Screening for Venous Thromboembolism in Asymptomatic Trauma Patients: Effective in High Risk Patients

Hypothesis: Through data analysis of a large cohort of trauma patients, a clinically applicable protocol can be developed based on various predisposing factors for VTE in asymptomatic patients. By isolating the factors that make these patients high risk for VTE, we can effectively lower the incidence of PE in hospitalized trauma patients.https://jdc.jefferson.edu/patientsafetyposters/1001/thumbnail.jp

Utilization of a Palliative Care Trigger in the Surgical Intensive Care Unit

Our project aims to expand palliative care availability in the SICU by implementing a consult trigger program. We also aim to learn about and measure compassion fatigue of providers within the SICU

Food and nutrient consumption patterns in third trimester Thai-Muslim pregnant women in rural Southern Thailand

The aims of this study were to determine food and nutrient intakes and the socio-economic factors influencing food and nutrient intakes of rural Thai-Muslim women in the third trimester of pregnancy. The study was conducted in Pattani province, Thailand, where 166 women were interviewed between 32 and 40 weeks gestation. A questionnaire, including a Food Frequency Questionnaire was used. Data on food items were compiled into the five basic Thai food groups, and food intakes were computed into macro and micro-nutrients. Mean weight intake of each of the five groups was below the recommended level for pregnant Thai women. Mean intake of niacin, vitamin A (RE) and vitamin C were above the recommended Thai level. Thiamin, calcium, phosphorus and iron intakes were lower than 50% of recommended levels. Intakes of the five food groups were not associated with socio-economic status, although total non-haem iron intake was associated with level of education. Underconsumption of food and nutrients among pregnant women in the study area was due to poor education, poverty and food availability. Integrated strategies should be considered to promote increased intakes to meet nutrient recommendations

Implementation of Multipronged Approach in Patients with Chest Trauma Reduces VAP and Unplanned Admission to the ICU

Problem The incidence of pulmonary complications in trauma patients with chest trauma has been reported to be as high as 49% (Ruibel L, 2022). However, all trauma patients are at risk for developing pulmonary complications due to a multitude of factors some pre-existing while others injury related sequela. Within our institution, we observed an increase in pulmonary complications through review of our TQIP (Spring 2020) and state registry data.https://jdc.jefferson.edu/surgeryposters/1013/thumbnail.jp

Higher education analytics: New trends in program assessments

© 2018, Springer International Publishing AG, part of Springer Nature. End of course evaluations technologies can provide critical analytics that can be used to improve the academic outcomes of almost any university. This paper presents key findings from a study conducted on more than twenty different academic degree-programs, regarding their use of end of course evaluation technology. Data was collected from an online survey instrument, in-depth interviews with academic administrators, and two case studies, one in the US and another in the UAE. The study reveals new trends including sectioning and categorization; questions standardization and benchmarking; alignment with key performance indicators and key learning outcomes; and grouping by course, program outcome, program, college, etc. in addition to those vertical structures, higher education institutions are vertically examining a specific question(s) across

The coordination of cell growth during fission yeast mating requires Ras1-GTP hydrolysis

The spatial and temporal control of polarity is fundamental to the survival of all organisms. Cells define their polarity using highly conserved mechanisms that frequently rely upon the action of small GTPases, such as Ras and Cdc42. Schizosaccharomyces pombe is an ideal system with which to study the control of cell polarity since it grows from defined tips using Cdc42-mediated actin remodeling. Here we have investigated the importance of Ras1-GTPase activity for the coordination of polarized cell growth during fission yeast mating. Following pheromone stimulation, Ras1 regulates both a MAPK cascade and the activity of Cdc42 to enable uni-directional cell growth towards a potential mating partner. Like all GTPases, when bound to GTP, Ras1 adopts an active conformation returning to an inactive state upon GTP-hydrolysis, a process accelerated through interaction with negative regulators such as GAPs. Here we show that, at low levels of pheromone stimulation, loss of negative regulation of Ras1 increases signal transduction via the MAPK cascade. However, at the higher concentrations observed during mating, hyperactive Ras1 mutations promote cell death. We demonstrate that these cells die due to their failure to coordinate active Cdc42 into a single growth zone resulting in disorganized actin deposition and unsustainable elongation from multiple tips. These results provide a striking demonstration that the deactivation stage of Ras signaling is fundamentally important in modulating cell polarity

Diaspirin-crosslinked hemoglobin reduces blood transfusion in noncardiac surgery: a multicenter, randomized, controlled, double-blinded trial.

