Completing the design spectra for graphs with six vertices and eight edges

Apart from two possible exceptions, the design spectrum has been determined for every graph with six vertices and at most eight edges. The purpose of this note is to establish the existence of the two missing designs, both of order 32

Geriatric nursing-sensitive indicators, a framework for delivering quality nursing care for the older person: A scoping review

Objective: This thesis aims to explore the concept of geriatric nursing-sensitive indicators (NSIs), which are used to measure care for the older population. Introduction: By the year 2050, the global number of older people is predicted to double, creating fiscal and practice challenges for nursing. Nursing is the largest workforce in the health sector and is best placed to influence the quality of care received by the older person as system demand increases. Geriatric NSIs provide the opportunity to describe this influence, as they reflect the quality and effectiveness of geriatric nurses when caring for the older person. Methods: Due to the broad nature of the research topic, a scoping review was considered appropriate. The methods were based on those of the Joanna Briggs Institute, which were in turn informed by Arksey and O’Malley. In addition, a group of context experts were utilised to ensure the conduct of the review was meaningful for clinical staff and policy makers. This thesis outlines the results of a scoping review prepared as a manuscript for publication. The manuscript presented for publication is positioned in chapter four as a continuation of the thesis that outlines the methods and results of the scoping review. Results: The scoping review was completed, and a manuscript was prepared and submitted for publication. Many indicators were identified that described the nursing care of the older person. In line with the methodology, these were mapped in a variety of ways including Donabedian’s Domains and Fundamentals of Care that are existing taxonomies and Specificity which was a novel approach. It was apparent that there was a great deal of inconsistency in the description of the indicators but grouping of indicators through commonality and classification simplified indicator descriptions. Conclusions: The scoping review identified that concepts associated with geriatric nursing sensitive indicators are complex, and that extracted indicators did not comprehensively reflect contemporary geriatric nursing care. The complexities identified in the scoping review included issues such as lack of indicator definition and consistency, relationships between indicators, methodology for risk adjustment of patient outcomes and performance measurement of indicators. Contemporary nursing issues were not comprehensively reflected in the extracted indicators. Additional indicators are required to address issues such as the consumer perspective of geriatric nursing care, nursing hospital avoidance strategies and case management of inpatients. The achievements of this project extended beyond the mere conduct of a review and subsequent reporting of results. The project provided an opportunity for the lead reviewer to immerse themselves and learn the methodology of a scoping review. In addition, the decision to present the thesis in this form also provided the experience of submitting a manuscript for publication.Thesis (MClinSc) -- University of Adelaide, Adelaide Nursing School, 202

Implementation of Tai Chi Among Individuals with Dementia in Long-Term Memory Care

This project focused on a dementia population within long-term care, where increased disablement occurs. A Tai Chi program was implemented into the daily routine of individuals in a long-term memory care facility to improve dynamic sitting balance for the performance of daily occupations.https://soar.usa.edu/otdcapstonessummer2023/1048/thumbnail.jp

Vasculogenic mimicry in malignant mesothelioma: an experimental and immunohistochemical analysis

SummaryVasculogenic mimicry, the process in which cancer cells form angiomatoid structures independent of or in addition to host angiogenesis has been recorded in several otherwise non-endothelial malignant neoplasms. This study describes evidence of routine vascular mimicry by human mesothelioma cell lines in vitro, when the cell lines are cultured alone or co-cultured with human umbilical vascular endothelial cells, with the formation of angiomatoid tubular networks. Vasculogenic mimicry is also supported by immunohistochemical demonstration of human-specific anti-mitochondria antibody labelling of tumour-associated vasculature of human mesothelioma cells xenotransplanted into nude mice, and by evidence of vascular mimicry in some biopsy samples of human malignant mesotheliomas. These studies show mosaic interlacing of cells that co-label or label individually for immunohistochemical markers of endothelial and mesothelial differentiation. If vascular mimicry in mesothelioma can be characterised more fully, this may facilitate identification of more specific and targeted therapeutic approaches such as anti-angiogenesis in combination with chemotherapy and immunotherapy or other therapeutic approaches

