on personal opinion or experience. Current literature and evidence regarding the use of sugammadex in RIA are based only on case reports or series.
METHODS: We did a literature search in 3 main databases, Medline, Embase, and Web of science. The final total articles were 356 published cases published in the literature. Two independent reviewers conducted the first screen, and 69 articles with confirmed RIA were selected. These articles were divided into RIA alone in 39 cases and RIA with sugammadex use in 28 cases. We looked at patient characteristics (age, sex, ASA classification), associated symptoms (incidence of bronchospasm or rash, duration of hypotension), discharge disposition to intensive care unit (ICU), and associated morbidity or mortality.
RESULTS: On comparing RIA vs. RIA with sugammadex use, we didn\u27t find a statistically significant difference in patient characteristics, associated symptoms, or discharge disposition to ICU. However, there was a statistically significant difference in morbidity (15.4% vs. 0, p-value 0.03). Mortality was 5% in RIA, and no patient died in RIA with sugammadex use (p-value 0.5). The number need to treat (NNT) analysis showed NNT with Sugammadex to prevent mortality = 20 and NNT with Sugammadex to avoid morbidity is 7.
CONCLUSIONS: Early recognition and treatment of anaphylaxis with Epinephrine is still the mainstay of treatment. Since muscle relaxants, specifically Rocuronium, are the most common cause, we suggest using sugammadex in case of suspected RIA. We recommend using sugammadex in case of cardiac arrest or refractory anaphylaxis as evidence of NNT to avoid organ dysfunction is 7 and potential evidence of mortality benefit. The recommended dose is 16 mg/kg
Assessing the Potential Effects of Fungicides on Nontarget Gut Fungi (Trichomycetes) and Their Associated Larval Black Fly Hosts
Fungicides are moderately hydrophobic and have been detected in water and sediment, particularly in agricultural watersheds, but typically are not included in routine water quality monitoring efforts. This is despite their widespread use and frequent application to combat fungal pathogens. Although the efficacy of these compounds on fungal pathogens is well documented, little is known about their effects on nontarget fungi. This pilot study, a field survey in southwestern Idaho from April to December 2010 on four streams with varying pesticide inputs (two agricultural and two reference sites), was conducted to assess nontarget impact of fungicides on gut fungi, or trichomycetes. Tissues of larval black flies (Diptera: Simuliidae), hosts of gut fungi, were analyzed for pesticide accumulation. Fungicides were detected in hosts from streams within agricultural watersheds but were not detected in hosts from reference streams. Gut fungi from agricultural sites exhibited decreased percent infestation, density and sporulation within the gut, and black fly tissues had elevated pesticide concentrations. Differences observed between the sites demonstrate a potential effect on this symbiotic system. Future research is needed to parse out the details of the complex biotic and abiotic relationships; however, these preliminary results indicate that impacts to nontarget organisms could have far-reaching consequences within aquatic ecosystems
Evaluation of mobile learning: Students' experiences in a new rural-based medical school
<p>Abstract</p> <p>Background</p> <p>Mobile learning (ML) is an emerging educational method with success dependent on many factors including the ML device, physical infrastructure and user characteristics. At Gippsland Medical School (GMS), students are given a laptop at the commencement of their four-year degree. We evaluated the educational impact of the ML program from students' perspectives.</p> <p>Methods</p> <p>Questionnaires and individual interviews explored students' experiences of ML. All students were invited to complete questionnaires. Convenience sampling was used for interviews. Quantitative data was entered to SPSS 17.0 and descriptive statistics computed. Free text comments from questionnaires and transcriptions of interviews were thematically analysed.</p> <p>Results</p> <p>Fifty students completed the questionnaire (response rate 88%). Six students participated in interviews. More than half the students owned a laptop prior to commencing studies, would recommend the laptop and took the laptop to GMS daily. Modal daily use of laptops was four hours. Most frequent use was for access to the internet and email while the most frequently used applications were Microsoft Word and PowerPoint. Students appreciated the laptops for several reasons. The reduced financial burden was valued. Students were largely satisfied with the laptop specifications. Design elements of teaching spaces limited functionality. Although students valued aspects of the virtual learning environment (VLE), they also made many suggestions for improvement.</p> <p>Conclusions</p> <p>Students reported many educational benefits from school provision of laptops. In particular, the quick and easy access to electronic educational resources as and when they were needed. Improved design of physical facilities would enhance laptop use together with a more logical layout of the VLE, new computer-based resources and activities promoting interaction.</p
