Palliative care needs in patients hospitalized with heart failure (PCHF) study: rationale and design

Abstract Aims The primary aim of this study is to provide data to inform the design of a randomized controlled clinical trial (RCT) of a palliative care (PC) intervention in heart failure (HF). We will identify an appropriate study population with a high prevalence of PC needs defined using quantifiable measures. We will also identify which components a specific and targeted PC intervention in HF should include and attempt to define the most relevant trial outcomes. Methods An unselected, prospective, near-consecutive, cohort of patients admitted to hospital with acute decompensated HF will be enrolled over a 2-year period. All potential participants will be screened using B-type natriuretic peptide and echocardiography, and all those enrolled will be extensively characterized in terms of their HF status, comorbidity, and PC needs. Quantitative assessment of PC needs will include evaluation of general and disease-specific quality of life, mood, symptom burden, caregiver burden, and end of life care. Inpatient assessments will be performed and after discharge outpatient assessments will be carried out every 4 months for up to 2.5 years. Participants will be followed up for a minimum of 1 year for hospital admissions, and place and cause of death. Methods for identifying patients with HF with PC needs will be evaluated, and estimates of healthcare utilisation performed. Conclusion By assessing the prevalence of these needs, describing how these needs change over time, and evaluating how best PC needs can be identified, we will provide the foundation for designing an RCT of a PC intervention in HF

SN 2007uy - metamorphosis of an aspheric Type Ib explosion

The supernovae of Type Ibc are rare and the detailed characteristics of these explosions have been studied only for a few events. Unlike Type II SNe, the progenitors of Type Ibc have never been detected in pre-explosion images. So, to understand the nature of their progenitors and the characteristics of the explosions, investigation of proximate events are necessary. Here we present the results of multi-wavelength observations of Type Ib SN 2007uy in the nearby ($\sim$ 29.5 Mpc) galaxy NGC 2770. Analysis of the photometric observations revealed this explosion as an energetic event with peak absolute R band magnitude $-18.5\pm0.16$, which is about one mag brighter than the mean value ($-17.6\pm0.6$) derived for well observed Type Ibc events. The SN is highly extinguished, E(B-V) = 0.63$\pm$0.15 mag, mainly due to foreground material present in the host galaxy. From optical light curve modeling we determine that about 0.3 M$_{\odot}$ radioactive $^{56}$Ni is produced and roughly 4.4 M$_{\odot}$ material is ejected during this explosion with liberated energy $\sim 15\times10^{51}$ erg, indicating the event to be an energetic one. Through optical spectroscopy, we have noticed a clear aspheric evolution of several line forming regions, but no dependency of asymmetry is seen on the distribution of $^{56}$Ni inside the ejecta. The SN shock interaction with the circumburst material is clearly noticeable in radio follow-up, presenting a Synchrotron Self Absorption (SSA) dominated light curve with a contribution of Free Free Absorption (FFA) during the early phases. Assuming a WR star, with wind velocity \ga 10^3 {\rm km s}^{-1}, as a progenitor, we derive a lower limit to the mass loss rate inferred from the radio data as \dot{M} \ga 2.4\times10^{-5} M$_{\odot}$, yr$^{-1}$, which is consistent with the results obtained for other Type Ibc SNe bright at radio frequencies.Comment: 22 pages, 13 figures, accepted for publication in MNRA

Alignment and Composition of Laminin-Polycaprolactone Nanofiber Blends Enhance Peripheral Nerve Regeneration

Peripheral nerve transection occurs commonly in traumatic injury, causing deficits distal to the injury site. Conduits for repair currently on the market are hollow tubes; however, they often fail due to slow regeneration over long gaps. To facilitate increased regeneration speed and functional recovery, the ideal conduit should provide biochemically relevant signals and physical guidance cues, thus playing an active role in regeneration. To that end, laminin and lamininpolycaprolactone (PCL) blend nanofibers were fabricated to mimic peripheral nerve basement membrane. In vitro assays established 10% (wt) laminin content is sufficient to retain neurite-promoting effects of laminin. In addition, modified collector plate design to introduce an insulating gap enabled the fabrication of aligned nanofibers. The effects of laminin content and fiber orientation were evaluated in rat tibial nerve defect model. The lumens of conduits were filled with nanofiber meshes of varying laminin content and alignment to assess changes in motor and sensory recovery. Retrograde nerve conduction speed at 6 weeks was significantly faster in animals receiving aligned nanofiber conduits than in those receiving random nanofiber conduits. Animals receiving nanofiber-filled conduits showed some conduction in both anterograde and retrograde directions, whereas in animals receiving hollow conduits, no impulse conduction was detected. Aligned PCL nanofibers significantly improved motor function; aligned laminin blend nanofibers yielded the best sensory function recovery. In both cases, nanofiber-filled conduits resulted in better functional recovery than hollow conduits. These studies provide a firm foundation for the use of naturalsynthetic blend electrospun nanofibers to enhance existing hollow nerve guidance conduits

Complete Genome Sequence and Methylome Analysis of Micrococcus luteus SA211, a Halophilic, Lithium-Tolerant Actinobacterium from Argentina

