Pre-hospital emergency nurse specialist's experiences in caring for patients with non-specific chief complaints in the ambulance - A qualitative interview study

Background: Pre-hospital emergency nurse (PEN) specialists are faced with patients presenting with non-specific chief complaints (NSC) to the emergency medical service (EMS) on a daily basis. These patients are often elderly and one in three has a serious condition and their acuity is not recognized. Objective: The aim of the current study was to explore PEN specialists' experiences in caring for patients presenting with non-specific chief complaints. Design: A qualitative study design with eleven individual interviews of PENs, between 2018 and 2020. Qualitative content analysis was used. Results: The analyses generated three categories including subcategories. The categories were "Unexplained suffering". "Systematic approach and experience enhances medical safety". "Organizational processes can be optimized". The relation between the categories compiled as 'In-depth systematic assessment is perceived to reduce suffering and increases patient safety. Conclusion: The PENs experiences in caring for patients presenting with non-specific chief complaints show that an in-depth systematic assessment may lead to a meaningful caring encounter which enables the identification of the cause of the chief complaint. Experience and a systematic approach were considered as essential to enhance medical safety. This could be strengthened through feedback on the nurse's care provided by care managers and employers. To optimize organizational processes, the development of the opportunity to convey the patient to different levels of care can be an important component.Peer reviewe

Two-vibron bound states in alpha-helix proteins : the interplay between the intramolecular anharmonicity and the strong vibron-phonon coupling

The influence of the intramolecular anharmonicity and the strong vibron-phonon coupling on the two-vibron dynamics in an $\alpha$-helix protein is studied within a modified Davydov model. The intramolecular anharmonicity of each amide-I vibration is considered and the vibron dynamics is described according to the small polaron approach. A unitary transformation is performed to remove the intramolecular anharmonicity and a modified Lang-Firsov transformation is applied to renormalize the vibron-phonon interaction. Then, a mean field procedure is realized to obtain the dressed anharmonic vibron Hamiltonian. It is shown that the anharmonicity modifies the vibron-phonon interaction which results in an enhancement of the dressing effect. In addition, both the anharmonicity and the dressing favor the occurrence of two different bound states which the properties strongly depend on the interplay between the anharmonicity and the dressing. Such a dependence was summarized in a phase diagram which characterizes the number and the nature of the bound states as a function of the relevant parameters of the problem. For a significant anharmonicity, the low frequency bound states describe two vibrons trapped onto the same amide-I vibration whereas the high frequency bound states refer to the trapping of the two vibrons onto nearest neighbor amide-I vibrations.Comment: may 2003 submitted to Phys. Rev.

From Davydov solitons to decoherence-free subspaces: self-consistent propagation of coherent-product states

The self-consistent propagation of generalized $D_{1}$ [coherent-product] states and of a class of gaussian density matrix generalizations is examined, at both zero and finite-temperature, for arbitrary interactions between the localized lattice (electronic or vibronic) excitations and the phonon modes. It is shown that in all legitimate cases, the evolution of $D_{1}$ states reduces to the disentangled evolution of the component $D_{2}$ states. The self-consistency conditions for the latter amount to conditions for decoherence-free propagation, which complement the $D_{2}$ Davydov soliton equations in such a way as to lift the nonlinearity of the evolution for the on-site degrees of freedom. Although it cannot support Davydov solitons, the coherent-product ansatz does provide a wide class of exact density-matrix solutions for the joint evolution of the lattice and phonon bath in compatible systems. Included are solutions for initial states given as a product of a [largely arbitrary] lattice state and a thermal equilibrium state of the phonons. It is also shown that external pumping can produce self-consistent Frohlich-like effects. A few sample cases of coherent, albeit not solitonic, propagation are briefly discussed.Comment: revtex3, latex2e; 22 pages, no figs.; to appear in Phys.Rev.E (Nov.2001

Correlation between acoustic divergence and phylogenetic distance in soniferous European gobiids (Gobiidae; Gobius lineage)

