Expanding Rural Opioid Addictions Treatment: An Inter-institutional, Inter-professional Telehealth Case Study Simulation

Purpose: To determine if inter-institutional collaboration, using telehealth technology, inter-professional education techniques, and case study methodology is a feasible way to teach health professions students how to appropriately address opioid addictions, especially in rural populations with limited health care access. Study subjects: Ten health professions students from four Virginia universities participated. Professions represented included medicine, nursing, physical therapy, social work, nutrition, and psychology at the graduate and undergraduate levels. Methods: Inter-professional faculty from four Virginia universities developed an opioid addiction simulation case study using a standardized patient. Students from different regions engaged in a facilitated patient interview and care planning via secure virtual meeting platform. Faculty observation and feedback, student feedback, and inter-professional education assessments were used to assess this pilot study. Findings: Inter-institutional faculty collaboration and telehealth technology was successfully employed to convene multiple health professions students from different sites; simulation case study methodology using a standardized patient was effective and compelling; students effectively utilized interprofessional competencies and skills to develop a comprehensive and holistic care plan for opioid addiction treatment. Conclusions: Telehealth technology, inter-professional education, and simulation case study methodology can be successfully used to teach health professions students how to collaborate to address the opioid crisis, especially in resource-limited rural areas. Implications: Many resources are necessary to successfully treat opioid addictions. By using telehealth technology combined with inter-professional concepts and skills, resources can be shared between institutions and professions to successfully treat patients with opioid addictions in resource-limited areas

Characterization of 3 PET tracers for Quantification of Mitochondrial and Synaptic function in Healthy Human Brain: 18F-BCPP-EF, 11C-SA-4503, 11C-UCB-J

Mitochondrial complex 1 (MC1) is involved in maintaining brain bioenergetics, the sigma 1 receptor (σ1R) responds to neuronal stress and synaptic vesicle protein 2A (SV2A) reflects synaptic integrity. Expression of each of these proteins is altered in neurodegenerative diseases. Here we characterise the kinetic behaviour of three positron emission tomography (PET) radioligands 18F-BCPP-EF, 11C-SA-4503 and 11CUCB- J, for the measurement of MC1, σ1R and SV2A, respectively, and determine appropriate analysis workflows for their application in future studies of the in vivo molecular pathology of these diseases. Methods: Twelve human subjects underwent dynamic PET scans including associated arterial blood sampling with each radioligand. A range of kinetic models were investigated to identify an optimal kinetic analysis method for each radioligand and a suitable acquisition duration. Results: All three radioligands readily entered the brain and yielded heterogeneous uptake consistent with the known distribution of the targets. The optimal models determined for the regional estimates of volume of distribution (VT) were multilinear analysis 1 (MA1) and the 2-tissue compartment (2TC) model for 18F-BCPP-EF, MA1 for 11C-SA- 4503, and both MA1 and the 1-tissue compartment (1TC) model for 11C-UCB-J. Acquisition times of 70, 80 and 60 minutes for 18F-BCPP-EF, 11C-SA-4503, 11C-UCB-J, respectively, provided good estimates of regional VT values. An effect of age was observed on 18F-BCPP-EF and 11C-UCB-J signal in the caudate. Conclusion: These ligands can be assessed for their potential to stratify patients or monitor the progression of molecular neuropathology in neurodegenerative diseases

Measuring Relations Between Concepts In Conceptual Spaces

The highly influential framework of conceptual spaces provides a geometric way of representing knowledge. Instances are represented by points in a high-dimensional space and concepts are represented by regions in this space. Our recent mathematical formalization of this framework is capable of representing correlations between different domains in a geometric way. In this paper, we extend our formalization by providing quantitative mathematical definitions for the notions of concept size, subsethood, implication, similarity, and betweenness. This considerably increases the representational power of our formalization by introducing measurable ways of describing relations between concepts.Comment: Accepted at SGAI 2017 (http://www.bcs-sgai.org/ai2017/). The final publication is available at Springer via https://doi.org/10.1007/978-3-319-71078-5_7. arXiv admin note: substantial text overlap with arXiv:1707.05165, arXiv:1706.0636

Perigraft air is not always pathological: a case report

© 2007 Ball et al; licensee BioMed Central Ltd

Bringing Brotherly Love to Interprofessional Education - Creating a Curriculum of Simulation with Multidisciplinary Objectives

Objectives: Learners attending this presentation/workshop will: Discuss the current trends in an interprofessional education curriculum Explore the possible pinnacles and pitfalls in developing an IPE educational curriculum, including institutional support for IPE programs Acquire the skills to develop simulation cases that foster interprofessional objectives Interprofessional collaboration and teamwork among health care professionals is essential to provide safe, high quality patient care. Unfortunately, dismantling of the existing educational silos between disciplines is fraught with challenges. Success requires multidisciplinary commitment and leadership, and must occur early in each student’s educational training. Although gaining popularity, interprofessional education (IPE) and communication is not commonly a focus in all health care disciplines. Drexel University ‘s College of Medicine and College of Nursing and Health Professions have developed a successful IPE curriculum in Women’s Health, built on a foundation of simulation and communication. Occurring three days per academic year over the last five years, the curriculum engages OB/GYN and anesthesia residents, undergraduate nursing, nurse practitioner, nurse anesthesia, physician assistant and midwifery students in outpatient and inpatient scenarios with active participant communication activities that crescendo through the year. Expert faculty with enhanced credentials in multi-fidelity simulation, Debriefing with Good JudgmentTM, and TeamSTEPPSTM participate in faculty development and interactive curriculum review to provide learners with rigorous, life-like experiences while learning to appropriately give bad news, handle stressful situations, and discuss important health related issues in a collaborative environment. The Drexel University Partnership for Interprofessional Education (DU-PIE) has presented workshops and live demonstrations nationally to teach faculty and staff how to devise an interprofessional curriculum for their institutions. Pinnacles and pitfalls encountered during the development and roll out of the Drexel model can assist programs to sustain and further enrich IPE programs. This interactive workshop will consist of a brief presentation, a small group activity to assist faculty and professional staff in creating the building blocks of an IPE simulation program including identifying stakeholders, lobbying for administrative support, and developing simulation cases that incorporate multidisciplinary IPE objectives, and group debriefing to share gained insights