Micrococcus luteus has been found in a wide range of habitats. We report the complete genome sequence and methylome analysis of strain SA211 isolated from a hypersaline, lithium-rich, high-altitude salt flat in Argentina with single-molecule real-time sequencing.Fil: Martínez, Fabiana Lilian. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Investigaciones para la Industria Química. Universidad Nacional de Salta. Facultad de Ingeniería. Instituto de Investigaciones para la Industria Química; Argentina. University of Maryland; Estados UnidosFil: Anton, B. P.. New England Biolabs; Estados UnidosFil: DasSarma, P.. University of Maryland; Estados UnidosFil: Rajal, Verónica Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Investigaciones para la Industria Química. Universidad Nacional de Salta. Facultad de Ingeniería. Instituto de Investigaciones para la Industria Química; ArgentinaFil: Irazusta, Verónica Patricia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Investigaciones para la Industria Química. Universidad Nacional de Salta. Facultad de Ingeniería. Instituto de Investigaciones para la Industria Química; ArgentinaFil: Roberts, Roy. New England Biolabs; Estados UnidosFil: DasSarma, S.. University of Maryland; Estados Unido

Using a model of group psychotherapy to support social research on sensitive topics

This article describes the exploratory use of professional therapeutic support by social researchers working on a sensitive topic. Talking to recently bereaved parents about the financial implications of their child's death was expected to be demanding work, and the research design included access to an independent psychotherapeutic service. Using this kind of professional support is rare within the general social research community, and it is useful to reflect on the process. There are likely to be implications for collection and interpretation of data, research output and the role and experience of the therapist. Here, the primary focus is the potential impact on researcher well-being

Factors Associated with the Acquisition and Severity of Gestational Listeriosis

Gravid mammals are more prone to listeriosis than their nongravid counterparts. However, many features of the disease in gravid animals are not well defined. We determined, in mice, that increased susceptibility to lethal infection following oral inoculation begins surprisingly early in pregnancy and extends through embryonic development. Pregnancy did not demonstrably increase the spread of listeriae from the intestine to the liver and spleen in the initial 96 h period post inoculation. Consequently, it appeared that gravid animals were competent to contain an enteric infection, but in those instances where escape did occur, a lethal outcome was more likely. Interestingly, colonic colonization level and prevalence, measured 96 h post inoculation, was significantly higher in gravid individuals. In terms of human risk factors for listeriosis, our results suggest that the window of listeriosis susceptibility afforded by pregnancy may be open longer than previously appreciated. Our results also suggest that while gravid animals are competent to contain an enteric infection, enteric carriage rate may be more of a factor in defining disease incidence than previously considered

The Ursinus Weekly, May 11, 1964

New Lost City Ramblers to perform Friday: Agency sponsors blue grass group • Bombers bombed by MSGA, faculty reviewing • UC scholar wins St. Andrews scholarship • Survey supports APO projects • Loved you Conrad : Spring festival succeeds with new program • Bible fellowship • Two classes elect officers today • Pi Nu Epsilon inducts members • Ursinus Circle • Obituary • Editorial: Attention administration • Mr. Pennypacker stages a remarkable performance: Robbins, Sinclair, Auchincloss and Matusow star in production • Spring hits UC campus with sun, fun and studies • Next President: Johnson • Letter to the Editor • Ursinus thinclads retain MAC crown: Cooper wins two, Dunn ties 440 record; Gladstone, Robart, Walter, relay take 1st • Softballers win; Season undefeated • Batsmen even for week: Defeated Drexel, split with Haverford and lost to LaSalle • Tennis loses 3rd; Bryn Mawr takes 4 • Lacrosse wins 4th; Swamp E-burg 13-3 • MAC summary • Greek gleaningshttps://digitalcommons.ursinus.edu/weekly/3110/thumbnail.jp

Exploring patient information needs in type 2 diabetes: A cross sectional study of questions

This study set out to analyze questions about type 2 diabetes mellitus (T2DM) from patients and the public. The aim was to better understand people's information needs by starting with what they do not know, discovered through their own questions, rather than starting with what we know about T2DM and subsequently finding ways to communicate that information to people affected by or at risk of the disease. One hundred and sixty-four questions were collected from 120 patients attending outpatient diabetes clinics and 300 questions from 100 members of the public through the Amazon Mechanical Turk crowdsourcing platform. Twenty-three general and diabetes-specific topics and five phases of disease progression were identified; these were used to manually categorize the questions. Analyses were performed to determine which topics, if any, were significant predictors of a question's being asked by a patient or the public, and similarly for questions from a woman or a man. Further analysis identified the individual topics that were assigned significantly more often to the crowdsourced or clinic questions. These were Causes (CI: [-0.07, -0.03], p < .001), Risk Factors ([-0.08, -0.03], p < .001), Prevention ([-0.06, -0.02], p < .001), Diagnosis ([-0.05, -0.02], p < .001), and Distribution of a Disease in a Population ([-0.05,-0.01], p = .0016) for the crowdsourced questions and Treatment ([0.03, 0.01], p = .0019), Disease Complications ([0.02, 0.07], p < .001), and Psychosocial ([0.05, 0.1], p < .001) for the clinic questions. No highly significant gender-specific topics emerged in our study, but questions about Weight were more likely to come from women and Psychosocial questions from men. There were significantly more crowdsourced questions about the time Prior to any Diagnosis ([(-0.11, -0.04], p = .0013) and significantly more clinic questions about Health Maintenance and Prevention after diagnosis ([0.07. 0.17], p < .001). A descriptive analysis pointed to the value provided by the specificity of questions, their potential to disclose emotions behind questions, and the as-yet unrecognized information needs they can reveal. Large-scale collection of questions from patients across the spectrum of T2DM progression and from the public-a significant percentage of whom are likely to be as yet undiagnosed-is expected to yield further valuable insights