School Mental Health Professionals' Training, Comfort, and Attitudes toward Interprofessional Collaboration with Pediatric Primary Care Providers

ERIC Educational Resources Information Center

Arora, Prerna G.; Connors, Elizabeth H.; Biscardi, Krystin A.; Hill, Allison M.

2016-01-01

Despite the well-documented need for interprofessional collaboration (IPC) between school mental health (SMH) professionals and pediatric primary care providers (PCPs), research on current collaborative practices of these professionals is limited. Accordingly, using survey methodology, this study investigated SMH professionals' previous training…

Towards accessible integrated palliative care: Perspectives of leaders from seven European countries on facilitators, barriers and recommendations for improvement.

PubMed

den Herder-van der Eerden, Marlieke; Ewert, Benjamin; Hodiamont, Farina; Hesse, Michaela; Hasselaar, Jeroen; Radbruch, Lukas

2017-01-01

Literature suggests that integrated palliative care (IPC) increases the quality of care for palliative patients at lower costs. However, knowledge on models encompassing all integration levels for successfully implementing IPC is scarce. The purpose of this paper is to describe the experiences of IPC leaders in seven European countries regarding core elements, facilitators and barriers of IPC implementation and provides recommendations for future policy and practice. A qualitative interview study was conducted between December 2013 and May 2014. In total, 34 IPC leaders in primary and secondary palliative care or public health in Belgium, Germany, Hungary, Ireland, the Netherlands, Spain and the UK were interviewed. Transcripts were analysed using thematic data analysis. IPC implementation efforts involved a multidisciplinary team approach and cross-sectional coordination. Informal professional relationships, basic medical education and general awareness were regarded as facilitators of IPC. Identified barriers included lack of knowledge about when to start palliative care, lack of collaboration and financial structures. Recommendations for improvement included access, patient-centeredness, coordination and cooperation, financing and ICT systems. Although IPC is becoming more common, action has been uneven at different levels. IPC implementation largely remains provisional and informal due to the lack of standardised treatment pathways, legal frameworks and financial incentives to support multilevel integration. In order to make IPC more accessible, palliative care education as well as legal and financial support within national healthcare systems needs to be enhanced.

Reality Check: Are We Truly Preparing Our Students for Interprofessional Collaborative Practice?

PubMed

Salfi, Jenn; Mohaupt, Jennifer; Patterson, Christine; Allen, Dianne

2015-06-01

Many academic settings offer interprofessional education (IPE) experiences that are of short duration and situated in safe, controlled environments such as classrooms or simulation labs. The purpose of this study was to examine the effects of a 10-week IPE strategy that was incorporated into the final clinical practicum of a BScN program. A mixed methods design was chosen, in the belief that qualitative data would help explain quantitative data from pre-test/post-test design (n = 268). Quantitative results revealed that participants disagreed more with statements on interprofessional collaboration (IPC) after completion of the strategy (p = 0.00). Qualitative findings reinforced these results, revealing a theme of common sense is not so common when it comes to IPC in the health-care setting. When student nurses are being prepared for IPC, IPE strategies should be as "real" as possible, with exposure to some of the realities of interprofessional team functioning. Copyright© by Ingram School of Nursing, McGill University.

AN ASSESSMENT OF INTEGRATED RISK ASSESSMENT (Journal Article)

EPA Science Inventory

In order to promote international understanding and acceptance of the integrated risk assessment process, the WHO/IPCS, in collaboration with the U.S. EPA and the OECD, initiated a number of activities related to integrated risk assessment. In this project, WHO/IPCS defines inte...

Listening to paediatric primary care nurses: a qualitative study of the potential for interprofessional oral health practice in six federally qualified health centres in Massachusetts and Maryland

PubMed Central

Bernstein, Judith; Gebel, Christina; Vargas, Clemencia; Geltman, Paul; Walter, Ashley; Garcia, Raul; Tinanoff, Norman

2017-01-01

Objectives To explore the opportunities for interprofessional collaboration (IPC) to improve paediatric oral health in federally qualified health centres (FQHCs), to identify challenges to IPC-led integration of oral health prevention into the well-child visit and to suggest strategies to overcome barriers. Sample Nurse managers (NMs), nurse practitioners (NPs), paediatric clinical staff and administrators in six FQHCs in two states were interviewed using a semistructured format. Design Grounded theory research. Topics included feasibility of integration, perceived barriers and strategies for incorporating oral health into paediatric primary care. Measurements Qualitative data were coded and analysed using NVivo 10 to generate themes iteratively. Results Nurses in diverse roles recognised the importance of oral health prevention but were unaware of professional guidelines for incorporating oral health into paediatric encounters. They valued collaborative care, specifically internal communication, joint initiatives and training and partnering with dental schools or community dental practices. Barriers to IPC included inadequate training, few opportunities for cross-communication and absence of charting templates in electronic health records. Conclusions NMs, NPs and paediatric nursing staff all value IPC to improve patients' oral health, yet are constrained by lack of oral health training and supportive charting and referral systems. With supports, they are willing to take on responsibility for introducing oral health preventive measures into the well-child visit, but will require IPC approaches to training and systems changes. IPC teams in the health centre setting can work together, if policy and administrative supports are in place, to provide oral health assessments, education, fluoride varnish application and dental referrals, decrease the prevalence of early childhood caries and increase access to a dental home for low-income children. PMID:28360245

Improving interprofessional collaboration: The effect of training in nonviolent communication.

PubMed

Museux, Anne-Claire; Dumont, Serge; Careau, Emmanuelle; Milot, Élise

2016-07-01

This article examines the effects of nonviolent communication (NVC) training on the interprofessional collaboration (IPC) of two health and social services sector care teams. The study was conducted in 2013 with two interprofessional teams (N = 9) using a mixed method research design to measure the effects of the training. Individual IPC competency was measured using the Team Observed Structured Clinical Encounter tool, and group competency using the Observed Interprofessional Collaboration tool. A focus group was held to collect participant perceptions of what they learned in the training. Results revealed improvements in individual competency in client/family-centered collaboration and role clarification. Improvements in group competency were also found with respect to teams' ability to develop a shared plan of action. Data suggests that participants accepted and adopted training content. After the training, they appeared better able to identify the effects of spontaneous communication, more understanding of the mechanisms of empathy, and in a better position to foster collective leadership.

Overcoming the obstacles of implementing infection prevention and control guidelines.

PubMed

Birgand, G; Johansson, A; Szilagyi, E; Lucet, J-C

2015-12-01

Reasons for a successful or unsuccessful implementation of infection prevention and control (IPC) guidelines are often multiple and interconnected. This article reviews key elements from the national to the individual level that contribute to the success of the implementation of IPC measures and gives perspectives for improvement. Governance approaches, modes of communication and formats of guidelines are discussed with a view to improve collaboration and transparency among actors. The culture of IPC influences practices and varies according to countries, specialties and healthcare providers. We describe important contextual aspects, such as relationships between actors and resources and behavioural features including professional background or experience. Behaviour change techniques providing goal-setting, feedback and action planning have proved effective in mobilizing participants and may be key to trigger social movements of implementation. The leadership of international societies in coordinating actions at international, national and institutional levels using multidisciplinary approaches and fostering collaboration among clinical microbiology, infectious diseases and IPC will be essential for success. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

INTRODUCTION AND STUDY DESIGN

EPA Science Inventory

Under the sponsorship of the UNEP/ILO/IPCS, 17 laboratories from diverse regions of the world participated in evaluating the utility of four plant bioassays for detecting genetic hazards of environmental chemicals. he bioassays included in this collaborative study were Arabidopsi...

Listening to paediatric primary care nurses: a qualitative study of the potential for interprofessional oral health practice in six federally qualified health centres in Massachusetts and Maryland.

PubMed

Bernstein, Judith; Gebel, Christina; Vargas, Clemencia; Geltman, Paul; Walter, Ashley; Garcia, Raul; Tinanoff, Norman

2017-03-29

To explore the opportunities for interprofessional collaboration (IPC) to improve paediatric oral health in federally qualified health centres (FQHCs), to identify challenges to IPC-led integration of oral health prevention into the well-child visit and to suggest strategies to overcome barriers. Nurse managers (NMs), nurse practitioners (NPs), paediatric clinical staff and administrators in six FQHCs in two states were interviewed using a semistructured format. Grounded theory research. Topics included feasibility of integration, perceived barriers and strategies for incorporating oral health into paediatric primary care. Qualitative data were coded and analysed using NVivo 10 to generate themes iteratively. Nurses in diverse roles recognised the importance of oral health prevention but were unaware of professional guidelines for incorporating oral health into paediatric encounters. They valued collaborative care, specifically internal communication, joint initiatives and training and partnering with dental schools or community dental practices. Barriers to IPC included inadequate training, few opportunities for cross-communication and absence of charting templates in electronic health records. NMs, NPs and paediatric nursing staff all value IPC to improve patients' oral health, yet are constrained by lack of oral health training and supportive charting and referral systems. With supports, they are willing to take on responsibility for introducing oral health preventive measures into the well-child visit, but will require IPC approaches to training and systems changes. IPC teams in the health centre setting can work together, if policy and administrative supports are in place, to provide oral health assessments, education, fluoride varnish application and dental referrals, decrease the prevalence of early childhood caries and increase access to a dental home for low-income children. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Filipino therapists' experiences and attitudes of interprofessional education and collaboration: A cross-sectional survey.

PubMed

Sy, Michael Palapal

2017-11-01

For the past more than 50 years, the World Health Organisation has acknowledged through empirical findings that health workers that learn together work together effectively to provide the best care for their patients. This study aimed to: (1) describe the perceived extent of interprofessional education (IPE) experience among Filipino occupational therapists (OTs), physical therapists (PTs), and speech-language-pathologists (SLPs); (2) identify their attitudes towards interprofessional collaboration (IPC); and (3) compare their attitudes towards IPC according to: prior IPE experience, classification of IPE experience, profession, years of practice, and practice setting. Using a cross-sectional survey design, a two-part questionnaire was sent to Filipino OTs, PTs, and SLPs working in the Philippines via an online survey application. The first part of the survey contained eight items of demographic information and the second part contained the 14-item Attitudes Towards Health Care Teams Scale (ATHCTS). Findings revealed that among the Filipino OT, PT and SLP respondents (n = 189), 70.9% had prior experience on IPE. Moreover, the three most commonly used IPE teaching-learning strategies were case discussion (clinical setting), small group discussion, didactics, and case discussion (community setting), while the use of didactics and case discussion (community setting) yielded more agreeable attitudes towards IPC. Among the 14 items in the ATHCTS, 11 were rated with agreeability and three items with neutrality. For professional variables, only the practice setting variable yielded a statistically significant finding confirming those working in the academia to be more agreeable towards IPC compared to other settings. However, years of practice and professional background variables both yielded no statistically significant difference implying no association between years of practice and attitude towards IPC and a homogenous composition among respondents, respectively. The results of this research are to springboard IPE initiatives within Philippine higher education institutions to enable evidence-based IPC approaches in clinical practice.

Representing complexity well: a story about teamwork, with implications for how we teach collaboration.

PubMed

Lingard, Lorelei; McDougall, Allan; Levstik, Mark; Chandok, Natasha; Spafford, Marlee M; Schryer, Catherine

2012-09-01

In order to be relevant and impactful, our research into health care teamwork needs to better reflect the complexity inherent to this area. This study explored the complexity of collaborative practice on a distributed transplant team. We employed the theoretical lenses of activity theory to better understand the nature of collaborative complexity and its implications for current approaches to interprofessional collaboration (IPC) and interprofessional education (IPE). Over 4 months, two trained observers conducted 162 hours of observation, 30 field interviews and 17 formal interviews with 39 members of a solid organ transplant team in a Canadian teaching hospital. Participants included consultant medical and surgical staff and postgraduate trainees, the team nurse practitioner, social worker, dietician, pharmacist, physical therapist, bedside nurses, organ donor coordinators and organ recipient coordinators. Data collection and inductive analysis for emergent themes proceeded iteratively. Daily collaborative practice involves improvisation in the face of recurring challenges on a distributed team. This paper focuses on the theme of 'interservice' challenges, which represent instances in which the 'core' transplant team (those providing daily care for transplant patients) work to engage the expertise and resources of other services in the hospital, such as those of radiology and pathology departments. We examine a single story of the core team's collaboration with cardiology, anaesthesiology and radiology services to decide whether a patient is appropriate for transplantation and use this story to consider the team's strategies in the face of conflicting expectations and preferences among these services. This story of collaboration in a distributed team calls into question two premises underpinning current models of IPC and IPE: the notion that stable professional roles exist, and the ideal of a unifying objective of 'caring for the patient'. We suggest important elaborations to these premises as they are used to conceptualise and teach IPC in order to better represent the intricacy of everyday collaborative work in health care. © Blackwell Publishing Ltd 2012.

The effects of interprofessional education - Self-reported professional competence among prehospital emergency care nursing students on the point of graduation - A cross-sectional study.

PubMed

Castrèn, M; Mäkinen, M; Nilsson, J; Lindström, V

2017-05-01

The aim of the study was to investigate whether interprofessional education (IPE) and interprofessional collaboration (IPC) during the educational program had an impact on prehospital emergency care nurses' (PECN) self-reported competence towards the end of the study program. A cross-sectional study using the Nurse Professional Competence (NPC) Scale was conducted. A comparison was made between PECN students from Finland who experienced IPE and IPC in the clinical setting, and PECN students from Sweden with no IPE and a low level of IPC. Forty-one students participated (Finnish n=19, Swedish n=22). The self-reported competence was higher among the Swedish students. A statistically significant difference was found in one competence area; legislation in nursing and safety planning (p<0.01). The Finnish students scored significantly higher on items related to interprofessional teamwork. Both the Swedish and Finnish students' self-reported professional competence was relatively low according to the NPC Scale. Increasing IPC and IPE in combination with offering a higher academic degree may be an option when developing the ambulance service and the study program for PECNs. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Impact of Structured Inter-professional Education on Health Care Professional Students' Perceptions of Collaboration in a Clinical Setting

PubMed Central

Lee, Sam; Lombardo, Samantha; Salama, Mariam; Ellis, Sandi; Kay, Theresa; Davies, Robyn; Landry, Michel D.

2012-01-01

ABSTRACT Purpose: To examine how a structured inter-professional education (IPE) clinical placement influences health care professional (HCP) students' perceptions of inter-professional collaboration (IPC) relative to that of students in a traditional clinical placement. Methods: This study used a mixed-methods design. The Interdisciplinary Education Perception Scale (IEPS) was administered to HCP students (n=36) in two Toronto hospitals before and after a structured 5-week IPE clinical placement to examine changes in their perceptions of IPC. Students in a traditional clinical placement (n=28) were used as a control group. Focus groups were then conducted with seven students who took part in the structured IPE clinical placement. A coding framework was devised a priori, and the qualitative results were used to explain the quantitative findings. Results: There were no statistically significant differences between groups after the structured IPE clinical placement, but the intervention group showed a greater positive trend in total IEPS scores from baseline to follow-up. Qualitative data suggest that students valued the knowledge and skills gained through the structured IPE clinical placement. Conclusions: Findings suggest that structured IPE clinical placements may provide students with valuable collaborative learning opportunities, enhanced respect for other professionals, and insight into the value of IPC in healthcare delivery. More research is needed to explore other factors that influence specific perceptions among physical therapy students. PMID:23450044

Interprofessional collaboration and family member involvement in intensive care units: emerging themes from a multi-sited ethnography.

PubMed

Reeves, Scott; McMillan, Sarah E; Kachan, Natasha; Paradis, Elise; Leslie, Myles; Kitto, Simon

2015-05-01

This article presents emerging findings from the first year of a two-year study, which employed ethnographic methods to explore the culture of interprofessional collaboration (IPC) and family member involvement in eight North American intensive care units (ICUs). The study utilized a comparative ethnographic approach - gathering observation, interview and documentary data relating to the behaviors and attitudes of healthcare providers and family members across several sites. In total, 504 hours of ICU-based observational data were gathered over a 12-month period in four ICUs based in two US cities. In addition, 56 semi-structured interviews were undertaken with a range of ICU staff (e.g. nurses, doctors and pharmacists) and family members. Documentary data (e.g. clinical guidelines and unit policies) were also collected to help develop an insight into how the different sites engaged organizationally with IPC and family member involvement. Directed content analysis enabled the identification and categorization of major themes within the data. An interprofessional conceptual framework was utilized to help frame the coding for the analysis. The preliminary findings presented in this paper illuminate a number of issues related to the nature of IPC and family member involvement within an ICU context. These findings are discussed in relation to the wider interprofessional and health services literature.

Preventing healthcare-associated infections through human factors engineering.

PubMed

Jacob, Jesse T; Herwaldt, Loreen A; Durso, Francis T

2018-05-24

Human factors engineering (HFE) approaches are increasingly being used in healthcare, but have been applied in relatively limited ways to infection prevention and control (IPC). Previous studies have focused on using selected HFE tools, but newer literature supports a system-based HFE approach to IPC. Cross-contamination and the existence of workarounds suggest that healthcare workers need better support to reduce and simplify steps in delivering care. Simplifying workflow can lead to better understanding of why a process fails and allow for improvements to reduce errors and increase efficiency. Hand hygiene can be improved using visual cues and nudges based on room layout. Using personal protective equipment appropriately appears simple, but exists in a complex interaction with workload, behavior, emotion, and environmental variables including product placement. HFE can help prevent the pathogen transmission through improving environmental cleaning and appropriate use of medical devices. Emerging evidence suggests that HFE can be applied in IPC to reduce healthcare-associated infections. HFE and IPC collaboration can help improve many of the basic best practices including use of hand hygiene and personal protective equipment by healthcare workers during patient care.

Exploring healthcare professionals' perceptions of the anesthesia assistant role and its impact on patients and interprofessional collaboration.

PubMed

Lam, Phoebe; Lopez Filici, Ana; Middleton, Claire; McGillicuddy, Patricia

2018-01-01

To practice interprofessional collaboration (IPC), understanding the roles of each profession in the team is key. Anesthesia assistants (AAs) are a relatively new addition to the Canadian healthcare system. As a result, its role in the delivery of anesthesia care can be misunderstood by other healthcare professionals. Using an exploratory multiple case study design, this article explores healthcare professionals' perceptions of the AA role and its impact on patients and IPC. Sixteen semi-structured, in-depth interviews were conducted with a purposive sample of nine healthcare professions from inside and outside the peri-operative care unit in two urban, acute care, university-affiliated teaching research hospitals in Ontario. A thematic analysis of the interview transcripts identified five overarching themes: limited understanding of the AA role, improved patient-centred care, improve IPC and interprofessional education, ongoing challenges, and the future direction for professional growth. Results indicated that despite regular clinical practice collaboration, participants have a limited understanding of AAs in terms of their educational prerequisites, scope of practice, and roles. One reason for this lack of understanding is that there is a high variability of titles and clinical duties for non-physician anesthesia providers. The diverse range of anesthesia services provided by AAs can also become a barrier to the full understanding of their scope of practice and roles. The limited understanding of the AA role was reported as one of AAs' ongoing challenges. It prevents AAs from realising their full scope of practice. Participants suggested that AAs' professional growth should focus on promoting and expanding their role. Understanding other healthcare professionals' perceptions of AAs will assist them to become better ambassadors for their role, and to more effectively promote and practice IPC. Ultimately, this will result in improved interprofessional teamwork to deliver effective and efficient patient care.

Current realities and future vision: Developing an interprofessional, integrated health care workforce.

PubMed

Dubus, Nicole; Howard, Heather

2016-10-01

This article shares findings from an interprofessional symposium that took place in Boston in the spring of 2015. Educators and practitioners from various disciplines shared challenges, successes, and ideas on best interprofessional collaboration (IPC) and curricula development. The findings include the importance of patient-and-family-centered care, which includes the patient and his/her family in the decision-making process; increased education regarding IPC in universities and major hospitals; and educational opportunities within health care systems.

Organizational determinants of interprofessional collaboration in integrative health care: systematic review of qualitative studies.

PubMed

Chung, Vincent C H; Ma, Polly H X; Hong, Lau Chun; Griffiths, Sian M

2012-01-01

Inteprofessional collaboration (IPC) between biomedically trained doctors (BMD) and traditional, complementary and alternative medicine practitioners (TCAMP) is an essential element in the development of successful integrative healthcare (IHC) services. This systematic review aims to identify organizational strategies that would facilitate this process. We searched 4 international databases for qualitative studies on the theme of BMD-TCAMP IPC, supplemented with a purposive search of 31 health services and TCAM journals. Methodological quality of included studies was assessed using published checklist. Results of each included study were synthesized using a framework approach, with reference to the Structuration Model of Collaboration. Thirty-seven studies of acceptable quality were included. The main driver for developing integrative healthcare was the demand for holistic care from patients. Integration can best be led by those trained in both paradigms. Bridge-building activities, positive promotion of partnership and co-location of practices are also beneficial for creating bonding between team members. In order to empower the participation of TCAMP, the perceived power differentials need to be reduced. Also, resources should be committed to supporting team building, collaborative initiatives and greater patient access. Leadership and funding from central authorities are needed to promote the use of condition-specific referral protocols and shared electronic health records. More mature IHC programs usually formalize their evaluation process around outcomes that are recognized both by BMD and TCAMP. The major themes emerging from our review suggest that successful collaborative relationships between BMD and TCAMP are similar to those between other health professionals, and interventions which improve the effectiveness of joint working in other healthcare teams with may well be transferable to promote better partnership between the paradigms. However, striking a balance between the different practices and preserving the epistemological stance of TCAM will remain the greatest challenge in successful integration.

Positive and Null Effects of Interprofessional Education on Attitudes toward Interprofessional Learning and Collaboration

ERIC Educational Resources Information Center

Kenaszchuk, Chris; Rykhoff, Margot; Collins, Laura; McPhail, Stacey; van Soeren, Mary

2012-01-01

Interprofessional education (IPE) for health and social care students may improve attitudes toward IPE and interprofessional collaboration (IPC). The quality of research on the association between IPE and attitudes is mediocre and IPE effect sizes are unknown. Students at a college in Toronto, Canada, attended an IPE workshop. A comparison group…

Remote Ischemic Preconditioning Enhances the Expression of Genes Encoding Antioxidant Enzymes and Endoplasmic Reticulum Stress-Related Proteins in Rat Skeletal Muscle.

PubMed

Park, Ui Jun; Kim, Hyoung Tae; Cho, Won Hyun; Park, Jae Hyoung; Jung, Hye Ra; Kim, Min Young

2016-12-01

Ischemic preconditioning (IPC), including remote IPC (rIPC) and direct IPC (dIPC), is a promising method to decrease ischemia-reperfusion (IR) injury. This study tested the effect of both rIPC and dIPC on the genes for antioxidant enzymes and endoplasmic reticulum (ER) stress-related proteins. Twenty rats were randomly divided into the control and study groups. In the control group (n=10), the right hind limb was sham-operated. The left hind limb (IscR) of the control group underwent IR injury without IPC. In the study group (n=10), the right hind limb received IR injury after 3 cycles of rIPC. The IscR received IR injury after 3 cycles of dIPC. Gene expression was analyzed by Quantitative real-time polymerase chain reaction from the anterior tibialis muscle. The expression of the antioxidant enzyme genes including glutathione peroxidase (GPx), superoxide dismutase (SOD) 1 and catalase (CAT) were significantly reduced in IscR compared with sham treatment. In comparison with IscR, rIPC enhanced the expression of GPx, SOD2, and CAT genes. dIPC enhanced the expression of SOD2 and CAT genes. The expression of SOD2 genes was consistently higher in rIPC than in dIPC, but the difference was only significant for SOD2. The expression of genes for ER stress-related proteins tended to be reduced in IscR in comparison with sham treatment. However, the difference was only significant for C/EBP homologous protein (CHOP). In comparison with IscR, rIPC significantly up-regulated activating transcription factor 4 and CHOP, whereas dIPC up-regulated CHOP. Both rIPC and dIPC enhanced expression of genes for antioxidant enzymes and ER stress-related proteins.

FRAMEWORK FOR THE INTEGRATION OF HEALTH AND ECOLOIGCAL RISK ASSESSMENT

EPA Science Inventory

The World Health Organization's International Programme on Chemical Safety (IPCS), the Organization for Economic Cooperation and Development (OECD), and the U.S. Environmental Protection Agency have developed a collaborative partnership to foster integration; of assessment approa...

Interprofessional collaboration: if not now, when?

PubMed

Fried, Jackie

2013-01-01

Interprofessional collaboration (IPC) is a driving force behind state-of-the art health care delivery. Health care experts, governmental bodies, health professions organizations and academicians support the need for collaborative models. Dental hygienists possess unique qualities that can enhance a collaborative team. As preventive therapists, health educators and holistic providers, they are positioned to contribute richly and meaningfully to team models. Health care reform, overwhelming oral health needs and growing associations between oral and systemic wellness add to the dental hygienist's relevance in collaborative arrangements. Dental hygiene clinical and educational models that speak to collaboration are operational in many U.S. states and the future bodes well for their continued growth.

Determinants of the Efficacy of Cardiac Ischemic Preconditioning: A Systematic Review and Meta-Analysis of Animal Studies

PubMed Central

Wever, Kimberley E.; Hooijmans, Carlijn R.; Riksen, Niels P.; Sterenborg, Thomas B.; Sena, Emily S.; Ritskes-Hoitinga, Merel; Warlé, Michiel C.

2015-01-01

Background Ischemic preconditioning (IPC) of the heart is a protective strategy in which a brief ischemic stimulus immediately before a lethal ischemic episode potently limits infarct size. Although very promising in animal models of myocardial infarction, IPC has not yet been successfully translated to benefit for patients. Objective To appraise all preclinical evidence on IPC for myocardial infarction and identify factors hampering translation. Methods and results Using systematic review and meta-analysis, we identified 503 animal studies reporting infarct size data from 785 comparisons between IPC-treated and control animals. Overall, IPC reduced myocardial infarction by 24.6% [95%CI 23.5, 25.6]. Subgroup analysis showed that IPC efficacy was reduced in comorbid animals and non-rodents. Efficacy was highest in studies using 2–3 IPC cycles applied <45 minutes before myocardial infarction. Local and remote IPC were equally effective. Reporting of study quality indicators was low: randomization, blinding and a sample size calculation were reported in 49%, 11% and 2% of publications, respectively. Conclusions Translation of IPC to the clinical setting may be hampered by the observed differences between the animals used in preclinical IPC studies and the patient population, regarding comorbidity, sex and age. Furthermore, the IPC protocols currently used in clinical trials could be optimized in terms of timing and the number of ischemic cycles applied. In order to inform future clinical trials successfully, future preclinical studies on IPC should aim to maximize both internal and external validity, since poor methodological quality may limit the value of the preclinical evidence. PMID:26580958

Children's Specialized Hospital and GetWellNetwork Collaborate to Improve Patient Education and Outcomes Using an Innovative Approach.

PubMed

Kompany, Laura; Luis, Kiersten; Manganaro, Julie; Motacki, Kathleen; Mustacchio, Elaine; Provenzano, Donna

2016-01-01

Patient education in a pediatric setting is unique. There are different patient ages, degrees of learning, and diagnoses to take into account when educating children and their families. A new and innovative trend in practice called Interactive Patient Care (IPC) integrates technology into care processes to advance pediatric nursing education and patient and family satisfaction. Children's Specialized Hospital is the first pediatric rehabilitation hospital to develop and implement this type of program using an IPC platform from the GetWellNetwork. With the implementation of the GetWellNetwork, Children's Specialized Hospital has achieved positive results in patient satisfaction, health care utilization, quality, and safety measures.

Working practices and success of infection prevention and control teams: a scoping study.

PubMed

Hale, R; Powell, T; Drey, N S; Gould, D J

2015-02-01

Little research has been undertaken on how infection prevention and control (IPC) teams operate and how their effectiveness is assessed. This review aimed to explore how IPC teams embed IPC throughout hospitals, balance outbreak management with strategic aspects of IPC work (e.g. education), and how IPC team performance is measured. A scoping exercise was performed combining literature searches, evidence synthesis, and intelligence from expert advisers. Eleven publications were identified. One paper quantified how IPC nurses spend their time, two described daily activities of IPC teams, five described initiatives to embed IPC across organizations following legislation since 1999 in the UK or changes in the delivery of healthcare, and three explored the contribution of IPC intermediaries (link nurses and champions). Eight publications reported research findings. The others reported how IPC teams are embedding IPC practice in UK hospitals. In conclusion, there is scope for research to explore different models of IPC team-working and effectiveness, and cost-effectiveness. Other topics that need addressing are the willingness and ability of ward staff to assume increased responsibility for IPC and the effectiveness of intermediaries. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Impact of infection prevention and control training on health facilities during the Ebola virus disease outbreak in Guinea.

PubMed

Keïta, Mory; Camara, Ansoumane Yassima; Traoré, Falaye; Camara, Mohamed ElMady; Kpanamou, André; Camara, Sékou; Tolno, Aminata; Houndjo, Bienvenu; Diallo, Fatimatou; Conté, Fatoumata; Subissi, Lorenzo

2018-04-24

In 2014-2016, West Africa faced the most deadly Ebola Virus Disease (EVD) outbreak in history. A key strategy to overcome this outbreak was continual staff training in Infection Prevention and Control (IPC), with a focus on Ebola. This research aimed to evaluate the impact of IPC training and the quality of IPC performance in health care facilities of one municipality of Conakry, Guinea. This study was conducted in February 2016. All health facilities within Ratoma municipality, Conakry, Guinea, were evaluated based on IPC performance standards developed by the Guinean Ministry of Health. The IPC performance of healthcare facilities was categorised into high or low IPC scores based on the median IPC score of the sample. The Mantel-Haenzsel method and logistic regression were used for statistical analysis. Twenty-five percent of health centres had one IPC-trained worker, 53% had at least two IPC-trained workers, and 22% of health centres had no IPC-trained workers. An IPC score above median was positively associated with the number of trained staff; health centres with two or more IPC-trained workers were eight times as likely to have an IPC score above median, while those with one IPC-trained worker were four times as likely, compared to centres with no trained workers. Health centres that implemented IPC cascade training to untrained medical staff were five times as likely to have an IPC score above median. This research highlights the importance of training healthcare staff in IPC and organising regular cascade trainings. IPC strategies implemented during the outbreak should continue to be reinforced for the better health of patients and medical staff, and be considered a key factor in any outbreak response.

Ischemic preconditioning provides both acute and delayed protection against renal ischemia and reperfusion injury in mice.

PubMed

Joo, Jin Deok; Kim, Mihwa; D'Agati, Vivette D; Lee, H Thomas

2006-11-01

Acute as well as delayed ischemic preconditioning (IPC) provides protection against cardiac and neuronal ischemia reperfusion (IR) injury. This study determined whether delayed preconditioning occurs in the kidney and further elucidated the mechanisms of renal IPC in mice. Mice were subjected to IPC (four cycles of 5 min of ischemia and reperfusion) and then to 30 min of renal ischemia either 15 min (acute IPC) or 24 h (delayed IPC) later. Both acute and delayed renal IPC provided powerful protection against renal IR injury. Inhibition of Akt but not extracellular signal-regulated kinase phosphorylation prevented the protection that was afforded by acute IPC. Neither extracellular signal-regulated kinase nor Akt inhibition prevented protection that was afforded by delayed renal IPC. Pretreatment with an antioxidant, N-(2-mercaptopropionyl)-glycine, to scavenge free radicals prevented the protection that was provided by acute but not delayed renal IPC. Inhibition of protein kinase C or pertussis toxin-sensitive G-proteins attenuated protection from both acute and delayed renal IPC. Delayed renal IPC increased inducible nitric oxide synthase (iNOS) as well as heat-shock protein 27 synthesis, and the renal protective effects of delayed preconditioning were attenuated by a selective inhibitor of iNOS (l-N(6)[1-iminoethyl]lysine). Moreover, delayed IPC was not observed in iNOS knockout mice. Both acute and delayed IPC were independent of A(1) adenosine receptors (AR) as a selective A(1)AR antagonist failed to block preconditioning and acute and delayed preconditioning occurred in mice that lacked A(1)AR. Therefore, this study demonstrated that acute or delayed IPC provides renal protection against IR injury in mice but involves distinct signaling pathways.

Descriptive study of interprofessional collaboration between physicians and osteopaths for the pediatric population in Quebec, Canada.

PubMed

Morin, Chantal; Desrosiers, Johanne; Gaboury, Isabelle

2017-11-14

Osteopathy is an increasingly popular healthcare approach that uses a wide variety of therapeutic manual techniques to address pain and somatic dysfunction. In Quebec, Canada, osteopathy is the complementary medicine most often recommended by family physicians. However, factors fostering the development of interprofessional collaboration (IPC) between physicians and osteopaths are unknown. This study aimed to describe the current situation in terms of IPC among practitioners working with pediatric patients. A self-administered questionnaire was sent to osteopaths, family physicians, and pediatricians involved with pediatric patients in the province of Quebec. The postal questionnaire captured general knowledge about osteopathy and its practice parameters and role, sources of information, communication aspects including having a professional relationship and referrals, and influence of the upcoming government regulation. Quantitative data from the questionnaires were analyzed using descriptive statistics. Logistic regression model for factors associated with osteopathic referrals and multiple linear regression analyses for the number of correct answers about general osteopathic practice parameters were performed. A total of 274 physicians (155 family physicians (response rate 13%) and 119 pediatricians (17%)) and 297 osteopaths (42%) completed the survey. According to physicians, osteopathy was most appropriate for musculoskeletal pain (241; 91%) and plagiocephaly (235; 88%). Osteopathic referral was positively associated with having a professional relationship (odds ratio [OR] 4.10 (95% confidence interval [CI] 2.12; 7.95), p < 0.001), personal consultation (OR 2.58 (95% CI 1.35; 4.93), p = 0.004), community-based practice (OR 1.89 (95% CI 1.03; 3.47), p = 0.040), and belief in the active role of osteopathy for pediatric conditions (OR 1.22 (95% CI 1.01; 1.47), p = 0.042). The majority of physicians (72%) and osteopaths (62%) considered the upcoming government regulation of osteopathy a positive factor for collaboration. Some collaboration already exists among these practitioners, including mutual referrals, but optimizing this collaboration still poses some challenges.

Sirtinol abrogates late phase of cardiac ischemia preconditioning in rats.

PubMed

Safari, Fereshteh; Shekarforoosh, Shahnaz; Hashemi, Tahmineh; Namvar Aghdash, Simin; Fekri, Asefeh; Safari, Fatemeh

2017-07-01

The aim of this study was to investigate the effect of sirtinol, as an inhibitor of sirtuin NAD-dependent histone deacetylases, on myocardial ischemia reperfusion injury following early and late ischemia preconditioning (IPC). Rats underwent sustained ischemia and reperfusion (IR) alone or proceeded by early or late IPC. Sirtinol (S) was administered before IPC. Arrhythmias were evaluated based on the Lambeth model. Infarct size (IS) was measured using triphenyltetrazolium chloride staining. The transcription level of antioxidant-coding genes was assessed by real-time PCR. In early and late IPC groups, IS and the number of arrhythmia were significantly decreased (P < 0.05 and P < 0.01 vs IR, respectively). In S + early IPC, incidences of arrhythmia and IS were not different compared with the early IPC group. However, in S + late IPC the IS was different from the late IPC group (P < 0.05). In late IPC but not early IPC, transcription levels of catalase (P < 0.01) and Mn-SOD (P < 0.05) increased, although this upregulation was not significant in the S + late IPC group. Our results are consistent with the notion that different mechanisms are responsible for early and late IPC. In addition, sirtuin NAD-dependent histone deacetylases may be implicated in late IPC-induced cardioprotection.

Confronting human papilloma virus/oropharyngeal cancer: a model for interprofessional collaboration.

PubMed

Fried, Jacquelyn L

2014-06-01

A collaborative practice model related to Human Papilloma Virus (HPV) associated oropharyngeal cancer highlights the role of the dental hygienist in addressing this condition. The incidence of HPV associated head and neck cancer is rising. Multiple professionals including the dental hygienist can work collaboratively to confront this growing public health concern. A critical review applies the growth and utilization of interprofessional education (IPE) and interprofessional collaboration (IPC) to multi-disciplinary models addressing the human papilloma virus and oropharyngeal cancers. A model related to HPV associated oropharyngeal cancer addresses an oral systemic condition that supports the inclusion of a dental hygienist on collaborative teams addressing prevention, detection, treatment and cure of OPC. Copyright © 2014 Elsevier Inc. All rights reserved.

78 FR 64925 - Request for Comments on Proposed Elimination of Patents Search Templates

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-30

... is a detailed, collaborative, and dynamic system that will enable patent examiners and the public to... launched in January 2013. CPC is a detailed, dynamic classification system that is based on the IPC and... updating. Further, the USPTO launched a new classification system, the Cooperative Patent Classification...

A novel pain interprofessional education strategy for trainees: Assessing impact on interprofessional competencies and pediatric pain knowledge

PubMed Central

Hunter, Judith P; Stinson, Jennifer; Campbell, Fiona; Stevens, Bonnie; Wagner, Susan J; Simmons, Brian; White, Meghan; van Wyk, Margaret

2015-01-01

BACKGROUND: Health care trainees/students lack knowledge and skills for the comprehensive clinical assessment and management of pain. Moreover, most teaching has been limited to classroom settings within each profession. OBJECTIVES: To develop and evaluate the feasibility and preliminary outcomes of the ‘Pain-Interprofessional Education (IPE) Placement’, a five-week pain IPE implemented in the clinical setting. The utility (content validity, readability, internal consistency and practical considerations) of the outcome measures was also evaluated. METHODS: A convenience sample of 21 trainees from eight professions was recruited over three Pain-IPE Placement cycles. Pre- and postcurriculum assessment included: pain knowledge (Pediatric Pain Knowledge and Attitudes Survey), IPE attitudes (Interdisciplinary Education Perception Scale [IEPS]) and IPE competencies (Interprofessional Care Core Competencies Global Rating Scales [IPC-GRS]), and qualitative feedback on process/acceptability. RESULTS: Recruitment and retention met expectations. Qualitative feedback was excellent. IPE measures (IEPS and IPC-GRS) exhibited satisfactory utility. Postcurriculum scores improved significantly: IEPS, P<0.05; IPC-GRS constructs, P<0.01; and competencies, P<0.001. However, the Pediatric Pain Knowledge and Attitudes Survey exhibited poor utility in professions without formal pharmacology training. Scores improved in the remaining professions (n=14; P<0.01). DISCUSSION: There was significant improvement in educational outcomes. The IEPS and IPC-GRS are useful measures of IPE-related learning. At more advanced training levels, a single pain-knowledge questionnaire may not accurately reflect learning across diverse professions. CONCLUSION: The Pain-IPE Placement is a successful collaborative learning model within a clinical context that successfully changed interprofessional competencies. The present study represents a first step at defining and assessing change in interprofessional competencies gained from Pain-IPE. PMID:25144859

Aldehyde dehydrogenase-2 inhibition blocks remote preconditioning in experimental and human models.

PubMed

Contractor, Hussain; Støttrup, Nicolaj B; Cunnington, Colin; Manlhiot, Cedric; Diesch, Jonathan; Ormerod, Julian O M; Jensen, Rebekka; Bøtker, Hans Erik; Redington, Andrew; Schmidt, Michael R; Ashrafian, Houman; Kharbanda, Rajesh K

2013-05-01

Mitochondrial aldehyde dehydrogenase-2 (ALDH-2) is involved in preconditioning pathways, but its role in remote ischaemic preconditioning (rIPC) is unknown. We investigated its role in animal and human models of rIPC. (i) In a rabbit model of myocardial infarction, rIPC alone reduced infarct size [69 ± 5.8 % (n = 11) to 40 ± 6.5 % (n = 12), P = 0.019]. However, rIPC protection was lost after pre-treatment with the ALDH-2 inhibitor cyanamide (62 ± 7.6 % controls, n = 10, versus 61 ± 6.9 % rIPC after cyanamide, n = 10, P > 0.05). (ii) In a forearm plethysmography model of endothelial ischaemia-reperfusion injury, 24 individuals of Asian ethnic origin underwent combined rIPC and ischaemia-reperfusion (IR). 11 had wild-type (WT) enzyme and 13 carried the Glu504Lys (ALDH2*2) polymorphism (rendering ALDH-2 functionally inactive). In WT individuals, rIPC protected against impairment of response to acetylcholine (P = 0.9), but rIPC failed to protect carriers of Glu504Lys polymorphism (P = 0.004). (iii) In a second model of endothelial IR injury, 12 individuals participated in a double-blind placebo-controlled crossover study, receiving the ALDH-2 inhibitor disulfiram 600 mg od or placebo for 48 h prior to assessment of flow-mediated dilation (FMD) before and after combined rIPC and IR. With placebo, rIPC was effective with no difference in FMD before and after IR (6.18 ± 1.03 % and 4.76 ± 0.93 % P = 0.1), but disulfiram inhibited rIPC with a reduction in FMD after IR (7.87 ± 1.27 % and 3.05 ± 0.53 %, P = 0.001). This study demonstrates that ALDH-2 is involved in the rIPC pathway in three distinct rabbit and human models. This has potential implications for future clinical studies of remote conditioning.

Understanding interprofessional relationships by the use of contact theory.

PubMed

Mohaupt, Jennifer; van Soeren, Mary; Andrusyszyn, Mary-Anne; Macmillan, Kathleen; Devlin-Cop, Sandra; Reeves, Scott

2012-09-01

The importance and necessity of interprofessional collaboration (IPC) present challenges for educators as they determine how best to achieve IPC through interprofessional education (IPE). Simulation-based teaching has been shown to enhance students' understanding of professional roles and promote positive attitudes toward team members; yet, empirical evidence providing direction on the conditions necessary to promote these positive outcomes is lacking. This study used a quasi-experimental design with a pre-/post-test to examine changes in undergraduate healthcare students' perceptions and attitudes toward IPC following their participation in an interprofessional simulation program. Allport's (1954) intergroup contact theory was used to help understand the nature of this IPE workshop and its reported outcomes. Participants included students in the final year of their respective programs (n = 84) such as pharmacy technician, paramedic, nursing and occupational therapy assistant/physical therapy assistant programs. These students were engaged in simulation exercises with interactive contact opportunities. Using the interdisciplinary education perceptions scale, statistically significant increases in positive attitudes in three of four sub-scales were found. An analysis of the structure and format of the workshop suggests that this IPE initiative fulfilled the key conditions suggested by intergroup contact theory. Attention to the key conditions provided by Allport's theory in the context of successful intergroup relationships may help provide direction for educators interested in planning IPE initiatives with student groups enrolled in various health programs.

Impact of Ischemic Preconditioning on Outcome in Clinical Liver Surgery: A Systematic Review

PubMed Central

Chu, Michael J. J.; Vather, Ryash; Hickey, Anthony J. R.; Phillips, Anthony R. J.; Bartlett, Adam S. J. R.

2015-01-01

Background. Ischemia-reperfusion injury is a major cause of post-liver-surgery complications. Ischemic preconditioning (IPC) has been demonstrated to protect against ischemia-reperfusion injury. Clinical studies have examined IPC in liver surgery but with conflicting results. This systematic review aimed to evaluate the effects of IPC on outcome in clinical liver surgery. Methods. An electronic search of OVID Medline and Embase databases was performed to identify studies that reported outcomes in patients undergoing liver surgery subjected to IPC. Basic descriptive statistics were used to summarise data from individual clinical studies. Results. 1093 articles were identified, of which 24 met the inclusion criteria. Seven topics were selected and analysed by subgroup. There were 10 studies in cadaveric liver transplantation, 2 in living-related liver transplantation, and 12 in liver resection. IPC decreases hepatocellular damage in liver surgery as determined by transaminases but does not translate to any significant clinical benefit in orthotopic liver transplant or liver resection. Conclusions. Available clinical evidence does not support routine use of IPC in liver surgery as it does not offer any apparent benefit in perioperative outcome. Further clinical studies will need to be carried out to determine the subset of patients that will benefit from IPC. PMID:25756045

Analysis of Federal Subsidies: Implied Price of Carbon

DOE Office of Scientific and Technical Information (OSTI.GOV)

D. Craig Cooper; Thomas Foulke

2010-10-01

For informed climate change policy, it is important for decision makers to be able to assess how the costs and benefits of federal energy subsidies are distributed and to be able to have some measure to compare them. One way to do this is to evaluate the implied price of carbon (IPC) for a federal subsidy, or set of subsidies; where the IPC is the cost of the subsidy to the U.S. Treasury divided by the emissions reductions it generated. Subsidies with lower IPC are more cost effective at reducing greenhouse gas emissions, while subsidies with a negative IPC actmore » to increase emissions. While simple in concept, the IPC is difficult to calculate in practice. Calculation of the IPC requires knowledge of (i) the amount of energy associated with the subsidy, (ii) the amount and type of energy that would have been produced in the absence of the subsidy, and (iii) the greenhouse gas emissions associated with both the subsidized energy and the potential replacement energy. These pieces of information are not consistently available for federal subsidies, and there is considerable uncertainty in cases where the information is available. Thus, exact values for the IPC based upon fully consistent standards cannot be calculated with available data. However, it is possible to estimate a range of potential values sufficient for initial comparisons. This study has employed a range of methods to generate “first order” estimates for the IPC of a range of federal subsidies using static methods that do not account for the dynamics of supply and demand. The study demonstrates that, while the IPC value depends upon how the inquiry is framed and the IPC cannot be calculated in a “one size fits all” manner, IPC calculations can provide a valuable perspective for climate policy analysis. IPC values are most useful when calculated within the perspective of a case study, with the method and parameters of the calculation determined by the case. The IPC of different policy measures can then be quantitatively evaluated within the case. Results can be qualitatively compared across cases, so long as such comparisons are considered to be preliminary and treated with the appropriate level of caution.« less

Effects of interprofessional education for medical and nursing students: enablers, barriers and expectations for optimizing future interprofessional collaboration - a qualitative study.

PubMed

Homeyer, Sabine; Hoffmann, Wolfgang; Hingst, Peter; Oppermann, Roman F; Dreier-Wolfgramm, Adina

2018-01-01

To ensure high quality patient care an effective interprofessional collaboration between healthcare professionals is required. Interprofessional education (IPE) has a positive impact on team work in daily health care practice. Nevertheless, there are various challenges for sustainable implementation of IPE. To identify enablers and barriers of IPE for medical and nursing students as well as to specify impacts of IPE for both professions, the 'Cooperative academical regional evidence-based Nursing Study in Mecklenburg-Western Pomerania' (Care-N Study M-V) was conducted. The aim is to explore, how IPE has to be designed and implemented in medical and nursing training programs to optimize students' impact for IPC. A qualitative study was conducted using the Delphi method and included 25 experts. Experts were selected by following inclusion criteria: (a) ability to answer every research question, one question particularly competent, (b) interdisciplinarity, (c) sustainability and (d) status. They were purposely sampled. Recruitment was based on existing collaborations and a web based search. The experts find more enablers than barriers for IPE between medical and nursing students. Four primary arguments for IPE were mentioned: (1) development and promotion of interprofessional thinking and acting, (2) acquirement of shared knowledge, (3) promotion of beneficial information and knowledge exchange, and (4) promotion of mutual understanding. Major barriers of IPE are the coordination and harmonization of the curricula of the two professions. With respect to the effects of IPE for IPC, experts mentioned possible improvements on (a) patient level and (b) professional level. Experts expect an improved patient-centered care based on better mutual understanding and coordinated cooperation in interprofessional health care teams. To sustainably implement IPE for medical and nursing students, IPE needs endorsement by both, medical and nursing faculties. In conclusion, IPE promotes interprofessional cooperation between the medical and the nursing profession. Skills in interprofessional communication and roles understanding will be primary preconditions to improve collaborative patient-centered care. The impact of IPE for patients and caregivers as well as for both professions now needs to be more specifically analysed in prospective intervention studies.

Low-molecular-weight heparin and intermittent pneumatic compression for thromboprophylaxis in critical patients

PubMed Central

WAN, BING; FU, HAI-YAN; YIN, JIANG-TAO; REN, GUO-QING

2015-01-01

The efficacy and safety of physiotherapeutic prophylaxis for venous thromboembolism in critically ill patients with heparin contraindication remains unclear. In the present study it was hypothesized that physiotherapy prophylaxis with intermittent pneumatic compression (IPC) would be safe and effective for patients unable to receive low-molecular-weight heparin (LMWH). In addition, this study investigated whether a combined therapy of IPC with LMWH would be more effective for the prophylaxis of deep vein thrombosis (DVT) in critical patients. A total of 500 patients were divided into four groups according to the prophylaxis of DVT. The IPC group consisted of 95 patients with heparin contraindication that received IPC treatment; the LMWH group consisted of 185 patients that received an LMWH injection; the LMWH + IPC group consisted of 75 patients that received IPC treatment and LMWH injection; and the control group consisted of 145 patients that received no IPC treatment or injection of LMWH. Each patient was evaluated clinically for development of DVT and the diagnosis was confirmed by Doppler study. Venous thromboembolism was a common complication among the trauma patients with severe injuries. Patients responded positively to the treatment used in the intervention groups. Patients exhibited an improved response to LMWH + ICP compared with IPC or LMWH alone, while no significant difference was detected between the IPC and LMWH groups. These results were applicable to patients that had a Wells score of ≥3; however, no significant differences in DVT incidence were observed among the patients who had a Wells score of <3. In this observational study, LMWH + ICP appeared to be more effective than either treatment alone in treating critically ill trauma patients with severe injuries that are at high risk for VTE and bleeding simultaneously. PMID:26668637

Infection prevention and control in health facilities in post-Ebola Liberia: don't forget the private sector!

PubMed Central

Musa, E.; Cooper, C.; Van den Bergh, R.; Owiti, P.; Baller, A.; Siafa, T.; Woldeyohannes, D.; Shringarpure, K.; Gasasira, A.

2017-01-01

Setting: Recognising the importance of infection prevention and control (IPC), a minimum standards tool (MST) was developed in Liberia to guide the safe (re-) opening and provision of care in health facilities. Objectives: To analyse the implementation of specific IPC measures after the 2014 Ebola virus outbreak between June 2015 and May 2016, and to compare the relative improvements in IPC between the public and private sectors. Design: A retrospective comparative cohort study. Results: We evaluated 723 (94%) of the 769 health facilities in Liberia. Of these, 437 (60%) were public and 286 (40%) were private. There was an overall improvement in the MST scores from a median of 13 to 14 out of a maximum possible score of 16. While improvements were observed in all aspects of IPC in both public and private health facilities, IPC implementation was systematically higher in public facilities. Conclusions: We demonstrate the feasibility of monitoring IPC implementation using the MST checklist in post-Ebola Liberia. Our study shows that improvements were made in key aspects of IPC after 1 year of evaluations and tailored recommendations. We also highlight the need to increase the focus on the private sector to achieve further improvements in IPC. PMID:28744446

Infection prevention and control in health facilities in post-Ebola Liberia: don't forget the private sector!

PubMed

Tremblay, N; Musa, E; Cooper, C; Van den Bergh, R; Owiti, P; Baller, A; Siafa, T; Woldeyohannes, D; Shringarpure, K; Gasasira, A

2017-06-21

Setting: Recognising the importance of infection prevention and control (IPC), a minimum standards tool (MST) was developed in Liberia to guide the safe (re-) opening and provision of care in health facilities. Objectives: To analyse the implementation of specific IPC measures after the 2014 Ebola virus outbreak between June 2015 and May 2016, and to compare the relative improvements in IPC between the public and private sectors. Design: A retrospective comparative cohort study. Results: We evaluated 723 (94%) of the 769 health facilities in Liberia. Of these, 437 (60%) were public and 286 (40%) were private. There was an overall improvement in the MST scores from a median of 13 to 14 out of a maximum possible score of 16. While improvements were observed in all aspects of IPC in both public and private health facilities, IPC implementation was systematically higher in public facilities. Conclusions: We demonstrate the feasibility of monitoring IPC implementation using the MST checklist in post-Ebola Liberia. Our study shows that improvements were made in key aspects of IPC after 1 year of evaluations and tailored recommendations. We also highlight the need to increase the focus on the private sector to achieve further improvements in IPC.

Post-ischemic conditioning in the rat retina is dependent upon ischemia duration and is not additive with ischemic pre-conditioning.