In fish, species identity can be encoded by sounds, which have been thoroughly investigated in European gobiids (Gobiidae, Gobius lineage). Recent evolutionary studies suggest that deterministic and/or stochastic forces could generate acoustic differences among related animal species, though this has not been investigated in any teleost group to date. In the present comparative study, we analysed the sounds from nine soniferous gobiids and quantitatively assessed their acoustic variability. Our interspecific acoustic study, incorporating for the first time the representative acoustic signals from the majority of soniferous gobiids, suggested that their sounds are truly species-specific (92% of sounds correctly classified into exact species) and each taxon possesses a unique set of spectro-temporal variables. In addition, we reconstructed phylogenetic relationships from a concatenated molecular dataset consisting of multiple molecular markers to track the evolution of acoustic signals in soniferous gobiids. The results of this study indicated that the genus Padogobius is polyphyletic, since P. nigricans was nested within the Ponto-Caspian clade, while the congeneric P. bonelli turned out to be a sister taxon to the remaining investigated soniferous species. Lastly, by extracting the acoustic and genetic distance matrices, sound variability and genetic distance were correlated for the first time to assess whether sound evolution follows a similar phylogenetic pattern. The positive correlation between the sound variability and genetic distance obtained here emphasizes that certain acoustic features from representative sounds could carry the phylogenetic signal in soniferous gobiids. Our study was the first attempt to evaluate the mutual relationship between acoustic variation and genetic divergence in any teleost fish

Relaxation channels of two-vibron bound states in \alpha-helix proteins

Relaxation channels for two-vibron bound states in an anharmonic alpha-helix protein are studied. It is pointed out that the relaxation originates in the interaction between the dressed anharmonic vibrons and the remaining phonons. This interaction is responsible for the occurrence of transitions between two-vibron eigenstates mediated by both phonon absorption and phonon emission. At biological temperature, it is shown that the relaxation rate does not significantly depends on the nature of the two-vibron state involved in the process. Therefore, the lifetime for both bound and free states is of the same order of magnitude and ranges between 0.1 and 1.0 ps for realistic parameters. By contrast, the relaxation channels strongly depend on the nature of the two-vibron states which is a consequence of the breather-like behavior of the two-vibron bound states.Comment: octobre 2003 - soumis Phys. Rev.

Physics of the Riemann Hypothesis

Physicists become acquainted with special functions early in their studies. Consider our perennial model, the harmonic oscillator, for which we need Hermite functions, or the Laguerre functions in quantum mechanics. Here we choose a particular number theoretical function, the Riemann zeta function and examine its influence in the realm of physics and also how physics may be suggestive for the resolution of one of mathematics' most famous unconfirmed conjectures, the Riemann Hypothesis. Does physics hold an essential key to the solution for this more than hundred-year-old problem? In this work we examine numerous models from different branches of physics, from classical mechanics to statistical physics, where this function plays an integral role. We also see how this function is related to quantum chaos and how its pole-structure encodes when particles can undergo Bose-Einstein condensation at low temperature. Throughout these examinations we highlight how physics can perhaps shed light on the Riemann Hypothesis. Naturally, our aim could not be to be comprehensive, rather we focus on the major models and aim to give an informed starting point for the interested Reader.Comment: 27 pages, 9 figure

Bilobalide modulates serotonin-controlled behaviors in the nematode Caenorhabditis elegans

<p>Abstract</p> <p>Background</p> <p>Dysfunctions in the serotonergic system have been implicated in several neurological disorders such as depression. Elderly individuals who have been diagnosed with clinical depression show elevated cases of neurodegenerative diseases. This has led to suggestions that modulating the serotonin (5-HT) system could provide an alternative method to current therapies for alleviating these pathologies. The neuroprotective effects of bilobalide <it>in vitro </it>have been documented. We aim to determine whether bilobalide affects the 5-HT system in the nematode <it>C. elegans</it>. The wild type worms, as well as well-characterized 5-HT mutants, were fed with bilobalide in a range of concentrations, and several 5-HT controlled behaviors were tested.</p> <p>Results</p> <p>We observed that bilobalide significantly inhibited 5-HT-controlled egg-laying behavior in a dose-dependent manner, which was blocked in the 5-HT receptor mutants (<it>ser-4, mod-1</it>), but not in the 5-HT transporter (<it>mod-5</it>) or synthesis (<it>tph-1</it>) mutants. Bilobalide also potentiated a 5-HT-controlled, experience-dependent locomotory behavior, termed the enhanced slowing response in the wild type animals. However, this effect was fully blocked in 5-HT receptor <it>mod-1 </it>and dopamine defective <it>cat-2 </it>mutants, but only partially blocked in <it>ser-4 </it>mutants. We also demonstrated that acetylcholine transmission was inhibited in a transgenic <it>C. elegans </it>strain that constitutively expresses Aβ, and bilobalide did not significantly affect this inhibition.</p> <p>Conclusion</p> <p>These results suggest that bilobalide may modulate specific 5-HT receptor subtypes, which involves interplay with dopamine transmission. Additional studies for the function of bilobalide in neurotransmitter systems could aid in our understanding of its neuroprotective properties.</p

