49 research outputs found

    Incidence of in-hospital cardiac arrest at general wards before and after implementation of an early warning score

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    Abstract Background In order to reduce the incidence of in-hospital cardiac arrest (IHCA) at general wards, medical emergency teams (MET) were implemented in the Capital Region of Denmark in 2012 as the efferent part of a track and trigger system. The National Early Warning Score (NEWS) system became the afferent part. This study aims at investigating the incidence of IHCA at general wards before and after the implementation of the NEWS system. Material and methods We included patients at least 18 years old with IHCA at general wards in our hospital in the periods of 2006 to 2011 (pre-EWS group) and 2013 to 2018 (post-EWS group). Data was obtained from a local database and the National In-Hospital Cardiac Arrest Registry (DANARREST). We calculated incidence rate ratios (IRR) for IHCA at general wards with 95% confidence interval (95% CI). Odds ratios (OR) for return of spontaneous circulation (ROSC) and 30-day survival were also calculated with 95% CI. Results A total of 444 IHCA occurred before the implementation of NEWS at general wards while 494 IHCA happened afterwards. The incidence rate of IHCA at general wards was 1.13 IHCA per 1000 admissions in the pre-EWS group (2006–2011) and 1.11 IHCA per 1000 admissions in the post-EWS group (2013–2018). The IRR between the two groups was 0.98 (95% CI [0.86;1.11], p = 0.71). The implementation did not affect the chance of ROSC with a crude OR of 1.14 (95% CI [0.88;1.47], p = 0.32) nor did it change the 30-day survival with a crude OR 1.30 (95% CI [0.96;1.75], p = 0.09). Conclusion Implementation of the EWS system at our hospital did not decrease the incidence rate of in-hospital cardiac arrest at general wards

    Forest Management Scenarios in a Changing Climate: Trade-Offs Between Carbon, Timber, and Old Forest

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    Balancing economic, ecological, and social values has long been a challenge in the forests of the Pacific Northwest, where conflict over timber harvest and old-growth habitat on public lands has been contentious for the past several decades. The Northwest Forest Plan, adopted two decades ago to guide management on federal lands, is currently being revised as the region searches for a balance between sustainable timber yields and habitat for sensitive species. In addition, climate change imposes a high degree of uncertainty on future forest productivity, sustainability of timber harvest, wildfire risk, and species habitat. We evaluated the long-term, landscape-scale trade-offs among carbon (C) storage, timber yield, and old forest habitat given projected climate change and shifts in forest management policy across 2.1 million hectares of forests in the Oregon Coast Range. Projections highlight the divergence between private and public lands under business-as-usual forest management, where private industrial forests are heavily harvested and many public (especially federal) lands increase C and old forest over time but provide little timber. Three alternative management scenarios altering the amount and type of timber harvest show widely varying levels of ecosystem C and old-forest habitat. On federal lands, ecological forestry practices also allowed a simultaneous increase in old forest and natural early-seral habitat. The ecosystem C implications of shifts away from current practices were large, with current practices retaining up to 105 Tg more C than the alternative scenarios by the end of the century. Our results suggest climate change is likely to increase forest productivity by 30–41% and total ecosystem C storage by 11–15% over the next century as warmer winter temperatures allow greater forest productivity in cooler months. These gains in C storage are unlikely to be offset by wildfire under climate change, due to the legacy of management and effective fire suppression. Our scenarios of future conditions can inform policy makers, land managers, and the public about the potential effects of land management alternatives, climate change, and the trade-offs that are inherent to management and policy in the region

    How Will Climate Change and Bioenergy Harvest Affect Carbon Storage in the Oregon Coast Range

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    This poster shows how the researchers used a simulation model to explore the impacts of varying scenarios of climate change and forest management on the ecosystem carbon

    Feasibility of Cowpea chlorotic mottle virus-like particles as scaffold for epitope presentations

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    Within the last decade Virus-Like Particles (VLPs) have increasingly received attention from scientists for their use as a carrier of (peptide) molecules or as scaffold to present epitopes for use in subunit vaccines. To test the feasibility of Cowpea chlorotic mottle virus (CCMV) particles as a scaffold for epitope presentation and identify sites for epitope fusion or insertion that would not interfere with virus-like-particle formation, chimeric CCMV coat protein (CP) gene constructs were engineered, followed by expression in E. coli and assessment of VLP formation. Various constructs were made encoding a 6x-His-tag, or selected epitopes from Influenza A virus [IAV] (M2e, HA) or Foot and Mouth Disease Virus [FMDV] (VP1 and 2C). The epitopes were either inserted 1) in predicted exposed loop structures of the CCMV CP protein, 2) fused to the amino- (N) or carboxyl-terminal (C) ends, or 3) to a N-terminal 24 amino acid (aa) deletion mutant (N¿24-CP) of the CP protein. Results High levels of insoluble protein expression, relative to proteins from the entire cell lysate, were obtained for CCMV CP and all chimeric derivatives. A straightforward protocol was used that, without the use of purification columns, successfully enabled CCMV CP protein solubilization, reassembly and subsequent collection of CCMV CP VLPs. While insertions of His-tag or M2e (7-23 aa) into the predicted external loop structures did abolish VLP formation, high yields of VLPs were obtained with all fusions of His-tag or various epitopes (13- 27 aa) from IAV and FMDV at the N- or C-terminal ends of CCMV CP or N¿24-CP. VLPs derived from CCMV CP still encapsulated RNA, while those from CCMV CP-chimera containing a negatively charged N-terminal domain had lost this ability. The usefulness and rapid ease of exploitation of CCMV VLPs for the production of potential subunit vaccines was demonstrated with the synthesis of chimeric CCMV VLPs containing selected sequences from the G N and G C glycoproteins of the recently emerged Schmallenberg orthobunyavirus at both termini of the CP protein. Conclusions CCMV VLPs can be successfully exploited as scaffold for epitope fusions up to 31 aa at the N- and C-terminus, and at a N-terminal 24 amino acid (aa) deletion mutant (N¿24-CP) of the CP protein
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