PubMed

Dreixler, John C; Shaikh, Afzhal R; Alexander, Michael; Savoie, Brian; Roth, Steven

2010-12-01

Ischemic pre-conditioning (IPC) provides neuroprotection in the rat retina from the damaging effects of severe ischemia. Recently, neuroprotection by retinal ischemic post-conditioning (Post-C), i.e., transient ischemia after more lengthy, damaging ischemia, was described, but its mechanisms are not yet known. One possible explanation of the effectiveness of Post-C is that it augments intrinsic neuroprotective mechanisms initiated during ischemia. Increasing duration of the damaging ischemic insult may therefore impact the effectiveness of Post-C. IPC, in contrast, sets in motion a series of neuroprotective events prior to the onset of ischemia. Thus, IPC and Post-C may operate by differing mechanisms. Accordingly, we examined the effect of retinal ischemic duration on post-ischemic outcome in vivo in rats after adding Post-C, and the impact of combining pre- and post-conditioning. Recovery after ischemia performed 24 h after IPC, or after Post-C performed 5 min after ischemia ended, was assessed functionally (electroretinography) and histologically at 7 days after ischemia. Durations of ischemia of 45 and 55 min were studied. Since recovery with IPC or Post-C alone, with 55 min of ischemia, did not achieve the same degree of effect (i.e., not complete recovery) exhibited in our previous studies of IPC using a different ischemia model, we also combined IPC and Post-C to test the hypothesis of the possible additive effects of the IPC and Post-C. We found that the recovery after Post-C was enhanced to a greater degree when ischemia was of longer duration. Post-C led to greater post-ischemic recovery compared to IPC. Both IPC and Post-C also attenuated structural damage to the retina. Contrary to our hypothesis, IPC and Post-C did not combine to enhance recovery after ischemia. In earlier studies, IPC attenuated post-ischemic apoptosis. To begin to examine the mechanism of Post-C, we studied its impact on apoptosis following ischemia. We examined apoptosis by determining the percentage of TUNEL-positive cells at 24 h after ischemia. Post-C attenuated apoptosis, but when combined with IPC, TUNEL was similar in the combined group to that of ischemia alone. We also examined the role of the recruitment of an inflammatory response in ischemia and Post-C. We found that inflammatory markers increased by ischemia were not altered by Post-C. We conclude that Post-C effectiveness depends upon the duration of ischemia; Post-C is not additive with IPC, and Post-C functions, in part, by preventing apoptotic damage to the inner retina. Post-C has considerable promise for clinical translation to eye diseases that cause blindness by ischemia. Copyright © 2010 Elsevier Ltd. All rights reserved.

Towards changing healthcare workers' behaviour: a qualitative study exploring non-compliance through appraisals of infection prevention and control practices.

PubMed

Shah, N; Castro-Sánchez, E; Charani, E; Drumright, L N; Holmes, A H

2015-06-01

Improving behaviour in infection prevention and control (IPC) practice remains a challenge, and understanding the determinants of healthcare workers' (HCWs) behaviour is fundamental to develop effective and sustained behaviour change interventions. To identify behaviours of HCWs that facilitated non-compliance with IPC practices, focusing on how appraisals of IPC duties and social and environmental circumstances shaped and influenced non-compliant behaviour. This study aimed to: (1) identify how HCWs rationalized their own behaviour and the behaviour of others; (2) highlight challenging areas of IPC compliance; and (3) describe the context of the working environment that may explain inconsistencies in IPC practices. Clinical staff at a National Health Service hospital group in London, UK were interviewed between December 2010 and July 2011 using qualitative methods. Responses were analysed using a thematic framework. Three ways in which HCWs appraised their behaviour were identified through accounts of IPC policies and practices: (1) attribution of responsibilities, with ambiguity about responsibility for certain IPC practices; (2) prioritization and risk appraisal, which demonstrated a divergence in values attached to some IPC policies and practices; and (3) hierarchy of influence highlighted that traditional clinical roles challenged work relationships. Overall, behaviours are not entirely independent of policy rules, but often an amalgamation of local normative practices, individual preferences and a degree of professional isolation. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Enhanced cell volume regulation: a key protective mechanism of ischemic preconditioning in rabbit ventricular myocytes.

PubMed

Diaz, Roberto J; Armstrong, Stephen C; Batthish, Michelle; Backx, Peter H; Ganote, Charles E; Wilson, Gregory J

2003-01-01

Accumulation of osmotically active metabolites, which create an osmotic gradient estimated at ~60 mOsM, and cell swelling are prominent features of ischemic myocardial cell death. This study tests the hypothesis that reduction of ischemic swelling by enhanced cell volume regulation is a key mechanism in the delay of ischemic myocardial cell death by ischemic preconditioning (IPC). Experimental protocols address whether: (i) IPC triggers a cell volume regulation mechanism that reduces cardiomyocyte swelling during subsequent index ischemia; (ii) this reduction in ischemic cell swelling is sufficient in magnitude to account for the IPC protection; (iii) the molecular mechanism that mediates IPC also mediates cell volume regulation. Two experimental models with rabbit ventricular myocytes were studied: freshly isolated pelleted myocytes and 48-h cultured myocytes. Myocytes were preconditioned either by distinct short simulated ischemia (SI)/simulated reperfusion protocols (IPC), or by subjecting myocytes to a pharmacological preconditioning (PPC) protocol (1 microM calyculin A, or 1 microM N(6)-2-(4-aminophenyl)ethyladenosine (APNEA), prior to subjecting them to either different durations of long SI or 30 min hypo-osmotic stress. Cell death (percent blue square myocytes) was monitored by trypan blue staining. Cell swelling was determined by either the bromododecane cell flotation assay (qualitative) or video/confocal microscopy (quantitative). Simulated ischemia induced myocyte swelling in both the models. In pelleted myocytes, IPC or PPC with either calyculin A or APNEA produced a marked reduction of ischemic cell swelling as determined by the cell floatation assay. In cultured myocytes, IPC substantially reduced ischemic cell swelling (P < 0.001). This IPC effect on ischemic cell swelling was related to an IPC and PPC (with APNEA) mediated triggering of cell volume regulatory decrease (RVD). IPC and APNEA also significantly (P < 0.001) reduced hypo-osmotic cell swelling. This IPC and APNEA effect was blocked by either adenosine receptor, PKC or Cl(-) channel inhibition. The osmolar equivalent for IPC protection approximated 50-60 mOsM, an osmotic gradient similar to the estimated ischemic osmotic load for preconditioned and non-preconditioned myocytes. The results suggest that cell volume regulation is a key mechanism that accounts for most of the IPC protection in cardiomyocytes.

Ischaemic preconditioning preferentially increases protein S-nitrosylation in subsarcolemmal mitochondria

PubMed Central

Sun, Junhui; Nguyen, Tiffany; Aponte, Angel M.; Menazza, Sara; Kohr, Mark J.; Roth, David M.; Patel, Hemal H.; Murphy, Elizabeth; Steenbergen, Charles

2015-01-01

Nitric oxide (NO) and protein S-nitrosylation (SNO) have been shown to play important roles in ischaemic preconditioning (IPC)-induced acute cardioprotection. The majority of proteins that show increased SNO following IPC are localized to the mitochondria, and our recent studies suggest that caveolae transduce acute NO/SNO cardioprotective signalling in IPC hearts. Due to the close association between subsarcolemmal mitochondria (SSM) and the sarcolemma/caveolae, we tested the hypothesis that SSM, rather than the interfibrillar mitochondria (IFM), are major targets for NO/SNO signalling derived from caveolae-associated eNOS. Following either control perfusion or IPC, SSM and IFM were isolated from Langendorff perfused mouse hearts, and SNO was analysed using a modified biotin switch method with fluorescent maleimide fluors. In perfusion control hearts, the SNO content was higher in SSM compared with IFM (1.33 ± 0.19, ratio of SNO content Perf-SSM vs. Perf-IFM), and following IPC SNO content significantly increased preferentially in SSM, but not in IFM (1.72 ± 0.17 and 1.07 ± 0.04, ratio of SNO content IPC-SSM vs. Perf-IFM, and IPC-IFM vs. Perf-IFM, respectively). Consistent with these findings, eNOS, caveolin-3, and connexin-43 were detected in SSM, but not in IFM, and IPC resulted in a further significant increase in eNOS/caveolin-3 levels in SSM. Interestingly, we did not observe an IPC-induced increase in SNO or eNOS/caveolin-3 in SSM isolated from caveolin-3−/− mouse hearts, which could not be protected with IPC. In conclusion, these results suggest that SSM may be the preferential target of sarcolemmal signalling-derived post-translational protein modification (caveolae-derived eNOS/NO/SNO), thus providing an important role in IPC-induced cardioprotection. PMID:25694588

"You're dealing with an emotionally charged individual...": an industry perspective on the challenges posed by medical tourists' informal caregiver-companions.

PubMed

Casey, Victoria; Crooks, Valorie A; Snyder, Jeremy; Turner, Leigh

2013-07-26

Patients engage in medical tourism when they privately obtain a medical care abroad. Previous research shows that many medical tourists travel abroad with friends and family members who provide support and assistance. Meanwhile, very little is known about this important stakeholder group, referred to here as caregiver-companions. In this article we examine the challenges that can be posed by caregiver-companions and the overall practice of informal caregiving in medical tourism from an industry perspective. Specifically, we report on the findings of interviews conducted with international patient coordinators (IPCs) who work at destination facilities. IPCs come into regular contact with caregiver-companions in their professional positions and thus are ideally suited to comment on trends they have observed among this stakeholder group as well as the challenges they can pose to medical tourists, health workers, and facilities. We conducted 20 semi-structured interviews with 21 IPCs from 16 different facilities across nine countries. Topics probed in the interviews included caregiver-companion roles, IPCs' and others' interaction with caregiver-companions, and potential health and safety risks posed to medical tourists and caregiver-companions. Thematic analysis of the verbatim transcripts was employed. Although most participants encouraged medical tourists to travel with a caregiver-companion, many challenges associated with caregiver-companions were identified. Three themes best characterize the challenges that emerged: (1) caregiver-companions require time, attention and resources; (2) caregiver-companions can disrupt the provision of quality care; and (3) caregiver-companions can be exposed to risks. IPCs pointed out that caregiver-companions may, for example, have a negative impact on the patient through cost of accompaniment or inadequate care provision. Caregiver-companions may also create unanticipated or extra work for IPCs, as additional clients and by ignoring established organizational rules, routines, and expectations. Furthermore, caregiver-companions may be susceptible to stresses and health and safety risks, which would further deteriorate their own abilities to offer the patient quality care. Although caregiver-companions can pose challenges to medical tourists, health workers, and medical tourism facilities, they can also assist in enhancing best care and offering meaningful support to medical tourists. If caregiver-companions are open to collaboration with IPCs, and particularly in the form of information sharing, then their experience abroad can be safer and less stressful for themselves and, by extension, for the accompanied patients and facility staff.

Combined PDF and Rietveld studies of ADORable zeolites and the disordered intermediate IPC-1P.

PubMed

Morris, Samuel A; Wheatley, Paul S; Položij, Miroslav; Nachtigall, Petr; Eliášová, Pavla; Čejka, Jiří; Lucas, Tim C; Hriljac, Joseph A; Pinar, Ana B; Morris, Russell E

2016-09-28

The disordered intermediate of the ADORable zeolite UTL has been structurally confirmed using the pair distribution function (PDF) technique. The intermediate, IPC-1P, is a disordered layered compound formed by the hydrolysis of UTL in 0.1 M hydrochloric acid solution. Its structure is unsolvable by traditional X-ray diffraction techniques. The PDF technique was first benchmarked against high-quality synchrotron Rietveld refinements of IPC-2 (OKO) and IPC-4 (PCR) - two end products of IPC-1P condensation that share very similar structural features. An IPC-1P starting model derived from density functional theory was used for the PDF refinement, which yielded a final fit of Rw = 18% and a geometrically reasonable structure. This confirms the layers do stay intact throughout the ADOR process and shows PDF is a viable technique for layered zeolite structure determination.

Using Behavioral Mapping to Examine the Validity of the IPIP-IPC

ERIC Educational Resources Information Center

Markey, Patrick; Anderson, Juliene M.; Markey, Charlotte

2013-01-01

Behavioral mapping, a method designed to relate behaviors to circumplex models, was used to examine the predictive validity of the International Personality Item Pool-Interpersonal Circumplex (IPIP-IPC). In this study, 96 participants first completed the IPIP-IPC and then were videotaped in a social interaction with a confederate. At the…

Individualised patient care: a framework for guidelines.

PubMed

Redfern, S

It is assumed that individualised patient care (IPC) benefits both patients and nurses. This study set out to clarify what IPC means to nurses and how they practise it, as well as how it is experienced by patients. With some exceptions, IPC was not practised widely in the seven wards used as case studies. Even in the wards where it was more common, there were some examples of bad practice. Factors that facilitated IPC were: the personal qualities of the nurses; a shared understanding among the ward team of the goals of nursing care and what constitutes good practice; levels of staffing and skill mix; effective leadership and management of nursing work.

Effect of ischemic preconditioning on antioxidant status in the gerbil hippocampal CA1 region after transient forebrain ischemia

PubMed Central

Park, Seung Min; Park, Chan Woo; Lee, Tae-Kyeong; Cho, Jeong Hwi; Park, Joon Ha; Lee, Jae-Chul; Chen, Bai Hui; Shin, Bich-Na; Ahn, Ji Hyeon; Tae, Hyun-Jin; Shin, Myoung Cheol; Ohk, Taek Geun; Cho, Jun Hwi; Won, Moo-Ho; Choi, Soo Young; Kim, In Hye

2016-01-01

Ischemic preconditioning (IPC) is a condition of sublethal transient global ischemia and exhibits neuroprotective effects against subsequent lethal ischemic insult. We, in this study, examined the neuroprotective effects of IPC and its effects on immunoreactive changes of antioxidant enzymes including superoxide dismutase (SOD) 1 and SOD2, catalase (CAT) and glutathione peroxidase (GPX) in the gerbil hippocampal CA1 region after transient forebrain ischemia. Pyramidal neurons of the stratum pyramidale (SP) in the hippocampal CA1 region of animals died 5 days after lethal transient ischemia without IPC (8.6% (ratio of remanent neurons) of the sham-operated group); however, IPC prevented the pyramidal neurons from subsequent lethal ischemic injury (92.3% (ratio of remanent neurons) of the sham-operated group). SOD1, SOD2, CAT and GPX immunoreactivities in the sham-operated animals were easily detected in pyramidal neurons in the stratum pyramidale (SP) of the hippocampal CA1 region, while all of these immunoreactivities were rarely detected in the stratum pyramidale at 5 days after lethal transient ischemia without IPC. Meanwhile, their immunoreactivities in the sham-operated animals with IPC were similar to (SOD1, SOD2 and CAT) or higher (GPX) than those in the sham-operated animals without IPC. Furthermore, their immunoreactivities in the stratum pyramidale of the ischemia-operated animals with IPC were steadily maintained after lethal ischemia/reperfusion. Results of western blot analysis for SOD1, SOD2, CAT and GPX were similar to immunohistochemical data. In conclusion, IPC maintained or increased the expression of antioxidant enzymes in the stratum pyramidale of the hippocampal CA1 region after subsequent lethal transient forebrain ischemia and IPC exhibited neuroprotective effects in the hippocampal CA1 region against transient forebrain ischemia. PMID:27630689

Involvement of Erythropoietin in Retinal Ischemic Preconditioning

PubMed Central

Dreixler, John C.; Hagevik, Sarah; Hemmert, Jonathan W.; Shaikh, Afzhal R.; Rosenbaum, Daniel M.; Roth, Steven

2009-01-01

Background The purpose of this study was to examine the role of erythropoietin in retinal ischemic preconditioning (IPC). Methods Rats were subjected to retinal ischemia after IPC. Electroretinography assessed functional recovery after ischemia; retinal sections were examined to determine loss of retinal ganglion cells, and Terminal Deoxynucleotidyl Transferase Mediated dUTP Nick End Labeling was used to assess apoptosis. Levels of downstream mediators were measured in retinal homogenates by Western blotting. To assess the involvement of erythropoietin in IPC, we measured levels of erythropoietin and its receptor (EPO-R) in retinal homogenates following IPC, using Western blotting. To examine erythropoietin’s role in IPC, we studied the impact of blocking erythropoietin via intravitreal injection of soluble EPO-R (sEPO-R) before IPC. Results Erythropoietin levels did not change following IPC, but EPO-R increased. Intravitreal injection of sEPO-R significantly attenuated both the functional and histological neuroprotection produced by IPC in comparison to control injection of denatured sEPO-R. Apoptotic damage after ischemia was enhanced in the sEPO-R treated retinas as indicated by fluorescent Terminal Deoxynucleotidyl Transferase Mediated dUTP Nick End Labeling. Phosphorylated extracellular-signal-regulated kinase (ERK) and heat shock protein 27 (Hsp27), but not protein kinase B (Akt), upregulated in denatured sEPO-R treated retinae, were attenuated in eyes injected with sEPO-R. Conclusions These results indicate that EPO-R upregulation is a critical component of the functional, histological, and anti-apoptotic protective effect of ischemic preconditioning on ischemia in the retina and that several downstream effectors may be involved in the neuroprotective actions of erythropoietin. PMID:19322943

Ischaemic preconditioning preferentially increases protein S-nitrosylation in subsarcolemmal mitochondria.

PubMed

Sun, Junhui; Nguyen, Tiffany; Aponte, Angel M; Menazza, Sara; Kohr, Mark J; Roth, David M; Patel, Hemal H; Murphy, Elizabeth; Steenbergen, Charles

2015-05-01

Nitric oxide (NO) and protein S-nitrosylation (SNO) have been shown to play important roles in ischaemic preconditioning (IPC)-induced acute cardioprotection. The majority of proteins that show increased SNO following IPC are localized to the mitochondria, and our recent studies suggest that caveolae transduce acute NO/SNO cardioprotective signalling in IPC hearts. Due to the close association between subsarcolemmal mitochondria (SSM) and the sarcolemma/caveolae, we tested the hypothesis that SSM, rather than the interfibrillar mitochondria (IFM), are major targets for NO/SNO signalling derived from caveolae-associated eNOS. Following either control perfusion or IPC, SSM and IFM were isolated from Langendorff perfused mouse hearts, and SNO was analysed using a modified biotin switch method with fluorescent maleimide fluors. In perfusion control hearts, the SNO content was higher in SSM compared with IFM (1.33 ± 0.19, ratio of SNO content Perf-SSM vs. Perf-IFM), and following IPC SNO content significantly increased preferentially in SSM, but not in IFM (1.72 ± 0.17 and 1.07 ± 0.04, ratio of SNO content IPC-SSM vs. Perf-IFM, and IPC-IFM vs. Perf-IFM, respectively). Consistent with these findings, eNOS, caveolin-3, and connexin-43 were detected in SSM, but not in IFM, and IPC resulted in a further significant increase in eNOS/caveolin-3 levels in SSM. Interestingly, we did not observe an IPC-induced increase in SNO or eNOS/caveolin-3 in SSM isolated from caveolin-3(-/-) mouse hearts, which could not be protected with IPC. In conclusion, these results suggest that SSM may be the preferential target of sarcolemmal signalling-derived post-translational protein modification (caveolae-derived eNOS/NO/SNO), thus providing an important role in IPC-induced cardioprotection. Published by Oxford University Press on behalf of the European Society of Cardiology 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Ischemic Preconditioning Blunts Muscle Damage Responses Induced by Eccentric Exercise.

PubMed

Franz, Alexander; Behringer, Michael; Harmsen, Jan-Frieder; Mayer, Constantin; Krauspe, Rüdiger; Zilkens, Christoph; Schumann, Moritz

2018-01-01

Ischemic preconditioning (IPC) is known to reduce muscle damage induced by ischemia and reperfusion injury during surgery. Because of similarities between the pathophysiological formation of ischemia and reperfusion injury and eccentric exercise-induced muscle damage (EIMD), as characterized by an intracellular accumulation of Ca, an increased production of reactive oxygen species, and increased proinflammatory signaling, the purpose of the present study was to investigate whether IPC performed before eccentric exercise may also protect against EIMD. Nineteen healthy men were matched to an eccentric-only (ECC; n = 9) or eccentric proceeded by IPC group (IPC + ECC; n = 10). The exercise protocol consisted of bilateral biceps curls (3 × 10 repetitions at 80% of the concentric one-repetition maximum). In IPC + ECC, IPC was applied bilaterally at the upper arms by a tourniquet (200 mm Hg) immediately before the exercise (3 × 5 min of occlusion, separated by 5 min of reperfusion). Creatine kinase (CK), arm circumference, subjective pain (visual analog scale score), and radial displacement (tensiomyography, maximal radial displacement) were assessed before IPC, preexercise, postexercise, and 20 min, 2 h, 24 h, 48 h, and 72 h postexercise. CK differed from baseline only in ECC at 48 h (P < 0.001) and 72 h (P < 0.001) postexercise. After 24, 48, and 72 h, CK was increased in ECC compared with IPC + ECC (between groups: 24 h, P = 0.004; 48 h, P < 0.001; 72 h, P < 0.001). The visual analog scale score was significantly higher in ECC at 24-72 h postexercise when compared with IPC + ECC (between groups: all P values < 0.001). The maximal radial displacement was decreased on all postexercise days in ECC (all P values < 0.001) but remained statistically unchanged in IPC + ECC (between groups: P < 0.01). These findings indicate that IPC performed before a bout of eccentric exercise of the elbow flexors blunts EIMD and exercise-induced pain while maintaining the contractile properties of the muscle.

Liver Ischemic Preconditioning (IPC) Improves Intestinal Microbiota Following Liver Transplantation in Rats through 16s rDNA-Based Analysis of Microbial Structure Shift

PubMed Central

Lu, Haifeng; Chen, Xinhua; Jiang, Jianwen; Liu, Hui; He, Yong; Ding, Songming; Hu, Zhenhua; Wang, Weilin; Zheng, Shusen

2013-01-01

Background Ischemia-reperfusion (I/R) injury is associated with intestinal microbial dysbiosis. The “gut-liver axis” closely links gut function and liver function in health and disease. Ischemic preconditioning (IPC) has been proven to reduce I/R injury in the surgery. This study aims to explore the effect of IPC on intestinal microbiota and to analyze characteristics of microbial structure shift following liver transplantation (LT). Methods The LT animal models of liver and gut IPC were established. Hepatic graft function was assessed by histology and serum ALT/AST. Intestinal barrier function was evaluated by mucosal ultrastructure, serum endotoxin, bacterial translocation, fecal sIgA content and serum TNF-α. Intestinal bacterial populations were determined by quantitative PCR. Microbial composition was characterized by DGGE and specific bacterial species were determined by sequence analysis. Principal Findings Liver IPC improved hepatic graft function expressed as ameliorated graft structure and reduced ALT/AST levels. After administration of liver IPC, intestinal mucosal ultrastructure improved, serum endotoxin and bacterial translocation mildly decreased, fecal sIgA content increased, and serum TNF-α decreased. Moreover, liver IPC promoted microbial restorations mainly through restoring Bifidobacterium spp., Clostridium clusters XI and Clostridium cluster XIVab on bacterial genus level. DGGE profiles indicated that liver IPC increased microbial diversity and species richness, and cluster analysis demonstrated that microbial structures were similar and clustered together between the NC group and Liver-IPC group. Furthermore, the phylogenetic tree of band sequences showed key bacteria corresponding to 10 key band classes of microbial structure shift induced by liver IPC, most of which were assigned to Bacteroidetes phylum. Conclusion Liver IPC cannot only improve hepatic graft function and intestinal barrier function, but also promote restorations of intestinal microbiota following LT, which may further benefit hepatic graft by positive feedback of the “gut-liver axis”. PMID:24098410

Liver ischemic preconditioning (IPC) improves intestinal microbiota following liver transplantation in rats through 16s rDNA-based analysis of microbial structure shift.

PubMed

Ren, Zhigang; Cui, Guangying; Lu, Haifeng; Chen, Xinhua; Jiang, Jianwen; Liu, Hui; He, Yong; Ding, Songming; Hu, Zhenhua; Wang, Weilin; Zheng, Shusen

2013-01-01

Ischemia-reperfusion (I/R) injury is associated with intestinal microbial dysbiosis. The "gut-liver axis" closely links gut function and liver function in health and disease. Ischemic preconditioning (IPC) has been proven to reduce I/R injury in the surgery. This study aims to explore the effect of IPC on intestinal microbiota and to analyze characteristics of microbial structure shift following liver transplantation (LT). The LT animal models of liver and gut IPC were established. Hepatic graft function was assessed by histology and serum ALT/AST. Intestinal barrier function was evaluated by mucosal ultrastructure, serum endotoxin, bacterial translocation, fecal sIgA content and serum TNF-α. Intestinal bacterial populations were determined by quantitative PCR. Microbial composition was characterized by DGGE and specific bacterial species were determined by sequence analysis. Liver IPC improved hepatic graft function expressed as ameliorated graft structure and reduced ALT/AST levels. After administration of liver IPC, intestinal mucosal ultrastructure improved, serum endotoxin and bacterial translocation mildly decreased, fecal sIgA content increased, and serum TNF-α decreased. Moreover, liver IPC promoted microbial restorations mainly through restoring Bifidobacterium spp., Clostridium clusters XI and Clostridium cluster XIVab on bacterial genus level. DGGE profiles indicated that liver IPC increased microbial diversity and species richness, and cluster analysis demonstrated that microbial structures were similar and clustered together between the NC group and Liver-IPC group. Furthermore, the phylogenetic tree of band sequences showed key bacteria corresponding to 10 key band classes of microbial structure shift induced by liver IPC, most of which were assigned to Bacteroidetes phylum. Liver IPC cannot only improve hepatic graft function and intestinal barrier function, but also promote restorations of intestinal microbiota following LT, which may further benefit hepatic graft by positive feedback of the "gut-liver axis".

Surveying Cystic Fibrosis Care Centers to Assess Adoption of Infection Prevention and Control Recommendations.

PubMed

Saiman, Lisa; Zhou, Juyan J; Jiang, Xiaotong; Kosorok, Michael R; Muhlebach, Marianne S

2018-04-15

OBJECTIVEIn 2013, the Cystic Fibrosis (CF) Foundation developed an updated guideline for infection prevention and control (IP&C) practices for CF. We sought to assess the adoption of specific recommendations by CF care centers.METHODSDirectors of the 277 CF care centers in the United States were asked to complete a confidential online survey regarding the adoption of selected IP&C recommendations. Selected recommendations were those we considered less likely to be incorporated into a center's written IP&C policies.RESULTSCenter directors from 198 of 277 CF centers (71%) completed the survey between December 2015 and June 2016; pediatric and larger centers were more likely to do so. Overall, 70% have adopted ≥75% of the selected recommendations. As recommended, almost all provided education to CF center staff (98%) and patients and families (97%); fewer developed educational materials in collaboration with local IP&C teams (59%) and/or patients and families (37%). Among 108 centers with non-English-speaking patients, 65 (60%) provided educational materials in relevant languages. Most (74%) held group education events; of the 138 centers with in-person meetings, 45% allowed 1 individual with CF to attend, and 51% allowed no individuals with CF to attend. Most centers (93%) held outdoor events, and 84% allowed >1 individual with CF to attend. Audits of exam-room cleaning were performed by 49% of CF centers.CONCLUSIONSCystic fibrosis centers in the United States have adopted many of the recommendations addressed in this survey. Nonetheless, these findings suggest opportunities for improvement. More CF centers should provide education to non-English-speaking patients and families, and CF centers should perform audits of room cleaning.Infect Control Hosp Epidemiol. 2018:1-5.

Infection Prevention and Control for Ebola in Health Care Settings - West Africa and United States.

PubMed

Hageman, Jeffrey C; Hazim, Carmen; Wilson, Katie; Malpiedi, Paul; Gupta, Neil; Bennett, Sarah; Kolwaite, Amy; Tumpey, Abbigail; Brinsley-Rainisch, Kristin; Christensen, Bryan; Gould, Carolyn; Fisher, Angela; Jhung, Michael; Hamilton, Douglas; Moran, Kerri; Delaney, Lisa; Dowell, Chad; Bell, Michael; Srinivasan, Arjun; Schaefer, Melissa; Fagan, Ryan; Adrien, Nedghie; Chea, Nora; Park, Benjamin J

2016-07-08

The 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa underscores the need for health care infection prevention and control (IPC) practices to be implemented properly and consistently to interrupt transmission of pathogens in health care settings to patients and health care workers. Training and assessing IPC practices in general health care facilities not designated as Ebola treatment units or centers became a priority for CDC as the number of Ebola virus transmissions among health care workers in West Africa began to affect the West African health care system and increasingly more persons became infected. CDC and partners developed policies, procedures, and training materials tailored to the affected countries. Safety training courses were also provided to U.S. health care workers intending to work with Ebola patients in West Africa. As the Ebola epidemic continued in West Africa, the possibility that patients with Ebola could be identified and treated in the United States became more realistic. In response, CDC, other federal components (e.g., Office of the Assistant Secretary for Preparedness and Response) and public health partners focused on health care worker training and preparedness for U.S. health care facilities. CDC used the input from these partners to develop guidelines on IPC for hospitalized patients with known or suspected Ebola, which was updated based on feedback from partners who provided care for Ebola patients in the United States. Strengthening and sustaining IPC helps health care systems be better prepared to prevent and respond to current and future infectious disease threats.The activities summarized in this report would not have been possible without collaboration with many U.S. and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html).

Stepwise introduction of the 'Best Care Always' central-line-associated bloodstream infection prevention bundle in a network of South African hospitals.

PubMed

Richards, G A; Brink, A J; Messina, A P; Feldman, C; Swart, K; van den Bergh, D

2017-09-01

Healthcare-associated infection (HCAI) remains a major international problem. The 'Best Care Always!' (BCA) campaign was launched in South Africa to reduce preventable HCAI, including central-line-associated bloodstream infection (CLABSI). The intervention took place in 43 Netcare Private Hospitals, increasing later to 49 with 958 intensive care units (ICUs) and 439 high-care (HC) beds and 1207 ICUs and 493 HC beds, respectively. Phase 1, April 2010 to March 2011, ICU infection prevention and control (IPC) nurse-driven change: commitment from management and doctors and training of IPC nurses. Bundle compliance and infections per 1000 central-line-days were incorporated as standard IPC measures and captured monthly. Phase 2, April 2011 to March 2012, breakthrough collaborative method: multiple regional learning sessions for nursing leaders, IPC nurses and unit managers. Phase 3, April 2012 to May 2016: sustained goal-setting, benchmarks, ongoing audits. A total of 1,119,558 central-line-days were recorded. Bundle compliance improved significantly from a mean of 73.1% [standard deviation (SD): 11.2; range: 40.6-81.7%] in Phase 1 to a mean of 90.5% (SD: 4.7; range: 76.5-97.2%) in Phase 3 (P = 0.0004). The CLABSI rate declined significantly from a mean of 3.55 (SD: 0.82; range: 2.54-5.78) per 1000 central-line-days in Phase 1 to a mean of 0.13 (SD: 0.09; range: 0-0.33) (P < 0.0001). This intervention, the first of its kind in South Africa, through considerable motivation and education, and through competition between hospitals resulted in significant decreases in CLABSI. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Organizational culture and its implications for infection prevention and control in healthcare institutions.

PubMed

De Bono, S; Heling, G; Borg, M A

2014-01-01

It is not uncommon for infection prevention and control (IPC) interventions to be successful in one hospital yet fail, or have significantly less success, when implemented in another healthcare institution. Organizational factors have been postulated to be a major reason. As a result, there has been an increasing drive in recent years to understand and address organizational culture (OC) in order to achieve improved healthcare performance. To examine the inter-relationship between OC and behavioural attitudes by healthcare professionals; to determine whether and how OC may impact on IPC compliance; and to highlight the potential for OC modification interventions to improve IPC practices within hospitals. Previous literature is reviewed and synthesized, using both IPC journals as well as publications focusing on human behaviour and organizational change. The article evaluates the theory of OC within healthcare settings and identifies how various elements appear to impact on IPC-related behaviour. It highlights the paucity of well-designed studies but identifies sporadic literature suggesting that well-designed and customized OC change initiatives can have a positive impact on IPC practices, such as hand hygiene. OC change appears to be a promising, albeit challenging, target for IPC improvement campaigns - both from a theoretical perspective as well as from the results of the few available studies. However, more data and quality information are needed to identify effective strategies that can elicit effective and sustained change. Published by Elsevier Ltd.

Infection prevention and control training and capacity building during the Ebola epidemic in Guinea

PubMed Central

Koivogui, Lamine; de Beer, Lindsey; Johnson, Candice Y.; Diaby, Dianka; Ouedraogo, Abdoulaye; Touré, Fatoumata; Bangoura, Fodé Ousmane; Chang, Michelle A.; Chea, Nora; Dotson, Ellen M.; Finlay, Alyssa; Fitter, David; Hamel, Mary J.; Hazim, Carmen; Larzelere, Maribeth; Park, Benjamin J.; Rowe, Alexander K.; Thompson-Paul, Angela M.; Twyman, Anthony; Barry, Moumié; Ntaw, Godlove; Diallo, Alpha Oumar

2018-01-01

Background During the 2014–2016 Ebola epidemic in West Africa, a key epidemiological feature was disease transmission within healthcare facilities, indicating a need for infection prevention and control (IPC) training and support. Methods IPC training was provided to frontline healthcare workers (HCW) in healthcare facilities that were not Ebola treatment units, as well as to IPC trainers and IPC supervisors placed in healthcare facilities. Trainings included both didactic and hands-on components, and were assessed using pre-tests, post-tests and practical evaluations. We calculated median percent increase in knowledge. Results From October–December 2014, 20 IPC courses trained 1,625 Guineans: 1,521 HCW, 55 IPC trainers, and 49 IPC supervisors. Median test scores increased 40% (interquartile range [IQR]: 19–86%) among HCW, 15% (IQR: 8–33%) among IPC trainers, and 21% (IQR: 15–30%) among IPC supervisors (all P<0.0001) to post-test scores of 83%, 93%, and 93%, respectively. Conclusions IPC training resulted in clear improvements in knowledge and was feasible in a public health emergency setting. This method of IPC training addressed a high demand among HCW. Valuable lessons were learned to facilitate expansion of IPC training to other prefectures; this model may be considered when responding to other large outbreaks. PMID:29489885

Interparental conflict and adolescent dating relationships: the role of perceived threat and self-blame appraisals.

PubMed

Kim, Kerri L; Jackson, Yo; Hunter, Heather L; Conrad, Selby M

2009-05-01

In line with the cognitive-contextual framework proposed by Grych and Fincham (1990), evidence suggests that children exposed to interparental conflict (IPC) are at risk for experiencing conflict within their own intimate relationships. The mediating role of adolescent appraisal in the relation between IPC and adolescent dating behavior was examined in the current study. Specifically, it was hypothesized that self-blame and threat appraisals would mediate the relation between IPC and adolescent maladaptive dating behaviors. To examine the potential mediating role of appraisal, 169 high school students completed the Children's Perception of Interparental Conflict (Grych, Seid, & Fincham, 1992) and Child and Adolescent Dating Relationships Inventory (Wolfe, Scott, Reitzel-Jaffe, Wekerle, Grasley, & Straatman, 2004). Findings suggest that self-blame appraisal partially mediated the relation between IPC and adolescent sexual aggression, and between IPC and adolescent threatening behavior. In addition, perceived threat appraisal partially mediated the relation between IPC and adolescent sexual aggression. Implications for the current findings are discussed.

Integrated Primary Care Readiness and Behaviors Scale: Development and validation in behavioral health professionals.

PubMed

Blaney, Cerissa L; Redding, Colleen A; Paiva, Andrea L; Rossi, Joseph S; Prochaska, James O; Blissmer, Bryan; Burditt, Caitlin T; Nash, Justin M; Bayley, Keri Dotson

2018-03-01

Although integrated primary care (IPC) is growing, several barriers remain. Better understanding of behavioral health professionals' (BHPs') readiness for and engagement in IPC behaviors could improve IPC research and training. This study developed measures of IPC behaviors and stage of change. The sample included 319 licensed, practicing BHPs with a range of interests and experience with IPC. Sequential measurement development procedures, with split-half cross-validation were conducted. Exploratory principal components analyses (N = 152) and confirmatory factor analyses (N = 167) yielded a 12-item scale with 2 factors: consultation/practice management (CPM) and intervention/knowledge (IK). A higher-order Integrated Primary Care Behavior Scale (IPCBS) model showed good fit to the data, and excellent internal consistencies. The multivariate analysis of variance (MANOVA) on the IPCBS demonstrated significant large-sized differences across stage and behavior groups. The IPCBS demonstrated good psychometric properties and external validation, advancing research, education, and training for IPC practice. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

[Effectiveness of intermittent pneumatic compression (IPC) on thrombosis prophylaxis: a systematic literature review].

PubMed

Rohrer, Ottilia; Eicher, Manuela

2006-06-01

Despite changes in patient demographics and short-ened length of hospital stay deep vein thrombosis (DVT) remains a major health care problem which may lead to a variety of other high risk complications. Current treatment guidelines focus on preventive measures. Beside drug therapy, physical measures executed by nursing professionals exist, the outcomes of which are discussed controversially. Based on 25 studies that were found in MEDLINE and the Cochrane library, this systematic literature review identifies the effectiveness of intermittent pneumatic compression (IPC) on thrombosis prophylaxis. In almost all medical settings IPC contributes to a significant reduction of the incidence of DVT. At the same time, IPC has minimal negative side effects and is also cost effective. Correct application of IPC and patient compliance are essential to achieve its effectiveness. An increased awareness within the healthcare team in identifying the risk for and implementing measures against DVT is needed. Guidelines need to be developed in order to improve the effectiveness of thrombosis prophylaxis with the implementation of IPC.

Interparental conflict, parenting, and childhood depression in a diverse urban population: the role of general cognitive style.

PubMed

O'Donnell, Ellen H; Moreau, Melissa; Cardemil, Esteban V; Pollastri, Alisha

2010-01-01

Research on the mechanisms by which interparental conflict (IPC) affects child depression suggests that both parenting and children's conflict appraisals play important roles, but few studies have explored the role of general cognitive style or included both parenting and cognitions in the same design. Moreover, the effects of IPC on minority children are not well understood. In this longitudinal study, parenting was examined as a mediator of the relation between increasing IPC and change in depression. General cognitive style was included as a moderator. The combined influence of parenting and cognitions was also explored. A racially and ethnically diverse sample of 88 fifth and sixth graders from two urban schools reported their cognitive style, depressive symptoms, and perceptions of conflict and parenting at two time points separated by one year. Parental warmth/rejection mediated the relation between IPC and depression, and general cognitive style acted as a moderator. Parenting, cognitive style, and IPC did not significantly interact to predict change in depression over time. Findings indicate that both parenting and children's general cognitive style play a role in understanding the impact of increasing IPC on children's well-being.

Adverse impact of intermittent portal clamping on long-term postoperative outcomes in hepatocellular carcinoma.

PubMed

Hao, S; Chen, S; Yang, X; Wan, C

2017-01-01

Introduction To evaluate the impact of intermittent portal clamping (IPC) on long-term postoperative outcomes in patients with hepatocellular carcinoma (HCC). Methods Clinical records of 355 patients underwent curative liver resection for HCC in January 2007 to December 2010 were retrospectively reviewed. According to how portal clamping was performed, patients were grouped as: IPC, n=113; other portal clamping (OPC), n=190; and no portal clamping (NPC), n=52. Results Median recurrence-free survival (RFS) was statistically significantly shorter in the IPC (39.4 months) than OPC (47.3 months, p=0.010) and NPC groups (51.4 months, p=0.008). Median overall survival (OS) was also significantly shorter with IPC (46.3 months), versus 52.9 months with OPC (p=0.022) and 56.2 months with NPC (p=0.015). Kaplan-Meier survival analysis revealed that 5-year cumulative RFS was much lower in the IPC (42.5%) than OPC (50.9%, p=0.014) and NPC groups (49.6%, p=0.013). Five-year cumulative OS was also much lower in the IPC (44.9%) than OPC (58.0%, p=0.020) and NPC groups (57.7%, p=0.025). On univariate analysis, tumour grade, size and number, TNM stage, blood transfusion, vascular invasion and IPC were significantly inversely correlated with RFS and OS. On multivariate analysis, tumour size and number, blood transfusion, vascular invasion and IPC remained significant. Conclusions Our study suggests that IPC is an independent risk factor for poor long-term postoperative outcomes in patients with HCC.

Ischemic preconditioning protects neurons from damage and maintains the immunoreactivity of kynurenic acid in the gerbil hippocampal CA1 region following transient cerebral ischemia

PubMed Central

LEE, JAE-CHUL; TAE, HYUN-JIN; CHO, GEUM-SIL; KIM, IN HYE; AHN, JI HYEON; PARK, JOON HA; CHEN, BAI HUI; CHO, JEONG-HWI; SHIN, BICH NA; CHO, JUN HWI; BAE, EUN JOO; PARK, JINSEU; KIM, YOUNG-MYEONG; CHOI, SOO YOUNG; WON, MOO-HO

2015-01-01

Pyramidal neurons in region I of hippocampus proper (CA1) are particularly vulnerable to excitotoxic processes following transient forebrain ischemia. Kynurenic acid (KYNA) is a small molecule derived from tryptophan when this amino acid is metabolized through the kynurenine pathway. In the present study, we examined the effects of ischemic preconditioning (IPC) on the immunoreactivity and protein levels of KYNA following 5 min of transient forebrain ischemia in gerbils. The animals were randomly assigned to 4 groups (sham-operated group, ischemia-operated group, IPC + sham-operated group and IPC + ischemia-operated group). IPC was induced by subjecting the gerbils to 2 min of ischemia followed by 1 day of recovery. In the ischemia-operated group, we observed a significant loss of pyramidal neurons in the CA1 stratum pyramidale (SP) at 5 days post-ischemia; however, in the IPC + ischemia-operated group, the pyramidal neurons were well protected. KYNA immunoreactivity in the SP of the ischemia-operated group was significantly altered following ischemia-reperfusion and was very low 5 days following ischemia-reperfusion. In the IPC + ischemia-operated group, however, KYNA immunoreactivity was constitutively detected in the SP of the CA1 region after the ischemic insult. We also found that the alteration pattern of the KYNA protein level in the CA1 region following ischemia was generally similar to the immunohistochemical changes observed. In brief, our findings demonstrated that IPC maintained and even increased KYNA immunoreactivity in the SP of the CA1 region following ischemia-reperfusion. The data from the present study thus indicate that the enhancement of KYNA expression by IPC may be necessary for neuronal survival following transient ischemic injury. PMID:25872573

Synthesis, characterization and investigation of electrochemical and spectroelectrochemical properties of peripherally tetra 4-phenylthiazole-2-thiol substituted metal-free, zinc(II), copper(II) and cobalt(II) phthalocyanines

NASA Astrophysics Data System (ADS)

Demirbaş, Ümit; Akçay, Hakkı Türker; Koca, Atıf; Kantekin, Halit

2017-08-01

In this study novel peripherally tetra 4-phenylthiazole-2-thiol substituted metal-free phthalocyanine (4) and its zinc(II) (5), copper(II) (6) and cobalt(II) (7) derivatives were synthesized and characterized by a combination of various spectroscopic techniques such as FT-IR, 1H-NMR, UV-vis and MALDI-TOF mass. Electrochemical characterizations of metallo-phthalocyanine complexes were conducted by voltammetric and in situ spectroelectrochemical measurements. CoIIPc went [CoIIPc-2]/[CoIPc-2]1-, [CoIPc-2]1-/[CoIPc-3]2-, [CoIPc-3]2-/[CoIPc-4]3- and [CoIIPc-2]/[CoIIPc-2]1+ reduction and oxidation processes respectively. Differently ZnIIPc only showed four ligand-based reductions and two ligand based oxidation processes.

Infection prevention staffing and resources in U.S. acute care hospitals: Results from the APIC MegaSurvey.

PubMed

Pogorzelska-Maziarz, Monika; Gilmartin, Heather; Reese, Sara

2018-06-01

Given the changing nature of infection prevention and control (IPC), appropriate infection preventionist (IP) staffing needs to be established. In this study, we aimed to describe current IP staffing levels and IPC department resources in U.S. acute care hospitals. These data came from the 2015 MegaSurvey conducted by the Association of Professionals in Infection Prevention and Epidemiology. Descriptive statistics and bivariate analyses were conducted to examine differences in respondent, facility, and department characteristics by facility size (average inpatient census ≤100 vs >100). Data from 1623 respondents were included. Most (72%) had single-site responsibilities and dedicated 76%-100% of their job to IPC (68%). The overall median IP staffing was 1.25 IPs per 100 inpatient census (interquartile range = 1.81). Almost half (46%) represented facilities with daily inpatient census ≤100; the average number of IPs in these facilities was 1.1 (standard deviation = 0.7). The reported number of IPs increased steadily with higher patient census. Significant differences were observed in IP staffing, responsibilities, and support to the IPC department between smaller and larger hospitals. This study represents the current snapshot of IP staffing and IPC resources in acute care hospitals. Findings indicate important differences between large and small facilities in staffing and IPC resources. The field of infection prevention would benefit from a comprehensive assessment of IPC department staffing and resource needs. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

Study on the effect of measuring methods on incident photon-to-electron conversion efficiency of dye-sensitized solar cells by home-made setup.

PubMed

Guo, Xiao-Zhi; Luo, Yan-Hong; Zhang, Yi-Duo; Huang, Xiao-Chun; Li, Dong-Mei; Meng, Qing-Bo

2010-10-01

An experimental setup is built for the measurement of monochromatic incident photon-to-electron conversion efficiency (IPCE) of solar cells. With this setup, three kinds of IPCE measuring methods as well as the convenient switching between them are achieved. The setup can also measure the response time and waveform of the short-circuit current of solar cell. Using this setup, IPCE results of dye-sensitized solar cells (DSCs) are determined and compared under different illumination conditions with each method. It is found that the IPCE values measured by AC method involving the lock-in technique are sincerely influenced by modulation frequency and bias illumination. Measurements of the response time and waveform of short-circuit current have revealed that this effect can be explained by the slow response of DSCs. To get accurate IPCE values by this method, the measurement should be carried out with a low modulation frequency and under bias illumination. The IPCE values measured by DC method under the bias light illumination will be disturbed since the short-circuit current increased with time continuously due to the temperature rise of DSC. Therefore, temperature control of DSC is considered necessary for IPCE measurement especially in DC method with bias light illumination. Additionally, high bias light intensity (>2 sun) is found to decrease the IPCE values due to the ion transport limitation of the electrolyte.

Partial ablation of adult Drosophila insulin-producing neurons modulates glucose homeostasis and extends life span without insulin resistance.

PubMed

Haselton, Aaron; Sharmin, Effat; Schrader, Janel; Sah, Megha; Poon, Peter; Fridell, Yih-Woei C

2010-08-01

In Drosophila melanogaster (D. melanogaster), neurosecretory insulin-like peptide-producing cells (IPCs), analogous to mammalian pancreatic beta cells are involved in glucose homeostasis. Extending those findings, we have developed in the adult fly an oral glucose tolerance test and demonstrated that IPCs indeed are responsible for executing an acute glucose clearance response. To further develop D. melanogaster as a relevant system for studying age-associated metabolic disorders, we set out to determine the impact of adult-specific partial ablation of IPCs (IPC knockdown) on insulin-like peptide (ILP) action, metabolic outcomes and longevity. Interestingly, while IPC knockdown flies are hyperglycemic and glucose intolerant, these flies remain insulin sensitive as measured by peripheral glucose disposal upon insulin injection and serine phosphorylation of a key insulin-signaling molecule, Akt. Significant increases in stored glycogen and triglyceride levels as well as an elevated level of circulating lipid measured in adult IPC knockdown flies suggest profound modulation in energy metabolism. Additional physiological outcomes measured in those flies include increased resistance to starvation and impaired female fecundity. Finally, increased life span and decreased mortality rates measured in IPC knockdown flies demonstrate that it is possible to modulate ILP action in adult flies to achieve life span extension without insulin resistance. Taken together, we have established and validated an invertebrate genetic system to further investigate insulin action, metabolic homeostasis and regulation of aging regulated by adult IPCs.

Improving Ebola infection prevention and control in primary healthcare facilities in Sierra Leone: a single-group pretest post-test, mixed-methods study.

PubMed

Ratnayake, Ruwan; Ho, Lara S; Ansumana, Rashid; Brown, Hannah; Borchert, Matthias; Miller, Laura; Kratz, Thomas; McMahon, Shannon A; Sahr, Foday

2016-01-01

Accomplishing infection prevention and control (IPC) in health facilities in Sub-Saharan Africa is challenging. Owing to poor IPC, healthcare workers (HCWs) were frequently infected during Sierra Leone's Ebola epidemic. In late 2014, IPC was rapidly and nationally scaled up. We carried out workshops in sampled facilities to further improve adherence to IPC. We investigated HCW experiences and observed practice gaps, before and after the workshops. We conducted an uncontrolled, before and after, mixed-methods study in eight health facilities in Bo and Kenema Districts during December 2014 and January 2015. Quantitative methods administered to HCWs at baseline and follow-up included a survey on attitudes and self-efficacy towards IPC, and structured observations of behaviours. The intervention involved a workshop for HCWs to develop improvement plans for their facility. We analysed the changes between rounds in survey responses and behaviours. We used interviews to explore attitudes and self-efficacy throughout the study period. HCWs described IPC as 'life-saving' and personal protective equipment (PPE) as uncomfortable for providers and frightening for patients. At baseline, self-efficacy was high (median=4/strongly agree). Responses reflecting unfavourable attitudes were low for glove use (median=1/strongly disagree, IQR, 1-2) and PPE use with ill family members (median=1, IQR, 1-2), and mixed for PPE use with ill HCWs (median=2/disagree, IQR, 1-4). Observations demonstrated consistent glove reuse and poor HCW handwashing. The maintenance of distance (RR 1.09, 95% CI 1.02 to 1.16) and patient handwashing (RR 1.19, 95% CI 1.3 to 1.25) improved to >90%. We found favourable attitudes towards IPC and gaps in practice. Risk perceptions of HCWs and tendencies to ration PPE where chronic supply chain issues normally lead to PPE stock-outs may affect practice. As Sierra Leone's Ebola Recovery Strategy aims to make all facilities IPC compliant, socio-behavioural improvements and a secure supply chain are essential.

Independent Blade Pitch Controller Design for a Three-Bladed Turbine Using Disturbance Accommodating Control

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Na; Wright, Alan D.; Johnson, Kathryn E.

Two independent pitch controllers (IPCs) based on the disturbance accommodating control (DAC) algorithm are designed for the three-bladed Controls Advanced Research Turbine to regulate rotor speed and to mitigate blade root flapwise bending loads in above-rated wind speed. One of the DAC-based IPCs is designed based on a transformed symmetrical-asymmetrical (TSA) turbine model, with wind disturbances being modeled as a collective horizontal component and an asymmetrical linear shear component. Another DAC-based IPC is designed based on a multiblade coordinate (MBC) transformed turbine model, with a horizontal component and a vertical shear component being modeled as step waveform disturbance. Both ofmore » the DAC-based IPCs are found via a regulation equation solved by Kronecker product. Actuator dynamics are considered in the design processes to compensate for actuator phase delay. The simulation study shows the effectiveness of the proposed DAC-based IPCs compared to a proportional-integral (PI) collective pitch controller (CPC). Improvement on rotor speed regulation and once-per-revolution and twice-per-revolution load reductions has been observed in the proposed IPC designs.« less

Independent Blade Pitch Controller Design for a Three-Bladed Turbine Using Disturbance Accommodating Control: Preprint

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Na; Wright, Alan D.; Johnson, Kathryn E.

Two independent pitch controllers (IPCs) based on the disturbance accommodating control (DAC) algorithm are designed for the three-bladed Controls Advanced Research Turbine to regulate rotor speed and to mitigate blade root flapwise bending loads in above-rated wind speed. One of the DAC-based IPCs is designed based on a transformed symmetrical-asymmetrical (TSA) turbine model, with wind disturbances being modeled as a collective horizontal component and an asymmetrical linear shear component. Another DAC-based IPC is designed based on a multiblade coordinate (MBC) transformed turbine model, with a horizontal component and a vertical shear component being modeled as step waveform disturbance. Both ofmore » the DAC-based IPCs are found via a regulation equation solved by Kronecker product. Actuator dynamics are considered in the design processes to compensate for actuator phase delay. The simulation study shows the effectiveness of the proposed DAC-based IPCs compared to a proportional-integral (PI) collective pitch controller (CPC). Improvement on rotor speed regulation and once-per-revolution and twice-per-revolution load reductions has been observed in the proposed IPC designs.« less

Recent progress and development of a speedster-EXD: a new event-triggered hybrid CMOS x-ray detector

NASA Astrophysics Data System (ADS)

Griffith, Christopher V.; Falcone, Abraham D.; Prieskorn, Zachary R.; Burrows, David N.

2015-08-01

We present the characterization of a new event-driven X-ray hybrid CMOS detector developed by Penn State University in collaboration with Teledyne Imaging Sensors. Along with its low susceptibility to radiation damage, low power consumption, and fast readout time to avoid pile-up, the Speedster-EXD has been designed with the capability to limit its readout to only those pixels containing charge, thus enabling even faster effective frame rates. The threshold for the comparator in each pixel can be set by the user so that only pixels with signal above the set threshold are read out. The Speedster-EXD hybrid CMOS detector also has two new in-pixel features that reduce noise from known noise sources: (1) a low-noise, high-gain CTIA amplifier to eliminate crosstalk from interpixel capacitance (IPC) and (2) in-pixel CDS subtraction to reduce kTC noise. We present the read noise, dark current, IPC, energy resolution, and gain variation measurements of one Speedster-EXD detector.