Statistical Mechanics and the Physics of the Many-Particle Model Systems

The development of methods of quantum statistical mechanics is considered in light of their applications to quantum solid-state theory. We discuss fundamental problems of the physics of magnetic materials and the methods of the quantum theory of magnetism, including the method of two-time temperature Green's functions, which is widely used in various physical problems of many-particle systems with interaction. Quantum cooperative effects and quasiparticle dynamics in the basic microscopic models of quantum theory of magnetism: the Heisenberg model, the Hubbard model, the Anderson Model, and the spin-fermion model are considered in the framework of novel self-consistent-field approximation. We present a comparative analysis of these models; in particular, we compare their applicability for description of complex magnetic materials. The concepts of broken symmetry, quantum protectorate, and quasiaverages are analyzed in the context of quantum theory of magnetism and theory of superconductivity. The notion of broken symmetry is presented within the nonequilibrium statistical operator approach developed by D.N. Zubarev. In the framework of the latter approach we discuss the derivation of kinetic equations for a system in a thermal bath. Finally, the results of investigation of the dynamic behavior of a particle in an environment, taking into account dissipative effects, are presented.Comment: 77 pages, 1 figure, Refs.37

1H NMR-based metabolomics combined with HPLC-PDA-MS-SPE-NMR for investigation of standardized Ginkgo biloba preparations

Commercial preparations of Ginkgo biloba are very complex mixtures prepared from raw leaf extracts by a series of extraction and prepurification steps. The pharmacological activity is attributed to a number of flavonoid glycosides and unique terpene trilactones (TTLs), with largely uncharacterized pharmacological profiles on targets involved in neurological disorders. It is therefore important to complement existing targeted analytical methods for analysis of Ginkgo biloba preparations with alternative technology platforms for their comprehensive and global characterization. In this work, 1H NMR-based metabolomics and hyphenation of high-performance liquid chromatography, photo-diode array detection, mass spectrometry, solid-phase extraction, and nuclear magnetic resonance spectroscopy (HPLC-PDA-MS-SPE-NMR) were used for investigation of 16 commercially available preparations of Ginkgo biloba. The standardized extracts originated from Denmark, Italy, Sweden, and United Kingdom, and the results show that 1H NMR spectra allow simultaneous assessment of the content as well as identity of flavonoid glycosides and TTLs based on a very simple sample-preparation procedure consisting of extraction, evaporation and reconstitution in acetone-d6. Unexpected or unwanted extract constituents were also easily identified in the 1H NMR spectra, which contrasts traditional methods that depend on UV absorption or MS ionizability and usually require availability of reference standards. Automated integration of 1H NMR spectral segments (buckets or bins of 0.02 ppm width) provides relative distribution plots of TTLs based on their H-12 resonances. The present study shows that 1H NMR-based metabolomics is an attractive method for non-selective and comprehensive analysis of Ginkgo extracts

Ca2+ Extrusion by NCX Is Compromised in Olfactory Sensory Neurons of OMP−/− Mice

The role of olfactory marker protein (OMP), a hallmark of mature olfactory sensory neurons (OSNs), has been poorly understood since its discovery. The electrophysiological and behavioral phenotypes of OMP knockout mice indicated that OMP influences olfactory signal transduction. However, the mechanism by which this occurs remained unknown.We used intact olfactory epithelium obtained from WT and OMP(-/-) mice to monitor the Ca(2+) dynamics induced by the activation of cyclic nucleotide-gated channels, voltage-operated Ca(2+) channels, or Ca(2+) stores in single dendritic knobs of OSNs. Our data suggested that OMP could act to modulate the Ca(2+)-homeostasis in these neurons by influencing the activity of the plasma membrane Na(+)/Ca(2+)-exchanger (NCX). Immunohistochemistry verifies colocalization of NCX1 and OMP in the cilia and knobs of OSNs. To test the role of NCX activity, we compared the kinetics of Ca(2+) elevation by stimulating the reverse mode of NCX in both WT and OMP(-/-) mice. The resulting Ca(2+) responses indicate that OMP facilitates NCX activity and allows rapid Ca(2+) extrusion from OSN knobs. To address the mechanism by which OMP influences NCX activity in OSNs we studied protein-peptide interactions in real-time using surface plasmon resonance technology. We demonstrate the direct interaction of the XIP regulatory-peptide of NCX with calmodulin (CaM).Since CaM also binds to the Bex protein, an interacting protein partner of OMP, these observations strongly suggest that OMP can influence CaM efficacy and thus alters NCX activity by a series of protein-protein interactions