Nitro-fatty acid formation and metabolism

Nitro-fatty acids (NO 2 -FA) are pleiotropic modulators of redox signaling pathways. Their effects on inflammatory signaling have been studied in great detail in cell, animal and clinical models primarily using exogenously administered nitro-oleic acid. While we know a considerable amount regarding NO 2 -FA signaling, endogenous formation and metabolism is relatively unexplored. This review will cover what is currently known regarding the proposed mechanisms of NO 2 -FA formation, dietary modulation of endogenous NO 2 -FA levels, pathways of NO 2 -FA metabolism and the detection of NO 2 -FA and corresponding metabolites.Fil: Buchan, Gregory J.. University of Pittsburgh; Estados UnidosFil: Bonacci, Gustavo Roberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Fazzari, Marco. University of Pittsburgh; Estados Unidos. Fondazione Ri.Med; ItaliaFil: Salvatore, Sonia Rosana. University of Pittsburgh; Estados UnidosFil: Gelhaus Wendell, Stacy. University of Pittsburgh; Estados Unido

How do dentists understand evidence and adopt it in practice?

Although there is now a large evidence-based dentistry literature, previous investigators have shown that dentists often consider research evidence irrelevant to their practice. To understand why this is the case, we conducted a qualitative study. Objective: Our aim was to identify how dentists define evidence and how they adopt it in practice. Methods: A qualitative study using grounded theory methodology was conducted. Ten dentists working in eight dental practices were interviewed about their experience and work processes while adopting evidence-based preventive care. Analysis involved transcript coding, detailed memo writing, and data interpretation. Results: Findings revealed that dentists’ direct observations – referred to as clinical evidence – provided the most tangible and trusted evidence in practice and during discussions with colleagues. Dentists described a detailed process used to gather, compare and implement clinical evidence. This process began when they were exposed to novelty in daily practice and proceeded through self-driven testing, producing clinical or tangible evidence that clinicians could use in practice. Conclusion: Based on these findings, we propose an alternative to the linear form of knowledge transfer commonly represented in the literature.National Health and Medical Research Council Project Grant 63271

The Victorian Newsletter (Spring 1981)

The Victorian Newsletter is sponsored for the Victorian Group of Modern Language Association by the University of Florida and is published twice annually.Style in Ruskin and Ruskin on Style / Wendell Stacy Johnson -- Literature and Dogma and Literature: New Textual Perspective on Matthew Arnold's Critical Organicism / William E. Buckler -- Hopkins' Paradigms of Language / Jerome Bump -- Clocking the Reader in the Long Victorian Novel / Michael Lund -- Symbolic Representation and The Means of Revolution in Daniel Deronda / Peter Dale -- Recent German Studies of Victorian Literature: 1979 / Werner Bies -- Books Receive

Serum metabolomic signatures of fatty acid oxidation defects differentiate host-response subphenotypes of acute respiratory distress syndrome

BACKGROUND: Fatty acid oxidation (FAO) defects have been implicated in experimental models of acute lung injury and associated with poor outcomes in critical illness. In this study, we examined acylcarnitine profiles and 3-methylhistidine as markers of FAO defects and skeletal muscle catabolism, respectively, in patients with acute respiratory failure. We determined whether these metabolites were associated with host-response ARDS subphenotypes, inflammatory biomarkers, and clinical outcomes in acute respiratory failure. METHODS: In a nested case-control cohort study, we performed targeted analysis of serum metabolites of patients intubated for airway protection (airway controls), Class 1 (hypoinflammatory), and Class 2 (hyperinflammatory) ARDS patients (N = 50 per group) during early initiation of mechanical ventilation. Relative amounts were quantified by liquid chromatography high resolution mass spectrometry using isotope-labeled standards and analyzed with plasma biomarkers and clinical data. RESULTS: Of the acylcarnitines analyzed, octanoylcarnitine levels were twofold increased in Class 2 ARDS relative to Class 1 ARDS or airway controls (P = 0.0004 and \u3c 0.0001, respectively) and was positively associated with Class 2 by quantile g-computation analysis (P = 0.004). In addition, acetylcarnitine and 3-methylhistidine were increased in Class 2 relative to Class 1 and positively correlated with inflammatory biomarkers. In all patients within the study with acute respiratory failure, increased 3-methylhistidine was observed in non-survivors at 30 days (P = 0.0018), while octanoylcarnitine was increased in patients requiring vasopressor support but not in non-survivors (P = 0.0001 and P = 0.28, respectively). CONCLUSIONS: This study demonstrates that increased levels of acetylcarnitine, octanoylcarnitine, and 3-methylhistidine distinguish Class 2 from Class 1 ARDS patients and airway controls. Octanoylcarnitine and 3-methylhistidine were associated with poor outcomes in patients with acute respiratory failure across the cohort independent of etiology or host-response subphenotype. These findings suggest a role for serum metabolites as biomarkers in ARDS and poor outcomes in critically ill patients early in the clinical course

How to do a grounded theory study: a worked example of a study of dental practices

<p>Abstract</p> <p>Background</p> <p>Qualitative methodologies are increasingly popular in medical research. Grounded theory is the methodology most-often cited by authors of qualitative studies in medicine, but it has been suggested that many 'grounded theory' studies are not concordant with the methodology. In this paper we provide a worked example of a grounded theory project. Our aim is to provide a model for practice, to connect medical researchers with a useful methodology, and to increase the quality of 'grounded theory' research published in the medical literature.</p> <p>Methods</p> <p>We documented a worked example of using grounded theory methodology in practice.</p> <p>Results</p> <p>We describe our sampling, data collection, data analysis and interpretation. We explain how these steps were consistent with grounded theory methodology, and show how they related to one another. Grounded theory methodology assisted us to develop a detailed model of the process of adapting preventive protocols into dental practice, and to analyse variation in this process in different dental practices.</p> <p>Conclusions</p> <p>By employing grounded theory methodology rigorously, medical researchers can better design and justify their methods, and produce high-quality findings that will be more useful to patients, professionals and the research community.</p

How do dentists understand evidence and adopt it in practice?