The role of personal resilience and personality traits of healthcare students on their attitudes towards interprofessional collaboration.

PubMed

Avrech Bar, Michal; Katz Leurer, Michal; Warshawski, Sigalit; Itzhaki, Michal

2018-02-01

Interprofessional collaboration (IPC) improves communication between healthcare workers and healthcare delivery. Interprofessional education (IPE) is essential in preparing healthcare students for cooperating with other healthcare disciplines in a real work setting. Although higher education settings have a responsibility to provide collaborative healthcare practice to students, IPE has not yet been prompted worldwide as a formal division in health professional education and in Israel IPE among health professions students is scarce. To examine the attitudes of health professions students towards IPC in correlation with their personal resilience and personality traits. A descriptive cross-sectional design was used. Participants were fourth year nursing, occupational therapy (OT), and physical therapy students studying in an academic undergraduate program at a School of Health Professions in a central university in Israel. Attitudes were assessed with a questionnaire consisting of the Interdisciplinary Education Perception Scale, the Connor-Davidson Resilience Scale, the Big Five Inventory of personality dimensions, and a question evaluating students' experience with the PBL (Problem-Based Learning) method. Questionnaires were completed by 184 health professions students. Nursing students' perception of actual cooperation with other professions and their perceived competency and autonomy in their profession were slightly lower than those of other students. Among nursing students, positive correlations were found between competency & autonomy and resilience (p<0.01) and between competency & autonomy and agreeableness (p<0.05). Positive correlations were also found between their perception of actual cooperation with other professions and: resilience (p<0.01), agreeableness (p<0.05), conscientiousness (p<0.05), and openness (p<0.05). Only OT students were familiar with and experienced in the PBL method. This experience with PBL was found correlated with more positive attitudes towards competency and autonomy in the profession and higher positive perception of actual cooperation with other professions. IPE, including PBL, should be integrated in health professions students' training. Copyright © 2017 Elsevier Ltd. All rights reserved.

“You’re dealing with an emotionally charged individual…”: an industry perspective on the challenges posed by medical tourists’ informal caregiver-companions

PubMed Central

2013-01-01

Background Patients engage in medical tourism when they privately obtain a medical care abroad. Previous research shows that many medical tourists travel abroad with friends and family members who provide support and assistance. Meanwhile, very little is known about this important stakeholder group, referred to here as caregiver-companions. In this article we examine the challenges that can be posed by caregiver-companions and the overall practice of informal caregiving in medical tourism from an industry perspective. Specifically, we report on the findings of interviews conducted with international patient coordinators (IPCs) who work at destination facilities. IPCs come into regular contact with caregiver-companions in their professional positions and thus are ideally suited to comment on trends they have observed among this stakeholder group as well as the challenges they can pose to medical tourists, health workers, and facilities. Methods We conducted 20 semi-structured interviews with 21 IPCs from 16 different facilities across nine countries. Topics probed in the interviews included caregiver-companion roles, IPCs’ and others’ interaction with caregiver-companions, and potential health and safety risks posed to medical tourists and caregiver-companions. Thematic analysis of the verbatim transcripts was employed. Results Although most participants encouraged medical tourists to travel with a caregiver-companion, many challenges associated with caregiver-companions were identified. Three themes best characterize the challenges that emerged: (1) caregiver-companions require time, attention and resources; (2) caregiver-companions can disrupt the provision of quality care; and (3) caregiver-companions can be exposed to risks. IPCs pointed out that caregiver-companions may, for example, have a negative impact on the patient through cost of accompaniment or inadequate care provision. Caregiver-companions may also create unanticipated or extra work for IPCs, as additional clients and by ignoring established organizational rules, routines, and expectations. Furthermore, caregiver-companions may be susceptible to stresses and health and safety risks, which would further deteriorate their own abilities to offer the patient quality care. Conclusions Although caregiver-companions can pose challenges to medical tourists, health workers, and medical tourism facilities, they can also assist in enhancing best care and offering meaningful support to medical tourists. If caregiver-companions are open to collaboration with IPCs, and particularly in the form of information sharing, then their experience abroad can be safer and less stressful for themselves and, by extension, for the accompanied patients and facility staff. PMID:23889860

An Online 3D Database System for Endangered Architectural and Archaeological Heritage in the South-Eastern Mediterranean

NASA Astrophysics Data System (ADS)

Abate, D.; Avgousti, A.; Faka, M.; Hermon, S.; Bakirtzis, N.; Christofi, P.

2017-10-01

This study compares performance of aerial image based point clouds (IPCs) and light detection and ranging (LiDAR) based point clouds in detection of thinnings and clear cuts in forests. IPCs are an appealing method to update forest resource data, because of their accuracy in forest height estimation and cost-efficiency of aerial image acquisition. We predicted forest changes over a period of three years by creating difference layers that displayed the difference in height or volume between the initial and subsequent time points. Both IPCs and LiDAR data were used in this process. The IPCs were constructed with the Semi-Global Matching (SGM) algorithm. Difference layers were constructed by calculating differences in fitted height or volume models or in canopy height models (CHMs) from both time points. The LiDAR-derived digital terrain model (DTM) was used to scale heights to above ground level. The study area was classified in logistic regression into the categories ClearCut, Thinning or NoChange with the values from the difference layers. We compared the predicted changes with the true changes verified in the field, and obtained at best a classification accuracy for clear cuts 93.1 % with IPCs and 91.7 % with LiDAR data. However, a classification accuracy for thinnings was only 8.0 % with IPCs. With LiDAR data 41.4 % of thinnings were detected. In conclusion, the LiDAR data proved to be more accurate method to predict the minor changes in forests than IPCs, but both methods are useful in detection of major changes.

Ischemic preconditioning maintains the immunoreactivities of glucokinase and glucokinase regulatory protein in neurons of the gerbil hippocampal CA1 region following transient cerebral ischemia

PubMed Central

CHO, YOUNG SHIN; CHO, JUN HWI; SHIN, BICH-NA; CHO, GEUM-SIL; KIM, IN HYE; PARK, JOON HA; AHN, JI HYEON; OHK, TAEK GEUN; CHO, BYUNG-RYUL; KIM, YOUNG-MYEONG; HONG, SEONGKWEON; WON, MOO-HO; LEE, JAE-CHUL

2015-01-01

Glucokinase (GK) is involved in the control of blood glucose homeostasis. In the present study, the effect of ischemic preconditioning (IPC) on the immunoreactivities of GK and its regulatory protein (GKRP) following 5 min of transient cerebral ischemia was investigated in gerbils. The gerbils were randomly assigned to four groups (sham-operated group, ischemia-operated group, IPC + sham-operated group and IPC + ischemia-operated group). IPC was induced by subjecting the gerbils to 2 min of ischemia, followed by 1 day of recovery. In the ischemia-operated group, a significant loss of neurons was observed in the stratum pyramidale (SP) of the hippocampal CA1 region (CA1) at 5 days post-ischemia; however, in the IPC+ischemia-operated group, the neurons in the SP were well protected. Following immunohistochemical investigation, the immunoreactivities of GK and GKRP in the neurons of the SP were markedly decreased in the CA1, but not the CA2/3, from 2 days post-ischemia, and were almost undetectable in the SP 5 days post-ischemia. In the IPC + ischemia-operated group, the immunoreactivities of GK and GKRP in the SP of the CA1 were similar to those in the sham-group. In brief, the findings of the present study demonstrated that IPC notably maintained the immunoreactivities of GK and GKRP in the neurons of the SP of CA1 following ischemia-reperfusion. This indicated that GK and GKRP may be necessary for neuron survival against transient cerebral ischemia. PMID:26134272

Efficacy of the Stendo Pulsating suit in patients with leg lymphedema: a pilot randomized study.

PubMed

Jonas, Patrick; Charlois, Stéphane; Chevalerias, Mélanie; Delmas, Dominique; Kerihuel, Jean-Charles; Blanchemaison, Philippe

2016-01-01

The "shear stress like" effect of pulsating suit sessions at 65 mm Hg (Stendo(®) device), evidenced in healthy volunteers, might stimulate venous return and act as a physiological pump in lymphedema patients. To evaluate the lower limb total volume (TV) decrease induced by a pulsating suit versus intermittent pneumatic compression (IPC) sessions during a five-day complex decongestive physiotherapy (CDP) treatment. Twenty-four leg lymphedema patients were randomized into a CDP group according to the current practices and a CDP group where IPC was replaced by the pulsating suit. Daily care consisted of manual lymphatic drainage (MLD), one hour IPC or Stendo sessions, and bandaging. The Stendo inflatable suit generates heart rate synchronized compression/decompression applied to the lower part of the body. The IPC device was TP05/TP07 (Eureduc Company). Efficacy was assessed by leg TV changes after 5 days' CDP treatment. TV decreases were more pronounced in the Stendo than the IPC group when adjusted to the baseline TV; TV decrease was 14.2 L (11.2%) in the Stendo group, 11.0 L (8.8%) in the IPC group (p = 0.052 - %TV change p = 0.08). A trend in improved quality of life was reported in favor of the Stendo group over the IPC groups (14.2% [SD: 23.4%] and 6.7% [SD:31.5%], respectively). No adverse event related to the Stendo device was reported. The promising Stendo results open the way to larger clinical studies targeting CDP maintenance and moderate lymphedema in outpatient settings.

Study on negative incident photon-to-electron conversion efficiency of quantum dot-sensitized solar cells

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Chunhui; Wu, Huijue; Zhu, Lifeng

2014-02-15

Recently, negative signals are frequently observed during the measuring process of monochromatic incident photon-to-electron conversion efficiency (IPCE) for sensitized solar cells by DC method. This phenomenon is confusing and hindering the reasonable evaluation of solar cells. Here, cause of negative IPCE values is studied by taking quantum dot-sensitized solar cell (QDSC) as an example, and the accurate measurement method to avoid the negative value is suggested. The negative background signals of QDSC without illumination are found the direct cause of the negative IPCE values by DC method. Ambient noise, significant capacitance characteristics, and uncontrolled electrochemical reaction all can lead tomore » the negative background signals. When the photocurrent response of device under monochromatic light illumination is relatively weak, the actual photocurrent signals will be covered by the negative background signals and the resulting IPCE values will appear negative. To improve the signal-to-noise ratio, quasi-AC method is proposed for IPCE measurement of solar cells with weak photocurrent response based on the idea of replacing the absolute values by the relative values.« less

Transcriptional regulation of intermediate progenitor cell generation during hippocampal development

PubMed Central

Harris, Lachlan; Zalucki, Oressia; Gobius, Ilan; McDonald, Hannah; Osinki, Jason; Harvey, Tracey J.; Essebier, Alexandra; Vidovic, Diana; Gladwyn-Ng, Ivan; Burne, Thomas H.; Heng, Julian I.; Richards, Linda J.; Gronostajski, Richard M.

2016-01-01

During forebrain development, radial glia generate neurons through the production of intermediate progenitor cells (IPCs). The production of IPCs is a central tenet underlying the generation of the appropriate number of cortical neurons, but the transcriptional logic underpinning this process remains poorly defined. Here, we examined IPC production using mice lacking the transcription factor nuclear factor I/X (Nfix). We show that Nfix deficiency delays IPC production and prolongs the neurogenic window, resulting in an increased number of neurons in the postnatal forebrain. Loss of additional Nfi alleles (Nfib) resulted in a severe delay in IPC generation while, conversely, overexpression of NFIX led to precocious IPC generation. Mechanistically, analyses of microarray and ChIP-seq datasets, coupled with the investigation of spindle orientation during radial glial cell division, revealed that NFIX promotes the generation of IPCs via the transcriptional upregulation of inscuteable (Insc). These data thereby provide novel insights into the mechanisms controlling the timely transition of radial glia into IPCs during forebrain development. PMID:27965439

Intermittent Pneumatic Compression for the Prevention of Venous Thromboembolism after Total Hip Arthroplasty

PubMed Central

Kwak, Hong Suk; Cho, Jai Ho; Kim, Jung Taek; Yoo, Jeong Joon

2017-01-01

Background Venous thromboembolism (VTE) is a relatively common and potentially life threatening complication after major hip surgery. There are two main types of prophylaxis: chemical and mechanical. Chemical prophylaxis is very effective but causes bleeding complications in surgical wounds and remote organs. On the other hand, mechanical methods are free of hemorrhagic complications but are less effective. We hypothesized that mechanical prophylaxis is effective enough for Asians in whom VTE occurs less frequently. This study evaluated the effect of intermittent pneumatic compression (IPC) in the prevention of VTE after major hip surgery. Methods Incidences of symptomatic VTE after primary total hip arthroplasty with and without application of IPC were compared. A total of 379 patients were included in the final analysis. The IPC group included 233 patients (106 men and 127 women) with a mean age of 54 years. The control group included 146 patients (80 men and 66 women) with a mean age of 53 years. All patients took low-dose aspirin for 6 weeks after surgery. IPC was applied to both legs just after surgery and maintained all day until discharge. When a symptom or a sign suspicious of VTE, such as swelling or redness of the foot and ankle, Homans' sign, and dyspnea was detected, computed tomography (CT) angiogram or duplex ultrasonogram was performed. Results Until 3 months after surgery, symptomatic VTE occurred in three patients in the IPC group and in 6 patients in the control group. The incidence of VTE was much lower in the IPC group (1.3%) than in the control group (4.1%), but the difference was not statistically significant. Complications associated with the application of IPC were not detected in any patient. Patients affected by VTE were older and hospitalized longer than the unaffected patients. Conclusions The results of this study suggest that IPC might be an effective and safe method for the prevention of postoperative VTE. PMID:28261425

Scaling up integrated prevention campaigns for global health: costs and cost-effectiveness in 70 countries

PubMed Central

Marseille, Elliot; Jiwani, Aliya; Raut, Abhishek; Verguet, Stéphane; Walson, Judd; Kahn, James G

2014-01-01

Objective This study estimated the health impact, cost and cost-effectiveness of an integrated prevention campaign (IPC) focused on diarrhoea, malaria and HIV in 70 countries ranked by per capita disability-adjusted life-year (DALY) burden for the three diseases. Methods We constructed a deterministic cost-effectiveness model portraying an IPC combining counselling and testing, cotrimoxazole prophylaxis, referral to treatment and condom distribution for HIV prevention; bed nets for malaria prevention; and provision of household water filters for diarrhoea prevention. We developed a mix of empirical and modelled cost and health impact estimates applied to all 70 countries. One-way, multiway and scenario sensitivity analyses were conducted to document the strength of our findings. We used a healthcare payer's perspective, discounted costs and DALYs at 3% per year and denominated cost in 2012 US dollars. Primary and secondary outcomes The primary outcome was cost-effectiveness expressed as net cost per DALY averted. Other outcomes included cost of the IPC; net IPC costs adjusted for averted and additional medical costs and DALYs averted. Results Implementation of the IPC in the 10 most cost-effective countries at 15% population coverage would cost US$583 million over 3 years (adjusted costs of US$398 million), averting 8.0 million DALYs. Extending IPC programmes to all 70 of the identified high-burden countries at 15% coverage would cost an adjusted US$51.3 billion and avert 78.7 million DALYs. Incremental cost-effectiveness ranged from US$49 per DALY averted for the 10 countries with the most favourable cost-effectiveness to US$119, US$181, US$335, US$1692 and US$8340 per DALY averted as each successive group of 10 countries is added ordered by decreasing cost-effectiveness. Conclusions IPC appears cost-effective in many settings, and has the potential to substantially reduce the burden of disease in resource-poor countries. This study increases confidence that IPC can be an important new approach for enhancing global health. PMID:24969782

Ischemic preconditioning improves mitochondrial tolerance to experimental calcium overload.

PubMed

Crestanello, Juan A; Doliba, Nicolai M; Babsky, Andriy M; Doliba, Natalia M; Niibori, Koki; Whitman, Glenn J R; Osbakken, Mary D

2002-04-01

Ca(2+) overload leads to mitochondrial uncoupling, decreased ATP synthesis, and myocardial dysfunction. Pharmacologically opening of mitochondrial K(ATP) channels decreases mitochondrial Ca(2+) uptake, improving mitochondrial function during Ca(2+) overload. Ischemic preconditioning (IPC), by activating mitochondrial K(ATP) channels, may attenuate mitochondrial Ca(2+) overload and improve mitochondrial function during reperfusion. The purpose of these experiments was to study the effect of IPC (1) on mitochondrial function and (2) on mitochondrial tolerance to experimental Ca(2+) overload. Rat hearts (n = 6/group) were subjected to (a) 30 min of equilibration, 25 min of ischemia, and 30 min of reperfusion (Control) or (b) two 5-min episodes of ischemic preconditioning, 25 min of ischemia, and 30 min of reperfusion (IPC). Developed pressure (DP) was measured. Heart mitochondria were isolated at end-Equilibration (end-EQ) and at end-Reperfusion (end-RP). Mitochondrial respiratory function (state 2, oxygen consumption with substrate only; state 3, oxygen consumption stimulated by ADP; state 4, oxygen consumption after cessation of ADP phosphorylation; respiratory control index (RCI, state 3/state 4); rate of oxidative phosphorylation (ADP/Deltat), and ADP:O ratio) was measured with polarography using alpha-ketoglutarate as a substrate in the presence of different Ca(2+) concentrations (0 to 5 x 10(-7) M) to simulate Ca(2+) overload. IPC improved DP at end-RP. IPC did not improve preischemic mitochondrial respiratory function or preischemic mitochondrial response to Ca(2+) loading. IPC improved state 3, ADP/Deltat, and RCI during RP. Low Ca(2+) levels (0.5 and 1 x 10(-7) M) stimulated mitochondrial function in both groups predominantly in IPC. The Control group showed evidence of mitochondrial uncoupling at lower Ca(2+) concentrations (1 x 10(-7) M). IPC preserved state 3 at high Ca(2+) concentrations. The cardioprotective effect of IPC results, in part, from preserving mitochondrial function during reperfusion and increasing mitochondrial tolerance to Ca(2+) loading at end-RP. Activation of mitochondrial K(ATP) channels by IPC and their improvement in Ca(2+) homeostasis during RP may be the mechanism underlying this protection.

Development of iron phosphate ceramic waste form to immobilize radioactive waste solution

NASA Astrophysics Data System (ADS)

Choi, Jongkwon; Um, Wooyong; Choung, Sungwook

2014-09-01

The objective of this research was to develop an iron phosphate ceramic (IPC) waste form using converter slag obtained as a by-product of the steel industry as a source of iron instead of conventional iron oxide. Both synthetic off-gas scrubber solution containing technetium-99 (or Re as a surrogate) and LiCl-KCl eutectic salt, a final waste solution from pyrochemical processing of spent nuclear fuel, were used as radioactive waste streams. The IPC waste form was characterized for compressive strength, reduction capacity, chemical durability, and contaminant leachability. Compressive strengths of the IPC waste form prepared with different types of waste solutions were 16 MPa and 19 MPa for LiCl-KCl eutectic salt and the off-gas scrubber simulant, respectively, which meet the minimum compressive strength of 3.45 MPa (500 psi) for waste forms to be accepted into the radioactive waste repository. The reduction capacity of converter slag, a main dry ingredient used to prepare the IPC waste form, was 4136 meq/kg by the Ce(IV) method, which is much higher than those of the conventional Fe oxides used for the IPC waste form and the blast furnace slag materials. Average leachability indexes of Tc, Li, and K for the IPC waste form were higher than 6.0, and the IPC waste form demonstrated stable durability even after 63-day leaching. In addition, the Toxicity Characteristic Leach Procedure measurements of converter slag and the IPC waste form with LiCl-KCl eutectic salt met the universal treatment standard of the leachability limit for metals regulated by the Resource Conservation and Recovery Act. This study confirms the possibility of development of the IPC waste form using converter slag, showing its immobilization capability for radionuclides in both LiCl-KCl eutectic salt and off-gas scrubber solutions with significant cost savings.

Development of iron phosphate ceramic waste form to immobilize radioactive waste solution

DOE Office of Scientific and Technical Information (OSTI.GOV)

Choi, Jongkwon; Um, Wooyong; Choung, Sungwook

The objective of this research was to develop an iron phosphate ceramic (IPC) waste form using converter slag obtained as a by-product of the steel industry as a source of iron instead of conventional iron oxide. Both synthetic off-gas scrubber solution containing technetium-99 (or Re as a surrogate) and LiCl-KCl eutectic salt, a final waste solution from pyrochemical processing of spent nuclear fuel, were used as radioactive waste streams. The IPC waste form was characterized for compressive strength, reduction capacity, chemical durability, and contaminant leachability. Compressive strengths of the IPC waste form prepared with different types of waste solutions weremore » 16 MPa and 19 MPa for LiCl-KCl eutectic salt and the off-gas scrubber simulant, respectively, which meet the minimum compressive strength of 3.45 MPa (500 psi) for waste forms to be accepted into the radioactive waste repository. The reduction capacity of converter slag, a main dry ingredient used to prepare the IPC waste form, was 4,136 meq/kg by the Ce(IV) method, which is much higher than those of the conventional Fe oxides used for the IPC waste form and the blast furnace slag materials. Average leachability indexes of Tc, Li, and K for the IPC waste form were higher than 6.0, and the IPC waste form demonstrated stable durability even after 63-day leaching. In addition, the Toxicity Characteristic Leach Procedure measurements of converter slag and the IPC waste form with LiCl-KCl eutectic salt met the universal treatment standard of the leachability limit for metals regulated by the Resource Conservation and Recovery Act. This study confirms the possibility of development of the IPC waste form using converter slag, showing its immobilization capability for radionuclides in both LiCl-KCl eutectic salt and off-gas scrubber solutions with significant cost savings.« less

Efficient differentiation of mouse embryonic stem cells into insulin-producing cells.

PubMed

Liu, Szu-Hsiu; Lee, Lain-Tze

2012-01-01

Embryonic stem (ES) cells are a potential source of a variety of differentiated cells for cell therapy, drug discovery, and toxicology screening. Here, we present an efficacy strategy for the differentiation of mouse ES cells into insulin-producing cells (IPCs) by a two-step differentiation protocol comprising of (i) the formation of definitive endoderm in monolayer culture by activin A, and (ii) this monolayer endoderm being induced to differentiate into IPCs by nicotinamide, insulin, and laminin. Differentiated cells can be obtained within approximately 7 days. The differentiation IPCs combined application of RT-PCR, ELISA, and immunofluorescence to characterize phenotypic and functional properties. In our study, we demonstrated that IPCs produced pancreatic transcription factors, endocrine progenitor marker, definitive endoderm, pancreatic β-cell markers, and Langerhans α and δ cells. The IPCs released insulin in a manner that was dose dependent upon the amount of glucose added. These techniques may be able to be applied to human ES cells, which would have very important ramifications for treating human disease.

Compliance with the national palestinian infection prevention and control protocol at governmental paediatric hospitals in gaza governorates.

PubMed

Eljedi, Ashraf; Dalo, Shareef

2014-08-01

Nosocomial infections are a significant burden for both patients and the healthcare system. For this reason, infection prevention and control (IPC) practices are extremely important. The Palestinian Ministry of Health adopted the national IPC Protocol in 2004. This study aimed to assess the compliance of healthcare providers (HCPs) with the Protocol in three governmental paediatric hospitals in Gaza governorates. This descriptive cross-sectional study was conducted from February to November 2010. Data were collected from a sample of doctors, nurses and physiotherapists (N = 334) using a self-administered questionnaire and observation checklists to record HCP practices and assess the hospital environment. The response rate was 92%. The most important reasons for non-compliance with the IPC Protocol were the absence of an education programme (61.5%), lack of knowledge (52.4%) and the scarcity of required supplies (46.9%). Only 2.3% of respondents had a copy of the IPC Protocol, while 65.8% did not know of its existence. Only 16.9% had participated in training sessions regarding general IPC practices. The observation checklist regarding HCP practices revealed low levels of compliance in hand washing (45.9%), wearing gloves (40.7%) and using antiseptics/disinfectants (49.16%). The health facilities checklist indicated that there was a lack of certain essential equipment and materials, such as covered waste containers and heavy-duty gloves. Due to the lack of HPC knowledge, the authors recommend that the IPC Protocol be made available in all hospitals. In addition, a qualified team should implement intensive IPC education and training programmes and facilities should provide the required equipment and materials.

Interparental Conflict, Community Violence, and Child Problems: Making Sense of Counterintuitive Findings

PubMed Central

Rosenfield, David; Jouriles, Ernest N.; McDonald, Renee; Mueller, Victoria

2014-01-01

Objective This research examines children's exposure to community violence as a potential moderator of the link between destructive interparental conflict (IPC) and child adjustment problems. In addition, this research extends the literature by evaluating children's threat appraisals of IPC as a process that might help explain moderator effects. Method Participants were 539 mothers and their 7-10 year old children. Children reported on their exposure to community violence and IPC, their threat appraisals of IPC, and their adjustment outcomes. Mothers reported on children's adjustment outcomes as well. Results Exposure to community violence mitigated the association between IPC and children's self-reported internalizing problems. Children's threat appraisals helped explain this effect. Discussion Exposure to high levels of community violence may weaken the extent to which children feel threatened by IPC, which may attenuate the relation between children's exposure to IPC and their self-reported internalizing problems. PMID:24827022

Ischemic preconditioning enhances critical power during a 3 minute all-out cycling test.

PubMed

Griffin, Patrick J; Ferguson, Richard A; Gissane, Conor; Bailey, Stephen J; Patterson, Stephen D

2018-05-01

This study tested the hypothesis that ischemic preconditioning (IPC) would increase critical power (CP) during a 3 minute all-out cycling test. Twelve males completed two 3 minute all-out cycling tests, in a crossover design, separated by 7 days. These tests were preceded by IPC (4 x 5 minute intervals at 220 mmHg bilateral leg occlusion) or SHAM treatment (4 x 5 minute intervals at 20 mmHg bilateral leg occlusion). CP was calculated as the mean power output during the final 30 s of the 3 minute test with W' taken as the total work done above CP. Muscle oxygenation was measured throughout the exercise period. There was a 15.3 ± 0.3% decrease in muscle oxygenation (TSI; [Tissue saturation index]) during the IPC stimulus, relative to SHAM. CP was significantly increased (241 ± 65 W vs. 234 ± 67 W), whereas W' (18.4 ± 3.8 vs 17.9 ± 3.7 kJ) and total work done (TWD) were not different (61.1 ± 12.7 vs 60.8 ± 12.7 kJ), between the IPC and SHAM trials. IPC enhanced CP during a 3 minute all-out cycling test without impacting W' or TWD. The improved CP after IPC might contribute towards the effect of IPC on endurance performance.

Signal transducers and activators of transcription: STATs-mediated mitochondrial neuroprotection.

PubMed

Lin, Hung Wen; Thompson, John W; Morris, Kahlilia C; Perez-Pinzon, Miguel A

2011-05-15

Cerebral ischemia is defined as little or no blood flow in cerebral circulation, characterized by low tissue oxygen and glucose levels, which promotes neuronal mitochondria dysfunction leading to cell death. A strategy to counteract cerebral ischemia-induced neuronal cell death is ischemic preconditioning (IPC). IPC results in neuroprotection, which is conferred by a mild ischemic challenge prior to a normally lethal ischemic insult. Although many IPC-induced mechanisms have been described, many cellular and subcellular mechanisms remain undefined. Some reports have suggested key signal transduction pathways of IPC, such as activation of protein kinase C epsilon, mitogen-activated protein kinase, and hypoxia-inducible factors, that are likely involved in IPC-induced mitochondria mediated-neuroprotection. Moreover, recent findings suggest that signal transducers and activators of transcription (STATs), a family of transcription factors involved in many cellular activities, may be intimately involved in IPC-induced ischemic tolerance. In this review, we explore current signal transduction pathways involved in IPC-induced mitochondria mediated-neuroprotection, STAT activation in the mitochondria as it relates to IPC, and functional significance of STATs in cerebral ischemia.

Signal Transducers and Activators of Transcription: STATs-Mediated Mitochondrial Neuroprotection

PubMed Central

Lin, Hung Wen; Thompson, John W.; Morris, Kahlilia C.

2011-01-01

Abstract Cerebral ischemia is defined as little or no blood flow in cerebral circulation, characterized by low tissue oxygen and glucose levels, which promotes neuronal mitochondria dysfunction leading to cell death. A strategy to counteract cerebral ischemia-induced neuronal cell death is ischemic preconditioning (IPC). IPC results in neuroprotection, which is conferred by a mild ischemic challenge prior to a normally lethal ischemic insult. Although many IPC-induced mechanisms have been described, many cellular and subcellular mechanisms remain undefined. Some reports have suggested key signal transduction pathways of IPC, such as activation of protein kinase C epsilon, mitogen-activated protein kinase, and hypoxia-inducible factors, that are likely involved in IPC-induced mitochondria mediated-neuroprotection. Moreover, recent findings suggest that signal transducers and activators of transcription (STATs), a family of transcription factors involved in many cellular activities, may be intimately involved in IPC-induced ischemic tolerance. In this review, we explore current signal transduction pathways involved in IPC-induced mitochondria mediated-neuroprotection, STAT activation in the mitochondria as it relates to IPC, and functional significance of STATs in cerebral ischemia. Antioxid. Redox Signal. 14, 1853–1861. PMID:20712401

Infection prevention and control of the Ebola outbreak in Liberia, 2014-2015: key challenges and successes.

PubMed

Cooper, Catherine; Fisher, Dale; Gupta, Neil; MaCauley, Rose; Pessoa-Silva, Carmem L

2016-01-05

Prior to the 2014-2015 Ebola outbreak, infection prevention and control (IPC) activities in Liberian healthcare facilities were basic. There was no national IPC guidance, nor dedicated staff at any level of government or healthcare facility (HCF) to ensure the implementation of best practices. Efforts to improve IPC early in the outbreak were ad hoc and messaging was inconsistent. In September 2014, at the height of the outbreak, the national IPC Task Force was established with a Ministry of Health (MoH) mandate to coordinate IPC response activities. A steering group of the Task Force, including representatives of the World Health Organization (WHO) and the United States Centers for Disease Control and Prevention (CDC), supported MoH leadership in implementing standardized messaging and IPC training for the health workforce. This structure, and the activities implemented under this structure, played a crucial role in the implementation of IPC practices and successful containment of the outbreak. Moving forward, a nationwide culture of IPC needs to be maintained through this governance structure in Liberia's health system to prevent and respond to future outbreaks.

The remote ischemic preconditioning algorithm: effect of number of cycles, cycle duration and effector organ mass on efficacy of protection.

PubMed

Johnsen, Jacob; Pryds, Kasper; Salman, Rasha; Løfgren, Bo; Kristiansen, Steen Buus; Bøtker, Hans Erik

2016-03-01

Remote ischemic preconditioning (rIPC), induced by cycles of transient limb ischemia and reperfusion (IR), is cardioprotective. The optimal rIPC-algorithm is not established. We investigated the effect of cycle numbers and ischemia duration within each rIPC-cycle and the influence of effector organ mass on the efficacy of cardioprotection. Furthermore, the duration of the early phase of protection by rIPC was investigated. Using a tourniquet tightened at the inguinal level, we subjected C57Bl/6NTac mice to intermittent hind-limb ischemia and reperfusion. The rIPC-protocols consisted of (I) two, four, six or eight cycles, (II) 2, 5 or 10 min of ischemia in each cycle, (III) single or two hind-limb occlusions and (IV) 0.5, 1.5, 2.0 or 2.5 h intervals from rIPC to index cardiac ischemia. All rIPC algorithms were followed by 5 min of reperfusion. The hearts were subsequently exposed to 25 min of global ischemia and 60 min of reperfusion in an ex vivo Langendorff model. Cardioprotection was evaluated by infarct size and post-ischemic hemodynamic recovery. Four to six rIPC cycles yielded significant cardioprotection with no further protection by eight cycles. Ischemic cycles lasting 2 min offered the same protection as cycles of 5 min ischemia, whereas prolonged cycles lasting 10 min abrogated protection. One and two hind-limb preconditioning were equally protective. In our mouse model, the duration of protection by rIPC was 1.5 h. These findings indicate that the number and duration of cycles rather than the tissue mass exposed to rIPC determines the efficacy of rIPC.

An x ray archive on your desk: The Einstein CD-ROM's

NASA Technical Reports Server (NTRS)

Prestwich, A.; Mcdowell, J.; Plummer, D.; Manning, K.; Garcia, M.

1992-01-01

Data from the Einstein Observatory imaging proportional counter (IPC) and high resolution imager (HRI) were released on several CD-ROM sets. The sets released so far include pointed IPC and HRI observations in both simple image and detailed photon event list format, as well as the IPC slew survey. With the data on these CD-ROMS's the user can perform spatial analysis (e.g., surface brightness distributions), spectral analysis (with the IPC event lists), and timing analysis (with the IPC and HRI event lists). The next CD-ROM set will contain IPC unscreened data, allowing the user to perform custom screening to recover, for instance, data during times of lost aspect data or high particle background rates.

Metabolomic profiling of the heart during acute ischemic preconditioning reveals a role for SIRT1 in rapid cardioprotective metabolic adaptation.

PubMed

Nadtochiy, Sergiy M; Urciuoli, William; Zhang, Jimmy; Schafer, Xenia; Munger, Joshua; Brookes, Paul S

2015-11-01

Ischemic preconditioning (IPC) protects tissues such as the heart from prolonged ischemia-reperfusion (IR) injury. We previously showed that the lysine deacetylase SIRT1 is required for acute IPC, and has numerous metabolic targets. While it is known that metabolism is altered during IPC, the underlying metabolic regulatory mechanisms are unknown, including the relative importance of SIRT1. Thus, we sought to test the hypothesis that some of the metabolic adaptations that occur in IPC may require SIRT1 as a regulatory mediator. Using both ex-vivo-perfused and in-vivo mouse hearts, LC-MS/MS based metabolomics and (13)C-labeled substrate tracing, we found that acute IPC altered several metabolic pathways including: (i) stimulation of glycolysis, (ii) increased synthesis of glycogen and several amino acids, (iii) increased reduced glutathione levels, (iv) elevation in the oncometabolite 2-hydroxyglutarate, and (v) inhibition of fatty-acid dependent respiration. The majority (83%) of metabolic alterations induced by IPC were ablated when SIRT1 was acutely inhibited with splitomicin, and a principal component analysis revealed that metabolic changes in response to IPC were fundamentally different in nature when SIRT1 was inhibited. Furthermore, the protective benefit of IPC was abrogated by eliminating glucose from perfusion media while sustaining normal cardiac function by burning fat, thus indicating that glucose dependency is required for acute IPC. Together, these data suggest that SIRT1 signaling is required for rapid cardioprotective metabolic adaptation in acute IPC. Copyright © 2015 Elsevier Ltd. All rights reserved.

Equivalent cardioprotection induced by ischemic and hypoxic preconditioning.

PubMed

Xiang, Xujin; Lin, Haixia; Liu, Jin; Duan, Zeyan

2013-04-01

We aimed to compare cardioprotection induced by various hypoxic preconditioning (HPC) and ischemic preconditioning (IPC) protocols. Isolated rat hearts were randomly divided into 7 groups (n = 7 per group) and received 3 or 5 cycles of 3-minute ischemia or hypoxia followed by 3-minute reperfusion (IPC33 or HPC33 or IPC53 or HPC53 group), 3 cycles of 5-minute ischemia or hypoxia followed by 5-minute reperfusion (IPC35 group or HPC35 group), or 30-minute perfusion (ischemic/reperfusion group), respectively. Then all the hearts were subjected to 50-minute ischemia and 120-minute reperfusion. Cardiac function, infarct size, and coronary flow rate (CFR) were evaluated. Recovery of cardiac function and CFR in IPC35, HPC35, and HPC53 groups was significantly improved as compared with I/R group (p < 0.01). There were no significant differences in cardiac function parameters between IPC35 and HPC35 groups. Consistently, infarct size was significantly reduced in IPC35, HPC35, and HPC53 groups compared with ischemic/reperfusion group. Multiple-cycle short duration HPC exerted cardioprotection, which was as powerful as that of IPC. Georg Thieme Verlag KG Stuttgart · New York.

Scaling up integrated prevention campaigns for global health: costs and cost-effectiveness in 70 countries.

PubMed

Marseille, Elliot; Jiwani, Aliya; Raut, Abhishek; Verguet, Stéphane; Walson, Judd; Kahn, James G

2014-06-26

This study estimated the health impact, cost and cost-effectiveness of an integrated prevention campaign (IPC) focused on diarrhoea, malaria and HIV in 70 countries ranked by per capita disability-adjusted life-year (DALY) burden for the three diseases. We constructed a deterministic cost-effectiveness model portraying an IPC combining counselling and testing, cotrimoxazole prophylaxis, referral to treatment and condom distribution for HIV prevention; bed nets for malaria prevention; and provision of household water filters for diarrhoea prevention. We developed a mix of empirical and modelled cost and health impact estimates applied to all 70 countries. One-way, multiway and scenario sensitivity analyses were conducted to document the strength of our findings. We used a healthcare payer's perspective, discounted costs and DALYs at 3% per year and denominated cost in 2012 US dollars. The primary outcome was cost-effectiveness expressed as net cost per DALY averted. Other outcomes included cost of the IPC; net IPC costs adjusted for averted and additional medical costs and DALYs averted. Implementation of the IPC in the 10 most cost-effective countries at 15% population coverage would cost US$583 million over 3 years (adjusted costs of US$398 million), averting 8.0 million DALYs. Extending IPC programmes to all 70 of the identified high-burden countries at 15% coverage would cost an adjusted US$51.3 billion and avert 78.7 million DALYs. Incremental cost-effectiveness ranged from US$49 per DALY averted for the 10 countries with the most favourable cost-effectiveness to US$119, US$181, US$335, US$1692 and US$8340 per DALY averted as each successive group of 10 countries is added ordered by decreasing cost-effectiveness. IPC appears cost-effective in many settings, and has the potential to substantially reduce the burden of disease in resource-poor countries. This study increases confidence that IPC can be an important new approach for enhancing global health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Building a taxonomy of integrated palliative care initiatives: results from a focus group

PubMed Central

Ewert, Benjamin; Hodiamont, Farina; van Wijngaarden, Jeroen; Payne, Sheila; Groot, Marieke; Hasselaar, Jeroen; Menten, Johann; Radbruch, Lukas

2016-01-01

Background Empirical evidence suggests that integrated palliative care (IPC) increases the quality of care for palliative patients and supports professional caregivers. Existing IPC initiatives in Europe vary in their design and are hardly comparable. InSuP-C, a European Union research project, aimed to build a taxonomy of IPC initiatives applicable across diseases, healthcare sectors and systems. Methods The taxonomy of IPC initiatives was developed in cooperation with an international and multidisciplinary focus group of 18 experts. Subsequently, a consensus meeting of 10 experts revised a preliminary taxonomy and adopted the final classification system. Results Consisting of eight categories, with two to four items each, the taxonomy covers the process and structure of IPC initiatives. If two items in at least one category apply to an initiative, a minimum level of integration is assumed to have been reached. Categories range from the type of initiative (items: pathway, model or guideline) to patients’ key contact (items: non-pc specialist, pc specialist, general practitioner). Experts recommended the inclusion of two new categories: level of care (items: primary, secondary or tertiary) indicating at which stage palliative care is integrated and primary focus of intervention describing IPC givers’ different roles (items: treating function, advising/consulting or training) in the care process. Conclusions Empirical studies are required to investigate how the taxonomy is used in practice and whether it covers the reality of patients in need of palliative care. The InSuP-C project will test this taxonomy empirically in selected initiatives using IPC. PMID:26647043

Role of ischaemic preconditioning in liver regeneration following major liver resection and transplantation

PubMed Central

Gomez, D; Homer-Vanniasinkam, S; Graham, AM; Prasad, KR

2007-01-01

Liver ischaemic preconditioning (IPC) is known to protect the liver from the detrimental effects of ischaemic-reperfusion injury (IRI), which contributes significantly to the morbidity and mortality following major liver surgery. Recent studies have focused on the role of IPC in liver regeneration, the precise mechanism of which are not completely understood. This review discusses the current understanding of the mechanism of liver regeneration and the role of IPC in this setting. Relevant articles were reviewed from the published literature using the Medline database. The search was performed using the keywords “liver”, “ischaemic reperfusion”, “ischaemic preconditioning”, “regeneration”, “hepatectomy” and “transplantation”. The underlying mechanism of liver regeneration is a complex process involving the interaction of cytokines, growth factors and the metabolic demand of the liver. IPC, through various mediators, promotes liver regeneration by up-regulating growth-promoting factors and suppresses growth-inhibiting factors as well as damaging stresses. The increased understanding of the cellular mechanisms involved in IPC will enable the development of alternative treatment modalities aimed at promoting liver regeneration following major liver resection and transplantation. PMID:17278187

Mitogen Activated Protein Kinase Phosphatase-1 (MKP-1) in Retinal Ischemic Preconditioning

PubMed Central

Dreixler, John C.; Bratton, Anthony; Du, Eugenie; Shaikh, Afzhal R.; Savoie, Brian; Michael, Alexander; Marcet, Marcus; Roth, Steven

2011-01-01

We previously described the phenomenon of retinal ischemic preconditioning (IPC) and we have shown the role of various signaling proteins in the protective pathways, including the mitogen-activated protein kinase p38. In this study we examined the role in IPC of mitogen-activated protein kinase phosphatase-1 (MKP-1), which inactivates p38. Ischemia was produced by elevation of intraocular pressure above systolic arterial blood pressure in adult Wistar rats. Preconditioning was produced by transient retinal ischemia for 5 min, 24 h prior to ischemia. Small interfering RNA (siRNA) to MKP-1 or a control non-silencing siRNA, was injected into the vitreous 6 h prior to IPC. Recovery was assessed by electroretinography (ERG) and histology. The a- and b-waves, and oscillatory potentials (OPs), measured before and 1 week after ischemia, were then normalized relative to pre-ischemic baseline, and corrected for diurnal variation in the normal non-ischemic eye. The P2, or post-photoreceptor component of the ERG (which reflects function of the rod bipolar cells in the inner retina), was derived using the Hood-Birch model. MKP-1 was localized in specific retinal cells using immunohistochemistry; levels of mitogen-activated protein kinases were measured using Western blotting. Injection of siRNA to MKP-1 significantly attenuated the protective effect of IPC as reflected by decreased recovery of the electroretinogram a- and b-waves and the P2 after ischemia. The injection of siRNA to MKP-1 reduced the number of cells in the retinal ganglion cell and outer nuclear layers after IPC and ischemia. Blockade of MKP-1 by siRNA also increased the activation of p38 at 24 h following IPC. MKP-1 siRNA did not alter the levels of phosphorylated jun N-terminal kinase (JNK) or extracellular signal-regulated kinase (ERK) after IPC. The results suggest the involvement of dual-specificity phosphatase MKP-1 in IPC and that MKP-1 is involved in IPC by regulating levels of activated MAPK p38. PMID:21094639

Improved differentiation of umbilical cord blood-derived mesenchymal stem cells into insulin-producing cells by PDX-1 mRNA transfection.

PubMed

Van Pham, Phuc; Thi-My Nguyen, Phuoc; Thai-Quynh Nguyen, Anh; Minh Pham, Vuong; Nguyen-Tu Bui, Anh; Thi-Tung Dang, Loan; Gia Nguyen, Khue; Kim Phan, Ngoc

2014-06-01

Numerous studies have sought to identify diabetes mellitus treatment strategies with fewer side effects. Mesenchymal stem cell (MSC) therapy was previously considered as a promising therapy; however, it requires the cells to be trans-differentiated into cells of the pancreatic-endocrine lineage before transplantation. Previous studies have shown that PDX-1 expression can facilitate MSC differentiation into insulin-producing cells (IPCs), but the methods employed to date use viral or DNA-based tools to express PDX-1, with the associated risks of insertional mutation and immunogenicity. Thus, this study aimed to establish a new method to induce PDX-1 expression in MSCs by mRNA transfection. MSCs were isolated from human umbilical cord blood and expanded in vitro, with stemness confirmed by surface markers and multipotentiality. MSCs were transfected with PDX-1 mRNA by nucleofection and chemically induced to differentiate into IPCs (combinatorial group). This IPC differentiation was then compared with that of untransfected chemically induced cells (inducer group) and uninduced cells (control group). We found that PDX-1 mRNA transfection significantly improved the differentiation of MSCs into IPCs, with 8.3±2.5% IPCs in the combinatorial group, 3.21±2.11% in the inducer group and 0% in the control. Cells in the combinatorial group also strongly expressed several genes related to beta cells (Pdx-1, Ngn3, Nkx6.1 and insulin) and could produce C-peptide in the cytoplasm and insulin in the supernatant, which was dependent on the extracellular glucose concentration. These results indicate that PDX-1 mRNA may offer a promising approach to produce safe IPCs for clinical diabetes mellitus treatment. Copyright © 2014 International Society of Differentiation. Published by Elsevier B.V. All rights reserved.

[Effects of circulating microvesicles derived from myocardial ischemic preconditioning on myocardial ischemia/reperfusion injury in rats].

PubMed

Wang, Yi-Lu; Liu, Miao; Shang, Man; Wang, Yao; Zhang, Qi; Wang, Shao-Xun; Wei, Su; Zhang, Kun-Wei; Liu, Chao; Wu, Yan-Na; Song, Jun-Qiu; Liu, Yan-Xia

2016-02-08

To investigate the effects of circulating microvesicles (MVs) derived from ischemic preconditioning (IPC) on myocardial ischemia/reperfusion (I/R) injury in rats and explore the underlying mechanism. To establish the IPC model, the rats were subjected to brief cycles of left anterior descending (LAD) coronary occlusion and reperfusion. The blood was drawn from abdominal aorta once the operation was finished. IPC-MVs were isolated by ultracentrifugation from the peripheral blood and characterized by flow cytometry. The myocardial I/R model of rats was established in vivo. Rats were injected via the femoral vein with IPC-MVs at 7 mg/kg. Morphological changes of myocardium were observed microscopically after HE staining. Apoptosis of myocardial cells was detected with TUNEL assay. Myocardial infarct size was detected by TTC staining. Moreover, activity of plasma lactate dehydrogenase (LDH) was tested by colorimetry. The activity of caspase 3 in myocardium was assayed with spectrophotometry. Expression levels of Bcl-2 and Bax protein were examined with Western blot. The concentration of IPC-MVs, which was detected by flow cytometry, was 4380±745 cells/ μ l. Compared with I/R group, IPC-MVs alleviated the damage of tissues in I/R injured rats significantly. The myocardial infarct size and the cardiomyocyte apoptotic index were obviously decreased after IPC-MVs treatment ( P <0.01, respectively). The activity of plasma LDH was significantly decreased in IPC-MVs treated rats ( P <0.01). Moreover, the activity of caspase 3 was markedly decreased after IPC-MVs treatment ( P <0.01). In addition, the expression of Bcl-2 was increased ( P <0.01), the expression of Bax was decreased ( P <0.01), the ratio of Bcl-2/Bax was significantly increased after IPC-MVs treatment ( P <0.01). IPC-MVs protected myocardial against I/R injury by up-regulating the expression of Bcl-2 protein, down-regulating the expression of Bax protein, increasing the ratio of Bcl-2/Bax and decreasing cleavage of caspase 3.

Identified peptidergic neurons in the Drosophila brain regulate insulin-producing cells, stress responses and metabolism by coexpressed short neuropeptide F and corazonin.

PubMed

Kapan, Neval; Lushchak, Oleh V; Luo, Jiangnan; Nässel, Dick R

2012-12-01

Insulin/IGF-like signaling regulates the development, growth, fecundity, metabolic homeostasis, stress resistance and lifespan in worms, flies and mammals. Eight insulin-like peptides (DILP1-8) are found in Drosophila. Three of these (DILP2, 3 and 5) are produced by a set of median neurosecretory cells (insulin-producing cells, IPCs) in the brain. Activity in the IPCs of adult flies is regulated by glucose and several neurotransmitters and neuropeptides. One of these, short neuropeptide F (sNPF), regulates food intake, growth and Dilp transcript levels in IPCs via the sNPF receptor (sNPFR1) expressed on IPCs. Here we identify a set of brain neurons that utilizes sNPF to activate the IPCs. These sNPF-expressing neurons (dorsal lateral peptidergic neurons, DLPs) also produce the neuropeptide corazonin (CRZ) and have axon terminations impinging on IPCs. Knockdown of either sNPF or CRZ in DLPs extends survival in flies exposed to starvation and alters carbohydrate and lipid metabolism. Expression of sNPF in DLPs in the sNPF mutant background is sufficient to rescue wild-type metabolism and response to starvation. Since CRZ receptor RNAi in IPCs affects starvation resistance and metabolism, similar to peptide knockdown in DLPs, it is likely that also CRZ targets the IPCs. Knockdown of sNPF, but not CRZ in DLPs decreases transcription of Dilp2 and 5 in the brain, suggesting different mechanisms of action on IPCs of the two co-released peptides. Our findings indicate that sNPF and CRZ co-released from a small set of neurons regulate IPCs, stress resistance and metabolism in adult Drosophila.

TB infection prevention and control experiences of South African nurses - a phenomenological study

PubMed Central

2011-01-01

Background The tuberculosis (TB) epidemic in South Africa is characterised by one of the highest levels of TB/HIV co-infection and growing multidrug-resistant TB worldwide. Hospitals play a central role in the management of TB. We investigated nurses' experiences of factors influencing TB infection prevention and control (IPC) practices to identify risks associated with potential nosocomial transmission. Methods The qualitative study employed a phenomenological approach, using semi-structured interviews with a quota sample of 20 nurses in a large tertiary academic hospital in Cape Town, South Africa. The data was subjected to thematic analysis. Results Nurses expressed concerns about the possible risk of TB transmission to both patients and staff. Factors influencing TB-IPC, and increasing the potential risk of nosocomial transmission, emerged in interconnected overarching themes. Influences related to the healthcare system included suboptimal IPC provision such as the lack of isolation facilities and personal protective equipment, and the lack of a TB-IPC policy. Further influences included inadequate TB training for staff and patients, communication barriers owing to cultural and linguistic differences between staff and patients, the excessive workload of nurses, and a sense of duty of care. Influences related to wider contextual conditions included TB concerns and stigma, and the role of traditional healers. Influences related to patient behaviour included late uptake of hospital care owing to poverty and the use of traditional medicine, and poor adherence to IPC measures by patients, family members and carers. Conclusions Several interconnected influences related to the healthcare system, wider contextual conditions and patient behavior could increase the potential risk of nosocomial TB transmission at hospital level. There is an urgent need for the implementation and evaluation of a comprehensive contextually appropriate TB IPC policy with the setting and auditing of standards for IPC provision and practice, adequate TB training for both staff and patients, and the establishment of a cross-cultural communication strategy, including rapid access to interpreters. PMID:21518434

Role of decoy molecules in neuronal ischemic preconditioning

PubMed Central

Panneerselvam, Mathivadhani; Patel, Piyush M.; Roth, David M.; Kidd, Michael W.; Chin-Lee, Blake; Head, Brian P.; Niesman, Ingrid R.; Inoue, Satoki; Patel, Hemal H.; Davis, Daniel P.

2011-01-01

Decoy receptors bind with TNF related apoptosis inducing ligands (TRAIL) but do not contain the cytoplasmic domains necessary to transduce apoptotic signals. We hypothesized that decoy receptors may confer neuronal protection against lethal ischemia after ischemic preconditioning (IPC). Mixed cortical neurons were exposed to IPC one day prior to TRAIL treatment or lethal ischemia. IPC increased decoy receptor but reduced death receptor expression compared to lethal ischemia. IPC-induced increase in decoy receptor expression was reduced by prior treatment with CAPE, a nuclear factor-kappa B inhibitor (NFκB). Expression of decoy molecules, dependent on NFκB, may mediate neuronal survival induced by IPC. PMID:21315738

Nitric oxide, PKC-ε, and connexin43 are crucial for ischemic preconditioning-induced chemical gap junction uncoupling.

PubMed

Rong, Bing; Xie, Fei; Sun, Tao; Hao, Li; Lin, Ming-Jie; Zhong, Jing-Quan

2016-10-25

Ischemic preconditioning (IPC) maintains connexin43 (Cx43) phosphorylation and reduces chemical gap junction (GJ) coupling in cardiomyocytes to protect against ischemic damage. However, the signal transduction pathways underlying these effects are not fully understood. Here, we investigated whether nitric oxide (NO) and protein kinase C-ε (PKC-ε) contribute to IPC-induced cardioprotection by maintaining Cx43 phosphorylation and inhibiting chemical GJ coupling. IPC reduced ischemia-induced myocardial infarction and increased cardiomyocyte survival; phosphorylated Cx43, eNOS, and PKC-ε levels; and chemical GJ uncoupling. Administration of the NO donor SNAP mimicked the effects of IPC both in vivo and in vitro, maintaining Cx43 phosphorylation, promoting chemical GJ uncoupling, and reducing myocardial infarction. Preincubation with the NO synthase inhibitor L-NAME or PKC-ε translocation inhibitory peptide (PKC-ε-TIP) abolished these effects of IPC. Additionally, by inducing NO production, IPC induced translocation of PKC-ε, but not PKC-δ, from the cytosolic to the membrane fraction in primary cardiac myocytes. IPC-induced cardioprotection thus involves increased NO production, PKC-ε translocation, Cx43 phosphorylation, and chemical GJ uncoupling.

