LLUSD Articulator - Volume 29, Number 1

Contents: 4 | Dean’s brown bag6 | Robert Smith’s generous gift8 | Inaugural RDAEF class graduates10 | Zambian miracle13 | Mark Estey new academic dean17 | Esther Valenzuela assistant dean18 | Graham Stacey retires20 | One Homecoming Number 226 | Fostering LLUSD student research34 | Student research winners42 | LLUSD at ASDR46 | Newshttps://scholarsrepository.llu.edu/articulator/1014/thumbnail.jp

Mice Deficient in GEM GTPase Show Abnormal Glucose Homeostasis Due to Defects in Beta-Cell Calcium Handling

Glucose-stimulated insulin secretion from beta-cells is a tightly regulated process that requires calcium flux to trigger exocytosis of insulin-containing vesicles. Regulation of calcium handling in beta-cells remains incompletely understood. Gem, a member of the RGK (Rad/Gem/Kir) family regulates calcium channel handling in other cell types, and Gem over-expression inhibits insulin release in insulin-secreting Min6 cells. The aim of this study was to explore the role of Gem in insulin secretion. We hypothesised that Gem may regulate insulin secretion and thus affect glucose tolerance in vivo

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Health Futures Foundation, Inc.: An online communications campaign

This thesis project focuses on effectively communicating Health Futures Foundation, Inc.\u27s (HFI), research findings on medicinal plants found in the Philippines. HFI is a non-profit and non-governmental organization based in Quezon City that focuses on building communities of wellness in different areas of the country. The initial communication audit with HFI revealed that the organization is unable to effectively communicate their research findings about medicinal plants of their target audience, the millennials. With the use of Zhang, Yu, Yan and Spil (2015) and Imroz\u27s (2013) application of Rogers\u27 (1983) Diffusion of Innovations theory, the researchers conducted a thorough communication audit in order to find the root cause of the problem. The researchers then crafted an online communications campaign in order to address this problem that includes the following (1) Infographics that included HFI\u27s background, the Republic Act which promotes Traditional and Alternative Medicine in the country, detailed information about medicinal plants, (2) crowdsourced testimonies from millennials, and lastly, (3) video clips of doctors answering frequently asked questions about medicinal plants and promoting its use. An interactive website was also designed in order to address HFI\u27s problem. The post-campaign evaluation revealed that the campaign was a success and indeed served its purpose in effectively communicating HFI\u27s researchers findings on medicinal plants and at the same time promoting a more positive perception about its practice. The success of the campaign in turn allows for millennials to expand their options when it comes to medication choices

Excess lipid availability increases mitochondrial fatty acid oxidative capacity in muscle evidence against a role for reduced fatty acid oxidation in lipid-induced insulin resistance in rodents

A reduced capacity for mitochondrial fatty acid oxidation in skeletal muscle has been proposed as a major factor leading to the accumulation of intramuscular lipids and their subsequent deleterious effects on insulin action. Here, we examine markers of mitochondrial fatty acid oxidative capacity in rodent models of insulin resistance associated with an oversupply of lipids. C57BL/6J mice were fed a high-fat diet for either 5 or 20 weeks. Several markers of muscle mitochondrial fatty acid oxidative capacity were measured, including 14C-palmitate oxidation, palmitoyl-CoA oxidation in isolated mitochondria, oxidative enzyme activity (citrate synthase, ߭hydroxyacyl CoA dehydrogenase, medium-chain acyl-CoA dehydrogenase, and carnitine palmitoyl-transferase 1), and expression of proteins involved in mitochondrial metabolism. Enzyme activity and mitochondrial protein expression were also examined in muscle from other rodent models of insulin resistance. Compared with standard diet-fed controls, muscle from fat-fed mice displayed elevated palmitate oxidation rate (5 weeks +23%, P < 0.05, and 20 weeks +29%, P < 0.05) and increased palmitoyl-CoA oxidation in isolated mitochondria (20 weeks +49%, P < 0.01). Furthermore, oxidative enzyme activity and protein expression of peroxisome proliferator-activated receptor ? coactivator (PGC)-1a, uncoupling protein (UCP) 3, and mitochondrial respiratory chain subunits were significantly elevated in fat-fed animals. A similar pattern was present in muscle of fat-fed rats, obese Zucker rats, and db/db mice, with increases observed for oxidative enzyme activity and expression of PGC-1a, UCP3, and subunits of the mitochondrial respiratory chain. These findings suggest that high lipid availability does not lead to intramuscular lipid accumulation and insulin resistance in rodents by decreasing muscle mitochondrial fatty acid oxidative capacity.No Full Tex