A Korean Family of Hypokalemic Periodic Paralysis with Mutation in a Voltage-gated Calcium Channel (R1239G)

Hypokalemic periodic paralysis (HOPP) is a rare disease characterized by reversible attacks of muscle weakness accompanied by episodic hypokalemia. Recent molecular work has revealed that the majority of familial HOPP is due to mutations in a skeletal muscle voltage-dependent calcium-channel: the dihydropyridine receptor. We report a 13-yr old boy with HOPP from a family in which 6 members are affected in three generations. Genetic examination identified a nucleotide 3705 C to G mutation in exon 30 of the calcium channel gene, CACNA1S. This mutation predicts a codon change from arginine to glycine at the amino acid position #1239 (R1239G). Among the three known mutations of the CACNA1S gene, the R1239G mutation was rarely reported. This boy and the other family members who did not respond to acetazolamide, showed a marked improvement of the paralytic symptoms after spironolactone treatment

Blockade of Aquaporin 1 Inhibits Proliferation, Motility, and Metastatic Potential of Mesothelioma In Vitro but not in an In Vivo Model

Copyright © 2015 Sonja Klebe et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background. Malignant mesothelioma (MM) is an aggressive tumor of the serosal membranes, mostly the pleura. It is related to asbestos exposure and has a poor prognosis. MM has a long latency period, and incidence is predicted to remain stable or increase until 2020. Currently, no biomarkers for a specific targeted therapy are available. Previously, we observed that expression of aquaporin 1 (AQP1) was an indicator of prognosis in two independent cohorts. Here we determine whether AQP1 inhibition has therapeutic potential in the treatment of MM. Methods. Functional studies were performed with H226 cells and primary MM cells harvested from pleural effusions. AQP1 expression and mesothelial phenotype was determined by immunohistochemistry. AQP1 function was inhibited by a pharmacological blocker (AqB050) or AQP1-specific siRNA. Cell proliferation, migration, and anchorage-independent cell growth were assessed. A nude mouse heterotopic xenograft model of MM was utilised for the in vivo studies. Results. Inhibition of AQP1 significantly decreases cell proliferation, metastatic potential, and motility without inducing nonspecific cytotoxicity or increasing apoptosis. In vivo blockade of AQP1 had no biologically significant effect on growth of established tumours. Conclusions. Targeted blockade of AQP1 restricts MM growth and migration in vitro. Further work is warranted to fully evaluate treatment potential in vivo

How Respiratory Muscle Strength Correlates with Cough Capacity in Patients with Respiratory Muscle Weakness

PURPOSE: The purpose of this study is to investigate how respiratory muscle strength correlates to cough capacity in patients with respiratory muscle weakness. MATERIALS AND METHODS: Forty-five patients with amyotrophic lateral sclerosis (ALS), 43 with cervical spinal cord injury (SCI), and 42 with Duchenne muscular dystrophy (DMD) were recruited. Pulmonary function tests including forced vital capacity (FVC) and respiratory muscle strength (maximal expiratory pressure, MEP; maximal inspiratory pressure, MIP) were performed. The correlation between respiratory muscle strength and cough capacity was analyzed. RESULTS: In the SCI group, FVC in a supine position (2,597 +/- 648 mL) was significantly higher than FVC in a sitting position (2,304 +/- 564 mL, p < 0.01). Conversely, in the ALS group, FVC sitting (1,370 +/- 604 mL) was significantly higher than in supine (1,168 +/- 599 mL, p < 0.01). In the DMD group, there was no statistically significant difference between FVC while sitting (1,342 +/- 506 mL) and FVC while supine (1,304 +/- 500 mL). In addition, the MEP and MIP of all three groups showed a significant correlation with peak cough flow (PCF) (p < 0.01, Pearson's correlation analysis). In the SCI group, MIP was more closely correlated with PCF, while in the ALS and DMD groups, MEP was more closely correlated with PCF (p < 0.01, multiple regression analysis). CONCLUSION: To generate cough flow, inspiratory muscle strength is significantly more important for SCI patients, while expiratory muscle function is significantly more important for ALS and DMD patients.ope