Perceived barriers to infection prevention and control for nursing home certified nursing assistants: a qualitative study.

PubMed

Travers, Jasmine; Herzig, Carolyn T A; Pogorzelska-Maziarz, Monika; Carter, Eileen; Cohen, Catherine C; Semeraro, Patricia K; Bjarnadottir, Ragnhildur I; Stone, Patricia W

2015-01-01

Healthcare-associated infections, while preventable, result in increased morbidity and mortality in nursing home (NH) residents. Frontline personnel, such as certified nursing assistants (CNAs), are crucial to successful implementation of infection prevention and control (IPC) practices. The purpose of this study was to explore barriers to implementing and maintaining IPC practices for NH CNAs as well as to describe strategies used to overcome these barriers. We conducted a multi-site qualitative study of NH personnel important to infection control. Audio-recorded interviews were transcribed verbatim and transcripts were analyzed using conventional content analysis. Five key themes emerged as perceived barriers to effective IPC for CNAs: 1) language/culture; 2) knowledge/training; 3) per-diem/part-time staff; 4) workload; and 5) accountability. Strategies used to overcome these barriers included: translating in-services, hands on training, on-the-spot training for per-diem/part-time staff, increased staffing ratios, and inclusion/empowerment of CNAs. Understanding IPC barriers and strategies to overcome these barriers may better enable NHs to achieve infection reduction goals. Copyright © 2015 Elsevier Inc. All rights reserved.

Lowbury Lecture 2013. Cultural determinants of infection control behaviour: understanding drivers and implementing effective change.

PubMed

Borg, M A

2014-03-01

Despite dealing with biomedical practices, infection prevention and control (IPC) is essentially a behavioural science. Human behaviour is influenced by various factors, including culture. Hofstede's model of cultural dimensions proposes that national cultures vary along consistent dimensions which can be grouped and scored as specific constructs. Studies have reported that three Hofstede constructs--power distance, uncertainty avoidance, and masculinity--show significant association with several key performance indicators relevant to IPC and antibiotic stewardship. In addition, national meticillin-resistant Staphylococcus aureus (MRSA) levels within Europe correlate well with general quality-of-care indices, including preventive strategies and patient rights. This suggests that IPC may be simply a microcosm of overall quality and safety standards within hospitals and countries. Effective improvement would therefore need to address underlying and embedded core cultural values relevant to patient safety and quality of care. Successful IPC strategies are likely to be those that are compatible with the cultural background where they are implemented. To this end, content analysis of many current IPC improvement tools identifies elements of strong compatibility with cultures that are low in uncertainty avoidance and power distance, and high in individualism and masculinity. However, this cultural combination is largely restricted to Anglo-Saxon countries, where most of the recent improvements in healthcare-associated infection (HCAI) incidence have taken place. There is a paucity of research on IPC behaviour change in different cultural backgrounds, especially countries that score high for power distance and/or uncertainty avoidance. This information is vital to inform IPC campaigns in these countries, which often show high HCAI prevalence. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Conduit Artery Diameter During Exercise Is Enhanced After Local, but Not Remote, Ischemic Preconditioning

PubMed Central

Cocking, Scott; Cable, N. T.; Wilson, Mathew G.; Green, Daniel J.; Thijssen, Dick H. J.; Jones, Helen

2018-01-01

Introduction: The ability of ischemic preconditioning (IPC) to enhance exercise capacity may be mediated through altering exercise-induced blood flow and/or vascular function. This study investigated the hypothesis that (local) IPC enhances exercise-induced blood flow responses and prevents decreases in vascular function following exercise. Methods: Eighteen healthy, recreationally trained, male participants (mean ±SD: age 32 ± 8 years; BMI 24.2 ± 2.3; blood pressure 122 ± 10/72 ± 8 mmHg; resting HR 58 ± 9 beats min-1) received IPC (220 mmHg; 4 × 5-min bilateral arms), REMOTE IPC (220 mmHg; 4 × 5-min bilateral legs), or SHAM (20 mmHg; 4 × 5-min bilateral arms) in a counterbalanced order prior to 30-min of submaximal (25% maximal voluntary contraction) unilateral rhythmic handgrip exercise. Brachial artery diameter and blood flow were assessed every 5-min throughout the 30-min submaximal exercise using high resolution ultrasonography. Pre- and post-exercise vascular function was measured using flow-mediated dilation (FMD). Results: IPC resulted in enlarged brachial artery diameter during exercise [0.016 cm (0.003–0.03 cm), P = 0.015] compared to REMOTE IPC, but blood flow during exercise was similar between conditions (P > 0.05). Blood flow (l/min) increased throughout exercise (time: P < 0.005), but there was no main effect of condition (P = 0.29) or condition ∗ time interaction (P = 0.83). Post-exercise FMD was similar between conditions (P > 0.05). Conclusion: Our data show that local (but not remote) IPC, performed as a strategy prior to exercise, enhanced exercise-induced conduit artery diameter dilation, but these changes do not translate into increased blood flow during exercise nor impact post-exercise vascular function. PMID:29740345

Building a taxonomy of integrated palliative care initiatives: results from a focus group.

PubMed

Ewert, Benjamin; Hodiamont, Farina; van Wijngaarden, Jeroen; Payne, Sheila; Groot, Marieke; Hasselaar, Jeroen; Menten, Johann; Radbruch, Lukas

2016-03-01

Empirical evidence suggests that integrated palliative care (IPC) increases the quality of care for palliative patients and supports professional caregivers. Existing IPC initiatives in Europe vary in their design and are hardly comparable. InSuP-C, a European Union research project, aimed to build a taxonomy of IPC initiatives applicable across diseases, healthcare sectors and systems. The taxonomy of IPC initiatives was developed in cooperation with an international and multidisciplinary focus group of 18 experts. Subsequently, a consensus meeting of 10 experts revised a preliminary taxonomy and adopted the final classification system. Consisting of eight categories, with two to four items each, the taxonomy covers the process and structure of IPC initiatives. If two items in at least one category apply to an initiative, a minimum level of integration is assumed to have been reached. Categories range from the type of initiative (items: pathway, model or guideline) to patients' key contact (items: non-pc specialist, pc specialist, general practitioner). Experts recommended the inclusion of two new categories: level of care (items: primary, secondary or tertiary) indicating at which stage palliative care is integrated and primary focus of intervention describing IPC givers' different roles (items: treating function, advising/consulting or training) in the care process. Empirical studies are required to investigate how the taxonomy is used in practice and whether it covers the reality of patients in need of palliative care. The InSuP-C project will test this taxonomy empirically in selected initiatives using IPC. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Role of adipose tissue derived stem cells differentiated into insulin producing cells in the treatment of type I diabetes mellitus.

PubMed

Amer, Mona G; Embaby, Azza S; Karam, Rehab A; Amer, Marwa G

2018-05-15

Generation of new β cells is an important approach in the treatment of type 1 diabetes mellitus (type 1 DM). Adipose tissue-derived stem cells (ADSCs) might be one of the best sources for cell replacement therapy for diabetes. Therefore, this work aimed to test the possible role of transplanted insulin-producing cells (IPCs) differentiated from ADSCs in treatment of streptozotocin (STZ) induced type I DM in rats. Type 1 DM was induced by single intra peritoneal injection with STZ (50 mg/kg BW). Half of the diabetic rats were left without treatment and the other half were injected with differentiated IPCs directly into the pancreas. ADSCs were harvested, cultured and identified by testing their phenotypes through flow cytometry. They were further subjected to differentiation into IPCs using differentiation medium. mRNA expression of pancreatic transcription factors (pdx1), insulin and glucose transporter-2 genes by real time PCR was done to detect the cellular differentiation and confirmed by stimulated insulin secretion. The pancreatic tissues from all groups were examined 2 months after IPC transplantation and were subjected to histological, Immunohistochemical and morphometric study. The differentiated IPCs showed significant expression of pancreatic β cell markers and insulin secretion in glucose dependent manner. Treatment with IPCs induced apparent regeneration, diffused proliferated islet cells and significant increase in C-peptide immune reaction. We concluded that transplantation of differentiated IPCs improved function and morphology of Islet cells in diabetic rats. Consequently, this therapy option may be a promising therapeutic approach to patient with type 1 DM if proven to be effective and safe. Copyright © 2018 Elsevier B.V. All rights reserved.

Distinct expression pattern of IFN-alpha and TNF-alpha in juvenile idiopathic arthritis synovial tissue.

PubMed

Gattorno, M; Chicha, L; Gregorio, A; Ferlito, F; Rossi, F; Jarrossay, D; Lanzavecchia, A; Martini, A; Manz, M G

2007-04-01

Recent laboratory and clinical data suggest that two prototype autoimmune diseases, systemic lupus erythematosus and rheumatoid arthritis are mainly driven by distinct cytokines, interferon (IFN)-alpha and tumour necrosis factor (TNF)-alpha, respectively. We here investigated the presence and characteristics of natural type I IFN-producing cells (IPCs), as well as IFN-alpha and TNF-alpha expression at sites of inflammation in juvenile idiopathic arthritis (JIA). Peripheral blood (PB) and synovial fluid (SF) mononuclear cells (MNCs) (n = 25 each) from JIA patients with active disease were studied. IPCs were identified as BCDA-2(+)CD123(+)HLA-DR(+)CD45RA(+) cells, and dendritic cells (DCs) as CD11c(+)CD14(-/low)lin(-) cells by flow cytometry. IPCs and DCs were analysed for Toll-like receptor-7 and -9 mRNA expression by real-time polymerase chain reaction. IFN-alpha was measured by enzyme-linked immunosorbent assay in serum, SF and in supernatants of influenza virus-infected, cultured IPCs. Synovial tissues of n = 6 additional JIA patients were analysed by immunohistochemistry using mAbs against CD123, IFN-alpha, TNF-alpha, CD3, CD19 and CD138. IPCs were enriched in SF MNCs compared with PB MNCs in all JIA patients. Influenza-induced, but no spontaneous IFN-alpha release was detected from SF IPCs, and serum and SF IFN-alpha levels were not elevated. Nonetheless, in synovial tissue IFN-alpha producing cells accumulated at inflammatory lymph-follicular-like structures, while TNF-alpha producing cells were mostly found at the lining and sublining layers. These data suggest that besides TNF-alpha-expressing cells, IFN-alpha-producing IPCs are involved in initiation, maintenance or regulation of the inflammatory response in JIA.

Asymptotic behavior of the daily increment distribution of the IPC, the mexican stock market index

NASA Astrophysics Data System (ADS)

Coronel-Brizio, H. F.; Hernández-Montoya, A. R.

2005-02-01

In this work, a statistical analysis of the distribution of daily fluctuations of the IPC, the Mexican Stock Market Index is presented. A sample of the IPC covering the 13-year period 04/19/1990 - 08/21/2003 was analyzed and the cumulative probability distribution of its daily logarithmic variations studied. Results showed that the cumulative distribution function for extreme variations, can be described by a Pareto-Levy model with shape parameters alpha=3.634 +- 0.272 and alpha=3.540 +- 0.278 for its positive and negative tails respectively. This result is consistent with previous studies, where it has been found that 2.5< alpha <4 for other financial markets worldwide.

Designing an Electronics Data Package for Printed Circuit Boards (PCBs)

DTIC Science & Technology

2013-08-01

finished PCB flatness deviation should be less than 0.010 inches per inch. 4  The minimum copper wall thickness of plated-thru holes should be...Memory Card International Association)  IPC-6015 MCM-L (Multi-Chip Module – Laminated )  IPC-6016 HDI (High Density Interconnect)  IPC-6018...Interconnect ICT In Circuit Tester IPC Association Connecting Electronics Industries MCM-L Multi-Chip Module – Laminated MIL Military NEMA National

Soft X-ray properties of Seyfert galaxies. I - Spectra

NASA Technical Reports Server (NTRS)

Kruper, J. S.; Canizares, C. R.; Urry, C. M.

1990-01-01

Results are presented from a study of soft X-ray spectra of 75 Seyfert galaxies observed by the Einstein Observatory IPC. The spectra in this sample (mostly high-luminosity Seyfert type 1s) are found to be consistent with a single power-law index alpha = 81. The AGN spectra observed with the IPC are compared with those from higher energy experiments, where AGN spectra have power law indices alpha = 0.7. It is found that the IPC spectra are systematically steeper than the HEAO 1 A-2 spectra of the same Seyfert galaxies, indicating a flattening toward higher energies.

Effect of intermittent pneumatic compression on disability, living circumstances, quality of life, and hospital costs after stroke: secondary analyses from CLOTS 3, a randomised trial.

PubMed

2014-12-01

The results of the CLOTS 3 trial showed that intermittent pneumatic compression (IPC) reduced the risk of deep vein thrombosis and improved survival in immobile patients with stroke. IPC is now being widely used in stroke units. Here we describe the disability, living circumstances, quality of life, and hospital costs of patients in CLOTS 3. In CLOTS 3, a parallel group trial in 94 UK hospitals, immobile patients with stroke from days 0 to 3 of admission were assigned with a computer-generated allocation sequence in a 1:1 ratio to IPC or no IPC through a central randomisation system. We followed up patients at about 6 months with postal or telephone questionnaire to assess the secondary endpoints: disability (Oxford Handicap Scale [OHS]), living circumstances, health-related quality of life (EQ5D-3L), and hospital costs (based on use of IPC and length of hospital stay). Patients and carers who completed the postal questionnaires were not masked to treatment allocation, but telephone follow-up in non-responders was masked. All analyses were by intention to treat. This trial is registered, number ISRCTN93529999. Between Dec 8, 2008, and Sept 6, 2012, we enrolled 2876 patients, with 1438 in each group. Despite the previously reported reduction in the risk of proximal deep vein thrombosis at 30 days (primary endpoint), there were no significant differences in disability (OHS 0-2 vs 3-6, adjusted odds ratio [OR] 0·98, 95% CI 0·80 to 1·19, p=0·83; adjusted ordinal analysis common OR 0·97, 95% CI 0·86 to 1·11), living circumstances (institutional care vs not; adjusted OR 1·11, 95% CI 0·89 to 1·37; p=0·358), or health-related quality of life (median utility value 0·26, IQR -0·07 to 0·66 with IPC, and 0·27, -0·06 to 0·64, with no IPC; p=0·952). The estimated cost of IPC was £64·10 per patient (SD 28·3). The direct costs of preventing a deep vein thrombosis and death were £1282 (95% CI 785 to 3077) and £2756 (1346 to not estimable), respectively, with IPC. Hospital costs increased by £451 with IPC compared with no IPC because of a longer stay in hospital (mean 44·5 days [SD 37·6] vs 42·8 days [37·2]; mean difference 1·8 days, 95% CI -1·0 to 4·5). By 6 months, despite an increase in survival (IPC 152·5 days [SD 60·6] vs no IPC 148·1 days [64·3]; mean difference 4·5 days, 95% CI -0·2 to 9·1), there was a non-significant increase in quality-adjusted survival associated with IPC (IPC 27·6 days [SD 40·6] vs no IPC 26·7 days [39·6]; mean difference 0·9 days, 95% CI -2·1 to 3·9). IPC is inexpensive, prevents deep vein thrombosis, improves survival but not functional outcomes, and does not lead to a significant gain in quality-adjusted survival. When deciding whether to treat patients with IPC, clinicians need to take into account all these potential effects. National Institute of Health Research Health Technology Assessment Programme, Chief Scientist Office of Scottish Government, and Covidien. Copyright © 2014 Dennis et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd. All rights reserved.

IPCS user's manual

DOE Office of Scientific and Technical Information (OSTI.GOV)

McGoldrick, P.R.

1980-12-11

The Interprocess Communications System (IPCS) was written to provide a virtual machine upon which the Supervisory Control and Diagnostic System (SCDS) for the Mirror Fusion Test Facility (MFTF) could be built. The hardware upon which the IPCS runs consists of nine minicomputers sharing some common memory.

Possible role of pannexin 1/P2x7 purinoceptor in neuroprotective mechanism of ischemic postconditioning in mice.

PubMed

Mahi, Namarta; Kumar, Amit; Jaggi, Amteshwar S; Singh, Nirmal; Dhawan, Ravi

2015-06-01

Previous studies have suggested a significant role of pannexin 1 (Panx1)/P2X7 receptor complex in cardioprotective mechanism of ischemic preconditioning and postconditioning (IPC). The present study has been undertaken to investigate whether Panx1/P2X7 purinoceptors are also involved in the neuroprotective mechanism of IPC in mice. Bilateral carotid artery occlusion (BCAO) for 12 min followed by reperfusion for 24 h was used to produce ischemia-reperfusion-induced cerebral injury in Swiss albino mice. For IPC immediately after BCAO of 12 min, three cycles of 10-s ischemia and reperfusion each were given and then prolonged reperfusion of 24 h was used. Cerebral infarct size was measured using triphenyltetrazolium chloride staining. Memory was evaluated using a Morris water maze test. Rotarod test, inclined beam walking test, and neurologic severity score (NSS) were used to assess motor dysfunction. Acetylcholine esterase levels, brain thiobarbituric acid reactive species, and glutathione level were also estimated. BCAO followed by reperfusion produced a significant increase in cerebral infarct size, NSS along with impairment of memory and motor dysfunction. It also increased brain acetylcholine esterase, thiobarbituric acid reactive species levels, and decreased the glutathione level. IPC produced a significant decrease in the cerebral infarct size and NSS along with reversal of ischemia-reperfusion-induced impairment of memory, motor dysfunction, and altered biochemical levels in the brain. IPC-induced neuroprotective effects were significantly abolished by pretreatment of mefloquine (15.0 mg/kg orally; 30.0 mg/kg orally), blocker of Panx1/P2X7 purinoceptor. Therefore, activation of Panx1/P2X7 purinoceptors appears to play a significant role in the neuroprotective mechanism of IPC. Copyright © 2015 Elsevier Inc. All rights reserved.

Role of phosphoinositide 3-kinase IA (PI3K-IA) activation in cardioprotection induced by ouabain preconditioning.

PubMed

Duan, Qiming; Madan, Namrata D; Wu, Jian; Kalisz, Jennifer; Doshi, Krunal Y; Haldar, Saptarsi M; Liu, Lijun; Pierre, Sandrine V

2015-03-01

Acute myocardial infarction, the clinical manifestation of ischemia-reperfusion (IR) injury, is a leading cause of death worldwide. Like ischemic preconditioning (IPC) induced by brief episodes of ischemia and reperfusion, ouabain preconditioning (OPC) mediated by Na/K-ATPase signaling protects the heart against IR injury. Class I PI3K activation is required for IPC, but its role in OPC has not been investigated. While PI3K-IB is critical to IPC, studies have suggested that ouabain signaling is PI3K-IA-specific. Hence, a pharmacological approach was used to test the hypothesis that OPC and IPC rely on distinct PI3K-I isoforms. In Langendorff-perfused mouse hearts, OPC was initiated by 4 min of ouabain 10 μM and IPC was triggered by 4 cycles of 5 min ischemia and reperfusion prior to 40 min of global ischemia and 30 min of reperfusion. Without affecting PI3K-IB, ouabain doubled PI3K-IA activity and Akt phosphorylation at Ser(473). IPC and OPC significantly preserved cardiac contractile function and tissue viability as evidenced by left ventricular developed pressure and end-diastolic pressure recovery, reduced lactate dehydrogenase release, and decreased infarct size. OPC protection was blunted by the PI3K-IA inhibitor PI-103, but not by the PI3K-IB inhibitor AS-604850. In contrast, IPC-mediated protection was not affected by PI-103 but was blocked by AS-604850, suggesting that PI3K-IA activation is required for OPC while PI3K-IB activation is needed for IPC. Mechanistically, PI3K-IA activity is required for ouabain-induced Akt activation but not PKCε translocation. However, in contrast to PKCε translocation which is critical to protection, Akt activity was not required for OPC. Further studies shall reveal the identity of the downstream targets of this new PI3K IA-dependent branch of OPC. These findings may be of clinical relevance in patients at risk for myocardial infarction with underlying diseases and/or medication that could differentially affect the integrity of cardiac PI3K-IA and IB pathways. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effects of ischemic preconditioning on PDGF-BB expression in the gerbil hippocampal CA1 region following transient cerebral ischemia

PubMed Central

Lee, Jae-Chul; Kim, Yang Hee; Lee, Tae-Kyeong; Kim, In Hye; Cho, Jeong Hwi; Cho, Geum-Sil; Shin, Bich-Na; Park, Joon Ha; Ahn, Ji Hyeon; Shin, Myoung Cheol; Cho, Jun Hwi; Kang, Il Jun; Won, Moo-Ho; Seo, Jeong Yeol

2017-01-01

Ischemic preconditioning (IPC) is induced by exposure to brief durations of transient ischemia, which results in ischemic tolerance to a subsequent longer or lethal period of ischemia. In the present study, the effects of IPC (2 min of transient cerebral ischemia) were examined on immunoreactivity of platelet-derived growth factor (PDGF)-BB and on neuroprotection in the gerbil hippocampal CA1 region following lethal transient cerebral ischemia (LTCI; 5 min of transient cerebral ischemia). IPC was subjected to a 2-min sublethal ischemia and a LTCI was given 5-min transient ischemia. The animals in all of the groups were given recovery times of 1, 2 and 5 days and change in PDGF-BB immunoreactivity was examined as was the neuronal damage/death in the hippocampus induced by LTCI. LTCI induced a significant loss of pyramidal neurons in the hippocampal CA1 region 5 days after LTCI, and significantly decreased PDGF-BB immunoreactivity in the CA1 pyramidal neurons from day 1 after LTCI. Conversely, IPC effectively protected the CA1 pyramidal neurons from LTCI and increased PDGF-BB immunoreactivity in the CA1 pyramidal neurons post-LTCI. In conclusion, the results demonstrated that LTCI significantly altered PDGF-BB immunoreactivity in pyramidal neurons in the hippocampal CA1 region, whereas IPC increased the immunoreactivity. These findings indicated that PDGF-BB may be associated with IPC-mediated neuroprotection. PMID:28627606

Behavioral medicine interventions for adult primary care settings: A review.

PubMed

Funderburk, Jennifer S; Shepardson, Robyn L; Wray, Jennifer; Acker, John; Beehler, Gregory P; Possemato, Kyle; Wray, Laura O; Maisto, Stephen A

2018-06-07

Health care organizations are embracing integrated primary care (IPC), in which mental health and behavioral health are addressed as part of routine care within primary care settings. Behavioral medicine concerns, which include health behavior change and coping with medical conditions, are common in primary care populations. Although there are evidence-based behavioral interventions that target a variety of behavioral medicine concerns, integrated behavioral health providers need interventions that are sufficiently brief (i.e., ≤6 appointments) to be compatible with IPC. We conducted a literature review of published studies examining behavioral interventions that target prevalent behavioral medicine concerns and can feasibly be employed by IPC providers in adult primary care settings. A total of 67 published articles representing 63 original studies met eligibility criteria. We extracted data on the behavioral interventions employed, results comparing the active intervention to a comparison group, general fit with IPC, and methodological quality. The vast majority of studies examined brief interventions targeting sleep difficulties and physical activity. The most commonly employed interventions were derived from cognitive-behavioral therapy and motivational interviewing. Outcomes were generally statistically significantly in favor of the active intervention relative to comparison, with highly variable methodological quality ratings (range = 0-5; M = 2.0). Results are discussed in relation to the need for further evidence for brief behavioral interventions targeting other behavioral medicine concerns beyond sleep and physical activity, as well as for more specificity regarding the compatibility of such interventions with IPC practice. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Effect of ischemic preconditioning on land-based sprinting in team-sport athletes.

PubMed

Gibson, Neil; White, James; Neish, Mhari; Murray, Andrew

2013-11-01

The study aimed to assess whether exposure to ischemic preconditioning (IPC) in a trained population would affect land-based maximal sprinting performance over 30 m. Twenty-five well-trained participants regularly involved in invasion-type team-sport events were recruited to take part in a randomized crossover study design. Participants underwent both an IPC and a placebo treatment involving 3 periods of 5-min occlusion applied unilaterally (3 × 5-min occlusion to each leg) at either 220 mmHg or 50 mmHg, respectively. Each period of occlusion was followed by 5 min of reperfusion. After treatment, 3 maximal sprints over a distance of 30 m were undertaken from a standing start interspersed with 1-min recovery. Split times were recorded at 10, 20, and 30 m. No significant effects of the IPC treatment were observed on sprint speed (P < .05) at any of the split timings; however, a small and negative effect was observed in female participants. Calculated effect sizes of the treatment were found to be trivial (<0.2). Results from the current study suggest there to be no benefit to team-sport players in using IPC as a means of enhancing sprint performance over a distance of 30 m. While IPC has been shown to be beneficial to sprint activities in other sports such as swimming, further research is required to elucidate whether this is the case over distances associated with land-based events in track and field or in events reliant on repeated-sprint ability.

Biocompatible interpolymer complex matrix tablets - an oral sustained release class-III antidiabetic drug

NASA Astrophysics Data System (ADS)

Ershadul Haque, S. K.; Sheela, A.

2017-11-01

Development of sustained release formulations of Metformin hydrochloride (Met) having low bioavailability and short half-life is one of the frontier areas of research towards achieving novel drug delivery systems. Towards the same, we have prepared interpolymer complexes (IPCs) of chitosan (CH) and two different viscosity grades of hydroxypropyl methylcellulose - HPMC (K4M and K100M) in various ratios, say, 4:6, 2:8, 1:9, respectively. The IPCs are characterized by Fourier transform infrared spectroscopy (FT-IR) and Thermo gravimetric analysis (TGA) techniques. Drug compatibility study is carried out by FT-IR and powder X-ray diffraction (XRD) techniques. The physical properties and drug content of formulated tablets are evaluated and found to be optimum. In addition, in vitro drug release kinetics is carried out at two different pH, say, 1.2 and 6.8. The release pattern from different polymeric matrices is shown in figure below: a) Chitosan, HPMC K4M and HPMC K100M b) IPCs of CH/HPMC K4M in [2:3, 1:4 and 1:9 ratios] c) IPCs of CH/HPMC K100M in [2:3, 1:4 and 1:9 ratios]. From the study, it has been observed that the drug release is sustained for a period of 12h in 1:9 ratio of CH: K100M IPC due to the formation of complex network matrix.

Nitric oxide, PKC-ε, and connexin43 are crucial for ischemic preconditioning-induced chemical gap junction uncoupling

PubMed Central

Sun, Tao; Hao, Li; Lin, Ming-Jie; Zhong, Jing-Quan

2016-01-01

Ischemic preconditioning (IPC) maintains connexin43 (Cx43) phosphorylation and reduces chemical gap junction (GJ) coupling in cardiomyocytes to protect against ischemic damage. However, the signal transduction pathways underlying these effects are not fully understood. Here, we investigated whether nitric oxide (NO) and protein kinase C-ε (PKC-ε) contribute to IPC-induced cardioprotection by maintaining Cx43 phosphorylation and inhibiting chemical GJ coupling. IPC reduced ischemia-induced myocardial infarction and increased cardiomyocyte survival; phosphorylated Cx43, eNOS, and PKC-ε levels; and chemical GJ uncoupling. Administration of the NO donor SNAP mimicked the effects of IPC both in vivo and in vitro, maintaining Cx43 phosphorylation, promoting chemical GJ uncoupling, and reducing myocardial infarction. Preincubation with the NO synthase inhibitor L-NAME or PKC-ε translocation inhibitory peptide (PKC-ε-TIP) abolished these effects of IPC. Additionally, by inducing NO production, IPC induced translocation of PKC-ε, but not PKC-δ, from the cytosolic to the membrane fraction in primary cardiac myocytes. IPC-induced cardioprotection thus involves increased NO production, PKC-ε translocation, Cx43 phosphorylation, and chemical GJ uncoupling. PMID:27655723

The functional performance of microencapsulated human pancreatic islet-derived precursor cells.

PubMed

Montanucci, Pia; Pennoni, Ilaria; Pescara, Teresa; Blasi, Paolo; Bistoni, Giovanni; Basta, Giuseppe; Calafiore, Riccardo

2011-12-01

We have examined long-term cultured, human islet-derived stem/precursor cells (hIPC). Whole human islets (HI) were obtained by multi-enzymatic digestion of cadaveric donor pancreases, plated on tissue flasks, and allowed to adhere and expand for several in vitro passages, in order to obtain hIPC. We detected specific stem cell markers (Oct-4, Sox-2, Nanog, ABCG2, Klf-4, CD117) in both intact HI and hIPC. Moreover, hIPC while retaining the expression of Glut-2, Pdx-1, CK-19, and ICA-512, started re-expressing Ngn3, thereby indicating acquisition of a specific pancreatic islet beta cell-oriented phenotype identity. The intrinsic plasticity of hIPC was documented by their ability to differentiate into various germ layer-derived cell phenotypes (ie, osteocytic, adipocytic and neural), including endocrine cells associated with insulin secretory capacity. To render hIPC suitable for transplantation we have enveloped them within our highly purified, alginate-based microcapsules. Upon intraperitoneal graft in NOD/SCID mice we have observed that the microcapsules acted as three-dimensional niches favouring post-transplant hIPC differentiation and acquisition of beta cell-like functional competence. Copyright © 2011 Elsevier Ltd. All rights reserved.

Drosophila insulin-producing cells are differentially modulated by serotonin and octopamine receptors and affect social behavior.

PubMed

Luo, Jiangnan; Lushchak, Oleh V; Goergen, Philip; Williams, Michael J; Nässel, Dick R

2014-01-01

A set of 14 insulin-producing cells (IPCs) in the Drosophila brain produces three insulin-like peptides (DILP2, 3 and 5). Activity in IPCs and release of DILPs is nutrient dependent and controlled by multiple factors such as fat body-derived proteins, neurotransmitters, and neuropeptides. Two monoamine receptors, the octopamine receptor OAMB and the serotonin receptor 5-HT1A, are expressed by the IPCs. These receptors may act antagonistically on adenylate cyclase. Here we investigate the action of the two receptors on activity in and output from the IPCs. Knockdown of OAMB by targeted RNAi led to elevated Dilp3 transcript levels in the brain, whereas 5-HT1A knockdown resulted in increases of Dilp2 and 5. OAMB-RNAi in IPCs leads to extended survival of starved flies and increased food intake, whereas 5-HT1A-RNAi produces the opposite phenotypes. However, knockdown of either OAMB or 5-HT1A in IPCs both lead to increased resistance to oxidative stress. In assays of carbohydrate levels we found that 5-HT1A knockdown in IPCs resulted in elevated hemolymph glucose, body glycogen and body trehalose levels, while no effects were seen after OAMB knockdown. We also found that manipulations of the two receptors in IPCs affected male aggressive behavior in different ways and 5-HT1A-RNAi reduced courtship latency. Our observations suggest that activation of 5-HT1A and OAMB signaling in IPCs generates differential effects on Dilp transcription, fly physiology, metabolism and social interactions. However the findings do not support an antagonistic action of the two monoamines and their receptors in this particular system.

SIMVASTATIN RESTORES ISCHEMIC PRECONDITIONING IN THE PRESENCE OF HYPERGLYCEMIA THROUGH A NITRIC OXIDE-MEDIATED MECHANISM

PubMed Central

Gu, Weidong; Kehl, Franz; Krolikowski, John G.; Pagel, Paul S.; Warltier, David C.; Kersten, Judy R.

2015-01-01

Background A growing body of evidence indicates that statins decrease perioperative cardiovascular risk and that these drugs may be particularly efficacious in diabetes. Diabetes or hyperglycemia abolish the cardioprotective effects of ischemic preconditioning (IPC). We tested the hypothesis that simvastatin restores the beneficial effects of IPC during hyperglycemia through a nitric oxide (NO)-mediated mechanism. Methods Myocardial infarct size was measured in dogs (n=76) subjected to coronary artery occlusion and reperfusion in the presence or absence of hyperglycemia (300 mg/dl) with or without IPC in separate groups. Additional dogs received simvastatin (20 mg orally daily for 3 days) in the presence or absence of IPC and hyperglycemia. Other dogs were pretreated with N-nitro-L-arginine methyl ester (L-NAME; 30 mg intracoronary) with or without IPC, hyperglycemia and simvastatin. Results IPC significantly (P<0.05) reduced infarct size (n=7, 7±2%) as compared to control (n=7, 29±3%). Hyperglycemia (n=7), simvastatin (n=7) and L-NAME alone (n=7), and simvastatin with hyperglycemia (n=6) did not alter infarct size. Hyperglycemia (n=7, 24±2%), but not L-NAME (n=5, 10±1%), blocked the protective effects of IPC. Simvastatin restored the protective effects of IPC in the presence of hyperglycemia (n=7, 14±1%), and this beneficial action was blocked by L-NAME (n=7, 29±4%). Conclusions The results indicate that simvastatin restored the cardioprotective effects of IPC during hyperglycemia by NO-mediated signaling. The results also suggest that enhanced cardioprotective signaling could be a mechanism for statin-induced decreases in perioperative cardiovascular risk. PMID:18362595

Do we really need to differentiate mesenchymal stem cells into insulin-producing cells for attenuation of the autoimmune responses in type 1 diabetes: immunoprophylactic effects of precursors to insulin-producing cells.

PubMed

Sharma, Anshu; Rani, Rajni

2017-07-12

Type 1 diabetes (T1D) is a multifactorial autoimmune disorder where pancreatic beta cells are lost before the clinical manifestations of the disease. Administration of mesenchymal stem cells (MSCs) or MSCs differentiated into insulin-producing cells (IPCs) have yielded limited success when used therapeutically. We have evaluated the immunoprophylactic potentials of precursors to insulin-producing cells (pIPCs) and IPCs in nonobese diabetic (NOD) mice to ask a basic question: do we need to differentiate MSCs into IPCs or will pIPCs suffice to attenuate autoimmune responses in T1D? Bone marrow-derived MSCs from Balb/c mice were characterized following the International Society for Cellular Therapy (ISCT) guidelines. MSCs cultured in high-glucose media for 11 to 13 passages were characterized for the expression of pancreatic lineage genes using real-time polymerase chain reaction. Expression of the PDX1 gene in pIPCs was assessed using Western blot and fluorescence-activated cell sorting (FACS). Triple-positive MSCs were differentiated into IPCs using a three-step protocol after sorting them for cell surface markers, i.e. CD29, CD44, and SCA-1. Nonobese diabetic mice were administered pIPCs, IPCs, or phosphate-buffered saline (PBS) into the tail vein at weeks 9 or 10 and followed-up for 29-30 weeks for fasting blood glucose levels. Two consecutive blood sugar levels of more than 250 mg/dl were considered diabetic. MSCs grown in high-glucose media for 11 to 13 passages expressed genes of the pancreatic lineage such as PDX1, beta2, neurogenin, PAX4, Insulin, and glucagon. Furthermore, Western blot and FACS analysis for PDX-1, a transcription factor necessary for beta cell maturation, confirmed that these cells were precursors of insulin-producing cells (pIPCs). NOD mice administered with pIPCs were better protected from developing diabetes with a protective efficacy of 78.4% (p < 0.009); however, administration of IPCs gave protective efficacy of 55% at the end of 28-30 weeks. Precursors to insulin-producing cells seem to have better potential to arrest autoimmune response in type 1 diabetes when administered before the onset of the disease in NOD mice. When translated to humans, autologous mesenchymal stem cells grown in high-glucose media for 10 to 13 passages may have beneficial effects in individuals at high risk of developing type 1 diabetes.

The Clots in Legs Or sTockings after Stroke (CLOTS) 3 trial: a randomised controlled trial to determine whether or not intermittent pneumatic compression reduces the risk of post-stroke deep vein thrombosis and to estimate its cost-effectiveness.

PubMed

Dennis, Martin; Sandercock, Peter; Graham, Catriona; Forbes, John; Smith, J

2015-09-01

Venous thromboembolism (VTE) is a common cause of death and morbidity in stroke patients. There are few data concerning the effectiveness of intermittent pneumatic compression (IPC) in treating patients with stroke. To establish whether or not the application of IPC to the legs of immobile stroke patients reduced their risk of deep vein thrombosis (DVT). Clots in Legs Or sTockings after Stroke (CLOTS) 3 was a multicentre, parallel-group, randomised controlled trial which allocated patients via a central randomisation system to IPC or no IPC. A technician blinded to treatment allocation performed compression duplex ultrasound (CDU) of both legs at 7-10 days and 25-30 days after enrolment. We followed up patients for 6 months to determine survival and later symptomatic VTE. Patients were analysed according to their treatment allocation. We enrolled 2876 patients in 94 UK hospitals between 8 December 2008 and 6 September 2012. patients admitted to hospital within 3 days of acute stroke and who were immobile on the day of admission (day 0) to day 3. age < 16 years; subarachnoid haemorrhage; and contra-indications to IPC including dermatitis, leg ulcers, severe oedema, severe peripheral vascular disease and congestive cardiac failure. Participants were allocated to routine care or routine care plus IPC for 30 days, or until earlier discharge or walking independently. The primary outcome was DVT in popliteal or femoral veins, detected on a screening CDU, or any symptomatic DVT in the proximal veins, confirmed by imaging, within 30 days of randomisation. The secondary outcomes included death, any DVTs, symptomatic DVTs, pulmonary emboli, skin breaks on the legs, falls with injury or fractures and duration of IPC use occurring within 30 days of randomisation and survival, symptomatic VTE, disability (as measured by the Oxford Handicap Scale), quality of life (as measured by the European Quality of Life-5 Dimensions 3 Level questionnaire) and length of initial hospital stay measured 6 months after randomisation. We allocated 1438 patients to IPC and 1438 to no IPC. The primary outcome occurred in 122 (8.5%) of 1438 patients allocated to IPC and 174 (12.1%) of 1438 patients allocated to no IPC, giving an absolute reduction in risk of 3.6% [95% confidence interval (CI) 1.4% to 5.8%] and a relative risk reduction of 0.69 (95% CI 0.55 to 0.86). After excluding 323 patients who died prior to any primary outcome and 41 who had no screening CDU, the primary outcome occurred in 122 of 1267 IPC participants compared with 174 of 1245 no-IPC participants, giving an adjusted odds ratio of 0.65 (95% CI 0.51 to 0.84; p = 0.001). Secondary outcomes in IPC compared with no-IPC participants were death in the treatment period in 156 (10.8%) versus 189 (13.1%) (p = 0.058); skin breaks in 44 (3.1%) versus 20 (1.4%) (p = 0.002); and falls with injury in 33 (2.3%) versus 24 (1.7%) (p = 0.221). Among patients treated with IPC, there was a statistically significant improvement in survival to 6 months (hazard ratio 0.86, 95% CI 0.73 to 0.99; p = 0.042), but no improvement in disability. The direct cost of preventing a DVT was £1282 per event (95% CI £785 to £3077). IPC is an effective and inexpensive method of reducing the risk of DVT and improving survival in immobile stroke patients. Further research should test whether or not IPC improves survival in other groups of high-risk hospitalised medical patients. In addition, research into methods to improve adherence to IPC might increase the benefits of IPC in stroke patients. Current Controlled Trials ISRCTN93529999. The start-up phase of the trial (December 2008-March 2010) was funded by the Chief Scientist Office of the Scottish Government (reference number CZH/4/417). The main phase of the trial was funded by the National Institute for Health Research Health Technology Assessment programme (reference number 08/14/03). Covidien Ltd (Mansfield, MA, USA) lent its Kendall SCD™ Express sequential compression system controllers to the 105 centres involved in the trial and donated supplies of its sleeves. It also provided logistical help in keeping our centres supplied with sleeves and training materials relevant to the use of their devices. Recruitment and follow-up were supported by the National Institute for Health Research-funded UK Stroke Research Network and by the Scottish Stroke Research Network, which was supported by NHS Research Scotland.

Mapping Electrical Crosstalk in Pixelated Sensor Arrays

NASA Technical Reports Server (NTRS)

Seshadri, S.; Cole, D. M.; Hancock, B. R.; Smith, R. M.

2008-01-01

Electronic coupling effects such as Inter-Pixel Capacitance (IPC) affect the quantitative interpretation of image data from CMOS, hybrid visible and infrared imagers alike. Existing methods of characterizing IPC do not provide a map of the spatial variation of IPC over all pixels. We demonstrate a deterministic method that provides a direct quantitative map of the crosstalk across an imager. The approach requires only the ability to reset single pixels to an arbitrary voltage, different from the rest of the imager. No illumination source is required. Mapping IPC independently for each pixel is also made practical by the greater S/N ratio achievable for an electrical stimulus than for an optical stimulus, which is subject to both Poisson statistics and diffusion effects of photo-generated charge. The data we present illustrates a more complex picture of IPC in Teledyne HgCdTe and HyViSi focal plane arrays than is presently understood, including the presence of a newly discovered, long range IPC in the HyViSi FPA that extends tens of pixels in distance, likely stemming from extended field effects in the fully depleted substrate. The sensitivity of the measurement approach has been shown to be good enough to distinguish spatial structure in IPC of the order of 0.1%.

The impact of economic recession on infection prevention and control.

PubMed

O'Riordan, M; Fitzpatrick, F

2015-04-01

The economic recession that began in 2007 led to austerity measures and public sector cutbacks in many European countries. Reduced resource allocation to infection prevention and control (IPC) programmes is impeding prevention and control of tuberculosis, HIV and vaccine-preventable infections. In addition, higher rates of infectious disease in the community have a significant impact on hospital services, although the extent of this has not been studied. With a focus on quick deficit reduction, preventive services such IPC may be regarded as non-essential. Where a prevention programme succeeds in reducing disease burden to a low level, its very success can undermine the perceived need for the programme. To mitigate the negative effects of recession, we need to: educate our political leaders about the economic benefits of IPC; better quantify the costs of healthcare-associated infection; and evaluate the effects of budget cuts on healthcare outcomes and IPC activities. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Insulin-producing cells could not mimic the physiological regulation of insulin secretion performed by pancreatic beta cells

PubMed Central

2013-01-01

Objective The aim of this study was to compare the difference between insulin-producing cells (IPCs) and normal human pancreatic beta cells both in physiological function and morphological features in cellular level. Methods The levels of insulin secretion were measured by enzyme-linked immunosorbent assay. The insulin gene expression was determined by real-time quantitative polymerase chain reaction. The morphological features were detected by atomic force microscopy (AFM) and laser confocal scanning microscopy. Results IPCs and normal human pancreatic beta cells were similar to each other under the observation in AFM with the porous structure features in the cytoplasm. Both number of membrane particle size and average roughness of normal human beta cells were higher than those of IPCs. Conclusions Our results firstly revealed that the cellular ultrastructure of IPCs was closer to that of normal human pancreatic beta cells, but they still could not mimic the physiological regulation of insulin secretion performed by pancreatic beta cells. PMID:23421382

Teacher Support as a Buffer between Interparental Conflict and Child Social Skills

ERIC Educational Resources Information Center

Spjeldnes, Solveig; Koeske, Gary; Sales, Esther

2010-01-01

This study, conducted in 2004, investigated the direct effect of interparental conflict (IPC) about child-raising issues on the social skills of middle-class US children who attended a suburban preschool and the buffering effect of teacher support (n = 170). Findings indicated that greater IPC was associated with poorer child social skills. The…

Modulation of the mitochondrial permeability transition pore complex in GSK-3beta-mediated myocardial protection.

PubMed

Nishihara, Masahiro; Miura, Tetsuji; Miki, Takayuki; Tanno, Masaya; Yano, Toshiyuki; Naitoh, Kazuyuki; Ohori, Katsuhiko; Hotta, Hiroyuki; Terashima, Yoshiaki; Shimamoto, Kazuaki

2007-11-01

Recently we found that the level of anti-infarct tolerance afforded by ischemic preconditioning (IPC) and erythropoietin (EPO) infusion was closely correlated with the level of Ser9-phospho-GSK-3beta upon reperfusion in the heart. To get an insight into the mechanism by which phospho-GSK-3beta protects the myocardium from ischemia/reperfusion injury, we examined the effects of IPC and EPO on interactions between GSK-3beta and subunits of the mitochondrial permeability transition pore (mPTP) in this study. Rat hearts were subjected to 25-min global ischemia and 5-min reperfusion in vitro with or without IPC plus EPO infusion (5 units/ml) before ischemia. Ventricular tissues were sampled before or after ischemia/reperfusion to separate subcellular fractions for immunoblotting and immunoprecipitation. Reperfusion increased mitochondrial GSK-3beta by 2-fold and increased phospho-GSK-3beta level in all fractions examined. Major subunits of mPTP, adenine nucleotide translocase (ANT) and voltage-dependent anion channel (VDAC), were co-immunoprecipitated with GSK-3beta after reperfusion. Phospho-GSK-3beta was co-immunoprecipitated with ANT but not with VDAC. IPC+EPO significantly increased the levels of GSK-3beta and phospho-GSK-3beta that were co-immunoprecipitated with ANT to 145+/-8% and 143+/-16%, respectively, of baseline but did not induce phospho-GSK-3beta-VDAC binding. A PKC inhibitor and a PI3 kinase inhibitor suppressed the IPC+EPO-induced increase in the level of phospho-GSK-3beta-ANT complex. The level of cyclophilin D co-immunoprecipitated with ANT after reperfusion was significantly reduced to 39+/-10% of the control by IPC+EPO. These results suggest that reduction in affinity of ANT to cyclophilin D by increased phospho-GSK-3beta binding to ANT may be responsible for suppression of mPTP opening and myocardial protection afforded by IPC+EPO.

Harassment and Violence Among Men Who Have Sex with Men (MSM) and Hijras After Reinstatement of India's "Sodomy Law".

PubMed

Li, Dennis H; Rawat, Shruta; Rhoton, Jayson; Patankar, Pallav; Ekstrand, Maria L; Simon Rosser, B R; Wilkerson, J Michael

2017-09-01

On December 11, 2013, the Indian Supreme Court recriminalized non-peno-vaginal sex under Sec. 377 of the Indian Penal Code (IPC), overturning a 2009 ruling that deemed IPC Sec. 377 unconstitutional. Similar "sodomy laws" in other countries have been associated with increased violence, harassment, and other discrimination against men who have sex with men (MSM) and transgender women. However, few studies have looked at the effects of such a law in an Indian context. This study examined experiences of victimization among MSM and hijra/transgender women (MSM-H) in the State of Maharashtra using a mixed-method approach. Data came from a quantitative survey and qualitative focus groups and interviews from an HIV prevention study as well as qualitative media and case reports from a local MSM-H-serving community-based organization. MSM-H in Maharashtra reported experiencing a high frequency of harassment, violence, and extortion, particularly from male sex partners met online and police. IPC Sec. 377 was implicated across qualitative sources as creating a culture of protection for harassment against MSM-H by being used directly as a tool for harassment, hindering victims of harassment from seeking legal recourse, and adversely impacting HIV and healthcare services. The reinstated IPC Sec. 377 may directly and indirectly facilitate negative health outcomes among MSM-H. Health agencies and advocates should continue to monitor the impact of IPC Sec. 377, incorporate rights-based approaches to protect MSM-H identities while addressing their health and well-being, and explore avenues to initiate discussions with the government to work toward repealing the law.

Time to diagnosis and treatment for cancer patients in the Netherlands: Room for improvement?

PubMed

Helsper, Charles C W; van Erp, Nicole N F; Peeters, Petra P H M; de Wit, Niek N J

2017-12-01

Reducing the duration of the diagnostic cancer care pathway is intensively pursued. The aim of this study was to chart the diagnostic pathway for the five most common cancers in the Netherlands. A retrospective cohort study using cancer patients' anonymised primary care data (free text and coded) linked to the Netherlands Cancer Registry. We determined the median duration of the following: 1. Primary care intervals (IPCs): the first cancer-related general practitioner consultation to referral, 2. Referral intervals (IRs): referral to diagnosis, 3. Treatment intervals (ITs): diagnosis to treatment and the overarching intervals, 4. Diagnostic intervals (IDs): IPC and IR combined and 5. Health care intervals (IHCs): IPC, IR and IT combined. For 465, 309, 197, 237 and 149 patients diagnosed with breast-, colorectal-, lung-, prostate cancer and melanoma, respectively; median IPC, IR and ID durations were shortest for breast cancer and melanoma (ID duration 7 and 21 days, respectively), intermediate for lung- and colon cancer (ID duration 49 and 54 days) and the longest for prostate cancer (ID duration 137 days). For all cancers, the duration of intervals increased steeply for the 10-25% with longest durations. For colorectal cancer, increasing ID durations showed increasing proportions of time attributable to primary care (IPC). Approximately 10-25% of cancer patients show substantially long duration of diagnostic intervals. Reducing primary care delay seems particularly relevant for colorectal cancer. Copyright © 2017 Elsevier Ltd. All rights reserved.

Repeated ischaemic preconditioning: a novel therapeutic intervention and potential underlying mechanisms.

PubMed

Thijssen, Dick H J; Maxwell, Joseph; Green, Daniel J; Cable, N Timothy; Jones, Helen

2016-06-01

What is the topic of this review? This review discusses the effects of repeated exposure of tissue to ischaemic preconditioning on cardiovascular function, the attendant adaptations and their potential clinical relevance. What advances does it highlight? We discuss the effects of episodic exposure to ischaemic preconditioning to prevent and/or attenuate ischaemic injury and summarize evidence pertaining to improvements in cardiovascular function and structure. Discussion is provided regarding the potential mechanisms that contribute to both local and systemic adaptation. Findings suggest that clinical benefits result from both the prevention of ischaemic events and the attenuation of their consequences. Ischaemic preconditioning (IPC) refers to the phenomenon whereby short periods of cyclical tissue ischaemia confer subsequent protection against ischaemia-induced injury. As a consequence, IPC can ameliorate the myocardial damage following infarction and can reduce infarct size. The ability of IPC to confer remote protection makes IPC a potentially feasible cardioprotective strategy. In this review, we discuss the concept that repeated exposure of tissue to IPC may increase the 'dose' of protection and subsequently lead to enhanced protection against ischaemia-induced myocardial injury. This may be relevant for clinical populations, who demonstrate attenuated efficacy of IPC to prevent or attenuate ischaemic injury (and therefore myocardial infarct size). Furthermore, episodic IPC facilitates repeated exposure to local (e.g. shear stress) and systemic stimuli (e.g. hormones, cytokines, blood-borne substances), which may induce improvement in vascular function and health. Such adaptation may contribute to prevention of cardio- and cerebrovascular events. The clinical benefits of repeated IPC may, therefore, result from both the prevention of ischaemic events and the attenuation of their consequences. We provide an overview of the literature pertaining to the impact of repeated IPC on cardiovascular function, related to both local and remote adaptation, as well as potential clinical implications. © 2016 The Authors. Experimental Physiology © 2016 The Physiological Society.

Payette River Basin Project: Improving Operational Forecasting in Complex Terrain through Chemistry

NASA Astrophysics Data System (ADS)

Blestrud, D.; Kunkel, M. L.; Parkinson, S.; Holbrook, V. P.; Benner, S. G.; Fisher, J.

2015-12-01

Idaho Power Company (IPC) is an investor owned hydroelectric based utility, serving customers throughout southern Idaho and eastern Oregon. The University of Arizona (UA) runs an operational 1.8-km resolution Weather and Research Forecast (WRF) model for IPC, which is incorporated into IPC near and real-time forecasts for hydro, solar and wind generation, load servicing and a large-scale wintertime cloud seeding operation to increase winter snowpack. Winter snowpack is critical to IPC, as hydropower provides ~50% of the company's generation needs. In efforts to improve IPC's near-term forecasts and operational guidance to its cloud seeding program, IPC is working extensively with UA and the National Center for Atmospheric Research (NCAR) to improve WRF performance in the complex terrain of central Idaho. As part of this project, NCAR has developed a WRF based cloud seeding module (WRF CS) to deliver high-resolution, tailored forecasts to provide accurate guidance for IPC's operations. Working with Boise State University (BSU), IPC is conducting a multiyear campaign to validate the WRF CS's ability to account for and disperse the cloud seeding agent (AgI) within the boundary layer. This improved understanding of how WRF handles the AgI dispersion and fate will improve the understanding and ultimately the performance of WRF to forecast other parameters. As part of this campaign, IPC has developed an extensive ground based monitoring network including a Remote Area Snow Sampling Device (RASSD) that provides spatially and temporally discrete snow samples during active cloud seeding periods. To quantify AgI dispersion in the complex terrain, BSU conducts trace element analysis using LA-ICP-MS on the RASSD sampled snow to provide measurements (at the 10-12 level) of incorporated AgI, measurements are compare directly with WRF CS's estimates of distributed AgI. Modeling and analysis results from previous year's research and plans for coming seasons will be presented.