Global prevalence of basic life support training: a systematic review and meta-analysis

Background and Aims: Out-of-hospital cardiac arrest exerts a large disease burden, which may be mitigated by bystander cardiopulmonary resuscitation and automated external defibrillation. We aimed to estimate the global prevalence and distribution of bystander training among laypersons, which are poorly understood, and to identify their determinants. Methods: We searched electronic databases for cross-sectional studies reporting the prevalence of bystander training from representative population samples. Pooled prevalence was calculated using random-effects models. Key outcome was cardiopulmonary resuscitation training (training within two-years and those who were ever trained). We explored determinants of interest using subgroup analysis and meta-regression. Results: 29 studies were included, representing 53,397 laypersons. Among national studies, the prevalence of cardiopulmonary resuscitation training within two-years and among those who were ever trained, and automated external defibrillator training was 10.02% (95% CI 6.60 -14.05), 42.04% (95% CI 30.98-53.28) and 21.08% (95% CI 10.16-34.66) respectively. Subgroup analyses by continent revealed pooled prevalence estimates of 31.58% (95%CI 18.70–46.09), 58.78% (95%CI 42.41–74.21), 18.93 (95% CI 0.00–62.94), 64.97% (95%CI 64.00–65.93), and 50.56% (95%CI 47.57–53.54) in Asia, Europe, Middle East, North America, and Oceania respectively, with significant subgroup differences (p < 0.01). A country’s income and cardiopulmonary resuscitation training (ever trained) (p = 0.033) were positively correlated. Similarly, this prevalence was higher among the highly educated (p<0.00001). Conclusions: Large regional variation exists in data availability and bystander training prevalence. Socioeconomic status correlated with prevalence of bystander training, and regional disparities were apparent between continents. Bystander training should be promoted, particularly in Asia, Middle East, and low-income regions. Data availability should be encouraged from under-represented regions.Published versionAFWH was supported by the Estate of Tan Sri Khoo Teck Puat (Khoo Clinical Scholars Programme), Khoo Pilot Award (KP/2019/0034), Duke-NUS Medical School and National Medical Research Council (NMRC/CS_Seedfd/012/2018)

Gem-deficient mice were glucose intolerant.

<p><b>A</b>) Eight (8) week old Gem^−/− mice had impaired glucose homeostasis on glucose tolerance testing (GTT). <b>B</b>) Glucose tolerance was also significantly worse in 12 week old Gem^−/− mice. <b>C</b>) Glucose stimulated insulin secretion in vivo was impaired in Gem^−/− mice. <b>D</b>) Whole body insulin sensitivity was un-altered in Gem^−/− mice, as indicated by insulin tolerance tests. <b>E</b>) Insulin release in isolated islets was impaired in Gem^−/− mice. <b>F</b>) Glucose stimulated increase in ATP content was normal in Gem^−/− mice. Error bars indicate ±1SEM. * = p&lt;0.05, ** = p&lt;0.01, *** = p&lt;0.001.</p

Gem-deficient mice have impaired calcium flux.

<p><b>A</b>) Gem^+/+ islets exposed to 11.1 mM glucose establish regular calcium oscillations. <b>B</b>) In contrast, islets from Gem^−/− mice have impaired oscillations. <b>C</b>) The calculated calcium at 11.1 mM glucose is significantly lower in Gem^−/− islets. Error bars indicate ±1SEM. * = p&lt;0.05.</p