Improving Communication Between Child Life Services and Nursing on an Inpatient Pediatric Unit

IMPROVING COMMUNICATION BETWEEN CHILD LIFE SERVICES AND NURSING ON AN INPATIENT HOSPITAL UNIT Effective communication between patient caregivers has been shown to reduce stress and trauma related to hospitalization and subsequent improved outcomes. An HCAHP score for a 30 bed acute inpatient pediatric unit illustrated the confusion faced by children as a result of nursing and care life specialists not working together as a team. A root cause analysis identified a number of issues as to why patients were not benefitting fully from child life services. Several counter measures were instituted with the goals of improving the HCAHP score and increasing child life utilization. Post KPI inception, there was an upward trend in the HCAHP score as well as a significant improvement in the creation of treatment plans between child life services and nursing. Next steps include sustaining current level of collaboration between both teams and expanding child life services to other hospital units

Genome wide association analysis in a mouse advanced intercross line

We are grateful to Heather Lawson at Washington University in St. Louis for providing LG and SM genome sequences. We thank the Gilad Lab and Functional Genomics Facility at the University of Chicago for generating DNA- and RNA-seq data. We wish to acknowledge outstanding technical assistance from Apurva Chitre at UCSD and Mike Jarsulic at the Biological Sciences Division Center for Research Informatics at the University of Chicago. We thank Clarissa Parker, John Novembre, Graham McVicker, Joe Davis, Peter Carbonetto and Shyam Gopalakrishnan for advice, training, and mentorship. Our work was funded by NIDA (AAP: R01DA021336) and NIAMS (AL: R01AR056280). We received additional support from NIGMS (NMG: T32GM007197; MGD: T32GM07281), NIDA (NMG: F31DA03635803), NHGRI (MA: R01 HG002899), and the IMS Elphinstone Scholarship at the University of Aberdeen (AIHC). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.Peer reviewedPublisher PD

Implementing Strategies to Reduce Central Line-Associated Blood Stream Infections on an Inpatient Pediatric Unit

STRATEGIES TO REDUCE CENTRAL LINE ASSOCIATED BLOODSTREAM INFECTIONS Every central line associated bloodstream infection (CLABSI) leads to poor outcomes, increased mortality and increased healthcare costs. A pediatric care team in an academic tertiary medical center set a goal to reduce the number of these infections on their unit. The team’s research showed that daily bathing greatly decreases CLABSI. Their baseline metrics demonstrated an unacceptable level of those with central lines being bathed. A root cause analysis revealed that patient and family refusal was the leading cause for those who did not bathe. A performance improvement plan was initiated that consisted of several KPIs. Post their rollout, a marked increase in the number of patients with central lines receiving baths was realized, as was a decrease in central line associated infections. Next steps include becoming a model for other patient care units and Maine Health associated hospitals

Dysregulation of ErbB4 Signaling Pathway in the Dorsal Hippocampus after Neonatal Hypoxia-Ischemia and Late Deficits in PV+ Interneurons, Synaptic Plasticity and Working Memory

Neonatal hypoxic-ischemic (HI) injury leads to deficits in hippocampal parvalbumin (PV)+ interneurons (INs) and working memory. Therapeutic hypothermia (TH) does not prevent these deficits. ErbB4 supports maturation and maintenance of PV+ IN. Thus, we hypothesized that neonatal HI leads to persistent deficits in PV+ INs, working memory and synaptic plasticity associated with ErbB4 dysregulation despite TH. P10 HI-injured mice were randomized to normothermia (NT, 36 °C) or TH (31 °C) for 4 h and compared to sham. Hippocampi were studied for α-fodrin, glial fibrillary acidic protein (GFAP), and neuroregulin (Nrg) 1 levels; erb-b2 receptor tyrosine kinase 4 (ErbB4)/ Ak strain transforming (Akt) activation; and PV, synaptotagmin (Syt) 2, vesicular-glutamate transporter (VGlut) 2, Nrg1, and ErbB4 expression in coronal sections. Extracellular field potentials and behavioral testing were performed. At P40, deficits in PV+ INs correlated with impaired memory and coincided with blunted long-term depression (LTD), heightened long-term potentiation (LTP) and increased Vglut2/Syt2 ratio, supporting excitatory-inhibitory (E/I) imbalance. Hippocampal Nrg1 levels were increased in the hippocampus 24 h after neonatal HI, delaying the decline documented in shams. Paradoxically ErbB4 activation decreased 24 h and again 30 days after HI. Neonatal HI leads to persistent deficits in hippocampal PV+ INs, memory, and synaptic plasticity. While acute decreased ErbB4 activation supports impaired maturation and survival after HI, late deficit reemergence may impair PV+ INs maintenance after HI

Encapsulation and Sustained Release of Curcumin using Superparamagnetic Silica Reservoirs

For controlled release and targeted delivery of curcumin in an aqueous medium a method of encapsulating curcumin and magnetic nanoparticles inside porous silica matrix has been developed. Curcumin and superparamagnetic nanoparticles are loaded inside porous silica in a single process. The graphic shows the TEM image of microtomed sample of Fe3O4 particles surrounded by a silica matrix

Emerging Themes from the ESA Symposium Entitled “Pollinator Nutrition: Lessons from Bees at Individual to Landscape Levels”