Ischemic preconditioning enhances integrity of coronary endothelial tight junctions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Zhao; Jin, Zhu-Qiu, E-mail: zhu-qiu.jin@sdstate.edu

2012-08-31

Highlights: Black-Right-Pointing-Pointer Cardiac tight junctions are present between coronary endothelial cells. Black-Right-Pointing-Pointer Ischemic preconditioning preserves the structural and functional integrity of tight junctions. Black-Right-Pointing-Pointer Myocardial edema is prevented in hearts subjected to ischemic preconditioning. Black-Right-Pointing-Pointer Ischemic preconditioning enhances translocation of ZO-2 from cytosol to cytoskeleton. -- Abstract: Ischemic preconditioning (IPC) is one of the most effective procedures known to protect hearts against ischemia/reperfusion (IR) injury. Tight junction (TJ) barriers occur between coronary endothelial cells. TJs provide barrier function to maintain the homeostasis of the inner environment of tissues. However, the effect of IPC on the structure and function of cardiacmore » TJs remains unknown. We tested the hypothesis that myocardial IR injury ruptures the structure of TJs and impairs endothelial permeability whereas IPC preserves the structural and functional integrity of TJs in the blood-heart barrier. Langendorff hearts from C57BL/6J mice were prepared and perfused with Krebs-Henseleit buffer. Cardiac function, creatine kinase release, and myocardial edema were measured. Cardiac TJ function was evaluated by measuring Evans blue-conjugated albumin (EBA) content in the extravascular compartment of hearts. Expression and translocation of zonula occludens (ZO)-2 in IR and IPC hearts were detected with Western blot. A subset of hearts was processed for the observation of ultra-structure of cardiac TJs with transmission electron microscopy. There were clear TJs between coronary endothelial cells of mouse hearts. IR caused the collapse of TJs whereas IPC sustained the structure of TJs. IR increased extravascular EBA content in the heart and myocardial edema but decreased the expression of ZO-2 in the cytoskeleton. IPC maintained the structure of TJs. Cardiac EBA content and edema were reduced in IPC hearts. IPC enhanced the translocation of ZO-2 from cytosol to cytoskeleton. In conclusion, TJs occur in normal mouse heart. IPC preserves the integrity of TJ structure and function that are vulnerable to IR injury.« less

Promoting health workers' ownership of infection prevention and control: using Normalization Process Theory as an interpretive framework.

PubMed

Gould, D J; Hale, R; Waters, E; Allen, D

2016-12-01

All health workers should take responsibility for infection prevention and control (IPC). Recent reduction in key reported healthcare-associated infections in the UK is impressive, but the determinants of success are unknown. It is imperative to understand how IPC strategies operate as new challenges arise and threats of antimicrobial resistance increase. The authors undertook a retrospective, independent evaluation of an action plan to enhance IPC and 'ownership' (individual accountability) for IPC introduced throughout a healthcare organization. Twenty purposively selected informants were interviewed. Data were analysed inductively. Normalization Process Theory (NPT) was applied to interpret the findings and explain how the action plan was operating. Six themes emerged through inductive analysis. Theme 1: 'Ability to make sense of ownership' provided evidence of the first element of NPT (coherence). Regardless of occupational group or seniority, informants understood the importance of IPC ownership and described what it entailed. They identified three prerequisites: 'Always being vigilant' (Theme 2), 'Importance of access to information' (Theme 3) and 'Being able to learn together in a no-blame culture' (Theme 4). Data relating to each theme provided evidence of the other elements of NPT that are required to embed change: planning implementation (cognitive participation), undertaking the work necessary to achieve change (collective action), and reflection on what else is needed to promote change as part of continuous quality improvement (reflexive monitoring). Informants identified barriers (e.g. workload) and facilitators (clear lines of communication and expectations for IPC). Eighteen months after implementing the action plan incorporating IPC ownership, there was evidence of continuous service improvement and significant reduction in infection rates. Applying a theory that identifies factors that promote/inhibit routine incorporation ('normalization') of IPC into everyday health care can help explain the success of IPC initiatives and inform implementation. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Ischemic Preconditioning Confers Epigenetic Repression of Mtor and Induction of Autophagy Through G9a-Dependent H3K9 Dimethylation.

PubMed

Gidlöf, Olof; Johnstone, Andrea L; Bader, Kerstin; Khomtchouk, Bohdan B; O'Reilly, Jiaqi J; Celik, Selvi; Van Booven, Derek J; Wahlestedt, Claes; Metzler, Bernhard; Erlinge, David

2016-12-22

Ischemic preconditioning (IPC) protects the heart from prolonged ischemic insult and reperfusion injury through a poorly understood mechanism. Post-translational modifications of histone residues can confer rapid and drastic switches in gene expression in response to various stimuli, including ischemia. The aim of this study was to investigate the effect of histone methylation in the response to cardiac ischemic preconditioning. We used cardiac biopsies from mice subjected to IPC to quantify global levels of 3 of the most well-studied histone methylation marks (H3K9me2, H3K27me3, and H3K4me3) with Western blot and found that H3K9me2 levels were significantly increased in the area at risk compared to remote myocardium. In order to assess which genes were affected by the increase in H3K9me2 levels, we performed ChIP-Seq and transcriptome profiling using microarray. Two hundred thirty-seven genes were both transcriptionally repressed and enriched in H3K9me2 in the area at risk of IPC mice. Of these, Mtor (Mechanistic target of rapamycin) was chosen for mechanistic studies. Knockdown of the major H3K9 methyltransferase G9a resulted in a significant decrease in H3K9me2 levels across Mtor, increased Mtor expression, as well as decreased autophagic activity in response to rapamycin and serum starvation. IPC confers an increase of H3K9me2 levels throughout the Mtor gene-a master regulator of cellular metabolism and a key player in the cardioprotective effect of IPC-leading to transcriptional repression via the methyltransferase G9a. The results of this study indicate that G9a has an important role in regulating cardiac autophagy and the cardioprotective effect of IPC. © 2016 The Authors and University of Miami Miller School of Medicine. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Knowledge, awareness, and attitude regarding infection prevention and control among medical students: a call for educational intervention.

PubMed

Ibrahim, Awab Ali; Elshafie, Sittana Shamseldin

2016-01-01

Medical students can be exposed to serious health care-associated infections, if they are not following infection prevention and control (IPC) measures. There is limited information regarding the knowledge, awareness, and practices of medical students regarding IPC and the educational approaches used to teach them these practices. To evaluate the knowledge, awareness, and attitude of medical students toward IPC guidelines, and the learning approaches to help improve their knowledge. A cross-sectional, interview-based survey included 73 medical students from Weill Cornell Medical College, Qatar. Students completed a questionnaire concerning awareness, knowledge, and attitude regarding IPC practices. Students' knowledge was assessed by their correct answers to the survey questions. A total of 48.44% of the respondents were aware of standard isolation precautions, 61.90% were satisfied with their training in IPC, 66.13% were exposed to hand hygiene training, while 85.48% had sufficient knowledge about hand hygiene and practiced it on a routine basis, but only 33.87% knew the duration of the hand hygiene procedure. Knowledge, attitude, and awareness of IPC measures among Weill Cornell Medical Students in Qatar were found to be inadequate. Multifaceted training programs may have to target newly graduated medical practitioners or the training has to be included in the graduate medical curriculum to enable them to adopt and adhere to IPC guidelines.

Healthcare-associated infections in intensive care units: epidemiology and infection control in low-to-middle income countries.

PubMed

Alp, Emine; Damani, Nizam

2015-10-29

Healthcare-associated infections (HAIs) are major patient safety problems in hospitals, especially in intensive care units (ICUs). Patients in ICUs are prone to HAIs due to reduced host defense mechanisms, low compliance with infection prevention and control (IPC) measures due to lack of education and training, and heavy workload and low staffing levels, leading to cross-transmission of microorganisms from patient to patient. Patients with HAIs have prolonged hospital stays, and have high morbidity and mortality, thus adding economic burden on the healthcare system. For various reasons, in low-to-middle income countries (LMICs), the scale of the problem is huge; each year, many people die from HAIs. In this review, epidemiology of HAIs and infection prevention and control measures in ICUs is discussed, with especial emphasis on LMICs. High rates of HAIs caused by multidrug-resistant organisms (MDROs) are serious problems in ICUs in LMICs. In view of increasing prevalence of MDROs, LMICs should establish effective IPC infrastructure, appoint IPC teams, and provide adequate training and resources. These resources to establish and appoint IPC teams can be released by avoiding ritualistic, wasteful, and unsafe IPC practices, and by diverting resources to implement basic IPC measures, including early detection of infection, isolation of patients, application of appropriate IPC precautions, adherence to hand hygiene, and implementation of HAIs care bundles and basic evidence-based practices.

Knowledge, awareness, and attitude regarding infection prevention and control among medical students: a call for educational intervention

PubMed Central

Ibrahim, Awab Ali; Elshafie, Sittana Shamseldin

2016-01-01

Background Medical students can be exposed to serious health care-associated infections, if they are not following infection prevention and control (IPC) measures. There is limited information regarding the knowledge, awareness, and practices of medical students regarding IPC and the educational approaches used to teach them these practices. Aim To evaluate the knowledge, awareness, and attitude of medical students toward IPC guidelines, and the learning approaches to help improve their knowledge. Methods A cross-sectional, interview-based survey included 73 medical students from Weill Cornell Medical College, Qatar. Students completed a questionnaire concerning awareness, knowledge, and attitude regarding IPC practices. Students’ knowledge was assessed by their correct answers to the survey questions. Findings A total of 48.44% of the respondents were aware of standard isolation precautions, 61.90% were satisfied with their training in IPC, 66.13% were exposed to hand hygiene training, while 85.48% had sufficient knowledge about hand hygiene and practiced it on a routine basis, but only 33.87% knew the duration of the hand hygiene procedure. Conclusion Knowledge, attitude, and awareness of IPC measures among Weill Cornell Medical Students in Qatar were found to be inadequate. Multifaceted training programs may have to target newly graduated medical practitioners or the training has to be included in the graduate medical curriculum to enable them to adopt and adhere to IPC guidelines. PMID:27579002

4-AMINOBIPHENYL & DNA REACTIVITY: CASE STUDY WITHIN THE CONTEXT OF THE 2006 IPCS HUMAN RELEVANCE FRAMEWORK FOR ANALYSIS OF A CANCER MODE OF ACTION FOR HUMANS

EPA Science Inventory

The IPCS Human Relevance Framework was evaluated for a DNA-reactive (genotoxic) carcinogen, 4-aminobiphenyl, based on a wealth of data in animals and humans. The mode of action involves metabolic activation by N-hydroxylation, followed by N-esterification leading to the formation...

Interparental Conflict, Parenting, and Childhood Depression in a Diverse Urban Population: The Role of General Cognitive Style

ERIC Educational Resources Information Center

O'Donnell, Ellen H.; Moreau, Melissa; Cardemil, Esteban V.; Pollastri, Alisha

2010-01-01

Research on the mechanisms by which interparental conflict (IPC) affects child depression suggests that both parenting and children's conflict appraisals play important roles, but few studies have explored the role of general cognitive style or included both parenting and cognitions in the same design. Moreover, the effects of IPC on minority…

No effect of serotoninergic gene variants on response to interpersonal counseling and antidepressants in major depression.

PubMed

Serretti, Alessandro; Fabbri, Chiara; Pellegrini, Silvia; Porcelli, Stefano; Politi, Pierluigi; Bellino, Silvio; Menchetti, Marco; Mariotti, Veronica; Demi, Cristina; Martinelli, Valentina; Cappucciati, Marco; Bozzatello, Paola; Brignolo, Elena; Brambilla, Paolo; Pae, Chi-Un; Balestrieri, Matteo; De Ronchi, Diana

2013-06-01

Gene variants within the serotonin pathway have been associated with major depressive disorder (MDD) treatment outcomes, however a possible different modulation on pharmacological or psychological treatments has never been investigated. One hundred sixty MDD patients were partially randomized to either inter-personal counseling (IPC) or antidepressants. The primary outcome was remission at week 8. Five serotonergic polymorphisms were investigated (COMT rs4680, HTR1A rs6295, HTR2A rs2224721, HTR2A rs7997012 and SLC6A4 rs421417). IPC (n=43) and antidepressant (n=117) treated patients did not show any difference in remission rates at week 8 (corrected for baseline severity, age and center). None of the studied gene variants impacted on response and remission rates at week 8 neither in the IPC nor in the antidepressant group. An analysis of the whole sample showed a trend of association between rs7997012 AA genotype and a better treatment outcome. Our study confirms that IPC is an effective psychological intervention comparable to antidepressants in mild-moderate MDD. Polymorphisms related to the serotonin system did not exert a major effect on clinical outcomes in none of the treatment groups.

Effectiveness of intermittent pneumatic compression in reduction of risk of deep vein thrombosis in patients who have had a stroke (CLOTS 3): a multicentre randomised controlled trial.

PubMed

Dennis, M; Sandercock, P; Reid, J; Graham, C; Forbes, J; Murray, G

2013-08-10

Venous thromboembolism is a common, potentially avoidable cause of death and morbidity in patients in hospital, including those with stroke. In surgical patients, intermittent pneumatic compression (IPC) reduces the risk of deep vein thrombosis (DVT), but no reliable evidence exists about its effectiveness in patients who have had a stroke. We assessed the effectiveness of IPC to reduce the risk of DVT in patients who have had a stroke. The CLOTS 3 trial is a multicentre parallel group randomised trial assessing IPC in immobile patients (ie, who cannot walk to the toilet without the help of another person) with acute stroke. We enrolled patients from day 0 to day 3 of admission and allocated them via a central randomisation system (ratio 1:1) to receive either IPC or no IPC. A technician who was masked to treatment allocation did a compression duplex ultrasound (CDU) of both legs at 7-10 days and, wherever practical, at 25-30 days after enrolment. Caregivers and patients were not masked to treatment assignment. Patients were followed up for 6 months to determine survival and later symptomatic venous thromboembolism. The primary outcome was a DVT in the proximal veins detected on a screening CDU or any symptomatic DVT in the proximal veins, confirmed on imaging, within 30 days of randomisation. Patients were analysed according to their treatment allocation. ISRCTN93529999. Between Dec 8, 2008, and Sept 6, 2012, 2876 patients were enrolled in 94 centres in the UK. The included patients were broadly representative of immobile stroke patients admitted to hospital and had a median age of 76 years (IQR 67-84). The primary outcome occurred in 122 (8·5%) of 1438 patients allocated IPC and 174 (12·1%) of 1438 patients allocated no IPC; an absolute reduction in risk of 3·6% (95% CI 1·4-5·8). Excluding the 323 patients who died before any primary outcome and 41 without any screening CDU, the adjusted OR for the comparison of 122 of 1267 patients vs 174 of 1245 patients was 0·65 (95% CI 0·51-0·84; p=0·001). Deaths in the treatment period occurred in 156 (11%) patients allocated IPC and 189 (13%) patients allocated no IPC died within the 30 days of treatment period (p=0·057); skin breaks on the legs were reported in 44 (3%) patients allocated IPC and in 20 (1%) patients allocated no IPC (p=0·002); falls with injury were reported in 33 (2%) patients in the IPC group and in 24 (2%) patients in the no-IPC group (p=0·221). IPC is an effective method of reducing the risk of DVT and possibly improving survival in a wide variety of patients who are immobile after stroke. National Institute of Health Research (NIHR) Health Technology Assessment (HTA) programme, UK; Chief Scientist Office of Scottish Government; Covidien (MA, USA). Copyright © 2013 The Authors. Open Access article distributed under the terms of CC BY-NC-ND. Published by Elsevier Ltd. All rights reserved.

“I Can Only Work So Hard Before I Burn Out.” A Time Sensitive Conceptual Integration of Ideological Psychological Contract Breach, Work Effort, and Burnout

PubMed Central

Jones, Samantha K.; Griep, Yannick

2018-01-01

Employees often draw meaning from personal experiences and contributions in their work, particularly when engaging in organizational activities that align with their personal identity or values. However, recent empirical findings have demonstrated how meaningful work can also have a negative effect on employee’s well-being as employees feel so invested in their work, they push themselves beyond their limits resulting in strain and susceptibility to burnout. We develop a framework to understand this “double edged” role of meaningful work by drawing from ideological psychological contracts (iPCs), which are characterized by employees and their employer who are working to contribute to a shared ideology or set of values. Limited iPC research has demonstrated employees may actually work harder in response to an iPC breach. In light of these counterintuitive findings, we propose the following conceptual model to theoretically connect our understanding of iPCs, perceptions of breach, increases in work effort, and the potential “dark side” of repeated occurrences of iPC breach. We argue that time plays a central role in the unfolding process of employees’ reactions to iPC breach over time. Further, we propose how perceptions of iPC breach relate to strain and, eventually, burnout. This model contributes to our understanding of the role of time in iPC development and maintenance, expands our exploration of ideology in the PC literature, and provides a framework to understanding why certain occupations are more susceptible to instances of strain and burnout. This framework has the potential to guide future employment interventions in ideology-infused organizations to help mitigate negative employee outcomes. PMID:29479334

"I Can Only Work So Hard Before I Burn Out." A Time Sensitive Conceptual Integration of Ideological Psychological Contract Breach, Work Effort, and Burnout.

PubMed

Jones, Samantha K; Griep, Yannick

2018-01-01

Employees often draw meaning from personal experiences and contributions in their work, particularly when engaging in organizational activities that align with their personal identity or values. However, recent empirical findings have demonstrated how meaningful work can also have a negative effect on employee's well-being as employees feel so invested in their work, they push themselves beyond their limits resulting in strain and susceptibility to burnout. We develop a framework to understand this "double edged" role of meaningful work by drawing from ideological psychological contracts (iPCs), which are characterized by employees and their employer who are working to contribute to a shared ideology or set of values. Limited iPC research has demonstrated employees may actually work harder in response to an iPC breach. In light of these counterintuitive findings, we propose the following conceptual model to theoretically connect our understanding of iPCs, perceptions of breach, increases in work effort, and the potential "dark side" of repeated occurrences of iPC breach. We argue that time plays a central role in the unfolding process of employees' reactions to iPC breach over time. Further, we propose how perceptions of iPC breach relate to strain and, eventually, burnout. This model contributes to our understanding of the role of time in iPC development and maintenance, expands our exploration of ideology in the PC literature, and provides a framework to understanding why certain occupations are more susceptible to instances of strain and burnout. This framework has the potential to guide future employment interventions in ideology-infused organizations to help mitigate negative employee outcomes.

Protective effect of preconditioning and adenosine pretreatment in experimental skeletal muscle reperfusion injury.

PubMed

Papanastasiou, S; Estdale, S E; Homer-Vanniasinkam, S; Mathie, R T

1999-07-01

Prolonged ischaemia followed by reperfusion (I/R) of skeletal muscle results in significant tissue injury. Ischaemic preconditioning (IPC), achieved by repeated brief periods of I/R before prolonged ischaemia or adenosine pretreatment, can prevent I/R injury in cardiac muscle. The aim of this study was to ascertain in a rodent model if damage to skeletal muscle due to global hindlimb tourniquet-induced I/R could be similarly attenuated. Anaesthetized rats were randomized (n = 6-10 per group) to five groups: sham-operated controls; I/R (4 h of ischaemia, 2 h of reperfusion); IPC (three cycles of 10 min of ischaemia/10 min of reperfusion) alone; IPC immediately preceding I/R; or adenosine 1000 microg/kg immediately before I/R. At the end of reperfusion, biopsies were taken from the left gastrocnemius muscle for measurement of myeloperoxidase (MPO) and reduced glutathione (GSH). Before ischaemia and at the end of reperfusion, blood samples were taken for measurement of nitric oxide metabolites, tumour necrosis factor (TNF) alpha and macrophage inflammatory protein (MIP) 2. IPC before I/R resulted in lower levels of MPO (P < 0.001) and TNF-alpha (P = 0.004), and higher levels of GSH (P < 0.001) and nitric oxide metabolites (P = 0.002) than I/R alone. Adenosine had effects comparable to IPC pretreatment (P < 0.001 for MPO, P = 0.002 for GSH, P = 0.02 for nitric oxide metabolites and P = 0.001 for TNF-alpha). There was no difference in the blood pressure or the MIP-2 concentration among the groups. IPC or pretreatment with adenosine ameliorates the I/R injury of skeletal muscle.

Mesenchymal stem cells and differentiated insulin producing cells are new horizons for pancreatic regeneration in type I diabetes mellitus.

PubMed

Domouky, Ayat M; Hegab, Ashraf S; Al-Shahat, Amal; Raafat, Nermin

2017-06-01

Diabetes mellitus has become the third human killer following cancer and cardiovascular disease. Millions of patients, often children, suffer from type 1 diabetes (T1D). Stem cells created hopes to regenerate damaged body tissues and restore their function. This work aimed at clarifying and comparing the therapeutic potential of differentiated and non-differentiated mesenchymal stem cells (MSCs) as a new line of therapy for T1D. 40 Female albino rats divided into group I (control): 10 rats and group II (diabetic), III and IV, 10 rats in each, were injected with streptozotocin (50mg/kg body weight). Group III (MSCs) were transplanted with bone marrow derived MSCs from male rats and group IV (IPCs) with differentiated insulin producing cells. Blood and pancreatic tissue samples were taken from all rats for biochemical and histological studies. MSCs reduced hyperglycemia in diabetic rats on day 15 while IPCs normalizes blood glucose level on day 7. Histological and morphometric analysis of pancreas of experimental diabetic rats showed improvement in MSCs-treated group but in IPCs-treated group, β-cells insulin immunoreactions were obviously returned to normal, with normal distribution of β-cells in the center and other cells at the periphery. Meanwhile, most of the pathological lesions were still detected in diabetic rats. MSCs transplantation can reduce blood glucose level in recipient diabetic rats. IPCs initiate endogenous pancreatic regeneration by neogenesis of islets. IPCs are better than MSCs in regeneration of β-cells. So, IPCs therapy can be considered clinically to offer a hope for patients suffering from T1D. Copyright © 2017 Elsevier Ltd. All rights reserved.

B Lymphocyte intestinal homing in inflammatory bowel disease

PubMed Central

2011-01-01

Background Inflammatory bowel disease (IBD) is thought to be due to an abnormal interaction between the host immune system and commensal microflora. Within the intestinal immune system, B cells produce physiologically natural antibodies but pathologically atypical anti-neutrophil antibodies (xANCAs) are frequently observed in patients with IBD. The objective is to investigate the localisation of immunoglobulin-producing cells (IPCs) in samples of inflamed intestinal tissue taken from patients with IBD, and their possible relationship with clinical features. Methods The IPCs in small intestinal, colonic and rectal biopsy specimens of patients with IBD were analysed by means of immunofluorescence using polyclonal rabbit anti-human Ig and goat anti-human IgM. The B cell phenotype of the IPC-positive samples was assessed using monoclonal antibodies specific for CD79, CD20, CD23, CD21, CD5, λ and κ chains. Statistical correlations were sought between the histological findings and clinical expression. Results The study involved 96 patients (64 with ulcerative colitis and 32 with Crohn's disease). Two different patterns of B lymphocyte infiltrates were found in the intestinal tissue: one was characterised by a strong to moderate stromal localisation of small IgM+/CD79+/CD20-/CD21-/CD23-/CD5± IPCs (42.7% of cases); in the other (57.3%) no such small IPCs were detected in stromal or epithelial tissues. IPCs were significantly less frequent in the patients with Crohn's disease than in those with ulcerative colitis (p = 0.004). Conclusion Our findings suggest that different immunopathogenetic pathways underlie chronic intestinal inflammation with different clinical expressions. The presence of small B lymphocytes resembling B-1 cells also seemed to be negatively associated with Crohn's disease. It can therefore be inferred that the gut contains an alternative population of B cells that have a regulatory function. PMID:22208453

Role of Heat Shock Protein 90 and Endothelial Nitric Oxide Synthase during Early Anesthetic and Ischemic Preconditioning

PubMed Central

Amour, Julien; Brzezinska, Anna K.; Weihrauch, Dorothee; Billstrom, Amie R.; Zielonka, Jacek; Krolikowski, John G.; Bienengraeber, Martin W.; Warltier, David C.; Pratt, Philip F.; Kersten, Judy R.

2009-01-01

Background Nitric oxide is known to be essential for early anesthetic (APC) and ischemic (IPC) preconditioning of myocardium. Heat shock protein 90 (Hsp90) regulates endothelial nitric oxide synthase (eNOS) activity. In this study, we tested the hypothesis that Hsp90-eNOS interactions modulate APC and IPC. Methods Myocardial infarct size was measured in rabbits after coronary occlusion and reperfusion in the absence or presence of preconditioning with 30 min of isoflurane (APC) or 5 min of coronary artery occlusion (IPC), and with or without pre-treatment with geldanamycin or radicicol, two chemically distinct Hsp90 inhibitors, or NG-nitro-L-arginine methylester, a non-specific NOS inhibitor. Isoflurane-dependent nitric oxide production was measured (ozone chemiluminescence) in human coronary artery endothelial cells or mouse cardiomyocytes, in the absence or presence of Hsp90 inhibitors or NG-nitro-L-arginine methylester. Interactions between Hsp90 and eNOS, and eNOS activation were assessed with immunoprecipitation, immunoblotting, and confocal microscopy. Results APC and IPC decreased infarct size (50% and 59%, respectively) and this action was abolished by Hsp90 inhibitors. NG-nitro-L-arginine methylester blocked APC but not IPC. Isoflurane increased nitric oxide production in human coronary artery endothelial cells, concomitantly with an increase in Hsp90-eNOS interaction (immunoprecipitation, immunoblotting, and immunohistochemistry). Pretreatment with Hsp90 inhibitors abolished isoflurane-dependent nitric oxide production and decreased Hsp90-eNOS interactions. Isoflurane did not increase nitric oxide production in mouse cardiomyocytes and eNOS was below the level of detection. Conclusion The results indicate that Hsp90 plays a critical role in mediating APC and IPC through protein-protein interactions, and suggest that endothelial cells are important contributors to nitric oxide-mediated signalling during APC. PMID:19194158

Use of Interpersonal Counseling for Modern Type Depression.

PubMed

Ono, Hisae; Yamamoto, Ami; Taketani, Reiko; Tsujimoto, Emi

2017-01-01

A novel form of depression, called "modern type depression" (MTD), has been increasing in prevalence in Japan. Patients with MTD present with an overt appeal of depressive mood and a desire to be excused from their work duties; as such, this can cause considerable trouble in the workplace. Psychosocial interventions should be primarily considered for the treatment of MTD. Interpersonal counseling (IPC), which has proven effective for treating subthreshold depression, may be effective for MTD. However, IPC is rarely done in Japan. Herein, we report on a successful case of IPC for a woman in her thirties who was about to quit her job due to MTD (diagnosed by the criteria for research use). After IPC, the patient enjoyed good communication with her boss and continued her job without succumbing to her depression. This case suggests that IPC may be effective for MTD in workers and further highlights the benefits of teaching interpersonal communication methods in the workplace.

Grounding theories of W(e)Learn: a framework for online interprofessional education.

PubMed

Casimiro, Lynn; MacDonald, Colla J; Thompson, Terrie Lynn; Stodel, Emma J

2009-07-01

Interprofessional care (IPC) is a prerequisite for enhanced communication between healthcare team members, improved quality of care, and better outcomes for patients. A move to an IPC model requires changing the learning experiences of healthcare providers during and after their qualification program. With the rapid growth of online and blended approaches to learning, an educational framework that explains how to construct quality learning events to provide IPC is pressing. Such a framework would offer a quality standard to help educators design, develop, deliver, and evaluate online interprofessional education (IPE) programs. IPE is an extremely delicate process due to issues related to knowledge, status, power, accountability, personality traits, and culture that surround IPC. In this paper, a review of the pertinent literature that would inform the development of such a framework is presented. The review covers IPC, IPE, learning theories, and eLearning in healthcare.

[Effect of the ischemic post-conditioning on the prevention of the cardio-renal damage in patients with acute ST-segment elevation myocardial infarction after primary percutaneous coronary intervention].

PubMed

Wang, Y Y; Li, T; Liu, Y W; Liu, B J; Hu, X M; Wang, Y; Gao, W Q; Wu, P; Huang, L; Li, X; Peng, W J; Ning, M

2017-04-24

Objective: To evaluate the effect of the ischemic post-conditioning (IPC) on the prevention of the cardio-renal damage in patients with acute ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PPCI). Methods: A total of 251 consecutive STEMI patients underwent PPCI in the heart center of Tianjin Third Central Hospital from January 2012 to June 2014 were enrolled in this prospective, randomized, control, single-blinded, clinical registry study. Patients were randomly divided into IPC group (123 cases) and control group (128 cases) with random number table. Patients in IPC group underwent three times of inflation/deflation with low inflation pressure using a balloon catheter within one minute after culprit vessel blood recovery, and then treated by PPCI. Patients in control group received PPCI procedure directly. The basic clinical characteristics, incidence of reperfusion arrhythmia during the procedure, the rate of electrocardiogram ST-segment decline, peak value of myocardial necrosis markers, incidence of contrast induced acute kidney injury(CI-AKI), and one-year major adverse cardiovascular events(MACE) which including myocardial infarction again, malignant arrhythmia, rehospitalization for heart failure, repeat revascularization, stroke, and death after the procedure were analyzed between the two groups. Results: The age of IPC group and control group were comparable((61.2±12.6) vs. (64.2±12.1) years old, P =0.768). The incidence of reperfusion arrhythmia during the procedure was significantly lower in the IPC group than in the control group(42.28% (52/123) vs. 57.03% (73/128), P =0.023). The rate of electrocardiogram ST-segment decline immediately after the procedure was significantly higher in the IPC group than in the control group (77.24% (95/123) vs. 64.84% (83/128), P =0.037). The peak value of myocardial necrosis markers after the procedure were significantly lower in the IPC group than in the control group(creatine kinase: 1 257 (682, 2 202) U/L vs. 1 737(794, 2 816)U/L, P =0.029; creatine kinase-MB: 123(75, 218)U/L vs.165(95, 288)U/L, P =0.010). The rate of CI-AKI after the procedure was significantly lower in the IPC group than in the control group(5.69%(7/123) vs. 14.06%(18/128), P =0.034). The rate of the one-year MACE was significantly lower in the IPC group than in the control group(7.32%(9/123) vs. 15.63% (20/128), P =0.040). Conclusion: The IPC strategy performed eight before PPCI can reduce myocardial ischemia- reperfusion injury, decline the rates of CI-AKI and one-year MACE significantly in STEMI patients, thus has a significant protective effect on heart and kidney in STEMI patients. Clinical Trial Registration Chinese Clinical Trials Registry, ChiCTR-ICR-15006590.

Current status of personnel and infrastructure resources for infection prevention and control programs in the Republic of Korea: A national survey.

PubMed

Yoon, Young Kyung; Lee, Sung Eun; Seo, Beom Sam; Kim, Hyeon Jeong; Kim, Jong Hun; Yang, Kyung Sook; Kim, Min Ja; Sohn, Jang Wook

2016-11-01

There is significant variability in personnel and infrastructural resources for infection prevention and control (IPC) among health care institutions. The aim of this study is to evaluate the current status of individual hospital-based IPC programs in the Republic of Korea (ROK). A multicenter cross-sectional survey of 100 hospitals participating in the national surveillance programs for multidrug-resistant organisms (MDROs) in the ROK was conducted in September 2015. The survey consisted of 140 standardized Web-based questionnaires. The survey response rate was 41.0%. The responding hospitals are largely organized with multibed rooms, with an insufficient numbers of single rooms. Employment status of infection specialists and hand hygiene resources were better in larger hospitals. The responding hospitals had 1 full-time infection control nurse per 400.3 ± 154.1 beds, with wide variations in training and experience. Facilities have great diversity in their approach to preventing MDROs. There appeared to be no difference in supplies consumption and protocols for IPC among the hospitals, stratified according to size. A greater availability of specialist personnel, single rooms, and a comprehensive IPC program, with the support of a policy-oriented management, is necessary to achieve effective IPC. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Interactions between iron(III)-hydroxide polymaltose complex and commonly used medications / laboratory studies in rats.

PubMed

Funk, Felix; Canclini, Camillo; Geisser, Peter

2007-01-01

Simple iron salts, such as iron sulphate, often interact with food and other medications reducing bioavailability and tolerability. Iron(III)-hydroxide polymaltose complex (IPC, Maltofer) provides a soluble form of non-ionic iron, making it an ideal form of oral iron supplementation. The physicochemical properties of IPC predict a low potential for interactions. The effects of co-administration with aluminium hydroxide (CAS 21645-51-2), acetylsalicylic acid (CAS 50-78-2), bromazepam (CAS 1812-30-2), calcium acetate (CAS 62-54-4), calcium carbonate (CAS 471-34-1), auranofin (CAS 34031-32-8), magnesium-L-aspartate hydrochloride (CAS 28184-71-6), methyldopa sesquihydrate (CAS 41372-08-1), paracetamol (CAS 103-90-2), penicillamine (CAS 52-67-5), sulfasalazine (CAS 599-79-1), tetracycline hydrochloride (CAS 64-75-5), calcium phosphate (CAS 7757-93-9) in combination with vitamin D3 (CAS 67-97-0), and a multi-vitamin preparation were tested in rats fed an iron-deficient diet. Uptake of iron from radiolabelled IPC with and without concomitant medications was compared. None of the medicines tested had a significant effect on iron uptake. Iron-59 retrieval from blood and major storage organs was 64-76% for IPC alone compared with 59-85% following co-administration with other medications. It is concluded that, under normal clinical conditions, IPC does not interact with these medications.

Passivation effects on quantum dots prepared by successive ionic layer adsorption and reaction

NASA Astrophysics Data System (ADS)

Dai, Qilin; Maloney, Scott; Chen, Weimin; Poudyal, Uma; Wang, Wenyong

2016-06-01

ZnS is typically used to passivate semiconductor quantum dots (QDs) prepared by the successive ionic layer adsorption and reaction (SILAR) method for solar cell applications, while for colloidal QDs, organic ligands are usually used for this passivation purpose. In this study we utilized oleylamine and oleic acid ligands, besides ZnS, to passivate QDs prepared by the SILAR approach, and investigated their effects on the incident photon-to-current efficiency (IPCE) performance of the solar cells. It was observed that oleylamine passivation decreased device performance, while oleic acid passivation improved the IPCE of the cells. Redshift of the IPCE onset wavelength was also observed after oleic acid coating, which was attributed to the delocalization of excitons in the CdS QDs.

Ischemic preconditioning of the lower extremity attenuates the normal hypoxic increase in pulmonary artery systolic pressure.

PubMed

Foster, Gary P; Westerdahl, Daniel E; Foster, Laura A; Hsu, Jeffrey V; Anholm, James D

2011-12-15

Ischemic pre-condition of an extremity (IPC) induces effects on local and remote tissues that are protective against ischemic injury. To test the effects of IPC on the normal hypoxic increase in pulmonary pressures and exercise performance, 8 amateur cyclists were evaluated under normoxia and hypoxia (13% F(I)O(2)) in a randomized cross-over trial. IPC was induced using an arterial occlusive cuff to one thigh for 5 min followed by deflation for 5 min for 4 cycles. In the control condition, the resting pulmonary artery systolic pressure (PASP) increased from a normoxic value of 25.6±2.3 mmHg to 41.8±7.2 mmHg following 90 min of hypoxia. In the IPC condition, the PASP increased to only 32.4±3.1 mmHg following hypoxia, representing a 72.8% attenuation (p=0.003). No significant difference was detected in cycle ergometer time trial duration between control and IPC conditions with either normoxia or hypoxia. IPC administered prior to hypoxic exposure was associated with profound attenuation of the normal hypoxic increase of pulmonary artery systolic pressure. Published by Elsevier B.V.

F-111E IPCS in flight

NASA Technical Reports Server (NTRS)

1975-01-01

This NASA Dryden Flight Research Center photograph taken in 1975 shows the General Dynamic IPCS/F-111E Aardvark with a camouflage paint pattern. This prototype F-111E was used during the flight testing of the Integrated Propulsion Control System (IPCS). The wings of the IPCS/F-111E are swept back to near 60 degrees for supersonic flight. During the same period as F-111 TACT program, an F-111E Aardvark (#67-0115) was flown at the NASA Flight Research Center to investigate an electronic versus a conventional hydro-mechanical controlled engine. The program called integrated propulsion control system (IPCS) was a joint effort by NASA's Lewis Research Center and Flight Research Center, the Air Force's Flight Propulsion Laboratory and the Boeing, Honeywell and Pratt & Whitney companies. The left engine of the F-111E was selected for modification to an all electronic system. A Pratt & Whitney TF30-P-9 engine was modified and extensively laboratory, and ground-tested before installation into the F-111E. There were 14 IPCS flights made from 1975 through 1976. The flight demonstration program proved an engine could be controlled electronically, leading to a more efficient Digital Electronic Engine Control System flown in the F-15.

National infection prevention and control programmes: Endorsing quality of care.

PubMed

Stempliuk, Valeska; Ramon-Pardo, Pilar; Holder, Reynaldo

2014-01-01

Core components Health care-associated infections (HAIs) are a major cause of morbidity and mortality. In addition to pain and suffering, HAIs increase the cost of health care and generates indirect costs from loss of productivity for patients and society as a whole. Since 2005, the Pan American Health Organization has provided support to countries for the assessment of their capacities in infection prevention and control (IPC). More than 130 hospitals in 18 countries were found to have poor IPC programmes. However, in the midst of many competing health priorities, IPC programmes are not high on the agenda of ministries of health, and the sustainability of national programmes is not viewed as a key point in making health care systems more consistent and trustworthy. Comprehensive IPC programmes will enable countries to reduce the mobility, mortality and cost of HAIs and improve quality of care. This paper addresses the relevance of national infection prevention and control (NIPC) programmes in promoting, supporting and reinforcing IPC interventions at the level of hospitals. A strong commitment from national health authorities in support of national IPC programmes is crucial to obtaining a steady decrease of HAIs, lowering health costs due to HAIs and ensuring safer care.

PCL/PVA nanofibrous scaffold improve insulin-producing cells generation from human induced pluripotent stem cells.

PubMed

Abazari, Mohammad Foad; Soleimanifar, Fatemeh; Aleagha, Maryam Nouri; Torabinejad, Sepehr; Nasiri, Navid; Khamisipour, Gholamreza; Mahabadi, Javad Amini; Mahboudi, Hossein; Enderami, Seyed Ehsan; Saburi, Ehsan; Hashemi, Javad; Kehtari, Mousa

2018-05-31

Pancreatic differentiation of stem cells will aid treatment of patients with type I diabetes mellitus (T1DM). Synthetic biopolymers utilization provided extracellular matrix (ECM) and desired attributes in vitro to enhance conditions for stem cells proliferation, attachment and differentiation. A mixture of polycaprolactone and polyvinyl alcohol (PCL/PVA)-based scaffold, could establish an in vitro three-dimensional (3D) culture model. The objective of this study was investigation of the human induced pluripotent stem cells (hiPSCs) differentiation capacity to insulin-producing cells (IPCs) in 3D culture were compared with conventional culture (2D) groups evaluated at the mRNA and protein levels by quantitative PCR and immunofluorescence assay, respectively. The functionality of differentiated IPCs was assessed by C-peptide and insulin release in response to glucose stimulation test. Real-Time PCR results showed that iPSCs-IPCs expressed pancreas-specific transcription factors (Insulin, Pdx1, Glucagon, Glut2 and Ngn3). The expressions of these transcription factors in PCL/PVA scaffold were higher than 2D groups. In addition to IPCs specific markers were detected by immunochemistry. These cells in both groups secreted insulin and C-peptide in a glucose challenge test by ELISA showing in vitro maturation. The results of current study demonstrated that enhanced differentiation of IPCs from hiPSCs could be result of PCL/PVA nanofibrous scaffolds. In conclusion, this research could provide a new approach to beta-like cells replacement therapies and pancreatic tissue engineering for T1DM in the future. Copyright © 2017. Published by Elsevier B.V.

Initiation of a ring approach to infection prevention and control at non-Ebola health care facilities - Liberia, January-February 2015.

PubMed

Nyenswah, Tolbert; Massaquoi, Moses; Gbanya, Miatta Zenabu; Fallah, Mosoka; Amegashie, Fred; Kenta, Adolphus; Johnson, Kumblytee L; Yahya, Disu; Badini, Mehboob; Soro, Lacina; Pessoa-Silva, Carmem L; Roger, Isabelle; Selvey, Linda; VanderEnde, Kristin; Murphy, Matthew; Cooley, Laura A; Olsen, Sonja J; Christie, Athalia; Vertefeuille, John; Navin, Thomas; McElroy, Peter; Park, Benjamin J; Esswein, Eric; Fagan, Ryan; Mahoney, Frank

2015-05-15

From mid-January to mid-February 2015, all confirmed Ebola virus disease (Ebola) cases that occurred in Liberia were epidemiologically linked to a single index patient from the St. Paul Bridge area of Montserrado County. Of the 22 confirmed patients in this cluster, eight (36%) sought and received care from at least one of 10 non-Ebola health care facilities (HCFs), including clinics and hospitals in Montserrado and Margibi counties, before admission to an Ebola treatment unit. After recognition that three patients in this emerging cluster had received care from a non-Ebola treatment unit, and in response to the risk for Ebola transmission in non-Ebola treatment unit health care settings, a focused infection prevention and control (IPC) rapid response effort for the immediate area was developed to target facilities at increased risk for exposure to a person with Ebola (Ring IPC). The Ring IPC approach, which provided rapid, intensive, and short-term IPC support to HCFs in areas of active Ebola transmission, was an addition to Liberia's proposed longer term national IPC strategy, which focused on providing a comprehensive package of IPC training and support to all HCFs in the country. This report describes possible health care worker exposures to the cluster's eight patients who sought care from an HCF and implementation of the Ring IPC approach. On May 9, 2015, the World Health Organization (WHO) declared the end of the Ebola outbreak in Liberia.

Incremental change in cross sectional area in small endotracheal tubes: A call for more size options.

PubMed

Mortelliti, Caroline L; Mortelliti, Anthony J

2016-08-01

To elucidate the relatively large incremental percent change (IPC) in cross sectional area (CSA) in currently available small endotracheal tubes (ETTs), and to make recommendation for lesser incremental change in CSA in these smaller ETTs, in order to minimize iatrogenic airway injury. The CSAs of a commercially available line of ETTs were calculated, and the IPC of the CSA between consecutive size ETTs was calculated and graphed. The average IPC in CSA with large ETTs was applied to calculate identical IPC in the CSA for a theoretical, smaller ETT series, and the dimensions of a new theoretical series of proposed small ETTs were defined. The IPC of CSA in the larger (5.0-8.0 mm inner diameter (ID)) ETTs was 17.07%, and the IPC of CSA in the smaller ETTs (2.0-4.0 mm ID) is remarkably larger (38.08%). Applying the relatively smaller IPC of CSA from larger ETTs to a theoretical sequence of small ETTs, starting with the 2.5 mm ID ETT, suggests that intermediate sizes of small ETTs (ID 2.745 mm, 3.254 mm, and 3.859 mm) should exist. We recommend manufacturers produce additional small ETT size options at the intuitive intermediate sizes of 2.75 mm, 3.25 mm, and 3.75 mm ID in order to improve airway management for infants and small children. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A Qualitative Assessment of Participation in a Rapid Scale-Up, Diagonally-Integrated MDG-Related Disease Prevention Campaign in Rural Kenya

PubMed Central

Dye, Timothy De Ver; Apondi, Rose; Lugada, Eric

2011-01-01

Background Many countries face severe scale-up barriers toward achievement of MDGs. We ascertained motivational and experiential dimensions of participation in a novel, rapid, “diagonal” Integrated Prevention Campaign (IPC) in rural Kenya that provided prevention goods and services to 47,000 people within one week, aimed at rapidly moving the region toward MDG achievement. Specifically, the IPC provided interventions and commodities targeting disease burden reduction in HIV/AIDS, malaria, and water-borne illness. Methods Qualitative in-depth interviews (IDI) were conducted with 34 people (18 living with HIV/AIDS and 16 not HIV-infected) randomly selected from IPC attendees consenting to participate. Interviews were examined for themes and patterns to elucidate participant experience and motivation with IPC. Findings Participants report being primarily motivated to attend IPC to learn of their HIV status (through voluntary counseling and testing), and with receipt of prevention commodities (bednets, water filters, and condoms) providing further incentive. Participants reported that they were satisfied with the IPC experience and offered suggestions to improve future campaigns. Interpretation Learning their HIV status motivated participants along with the incentive of a wider set of commodities that were rapidly deployed through IPC in this challenging region. The critical role of wanting to know their HIV status combined with commodity incentives may offer a new model for rapid scaled-up of prevention strategies that are wider in scope in rural Africa. PMID:21267452

Sex-Specific Impact of Ischemic Preconditioning on Tissue Oxygenation and Maximal Concentric Force

PubMed Central

Paradis-Deschênes, Pénélope; Joanisse, Denis R.; Billaut, François

2017-01-01

Prior peripheral hypoxia induced via remote ischemic preconditioning (IPC) can improve physical performance in male athletes through improved O2 delivery and utilization. Since females may have an innate protective mechanism against ischemia-reperfusion injury, and since muscle metabolism during contraction differs between sexes, it is relevant to examine the impact of sex in response to IPC to determine whether it is also ergogenic in females. In a randomized, crossover, single-blind study, we investigated muscle performance, hemodynamic and O2 uptake in strength-trained males (n = 9) and females (n = 8) performing five sets of 5 maximum voluntary knee extensions on an isokinetic dynamometer, preceded by either IPC (3 × 5-min ischemia/5-min reperfusion cycles at 200 mmHg) or SHAM (20 mmHg). Changes in deoxy-hemoglobin (Δ[HHb], expressed in percentage of arterial occlusion and considered an index of O2 extraction), and total hemoglobin (Δ[THb]) concentrations of the vastus lateralis muscle were continuously monitored by near-infrared spectroscopy. The metabolic efficiency of the contractions was calculated as the average force/Δ[HHb]avg ratio. Cohen's effect sizes (ES) ± 90% confidence limits were used to estimate IPC-induced changes and sex differences. IPC increased total muscular force in males only (13.0%, ES 0.64, 0.37;0.90), and this change was greater than in females (10.4% difference, ES 0.40, 0.10;0.70). Percent force decrement was only attenuated in females (−19.8%, ES −0.38, −0.77;0.01), which was clearly different than males (sex difference: ES 0.45, −0.16;1.07). IPC also induced different changes between sexes for average muscle O2 uptake in set 2 (males: 6.4% vs. females: −16.7%, ES 0.21, −0.18;0.60), set 3 (males: 7.0% vs. females: −44.4%, ES 0.56, −0.17;1.29), set 4 (males: 9.1% vs. females: −40.2%, ES 0.51, −0.10;1.13), and set 5 (males: 10.2% vs. females: −40.4%, ES 0.52, −0.04;1.09). However, metabolic efficiency was not meaningfully different between conditions and sexes. IPC increased muscle blood volume (↑[THb]) at rest and during recovery between sets, to the same extent in both sexes. Despite a similar IPC-induced initial increase in O2 delivery in both sexes, males displayed greater peripheral O2 extraction and greater strength enhancement. This ergogenic effect appears to be mediated in part via an up regulated oxidative function in males. We conclude that strength-trained males might benefit more from IPC than their female counterparts during repeated, maximal efforts. PMID:28105020

Sex-Specific Impact of Ischemic Preconditioning on Tissue Oxygenation and Maximal Concentric Force.

PubMed

Paradis-Deschênes, Pénélope; Joanisse, Denis R; Billaut, François

2016-01-01

Prior peripheral hypoxia induced via remote ischemic preconditioning (IPC) can improve physical performance in male athletes through improved O 2 delivery and utilization. Since females may have an innate protective mechanism against ischemia-reperfusion injury, and since muscle metabolism during contraction differs between sexes, it is relevant to examine the impact of sex in response to IPC to determine whether it is also ergogenic in females. In a randomized, crossover, single-blind study, we investigated muscle performance, hemodynamic and O 2 uptake in strength-trained males ( n = 9) and females ( n = 8) performing five sets of 5 maximum voluntary knee extensions on an isokinetic dynamometer, preceded by either IPC (3 × 5-min ischemia/5-min reperfusion cycles at 200 mmHg) or SHAM (20 mmHg). Changes in deoxy-hemoglobin (Δ[HHb], expressed in percentage of arterial occlusion and considered an index of O 2 extraction), and total hemoglobin (Δ[THb]) concentrations of the vastus lateralis muscle were continuously monitored by near-infrared spectroscopy. The metabolic efficiency of the contractions was calculated as the average force/Δ[HHb] avg ratio. Cohen's effect sizes (ES) ± 90% confidence limits were used to estimate IPC-induced changes and sex differences. IPC increased total muscular force in males only (13.0%, ES 0.64, 0.37;0.90), and this change was greater than in females (10.4% difference, ES 0.40, 0.10;0.70). Percent force decrement was only attenuated in females (-19.8%, ES -0.38, -0.77;0.01), which was clearly different than males (sex difference: ES 0.45, -0.16;1.07). IPC also induced different changes between sexes for average muscle O 2 uptake in set 2 (males: 6.4% vs. females: -16.7%, ES 0.21, -0.18;0.60), set 3 (males: 7.0% vs. females: -44.4%, ES 0.56, -0.17;1.29), set 4 (males: 9.1% vs. females: -40.2%, ES 0.51, -0.10;1.13), and set 5 (males: 10.2% vs. females: -40.4%, ES 0.52, -0.04;1.09). However, metabolic efficiency was not meaningfully different between conditions and sexes. IPC increased muscle blood volume (↑[THb]) at rest and during recovery between sets, to the same extent in both sexes. Despite a similar IPC-induced initial increase in O 2 delivery in both sexes, males displayed greater peripheral O 2 extraction and greater strength enhancement. This ergogenic effect appears to be mediated in part via an up regulated oxidative function in males. We conclude that strength-trained males might benefit more from IPC than their female counterparts during repeated, maximal efforts.

The role of 17-beta estradiol in ischemic preconditioning protection of the heart.

PubMed

Babiker, Fawzi A; Hoteit, Lamia J; Joseph, Shaji; Mustafa, Abu Salim; Juggi, Jasbir S

2012-09-01

The protective effects of 17-beta estradiol (E2) on cardiac tissue during ischemia/reperfusion (I/R) injury have not yet been fully elucidated. To assess the protective effects of short- and long-term E2 treatments on cardiac tissue exposed to I/R, and to assess the effects of these treatments in combination with ischemic preconditioning (IPC) on cardiac protection from I/R injury. SPRAGUE DAWLEY RATS WERE ASSIGNED TO THE FOLLOWING TREATMENT PROTOCOLS: control (no preconditioning); IPC (isolated hearts were subjected to two cycles of 5 min global ischemia followed by 10 min of reperfusion); E2 preconditioning (E2PC; isolated hearts were subjected to E2 pharmacological perfusion for 15 min); short-term in vivo E2 pretreatment for 3 h; long-term in vivo E2 pretreatment or withdrawal (ovariectomy followed by a six-week treatment with E2 or a placebo); combined IPC and E2PC; combined IPC and short- or long-term E2 pretreatments or withdrawal. All hearts were isolated and stabilized for at least 30 min before being subjected to 40 min of global ischemia followed by 30 min of reperfusion; left ventricular function and vascular hemodynamics were then assessed. IPC, E2PC and short-term E2 pretreatment led to the recovery of left ventricle function and vascular hemodynamics. Long-term E2 and placebo treatments did not result in any protection compared with untreated controls. The combination of E2PC or short-term E2 treatments with IPC did not block the IPC protection or result in any additional protection to the heart. Long-term E2 treatment blocked IPC protection; however, placebo treatment did not. Short-term treatment with E2 protected the heart against I/R injury through a pathway involving the regulation of tumour necrosis factor-alpha. The combination of short-term E2 treatment with IPC did not provide additional protection to the heart. Short-term E2 treatment may be a suitable alternative for classical estrogen replacement therapy.

Ischemic preconditioning increases GSK-3β/β-catenin levels and ameliorates liver ischemia/reperfusion injury in rats.

