MT FdR: a ferredoxin reductase from M. tuberculosis that couples to MT CYP51

AbstractWe report the molecular cloning, expression and partial characterization of MT FdR, an FAD-associated flavoprotein, from Mycobacterium tuberculosis similar to the oxygenase-coupled NADH-dependent ferredoxin reductases (ONFR). We establish, through kinetic and spectral analysis, that MT FdR preferentially uses NADH as cofactor. Furthermore, MT FdR forms a complex with mycobacterial ferredoxin (MT Fdx) and MT CYP51, a cytochrome P450 (CYP) from M. tuberculosis that is similar to lanosterol 14α-demethylase isozymes. This reconstituted system transfers electrons from the cofactor to the heme iron of MT CYP51 and effects the demethylation of lanosterol

Development of Maine Ongoing Outreach Simulation Education (MOOSE), a Novel Telesimulation Program, to Improve Neonatal Resuscitation in a Rural Community Hospital

Objective- To implement monthly neonatal resuscitation telesimulation team training sessions in a rural community hospital delivery room that is feasible, sustainable, and replicable at other sites.https://knowledgeconnection.mainehealth.org/lambrew-retreat-2021/1010/thumbnail.jp

A Simulation-Based Outreach Program Improves Delivery Room Team Confidence in Neonatal Resuscitation at Rural Community Hospitals

Objective- Our goal is to pilot the use of an onsite Neonatal Community Outreach Education Program to improve provider confidence with procedural skills and neonatal resuscitation in the delivery room.https://knowledgeconnection.mainehealth.org/lambrew-retreat-2021/1008/thumbnail.jp

Multicystic Dysplastic Kidney With Mass Effect in a Neonate Treated With Nephrectomy: Case Report

Multicystic Dysplastic Kidney is a developmental disease that results in a lobulated kidney of noncommunicating cysts and abnormal parenchymal tissue. Dysplastic kidneys are usually benign and often involute over time with conservative management. The second most common cause of palpable abdominal mass in a neonate, Multicystic Dysplastic Kidney can cause respiratory distress secondary to extrinsic compression. However, such cases are sparse. Here we present the case of an otherwise healthy term newborn with an exceptionally large MCDK requiring CPAP support and intubation. His respiratory distress improved immediately after nephrectomy. Communication about cases like this will inform management of future comparable cases

Simulation-Based Outreach Program Improves Rural Hospitals\u27 Team Confidence in Neonatal Resuscitation

INTRODUCTION: Neonatal resuscitation is a high acuity, low occurrence event (HALO), and in rural community hospitals, low birth rates prevent providers from regular opportunities to maintain essential resuscitation skills. Simulation is an effective training modality for medical education, although resources for simulation are often limited in rural hospitals. Our primary objective was to test the hypothesis that in situ neonatal resuscitation simulation training improves rural hospitals\u27 delivery room team confidence in performing key Neonatal Resuscitation Program (NRP) skills. Our secondary objective was to compare confidence to performance as measured by adherence to NRP® guidelines. METHODS: We conducted a quasi-experimental pre-training survey and post-training survey of delivery room team confidence in NRP skills at five level one delivery hospitals before and after an in situ simulation training program. Participants included rural hospitals\u27 usual delivery room team members. Participants rated their confidence on a five-point Likert scale. Simulations were analyzed using an adapted version of a validated scoring tool for NRP adherence and presented as overall percentage scores. RESULTS: Our data demonstrate a significant improvement in self-assessed confidence levels pre- and post-simulation training in key areas of neonatal resuscitation. Participants reported higher confidence in airway management (4 vs. 3, p=0.003), emergency intravenous access (3 vs. 2, p=0.007), and the ability to manage a code in the delivery room (4 vs. 3, p=0.013) and the operating room (4 vs. 3, p=0.028). Improvements were also noted in their team member\u27s knowledge and skills to perform neonatal resuscitation. While improvements were appreciated in confidence, the performance of skills (NRP adherence scores) was often in the sub-optimal performance range. CONCLUSIONS: An in situ-based neonatal resuscitation outreach simulation program improves self-confidence among rural delivery room teams. Additional research is needed to understand how to translate improved confidence into actual improved performance