Mental Health Assessments in ICU and Acute Care

The purpose of our critically appraised topic is to provide a brief summary of assessments that may be relevant to the burn unit or ICU setting, including their validity, reliability, specificity, sensitivity, and limitations. We had a total of eight articles with the following study designs: Systematic Review (2 articles), Longitudinal Study (1 article), Comparative Analysis (1 article), Correlational Analysis (2 articles) and Methodological (2 articles). These articles looked at the reliability, validity, specificity, and sensitivity of the following assessments: Abbreviated Burn Specific Anxiety Scale (A-BSPAS), Beck Depression Inventory-II, Brief Coping Orientation to Problems Experience (B-COPE), Concise Mental Health Checklist (CMHC-9), Confusion Assessment Method for Intensive Care Units (CAM-ICU), Startle, Physiological arousal, Anger, and Numbness (SPAN), Trauma Screening Questionnaire (TSQ), The Confusion Assessment Method (CAM), and Wound-Quality of Life. We found the following assessments applicable for the burn unit or ICU: CAM, B-COPE, CAM-ICU Flowsheet. Our clinical recommendations are for these assessments to be used to perform a screening of the client\u27s mental state, which will help the Occupational therapist develop and plan interventions

Chain-selective isotopic labeling of the heterodimeric type iii secretion chaperone, scc4:Scc1, reveals the total structural rearrangement of the chlamydia trachomatis bi-functional protein, scc4

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. Scc4 is an unusual bi-functional protein from Chlamydia trachomatis (CT) that functions as a type III secretion system (T3SS) chaperone and an RNA polymerase (RNAP)-binding protein. Both functions require interactions with protein partners during specific stages of the CT developmental cycle. As a T3SS chaperone, Scc4 binds Scc1 during the late stage of development to form a heterodimer complex, which chaperones the essential virulence effector, CopN. During the early-middle stage of development, Scc4 regulates T3SS gene expression by binding the σ66-containing RNAP holoenzyme. In order to study the structure and association mechanism of the Scc4:Scc1 T3SS chaperone complex using nuclear magnetic resonance (NMR) spectroscopy, we developed an approach to selectively label each chain of the Scc4:Scc1 complex with the15N-isotope. The approach allowed one protein to be visible in the NMR spectrum at a time, which greatly reduced resonance overlap and permitted comparison of the backbone structures of free and bound Scc4.1H,15N-heteronuclear single quantum coherence spectra of the15N-Scc4:Scc1 and Scc4:15N-Scc1 complexes showed a total structural rearrangement of Scc4 upon binding Scc1 and a dynamic region isolated to Scc1, respectively. Development of the chain-selective labeling approach revealed that the association of Scc4 and Scc1 requires partial denaturation of Scc1 to form the high affinity complex, while low affinity interactions occurred between the isolated proteins under non-denaturing conditions. These results provide new models for Scc4′s functional switching mechanism and Scc4:Scc1 association in CT

Impact of HPV vaccine hesitancy on cervical cancer in Japan : a modelling study

Funding National Health and Medical Research Council Australia Centre of Research Excellence in Cervical Cancer Control, Japan Society for the Promotion of Science. Acknowledgments This study was part-funded via the National Health and Medical Research Council Australia Centre of Research Excellence in Cervical Cancer Control (C4; 1135172) and a grant-in-aid from the Japan Society for the Promotion of Science (16K15367).Peer reviewedPublisher PD

Management of coronary artery fistulae Patient selection and results of transcatheter closure

AbstractObjectivesWe report short-term findings in 33 patients after transcatheter closure (TCC) of coronary artery fistulae (CAF) and compare our results with those reported in the recent transcatheter and surgical literature.BackgroundTranscatheter closure of CAF has been advocated as a minimally invasive alternative to surgery.MethodsWe reviewed all patients presenting with significant CAF between January 1988 and August 2000. Those with additional complex cardiac disease requiring surgical management were excluded.ResultsOf 39 patients considered for TCC, occlusion devices were placed in 33 patients (85%) at 35 procedures and included coils in 28, umbrella devices in 6 and a Grifka vascular occlusion device in 1. Post-deployment angiograms demonstrated complete occlusion in 19, trace in 11, or small residual flow in 5. Follow-up echocardiograms (median, 2.8 years) in 27 patients showed no flow in 22 or small residual flow in 5. Of the 6 patients without follow-up imaging, immediate post-deployment angiograms showed complete occlusion in 5 or small residual flow in 1. Thus, complete occlusion was accomplished in 27 patients (82%). Early complications included transient ST-T wave changes in 5, transient arrhythmias in 4 and single instances of distal coronary artery spasm, fistula dissection and unretrieved coil embolization. There were no deaths or long-term morbidity. Device placement was not attempted in 6 patients (15%), because of multiple fistula drainage sites in 4, extreme vessel tortuosity in 1 and an intracardiac hemangioma in 1.ConclusionsA comparison of our results with those in the recent transcatheter and surgical literature shows similar early effectiveness, morbidity and mortality. From data available, TCC of CAF is an acceptable alternative to surgery in most patients

