Emergency nurses’ experiences of the implementation of early goal-directed fluid resuscitation therapy in the management of sepsis

Background: Severe sepsis is a life-threatening condition caused by the body’s overwhelming immune response to an infection. It can lead to organ failure and death if immediate treatment, such as intravenous (IV) fluids and antibiotics, are not commenced within the first hour. While a large number of studies have analysed the administration of first-dose antibiotics, the time-critical initiation of IV fluids has not always been given its deserved priority. To date, studies have not explored factors that inhibit timely IV fluid administration and the experience of emergency nurses relating to initiating early goal-directed fluid resuscitation (EGDFR). Purpose: To explore the experiences of emergency nurses related to initiating EGDFR in the care of patients with sepsis Methods: A qualitative exploratory approach, encompassing face-to-face semi-structured interviews, was used for data collection. Ten registered nurses were interviewed, who were currently practicing in emergency settings across New South Wales (NSW). Braun and Clarke’s (2006) thematic analysis framework guided the data analysis. Findings: Three themes and associated subthemes were identified. The three themes are (i) Nurses’ perceptions and experiences regarding IV fluid administration in sepsis, (ii) Challenges related to initiating IV fluid, and (iii) Strategies to improve compliance with EGDFR. Participants described various factors they found that inhibited timely initiation of IV fluids, including busyness of the department, delayed diagnosis of sepsis, complex patient presentations and limited scope of nurses’ practice to initiate IV fluids. Conclusion: It is anticipated that the outcomes of this research will provide an impetus for re-evaluating current protocol guidelines to provide a positive impact on the scope of emergency nurse practice for initiating EGDFR

miR-484 Functions as an Onco-miR in Triple Negative Breast Cancer

Triple negative breast cancer (TNBC) is a highly aggressive subtype of breast cancer (BC), with a poor prognosis with currently used therapies, and thus represents an unmet therapeutic challenge. Lack of molecular targets (i.e. ER, PR, HER2) and significant genetic heterogeneity are the major reasons contributing to early relapse and high mortality rates. Numerous studies have indicated that microRNAs (miRs) have an important role in BC progression, invasion, angiogenesis, and metastasis. We analyzed miRNA expression profiles of BC patient data bases and identified that miR-484 is highly upregulated in all subtypes of BC patients, with the highest expression in TNBC patients. miR-484 was found to be associated with significantly shorter patient survival, while inhibition of miR-484 in TNBC cells led to significant reduction of cell proliferation, motility and invasion, and induced cell cycle arrest and apoptosis. Furthermore, we found that miR-484 is inversely correlated with levels of HOXA5 in patients’ tumors and demonstrated that miR-484 directly binds to the 3¢-untranslated region (3¢-UTR) of HOXA5 mRNA to suppress its expression. Moreover, HOXA5 over-expression recapitulated the effects of miR-484 inhibition. In vivo therapeutic targeting of miR-484 by systemic administration of anti-miR-484 nanoparticles significantly induced HOXA5 expression and suppressed tumor growth and progression in orthotopic xenograft mouse models of TNBC. Thus, our findings provide new insights about the oncogenic role of miR-484 and suggest that miR-484 represents a novel therapeutic target in TNBC

RICHIE: A Step-by-step Navigation Widget to Enhance Broad Hierarchy Exploration on Handheld Tactile Devices

International audienceExploring large hierarchies is still a challenging task, especially for handheld tactile devices, due to the lack of visualization space and finger's occlusion. In this paper, we propose the RICHIE (Radial In-Cremental HIerarchy Exploration) tool, a new radial widget that allows step-by-step navigation through large hierarchies. We designed it to fit handheld tactile requirements such as target reaching and space optimization. Depth exploration is made by shifting two levels of hierarchy at the same time, for reducing the screen occupation. This widget was implemented in order to adapt a Command and Control (C2) system to mobile tactile devices, as these systems require the on-screen presence of an important unit's hierarchy (the ORder of BATtle). Nevertheless, we are convinced that RICHIE could be used on several systems that require hierarchical data exploration, such as phylogenetic trees or file browsing