Biofluid Diagnostics by FTIR Spectroscopy: A Platform Technology for Cancer Detection
Fourier Transform Infrared Spectroscopy (FTIR) has been largely employed by scientific researchers to improve diagnosis and treatment of cancer, using various biofluids and tissues. The technology has proved to be easy to use, rapid and cost-effective for analysis on human blood serum to discriminate between cancer versus healthy control samples. The high sensitivity and specificity achievable during samples classification aided by machine learning algorithms, offers an opportunity to transform cancer referral pathways, as it has been demonstrated in a unique and recent prospective clinical validation study on brain tumours. We herein highlight the importance of early detection in cancer research using FTIR, discussing the technique, the suitability of serum for analysis and previous studies, with special focus on pre-clinical factors and clinical translation requirements and development
Recommended from our members
A Search for Dark Higgs Bosons
Recent astrophysical and terrestrial experiments have motivated the proposal
of a dark sector with GeV-scale gauge boson force carriers and new Higgs
bosons. We present a search for a dark Higgs boson using 516 fb-1 of data
collected with the BABAR detector. We do not observe a significant signal and
we set 90% confidence level upper limits on the product of the Standard
Model-dark sector mixing angle and the dark sector coupling constant.Comment: 7 pages, 5 postscript figures, published version with improved plots
for b/w printin
Performance of CMS muon reconstruction in pp collision events at sqrt(s) = 7 TeV
The performance of muon reconstruction, identification, and triggering in CMS
has been studied using 40 inverse picobarns of data collected in pp collisions
at sqrt(s) = 7 TeV at the LHC in 2010. A few benchmark sets of selection
criteria covering a wide range of physics analysis needs have been examined.
For all considered selections, the efficiency to reconstruct and identify a
muon with a transverse momentum pT larger than a few GeV is above 95% over the
whole region of pseudorapidity covered by the CMS muon system, abs(eta) < 2.4,
while the probability to misidentify a hadron as a muon is well below 1%. The
efficiency to trigger on single muons with pT above a few GeV is higher than
90% over the full eta range, and typically substantially better. The overall
momentum scale is measured to a precision of 0.2% with muons from Z decays. The
transverse momentum resolution varies from 1% to 6% depending on pseudorapidity
for muons with pT below 100 GeV and, using cosmic rays, it is shown to be
better than 10% in the central region up to pT = 1 TeV. Observed distributions
of all quantities are well reproduced by the Monte Carlo simulation.Comment: Replaced with published version. Added journal reference and DO
Performance of CMS muon reconstruction in pp collision events at sqrt(s) = 7 TeV
The performance of muon reconstruction, identification, and triggering in CMS
has been studied using 40 inverse picobarns of data collected in pp collisions
at sqrt(s) = 7 TeV at the LHC in 2010. A few benchmark sets of selection
criteria covering a wide range of physics analysis needs have been examined.
For all considered selections, the efficiency to reconstruct and identify a
muon with a transverse momentum pT larger than a few GeV is above 95% over the
whole region of pseudorapidity covered by the CMS muon system, abs(eta) < 2.4,
while the probability to misidentify a hadron as a muon is well below 1%. The
efficiency to trigger on single muons with pT above a few GeV is higher than
90% over the full eta range, and typically substantially better. The overall
momentum scale is measured to a precision of 0.2% with muons from Z decays. The
transverse momentum resolution varies from 1% to 6% depending on pseudorapidity
for muons with pT below 100 GeV and, using cosmic rays, it is shown to be
better than 10% in the central region up to pT = 1 TeV. Observed distributions
of all quantities are well reproduced by the Monte Carlo simulation.Comment: Replaced with published version. Added journal reference and DO
- âŚ