Preventing neuromuscular deconditioning in critically ill patients

Critically ill patients can be prescribed bed rest as a therapeutic intervention. Immobility from bed rest can cause neuromuscular deconditioning and weakness. Preventing immobility by implementing mobilization activities may prevent these complications from occurring. Currently, mobility protocols are lacking. The purpose of this literature review is to analyze the evidence related to mobilizing patients in the Intensive Care Unit (ICU). In the future, a standard mobility protocol should be instituted for critically ill patients indicating when and how to begin mobilization. The efficacy of mobility protocols relies on an interdisciplinary team for positive outcomes to prevent complications of inactivity and promote patient safety. Future implementation of mobilization can decrease patients\u27 lengths of stay and extensive rehabilitation from inactivity. Nursing education, practice and research should focus on interventions to prevent complications of immobility by identifying mobilization techniques, safety approaches and the use of protocols

Real Space Visualization of Thermomagnetic Irreversibility within Supercooling and Superheating Spinodals in Mn1.85Co0.15SbMn_{1.85}Co_{0.15}Sb using Scanning Hall Probe Microscopy

Phase coexistence across disorder-broadened and magnetic-field-induced first order antiferromagnetic to ferrimagnetic transition in polycrystalline $Mn_{1.85}Co_{0.15}Sb$ has been studied mesoscopically by Scanning Hall Probe Microscope at 120K and up to 5 Tesla magnetic fields. We have observed hysteresis with varying magnetic field and the evolution of coexisting antiferromagnetic and ferrimagnetic state on mesoscopic length scale. These studies show that the magnetic state of the system at low field depends on the path followed to reach 120 K. The low field magnetic states are mesoscopically different for virgin and second field increasing cycle when 120 K is reached by warming from 5K, but are the same within measurement accuracy when the measuring temperature of 120K is reached from 300K by cooling

Rapid Determination of Manganese by Differential Pulse and Alternating Current (1st harmonic) Polarography

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3D Engineered Peripheral Nerve: Towards A New Era of Patient-Specific Nerve Repair Solutions

Reconstruction of peripheral nerve injuries (PNIs) with substance loss remains challenging because of limited treatment solutions and unsatisfactory patient outcomes. Currently, nerve autografting is the first-line management choice for bridging critical-sized nerve defects. The procedure, however, is often complicated by donor site morbidity and paucity of nerve tissue, raising a quest for better alternatives. The application of other treatment surrogates, such as nerve guides remains questionable, and inefficient in irreducible nerve gaps. More importantly, these strategies lack customization for personalized patient therapy, which is a significant drawback of these nerve repair options. This negatively impacts the fascicle-to-fascicle regeneration process, critical to restoring the physiological axonal pathway of the disrupted nerve. Recently, the use of additive manufacturing (AM) technologies has offered major advancements to the bioengineering solutions for PNI therapy. These techniques aim to reinstate the native nerve fascicle pathway using biomimetic approaches, thereby augmenting end-organ innervation. AM-based approaches, such as 3D bioprinting, are capable of biofabricating 3D engineered nerve graft scaffolds in a patient-specific manner with high precision. Moreover, realistic in vitro models of peripheral nerve tissues that represent the physiologically and functionally relevant environment of human organs could also be developed. However, the technology is still nascent and faces major translational hurdles. In this review, we spotlighted the clinical burden of PNIs and most up-to-date treatment to address nerve gaps. Next, a summarized illustration of the nerve ultrastructure that guides research solutions is discussed. This is followed by a contrast of the existing bioengineering strategies used to repair peripheral nerve discontinuities. In addition, we elaborated on the most recent advances in 3D printing (3DP) and biofabrication applications in peripheral nerve modeling and engineering. Finally, the major challenges that limit the evolution of the field along with their possible solutions are also critically analyzed

Correlation between maternal serum biochemical markers with karyotyping for prenatal screening of foetal chromosomal abnormalities

Background: Prenatal screening for chromosomal abnormalities can be done by biochemical screening tests like dual marker test (DMT), triple marker test (TMT) and quadruple marker test (QMT). It is important to identify ideal screening test among them which best correlates with result of karyotyping which is confirmatory test of foetal chromosomal abnormalities. This helps to decrease need for invasive prenatal tests for foetal karyotyping. This study aims to evaluate sensitivity, specificity, diagnostic accuracy and correlation of DMT, TMT, and QMT with results of karyotyping.Methods: Retrospective observational study was conducted in tertiary care maternity hospital over one year- 1st January 2015 to 31st December 2015. Women with singleton pregnancy undergoing DMT, TMT or QMT were included.Results: Of the 529 women screened by biochemical marker tests, 462 (87.33%) were screen negative and 67 (12.66%) women were screen positive. In 56 women, it was false positive (83.58%) and in 11 women true positive (16.41%). In 461 women the test results were true negative (99.78%), but in one case, result was false negative (0.21%).  3/11 (27.27%)women with foetal chromosomal abnormalities were primigravidae. 4/11 (36.36%)women were below 35 years. DMT and QMT had higher sensitivity (both 100%) and specificity (90.00% and 93.18% respectively) than TMT (sensitivity 80% and specificity 82.61%). Positive likelihood ratio (LR+) was 1.00 in DMT. Diagnostic odds ratio was highest with DMT (DOR=115.11) and best correlated with karyotyping results (coefficient of correlation 0.4).Conclusions: Universal screening of antenatal women, irrespective of their age and parity is suggested. DMT has highest diagnostic value and best correlation with the results of karyotyping. Hence the dual marker test can be considered to be better test for screening for aneuploidy