Practical aspects in the management of hypokalemic periodic paralysis

Management considerations in hypokalemic periodic paralysis include accurate diagnosis, potassium dosage for acute attacks, choice of diuretic for prophylaxis, identification of triggers, creating a safe physical environment, peri-operative measures, and issues in pregnancy. A positive genetic test in the context of symptoms is the gold standard for diagnosis. Potassium chloride is the favored potassium salt given at 0.5–1.0 mEq/kg for acute attacks. The oral route is favored, but if necessary, a mannitol solvent can be used for intravenous administration. Avoidance of or potassium prophylaxis for common triggers, such as rest after exercise, high carbohydrate meals, and sodium, can prevent attacks. Chronically, acetazolamide, dichlorphenamide, or potassium-sparing diuretics decrease attack frequency and severity but are of little value acutely. Potassium, water, and a telephone should always be at a patient's bedside, regardless of the presence of weakness. Perioperatively, the patient's clinical status should be checked frequently. Firm data on the management of periodic paralysis during pregnancy is lacking. Patient support can be found at

Chronic elevation of pulmonary microvascular pressure in chronic heart failure reduces bi-directional pulmonary fluid flux

Aims. Chronic heart failure leads to pulmonary vascular remodelling and thickening of the alveolar–capillary barrier. We examined whether this protective effect may slow resolution of pulmonary oedema consistent with decreased bi-directional fluid flux. Methods and results. Seven weeks following left coronary artery ligation, we measured both fluid flux during an acute rise in left atrial pressure (n = 29) and intrinsic alveolar fluid clearance (n = 45) in the isolated rat lung. Chronic elevation of pulmonary microvascular pressure prevented pulmonary oedema and decreased lung compliance when left atrial pressure was raised to 20 cmH2O, and was associated with reduced expression of endothelial aquaporin 1 (P = 0.03). However, no other changes were found in mediators of fluid flux or cellular fluid channels. In isolated rat lungs, chronic LV dysfunction (LV end-diastolic pressure and infarct circumference) was also inversely related to alveolar fluid clearance (P ≤ 0.001). The rate of pulmonary oedema reabsorption was estimated by plasma volume expansion in eight patients with a previous clinical history of chronic heart failure and eight without, who presented with acute pulmonary oedema. Plasma volume expansion was reduced at 24 h in those with chronic heart failure (P = 0.03). Conclusions. Chronic elevation of pulmonary microvascular pressure in CHF leads to decreased intrinsic bi-directional fluid flux at the alveolar–capillary barrier. This adaptive response defends against alveolar flooding, but may delay resolution of alveolar oedema.A National Health and Medical Research Council (NHMRC) grant (#375129); Australian and New Zealand College of Anaesthetists (ANZCA) grant (#08/020); the Flinders Medical Centre Foundation

A Descriptive, Multiyear Examination of Positive Behavior Support

A major goal of positive behavior support (PBS) is to produce broad-based, long-term improvements in adaptive behavior; however, the empirical base, at present, is mainly composed of relatively short-term studies carried out in circumscribed contexts. Therefore, a need exists for reliable data that can inform the field regarding the comprehensive lifestyle effects of PBS implementation in natural community contexts over extended periods of time. The current investigation was conducted to provide a descriptive analysis of PBS with diverse participants and broad measurement strategies over multiple years. Using extensive data portfolios for 21 participants, we employed rating scales to quantify changes in key variables from baseline through 2 years of intervention. The data revealed variable levels of intervention integrity, generalized reductions in problem behavior with occasional relapses, and encouraging enhancements across six domains of quality of life. This study represents an initial attempt to understand the processes and outcomes of behavioral support by documenting behavioral patterns across full days, entire years, and all environments. We discuss the need to consider new conceptual and methodological frameworks for further study of efficacious and sustainable behavior support