The Grizzly, April 25, 2013

Students, Dean Recall Boston During Bombings • Wismer to Get Summer Makeover • Residence Life Expands Gender-Neutral Housing • UC Organic Farm • Alumni Always Welcome • Ninjutsu Club\u27s New Identity • B\u27 Nats\u27 Concert • Opinion: Consider Your Privilege at Thrift Shops • Grizzly Staff Thanks Dr. Kirstie Hettinga • Senior Day Ahead for Spring Athletes • Cheers and Jeers: Ursinus, Philadelphia Athletics • Women\u27s Lacrosse Falls Shorthttps://digitalcommons.ursinus.edu/grizzlynews/1883/thumbnail.jp

The origins of haplotype 58 (H58) Salmonella enterica serovar Typhi

Antimicrobial resistance (AMR) poses a serious threat to the clinical management of typhoid fever. AMR in Salmonella Typhi (S. Typhi) is commonly associated with the H58 lineage, a lineage that arose comparatively recently before becoming globally disseminated. To better understand when and how H58 emerged and became dominant, we performed detailed phylogenetic analyses on contemporary genome sequences from S. Typhi isolated in the period spanning the emergence. Our dataset, which contains the earliest described H58 S. Typhi organism, indicates that ancestral H58 organisms were already multi-drug resistant (MDR). These organisms emerged spontaneously in India in 1987 and became radially distributed throughout South Asia and then globally in the ensuing years. These early organisms were associated with a single long branch, possessing mutations associated with increased bile tolerance, suggesting that the first H58 organism was generated during chronic carriage. The subsequent use of fluoroquinolones led to several independent mutations in gyrA. The ability of H58 to acquire and maintain AMR genes continues to pose a threat, as extensively drug-resistant (XDR; MDR plus resistance to ciprofloxacin and third generation cephalosporins) variants, have emerged recently in this lineage. Understanding where and how H58 S. Typhi originated and became successful is key to understand how AMR drives successful lineages of bacterial pathogens. Additionally, these data can inform optimal targeting of typhoid conjugate vaccines (TCVs) for reducing the potential for emergence and the impact of new drug-resistant variants. Emphasis should also be placed upon the prospective identification and treatment of chronic carriers to prevent the emergence of new drug resistant variants with the ability to spread efficiently

Main-Belt Comet P/2012 T1 (PANSTARRS)

We present initial results from observations and numerical analyses aimed at characterizing main-belt comet P/2012 T1 (PANSTARRS). Optical monitoring observations were made between October 2012 and February 2013 using the University of Hawaii 2.2 m telescope, the Keck I telescope, the Baade and Clay Magellan telescopes, Faulkes Telescope South, the Perkins Telescope at Lowell Observatory, and the Southern Astrophysical Research (SOAR) telescope. The object's intrinsic brightness approximately doubles from the time of its discovery in early October until mid-November and then decreases by ~60% between late December and early February, similar to photometric behavior exhibited by several other main-belt comets and unlike that exhibited by disrupted asteroid (596) Scheila. We also used Keck to conduct spectroscopic searches for CN emission as well as absorption at 0.7 microns that could indicate the presence of hydrated minerals, finding an upper limit CN production rate of QCN<1.5x10^23 mol/s, from which we infer a water production rate of QH2O<5x10^25 mol/s, and no evidence of the presence of hydrated minerals. Numerical simulations indicate that P/2012 T1 is largely dynamically stable for >100 Myr and is unlikely to be a recently implanted interloper from the outer solar system, while a search for potential asteroid family associations reveal that it is dynamically linked to the ~155 Myr-old Lixiaohua asteroid family.Comment: 15 pages, 4 figures, accepted for publication in ApJ Letter

Volume 12

Introduction, Dr. Roger A. Byrne, Dean From the Editor, Dr. Larissa Kat Tracy From the Designers, Rachel English, Rachel Hanson Immortality in the Mortal World: Otherworldly Intervention in Lanval and The Wife of Bath\u27s Tale by Haleigh James Analysis of Phenolic Compounds in Moroccan Olive Oils by HPLC by Hannah Meyls Art by Hope Irvin The Effects of Cell Phone Use on Gameplay Enjoyment and Frustration by Megan E. Hlavaty, Samara L. Gall, and Austin J. Funk Care, No Matter What: Planned Parenthood\u27s Use of Organizational Rhetoric to Expand its Reputation by Karyn Keane Analysis of Petroleum Products for Forensic and Environmental Applications by Sarah Ghali, Antonio Harvey, and Katelynn McCrillis Art by Andrew Jones The Triangle Shirtwaist Factory Fire by Rachel Hazelwood Art by Madison Schmitz Ercilla y la imitacion: Araucanos al estilo europeo by Marija Venta Design by Haley Tebo Design by Jeremiah Gilmer White Supremacist\u27s Appropriation of the Persuasion of Passivity in Marvel\u27s Captain America by Bridget Dunn Design by Benjamin Sullivan Art by McKenzie Johnso

Considering racial and ethnic preferences in communication and interactions among the patient, family member, and physician following diagnosis of localized prostate cancer: study of a US population

Prostate cancer is the most commonly diagnosed cancer among American men. The multiple treatment options for localized prostate cancer and potential side effects can complicate the decision-making process. We describe the level of engagement and communication among the patient, family member, and physician (the decision-making “triad”) in the decision process prior to treatment. Using the Family and Cancer Therapy Selection (FACTS) study baseline survey data, we note racial/ethnic variations in communication among the triad. Sensitivity to and awareness of decision-making styles of both the patient and their family member (or caregiver) may enable clinicians to positively influence communication exchanges about important clinical decisions