PubMed

Yan, Yichao; Li, Guangying; Tian, Xiaofeng; Ye, Yingjiang; Gao, Zhidong; Yao, Jihong; Zhang, Feng; Wang, Shan

2015-06-01

Ischemic preconditioning (IPC) ameliorates ischemia/reperfusion (I/R) injury in a number of organs, and the glycogen synthase kinase-3β (GSK-3β)/β-catenin signaling pathway regulates I/R-induced proliferation and apoptosis in the central nervous system and heart. However, the function of this signaling pathway in IPC during liver I/R remains unclear. Thus, in this study, we aimed to investigte the role of the GSK-3β/β-catenin pathway during I/R and following ischemic preconditioning. For this purpose, 30 Sprague-Dawley rats were randomly divided into the sham-operated, the I/R and the IPC groups (n=10). Following reperfusion, liver pathology, as well as alanine aminotransferase (ALT), aspartate aminotransferase (AST), maleic dialdehyde (MDA) and superoxide dismutase (SOD) levels were assessed. Western blot analysis was performed to quantify the GSK-3β, Ser9-phospho-GSK-3β (p-GSK-3β), cytosolic and nuclear β-catenin, vascular endothelial growth factor (VEGF), Bcl-2 and survivin levels. In addition, the Bcl-2 and survivin mRNA levels were assessed by RT-qPCR. Compared with the sham-operated group, I/R increased serum ALT, AST and MDA activity and decreased SOD levels, while IPC significantly decreased serum ALT, AST and MDA activity and increased SOD levels, compared with the I/R group. Simultaneously, I/R increased p-GSK-3β protein expression, and decreased Bcl-2 and survivin protein and mRNA levels. IPC further increased the protein expression of p-GSK-3β, and also increased cytosolic and nuclear β-catenin and VEGF expression compared with the I/R group; the expression of Bcl-2 and survivin was also increased by IPC, both at the mRNA and protein level. The total GSK-3β expression remained unaltered in all the groups. In conclusion, our data demonstrate that IPC exerts protective effects against liver injury induced by I/R and activates the GSK-3β/β-catenin signaling pathway.

Protocol of the Australasian Malignant Pleural Effusion (AMPLE) trial: a multicentre randomised study comparing indwelling pleural catheter versus talc pleurodesis

PubMed Central

Fysh, Edward T H; Thomas, Rajesh; Read, Catherine A; Lam, Ben C H; Yap, Elaine; Horwood, Fiona C; Lee, Pyng; Piccolo, Francesco; Shrestha, Ranjan; Garske, Luke A; Lam, David C L; Rosenstengel, Andrew; Bint, Michael; Murray, Kevin; Smith, Nicola A; Lee, Y C Gary

2014-01-01

Introduction Malignant pleural effusion can complicate most cancers. It causes breathlessness and requires hospitalisation for invasive pleural drainages. Malignant effusions often herald advanced cancers and limited prognosis. Minimising time spent in hospital is of high priority to patients and their families. Various treatment strategies exist for the management of malignant effusions, though there is no consensus governing the best choice. Talc pleurodesis is the conventional management but requires hospitalisation (and substantial healthcare resources), can cause significant side effects, and has a suboptimal success rate. Indwelling pleural catheters (IPCs) allow ambulatory fluid drainage without hospitalisation, and are increasingly employed for management of malignant effusions. Previous studies have only investigated the length of hospital care immediately related to IPC insertion. Whether IPC management reduces time spent in hospital in the patients’ remaining lifespan is unknown. A strategy of malignant effusion management that reduces hospital admission days will allow patients to spend more time outside hospital, reduce costs and save healthcare resources. Methods and analysis The Australasian Malignant Pleural Effusion (AMPLE) trial is a multicentred, randomised trial designed to compare IPC with talc pleurodesis for the management of malignant pleural effusion. This study will randomise 146 adults with malignant pleural effusions (1:1) to IPC management or talc slurry pleurodesis. The primary end point is the total number of days spent in hospital (for any admissions) from treatment procedure to death or end of study follow-up. Secondary end points include hospital days specific to pleural effusion management, adverse events, self-reported symptom and quality-of-life scores. Ethics and dissemination The Sir Charles Gairdner Group Human Research Ethics Committee has approved the study as have the ethics boards of all the participating hospitals. The trial results will be published in peer-reviewed journals and presented at scientific conferences. Trial registration numbers Australia New Zealand Clinical Trials Registry—ACTRN12611000567921; National Institutes of Health—NCT02045121. PMID:25377015

Demographics and the correlation between irrational parenthood cognitions and marital relationship quality in infertile women in Zanjan province in 2016.

PubMed

Safaei Nezhad, Arezoo; Vakili, Mohammad Masoud; Ebrahimi, Loghman; Kharaghani, Roghieh

2018-06-11

The study determined the correlation between Irrational Parenthood Cognitions (IPC) and marital quality by demographic variables in infertile women. A correlational study with a census method was conducted on all primary infertile women, who had a file in Zanjan, Iran. A 47% significant positive correlation was showed between IPC and marital quality (p < 0.001). The highest correlation was observed in the subsets of women aged 31-40 years, with high level of education, those at third socioeconomic classes, those with less than 10 years of married life, and women whose husband had no children from their previous marriage (all ps < 0.05). Providing counseling services to women with primary infertility, especially high-risk women may help to reduce IPC and to improve marital quality. © 2018 Wiley Periodicals, Inc.

A survey of Canadian regulated complementary and alternative medicine schools about research, evidence-based health care and interprofessional training, as well as continuing education

PubMed Central

2013-01-01

Background While some effort has been made to integrate complementary and alternative medicine (CAM) information in conventional biomedical training, it is unclear whether regulated Canadian CAM schools’ students are exposed to research activities and continuing education, or whether topics such as evidence-based health care and interprofessional collaboration (IPC) are covered during their training. Since these areas are valued by the biomedical training field, this may help to bridge the attitudinal and communication gaps between these different practices. The aim of this study was to describe the training offered in these areas and gather the perceptions of curriculum/program directors in regulated Canadian CAM schools. Methods A two-phase study consisting of an electronic survey and subsequent semi-structured telephone interviews was conducted with curriculum/program (C/P) directors in regulated Canadian CAM schools. Questions assessed the extent of the research, evidence-based health care, IPC training and continuing education, as well as the C/P directors’ perceptions about the training. Descriptive statistics were used to describe the schools’, curriculum’s and the C/P directors’ characteristics. Content analysis was conducted on the interview material. Results Twenty-eight C/P directors replied to the electronic survey and 11 participated in the interviews, representing chiropractic, naturopathy, acupuncture and massage therapy schools. Canadian regulated CAM schools offered research and evidence-based health care training as well as opportunities for collaboration with biomedical peers and continuing education to a various extent (58% to 91%). Although directors were generally satisfied with the training offered at their school, they expressed a desire for improvements. They felt future CAM providers should understand research findings and be able to rely on high quality research and to communicate with conventional care providers as well as to engage in continuing education. Limited length of the curriculum was one of the barriers to such improvements. Conclusions These findings seem to reinforce the directors’ interest and the importance of integrating these topics in order to ensure best CAM practices and improve communication between CAM and conventional providers. PMID:24373181

Implementation of internal model based control and individual pitch control to reduce fatigue loads and tower vibrations in wind turbines

NASA Astrophysics Data System (ADS)

Mohammadi, Ebrahim; Fadaeinedjad, Roohollah; Moschopoulos, Gerry

2018-05-01

Vibration control and fatigue loads reduction are important issues in large-scale wind turbines. Identifying the vibration frequencies and tuning dampers and controllers at these frequencies are major concerns in many control methods. In this paper, an internal model control (IMC) method with an adaptive algorithm is implemented to first identify the vibration frequency of the wind turbine tower and then to cancel the vibration signal. Standard individual pitch control (IPC) is also implemented to compare the performance of the controllers in term of fatigue loads reduction. Finally, the performance of the system when both controllers are implemented together is evaluated. Simulation results demonstrate that using only IMC or IPC alone has advantages and can reduce fatigue loads on specific components. IMC can identify and suppress tower vibrations in both fore-aft and side-to-side directions, whereas, IPC can reduce fatigue loads on blades, shaft and yaw bearings. When both IMC and IPC are implemented together, the advantages of both controllers can be used. The aforementioned analysis and comparisons were not studied in literature and this study fills this gap. FAST, AreoDyn and Simulink are used to simulate the mechanical, aerodynamic and electrical aspects of wind turbine.

Phonetic complexity and stuttering in Spanish

PubMed Central

Howell, Peter; Au-Yeung, James

2007-01-01

The current study investigated whether phonetic complexity affected stuttering rate for Spanish speakers. The speakers were assigned to three age groups (6-11, 12-17 and 18 years plus) that were similar to those used in an earlier study on English. The analysis was performed using Jakielski's (1998) Index of Phonetic Complexity (IPC) scheme in which each word is given an IPC score based on the number of complex attributes it includes for each of eight factors. Stuttering on function words for Spanish did not correlate with IPC score for any age group. This mirrors the finding for English that stuttering on these words is not affected by phonetic complexity. The IPC scores of content words correlated positively with stuttering rate for 6-11 year old and adult speakers. Comparison was made between the languages to establish whether or not experience with the factors determines the problem they pose for speakers (revealed by differences in stuttering rate). Evidence was obtained that four factors found to be important determinants of stuttering on content words in English for speakers aged 12 and above, also affected Spanish speakers. This occurred despite large differences in frequency of usage of these factors. It is concluded that phonetic factors affect stuttering rate irrespective of a speaker's experience with that factor. PMID:17364620

Phonetic complexity and stuttering in Spanish.

PubMed

Howell, Peter; Au-Yeung, James

2007-02-01

The current study investigated whether phonetic complexity affected stuttering rate for Spanish speakers. The speakers were assigned to three age groups (6-11, 12-17 and 18-years plus) that were similar to those used in an earlier study on English. The analysis was performed using Jakielski's Index of Phonetic Complexity (IPC) scheme in which each word is given an IPC score based on the number of complex attributes it includes for each of eight factors. Stuttering on function words for Spanish did not correlate with IPC score for any age group. This mirrors the finding for English that stuttering on these words is not affected by phonetic complexity. The IPC scores of content words correlated positively with stuttering rate for 6-11-year-old and adult speakers. Comparison was made between the languages to establish whether or not experience with the factors determines the problem they pose for speakers (revealed by differences in stuttering rate). Evidence was obtained that four factors found to be important determinants of stuttering on content words in English for speakers aged 12 and above, also affected Spanish speakers. This occurred despite large differences in frequency of usage of these factors. It is concluded that phonetic factors affect stuttering rate irrespective of a speaker's experience with that factor.

No Effect of Serotoninergic Gene Variants on Response to Interpersonal Counseling and Antidepressants in Major Depression

PubMed Central

Fabbri, Chiara; Pellegrini, Silvia; Porcelli, Stefano; Politi, Pierluigi; Bellino, Silvio; Menchetti, Marco; Mariotti, Veronica; Demi, Cristina; Martinelli, Valentina; Cappucciati, Marco; Bozzatello, Paola; Brignolo, Elena; Brambilla, Paolo; Pae, Chi-Un; Balestrieri, Matteo; De Ronchi, Diana

2013-01-01

Objective Gene variants within the serotonin pathway have been associated with major depressive disorder (MDD) treatment outcomes, however a possible different modulation on pharmacological or psychological treatments has never been investigated. Methods One hundred sixty MDD patients were partially randomized to either inter-personal counseling (IPC) or antidepressants. The primary outcome was remission at week 8. Five serotonergic polymorphisms were investigated (COMT rs4680, HTR1A rs6295, HTR2A rs2224721, HTR2A rs7997012 and SLC6A4 rs421417). Results IPC (n=43) and antidepressant (n=117) treated patients did not show any difference in remission rates at week 8 (corrected for baseline severity, age and center). None of the studied gene variants impacted on response and remission rates at week 8 neither in the IPC nor in the antidepressant group. An analysis of the whole sample showed a trend of association between rs7997012 AA genotype and a better treatment outcome. Conclusion Our study confirms that IPC is an effective psychological intervention comparable to antidepressants in mild-moderate MDD. Polymorphisms related to the serotonin system did not exert a major effect on clinical outcomes in none of the treatment groups. PMID:23798967

Use of an Internal Positive Control in a Multiplex Reverse Transcription-PCR To Detect West Nile Virus RNA in Mosquito Pools

PubMed Central

Eisler, Diane L.; McNabb, Alan; Jorgensen, Danielle R.; Isaac-Renton, Judith L.

2004-01-01

We report on the use of West Nile virus Armored RNA as an internal positive control (IPC) for the extraction and reverse transcription-PCR (RT-PCR) of RNA extracted from field-collected mosquitoes and on a multiplex real-time Taqman RT-PCR to simultaneously detect the 3′ noncoding region of West Nile virus and the West Nile virus NS5-2 region comprising the IPC. Mosquito pools from the province of British Columbia, Canada (n = 635), were tested in duplicate and found to be negative for West Nile virus and positive for the IPC. Known West Nile virus-positive supernatants from mosquito pools from the provinces of Alberta and Manitoba were tested in duplicate and found to be positive for both regions of the West Nile virus genome. The mean cycle threshold (Ct) value for the IPC in batch extraction controls ± 2 standard deviations was found to be 36.43 ± 1.78 cycles. IPCs of 98.4% (624) of West Nile virus-negative pools fell within this range, indicating the reproducibility of RNA extraction and RT-PCR for pools varying in mosquito genus and number. A comparison of mosquito pool genera revealed no significant genus effect on the Ct value of the IPC. The incorporation of West Nile virus Armored RNA as an IPC allows monitoring of RNA extraction and RT-PCR and detection of false-negative results due to failures in these processes or to PCR inhibition, respectively. PMID:14766868

Stromal cell derived factor-1alpha protects stem cell derived insulin-producing cells from glucotoxicity under high glucose conditions in-vitro and ameliorates drug induced diabetes in rats

PubMed Central

2013-01-01

Background Diabetes mellitus is affecting more than 300 million people worldwide. Current treatment strategies cannot prevent secondary complications. Stem cells due to their regenerative power have long been the attractive target for the cell-based therapies. Mesenchymal stem cells (MSCs) possess the ability to differentiate into several cell types and to escape immune recognition in vitro. MSCs can be differentiated into insulin-producing cells (IPCs) and could be an exciting therapy for diabetes but problems like poor engraftment and survivability need to be confronted. It was hypothesized that stromal cell derived factor- 1alpha (SDF-1alpha) will enhance therapeutic potential of stem cell derived IPCs by increasing their survival and proliferation rate. Methods Novel culture conditions were developed to differentiate bone marrow derived mesenchymal stem cells (BMSCs) into IPCs by using endocrine differentiation inducers and growth factors via a three stage protocol. In order to enhance their therapeutic potential, we preconditioned IPCs with SDF-1alpha. Results Our results showed that SDF-1alpha increases survival and proliferation of IPCs and protects them from glucotoxicity under high glucose conditions in vitro. SDF-1alpha also enhances the glucose responsive insulin secretion in IPCs in vitro. SDF-1alpha preconditioning reverses hyperglycemia and increase serum insulin in drug induced diabetic rats. Conclusions The differentiation of BMSCs into IPCs and enhancement of their therapeutic potential by SDF-1alpha preconditioning may contribute to cell based therapies for diabetes. PMID:23648189

Health Worker Focused Distributed Simulation for Improving Capability of Health Systems in Liberia.

PubMed

Gale, Thomas C E; Chatterjee, Arunangsu; Mellor, Nicholas E; Allan, Richard J

2016-04-01

The main goal of this study was to produce an adaptable learning platform using virtual learning and distributed simulation, which can be used to train health care workers, across a wide geographical area, key safety messages regarding infection prevention control (IPC). A situationally responsive agile methodology, Scrum, was used to develop a distributed simulation module using short 1-week iterations and continuous synchronous plus asynchronous communication including end users and IPC experts. The module contained content related to standard IPC precautions (including handwashing techniques) and was structured into 3 distinct sections related to donning, doffing, and hazard perception training. Using Scrum methodology, we were able to link concepts applied to best practices in simulation-based medical education (deliberate practice, continuous feedback, self-assessment, and exposure to uncommon events), pedagogic principles related to adult learning (clear goals, contextual awareness, motivational features), and key learning outcomes regarding IPC, as a rapid response initiative to the Ebola outbreak in West Africa. Gamification approach has been used to map learning mechanics to enhance user engagement. The developed IPC module demonstrates how high-frequency, low-fidelity simulations can be rapidly designed using scrum-based agile methodology. Analytics incorporated into the tool can help demonstrate improved confidence and competence of health care workers who are treating patients within an Ebola virus disease outbreak region. These concepts could be used in a range of evolving disasters where rapid development and communication of key learning messages are required.

Remote limb ischemic preconditioning (rIPC) activates antioxidant and antiapoptotic genes and inhibits proinflammatory cytokine genes in renal ischemia/reperfusion injury.

PubMed

Hussein, Abdelaziz M; Harraz, Ahmed M; Awadalla, Amira; Barakat, Nashwa; Khater, Shery; Shokeir, Ahmed A

2016-01-01

The mechanisms underlying the renoprotective effect for remote limb ischemic preconditioning (rIPC) against renal ischemia/reperfusion injury need further elucidation. In our work, one hundred and twenty male Sprague Dawley rats were randomized into 3 groups; sham, I/R group (left renal 45 min ischemia) and rIPC (as I/R group with 3 cycles of left femoral ischemic PC just before renal ischemia). Rats were sacrificed at 2 h, 24 h, 48 h and 7 days. Serum creatinine and urea were measured at the baseline and endpoints. Also, histopathological examination and assessment of the expression of inflammatory cytokines e.g. TNF-α, IL-1β and ICAM-1 and antioxidant genes: Nrf2, HO-1 and NQO-1 and anti-apoptotic gene Bcl-2 in left kidney were done by the end of experiment. The results of this study demonstrated that, rIPC caused significant improvement in serum creatinine and BUN levels and in the expression of antioxidant genes and Bcl-2 antiapoptotic gene with significant attenuation of pro-inflammatory cytokines and histopathological damage score at all-time points compared to I/R group (p ≤ 0.05). In conclusion, inhibition of inflammatory cytokine (TNF-α, IL-1β and ICAM-1) formation and activation of antioxidant genes: Nrf2, HO-1 and NQO-1 and anti-apoptotic gene Bcl-2 could be possible underlying mechanisms for the renoprotective effect of rIPC.

Comparing cost of indwelling pleural catheter vs talc pleurodesis for malignant pleural effusion.

PubMed

Penz, Erika D; Mishra, Eleanor K; Davies, Helen E; Manns, Braden J; Miller, Robert F; Rahman, Najib M

2014-10-01

Malignant pleural effusion is associated with short life expectancy and significant morbidity. A randomized controlled trial comparing indwelling pleural catheters (IPCs) with talc pleurodesis found that IPCs reduced in-hospital time and the need for additional procedures but were associated with excess adverse events. Using data from the clinical trial, we compared costs associated with use of IPCs and with talc pleurodesis. Resource use and adverse events were captured through case report forms over the 1-year trial follow-up. Costs for outpatient and inpatient visits, diagnostic imaging, nursing, and doctor time were obtained from the UK National Health Service reference costs and University of Kent's Unit Costs of Health and Social Care 2011 and inflated to 2013 using the UK Consumer Price Index. Procedure supply costs were obtained from the manufacturer. Difference in mean costs was compared using nonparametric bootstrapping. All costs were converted to US dollars using the Organisation for Economic Co-operation and Development Purchasing Power Parity Index. Overall mean cost (SD) for managing patients with IPCs and talc pleurodesis was $4,993 ($5,529) and $4,581 ($4,359), respectively. The incremental mean cost difference was $401, with 95% CI of -$1,387 to $2,261. The mean cost related to ongoing drainage in the IPC group was $1,011 ($732) vs $57 ($213) in the talc pleurodesis group (P = .001). This included the cost of drainage bottles, dressing changes in the first month, and catheter removal. There was no significant difference in cost of the initial intervention or adverse events between the groups. For patients with survival < 14 weeks, IPC is significantly less costly than talc pleurodesis, with mean cost difference of -$1,719 (95% CI, -$3,376 to -$85). There is no significant difference in the mean cost of managing patients with IPCs compared with talc pleurodesis. For patients with limited survival, IPC appears less costly. isrctn.org; No.: ISRCTN87514420; URL: www.isrctn.org.

Pretreatment with the nitric oxide donor SNAP or nerve transection blocks humoral preconditioning by remote limb ischemia or intra-arterial adenosine.

PubMed

Steensrud, Tor; Li, Jing; Dai, Xiaojing; Manlhiot, Cedric; Kharbanda, Rajesh K; Tropak, Michael; Redington, Andrew

2010-11-01

We have previously shown that remote ischemic preconditioning (rIPC) by transient limb ischemia leads to the release of a circulating factor(s) that induces potent myocardial protection. Intra-arterial injection of adenosine into a limb also leads to cardioprotection, but the mechanism of its signal transduction is poorly understood. Eleven groups of rabbits received saline control or rIPC or adenosine administration with additional pretreatment with the nitric oxide (NO) synthase blocker N(G)-nitro-l-arginine methyl ester, the NO donor S-nitroso-N-acetylpenicillamine, its non-NO-donating derivative N-acetylpenicillamine, or femoral nerve section. Blood was then drawn from each animal, and the dialysate of the plasma was used to perfuse a naïve heart from an untreated donor. Infarct size was measured after 30 min of global ischemia and 120 min reperfusion. When compared with that of the control, mean infarct size was significantly smaller in groups treated with rIPC alone (P < 0.01) and intra-arterial adenosine (P < 0.01). Pretreatment with N(G)-nitro-l-arginine methyl ester or N-acetylpenicillamine did not affect the level of protection induced by rIPC (P = not significant, compared with rIPC alone) or intra-arterial adenosine (P = not significant, compared with intra-arterial adenosine alone), but prior femoral nerve transection or pretreatment with S-nitroso-N-acetylpenicillamine abolished the cardioprotective effect of intra-arterial adenosine and rIPC. Intra-arterial adenosine, like rIPC, releases a blood-borne cardioprotective factor(s) that is dependent on an intact femoral nerve and is inhibited by pretreatment with a NO donor. These results may be important when designing or assessing the results of clinical trials of adenosine or rIPC cardioprotection, where NO donors are used as part of therapy.

Estrogen-dependent efficacy of limb ischemic preconditioning in female rats.

PubMed

Pócs, Levente; Janovszky, Ágnes; Garab, Dénes; Terhes, Gabriella; Ocsovszki, Imre; Kaszaki, József; Boros, Mihály; Piffkó, József; Szabó, Andrea

2018-01-01

Our aim was to examine the effects of ischemic preconditioning (IPC) on the local periosteal and systemic inflammatory consequences of hindlimb ischemia-reperfusion (IR) in Sprague-Dawley rats with chronic estrogen deficiency (13 weeks after ovariectomy, OVX) in the presence and absence of chronic 17beta-estradiol supplementation (E2, 20 µg kg -1 , 5 days/week for 5 weeks); sham-operated (non-OVX) animals served as controls. As assessed by intravital fluorescence microscopy, rolling and the firm adhesion of polymorphonuclear neutrophil leukocytes (PMNs) gave similar results in the Sham + IR and OVX + IR groups in the tibial periosteal microcirculation during the 3-h reperfusion period after a 60-min tourniquet ischemia. Postischemic increases in periosteal PMN adhesion and PMN-derived adhesion molecule CD11b expressions, however, were significantly reduced by IPC (two cycles of 10'/10') in Sham animals, but not in OVX animals; neither plasma free radical levels (as measured by chemiluminescence), nor TNF-alpha release was affected by IPC. E2 supplementation in OVX animals restored the IPC-related microcirculatory integrity and PMN-derived CD11b levels, and TNF-alpha and free radical levels were reduced by IPC only with E2. An enhanced estrogen receptor beta expression could also be demonstrated after E2 in the periosteum. Overall, the beneficial periosteal microcirculatory effects of limb IPC are lost in chronic estrogen deficiency, but they can be restored by E2 supplementation. This suggests that the presence of endogenous estrogen is a necessary facilitating factor of the anti-inflammatory protection provided by limb IPC in females. The IPC-independent effects of E2 on inflammatory reactions should also be taken into account in this model. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:97-105, 2018. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Conserved and Divergent Features of Mesenchymal Progenitor Cell Types within the Cortical Nephrogenic Niche of the Human and Mouse Kidney.

PubMed

Lindström, Nils O; Guo, Jinjin; Kim, Albert D; Tran, Tracy; Guo, Qiuyu; De Sena Brandine, Guilherme; Ransick, Andrew; Parvez, Riana K; Thornton, Matthew E; Basking, Laurence; Grubbs, Brendan; McMahon, Jill A; Smith, Andrew D; McMahon, Andrew P

2018-03-01

Cellular interactions among nephron, interstitial, and collecting duct progenitors drive mammalian kidney development. In mice, Six2 + nephron progenitor cells (NPCs) and Foxd1 + interstitial progenitor cells (IPCs) form largely distinct lineage compartments at the onset of metanephric kidney development. Here, we used the method for analyzing RNA following intracellular sorting (MARIS) approach, single-cell transcriptional profiling, in situ hybridization, and immunolabeling to characterize the presumptive NPC and IPC compartments of the developing human kidney. As in mice, each progenitor population adopts a stereotypical arrangement in the human nephron-forming niche: NPCs capped outgrowing ureteric branch tips, whereas IPCs were sandwiched between the NPCs and the renal capsule. Unlike mouse NPCs, human NPCs displayed a transcriptional profile that overlapped substantially with the IPC transcriptional profile, and key IPC determinants, including FOXD1 , were readily detected within SIX2 + NPCs. Comparative gene expression profiling in human and mouse Six2/SIX2 + NPCs showed broad agreement between the species but also identified species-biased expression of some genes. Notably, some human NPC-enriched genes, including DAPL1 and COL9A2 , are linked to human renal disease. We further explored the cellular diversity of mesenchymal cell types in the human nephrogenic niche through single-cell transcriptional profiling. Data analysis stratified NPCs into two main subpopulations and identified a third group of differentiating cells. These findings were confirmed by section in situ hybridization with novel human NPC markers predicted through the single-cell studies. This study provides a benchmark for the mesenchymal progenitors in the human nephrogenic niche and highlights species-variability in kidney developmental programs. Copyright © 2018 by the American Society of Nephrology.

Pre-EDIT: protocol for a randomised feasibility trial of elastance-directed intrapleural catheter or talc pleurodesis (EDIT) in malignant pleural effusion

PubMed Central

Martin, Geoffrey A; Tsim, Selina; Kidd, Andrew C; Foster, John E; McLoone, Philip; Chalmers, Anthony

2018-01-01

Introduction Non-expansile lung (NEL) is a common cause of talc pleurodesis (TP) failure in malignant pleural effusion (MPE), but is often occult prior to drainage. Reliable detection of NEL would allow patients to be allocated between intrapleural catheter (IPC) and TP. High pleural elastance (PEL) has been associated with NEL in observational studies. Pre-EDIT is a randomised feasibility trial of elastance-directed IPC or TP (EDIT) management using a novel, purpose-built digital pleural manometer (Rocket Medical, UK). Methods and analysis Consecutive patients with MPE without prior evidence of NEL or preference for IPC will be randomised 1:1 between EDIT management and standard care (an attempt at TP). The primary objective is to determine whether sufficient numbers of patients (defined as 30 within 12 months (or 15 over 6 months)) can be recruited and randomised to justify a subsequent phase III trial testing the efficacy of EDIT management. Secondary objectives include safety, technical feasibility and validation of study design elements, including the definition of PEL using 4D pleural MRI before and after fluid aspiration. EDIT involves PEL assessment during a large volume pleural fluid aspiration, followed by an attempt at TP or placement of an IPC within 24 hours. Patients will be allocated to IPC if the rolling average PEL sustained over at least 250 mL fluid aspirated (PEL250) is ≥ 14.5 cm H2O/L. Ethics and dissemination Pre-EDIT was approved by the West of Scotland Regional Ethics Committee on 8 March 2017 (Ref: 17/WS/0042). Results will be presented at scientific meetings and published in peer-reviewed journals. Trial registration number NCT03319186; Pre-results. PMID:29862030

[Personalized nursing care in hospital and its effects on the patient-nurse trust relationship].

PubMed

García-Juárez, María del Rosario; López-Alonso, Sergio R; Moreno-Verdugo, Ana; Guerra-González, Sara; Fernández-Corchero, Juana; Márquez-Borrego, M José; Orozco-Cózar, M José; Ramos-Bosquet, Gádor

2013-01-01

To determine the level of implementation of an inpatient personalized nursing care model in four hospitals of the Andalusian Health Service, and to determine if there is an association between this model and the perception of trust in the nurse by the patient. An observational cross-sectional study included the patients discharged during a period of 12 months from hospital wards that used the Inpatient Personalized Nursing Care Model of the Andalusian Health Service (based on Primary Nursing Model). The level of implemention was evaluated using the Nursing Care Personalized Index (IPC), made by «patient report» methodology, and the nurse-patient trust relationship was evaluated at the same time as the IPC. Statistical analysis included descriptive data analysis, Chi-squared test, and bivariate and multivariate logistic regression, with and without stratifying by hospitals wards. A total of 817 patient were included. The implementation of the inpatient personalized nursing care model varied between 61 and 79%. The IPC values showed a strong association with the nurse-patient trust relationship, and that for each point increase in the IPC score, the probability of a nurse-patient trust relationship increased between 50 and 130% (0.120.58). The implementation of a personalized nursing care model in the wards studied was higher in the surgicals wards and at regular level in medical wards. Furthermore, the influence of the inpatient personalized nursing care model on the nurse-patient trust relationship has been demonstrated using the IPC model. This trust is the main component for the establishment of a therapeutic relationship. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Ischemic Preconditioning Protects Astrocytes against Oxygen Glucose Deprivation Via the Nuclear Erythroid 2-Related Factor 2 Pathway.

PubMed

Narayanan, Srinivasan V; Dave, Kunjan R; Perez-Pinzon, Miguel A

2018-04-01

Induction of ischemic preconditioning (IPC) represents a potential therapy against cerebral ischemia by activation of adaptive pathways and modulation of mitochondria to induce ischemic tolerance to various cells and tissues. Mitochondrial dysfunction has been ascribed to contribute to numerous neurodegenerative conditions and cerebral ischemia. Nuclear erythroid 2-related factor 2 (Nrf2) is a transcription factor that has traditionally been involved in upregulating cellular antioxidant systems to combat oxidative stress in the brain; however, the association of Nrf2 with mitochondria in the brain remains unclear. In the present study, we investigated the effects of Nrf2 on (i) IPC-induced protection of astrocytes; (ii) OXPHOS protein expression; and (iii) mitochondrial supercomplex formation.Oxygen-glucose deprivation (OGD) was used as an in vitro model of cerebral ischemia and IPC in cultured rodent astrocytes derived from WT C57Bl/6J and Nrf2 -/- mice. OXPHOS proteins were probed via western blotting, and supercomplexes were determined by blue native gel electrophoresis.IPC-induced cytoprotection in wild-type, but not Nrf2 -/- mouse astrocyte cultures following a lethal duration of OGD. In addition, our results suggest that Nrf2 localizes to the outer membrane in non-synaptic brain mitochondria, and that a lack of Nrf2 in vivo produces altered supercomplex formation in mitochondria.Our findings support a role of Nrf2 in mediating IPC-induced protection in astrocytes, which can profoundly impact the ischemic tolerance of neurons. In addition, we provide novel evidence for the association of Nrf2 to brain mitochondria and supercomplex formation. These studies offer new targets and pathways of Nrf2, which may be heavily implicated following cerebral ischemia.

Counting the costs: Comparing depot medroxyprogesterone acetate and norethisterone oenanthate utilisation patterns in South Africa

PubMed Central

2001-01-01

Background In South Africa, where health care resources are limited, it is important to ensure that drugs provision and use is rational. The Essential Drug List includes depot medroxyprogesterone acetate (DMPA) and norethisterone oenanthate (NET-EN) as injectable progestagen-only contraceptives (IPCs), and both products are extensively used. Objectives and Methods Utilisation patterns of the injectable contraceptive products DMPA and NET-EN are compared in the context of current knowledge of the safety and efficacy of these agents. Utilisation patterns were analysed by means of a Pareto (ABC) analysis of IPCs issued from 4 South African provincial pharmaceutical depots over 3 financial years. A case study from rural KwaZulu-Natal, South Africa, is used to examine utilisation patterns and self-reported side effects experienced by 187 women using IPCs. Results IPCs accounted for a substantial share of total state expenditure on drugs. While more DMPA than NET-EN was issued, NET-EN distribution from 2 depots increased over the 3-year period. Since DMPA was cheaper, if all NET-EN clients in the 1999/2000 financial year (annualised) had used DMPA, the 4 depots could have saved 4.95 million South African Rands on product acquisition costs alone. The KZN case study showed slightly more NET-EN (54%) than DMPA (46%) use; no significant differences in self-reported side effects; and that younger women were more likely to use NET-EN than DMPA (p = 0.0001). Conclusions Providing IPCs on the basis of age is not appropriate or cost effective. Rational use of these products should include consideration of the cost of prescribing one over another. PMID:11401729

Changing panorama for surveillance of device-associated healthcare infections: Challenges faced in implementation of current guidelines.

PubMed

Gupta, Renu; Sharma, Sangeeta; Saxena, Sonal

2018-01-01

Healthcare-associated infections (HAI) are preventable in up to 30% of patients with evidence-based infection prevention and control (IPC) activities. IPC activities require effective surveillance to generate data for the HAI rates, defining priority areas, identifying processes amenable for improvement and institute interventions to improve patient's safety. However, uniform, accurate and standardised surveillance methodology using objective definitions can only generate meaningful data for effective execution of IPC activities. The highly exhaustive, complex and ever-evolving infection surveillance methodology pose a challenge for effective data capture, analysis and interpretation by ground level personnel. The present review addresses the gaps in knowledge and day-to-day challenges in surveillance faced by infection control team for effective implementation of IPC activities.

Sense of agency is related to gamma band coupling in an inferior parietal-preSMA circuitry

PubMed Central

Ritterband-Rosenbaum, Anina; Nielsen, Jens B.; Christensen, Mark S.

2014-01-01

In the present study we tested whether sense of agency (SoA) is reflected by changes in coupling between right medio-frontal/supplementary motor area (SMA) and inferior parietal cortex (IPC). Twelve healthy adult volunteers participated in the study. They performed a variation of a line-drawing task (Nielsen, 1963; Fourneret and Jeannerod, 1998), in which they moved a cursor on a digital tablet with their right hand without seeing the hand. Visual feedback displayed on a computer monitor was either in correspondence with or deviated from the actual movement. This made participants uncertain as to the agent of the movement and they reported SoA in approximately 50% of trials when the movement was computer-generated. We tested whether IPC-preSMA coupling was associated with SoA, using dynamic causal modeling (DCM) for induced responses (Chen et al., 2008; Herz et al., 2012). Nine different DCMs were constructed for the early and late phases of the task, respectively. All models included two regions: a superior medial gyrus (preSMA) region and a right supramarginal gyrus (IPC) region. Bayesian models selection (Stephan et al., 2009) favored a model with input to IPC and modulation of the forward connection to SMA in the late task phase, and a model with input to preSMA and modulation of the backward connection was favored for the early task phase. The analysis shows that IPC source activity in the 50–60 Hz range modulated preSMA source activity in the 40–70 Hz range in the presence of SoA compared with no SoA in the late task phase, but the test of the early task phase did not reveal any differences between presence and absence of SoA. We show that SoA is associated with a directionally specific between frequencies coupling from IPC to preSMA in the higher gamma (ɣ) band in the late task phase. This suggests that SoA is a retrospective perception, which is highly dependent on interpretation of the outcome of the performed action. PMID:25076883

Brain ischemic preconditioning protects against ischemic injury and preserves the blood-brain barrier via oxidative signaling and Nrf2 activation.

PubMed

Yang, Tuo; Sun, Yang; Mao, Leilei; Zhang, Meijuan; Li, Qianqian; Zhang, Lili; Shi, Yejie; Leak, Rehana K; Chen, Jun; Zhang, Feng

2018-05-06

Brain ischemic preconditioning (IPC) with mild ischemic episodes is well known to protect the brain against subsequent ischemic challenges. However, the underlying mechanisms are poorly understood. Here we demonstrate the critical role of the master redox transcription factor, nuclear factor (erythroid-derived 2)-like 2 (Nrf2), in IPC-mediated neuroprotection and blood-brain barrier (BBB) preservation. We report that IPC causes generation of endogenous lipid electrophiles, including 4-hydroxy-2-nonenal (4-HNE), which release Nrf2 from inhibition by Keap1 (via Keap1-C288) and inhibition by glycogen synthase kinase 3β (via GSK3β-C199). Nrf2 then induces expression of its target genes, including a new target, cadherin 5, a key component of adherens junctions of the BBB. These effects culminate in mitigation of BBB leakage and of neurological deficits after stroke. Collectively, these studies are the first to demonstrate that IPC protects the BBB against ischemic injury by generation of endogenous electrophiles and activation of the Nrf2 pathway through inhibition of Keap1- and GSK3β-dependent Nrf2 degradation. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Comparison of Immature Platelet Count to Established Predictors of Platelet Reactivity During Thienopyridine Therapy.

PubMed

Stratz, Christian; Bömicke, Timo; Younas, Iris; Kittel, Anja; Amann, Michael; Valina, Christian M; Nührenberg, Thomas; Trenk, Dietmar; Neumann, Franz-Josef; Hochholzer, Willibald

2016-07-19

Previous data suggest that reticulated platelets significantly affect antiplatelet response to thienopyridines. It is unknown whether parameters describing reticulated platelets can predict antiplatelet response to thienopyridines. The authors sought to determine the extent to which parameters describing reticulated platelets can predict antiplatelet response to thienopyridine loading compared with established predictors. This study randomized 300 patients undergoing elective coronary stenting to loading with clopidogrel 600 mg, prasugrel 30 mg, or prasugrel 60 mg. Adenosine diphosphate (ADP)-induced platelet reactivity was assessed by impedance aggregometry before loading (intrinsic platelet reactivity) and again on day 1 after loading. Multiple parameters of reticulated platelets were assessed by automated whole blood flow cytometry: absolute immature platelet count (IPC), immature platelet fraction, and highly fluorescent immature platelet fraction. Each parameter of reticulated platelets correlated significantly with ADP-induced platelet reactivity (p < 0.01 for all 3 parameters). In a multivariable model including all 3 parameters, only IPC remained a significant predictor of platelet reactivity (p < 0.001). In models adjusting each of the 3 parameters for known predictors of on-treatment platelet reactivity including cytochrome P450 2C19 (CYP2C19) polymorphisms, age, body mass index, diabetes, and intrinsic platelet reactivity, only IPC prevailed as an independent predictor (p = 0.001). In this model, IPC was the strongest predictor of on-treatment platelet reactivity followed by intrinsic platelet reactivity. IPC is the strongest independent platelet count-derived predictor of antiplatelet response to thienopyridine treatment. Given its easy availability, together with its even stronger association with on-treatment platelet reactivity compared with known predictors, including the CYP2C19*2 polymorphism, IPC may become the preferred predictor of antiplatelet response to thienopyridine treatment. (Impact of Extent of Clopidogrel-Induced Platelet Inhibition During Elective Stent Implantation on Clinical Event Rate-Advanced Loading Strategies [ExcelsiorLOAD]; DRKS00006102). Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Hygiene on maternity units: lessons from a needs assessment in Bangladesh and India

PubMed Central

Cross, Suzanne; Afsana, Kaosar; Banu, Morsheda; Mavalankar, Dileep; Morrison, Emma; Rahman, Atiya; Roy, Tapash; Saxena, Deepak; Vora, Kranti; Graham, Wendy J

2016-01-01

Background As the proportion of deliveries in health institutions increases in low- and middle-income countries, so do the challenges of maintaining standards of hygiene and preventing healthcare-associated infections (HCAIs) in mothers and babies. Adequate water, sanitation, and hygiene (WASH) and infection prevention and control (IPC) in these settings should be seen as integral parts of the broader domain of quality care. Assessment approaches are needed which capture standards for both WASH and IPC, and so inform quality improvement processes. Design A needs assessment was conducted in seven maternity units in Gujarat, India, and eight in Dhaka Division, Bangladesh in 2014. The WASH & CLEAN study developed and applied a suite of tools – a ‘walkthrough checklist’ which included the collection of swab samples, a facility needs assessment tool and document review, and qualitative interviews with staff and recently delivered women – to establish the state of hygiene as measured by visual cleanliness and the presence of potential pathogens, and individual and contextual determinants or drivers. Results No clear relationship was found between visually assessed cleanliness and the presence of pathogens; findings from qualitative interviews and the facility questionnaire found inadequacies in IPC training for healthcare providers and no formal training at all for ward cleaners. Lack of written policies and protocols, and poor monitoring and supervision also contributed to suboptimal IPC standards. Conclusions Visual assessment of cleanliness and hygiene is an inadequate marker for ‘safety’ in terms of the presence of potential pathogens and associated risk of infection. Routine environmental screening of high-risk touch sites using simple microbiology could improve detection and control of pathogens. IPC training for both healthcare providers and ward cleaners represents an important opportunity for quality improvement. This should occur in conjunction with broader systems changes, including the establishment of functioning IPC committees, implementing standard policies and protocols, and improving health management information systems to capture information on maternal and newborn HCAIs. PMID:27964775

Quantitative characterisation of clinically significant intra-prostatic cancer by prostate-specific membrane antigen (PSMA) expression and cell density on PSMA-11.

PubMed

Domachevsky, Liran; Goldberg, Natalia; Bernstine, Hanna; Nidam, Meital; Groshar, David

2018-05-30

To quantitatively characterize clinically significant intra-prostatic cancer (IPC) by prostate-specific membrane antigen (PSMA) expression and cell density on PSMA-11 positron emission tomography/magnetic resonance (PET/MR). Retrospective study approved by the institutional review board with informed written consent obtained. Patients with a solitary, biopsy-proven prostate cancer, Gleason score (GS) ≥7, presenting for initial evaluation by PET/computerised tomography (PET/CT), underwent early prostate PET/MR immediately after PSMA-11 tracer injection. PET/MR [MRI-based attenuation correction (MRAC)] and PET/CT [CT-based AC (CTAC)] maximal standardised uptake value (SUVmax) and minimal and mean apparent diffusion coefficient (ADCmin, ADCmean; respectively) in normal prostatic tissue (NPT) were compared to IPC area. The relationship between SUVmax, ADCmin and ADCmean measurements was obtained. Twenty-two patients (mean age 69.5±5.0 years) were included in the analysis. Forty-four prostate areas were evaluated (22 IPC and 22 NPT). Median MRAC SUVmax of NPT was significantly lower than median MRAC SUVmax of IPC (p < 0.0001). Median ADCmin and ADCmean of NPT was significantly higher than median ADCmin and ADCmean of IPC (p < 0.0001). A very good correlation was found between MRAC SUVmax with CTAC SUVmax (rho = -0.843, p < 0.0001). A good inverse relationship was found between MRAC SUVmax and CTAC SUVmax with ADCmin (rho = -0.717, p < 0.0001 and -0.740, p < 0.0001; respectively; Z = 0.22, p = 0.82, NS) and with MRAC SUVmax and ADCmean (rho = -0.737, p < 0.0001). PET/MR SUVmax, ADCmin and ADCmean are distinct biomarkers able to differentiate between IPC and NPT in naïve prostate cancer patients with GS ≥ 7. • PSMA PET/MR metrics differentiate between normal and tumoural prostatic tissue. • A multi-parametric approach combining molecular and anatomical information might direct prostate biopsy. • PSMA PET/MR metrics are warranted for radiomics analysis.

Cost-effectiveness of indwelling pleural catheter compared with talc in malignant pleural effusion.

PubMed

Olfert, Jordan A P; Penz, Erika D; Manns, Braden J; Mishra, Eleanor K; Davies, Helen E; Miller, Robert F; Luengo-Fernandez, Ramon; Gao, Song; Rahman, Najib M

2017-05-01

Malignant pleural effusion is associated with morbidity and mortality. A randomized controlled trial previously compared clinical outcomes and resource use with indwelling pleural catheter (IPC) and talc pleurodesis in this population. Using unpublished quality of life data, we estimate the cost-effectiveness of IPC compared with talc pleurodesis. Healthcare utilization and costs were captured during the trial. Utility weights produced by the EuroQol Group five-dimensional three-level questionnaire and survival were used to determine quality-adjusted life-years (QALYs) gained. The incremental cost-effectiveness ratio (ICER) was calculated over the 1-year trial period. Sensitivity analysis used patient survival data and modelled additional nursing time required per week for catheter drainage. Utility scores, cost and QALYs gained did not differ significantly between groups. The ICER for IPC compared with talc was favorable at $US10 870 per QALY gained. IPC was less costly with a probability exceeding 95% of being cost-effective when survival was <14 weeks, and was more costly when 2-h nursing time per week was assumed for catheter drainage. IPC is cost-effective when compared with talc, although substantial uncertainty exists around this estimate. IPC appears most cost-effective in patients with limited survival. If significant nursing time is required for catheter drainage, IPC becomes less likely to be cost-effective. Either therapy may be considered as a first-line option in treating malignant pleural effusion in patients without history of prior pleurodesis, with consideration for patient survival, support and preferences. © 2016 The Authors. Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology.

Signal dependence of inter-pixel capacitance in hybridized HgCdTe H2RG arrays for use in James Webb space telescope's NIRcam

NASA Astrophysics Data System (ADS)

Donlon, Kevan; Ninkov, Zoran; Baum, Stefi

2016-08-01

Interpixel capacitance (IPC) is a deterministic electronic coupling by which signal generated in one pixel is measured in neighboring pixels. Examination of dark frames from test NIRcam arrays corroborates earlier results and simulations illustrating a signal dependent coupling. When the signal on an individual pixel is larger, the fractional coupling to nearest neighbors is lesser than when the signal is lower. Frames from test arrays indicate a drop in average coupling from approximately 1.0% at low signals down to approximately 0.65% at high signals depending on the particular array in question. The photometric ramifications for this non-uniformity are not fully understood. This non-uniformity intro-duces a non-linearity in the current mathematical model for IPC coupling. IPC coupling has been mathematically formalized as convolution by a blur kernel. Signal dependence requires that the blur kernel be locally defined as a function of signal intensity. Through application of a signal dependent coupling kernel, the IPC coupling can be modeled computationally. This method allows for simultaneous knowledge of the intrinsic parameters of the image scene, the result of applying a constant IPC, and the result of a signal dependent IPC. In the age of sub-pixel precision in astronomy these effects must be properly understood and accounted for in order for the data to accurately represent the object of observation. Implementation of this method is done through python scripted processing of images. The introduction of IPC into simulated frames is accomplished through convolution of the image with a blur kernel whose parameters are themselves locally defined functions of the image. These techniques can be used to enhance the data processing pipeline for NIRcam.

Protection of ischemic preconditioning on renal neural function in rats with acute renal failure.

PubMed

Wu, Ming-Shiou; Chien, Chiang-Ting; Ma, Ming-Chieh; Chen, Chau-Fong

2009-11-30

We tested whether tolerance induced by ischemic preconditioning (IPC) in kidneys was related to renal nerves. Experimental acute renal failure (ARF) in a rat model was induced for 45 min of left renal arterial occlusion (RAO), followed by 6 or 24 h of reperfusion (ischemic reperfusion (I/R) group). The episode of IPC was four cycles of 4 min of RAO at 11 min intervals and then the I/R injury was treated as above (IPC-I/R group). After 6 h of reperfusion, polyuria was found in the I/R group associated with an enhancement of afferent renal nerve activity (ARNA) and a reflexive decrease in efferent renal nerve activity (ERNA). Changes in nerve responses were related with a reduction in neutral endopeptidase (NEP) activity and an increased release of substance P (SP). After 24 h of reperfusion, the I/R group showed oliguria which was associated with a lower ARNA, hyperactivity of ERNA and a nine-fold increase in SP release due to a further 52% loss in NEP activity. Prior IPC treatment did not affect the changed ischemia-induced excretory and nervous activity patterns during the first 6 h of reperfusion, but normalized both responses in the kidneys 24 h after ischemia. The IPC-mediated protection in oliguric ARF was related to the preservation of NEP activity to only 25% loss that caused an increase of SP amounts of only three-fold and a minor change in neurokinin 1 receptor (NK-1R) activities. Finally, both excretory and sensory responses in oliguric ARF after saline loading were significantly ameliorated by IPC. We conclude that IPC results in preservation of the renal sensory response in postischemic kidneys and has a beneficial effect on controlling efferent renal sympathetic nerve activity and excretion of solutes and water.

p57KIP2 regulates radial glia and intermediate precursor cell cycle dynamics and lower layer neurogenesis in developing cerebral cortex

PubMed Central

Mairet-Coello, Georges; Tury, Anna; Van Buskirk, Elise; Robinson, Kelsey; Genestine, Matthieu; DiCicco-Bloom, Emanuel

2012-01-01

During cerebral cortex development, precise control of precursor cell cycle length and cell cycle exit is required for balanced precursor pool expansion and layer-specific neurogenesis. Here, we defined the roles of cyclin-dependent kinase inhibitor (CKI) p57KIP2, an important regulator of G1 phase, using deletion mutant mice. Mutant mice displayed macroencephaly associated with cortical hyperplasia during late embryogenesis and postnatal development. Embryonically, proliferation of radial glial cells (RGC) and intermediate precursors (IPC) was increased, expanding both populations, with greater effect on IPCs. Furthermore, cell cycle re-entry was increased during early corticogenesis, whereas cell cycle exit was augmented at middle stage. Consequently, neurogenesis was reduced early, whereas it was enhanced during later development. In agreement, the timetable of early neurogenesis, indicated by birthdating analysis, was delayed. Cell cycle dynamics analyses in mutants indicated that p57KIP2 regulates cell cycle length in both RGCs and IPCs. By contrast, related CKI p27KIP1 controlled IPC proliferation exclusively. Furthermore, p57KIP2 deficiency markedly increased RGC and IPC divisions at E14.5, whereas p27KIP1 increased IPC proliferation at E16.5. Consequently, loss of p57KIP2 increased primarily layer 5-6 neuron production, whereas loss of p27KIP1 increased neurons specifically in layers 2-5. In conclusion, our observations suggest that p57KIP2 and p27KIP1 control neuronal output for distinct cortical layers by regulating different stages of precursor proliferation, and support a model in which IPCs contribute to both lower and upper layer neuron generation. PMID:22223678

A complete public archive for the Einstein IPC

NASA Technical Reports Server (NTRS)

Helfand, David J.

1995-01-01

This report documents progress made in the period 24 Sept. 1993 - 23 Sept. 1995 on the project described in our proposal 'A Complete Public Archive for the Einstein IPC' which was approved under the Astrophysics Data Program in 1992. We have completed most of the principal objectives of the original proposal; a NFE was recently approved so that costs for publications in press can be covered and we can complete the public record for the Einstein IPC database.

Developmentally Regulated Sphingolipid Synthesis in African Trypanosomes

PubMed Central

Sutterwala, Shaheen S.; Hsu, Fong Fu; Sevova, Elitza S.; Schwartz, Kevin J.; Zhang, Kai; Key, Phillip; Turk, John; Beverley, Stephen M.; Bangs, James D.

2008-01-01

Sphingolipids are essential components of eukaryotic membranes, and many unicellular eukaryotes, including kinetoplastid protozoa, are thought to synthesize exclusively inositol phosphorylceramide (IPC). Here we characterize sphingolipids from Trypanosoma brucei, and a trypanosome sphingolipid synthase gene family (TbSLS1-4) that is orthologous to Leishmania IPC synthase. Procyclic trypanosomes contain IPC, but also sphingomyelin, while surprisingly bloodstream stage parasites contain sphingomyelin and ethanolamine phosphorylceramide (EPC), but no detectable IPC. In vivo fluorescent ceramide labeling confirmed stage specific biosynthesis of both sphingomyelin and IPC. Expression of TbSLS4 in Leishmania resulted in production of sphingomyelin and EPC suggesting that the TbSLS gene family has bi-functional synthase activity. RNAi silencing of TbSLS1-4 in bloodstream trypanosomes led to rapid growth arrest and eventual cell death. Ceramide levels were increased >3-fold by silencing suggesting a toxic downstream effect mediated by this potent intracellular messenger. Topology predictions support a revised six transmembrane domain model for the kinetoplastid sphingolipid synthases consistent with the proposed mammalian SM synthase structure. This work reveals novel diversity and regulation in sphingolipid metabolism in this important group of human parasites. PMID:18699867

Interactions of GSK-3β with mitochondrial permeability transition pore modulators during preconditioning: age-associated differences.

PubMed

Zhu, Jiang; Rebecchi, Mario J; Glass, Peter S A; Brink, Peter R; Liu, Lixin

2013-04-01

Anesthetic preconditioning (APC) and ischemic preconditioning (IPC) are lost with normal aging. Here, we investigated age-related difference between phosphoglycogen synthase kinase-3beta (pGSK-3β) and pGSK-3β with modulators of mitochondrial permeability transition pore, including adenine nucleotide translocase (ANT), cyclophilin-D, or voltage-dependent anion channel. APC or IPC significantly increased pGSK-3β in the young groups in both the cytosol and the mitochondria and also significantly increased pGSK-3β in co-immunoprecipitates with ANT. Importantly, the level of cyclophilin-D in co-immunoprecipitates with ANT was significantly decreased in the young APC and IPC groups, but not in old rats. We also found that APC or IPC significantly prolonged mitochondrial permeability transition pore opening time in the young cardiomyocytes under oxidative stress, but not in the elderly. Attenuation of APC or IPC protection in the aging heart is associated with failure to reduce ANT-cyclophilin-D interactions and to decreased pGSK-3β responsiveness of ANT, critical modulators of mitochondrial permeability transition pore.