Internet television in Bangladesh: past and present

The development of digital technologies has radically changed the direction of the development of modern media. Professional producers of information - newspapers, radio broadcasting, and television - entered the Internet no more than fifteen years ago. The Internet is used by almost all types of media in the world as an additional channel for the transmission and distribution of content. Many media experts see a great future in the Internet media market. In Bangladesh, home to 160 million people, Internet media are already popular and growing rapidly. Internet TV began to function at the beginning of the 21st century. It was created specifically for broadcasting on the network, which requires a high level of technical equipment from both the producer and the content provider and the consumer. Therefore, chronologically, television was the last type of media that entered the Internet. In this report, we analyze the basic features of Internet Television that exists in contemporary Bangladesh and provide an account of the development trends. We analyzed Internet Television broadcasters in Bangladesh, like "ATN Music", "Popcorn Live". This study is based on both primary and secondary sources of qualitative data to understand the ability of Internet TV to provide news, qualitive information, together with the challenges and opportunities of it to work in the ever-changing media landscape

The clinical and immunological changes induced in man by schistosomiasis

This study commenced with an investigation of the role immunological changes have in the production of the anaemia of schistosumiasis and of the role that complement-mediated mechanisms play in the production of that anaemia. The investigation of these mechanisms necessitated which developed in these animals was found to be mainly normochromic, progressive and of a haemoclytlc nature. A technique for the measurement of complement in the sera of the mice was developed using radioactive materials and employing an immuno-haemolytlc mechanism. Anaemia was found to be significantly more related to a fall in complement rather than to splenomegaly. The importance of complement in the production of anaemia led to the Investigation of its importance in other pathological processes involving rnembranes upon which complement could be deposited. Fluorescent techniques ware used for this part of the work. Nepthropathy caused by compliment deposits ln the renal glomeruli was particularly investigated. In view of the evidence existing stat, a similar mechanism might be Involved in trypanosomiasis, however, the study was extended to thls Infection. A study of complement in human infection with schistosomiasis was also carried out and in this study the complement was measured by radial immuno--diffusion test. A strong positive relationship between haemoglobin and complement was found in Infected patients but not in those with schistosomiasis but without anaemia, nor was complement found to be reduced in a series of controls. Treatment with Hycanthone in man was found to be followed six weeks later by a fall in in the complement level in the serum and in the serum content immunoglobulin M ( JgM ). This part of the work led to the deduction that there is an association Between complement and immunoglobulin M in attacking schistosonin worms. A further disease in which a complement-mediated mechanism was thought to be possible in sprue in in which damage to the intestined mucosa leading to malabsorption could be complement mediated. Some patients with sprue were therefore investigated. Similarities were detected, in so far compliment-mediated immune processes are concerned between patients with sprue and those with schistosomiasis

Injective envelopes of transition systems and Ferrers languages

We consider reflexive and involutive transition systems over an ordered alphabet $A$ equipped with an involution. We give a description of the injective envelope of any two-element set in terms of Galois lattice, from which we derive a test of its finiteness. Our description leads to the notion of Ferrers language.Comment: 23 page

Enzymology of H2S Biogenesis, Decay and Signaling

Significance: Hydrogen sulfide (H2S), produced by the desulfuration of cysteine or homocysteine, functions as a signaling molecule in an array of physiological processes including regulation of vascular tone, the cellular stress response, apoptosis, and inflammation. Recent Advances: The low steady-state levels of H2S in mammalian cells have been recently shown to reflect a balance between its synthesis and its clearance. The subversion of enzymes in the cytoplasmic trans-sulfuration pathway for producing H2S from cysteine and/or homocysteine versus producing cysteine from homocysteine, presents an interesting regulatory problem. Critical Issues: It is not known under what conditions the enzymes operate in the canonical trans-sulfuration pathway and how their specificity is switched to catalyze the alternative H2S-producing reactions. Similarly, it is not known if and whether the mitochondrial enzymes, which oxidize sulfide and persulfide (or sulfane sulfur), are regulated to increase or decrease H2S or sulfane-sulfur pools. Future Directions: In this review, we focus on the enzymology of H2S homeostasis and discuss H2S-based signaling via persulfidation and thionitrous acid. Antioxid. Redox Signal. 20, 770?782.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140254/1/ars.2013.5339.pd