Potentiality in Biology

We take the potentialities that are studied in the biological sciences (e.g., totipotency) to be an important subtype of biological dispositions. The goal of this paper is twofold: first, we want to provide a detailed understanding of what biological dispositions are. We claim that two features are essential for dispositions in biology: the importance of the manifestation process and the diversity of conditions that need to be satisfied for the disposition to be manifest. Second, we demonstrate that the concept of a disposition (or potentiality) is a very useful tool for the analysis of the explanatory practice in the biological sciences. On the one hand it allows an in-depth analysis of the nature and diversity of the conditions under which biological systems display specific behaviors. On the other hand the concept of a disposition may serve a unificatory role in the philosophy of the natural sciences since it captures not only the explanatory practice of biology, but of all natural sciences. Towards the end we will briefly come back to the notion of a potentiality in biology

Live to cheat another day: bacterial dormancy facilitates the social exploitation of beta-lactamases

The breakdown of antibiotics by β-lactamases may be cooperative, since resistant cells can detoxify their environment and facilitate the growth of susceptible neighbours. However, previous studies of this phenomenon have used artificial bacterial vectors or engineered bacteria to increase the secretion of β-lactamases from cells. Here, we investigated whether a broad-spectrum β-lactamase gene carried by a naturally occurring plasmid (pCT) is cooperative under a range of conditions. In ordinary batch culture on solid media, there was little or no evidence that resistant bacteria could protect susceptible cells from ampicillin, although resistant colonies could locally detoxify this growth medium. However, when susceptible cells were inoculated at high densities, late-appearing phenotypically susceptible bacteria grew in the vicinity of resistant colonies. We infer that persisters, cells that have survived antibiotics by undergoing a period of dormancy, founded these satellite colonies. The number of persister colonies was positively correlated with the density of resistant colonies and increased as antibiotic concentrations decreased. We argue that detoxification can be cooperative under a limited range of conditions: if the toxins are bacteriostatic rather than bacteridical; or if susceptible cells invade communities after resistant bacteria; or if dormancy allows susceptible cells to avoid bactericides. Resistance and tolerance were previously thought to be independent solutions for surviving antibiotics. Here, we show that these are interacting strategies: the presence of bacteria adopting one solution can have substantial effects on the fitness of their neighbours

Dipyridamole-thallium/sestamibi before vascular surgery: A prospective blinded study in moderate-risk patients

AbstractPurpose: This study assessed in a prospective, blinded fashion whether a reversible defect on dipyridamole-thallium (DTHAL)/sestamibi (DMIBI) can predict adverse cardiac events after elective vascular surgery in patients with one or more clinical risk factors. Methods: Consecutive patients with one or more clinical risk factors underwent a preoperative blinded DTHAL/DMIBI. Patients with recent congestive heart failure (CHF) or myocardial infarction (MI) or severe or unstable angina were excluded. Results: Eighty patients (78% men; mean age, 65 years) completed the study. Diabetes mellitus was the most frequent clinical risk factor (73%), followed by age older than 70 years (41%), angina (29%), Q wave on electrocardiogram (26%), history of CHF (7%), and ventricular ectopy (3%). The results of DTHAL/DMIBI were normal in 36 patients (45%); a reversible plus or minus fixed defect was demonstrated in 28 patients (36%), and a fixed defect alone was demonstrated in 15 patients (19%). Nine adverse cardiac events (11%) occurred, including three cases of CHF, and one case each of unstable angina, Q wave MI, non-Q wave MI, and cardiac arrest (successfully resuscitated). Two cardiac deaths occurred (2% overall mortality), one after a Q wave MI and one after CHF and a non-Q wave MI. The cardiac event rate was 14% for reversible defect and 9.8% without reversible defect (P =.71). The cardiac event rate was 12.5% (one of eight cases) for two or more reversible defects, versus 11.1% (eight of 72 cases) for fewer than two reversible defects (P = 1.0). The sensitivity rate of two or more areas of redistribution was 11% (95% CI, 0.3%-48%), the specificity rate was 90%, and the positive and negative predictive values were 12.5% and 89%, respectively. Conclusion: Our study demonstrated no association between reversible defects on DTHAL/DMIBI and adverse cardiac events in moderate-risk patients undergoing elective vascular surgery. (J Vasc Surg 2000;32:77-89.

Colored Resonant Signals at the LHC: Largest Rate and Simplest Topology

We study the colored resonance production at the LHC in a most general approach. We classify the possible colored resonances based on group theory decomposition, and construct their effective interactions with light partons. The production cross section from annihilation of valence quarks or gluons may be on the order of 400 - 1000 pb at LHC energies for a mass of 1 TeV with nominal couplings, leading to the largest production rates for new physics at the TeV scale, and simplest event topology with dijet final states. We apply the new dijet data from the LHC experiments to put bounds on various possible colored resonant states. The current bounds range from 0.9 to 2.7 TeV. The formulation is readily applicable for future searches including other decay modes.Comment: 29 pages, 9 figures. References updated and additional K-factors include