Where is the client/patient voice in interprofessional healthcare team assessments? Findings from a one-day forum.

PubMed

Soklaridis, Sophie; Romano, Donna; Fung, Wai Lun Alan; Martimianakis, Maria Athina Tina; Sargeant, Joan; Chambers, Jennifer; Wiljer, David; Silver, Ivan

2017-01-01

There is a growing interest in interprofessional care (IPC) as a way to provide better healthcare. However, it is difficult to evaluate this mode of healthcare delivery because identifying the appropriate measurement tool is a challenge, given the wide diversity in team composition and settings. Adding to this complexity is a key gap in the IPC evaluation research: the client/patient perspective. This perspective has generally not been included in the development of IPC healthcare team evaluations. The authors received a Canadian Institute for Health Research Planning Grant to host a one-day forum with 24 participants from across Canada representing health professions such as social work, medicine, occupational therapy, and physical therapy, in addition to researchers, client/patient advocates, and hospital administrators. The overarching goal of the forum was to create a demonstration project that supports the development of an IPC assessment tool for healthcare teams that includes clients/patients. Using a concept mapping methodology, participants discussed client/patient inclusion in IPC assessments, and through a consensus process, chose a demonstration project for further development.

Knowledge, Attitudes, and Practices of Family Physicians and Nurses Regarding Unintentional Injuries among Children under 15 Years in Cairo, Egypt

PubMed Central

Elboray, Shereen; Elawdy, Mohamed Yehia; Dewedar, Sahar; Elezz, Nahla Abo; El-Setouhy, Maged; Smith, Gordon S.; Hirshon, Jon Mark

2015-01-01

Unintentional injuries are a leading cause of death among children, especially in developing countries. Lack of reliable data regarding primary health care professionals’ role in childhood unintentional injury prevention hinders development of effective prevention strategies. A survey of 99 family physicians and nurses from 10 family health centres sought to develop insight into their knowledge, attitudes and practices regarding unintentional injury prevention for children <15 in Cairo, Egypt. Approximately 60% were familiar with the terms unintentional injuries and injury prevention. Falls and road traffic crashes were identified as primary causes of childhood injuries by 54.5%. While > 90% agreed injury prevention counselling (IPC) could be effective, only 50.5% provided IPC. Lack of time and educational materials were the leading barriers to provision of IPC (91.9%, 85.9%, respectively), while thinking counseling is not part of their clinical duties was the least perceived barrier (9.1%). There is a large disconnect between providers’ knowledge, attitudes and practices regarding IPC, more training and provision of counseling tools are essential for improving IPC by Egyptian medical providers. PMID:26176681

Under a nonadherent state, bone marrow mesenchymal stem cells can be efficiently induced into functional islet-like cell clusters to normalize hyperglycemia in mice: a control study.

PubMed

Zhang, Yihua; Dou, Zhongying

2014-05-08

Bone marrow mesenchymal stem cells (BMSCs) possess low immunogenicity and immunosuppression as an allograft, can differentiate into insulin-producing cells (IPCs) by in vitro induction, and may be a valuable cell source to regenerate pancreatic islets. However, the very low differentiation efficiency of BMSCs towards IPCs under adherent induction has thus far hindered the clinical exploitation of these cells. The aim of this study is to explore a new way to efficiently induce BMSCs into IPCs and lay the groundwork for their clinical exploitation. In comparison with adherent induction, BMSCs of human first-trimester abortus (hfBMSCs) under a nonadherent state were induced towards IPCs in noncoated plastic dishes using a three-stage induction procedure developed by the authors. Induction effects were evaluated by statistics of the cell clustering rate of induced cells, and ultrastructural observation, dithizone staining, quantitative polymerase chain reaction and immunofluorescence assay, insulin and c-peptide release under glucose stimulus of cell clusters, as well as transplantation test of the cell clusters in diabetic model mice. With (6.175 ± 0.263) × 105 cells in 508.5 ± 24.5 cell clusters, (3.303 ± 0.331) × 105 single cells and (9.478 ± 0.208) × 105 total cell count on average, 65.08 ± 2.98% hfBMSCs differentiated into pancreatic islet-like cell clusters after nonadherent induction. With (3.993 ± 0.344) × 105 cells in 332.3 ± 41.6 cell clusters, (5.437 ± 0.434) × 105 single cells and (9.430 ± 0.340) × 105 total cell count on average, 42.37 ± 3.70% hfBMSCs differentiated into pancreatic islet-like cell clusters after adherent induction (P < 0.01, n = 10). The former is significantly higher than the latter. Calculated according to the cell clustering rate and IPC percentage in the cell clusters, 29.80 ± 3.95% hfBMSCs differentiated into IPCs after nonadherent induction and 18.40 ± 2.08% hfBMSCs differentiated into IPCs after adherent induction (P < 0.01, n = 10), the former significantly higher than the latter. The cell clusters expressed a broad gene profile related to pancreatic islet cells, released insulin and c-peptide in a glucose concentration-dependent manner, and normalized hyperglycemia of streptozocin-induced mice for at least 80 days following xenograft. Blood glucose of grafted mice rose again after their graft removed. A series of examination of the grafts showed that transplanted cells produced human insulin in recipients. Our studies demonstrate that nonadherent induction can greatly promote BMSCs to form pancreatic islet-like cell clusters, thereby improving the differentiation efficiency of BMSCs towards IPCs.

Endodermal differentiation of human pluripotent stem cells to insulin-producing cells in 3D culture

PubMed Central

Takeuchi, Hiroki; Nakatsuji, Norio; Suemori, Hirofumi

2014-01-01

Insulin-producing cells (IPCs) derived from human pluripotent stem cells (hPSCs) may be useful in cell therapy and drug discovery for diabetes. Here, we examined various growth factors and small molecules including those previously reported to develop a robust differentiation method for induction of mature IPCs from hPSCs. We established a protocol that induced PDX1-positive pancreatic progenitor cells at high efficiency, and further induced mature IPCs by treatment with forskolin, dexamethasone, Alk5 inhibitor II and nicotinamide in 3D culture. The cells that differentiated into INSULIN-positive and C-PEPTIDE-positive cells secreted insulin in response to glucose stimulation, indicating a functional IPC phenotype. We also found that this method was applicable to different types of hPSCs. PMID:24671046

Imaging proportional counters for the stellar X-ray polarimeter. [on Soviet Spectrum X-Gamma mission

NASA Technical Reports Server (NTRS)

Watkins, R. B., Jr.; Kaaret, P.

1990-01-01

The xenon-filled IPCs being developed for the Stellar X-ray Polarimeter are described. The requirements placed on the IPCs by the design of the polarimeter are discussed and results on the performance of prototype counters are presented. The design of a prototype of the IPCs is described. Finally, the performance of the prototype is reported. Due to the extremely low count rates encountered in X-ray polarimetry, efficient background rejection is the most critical parameter of the IPCs. Using a background rejection scheme employing anticoincidence and pulse shape discrimination, a rejection efficiency of 99 percent has been achieved for Co-60-induced events over an energy range of 2 to 15 keV while retaining more than 80 percent of the X-ray efficiency.

Involvement of atrial natriuretic peptide in abrogated cardioprotective effect of ischemic preconditioning in ovariectomized rat heart.

PubMed

Vishwakarma, V K; Goyal, A; Gupta, J K; Upadhyay, P K; Yadav, H N

2018-07-01

Nitric oxide (NO) is an effective mediator of ischemic preconditioning (IPC)-induced cardioprotection. Atrial natriuretic peptide (ANP) is downregulated after ovariectomy, which results in reduction in the level of NO. The present study deals with the investigation of the role of ANP in abrogated cardioprotective effect of IPC in the ovariectomized rat heart. Heart was isolated from ovariectomized rat and mounted on Langendorff's apparatus, subjected to 30 min of ischemia and 120 min of reperfusion. IPC was given by four cycles of 5 min of ischemia and 5 min of reperfusion with Krebs-Henseleit solution. The myocardial infract size was estimated employing triphenyltetrazolium chloride stain, and coronary effluent was analyzed for creatine kinase-MB (CK-MB) and lactate dehydrogenase (LDH) release to consider the degree of myocardial injury. The cardiac release of NO was estimated by measuring the level of nitrite in coronary effluent. IPC-mediated cardioprotection was significantly attenuated in ovariectomized rat as compared to normal rat, which was restored by perfusion with ANP. However, this observed cardioprotection was significantly attenuated by perfusion with L-NAME, an endothelial nitric oxide synthase inhibitor, and Glibenclamide, a K ATP channel blocker, alone or in combination noted in terms of increase in myocardial infract size, release of CK-MB and LDH, and also decrease in release of NO. Thus, it is suggested that ANP restores the attenuated cardioprotective effect of IPC in the ovariectomized rat heart which may be due to increase in the availability of NO and consequent increase activation of mitochondrial K ATP channels.

Dysregulated left inferior parietal activity in schizophrenia and depression: functional connectivity and characterization

PubMed Central

Müller, Veronika I.; Cieslik, Edna C.; Laird, Angela R.; Fox, Peter T.; Eickhoff, Simon B.

2013-01-01

The inferior parietal cortex (IPC) is a heterogeneous region that is known to be involved in a multitude of diverse different tasks and processes, though its contribution to these often-complex functions is yet poorly understood. In a previous study we demonstrated that patients with depression failed to deactivate the left IPC during processing of congruent audiovisual information. We now found the same dysregulation (same region and condition) in schizophrenia. By using task-independent (resting state) and task-dependent meta-analytic connectivity modeling (MACM) analyses we aimed at characterizing this particular region with regard to its connectivity and function. Across both approaches, results revealed functional connectivity of the left inferior parietal seed region with bilateral IPC, precuneus and posterior cingulate cortex (PrC/PCC), medial orbitofrontal cortex (mOFC), left middle frontal (MFG) as well as inferior frontal (IFG) gyrus. Network-level functional characterization further revealed that on the one hand, all interconnected regions are part of a network involved in memory processes. On the other hand, sub-networks are formed when emotion, language, social cognition and reasoning processes are required. Thus, the IPC-region that is dysregulated in both depression and schizophrenia is functionally connected to a network of regions which, depending on task demands may form sub-networks. These results therefore indicate that dysregulation of left IPC in depression and schizophrenia might not only be connected to deficits in audiovisual integration, but is possibly also associated to impaired memory and deficits in emotion processing in these patient groups. PMID:23781190

Sterol and genomic analyses validate the sponge biomarker hypothesis.

PubMed

Gold, David A; Grabenstatter, Jonathan; de Mendoza, Alex; Riesgo, Ana; Ruiz-Trillo, Iñaki; Summons, Roger E

2016-03-08

Molecular fossils (or biomarkers) are key to unraveling the deep history of eukaryotes, especially in the absence of traditional fossils. In this regard, the sterane 24-isopropylcholestane has been proposed as a molecular fossil for sponges, and could represent the oldest evidence for animal life. The sterane is found in rocks ∼650-540 million y old, and its sterol precursor (24-isopropylcholesterol, or 24-ipc) is synthesized today by certain sea sponges. However, 24-ipc is also produced in trace amounts by distantly related pelagophyte algae, whereas only a few close relatives of sponges have been assayed for sterols. In this study, we analyzed the sterol and gene repertoires of four taxa (Salpingoeca rosetta, Capsaspora owczarzaki, Sphaeroforma arctica, and Creolimax fragrantissima), which collectively represent the major living animal outgroups. We discovered that all four taxa lack C30 sterols, including 24-ipc. By building phylogenetic trees for key enzymes in 24-ipc biosynthesis, we identified a candidate gene (carbon-24/28 sterol methyltransferase, or SMT) responsible for 24-ipc production. Our results suggest that pelagophytes and sponges independently evolved C30 sterol biosynthesis through clade-specific SMT duplications. Using a molecular clock approach, we demonstrate that the relevant sponge SMT duplication event overlapped with the appearance of 24-isopropylcholestanes in the Neoproterozoic, but that the algal SMT duplication event occurred later in the Phanerozoic. Subsequently, pelagophyte algae and their relatives are an unlikely alternative to sponges as a source of Neoproterozoic 24-isopropylcholestanes, consistent with growing evidence that sponges evolved long before the Cambrian explosion ∼542 million y ago.

Sterol and genomic analyses validate the sponge biomarker hypothesis

PubMed Central

Gold, David A.; Grabenstatter, Jonathan; de Mendoza, Alex; Riesgo, Ana; Ruiz-Trillo, Iñaki

2016-01-01

Molecular fossils (or biomarkers) are key to unraveling the deep history of eukaryotes, especially in the absence of traditional fossils. In this regard, the sterane 24-isopropylcholestane has been proposed as a molecular fossil for sponges, and could represent the oldest evidence for animal life. The sterane is found in rocks ∼650–540 million y old, and its sterol precursor (24-isopropylcholesterol, or 24-ipc) is synthesized today by certain sea sponges. However, 24-ipc is also produced in trace amounts by distantly related pelagophyte algae, whereas only a few close relatives of sponges have been assayed for sterols. In this study, we analyzed the sterol and gene repertoires of four taxa (Salpingoeca rosetta, Capsaspora owczarzaki, Sphaeroforma arctica, and Creolimax fragrantissima), which collectively represent the major living animal outgroups. We discovered that all four taxa lack C30 sterols, including 24-ipc. By building phylogenetic trees for key enzymes in 24-ipc biosynthesis, we identified a candidate gene (carbon-24/28 sterol methyltransferase, or SMT) responsible for 24-ipc production. Our results suggest that pelagophytes and sponges independently evolved C30 sterol biosynthesis through clade-specific SMT duplications. Using a molecular clock approach, we demonstrate that the relevant sponge SMT duplication event overlapped with the appearance of 24-isopropylcholestanes in the Neoproterozoic, but that the algal SMT duplication event occurred later in the Phanerozoic. Subsequently, pelagophyte algae and their relatives are an unlikely alternative to sponges as a source of Neoproterozoic 24-isopropylcholestanes, consistent with growing evidence that sponges evolved long before the Cambrian explosion ∼542 million y ago. PMID:26903629

Effect of Hypoglycemic Agents on Ischemic Preconditioning in Patients With Type 2 Diabetes and Symptomatic Coronary Artery Disease

PubMed Central

Rahmi, Rosa Maria; Uchida, Augusto Hiroshi; Rezende, Paulo Cury; Lima, Eduardo Gomes; Garzillo, Cibele Larrosa; Favarato, Desiderio; Strunz, Celia M.C.; Takiuti, Myrthes; Girardi, Priscyla; Hueb, Whady; Kalil Filho, Roberto; Ramires, José A.F.

2013-01-01

OBJECTIVE To assess the effect of two hypoglycemic drugs on ischemic preconditioning (IPC) patients with type 2 diabetes and coronary artery disease (CAD). RESEARCH DESIGN AND METHODS We performed a prospective study of 96 consecutive patients allocated into two groups: 42 to group repaglinide (R) and 54 to group vildagliptin (V). All patients underwent two consecutive exercise tests (ET1 and ET2) in phase 1 without drugs. In phase 2, 1 day after ET1 and -2, 2 mg repaglinide three times daily or 50 mg vildagliptin twice daily was given orally to patients in the respective group for 6 days. On the seventh day, 60 min after 6 mg repaglinide or 100 mg vildagliptin, all patients underwent two consecutive exercise tests (ET3 and ET4). RESULTS In phase 1, IPC was demonstrated by improvement in the time to 1.0 mm ST-segment depression and rate pressure product (RPP). All patients developed ischemia in ET3; however, 83.3% of patients in group R experienced ischemia earlier in ET4, without significant improvement in RPP, indicating the cessation of IPC (P < 0.0001). In group V, only 28% of patients demonstrated IPC cessation, with 72% still having the protective effect (P < 0.0069). CONCLUSIONS Repaglinide eliminated myocardial IPC, probably by its effect on the KATP channel. Vildagliptin did not damage this protective mechanism in a relevant way in patients with type 2 diabetes and CAD, suggesting a good alternative treatment in this population. PMID:23250803

Serious electronic games as behavioural change interventions in healthcare-associated infections and infection prevention and control: a scoping review of the literature and future directions.

PubMed

Castro-Sánchez, Enrique; Kyratsis, Yiannis; Iwami, Michiyo; Rawson, Timothy M; Holmes, Alison H

2016-01-01

The uptake of improvement initiatives in infection prevention and control (IPC) has often proven challenging. Innovative interventions such as 'serious games' have been proposed in other areas to educate and help clinicians adopt optimal behaviours. There is limited evidence about the application and evaluation of serious games in IPC. The purposes of the study were: a) to synthesise research evidence on the use of serious games in IPC to support healthcare workers' behaviour change and best practice learning; and b) to identify gaps across the formulation and evaluation of serious games in IPC. A scoping study was conducted using the methodological framework developed by Arksey and O'Malley. We interrogated electronic databases (Ovid MEDLINE, Embase Classic + Embase, PsycINFO, Scopus, Cochrane, Google Scholar) in December 2015. Evidence from these studies was assessed against an analytic framework of intervention formulation and evaluation. Nine hundred sixty five unique papers were initially identified, 23 included for full-text review, and four finally selected. Studies focused on intervention inception and development rather than implementation. Expert involvement in game design was reported in 2/4 studies. Potential game users were not included in needs assessment and game development. Outcome variables such as fidelity or sustainability were scarcely reported. The growing interest in serious games for health has not been coupled with adequate evaluation of processes, outcomes and contexts involved. Explanations about the mechanisms by which game components may facilitate behaviour change are lacking, further hindering adoption.

IPCS implications for future supersonic transport aircraft

NASA Technical Reports Server (NTRS)

Billig, L. O.; Kniat, J.; Schmidt, R. D.

1976-01-01

The Integrated Propulsion Control System (IPCS) demonstrates control of an entire supersonic propulsion module - inlet, engine afterburner, and nozzle - with an HDC 601 digital computer. The program encompasses the design, build, qualification, and flight testing of control modes, software, and hardware. The flight test vehicle is an F-111E airplane. The L.H. inlet and engine will be operated under control of a digital computer mounted in the weapons bay. A general description and the current status of the IPCS program are given.

Protocol of the Australasian Malignant Pleural Effusion (AMPLE) trial: a multicentre randomised study comparing indwelling pleural catheter versus talc pleurodesis.

PubMed

Fysh, Edward T H; Thomas, Rajesh; Read, Catherine A; Kwan, Ben C H; Lam, Ben C H; Yap, Elaine; Horwood, Fiona C; Lee, Pyng; Piccolo, Francesco; Shrestha, Ranjan; Garske, Luke A; Lam, David C L; Rosenstengel, Andrew; Bint, Michael; Murray, Kevin; Smith, Nicola A; Lee, Y C Gary

2014-11-06

Malignant pleural effusion can complicate most cancers. It causes breathlessness and requires hospitalisation for invasive pleural drainages. Malignant effusions often herald advanced cancers and limited prognosis. Minimising time spent in hospital is of high priority to patients and their families. Various treatment strategies exist for the management of malignant effusions, though there is no consensus governing the best choice. Talc pleurodesis is the conventional management but requires hospitalisation (and substantial healthcare resources), can cause significant side effects, and has a suboptimal success rate. Indwelling pleural catheters (IPCs) allow ambulatory fluid drainage without hospitalisation, and are increasingly employed for management of malignant effusions. Previous studies have only investigated the length of hospital care immediately related to IPC insertion. Whether IPC management reduces time spent in hospital in the patients' remaining lifespan is unknown. A strategy of malignant effusion management that reduces hospital admission days will allow patients to spend more time outside hospital, reduce costs and save healthcare resources. The Australasian Malignant Pleural Effusion (AMPLE) trial is a multicentred, randomised trial designed to compare IPC with talc pleurodesis for the management of malignant pleural effusion. This study will randomise 146 adults with malignant pleural effusions (1:1) to IPC management or talc slurry pleurodesis. The primary end point is the total number of days spent in hospital (for any admissions) from treatment procedure to death or end of study follow-up. Secondary end points include hospital days specific to pleural effusion management, adverse events, self-reported symptom and quality-of-life scores. The Sir Charles Gairdner Group Human Research Ethics Committee has approved the study as have the ethics boards of all the participating hospitals. The trial results will be published in peer-reviewed journals and presented at scientific conferences. Australia New Zealand Clinical Trials Registry-ACTRN12611000567921; National Institutes of Health-NCT02045121. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The Einstein database of IPC x-ray observations of optically selected and radio-selected quasars, 1.

NASA Technical Reports Server (NTRS)

Wilkes, Belinda J.; Tananbaum, Harvey; Worrall, D. M.; Avni, Yoram; Oey, M. S.; Flanagan, Joan

1994-01-01

We present the first volume of the Einstein quasar database. The database includes estimates of the X-ray count rates, fluxes, and luminosities for 514 quasars and Seyfert 1 galaxies observed with the Imaging Proportional Counter (IPC) aboard the Einstein Observatory. All were previously known optically selected or radio-selected objects, and most were the targets of the X-ray observations. The X-ray properties of the Active Galactic Nuclei (AGNs) have been derived by reanalyzing the IPC data in a systematic manner to provide a uniform database for general use by the astronomical community. We use the database to extend earlier quasar luminosity studies which were made using only a subset of the currently available data. The database can be accessed on internet via the SAO Einstein on-line system ('Einline') and is available in ASCII format on magnetic tape and DOS diskette.

Cold-sensing regulates Drosophila growth through insulin-producing cells

PubMed Central

Li, Qiaoran; Gong, Zhefeng

2015-01-01

Across phyla, body size is linked to climate. For example, rearing fruit flies at lower temperatures results in bigger body sizes than those observed at higher temperatures. The underlying molecular basis of this effect is poorly understood. Here we provide evidence that the temperature-dependent regulation of Drosophila body size depends on a group of cold-sensing neurons and insulin-producing cells (IPCs). Electrically silencing IPCs completely abolishes the body size increase induced by cold temperature. IPCs are directly innervated by cold-sensing neurons. Stimulation of these cold-sensing neurons activates IPCs, promotes synthesis and secretion of Drosophila insulin-like peptides and induces a larger body size, mimicking the effects of rearing the flies in cold temperature. Taken together, these findings reveal a neuronal circuit that mediates the effects of low temperature on fly growth. PMID:26648410

The Caspase 1 Inhibitor VX-765 Protects the Isolated Rat Heart via the RISK Pathway.

PubMed

Do Carmo, Helison; Arjun, Sapna; Petrucci, Orlando; Yellon, Derek M; Davidson, Sean M

2018-04-01

Protecting the heart from ischaemia-reperfusion (IR) injury is a major goal in patients presenting with an acute myocardial infarction. Pyroptosis is a novel form of cell death in which caspase 1 is activated and cleaves interleukin 1β. VX-785 is a highly selective, prodrug caspase 1 inhibitor that is also clinically available. It has been shown to be protective against acute IR in vivo rat model, and therefore might be a promising possibility for future cardioprotective therapy. However, it is not known whether protection by VX-765 involves the reperfusion injury salvage kinase (RISK) pathway. We therefore investigated whether VX-765 protects the isolated, perfused rat heart via the PI3K/Akt pathway and whether protection was additive with ischaemic preconditioning (IPC). Langendorff-perfused rat hearts were subject to ischaemia and reperfusion injury in the presence of 30 μM VX-765, with precedent IPC, or the combination of VX-765 and IPC. VX-765 reduced infarct size (28 vs 48% control; P < 0.05) to a similar extent as IPC (30%; P < 0.05). The PI3 kinase inhibitor, wortmannin, abolished the protective effect of VX-765. Importantly in the model used, we were unable to show additive protection with VX-765 + IPC. The caspase 1 inhibitor, VX-765, was able to reduce myocardial infarction in a model of IR injury. However, the addition of IPC did not demonstrate any further protection.

Preconditioning results in S-nitrosylation of proteins involved in regulation of mitochondrial energetics and calcium transport.

PubMed

Sun, Junhui; Morgan, Meghan; Shen, Rong-Fong; Steenbergen, Charles; Murphy, Elizabeth

2007-11-26

Nitric oxide has been shown to be an important signaling messenger in ischemic preconditioning (IPC). Accordingly, we investigated whether protein S-nitrosylation occurs in IPC hearts and whether S-nitrosoglutathione (GSNO) elicits similar effects on S-nitrosylation and cardioprotection. Preceding 20 minutes of no-flow ischemia and reperfusion, hearts from C57BL/6J mice were perfused in the Langendorff mode and subjected to the following conditions: (1) control perfusion; (2) IPC; or (3) 0.1 mmol/L GSNO treatment. Compared with control, IPC and GSNO significantly improved postischemic recovery of left ventricular developed pressure and reduced infarct size. IPC and GSNO both significantly increased S-nitrosothiol contents and S-nitrosylation levels of the L-type Ca2+ channel alpha1 subunit in heart membrane fractions. We identified several candidate S-nitrosylated proteins by proteomic analysis following the biotin switch method, including the cardiac sarcoplasmic reticulum Ca2+-ATPase, alpha-ketoglutarate dehydrogenase, and the mitochondrial F1-ATPase alpha1 subunit. The activities of these enzymes were altered in a concentration-dependent manner by GSNO treatment. We further developed a 2D DyLight fluorescence difference gel electrophoresis proteomic method that used DyLight fluors and a modified biotin switch method to identify S-nitrosylated proteins. IPC and GSNO produced a similar pattern of S-nitrosylation modification and cardiac protection against ischemia/reperfusion injury, suggesting that protein S-nitrosylation may play an important cardioprotective role in heart.

The Loss of Myocardial Benefit following Ischemic Preconditioning Is Associated with Dysregulation of Iron Homeostasis in Diet-Induced Diabetes

PubMed Central

Berenshtein, Eduard; Eliashar, Ron; Chevion, Mordechai

2016-01-01

Whether the diabetic heart benefits from ischemic preconditioning (IPC), similar to the non-diabetic heart, is a subject of controversy. We recently proposed new roles for iron and ferritin in IPC-protection in Type 1-like streptozotocin-induced diabetic rat heart. Here, we investigated iron homeostasis in Cohen diabetic sensitive rat (CDs) that develop hyperglycemia when fed on a high-sucrose/low-copper diet (HSD), but maintain normoglycemia on regular-diet (RD). Control Cohen-resistant rats (CDr) maintain normoglycemia on either diet. The IPC procedure improved the post-ischemic recovery of normoglycemic hearts (CDr-RD, CDr-HSD and CDs-RD). CDs-HSD hearts failed to show IPC-associated protection. The recovery of these CDs-HSD hearts following I/R (without prior IPC) was better than their RD controls. During IPC ferritin levels increased in normoglycemic hearts, and its level was maintained nearly constant during the subsequent prolonged ischemia, but decayed to its baseline level during the reperfusion phase. In CDs-HSD hearts the baseline levels of ferritin and ferritin-saturation with iron were notably higher than in the controls, and remained unchanged during the entire experiment. This unique and abnormal pattern of post-ischemic recovery of CDs-HSD hearts is associated with marked changes in myocardial iron homeostasis, and suggests that iron and iron-proteins play a causative role/s in the etiology of diabetes-associated cardiovascular disorders. PMID:27458721

Ischemic preconditioning inhibits over-expression of arginyl-tRNA synthetase gene Rars in ischemia-injured neurons.

PubMed

Shen, Yin; Zhao, Hong-Yang; Wang, Hai-Jun; Wang, Wen-Liang; Zhang, Li-Zhi; Fu, Rong

2016-08-01

The expression changes of Rars gene in ischemia-injured neurons were investigated by detecting its translational product arginyl-tRNA synthetase (ArgRS), and the inhibitory effects of ischemic preconditioning (IPC) on Rars gene were explored. Both IPC model and prolonged ischemia (PI) model were established by using the classic oxygen glucose deprivation (OGD) method. The primary cultured neurons were assigned into the following groups: the experimental group (IPC+PI group), undergoing PI after a short period of IPC; the conditional control group (PI control group), subjected to PI without IPC; blank control group, the normally cultured neurons. The Rars transcriptional activities and ArgRS expression levels were measured at different time points after re-oxygenation (3 h/6 h/12 h/24 h). Data were collected and statistically analyzed. Compared to the blank control group, the Rars activities and ArgRS levels were significantly increased in PI control group, peaking at the time point of 6 h after re-oxygenation. Rars activities and ArgRS levels were significantly lower in the experimental group than in the PI control group at different time points after re-oxygenation. PI insult can induce an escalating activity of Rars and lead to ArgRS over-expression in primary cultured neurons. IPC can inhibit the increased Rars activity and down-regulate ArgRS expression of ischemia-insulted neurons. This mechanism may confer ischemic tolerance on neurons.

Reduction of Syndecan Transcript Levels in the Insulin-Producing Cells Affects Glucose Homeostasis in Adult Drosophila melanogaster.

PubMed

Warren, Jonathan L; Hoxha, Eneida; Jumbo-Lucioni, Patricia; De Luca, Maria

2017-11-01

Signaling by direct cell-matrix interactions has been shown to impact the transcription, secretion, and storage of insulin in mammalian β cells. However, more research is still needed in this area. Syndecans are transmembrane heparan sulfate proteoglycans that function independently and in synergy with integrin-mediated signaling to mediate cell adhesion to the extracellular matrix. In this study, we used the model organism Drosophila melanogaster to determine whether knockdown of the Syndecan (Sdc) gene expression specifically in the insulin-producing cells (IPCs) might affect insulin-like peptide (ILP) production and secretion. IPCs of adult flies produce three ILPs (ILP2, ILP3, and ILP5), which have significant homology to mammalian insulin. We report that flies with reduced Sdc expression in the IPCs did not show any difference in the expression of ilp genes compared to controls. However, they had significantly reduced levels of the circulating ILP2 protein, higher circulating carbohydrates, and were less glucose tolerant than control flies. Finally, we found that IPCs-specific Sdc knockdown led to reduced levels of head Glucose transporter1 gene expression, extracellular signal-regulated kinase phosphorylation, and reactive oxygen species. Taken together, our findings suggest a cell autonomous role for Sdc in insulin release in D. melanogaster.

Implementation of tuberculosis infection prevention and control in Mozambican health care facilities.

PubMed

Brouwer, M; Coelho, E; das Dores Mosse, C; van Leth, F

2015-01-01

District and urban health care facilities in three provinces (Manica, Sofala, Tete) in central Mozambique. To assess the level of implementation of selected tuberculosis infection prevention and control (TB-IPC) measures. In a cross-sectional study of TB-IPC implementation in 29 health care facilities, we assessed TB clinics, laboratories, out-patient departments and medical and TB wards. Assessment included selected managerial, administrative and environmental measures and the availability and use of respiratory protective equipment (N95 respirators). Guidelines for diagnosis and treatment of (presumptive) TB patients were not present in all facilities. Staff instructed patients on sputum collection in 91%, but only 4% observed it. Using a pragmatic '20% rule', 52% of the rooms assessed had adequate ventilation. Potentially, this could be increased to 76%. Three quarters of the health care workers had N95 respirators. Only 36% knew how to use it correctly. Implementation of TB-IPC measures showed wide variations within health care facilities. Relatively simple measures to improve TB-IPC include the availability of guidelines, opening doors and windows to improve ventilation, and training and support on correct N95 respirator use. However, even relatively simple measures are challenging to implement, and require careful attention in and evaluation of the implementation process.

Tower Based Load Measurements for Individual Pitch Control and Tower Damping of Wind Turbines

NASA Astrophysics Data System (ADS)

Kumar, A. A.; Hugues-Salas, O.; Savini, B.; Keogh, W.

2016-09-01

The cost of IPC has hindered adoption outside of Europe despite significant loading advantages for large wind turbines. In this work we presented a method for applying individual pitch control (including for higher-harmonics) using tower-top strain gauge feedback instead of blade-root strain gauge feedback. Tower-top strain gauges offer hardware savings of approximately 50% in addition to the possibility of easier access for maintenance and installation and requiring a less specialised skill-set than that required for applying strain gauges to composite blade roots. A further advantage is the possibility of using the same tower-top sensor array for tower damping control. This method is made possible by including a second order IPC loop in addition to the tower damping loop to reduce the typically dominating 3P content in tower-top load measurements. High-fidelity Bladed simulations show that the resulting turbine spectral characteristics from tower-top feedback IPC and from the combination of tower-top IPC and damping loops largely match those of blade-root feedback IPC and nacelle- velocity feedback damping. Lifetime weighted fatigue analysis shows that the methods allows load reductions within 2.5% of traditional methods.

Challenges in designing a Taqman-based multiplex assay for the simultaneous detection of Herpes simplex virus types 1 and 2 and Varicella-zoster virus.

PubMed

Weidmann, Manfred; Armbruster, Katrin; Hufert, Frank T

2008-08-01

To optimise molecular detection of herpesviruses an internally controlled multiplex Taqman-PCR for the detection of Herpes simplex virus 1 (HSV1), Herpes simplex virus 2 (HSV2) and Varicella-zoster virus (VZV) was developed. The selection of the dye combination working on the ABI 7700 cycler for this multiplex PCR revealed crosstalk phenomena between several combinations of reference dyes and reporter dyes. A final dye combination with CY5 as reference dye and FAM/JOE/TXR as reporter dyes was selected. The influence of the concentration of the internal positive control (IPC) concentration on the quantitative results of HSV1, HSV2 and VZV positive patient samples was analysed. The results indicate that high IPC concentrations are detrimental for the sensitivity of the multiplex assay and that the presence of the IPC molecule narrows the dynamic range of the duplex PCRs between any of the virus PCRs and the IPC-PCR. The optimised multiplex assay detecting HSV1, HSV2 and VZV using 10(3) IPC molecules showed a performance and sensitivity comparable to that of the individual assays.

Core components for effective infection prevention and control programmes: new WHO evidence-based recommendations.

PubMed

Storr, Julie; Twyman, Anthony; Zingg, Walter; Damani, Nizam; Kilpatrick, Claire; Reilly, Jacqui; Price, Lesley; Egger, Matthias; Grayson, M Lindsay; Kelley, Edward; Allegranzi, Benedetta

2017-01-01

Health care-associated infections (HAI) are a major public health problem with a significant impact on morbidity, mortality and quality of life. They represent also an important economic burden to health systems worldwide. However, a large proportion of HAI are preventable through effective infection prevention and control (IPC) measures. Improvements in IPC at the national and facility level are critical for the successful containment of antimicrobial resistance and the prevention of HAI, including outbreaks of highly transmissible diseases through high quality care within the context of universal health coverage. Given the limited availability of IPC evidence-based guidance and standards, the World Health Organization (WHO) decided to prioritize the development of global recommendations on the core components of effective IPC programmes both at the national and acute health care facility level, based on systematic literature reviews and expert consensus. The aim of the guideline development process was to identify the evidence and evaluate its quality, consider patient values and preferences, resource implications, and the feasibility and acceptability of the recommendations. As a result, 11 recommendations and three good practice statements are presented here, including a summary of the supporting evidence, and form the substance of a new WHO IPC guideline.

Retinal determination genes coordinate neuroepithelial specification and neurogenesis modes in the Drosophila optic lobe

PubMed Central

Apitz, Holger

2016-01-01

Differences in neuroepithelial patterning and neurogenesis modes contribute to area-specific diversifications of neural circuits. In the Drosophila visual system, two neuroepithelia, the outer (OPC) and inner (IPC) proliferation centers, generate neuron subtypes for four ganglia in several ways. Whereas neuroepithelial cells in the medial OPC directly convert into neuroblasts, in an IPC subdomain they generate migratory progenitors by epithelial-mesenchymal transition that mature into neuroblasts in a second proliferative zone. The molecular mechanisms that regulate the identity of these neuroepithelia, including their neurogenesis modes, remain poorly understood. Analysis of Polycomblike revealed that loss of Polycomb group-mediated repression of the Hox gene Abdominal-B (Abd-B) caused the transformation of OPC to IPC neuroepithelial identity. This suggests that the neuroepithelial default state is IPC-like, whereas OPC identity is derived. Ectopic Abd-B blocks expression of the highly conserved retinal determination gene network members Eyes absent (Eya), Sine oculis (So) and Homothorax (Hth). These factors are essential for OPC specification and neurogenesis control. Finally, eya and so are also sufficient to confer OPC-like identity, and, in parallel with hth, the OPC-specific neurogenesis mode on the IPC. PMID:27381228

Imaginary Play Companions: Characteristics and Functions.

ERIC Educational Resources Information Center

Kalyan-Masih, V.

1986-01-01

Investigates some of the following characteristics associated with young children playing with imaginary play companions (IPCs): intelligence, parental and socioeconomic and educational background, family size, and birth order. Compares these children to those without IPCs. (HOD)

Beyond hand hygiene: a qualitative study of the everyday work of preventing cross-contamination on hospital wards.

PubMed

Hor, Su-Yin; Hooker, Claire; Iedema, Rick; Wyer, Mary; Gilbert, Gwendolyn L; Jorm, Christine; O'Sullivan, Matthew Vincent Neil

2017-07-01

Hospital-acquired infections are the most common adverse event for inpatients worldwide. Efforts to prevent microbial cross-contamination currently focus on hand hygiene and use of personal protective equipment (PPE), with variable success. Better understanding is needed of infection prevention and control (IPC) in routine clinical practice. We report on an interventionist video-reflexive ethnography study that explored how healthcare workers performed IPC in three wards in two hospitals in New South Wales, Australia: an intensive care unit and two general surgical wards. We conducted 46 semistructured interviews, 24 weeks of fieldwork (observation and videoing) and 22 reflexive sessions with a total of 177 participants (medical, nursing, allied health, clerical and cleaning staff, and medical and nursing students). We performed a postintervention analysis, using a modified grounded theory approach, to account for the range of IPC practices identified by participants. We found that healthcare workers' routine IPC work goes beyond hand hygiene and PPE. It also involves, for instance, the distribution of team members during rounds, the choreography of performing aseptic procedures and moving 'from clean to dirty' when examining patients. We account for these practices as the logistical work of moving bodies and objects across boundaries, especially from contaminated to clean/vulnerable spaces, while restricting the movement of micro-organisms through cleaning, applying barriers and buffers, and trajectory planning. Attention to the logistics of moving people and objects around healthcare spaces, especially into vulnerable areas, allows for a more comprehensive approach to IPC through better contextualisation of hand hygiene and PPE protocols, better identification of transmission risks, and the design and promotion of a wider range of preventive strategies and solutions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Role of Homocysteine in the Ischemic Stroke and Development of Ischemic Tolerance

PubMed Central

Lehotský, Ján; Tothová, Barbara; Kovalská, Maria; Dobrota, Dušan; Beňová, Anna; Kalenská, Dagmar; Kaplán, Peter

2016-01-01

Homocysteine (Hcy) is a toxic, sulfur-containing intermediate of methionine metabolism. Hyperhomocysteinemia (hHcy), as a consequence of impaired Hcy metabolism or defects in crucial co-factors that participate in its recycling, is assumed as an independent human stroke risk factor. Neural cells are sensitive to prolonged hHcy treatment, because Hcy cannot be metabolized either by the transsulfuration pathway or by the folate/vitamin B12 independent remethylation pathway. Its detrimental effect after ischemia-induced damage includes accumulation of reactive oxygen species (ROS) and posttranslational modifications of proteins via homocysteinylation and thiolation. Ischemic preconditioning (IPC) is an adaptive response of the CNS to sub-lethal ischemia, which elevates tissues tolerance to subsequent ischemia. The main focus of this review is on the recent data on homocysteine metabolism and mechanisms of its neurotoxicity. In this context, the review documents an increased oxidative stress and functional modification of enzymes involved in redox balance in experimentally induced hyperhomocysteinemia. It also gives an interpretation whether hyperhomocysteinemia alone or in combination with IPC affects the ischemia-induced neurodegenerative changes as well as intracellular signaling. Studies document that hHcy alone significantly increased Fluoro-Jade C- and TUNEL-positive cell neurodegeneration in the rat hippocampus as well as in the cortex. IPC, even if combined with hHcy, could still preserve the neuronal tissue from the lethal ischemic effects. This review also describes the changes in the mitogen-activated protein kinase (MAPK) protein pathways following ischemic injury and IPC. These studies provide evidence for the interplay and tight integration between ERK and p38 MAPK signaling mechanisms in response to the hHcy and also in association of hHcy with ischemia/IPC challenge in the rat brain. Further investigations of the protective factors leading to ischemic tolerance and recognition of the co-morbid risk factors would result in development of new avenues for exploration of novel therapeutics against ischemia and stroke. PMID:27932944

Zoonotic disease risk perceptions in the British veterinary profession.

PubMed

Robin, Charlotte; Bettridge, Judy; McMaster, Fiona

2017-01-01

In human and veterinary medicine, reducing the risk of occupationally-acquired infections relies on effective infection prevention and control practices (IPCs). In veterinary medicine, zoonoses present a risk to practitioners, yet little is known about how these risks are understood and how this translates into health protective behaviour. This study aimed to explore risk perceptions within the British veterinary profession and identify motivators and barriers to compliance with IPCs. A cross-sectional study was conducted using veterinary practices registered with the Royal College of Veterinary Surgeons. Here we demonstrate that compliance with IPCs is influenced by more than just knowledge and experience, and understanding of risk is complex and multifactorial. Out of 252 respondents, the majority were not concerned about the risk of zoonoses (57.5%); however, a considerable proportion (34.9%) was. Overall, 44.0% of respondents reported contracting a confirmed or suspected zoonoses, most frequently dermatophytosis (58.6%). In veterinary professionals who had previous experience of managing zoonotic cases, time or financial constraints and a concern for adverse animal reactions were not perceived as barriers to use of personal protective equipment (PPE). For those working in large animal practice, the most significant motivator for using PPE was concerns over liability. When assessing responses to a range of different "infection control attitudes", veterinary nurses tended to have a more positive perspective, compared with veterinary surgeons. Our results demonstrate that IPCs are not always adhered to, and factors influencing motivators and barriers to compliance are not simply based on knowledge and experience. Educating veterinary professionals may help improve compliance to a certain extent, however increased knowledge does not necessarily equate to an increase in risk-mitigating behaviour. This highlights that the construction of risk is complex and circumstance-specific and to get a real grasp on compliance with IPCs, this construction needs to be explored in more depth. Copyright © 2016. Published by Elsevier B.V.

Analysis of ASTER data for mapping bauxite rich pockets within high altitude lateritic bauxite, Jharkhand, India

NASA Astrophysics Data System (ADS)

Guha, Arindam; Singh, Vivek Kr.; Parveen, Reshma; Kumar, K. Vinod; Jeyaseelan, A. T.; Dhanamjaya Rao, E. N.

2013-04-01

Bauxite deposits of Jharkhand in India are resulted from the lateritization process and therefore are often associated with the laterites. In the present study, ASTER (Advanced Space borne Thermal Emission and Reflection Radiometer) image is processed to delineate bauxite rich pockets within the laterites. In this regard, spectral signatures of lateritic bauxite samples are analyzed in the laboratory with reference to the spectral features of gibbsite (main mineral constituent of bauxite) and goethite (main mineral constituent of laterite) in VNIR-SWIR (visible-near infrared and short wave infrared) electromagnetic domain. The analysis of spectral signatures of lateritic bauxite samples helps in understanding the differences in the spectral features of bauxites and laterites. Based on these differences; ASTER data based relative band depth and simple ratio images are derived for spatial mapping of the bauxites developed within the lateritic province. In order to integrate the complementary information of different index image, an index based principal component (IPC) image is derived to incorporate the correlative information of these indices to delineate bauxite rich pockets. The occurrences of bauxite rich pockets derived from density sliced IPC image are further delimited by the topographic controls as it has been observed that the major bauxite occurrences of the area are controlled by slope and altitude. In addition to above, IPC image is draped over the digital elevation model (DEM) to illustrate how bauxite rich pockets are distributed with reference to the topographic variability of the terrain. Bauxite rich pockets delineated in the IPC image are also validated based on the known mine occurrences and existing geological map of the bauxite. It is also conceptually validated based on the spectral similarity of the bauxite pixels delineated in the IPC image with the ASTER convolved laboratory spectra of bauxite samples.

Morphine preconditioning confers cardioprotection in doxorubicin-induced failing rat hearts via ERK/GSK-3β pathway independent of PI3K/Akt.

PubMed

He, Shu-Fang; Jin, Shi-Yun; Wu, Hao; Wang, Bin; Wu, Yun-Xiang; Zhang, Shu-Jie; Irwin, Michael G; Wong, Tak-Ming; Zhang, Ye

2015-11-01

Preconditioning against myocardial ischemia-reperfusion (I/R) injury can be suppressed in some pathological conditions. This study was designed to investigate whether morphine preconditioning (MPC) exerts cardioprotection in doxorubicin (DOX)-induced heart failure in rats and the mechanisms involved. Phosphatidylinositol-3 kinase/protein kinase B (PI3K/Akt), extracellular signal-regulated kinase (ERK) and glycogen synthase kinase (GSK)-3β pathways were examined. Normal and DOX-induced failing rat hearts were subjected to I/R injury using a Langendorff perfusion system with or without MPC or ischemic preconditioning (IPC). The PI3K inhibitor (wortmannin) or ERK inhibitor (PD98059) was infused before MPC. In normal hearts, both MPC and IPC significantly reduced infarct size and the rise in lactate dehydrogenase (LDH) level caused by I/R injury. Pretreatment with wortmannin or PD98059 abrogated the protective effects of MPC and suppressed the phosphorylation of Akt, ERK and GSK-3β. In failing rat hearts, however, MPC retained its cardioprotection while IPC did not. This protective effect was abolished by PD98059 but not wortmannin. MPC increased the level of p-ERK rather than p-Akt. The phosphorylation of GSK-3β induced by MPC was reversed by PD98059 only. IPC did not elevate the expression of p-ERK, p-Akt and p-GSK-3β in failing rat hearts. We conclude that MPC is cardioprotective in rats with DOX-induced heart failure while IPC is not. The effect of MPC appears to be mediated via the ERK/GSK-3β pathway independent of PI3K/Akt. Copyright © 2015 Elsevier Inc. All rights reserved.

Infection Prevention and Control Programs in United States Nursing Homes: Results of a National Survey

PubMed Central

Herzig, Carolyn T. A.; Stone, Patricia W.; Castle, Nicholas; Pogorzelska-Maziarz, Monika; Larson, Elaine L.; Dick, Andrew W.

2015-01-01

Objectives The objectives of this study were to (1) obtain a national perspective of the current state of nursing home (NH) infection prevention and control (IPC) programs and (2) examine differences in IPC program characteristics for NHs that had and had not received an infection control deficiency citation. Design A national cross-sectional survey of randomly sampled NHs was conducted and responses were linked with Certification and Survey Provider Enhanced Reporting (CASPER) and NH Compare data. Setting Surveys were completed and returned by 990 NHs (response rate 39%) between December 2013 and December 2014. Participants The person in charge of the IPC program at each NH completed the survey. Measurements The survey consisted of 34 items related to respondent demographics, IPC program staffing, stability of the workforce, resources and challenges, and resident care and employee processes. Facility characteristics and infection control deficiency citations were assessed using CASPER and NH Compare data. Results Most respondents had at least two responsibilities in addition to those related to infection control (54%) and had no specific IPC training (61%). While many practices and processes were consistent with infection prevention guidelines for NHs, there was wide variation in programs across the US. About 36% of responding facilities had received an infection control deficiency citation. NHs that received citations had infection control professionals with less experience (P = .01) and training (P = .02) and were less likely to provide financial resources for continuing education in infection control (P = .01). Conclusion The findings demonstrate that a lack of adequately trained infection prevention personnel is an important area for improvement. Furthermore, there is a need to identify specific evidence-based practices to reduce infection risk in NHs. PMID:26712489

Infection Prevention and Control Programs in US Nursing Homes: Results of a National Survey.

PubMed

Herzig, Carolyn T A; Stone, Patricia W; Castle, Nicholas; Pogorzelska-Maziarz, Monika; Larson, Elaine L; Dick, Andrew W

2016-01-01

The objectives of this study were to (1) obtain a national perspective of the current state of nursing home (NH) infection prevention and control (IPC) programs and (2) examine differences in IPC program characteristics for NHs that had and had not received an infection control deficiency citation. A national cross-sectional survey of randomly sampled NHs was conducted and responses were linked with Certification and Survey Provider Enhanced Reporting (CASPER) and NH Compare data. Surveys were completed and returned by 990 NHs (response rate 39%) between December 2013 and December 2014. The person in charge of the IPC program at each NH completed the survey. The survey consisted of 34 items related to respondent demographics, IPC program staffing, stability of the workforce, resources and challenges, and resident care and employee processes. Facility characteristics and infection control deficiency citations were assessed using CASPER and NH Compare data. Most respondents had at least 2 responsibilities in addition to those related to infection control (54%) and had no specific IPC training (61%). Although many practices and processes were consistent with infection prevention guidelines for NHs, there was wide variation in programs across the United States. Approximately 36% of responding facilities had received an infection control deficiency citation. NHs that received citations had infection control professionals with less experience (P = .01) and training (P = .02) and were less likely to provide financial resources for continuing education in infection control (P = .01). The findings demonstrate that a lack of adequately trained infection prevention personnel is an important area for improvement. Furthermore, there is a need to identify specific evidence-based practices to reduce infection risk in NHs. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Generation of insulin-producing cells from rat mesenchymal stem cells using an aminopyrrole derivative XW4.4.

PubMed

Ouyang, Jingfeng; Huang, Wei; Yu, Wanwan; Xiong, Wei; Mula, Ramanjaneya V R; Zou, Hongbin; Yu, Yongping

2014-02-05

Type 1 diabetes mellitus (T1DM), a multisystem disease with both biochemical and anatomical/structural consequences, is a major health concern worldwide. Pancreatic islet transplantation provides a promising treatment for T1DM. However, the limited availability of islet tissue or new sources of insulin producing cells (IPCs) that are responsive to glucose hinder this promising approach. Though slow, the development of pancreatic beta-cell lines from rodent or human origin has been steadily progressing. Bone marrow-derived mesenchymal stem cells (MSCs) are multipotent, culture-expanded, non-hematopoietic cells that are currently being investigated as a novel cellular therapy. The in vitro differentiation potential of IPCs has raised hopes for a treatment of clinical diseases associated with autoimmunity. We screened for small molecules that induce pancreatic differentiation of IPCs. There are some compounds which showed positive effects on the DTZ staining. The aminopyrrole derivative compound XW4.4 which shows the best activity among them was found to induce pancreatic differentiation of rat MSCs (rMSCs). The in vitro studies indicated that treatment of rMSCs with compound XW4.4 resulted in differentiated cells with characteristics of IPCs including islet-like clusters, spherical, grape-like morphology, insulin secretion, positive for dithizone, glucose stimulation and expression of pancreatic endocrine cell marker genes. The data has also suggested that hepatocyte nuclear factor 3β (HNF 3β) may be involved in pancreatic differentiation of rMSCs when treated with XW4.4. Results indicate that XW4.4 induced rMSCs support the efforts to derive functional IPCs and serve as a means to alleviate limitations surrounding islet cell transplantation in the treatment of T1DM. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Bony fish myelin: evidence for common major structural glycoproteins in central and peripheral myelin of trout.

PubMed

Jeserich, G; Waehneldt, T V

1986-02-01

Peripheral nervous system (PNS) myelin from the rainbow trout (Salmo gairdneri) banded at a density of 0.38 M sucrose. The main myelin proteins consisted of (1) two basic proteins, BPa and BPb (11,500 and 13,000 MW, similar to those of trout central nervous system (CNS) myelin proteins BP1 and BP2), and (2) two glycosylated components, IPb (24,400 MW) and IPc (26,200 MW). IPc comigrated with trout CNS myelin protein IP2 in sodium dodecyl sulfate-polyacrylamide gel electrophoresis, whereas trout CNS myelin protein IP1 had a lower molecular weight (23,000). Following two-dimensional separation, however, both IPb and IPc from PNS showed two components; the more acidic component of IPc comigrated with IP2 from CNS. PNS tissue autolysis led to the formation of IPa (20,000 MW), consisting of two components in isoelectric focusing of which again the more acidic one comigrated with the CNS autolysis product IP0. Limited enzymatic digestion of isolated IP proteins from PNS and CNS led to closely similar degradation patterns, being most pronounced in the case of IP2 and IPc. Immunoblotting revealed that all IP components from trout PNS and CNS myelins reacted with antibodies to trout IP1 (CNS) and bovine P0 protein (PNS) whereas antibodies to rat PLP (CNS) were entirely unreactive. All BP components from trout PNS and CNS myelins bound to antibodies against human myelin basic protein. On the basis of these studies trout PNS and CNS myelins contain at least one common IP glycoprotein, whereas other members of the IP myelin protein family appear closely related. In the CNS myelin of trout the IP components appear to replace PLP.(ABSTRACT TRUNCATED AT 250 WORDS)

Does intermittent pneumatic leg compression enhance muscle recovery after strenuous eccentric exercise?

