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Systems and methods for altering visual acuity
Provided are systems operable to effect a temporary change in a modulation transfer function (MTF) of a target imaging system. The systems include a light source operable to produce light for transient propagation onto at least a portion of the target imaging system, a power source in operative communication with the light source and configured to effect the production of light from the light source, and a transmission unit in operative communication with the light source and configured to propagate the produced light onto at least a portion of the target imaging system. The propagated light is configured for absorbance by the portion of the target imaging system; the absorbance causes an increase in temperature and a change in a refractive index profile of at least the portion of the imaging system. The change in refractive index profile produces a temporary change in the MTF of the imaging system.Board of Regents, University of Texas Syste
Medication-taking behaviours in chronic kidney disease with multiple chronic conditions: a meta-ethnographic synthesis of qualitative studies
Aims and objectives
To identify behaviours associated with taking medications and medication adherence reported in qualitative studies of adults with chronic kidney disease and coexisting multiple chronic conditions.
Background
To inform medication adherence interventions, information is needed to clarify the nature of the relationships between behaviours that support medication-taking and medication adherence in multiple chronic conditions.
Design
Meta-ethnographic review and synthesis.
Methods
CINAHL Complete, MEDLINE and PsycINFO databases were searched. Five qualitative studies met the inclusion criteria. A meta-ethnographic approach was used for synthesis. Medication-taking behaviours were abstracted from study findings and synthesised according to the contexts in which they occur and interpreted within a new developing framework named the Medication-taking Across the Care Continuum and Adherence-related Outcomes.
Results
Twenty categories of medication-taking behaviours occurred in three main contexts: (1) patient–provider clinical encounters, (2) pharmacy encounters and (3) day-to-day management. These behaviours are distinctly different, multilevel and interrelated. Together they represent a process occurring across a continuum.
Conclusions
Future medication adherence research should consider using a multilevel ecological view of medication management. Clinical practice and policy development can benefit from further understanding socio-contextual behaviours that occur across the continuum. Nurses should have greater presence in chronic disease management and be positioned to support the day-to-day home management of patients' medications
Efficiency of spinal anesthesia versus general anesthesia for lumbar spinal surgery: a retrospective analysis of 544 patients.
BACKGROUND: Previous studies have shown varying results in selected outcomes when directly comparing spinal anesthesia to general in lumbar surgery. Some studies have shown reduced surgical time, postoperative pain, time in the postanesthesia care unit (PACU), incidence of urinary retention, postoperative nausea, and more favorable cost-effectiveness with spinal anesthesia. Despite these results, the current literature has also shown contradictory results in between-group comparisons.
MATERIALS AND METHODS: A retrospective analysis was performed by querying the electronic medical record database for surgeries performed by a single surgeon between 2007 and 2011 using procedural codes 63030 for diskectomy and 63047 for laminectomy: 544 lumbar laminectomy and diskectomy surgeries were identified, with 183 undergoing general anesthesia and 361 undergoing spinal anesthesia (SA). Linear and multivariate regression analyses were performed to identify differences in blood loss, operative time, time from entering the operating room (OR) until incision, time from bandage placement to exiting the OR, total anesthesia time, PACU time, and total hospital stay. Secondary outcomes of interest included incidence of postoperative spinal hematoma and death, incidence of paraparesis, plegia, post-dural puncture headache, and paresthesia, among the SA patients.
RESULTS: SA was associated with significantly lower operative time, blood loss, total anesthesia time, time from entering the OR until incision, time from bandage placement until exiting the OR, and total duration of hospital stay, but a longer stay in the PACU. The SA group experienced one spinal hematoma, which was evacuated without any long-term neurological deficits, and neither group experienced a death. The SA group had no episodes of paraparesis or plegia, post-dural puncture headaches, or episodes of persistent postoperative paresthesia or weakness.
CONCLUSION: SA is effective for use in patients undergoing elective lumbar laminectomy and/or diskectomy spinal surgery, and was shown to be the more expedient anesthetic choice in the perioperative setting
Knowledge and Awareness Among Patients with Chronic Kidney Disease Stage 3
Knowledge is a prerequisite for changing behavior, and is useful for improving outcomes and reducing mortality rates in patients diagnosed with chronic kidney disease (CKD). The purpose of this article is to describe baseline CKD knowledge and awareness obtained as part of a larger study testing the feasibility of a self-management intervention. Thirty patients were recruited who had CKD Stage 3 with coexisting diabetes and hypertension. Fifty-four percent of the sample were unaware of their CKD diagnosis. Participants had a moderate amount of CKD knowledge. This study suggests the need to increase knowledge in patients with CKD Stage 3 to aid in slowing disease progression
Breast cancer metastasis suppressor 1 (BRMS1) inhibits osteopontin transcription by abrogating NF-ÎşB activation
BACKGROUND: Osteopontin (OPN), a secreted phosphoglycoprotein, has been strongly associated with tumor progression and aggressive cancers. MDA-MB-435 cells secrete very high levels of OPN. However metastasis-suppressed MDA-MB-435 cells, which were transfected with breast cancer metastasis suppressor 1 (BRMS1), expressed significantly less OPN. BRMS1 is a member of mSin3-HDAC transcription co-repressor complex and has been shown to suppress the metastasis of breast cancer and melanoma cells in animal models. Hence we hypothesized that BRMS1 regulates OPN expression. RESULTS: The search for a BRMS1-regulated site on the OPN promoter, using luciferase reporter assays of the promoter deletions, identified a novel NF-ÎşB site (OPN/NF-ÎşB). Electrophoretic mobility shift assays and chromatin immunoprecipitations (ChIP) confirmed this site to be an NF-ÎşB-binding site. We also show a role of HDAC3 in suppression of OPN via OPN/NF-ÎşB. CONCLUSION: Our results show that BRMS1 regulates OPN transcription by abrogating NF-ÎşB activation. Thus, we identify OPN, a tumor-metastasis activator, as a crucial downstream target of BRMS1. Suppression of OPN may be one of the possible underlying mechanisms of BRMS1-dependent suppression of tumor metastasis