UNLABELLED: In this randomized, prospective, double-blinded clinical trial, we sought to investigate whether diaspirin-crosslinked hemoglobin (DCLHb) can reduce the perioperative use of allogeneic blood transfusion. One-hundred-eighty-one elective surgical patients were enrolled at 19 clinical sites from 1996 to 1998. Selection criteria included anticipated transfusion of 2-4 blood units, aortic repair, and major joint or abdomino-pelvic surgery. Once a decision to transfuse had been made, patients received initially up to 3 250-mL infusions of 10% DCLHb (n = 92) or 3 U of packed red blood cells (PRBCs) (n = 89). DCLHb was infused during a 36-h perioperative window. On the day of surgery, 58 of 92 (64%; confidence interval [CI], 54%-74%) DCLHb-treated patients received no allogeneic PRBC transfusions. On Day 1, this number was 44 of 92 (48%; CI, 37%-58%) and decreased further until Day 7, when it was 21 of 92 (23%; CI, 15%-33%). During the 7-day period, 2 (1-4) units of PRBC per patient were used in the DCLHb group compared with 3 (2-4) units in the control patients (P = 0.002; medians and 25th and 75th percentiles). Mortality (4% and 3%, respectively) and incidence of suffering at least one serious adverse event (21% and 15%, respectively) were similar in DCLHb and PRBC groups. The incidence of jaundice, urinary side effects, and pancreatitis were more frequent in DCLHb patients. The study was terminated early because of safety concerns. Whereas the side-effect profile of modified hemoglobin solutions needs to be improved, our data show that hemoglobin solutions can be effective at reducing exposure to allogeneic blood for elective surgery. IMPLICATIONS: In a randomized, double-blinded red blood cell controlled, multicenter trial, diaspirin-crosslinked hemoglobin spared allogeneic transfusion in 23% of patients undergoing elective noncardiac surgery. The observed side-effect profile indicates a need for improvement in hemoglobin development

Nutrient composition of important fish species in Bangladesh and potential contribution to recommended nutrient intakes

Fish, in Bangladesh where malnutrition remains a significant development challenge, is an irreplaceable animal-source food in the diet of millions. However, existing data on the nutrient composition of fish do not reflect the large diversity available and have focused on only a few select nutrients. The purpose of this study was to fill the gaps in existing data on the nutrient profiles of common fish in Bangladesh by analysing the proximate, vitamin, mineral and fatty acid composition of 55 fish, shrimp and prawn species from inland capture, aquaculture and marine capture fisheries. When comparing species, the composition of nutrients of public health significance was diverse. Iron ranged from 0.34 to 19. mg/100. g, zinc from 0.6 to 4.7. mg/100. g, calcium from 8.6 to 1900. mg/100. g, vitamin A from 0 to 2503. μg/100. g and vitamin B12 from 0.50 to 14. μg/100. g. Several species were rich in essential fatty acids, particularly docosohexaenoic acid in capture fisheries species (86-310. mg/100. g). The potential contribution of each species to recommended nutrient intakes (RNIs) for pregnant and lactating women (PLW) and infants was calculated. Seven species for PLW and six species for infants, all from inland capture, and all typically consumed whole with head and bones, could potentially contribute ≥25% of RNIs for three or more of these nutrients, simultaneously, from a standard portion. This illustrates the diversity in nutrient content of fish species and in particular the rich nutrient composition of small indigenous species, which should guide policy and programmes to improve food and nutrition security in Bangladesh