Although there is now a large evidence-based dentistry literature, previous investigators have shown that dentists often consider research evidence irrelevant to their practice. To understand why this is the case, we conducted a qualitative study. Objective: Our aim was to identify how dentists define evidence and how they adopt it in practice. Methods: A qualitative study using grounded theory methodology was conducted. Ten dentists working in eight dental practices were interviewed about their experience and work processes while adopting evidence-based preventive care. Analysis involved transcript coding, detailed memo writing, and data interpretation. Results: Findings revealed that dentists\u27 direct observations - referred to as clinical evidence - provided the most tangible and trusted evidence in practice and during discussions with colleagues. Dentists described a detailed process used to gather, compare and implement clinical evidence. This process began when they were exposed to novelty in daily practice and proceeded through self-driven testing, producing clinical or tangible evidence that clinicians could use in practice. Conclusion: Based on these findings, we propose an alternative to the linear form of knowledge transfer commonly represented in the literature

How do dentists and their teams incorporate evidence about preventive care? An empirical study

Objectives To identify how dentists and their teams adopt evidence‐based preventive care. Methods A qualitative study using grounded theory methodology was conducted. We interviewed 23 participants working in eight dental practices about their experience and work processes, while adopting evidence‐based preventive care. During the study, Charmaz\u27s grounded theory methodology was employed to examine the social process of adopting preventive dental care in dental practices. Charmaz\u27s iteration of the constant comparative method was used during the data analysis. This involved coding of interview transcripts, detailed memo‐writing and drawing diagrams. The transcripts were analyzed as soon as possible after each round of interviews in each dental practice. Coding was conducted primarily by AS, supported by team meetings and discussions when researchers compared their interpretations. Results Participants engaged in a slow process of adapting evidence‐based protocols and guidelines to the existing logistics of the practices. This process was influenced by practical, philosophical, and historical aspects of dental care, and a range of barriers and facilitators. In particular, dentists spoke spontaneously about two deeply held \u27rules\u27 underpinning continued restorative treatment, which acted as barriers to provide preventive care: (i) dentists believed that some patients were too \u27unreliable\u27 to benefit from prevention; and (ii) dentists believed that patients thought that only tangible restorative treatment offered \u27value for money\u27. During the adaptation process, some dentists and teams transitioned from their initial state - selling restorative care - through an intermediary stage - learning by doing and educating patients about the importance of preventive care - and finally to a stage where they were offering patients more than just restorative care. Resources were needed for the adaptation process to occur, including: the ability to maintain the financial viability of the practice, appropriate technology, time, and supportive dental team relationships. Conclusions The findings from this study show that with considerable effort, motivation and coordination, it is possible for dental practices to work against the dental \u27mainstream\u27 and implement prevention as their clinical norm. This study has shown that dental practice is not purely scientific, but it includes cultural, social, and economic resources that interfere with the provision of preventive care

Experiences of dental care: what do patients value?

Background Dentistry in Australia combines business and health care service, that is, the majority of patients pay money for tangible dental procedures such as fluoride applications, dental radiographs, dental fillings, crowns, and dentures among others. There is evidence that patients question dentists\u27 behaviours and attitudes during a dental visit when those highly technical procedures are performed. However, little is known about how patients\u27 experience dental care as a whole. This paper illustrates the findings from a qualitative study recently undertaken in general dental practice in Australia. It focuses on patients\u27 experiences of dental care, particularly on the relationship between patients and dentists during the provision of preventive care and advice in general dental practices. Methods Seventeen patients were interviewed. Data analysis consisted of transcript coding, detailed memo writing, and data interpretation. Results Patients described their experiences when visiting dental practices with and without a structured preventive approach in place, together with the historical, biological, financial, psychosocial and habitual dimensions of their experience. Potential barriers that could hinder preventive activities as well as facilitators for prevention were also described. The offer of preventive dental care and advice was an amazing revelation for this group of patients as they realized that dentists could practice dentistry without having to drill and fill their teeth. All patients, regardless of the practice they came from or their level of clinical risk of developing dental caries, valued having a caring dentist who respected them and listened to their concerns without blaming them for their oral health status. These patients complied with and supported the preventive care options because they were being treated as a person not as a patient by their dentists. Patients valued dentists who made them aware of existing preventive options, educated them about how to maintain a healthy mouth and teeth, and supported and reassured them frequently during visits. Conclusions Patients valued having a supportive and caring dentist and a dedicated dental team. The experience of having a dedicated, supportive and caring dentist helped patients to take control of their own oral health. These dentists and dental teams produced profound changes in not just the oral health care routines of patients, but in the way patients thought about their own oral health and the role of dental professionals