Brown hyena habitat selection varies among sites in a semi-arid region of southern Africa
In the last 50 years, the human impact on ecosystems has been greater than during any other time period in human history (Millennium Ecosystem Assessment 2003). Large carnivores face anthropogenic threats worldwide, specifically persecution, habitat degradation, and habitat fragmentation (Everatt et al. 2014; Groom et al. 2014; Ripple et al. 2014; Wolfe et al. 2015). Because large carnivores often occupy high trophic levels, their presence influences species at lower levels through trophic cascades (Ripple et al. 2014). Natural experiments, taking advantage of large carnivore management, have shown that large predators provide fundamental ecosystem and economic services that help maintain healthy and diverse ecosystems (Ripple et al. 2014). Additionally, carnivores play an important role in other ecosystem processes, for example, scavenging carnivores may provide regulatory services, such as waste removal, nutrient cycling, and disease regulation. Such services add stability to ecosystems and ensure energy flow through multiple trophic levels (DeVault et al. 2003; Wilson and Wolkovich 2011)
Integrating Dynamic Subsurface Habitat Metrics Into Species Distribution Models
Species distribution models (SDMs) have become key tools for describing and predicting species habitats. In the marine domain, environmental data used in modeling species distributions are often remotely sensed, and as such have limited capacity for interpreting the vertical structure of the water column, or are sampled in situ, offering minimal spatial and temporal coverage. Advances in ocean models have improved our capacity to explore subsurface ocean features, yet there has been limited integration of such features in SDMs. Using output from a data-assimilative configuration of the Regional Ocean Modeling System, we examine the effect of including dynamic subsurface variables in SDMs to describe the habitats of four pelagic predators in the California Current System (swordfish Xiphias gladius, blue sharks Prionace glauca, common thresher sharks Alopias vulpinus, and shortfin mako sharks lsurus oxyrinchus). Species data were obtained from the California Drift Gillnet observer program (1997-2017). We used boosted regression trees to explore the incremental improvement enabled by dynamic subsurface variables that quantify the structure and stability of the water column: isothermal layer depth and bulk buoyancy frequency. The inclusion of these dynamic subsurface variables significantly improved model explanatory power for most species. Model predictive performance also significantly improved, but only for species that had strong affiliations with dynamic variables (swordfish and shortfin mako sharks) rather than static variables (blue sharks and common thresher sharks). Geospatial predictions for all species showed the integration of isothermal layer depth and bulk buoyancy frequency contributed value at the mesoscale level (\u3c 100 km) and varied spatially throughout the study domain. These results highlight the utility of including dynamic subsurface variables in SDM development and support the continuing ecological use of biophysical output from ocean circulation models
Sulfide Generation by Dominant Halanaerobium Microorganisms in Hydraulically Fractured Shales
Hydraulic fracturing of black shale formations has greatly increased United States oil and natural gas recovery. However, the accumulation of biomass in subsurface reservoirs and pipelines is detrimental because of possible well souring, microbially induced corrosion, and pore clogging. Temporal sampling of produced fluids from a well in the Utica Shale revealed the dominance of Halanaerobium strains within the in situ microbial community and the potential for these microorganisms to catalyze thiosulfate-dependent sulfidogenesis. From these field data, we investigated biogenic sulfide production catalyzed by a Halanaerobium strain isolated from the produced fluids using proteogenomics and laboratory growth experiments. Analysis of Halanaerobium isolate genomes and reconstructed genomes from metagenomic data sets revealed the conserved presence of rhodanese-like proteins and anaerobic sulfite reductase complexes capable of converting thiosulfate to sulfide. Shotgun proteomics measurements using a Halanaerobium isolate verified that these proteins were more abundant when thiosulfate was present in the growth medium, and culture-based assays identified thiosulfate-dependent sulfide production by the same isolate. Increased production of sulfide and organic acids during the stationary growth phase suggests that fermentative Halanaerobium uses thiosulfate to remove excess reductant. These findings emphasize the potential detrimental effects that could arise from thiosulfate-reducing microorganisms in hydraulically fractured shales, which are undetected by current industry-wide corrosion diagnostics. IMPORTANCE Although thousands of wells in deep shale formations across the United States have been hydraulically fractured for oil and gas recovery, the impact of microbial metabolism within these environments is poorly understood. Our research demonstrates that dominant microbial populations in these subsurface ecosystems contain the conserved capacity for the reduction of thiosulfate to sulfide and that this process is likely occurring in the environment. Sulfide generation (also known as “souring”) is considered deleterious in the oil and gas industry because of both toxicity issues and impacts on corrosion of the subsurface infrastructure. Critically, the capacity for sulfide generation via reduction of sulfate was not detected in our data sets. Given that current industry wellhead tests for sulfidogenesis target canonical sulfate-reducing microorganisms, these data suggest that new approaches to the detection of sulfide-producing microorganisms may be necessary
Critical appraisal skills training for health care professionals: a randomized controlled trial [ISRCTN46272378]
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