Bilimsel modellerin ontolojisi

06.03.2018 tarihli ve 30352 sayılı Resmi Gazetede yayımlanan “Yükseköğretim Kanunu İle Bazı Kanun Ve Kanun Hükmünde Kararnamelerde Değişiklik Yapılması Hakkında Kanun” ile 18.06.2018 tarihli “Lisansüstü Tezlerin Elektronik Ortamda Toplanması, Düzenlenmesi ve Erişime Açılmasına İlişkin Yönerge” gereğince tam metin erişime açılmıştır.Günümüz bilim felsefecileri modellerin bilimsel etkinliğin vazgeçilmez araçları oldukları konusunda hemfikirdirler. Çoğu bilim felsefecisinin uzlaştığı bir diğer nokta daha varsa, o da modellerin temsiller olduklarıdır. Geleneksel görüş, modellerin belli bir hedef sistemi doğrulukla temsil ettikleri için bize hedef sistem hakkında bilgi verdikleri yönündedir. Başka bir deyişle modellerin epistemik değeri, model ile hedef sistemin özellikleri arasındaki nesnel bir temsil ilişkisine dayanır. Öte yandan bazılarının fark ettiği üzere model sistem ile hedef sistem arasında her zaman doğrudan bir ilişkiden söz etmek mümkün değildir. Bilginler sıklıkla gerçek sistemler üzerinde değil, hipotetik sistemler üzerinde çalışırlar. Bu durumda modellerin ne türden varlıklar oldukları sorusu önemli bir problem olarak belirir. Modelleme pratiğini anlamlandırma çabasında son on ya da en fazla on beş yıl içerisinde ortaya çıkan bazı görüşler sanat eserleri ile bilimsel modeller arasında geçerli olan bazı benzerliklere dikkat çekerler. Bunlar arasında en dikkat çekici olanı, modellerin, sanat felsefecisi Kendall Walton'ın terime verdiği anlamda "kurgusal" olduklarıdır. Bu çalışma da modeller ile edebi eserler arasında çeşitli benzerlikler kurulabileceğine ilişkin bir düşüncenin ürünüdür. Ortaya konulan görüş temelde sanat felsefecisi ve metafizikçi Amie Thomasson'ın görüşlerine dayanmakta ve bilimsel modellerin insan yapımı nesneler, yapıntılar (artifact) olduklarını öne sürmektedir. Yapıntıcılık adını alan bu görüşe göre modeller belli problemleri çözmede bilginler tarafından kullanılan araçlardan ibarettir. Bu türden bir görüş, modelleri salt temsil amacıyla kullanılan nesneler olarak görmek yerine, bilginlerin belli amaçları gerçekleştirmede kullandıkları araçlar olarak kavrar. Böylelikle temsilci görüşleri ve hatta Waltoncı bilimsel modelleme izahını da içine alan daha kapsayıcı bir çerçeve sunar.All philosophers of science today agree that the models are indispensable part of the scientific activity. If there is an additional point that unites at least most of the philosophers of science, it is that models are representations. Traditional view says that models give us knowledge about a certain target system due to their accurately representing that system. In other words, the epistemic value of models is based on an objective representational relationship between the properties of a model and its target. But as some observe, it is always not the case that there is such a direct relationship between the two. Scientists often work not on real systems but on hypothetical systems. Thus arises the important question of what kind of entites scientific models are. In an attempt to make sense of the modelling activity that emerges over the last decade or fifteen years, some accounts draw attention to certain similarities between scientific models and the works of art. The most notable among them is the view that models are "fictional" in the sense Kendall Walton, a prominent philosopher of art, has used it. This work, also, is an outcome of a view in which it is claimed that there are various similarities between models and literary works of art. But the work essentially takes its support from the views of Amie Thomasson, a philosopher of art and a metaphysician, and asserts that scientific models are human-made objects, that is, artifacts. According to the account (artifactualism) that is presented here, models are some kind of tools put into use by scientists to solve certain problems. This view considers models as tools that are used in achieving a goal instead of solely seeing them as representations of a target system. So, it comprises not only the representational approach but even the Waltonian account of scientific modelling

The features of online news websites in Bangladesh

The Internet has opened borderless opportunities in the field of journalism and mass communication, especially significant on how journalistic stories will be created and distributed across the multiple platforms. Since 2006 Bangladeshi mainstream news organizations have been transforming and reshaping their strategy towards being a digital-only news outlet. News organizations are now using different features of mobile devices and social media to tell stories and engage with their target audiences. We consider digital-only platforms as a new media, social media and convergence media platforms. Almost each traditional media outlet observed has the analogue or another version on the web. Social media platforms, like Facebook, Twitter, weblogs, Tik Tok have provided the opportunity for the traditional journalists to share news quickly, get feedback from the audience and have two-way communication with the reader. Over the years they have created thousands of new jobs for aspiring journalists. In this article, we analyze the basic features of online news media that exists in contemporary Bangladesh and provide an account of the development trends. We outline the new genres, techniques and use as a sample two most famous online news platforms: The Daily Star and bdnews24. This study is based on both primary and secondary sources of qualitative data to understand the new genres of online news media, challenges and opportunities to work in the ever-changing media landscape