Pollinator populations are declining (Biesmeijer et al., 2006; Brodschneider et al., 2018; Cameron et al., 2011; Goulson, Lye, & Darvill, 2008; Kulhanek et al., 2017; National Research Council, 2007; Oldroyd, 2007), and both anecdotal and experimental evidence suggest that limited access to high quality forage might play a role (Carvell, Meek, Pywell, Goulson, & Nowakowski, 2007; Deepa et al., 2017; Goulson, Nicholls, Botias, & Rotheray, 2015; Potts et al., 2003, 2010; Vanbergen & The Insect Pollinators Initiative, 2013; Vaudo, Tooker, Grozinger, & Patch, 2015; Woodard, 2017). Multiple researchers are earnestly addressing this topic in a diverse array of insect-pollinator systems. As research continues to be published, increased communication among scientists studying the topic of nutrition is essential for improving pollinator health

Genome wide association analysis in a mouse advanced intercross line

We are grateful to Heather Lawson at Washington University in St. Louis for providing LG and SM genome sequences. We thank the Gilad Lab and Functional Genomics Facility at the University of Chicago for generating DNA- and RNA-seq data. We wish to acknowledge outstanding technical assistance from Apurva Chitre at UCSD and Mike Jarsulic at the Biological Sciences Division Center for Research Informatics at the University of Chicago. We thank Clarissa Parker, John Novembre, Graham McVicker, Joe Davis, Peter Carbonetto and Shyam Gopalakrishnan for advice, training, and mentorship. Our work was funded by NIDA (AAP: R01DA021336) and NIAMS (AL: R01AR056280). We received additional support from NIGMS (NMG: T32GM007197; MGD: T32GM07281), NIDA (NMG: F31DA03635803), NHGRI (MA: R01 HG002899), and the IMS Elphinstone Scholarship at the University of Aberdeen (AIHC). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.Peer reviewedPublisher PD

Role of p73 in Alzheimer disease: lack of association in mouse models or in human cohorts.

BACKGROUND: P73 belongs to the p53 family of cell survival regulators with the corresponding locus Trp73 producing the N-terminally distinct isoforms, TAp73 and DeltaNp73. Recently, two studies have implicated the murine Trp73 in the modulation in phospho-tau accumulation in aged wild type mice and in young mice modeling Alzheimer's disease (AD) suggesting that Trp73, particularly the DeltaNp73 isoform, links the accumulation of amyloid peptides to the creation of neurofibrillary tangles (NFTs). Here, we reevaluated tau pathologies in the same TgCRND8 mouse model as the previous studies. RESULTS: Despite the use of the same animal models, our in vivo studies failed to demonstrate biochemical or histological evidence for misprocessing of tau in young compound Trp73+/- + TgCRND8 mice or in aged Trp73+/- mice analyzed at the ages reported previously, or older. Secondly, we analyzed an additional mouse model where the DeltaNp73 was specifically deleted and confirmed a lack of impact of the DeltaNp73 allele, either in heterozygous or homozygous form, upon tau pathology in aged mice. Lastly, we also examined human TP73 for single nucleotide polymorphisms (SNPs) and/or copy number variants in a meta-analysis of 10 AD genome-wide association datasets. No SNPs reached significance after correction for multiple testing and no duplications/deletions in TP73 were found in 549 cases of AD and 544 non-demented controls. CONCLUSION: Our results fail to support P73 as a contributor to AD pathogenesis.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Association of the CpG Methylation Pattern of the Proximal Insulin Gene Promoter with Type 1 Diabetes

The insulin (INS) region is the second most important locus associated with Type 1 Diabetes (T1D). The study of the DNA methylation pattern of the 7 CpGs proximal to the TSS in the INS gene promoter revealed that T1D patients have a lower level of methylation of CpG -19, -135 and -234 (p = 2.10−16) and a higher methylation of CpG -180 than controls, while methylation was comparable for CpG -69, -102, -206. The magnitude of the hypomethylation relative to a control population was 8–15% of the corresponding levels in controls and was correlated in CpGs -19 and -135 (r = 0.77) and CpG -135 and -234 (r = 0.65). 70/485 (14%) of T1D patients had a simultaneous decrease in methylation of CpG -19, -135, -234 versus none in 317 controls. CpG methylation did not correlate with glycated hemoglobin or with T1D duration. The methylation of CpG -69, -102, -180, -206, but not CpG -19, -135, -234 was strongly influenced by the cis-genotype at rs689, a SNP known to show a strong association with T1D. We hypothesize that part of this genetic association could in fact be mediated at the statistical and functional level by the underlying changes in neighboring CpG methylation. Our observation of a CpG-specific, locus-specific methylation pattern, although it can provide an epigenetic biomarker of a multifactorial disease, does not indicate whether the reported epigenetic pattern preexists or follows the establishment of T1D. To explore the effect of chronic hyperglycemia on CpG methylation, we studied non obese patients with type 2 diabetes (T2D) who were found to have decreased CpG-19 methylation versus age-matched controls, similar to T1D (p = 2.10−6) but increased CpG-234 methylation (p = 5.10−8), the opposite of T1D. The causality and natural history of the different epigenetic changes associated with T1D or T2D remain to be determined