PubMed

Cochrane, D J; Booker, H R; Mundel, T; Barnes, M J

2013-11-01

Intermittent pneumatic compression (IPC) has gained rapid popularity as a post-exercise recovery modality. Despite its widespread use and anecdotal claims for enhancing muscle recovery there is no scientific evidence to support its use. 10 healthy, active males performed a strenuous bout of eccentric exercise (3 sets of 100 repetitions) followed by IPC treatment or control performed immediately after exercise and at 24 and 48 h post-exercise. Muscular performance measurements were taken prior to exercise and 24, 48 and 72 h post-exercise and included single-leg vertical jump (VJ) and peak and average isometric [knee angle 75º] (ISO), concentric (CON) and eccentric (ECC) contractions performed at slow (30° · s⁻¹) and fast (180° · s⁻¹) velocities. Plasma creatine kinase (CK) samples were taken at pre- and post-exercise 24, 48 and 72 h. Strenuous eccentric exercise resulted in a significant decrease in peak ISO, peak and average CON (30° · s⁻¹) at 24 h compared to pre-exercise for both IPC and control, however VJ performance remained unchanged. There were no significant differences between conditions (IPC and control) or condition-time interactions for any of the contraction types (ISO, CON, ECC) or velocities (CON, ECC 30° · s⁻¹ and 180° · s⁻¹). However, CK was significantly elevated at 24 h compared to pre-exercise in both conditions (IPC and control). IPC did not attenuate muscle force loss following a bout of strenuous eccentric exercise in comparison to a control. While IPC has been used in the clinical setting to treat pathologic conditions, the parameters used to treat muscle damage following strenuous exercise in healthy participants are likely to be very different than those used to treat pathologic conditions. © Georg Thieme Verlag KG Stuttgart · New York.

Infection prevention and control strategies in the era of limited resources and quality improvement: a perspective paper.

PubMed

Vandijck, Dominique; Cleemput, Irina; Hellings, Johan; Vogelaers, Dirk

2013-11-01

This paper aims to describe, using an evidence-based approach, the importance of and the resources necessary for implementing effective infection prevention and control (IPC) programmes. The intrinsic and explicit values of such strategies are presented from a clinical, health-economic and patient safety perspective. Policy makers and hospital managers are committed to providing comprehensive, accessible, and affordable healthcare of high quality. Changes in the healthcare system over time accompanied with variations in demographics and case-mix have considerably affected the availability, quality and ultimately the safety of healthcare. The main goal of an IPC programme is to prevent and control healthcare-associated infections (HAI). Many patient-, healthcare provider-, and organizational factors are associated with an increased risk for acquiring HAIs and may impact both the quality and outcome of patient care. Evidence has been published in support of having an effective IPC programme. It has been estimated that about one-third of HAIs could be prevented if key elements of the evidence-based recommendations for IPC are adequately introduced and followed. However, several healthcare agencies from over the world have reported deficits in the essential resources and components of current IPC programmes. To meet its main goal, staffing, training, and infrastructure requirements are needed. Nevertheless, and given the economic crisis, policy makers and hospital managers may be tempted to not increase or even to reduce the budget as it consumes resources and does not generate sufficient visible revenue. IPC is a critical issue in patient safety, as HAIs are by far the most common complication affecting admitted patients. The significant clinical and health-economic burden HAIs place on the healthcare system speak to the importance of getting introduced effective IPC programmes. Copyright © 2013 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

A nano-bio interfacial protein corona on silica nanoparticle.

PubMed

Zhang, Hongyan; Peng, Jiaxi; Li, Xin; Liu, Shengju; Hu, Zhengyan; Xu, Guiju; Wu, Ren'an

2018-07-01

Nano-bio interaction takes the crucial role in bio-application of nanoparticles. The systematic mapping of interfacial proteins remains the big challenge as low level of proteins within interface regions and lack of appropriate technology. Here, a facile proteomic strategy was developed to characterize the interfacial protein corona (noted as IPC) that has strong interactions with silica nanoparticle, via the combination of the vigorous elution with high concentration sodium dodecyl sulfate (SDS) and the pre-isolation of sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). The trace level IPCs for silica nanoparticle were thus qualitatively and quantitatively identified. Bioinformatics analyses revealed the intrinsic compositions, relevance and potential regularity addressing the strong interactions between IPC and nanoparticle. This strategy in determining IPCs is opening an avenue to give a deep insight to understand the interaction between proteins and not only nanoparticles but also other bulk materials. Copyright © 2018 Elsevier B.V. All rights reserved.

Brownian motion of polyphosphate complexes in yeast vacuoles: characterization by fluorescence microscopy with image analysis.

PubMed

Puchkov, Evgeny O

2010-06-01

In the vacuoles of Saccharomyces cerevisiae yeast cells, vividly moving insoluble polyphosphate complexes (IPCs) <1 microm size, stainable by a fluorescent dye, 4',6-diamidino-2-phenylindole (DAPI), may appear under some growth conditions. The aim of this study was to quantitatively characterize the movement of the IPCs and to evaluate the viscosity in the vacuoles using the obtained data. Studies were conducted on S. cerevisiae cells stained by DAPI and fluorescein isothyocyanate-labelled latex microspheres, using fluorescence microscopy combined with computer image analysis (ImageJ software, NIH, USA). IPC movement was photorecorded and shown to be Brownian motion. On latex microspheres, a methodology was developed for measuring a fluorescing particle's two-dimensional (2D) displacements and its size. In four yeast cells, the 2D displacements and sizes of the IPCs were evaluated. Apparent viscosity values in the vacuoles of the cells, computed by the Einstein-Smoluchowski equation using the obtained data, were found to be 2.16 +/- 0.60, 2.52 +/- 0.63, 3.32 +/- 0.9 and 11.3 +/- 1.7 cP. The first three viscosity values correspond to 30-40% glycerol solutions. The viscosity value of 11.3 +/- 1.7 cP was supposed to be an overestimation, caused by the peculiarities of the vacuole structure and/or volume in this particular cell. This conclusion was supported by the particular quality of the Brownian motion trajectories set in this cell as compared to the other three cells.

Impact of ischemic preconditioning on surgical treatment of brain tumors: a single-center, randomized, double-blind, controlled trial.

PubMed

Sales, Arthur H A; Barz, Melanie; Bette, Stefanie; Wiestler, Benedikt; Ryang, Yu-Mi; Meyer, Bernhard; Bretschneider, Martin; Ringel, Florian; Gempt, Jens

2017-07-25

Postoperative ischemia is a frequent phenomenon in patients with brain tumors and is associated with postoperative neurological deficits and impaired overall survival. Particularly in the field of cardiac and vascular surgery, the application of a brief ischemic stimulus not only in the target organ but also in remote tissues can prevent subsequent ischemic damage. We hypothesized that remote ischemic preconditioning (rIPC) in patients with brain tumors undergoing elective surgical resection reduces the incidence of postoperative ischemic tissue damage and its consequences. Sixty patients were randomly assigned to two groups, with 1:1 allocation, stratified by tumor type (glioma or metastasis) and previous treatment with radiotherapy. rIPC was induced by inflating a blood pressure cuff placed on the upper arm three times for 5 min at 200 mmHg in the treatment group after induction of anesthesia. Between the cycles, the blood pressure cuff was released to allow reperfusion. In the control group no preconditioning was performed. Early postoperative magnetic resonance images (within 72 h after surgery) were evaluated by a neuroradiologist blinded to randomization for the presence of ischemia and its volume. Fifty-eight of the 60 patients were assessed for occurrence of postoperative ischemia. Of these 58 patients, 44 had new postoperative ischemic lesions. The incidence of new postoperative ischemic lesions was significantly higher in the control group (27/31) than in the rIPC group (17/27) (p = 0.03). The median infarct volume was 0.36 cm 3 (interquartile range (IR): 0.0-2.35) in the rIPC group compared with 1.30 cm 3 (IR: 0.29-3.66) in the control group (p = 0.09). Application of rIPC was associated with reduced incidence of postoperative ischemic tissue damage in patients undergoing elective brain tumor surgery. This is the first study indicating a benefit of rIPC in brain tumor surgery. German Clinical Trials Register, DRKS00010409 . Retrospectively registered on 13 October 2016.

Infection prevention and control practitioners: improving engagement.

PubMed

Aziz, Ann-Marie

Every healthcare worker plays a vital part in minimising the risk of cross infection. Infection prevention and control (IPC) practitioners have the skills and competencies to assist organisations in improving engagement among staff and play a vital part in achieving this. IPC practitioners have skills in clinical practice, education, research and leadership, and these skills ensure high-quality care for patients and support strategies for engaging staff. This article highlights how IPC practitioners' skills and competencies are required for preventing infection and improving staff engagement. Engaged staff generate positive outcomes for both patients and staff, which is a welcome result for all healthcare organisations.

How Maryland increased infection prevention and control activity in long-term care facilities, 2003-2008.

PubMed

Roup, Brenda J; Scaletta, Joseph M

2011-05-01

In January 2003, the Maryland Department of Health and Mental Hygiene (DHMH) assessed the state of infection prevention and control (IPC) resources and practices in all long-term care facilities (LTC) in the state. Only 8.1% of facilities that responded employed a trained IPC professional (IP) who managed the facility IPC program. Between 2003 and 2008, the DHMH partnered with long-term care industry trade associations and spearheaded regulatory, educational, and financial initiatives to improve this situation. In January 2008, all LTC facilities in the state were resurveyed to determine the impact of these initiatives on IPC activities. The 2008 survey indicated that 44% of LTC facilities used a trained IP who managed the IPC program, a 5-fold increase from 2003. Unpublished DHMH outbreak data indicated that LTC facilities with a trained IP recognized and reported outbreaks to the local health department 2 days sooner than facilities without a trained IP, resulting in fewer cases of disease. Multiple initiatives with concerned stakeholders and LTC partners over the course of 5 years resulted in increased numbers of LTC facilities with trained IPs who recognized and responded to outbreaks sooner than facilities without trained IPs. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Feature article: adoption of an official ISEA glossary

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zartarian, Valerie; Bahadori, Tina; McKone, Thomas

2004-09-15

The International Society for Exposure Analysis (ISEA) and its Nomenclature Committee have been involved since the mid-1990s in an intermittent but ongoing effort to develop an official ISEA glossary. Several related activities have stimulated greater interest and discussion nationally and internationally on a common exposure language. Among these activities are a 1997 Journal of Exposure Analysis and Environmental Epidemiology feature article on exposure and dose definitions and a 1999-initiated project of the International Programme on Chemical Safety (IPCS) (WHO/ILO/UNEP) to confront terminology issues hindering harmonization in the area of exposure assessment. Recently the ISEA members voted in support of adoptingmore » the IPCS glossary as the official ISEA glossary, and the ISEA Executive Board agreed to accept this recommendation. In this feature article we (1) describe the process through which the ISEA adopted the IPCS glossary as the official ISEA glossary, (2) present the joint IPC S/ISEA glossary of terms and their definitions, and (3) discuss plans for how the glossary can be used by ISEA and updated over time by ISEA and IPCS. The glossary is intended to be a living document that reflects the latest usage and maintains international harmonization of exposure terminology that can be practically applied to improve communication in exposure and related fields.« less

Adoption of an official ISEA glossary.

PubMed

Zartarian, Valerie; Bahadori, Tina; McKone, Tom

2005-01-01

The International Society for Exposure Analysis (ISEA) and its Nomenclature Committee have been involved since the mid-1990s in an intermittent but ongoing effort to develop an official ISEA glossary. Several related activities have stimulated greater interest and discussion nationally and internationally on a common exposure language. Among these activities are a 1997 Journal of Exposure Analysis and Environmental Epidemiology feature article on exposure and dose definitions and a 1999-initiated project of the International Programme on Chemical Safety (IPCS) (WHO/ILO/UNEP) to confront terminology issues hindering harmonization in the area of exposure assessment. Recently, the ISEA members voted in support of adopting the IPCS glossary as the official ISEA glossary, and the ISEA Executive Board agreed to accept this recommendation. In this feature article, we (1) describe the process through which the ISEA adopted the IPCS glossary as the official ISEA glossary, (2) present the joint IPCS/ISEA glossary of terms and their definitions, and (3) discuss plans for how the glossary can be used by ISEA and updated over time by ISEA and IPCS. The glossary is intended to be a living document that reflects the latest usage and maintains international harmonization of exposure terminology that can be practically applied to improve communication in exposure and related fields.

Differentiation of Human Mesenchymal Stem Cells into Insulin Producing Cells by Using A Lentiviral Vector Carrying PDX1.

PubMed

Allahverdi, Amir; Abroun, Saied; Jafarian, Arefeh; Soleimani, Masoud; Taghikhani, Mohammad; Eskandari, Fatemeh

2015-01-01

Type I diabetes is an immunologically-mediated devastation of insulin producing cells (IPCs) in the pancreatic islet. Stem cells that produce β-cells are a new promising tool. Adult stem cells such as mesenchymal stem cells (MSCs) are self renewing multi potent cells showing capabilities to differentiate into ectodermal, mesodermal and endodermal tissues. Pancreatic and duodenal homeobox factor 1 (PDX1) is a master regulator gene required for embryonic development of the pancreas and is crucial for normal pancreatic islets activities in adults. We induced the over-expression of the PDX1 gene in human bone marrow MSCs (BM-MSCs) by Lenti-PDX1 in order to generate IPCs. Next, we examine the ability of the cells by measuring insulin/c-peptide production and INSULIN and PDX1 gene expressions. After transduction, MSCs changed their morphology at day 5 and gradually differentiated into IPCs. INSULIN and PDX1 expressions were confirmed by real time polymerase chain reaction (RT-PCR) and immunostaining. IPC secreted insulin and C-peptide in the media that contained different glucose concentrations. MSCs differentiated into IPCs by genetic manipulation. Our result showed that lentiviral vectors could deliver PDX1 gene to MSCs and induce pancreatic differentiation.

Ischemic Preconditioning Enhances Performance and Erythrocyte Deformability of Responders.

PubMed

Tomschi, Fabian; Niemann, David; Bloch, Wilhelm; Predel, Hans-Georg; Grau, Marijke

2018-06-08

This pilot study aimed to evaluate the differential effects of a remote ischemic preconditioning (rIPC) manoeuvre on performance and red blood cell (RBC) deformability compared to a sham control and a placebo setting. Ten male subjects performed three test settings in a single-blind, crossover, and randomized control design. All settings started with 20 min of rest and were followed by 4 cycles of occlusion/reperfusion consisting of 5 min each. During rIPC and placebo, the cuff pressure was inflated to 200 mmHg and 120 mmHg, respectively. During the sham control setting, 10 mmHg pressure was applied. All tests were followed by a cycle exercise with lactate diagnostics. Power at 2 and 4 mmol/l lactate thresholds were calculated. RBC deformability was measured before and after the respective manoeuvre. Results showed that no effect resulted from any manoeuvre on performance values or RBC deformability. But 6 subjects showed a higher power at the 2 mmol/l threshold, and 5 subjects exerted higher power at the 4 mmol/l threshold when the rIPC manoeuvre preceded the exercise. In these responsive subjects, RBC deformability also improved. Hence, rIPC effects are much influenced by the subjects' responsiveness, and improved RBC deformability might contribute to enhanced performance in responsive subjects. © Georg Thieme Verlag KG Stuttgart · New York.

Qualitative study of views and experiences of performance management for healthcare-associated infections.

PubMed

Brewster, L; Tarrant, C; Dixon-Woods, M

2016-09-01

Centrally led performance management regimes using standard setting, monitoring, and incentives have become a prominent feature of infection prevention and control (IPC) in health systems. To characterize views and experiences of regulation and performance management relating to IPC in English hospitals. Two qualitative datasets containing 139 interviews with healthcare workers and managers were analysed. Data directly relevant to performance management and IPC were extracted. Data analysis was based on the constant comparative method. Participants reported that performance management regimes had mobilized action around specific infections. The benefits of establishing organizational structures of accountability were seen in empirical evidence of decreasing infection rates. Performance management was not, however, experienced as wholly benign, and setting targets in one area was seen to involve risks of 'tunnel vision' and the marginalization of other potentially important issues. Financial sanctions were viewed especially negatively; performance management was associated with risks of creating a culture of fearfulness, suppressing learning and disrupting inter-professional relationships. Centrally led performance management may have some important roles in IPC, but identifying where it is appropriate and determining its limits is critical. Persisting with harsh regimes may affect relationships and increase resistance to continued improvement efforts, but leaving all improvement to local teams may also be a flawed strategy. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Infection prevention and control practices related to Clostridium difficile infection in Canadian acute and long-term care institutions.

PubMed

Wilkinson, Krista; Gravel, Denise; Taylor, Geoffrey; McGeer, Allison; Simor, Andrew; Suh, Kathryn; Moore, Dorothy; Kelly, Sharon; Boyd, David; Mulvey, Michael; Mounchili, Aboubakar; Miller, Mark

2011-04-01

Clostridium difficile is an important pathogen in Canadian health care facilities, and infection prevention and control (IPC) practices are crucial to reducing C difficile infections (CDIs). We performed a cross-sectional study to identify CDI-related IPC practices in Canadian health care facilities. A survey assessing facility characteristics, CDI testing strategies, CDI contact precautions, and antimicrobial stewardship programs was sent to Canadian health care facilities in February 2005. Responses were received from 943 (33%) facilities. Acute care facilities were more likely than long-term care (P < .001) and mixed care facilities (P = .03) to submit liquid stools from all patients for CDI testing. Physician orders were required before testing for CDI in 394 long-term care facilities (66%)-significantly higher than the proportions in acute care (41%; P < .001) and mixed care sites (49%; P < .001). A total of 841 sites (93%) had an infection control manual, 639 (76%) of which contained CDI-specific guidelines. Antimicrobial stewardship programs were reported by 40 (29%) acute care facilities; 19 (54%) of these sites reported full enforcement of the program. Canadian health care facilities have widely varying C difficile IPC practices. Opportunities exist for facilities to take a more active role in IPC policy development and implementation, as well as antimicrobial stewardship. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

In situ solid-state NMR and XRD studies of the ADOR process and the unusual structure of zeolite IPC-6

NASA Astrophysics Data System (ADS)

Morris, Samuel A.; Bignami, Giulia P. M.; Tian, Yuyang; Navarro, Marta; Firth, Daniel S.; Čejka, Jiří; Wheatley, Paul S.; Dawson, Daniel M.; Slawinski, Wojciech A.; Wragg, David S.; Morris, Russell E.; Ashbrook, Sharon E.

2017-10-01

The assembly-disassembly-organization-reassembly (ADOR) mechanism is a recent method for preparing inorganic framework materials and, in particular, zeolites. This flexible approach has enabled the synthesis of isoreticular families of zeolites with unprecedented continuous control over porosity, and the design and preparation of materials that would have been difficult—or even impossible—to obtain using traditional hydrothermal techniques. Applying the ADOR process to a parent zeolite with the UTL framework topology, for example, has led to six previously unknown zeolites (named IPC-n, where n = 2, 4, 6, 7, 9 and 10). To realize the full potential of the ADOR method, however, a further understanding of the complex mechanism at play is needed. Here, we probe the disassembly, organization and reassembly steps of the ADOR process through a combination of in situ solid-state NMR spectroscopy and powder X-ray diffraction experiments. We further use the insight gained to explain the formation of the unusual structure of zeolite IPC-6.

Isometric pre-conditioning blunts exercise-induced muscle damage but does not attenuate changes in running economy following downhill running.

PubMed

Lima, Leonardo C R; Bassan, Natália M; Cardozo, Adalgiso C; Gonçalves, Mauro; Greco, Camila C; Denadai, Benedito S

2018-05-08

Running economy (RE) is impaired following unaccustomed eccentric-biased exercises that induce muscle damage. It is also known that muscle damage is reduced when maximal voluntary isometric contractions (MVIC) are performed at a long muscle length 2-4 days prior to maximal eccentric exercise with the same muscle, a phenomenon that can be described as isometric pre-conditioning (IPC). We tested the hypothesis that IPC could attenuate muscle damage and changes in RE following downhill running. Thirty untrained men were randomly assigned into experimental or control groups and ran downhill on a treadmill (-15%) for 30 min. Participants in the experimental group completed 10 MVIC in a leg press machine two days prior to downhill running, while participants in the control group did not perform IPC. The magnitude of changes in muscle soreness determined 48 h after downhill running was greater for the control group (122 ± 28 mm) than for the experimental group (92 ± 38 mm). Isometric peak torque recovered faster in the experimental group compared with the control group (3 days vs. no full recovery, respectively). No significant effect of IPC was found for countermovement jump height, serum creatine kinase activity or any parameters associated with RE. These results supported the hypothesis that IPC attenuates changes in markers of muscle damage. The hypothesis that IPC attenuates changes in RE was not supported by our data. It appears that the mechanisms involved in changes in markers of muscle damage and parameters associated with RE following downhill running are not completely shared. Copyright © 2018 Elsevier B.V. All rights reserved.

Adverse Effects on β-Adrenergic Receptor Coupling: Ischemic Postconditioning Failed to Preserve Long-Term Cardiac Function.

PubMed

Schreckenberg, Rolf; Bencsik, Péter; Weber, Martin; Abdallah, Yaser; Csonka, Csaba; Gömöri, Kamilla; Kiss, Krisztina; Pálóczi, János; Pipis, Judit; Sárközy, Márta; Ferdinandy, Péter; Schulz, Rainer; Schlüter, Klaus-Dieter

2017-12-22

Ischemic preconditioning (IPC) and ischemic postconditioning (IPoC) are currently among the most efficient strategies protecting the heart against ischemia/reperfusion injury. However, the effect of IPC and IPoC on functional recovery following ischemia/reperfusion is less clear, particularly with regard to the specific receptor-mediated signaling of the postischemic heart. The current article examines the effect of IPC or IPoC on the regulation and coupling of β-adrenergic receptors and their effects on postischemic left ventricular function. The β-adrenergic signal transduction was analyzed in 3-month-old Wistar rats for each of the intervention strategies (Sham, ischemia/reperfusion, IPC, IPoC) immediately and 7 days after myocardial infarction. Directly after the infarction a cardioprotective potential was demonstrated for both IPC and IPoC: the infarct size was reduced, apoptosis and production of reactive oxygen species were lowered, and the myocardial tissue was preserved. Seven days after myocardial ischemia, only IPC hearts showed significant functional improvement. Along with a deterioration in fractional shortening, IPoC hearts no longer responded adequately to β-adrenergic stimulation. The stabilization of β-adrenergic receptor kinase-2 via increased phosphorylation of Mdm2 (an E3-ubiquitin ligase) was responsible for desensitization of β-adrenergic receptors and identified as a characteristic specific to IPoC hearts. Immediately after myocardial infarction, rapid and transient activation of β-adrenergic receptor kinase-2 may be an appropriate means to protect the injured heart from excessive stress. In the long term, however, induction and stabilization of β-adrenergic receptor kinase-2, with the resultant loss of positive inotropic function, leads to the functional picture of heart failure. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Temperature effects on CO2-sensitive intrapulmonary chemoreceptors in the lizard, Tupinambis nigropunctatus.

PubMed

Douse, M A; Mitchell, G S

1988-06-01

Body temperature (Tb) effects on CO2 responses of 17 intrapulmonary chemoreceptors (IPC) were investigated in 9 anesthetized (pentobarbital; 30 mg/kg) and unidirectionally ventilated tegu lizards (Tupinambis nigropunctatus). At 30 degrees C, all IPC (n = 15) had a stable discharge pattern. At 20 degrees C, IPC discharge (n = 14) was stable at high PCO2 but irregular at low PCO2 and often (10/14) consisted of bursts of activity separated by one or more seconds of quiescence. Responses of IPC to static and dynamic changes in PCO2 were quantified at both Tb and the discharge rate vs PCO2 response curves were compared. Static discharge frequency (fSTAT) decreased as PCO2 increased at both Tb. At 20 degrees C: (1) fSTAT was diminished at all PCO2 levels relative to 30 degrees C; and (2) the slope of the fSTAT vs PCO2 relationship was markedly attenuated. The Q10 was 3.7 +/- 0.5 and was independent of PCO2. The peak discharge associated with a step decrease in PCO2 (dynamic response; fDYN) also decreased as PCO2 increased. At 20 degrees C: (1) fDYN was diminished at all PCO2 levels relative to 30 degrees C; but (2) the slope of the fDYN vs PCO2 relationship was similar at both Tb. The Q10 was 2.6 +/- 0.3 and was significantly less than the Q10 of fSTAT (P less than 0.05). Acute changes in Tb exert large effects on the CO2 response and discharge pattern of IPC; these effects on IPC may be important in ventilatory control at different Tb in lizards.

Steatotic livers are susceptible to normothermic ischemia-reperfusion injury from mitochondrial Complex-I dysfunction

PubMed Central

Chu, Michael JJ; Premkumar, Rakesh; Hickey, Anthony JR; Jiang, Yannan; Delahunt, Brett; Phillips, Anthony RJ; Bartlett, Adam SJR

2016-01-01

AIM: To assess the effects of ischemic preconditioning (IPC, 10-min ischemia/10-min reperfusion) on steatotic liver mitochondrial function after normothermic ischemia-reperfusion injury (IRI). METHODS: Sixty male Sprague-Dawley rats were fed 8-wk with either control chow or high-fat/high-sucrose diet inducing > 60% mixed steatosis. Three groups (n = 10/group) for each dietary state were tested: (1) the IRI group underwent 60 min partial hepatic ischemia and 4 h reperfusion; (2) the IPC group underwent IPC prior to same standard IRI; and (3) sham underwent the same surgery without IRI or IPC. Hepatic mitochondrial function was analyzed by oxygraphs. Mitochondrial Complex-I, Complex-II enzyme activity, serum alanine aminotransferase (ALT), and histological injury were measured. RESULTS: Steatotic-IRI livers had a greater increase in ALT (2476 ± 166 vs 1457 ± 103 IU/L, P < 0.01) and histological injury following IRI compared to the lean liver group. Steatotic-IRI demonstrated lower Complex-I activity at baseline [78.4 ± 2.5 vs 116.4 ± 6.0 nmol/(min.mg protein), P < 0.001] and following IRI [28.0 ± 6.2 vs 104.3 ± 12.6 nmol/(min.mg protein), P < 0.001]. Steatotic-IRI also demonstrated impaired Complex-I function post-IRI compared to the lean liver IRI group. Complex-II activity was unaffected by hepatic steatosis or IRI. Lean liver mitochondrial function was unchanged following IRI. IPC normalized ALT and histological injury in steatotic livers but had no effect on overall steatotic liver mitochondrial function or individual mitochondrial complex enzyme activities. CONCLUSION: Warm IRI impairs steatotic liver Complex-I activity and function. The protective effects of IPC in steatotic livers may not be mediated through mitochondria. PMID:27217699

Development of an Internal Positive Control for Rapid Diagnosis of Avian Influenza Virus Infections by Real-Time Reverse Transcription-PCR with Lyophilized Reagents

PubMed Central

Das, Amaresh; Spackman, Erica; Senne, Dennis; Pedersen, Jan; Suarez, David L.

2006-01-01

We developed an internal positive control (IPC) RNA to help ensure the accuracy of the detection of avian influenza virus (AIV) RNA by reverse transcription (RT)-PCR and real-time RT-PCR (RRT-PCR). The IPC was designed to have the same binding sites for the forward and reverse primers of the AIV matrix gene as the target amplicon, but it had a unique internal sequence used for the probe site. The amplification of the viral RNA and the IPC by RRT-PCR were monitored with two different fluorescent probes in a multiplex format, one specific for the AIV matrix gene and the other for the IPC. The RRT-PCR test was further simplified with the use of lyophilized bead reagents for the detection of AIV RNA. The RRT-PCR with the bead reagents was more sensitive than the conventional wet reagents for the detection of AIV RNA. The IPC-based RRT-PCR detected inhibitors in blood, kidney, lungs, spleen, intestine, and cloacal swabs, but not allantoic fluid, serum, or tracheal swabs The accuracy of RRT-PCR test results with the lyophilized beads was tested on cloacal and tracheal swabs from experimental birds inoculated with AIV and compared with virus isolation (VI) on embryonating chicken eggs. There was 97 to 100% agreement of the RRT-PCR test results with VI for tracheal swabs and 81% agreement with VI for cloacal swabs, indicating a high level of accuracy of the RRT-PCR assay. The same IPC in the form of armored RNA was also used to monitor the extraction of viral RNA and subsequent detection by RRT-PCR. PMID:16954228

Pulmonary hypertension and ventilation during exercise: Role of the pre-capillary component.

PubMed

Caravita, Sergio; Faini, Andrea; Deboeck, Gael; Bondue, Antoine; Naeije, Robert; Parati, Gianfranco; Vachiéry, Jean-Luc

2017-07-01

Excessive exercise-induced hyperventilation and high prevalence of exercise oscillatory breathing (EOB) are present in patients with post-capillary pulmonary hypertension (PH) complicating left heart disease (LHD). Patients with pre-capillary PH have even higher hyperventilation but no EOB. We sought to determine the impact of a pre-capillary component of PH on ventilatory response to exercise in patients with PH and left heart disease. We retrospectively compared patients with idiopathic or heritable pulmonary arterial hypertension (PAH, n = 29), isolated post-capillary PH (IpcPH, n = 29), and combined post- and pre-capillary PH (CpcPH, n = 12). Diastolic pressure gradient (DPG = diastolic pulmonary artery pressure - pulmonary wedge pressure) was used to distinguish IpcPH (DPG <7 mm Hg) from CpcPH (DPG ≥7 mm Hg). Pulmonary vascular resistance (PVR) was higher in PAH, intermediate in CpcPH, and low in IpcPH. All patients with CpcPH but 1 had PVR >3 Wood unit. Exercise-induced hyperventilation (high minute ventilation over carbon dioxide production, low end-tidal carbon dioxide) was marked in PAH, intermediate in CpcPH, and low in IpcPH (p < 0.001) and correlated with DPG and PVR. Prevalence of EOB decreased from IpcPH to CpcPH to PAH (p < 0.001). Patients with CpcPH may have worse hemodynamics than patients with IpcPH and distinct alterations of ventilatory control, consistent with more exercise-induced hyperventilation and less EOB. This might be explained at least in part by the presence and extent of pulmonary vascular disease. Copyright © 2017 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Incoherent pair generation in a beam-beam interaction simulation

NASA Astrophysics Data System (ADS)

Rimbault, C.; Bambade, P.; Mönig, K.; Schulte, D.

2006-03-01

This paper deals with two topics: the generation of incoherent pairs in two beam-beam simulation programs, GUINEA-PIG and CAIN, and the influence of the International Linear Collider (ILC) beam parameter choices on the background in the micro vertex detector (VD) induced by direct hits. One of the processes involved in incoherent pair creation (IPC) is equivalent to a four fermions interaction and its cross section can be calculated exactly with a dedicated generator, BDK. A comparison of GUINEA-PIG and CAIN results with BDK allows to identify and quantify the uncertainties on IPC background predictions and to benchmark the GUINEA-PIG calculation. Based on this simulation and different VD designs, the five currently suggested ILC beam parameter sets have been compared regarding IPC background induced in the VD by direct IPC hits. We emphasize that the high luminosity set, as it is currently defined, would constrain both the choices of magnetic field and VD inner layer radius.

A family of zeolites with controlled pore size prepared using a top-down method

NASA Astrophysics Data System (ADS)

Roth, Wieslaw J.; Nachtigall, Petr; Morris, Russell E.; Wheatley, Paul S.; Seymour, Valerie R.; Ashbrook, Sharon E.; Chlubná, Pavla; Grajciar, Lukáš; Položij, Miroslav; Zukal, Arnošt; Shvets, Oleksiy; Čejka, Jiří

2013-07-01

The properties of zeolites, and thus their suitability for different applications, are intimately connected with their structures. Synthesizing specific architectures is therefore important, but has remained challenging. Here we report a top-down strategy that involves the disassembly of a parent zeolite, UTL, and its reassembly into two zeolites with targeted topologies, IPC-2 and IPC-4. The three zeolites are closely related as they adopt the same layered structure, and they differ only in how the layers are connected. Choosing different linkers gives rise to different pore sizes, enabling the synthesis of materials with predetermined pore architectures. The structures of the resulting zeolites were characterized by interpreting the X-ray powder-diffraction patterns through models using computational methods; IPC-2 exhibits orthogonal 12- and ten-ring channels, and IPC-4 is a more complex zeolite that comprises orthogonal ten- and eight-ring channels. We describe how this method enables the preparation of functional materials and discuss its potential for targeting other new zeolites.

Clonal type I interferon-producing and dendritic cell precursors are contained in both human lymphoid and myeloid progenitor populations.

PubMed

Chicha, Laurie; Jarrossay, David; Manz, Markus G

2004-12-06

Because of different cytokine responsiveness, surface receptor, and transcription factor expression, human CD11c(-) natural type I interferon-producing cells (IPCs) and CD11c(+) dendritic cells were thought to derive through lymphoid and myeloid hematopoietic developmental pathways, respectively. To directly test this hypothesis, we used an in vitro assay allowing simultaneous IPC, dendritic cell, and B cell development and we tested lymphoid and myeloid committed hematopoietic progenitor cells for their developmental capacity. Lymphoid and common myeloid and granulocyte/macrophage progenitors were capable of developing into both functional IPCs, expressing gene transcripts thought to be associated with lymphoid lineage development, and into dendritic cells. However, clonal progenitors for both populations were about fivefold more frequent within myeloid committed progenitor cells. Thus, in humans as in mice, natural IPC and dendritic cell development robustly segregates with myeloid differentiation. This would fit with natural interferon type I-producing cell and dendritic cell activity in innate immunity, the evolutionary older arm of the cellular immune system.

Early Effects of Prolonged Cardiac Arrest and Ischemic Postconditioning during Cardiopulmonary Resuscitation on Cardiac and Brain Mitochondrial Function in Pigs.

PubMed

Matsuura, Timothy R; Bartos, Jason A; Tsangaris, Adamantios; Shekar, Kadambari Chandra; Olson, Matthew D; Riess, Matthias L; Bienengraeber, Martin; Aufderheide, Tom P; Neumar, Robert W; Rees, Jennifer N; McKnite, Scott H; Dikalova, Anna E; Dikalov, Sergey I; Douglas, Hunter F; Yannopoulos, Demetris

2017-07-01

Out-of-hospital cardiac arrest (CA) is a prevalent medical crisis resulting in severe injury to the heart and brain and an overall survival of less than 10%. Mitochondrial dysfunction is predicted to be a key determinant of poor outcomes following prolonged CA. However, the onset and severity of mitochondrial dysfunction during CA and cardiopulmonary resuscitation (CPR) is not fully understood. Ischemic postconditioning (IPC), controlled pauses during the initiation of CPR, has been shown to improve cardiac function and neurologically favorable outcomes after 15min of CA. We tested the hypothesis that mitochondrial dysfunction develops during prolonged CA and can be rescued with IPC during CPR (IPC-CPR). A total of 63 swine were randomized to no ischemia (Naïve), 19min of ventricular fibrillation (VF) CA without CPR (Untreated VF), or 15min of CA with 4min of reperfusion with either standard CPR (S-CPR) or IPC-CPR. Mitochondria were isolated from the heart and brain to quantify respiration, rate of ATP synthesis, and calcium retention capacity (CRC). Reactive oxygen species (ROS) production was quantified from fresh frozen heart and brain tissue. Compared to Naïve, Untreated VF induced cardiac and brain ROS overproduction concurrent with decreased mitochondrial respiratory coupling and CRC, as well as decreased cardiac ATP synthesis. Compared to Untreated VF, S-CPR attenuated brain ROS overproduction but had no other effect on mitochondrial function in the heart or brain. Compared to Untreated VF, IPC-CPR improved cardiac mitochondrial respiratory coupling and rate of ATP synthesis, and decreased ROS overproduction in the heart and brain. Fifteen minutes of VF CA results in diminished mitochondrial respiration, ATP synthesis, CRC, and increased ROS production in the heart and brain. IPC-CPR attenuates cardiac mitochondrial dysfunction caused by prolonged VF CA after only 4min of reperfusion, suggesting that IPC-CPR is an effective intervention to reduce cardiac injury. However, reperfusion with both CPR methods had limited effect on mitochondrial function in the brain, emphasizing an important physiological divergence in post-arrest recovery between those two vital organs. Copyright © 2017 Elsevier B.V. All rights reserved.

Hypoxic Air Inhalation and Ischemia Interventions Both Elicit Preconditioning Which Attenuate Subsequent Cellular Stress In vivo Following Blood Flow Occlusion and Reperfusion.

PubMed

Barrington, James H; Chrismas, Bryna C R; Gibson, Oliver R; Tuttle, James; Pegrum, J; Govilkar, S; Kabir, Chindu; Giannakakis, N; Rayan, F; Okasheh, Z; Sanaullah, A; Ng Man Sun, S; Pearce, Oliver; Taylor, Lee

2017-01-01

Ischemic preconditioning (IPC) is valid technique which elicits reductions in femoral blood flow occlusion mediated reperfusion stress (oxidative stress, Hsp gene transcripts) within the systemic blood circulation and/or skeletal muscle. It is unknown whether systemic hypoxia, evoked by hypoxic preconditioning (HPC) has efficacy in priming the heat shock protein (Hsp) system thus reducing reperfusion stress following blood flow occlusion, in the same manner as IPC. The comparison between IPC and HPC being relevant as a preconditioning strategy prior to orthopedic surgery. In an independent group design, 18 healthy men were exposed to 40 min of (1) passive whole-body HPC (FiO 2 = 0.143; no ischemia. N = 6), (2) IPC (FiO 2 = 0.209; four bouts of 5 min ischemia and 5 min reperfusion. n = 6), or (3) rest (FiO 2 = 0.209; no ischemia. n = 6). The interventions were administered 1 h prior to 30 min of tourniquet derived femoral blood flow occlusion and were followed by 2 h subsequent reperfusion. Systemic blood samples were taken pre- and post-intervention. Systemic blood and gastrocnemius skeletal muscle samples were obtained pre-, 15 min post- (15PoT) and 120 min (120PoT) post-tourniquet deflation. To determine the cellular stress response gastrocnemius and leukocyte Hsp72 mRNA and Hsp32 mRNA gene transcripts were determined by RT-qPCR. The plasma oxidative stress response (protein carbonyl, reduced glutathione/oxidized glutathione ratio) was measured utilizing commercially available kits. In comparison to control, at 15PoT a significant difference in gastrocnemius Hsp72 mRNA was seen in HPC (-1.93-fold; p = 0.007) and IPC (-1.97-fold; p = 0.006). No significant differences were observed in gastrocnemius Hsp32 and Hsp72 mRNA, leukocyte Hsp72 and Hsp32 mRNA, or oxidative stress markers ( p > 0.05) between HPC and IPC. HPC provided near identical amelioration of blood flow occlusion mediated gastrocnemius stress response (Hsp72 mRNA), compared to an established IPC protocol. This was seen independent of changes in systemic oxidative stress, which likely explains the absence of change in Hsp32 mRNA transcripts within leukocytes and the gastrocnemius. Both the established IPC and novel HPC interventions facilitate a priming of the skeletal muscle, but not leukocyte, Hsp system prior to femoral blood flow occlusion. This response demonstrates a localized tissue specific adaptation which may ameliorate reperfusion stress.

Hypoxic Air Inhalation and Ischemia Interventions Both Elicit Preconditioning Which Attenuate Subsequent Cellular Stress In vivo Following Blood Flow Occlusion and Reperfusion

PubMed Central

Barrington, James H.; Chrismas, Bryna C. R.; Gibson, Oliver R.; Tuttle, James; Pegrum, J.; Govilkar, S.; Kabir, Chindu; Giannakakis, N.; Rayan, F.; Okasheh, Z.; Sanaullah, A.; Ng Man Sun, S; Pearce, Oliver; Taylor, Lee

2017-01-01

Ischemic preconditioning (IPC) is valid technique which elicits reductions in femoral blood flow occlusion mediated reperfusion stress (oxidative stress, Hsp gene transcripts) within the systemic blood circulation and/or skeletal muscle. It is unknown whether systemic hypoxia, evoked by hypoxic preconditioning (HPC) has efficacy in priming the heat shock protein (Hsp) system thus reducing reperfusion stress following blood flow occlusion, in the same manner as IPC. The comparison between IPC and HPC being relevant as a preconditioning strategy prior to orthopedic surgery. In an independent group design, 18 healthy men were exposed to 40 min of (1) passive whole-body HPC (FiO2 = 0.143; no ischemia. N = 6), (2) IPC (FiO2 = 0.209; four bouts of 5 min ischemia and 5 min reperfusion. n = 6), or (3) rest (FiO2 = 0.209; no ischemia. n = 6). The interventions were administered 1 h prior to 30 min of tourniquet derived femoral blood flow occlusion and were followed by 2 h subsequent reperfusion. Systemic blood samples were taken pre- and post-intervention. Systemic blood and gastrocnemius skeletal muscle samples were obtained pre-, 15 min post- (15PoT) and 120 min (120PoT) post-tourniquet deflation. To determine the cellular stress response gastrocnemius and leukocyte Hsp72 mRNA and Hsp32 mRNA gene transcripts were determined by RT-qPCR. The plasma oxidative stress response (protein carbonyl, reduced glutathione/oxidized glutathione ratio) was measured utilizing commercially available kits. In comparison to control, at 15PoT a significant difference in gastrocnemius Hsp72 mRNA was seen in HPC (−1.93-fold; p = 0.007) and IPC (−1.97-fold; p = 0.006). No significant differences were observed in gastrocnemius Hsp32 and Hsp72 mRNA, leukocyte Hsp72 and Hsp32 mRNA, or oxidative stress markers (p > 0.05) between HPC and IPC. HPC provided near identical amelioration of blood flow occlusion mediated gastrocnemius stress response (Hsp72 mRNA), compared to an established IPC protocol. This was seen independent of changes in systemic oxidative stress, which likely explains the absence of change in Hsp32 mRNA transcripts within leukocytes and the gastrocnemius. Both the established IPC and novel HPC interventions facilitate a priming of the skeletal muscle, but not leukocyte, Hsp system prior to femoral blood flow occlusion. This response demonstrates a localized tissue specific adaptation which may ameliorate reperfusion stress. PMID:28824456

A tumor-penetrating peptide enhances circulation-independent targeting of peritoneal carcinomatosis

PubMed Central

Sugahara, Kazuki N.; Scodeller, Pablo; Braun, Gary B.; de Mendoza, Tatiana Hurtado; Yamazaki, Chisato M.; Kluger, Michael D.; Kitayama, Joji; Alvarez, Edwin; Howell, Stephen B.; Teesalu, Tambet; Ruoslahti, Erkki; Lowy, Andrew M.

2015-01-01

Peritoneal carcinomatosis is a major source of morbidity and mortality in patients with advanced abdominal neoplasms. Intraperitoneal chemotherapy (IPC) is an area of intense interest given its efficacy in ovarian cancer. However, IPC suffers from poor drug penetration into peritoneal tumors. As such, extensive cytoreductive surgery is required prior to IPC. Here, we explore the utility of iRGD, a tumor-penetrating peptide, for improved tumor-specific penetration of intraperitoneal compounds and enhanced IPC in mice. Intraperitoneally administered iRGD significantly enhanced penetration of an attached fluorescein into disseminated peritoneal tumor nodules. The penetration was tumor-specific, circulation-independent, and mediated by the neuropilin-binding RXXK tissue-penetration peptide motif of iRGD. Q-iRGD, which fluoresces upon cleavage, including the one that leads to RXXK activation, specifically labeled peritoneal metastases displaying different growth patterns in mice. Importantly, iRGD enhanced intratumoral entry of intraperitoneally co-injected dextran to approximately 300% and doxorubicin to 250%. Intraperitoneal iRGD/doxorubicin combination therapy inhibited the growth of bulky peritoneal tumors and reduced systemic drug toxicity. iRGD delivered attached fluorescein and co-applied nanoparticles deep into fresh human peritoneal metastasis explants. These results indicate that intraperitoneal iRGD co-administration serves as a simple and effective strategy to facilitate tumor detection and improve the therapeutic index of IPC for peritoneal carcinomatosis. PMID:26071630

The Generation of Insulin Producing Cells from Human Mesenchymal Stem Cells by MiR-375 and Anti-MiR-9.

PubMed

Jafarian, Arefeh; Taghikani, Mohammad; Abroun, Saeid; Allahverdi, Amir; Lamei, Maryam; Lakpour, Niknam; Soleimani, Masoud

2015-01-01

MicroRNAs (miRNAs) are a group of endogenous small non-coding RNAs that regulate gene expression at the post-transcriptional level. A number of studies have led to the notion that some miRNAs have key roles in control of pancreatic islet development and insulin secretion. Based on some studies on miRNAs pattern, the researchers in this paper investigated the pancreatic differentiation of human bone marrow mesenchymal stem cells (hBM-MSCs) by up-regulation of miR-375 and down-regulation of miR-9 by lentiviruses containing miR-375 and anti-miR-9. After 21 days of induction, islet-like clusters containing insulin producing cells (IPCs) were confirmed by dithizone (DTZ) staining. The IPCs and β cell specific related genes and proteins were detected using qRT-PCR and immunofluorescence on days 7, 14 and 21 of differentiation. Glucose challenge test was performed at different concentrations of glucose so extracellular and intracellular insulin and C-peptide were assayed using ELISA kit. Although derived IPCs by miR-375 alone were capable to express insulin and other endocrine specific transcription factors, the cells lacked the machinery to respond to glucose. It was found that over-expression of miR-375 led to a reduction in levels of Mtpn protein in derived IPCs, while treatment with anti-miR-9 following miR-375 over-expression had synergistic effects on MSCs differentiation and insulin secretion in a glucose-regulated manner. The researchers reported that silencing of miR-9 increased OC-2 protein in IPCs that may contribute to the observed glucose-regulated insulin secretion. Although the roles of miR-375 and miR-9 are well known in pancreatic development and insulin secretion, the use of these miRNAs in transdifferentiation was never demonstrated. These findings highlight miRNAs functions in stem cells differentiation and suggest that they could be used as therapeutic tools for gene-based therapy in diabetes mellitus.

Views of the United States healthcare system: Findings from documentary analysis of an interprofessional education course.

PubMed

Bultas, Margaret W; Ruebling, Irma; Breitbach, Anthony; Carlson, Judy

2016-11-01

As the healthcare system of the United States becomes more complex, collaboration among health professionals is becoming an essential aspect in improving the health of individuals and populations. An interprofessional education course entitled "Health Care System and Health Promotion" was developed to allow health profession students to work and learn together about issues related to healthcare delivery, health promotion, and the effect of policy issues on key stakeholders in the system. A qualitative document analysis research design was used to evaluate the effect of this interprofessional course on students' views of the current healthcare system of the United States. Fifty-nine student articles were analysed using document analysis. Health professions represented in the sample included occupational therapy, physical therapy, athletic training, nursing, and radiation therapy, nuclear medicine technology, and magnetic resonance imaging. Eight themes were identified including: increased personal awareness, the need for a system change, concern for access, affordability of healthcare, vision for future practice role, need for quality care, the value of interprofessional collaboration (IPC), and the importance of disease prevention. The results of the study suggest that healthcare education can benefit from the integration of Interprofessional Education (IPE) courses into their curriculum especially when teaching content common to all healthcare professions such as healthcare systems and health promotion.

The Einstein All-Sky IPC slew survey

NASA Technical Reports Server (NTRS)

Elvis, Martin; Plummer, David; Fabbiano, G.

1989-01-01

The construction of the Einstein All-Sky Imaging Proportional Counter (IPC) slew survey is considered. It contains approximately 1000 sources between 10(exp -12) and 10(exp -10) erg/sq cm/s with a concentration toward the ecliptic poles and away from the galactic plane. Several sizable samples of bright soft X-ray selected objects for follow-up ROSAT and ASTRO-D observations and statistical study are presented. The survey source list is expected to be available by late 1989. Both paper and remote access online data base versions are to be available. An identification program is considered.

Morphine preconditioning confers cardioprotection in doxorubicin-induced failing rat hearts via ERK/GSK-3β pathway independent of PI3K/Akt

DOE Office of Scientific and Technical Information (OSTI.GOV)

He, Shu-Fang; Jin, Shi-Yun; Wu, Hao

Preconditioning against myocardial ischemia–reperfusion (I/R) injury can be suppressed in some pathological conditions. This study was designed to investigate whether morphine preconditioning (MPC) exerts cardioprotection in doxorubicin (DOX)-induced heart failure in rats and the mechanisms involved. Phosphatidylinositol-3 kinase/protein kinase B (PI3K/Akt), extracellular signal-regulated kinase (ERK) and glycogen synthase kinase (GSK)-3β pathways were examined. Normal and DOX-induced failing rat hearts were subjected to I/R injury using a Langendorff perfusion system with or without MPC or ischemic preconditioning (IPC). The PI3K inhibitor (wortmannin) or ERK inhibitor (PD98059) was infused before MPC. In normal hearts, both MPC and IPC significantly reduced infarct sizemore » and the rise in lactate dehydrogenase (LDH) level caused by I/R injury. Pretreatment with wortmannin or PD98059 abrogated the protective effects of MPC and suppressed the phosphorylation of Akt, ERK and GSK-3β. In failing rat hearts, however, MPC retained its cardioprotection while IPC did not. This protective effect was abolished by PD98059 but not wortmannin. MPC increased the level of p-ERK rather than p-Akt. The phosphorylation of GSK-3β induced by MPC was reversed by PD98059 only. IPC did not elevate the expression of p-ERK, p-Akt and p-GSK-3β in failing rat hearts. We conclude that MPC is cardioprotective in rats with DOX-induced heart failure while IPC is not. The effect of MPC appears to be mediated via the ERK/GSK-3β pathway independent of PI3K/Akt. - Highlights: • Morphine and ischemic preconditioning are cardioprotective in normal rat hearts. • Ischemic preconditioning fails to confer cardioprotection in rats with heart failure. • Morphine retains cardioprotection in doxorubicin-induced heart failure. • Morphine exerts cardioprotection via the ERK/GSK-β pathway independent of PI3K/Akt.« less

Redesigning inpatient care: Testing the effectiveness of an accountable care team model.

PubMed

Kara, Areeba; Johnson, Cynthia S; Nicley, Amy; Niemeier, Michael R; Hui, Siu L

2015-12-01

US healthcare underperforms on quality and safety metrics. Inpatient care constitutes an immense opportunity to intervene to improve care. Describe a model of inpatient care and measure its impact. A quantitative assessment of the implementation of a new model of care. The graded implementation of the model allowed us to follow outcomes and measure their association with the dose of the implementation. Inpatient medical and surgical units in a large academic health center. Eight interventions rooted in improving interprofessional collaboration (IPC), enabling data-driven decisions, and providing leadership were implemented. Outcome data from August 2012 to December 2013 were analyzed using generalized linear mixed models for associations with the implementation of the model. Length of stay (LOS) index, case-mix index-adjusted variable direct costs (CMI-adjusted VDC), 30-day readmission rates, overall patient satisfaction scores, and provider satisfaction with the model were measured. The implementation of the model was associated with decreases in LOS index (P < 0.0001) and CMI-adjusted VDC (P = 0.0006). We did not detect improvements in readmission rates or patient satisfaction scores. Most providers (95.8%, n = 92) agreed that the model had improved the quality and safety of the care delivered. Creating an environment and framework in which IPC is fostered, performance data are transparently available, and leadership is provided may improve value on both medical and surgical units. These interventions appear to be well accepted by front-line staff. Readmission rates and patient satisfaction remain challenging. © 2015 Society of Hospital Medicine.

[Manufacture and application of laparoscopic extraperitoneal sigmoid colostomy].

PubMed

Jin, Hei-ying; DU, Yong-hong; Wang, Xiao-feng; Yao, Hang; Wu, Kun-lan; Zhang, Bei; Zhang, Jin-hao

2013-10-01

To investigate the safety and feasibility of laparoscopic extraperitoneal sigmoid colostomy. Thirty-six patients with low rectal cancer undergoing laproscopic abdominoperineal resection from July 2011 to July 2012 were prospectively enrolled in the study and randomly divided into extraperitoneal colostomy group(EPC, n=18) and internal peritoneal colostomy group(IPC, n=18). Follow-up period was 4-16 (median, 7) months and postoperative complications were compared between two groups. One case in EPC group was converted to IPC because of poor blood supply of the proximal sigmoid, who was eliminated from the subsequent analysis. Compared with the IPC group, the surgery time was longer in EPC group [(25.3±8.5) min vs. (14.7±6.4) min], while the difference was not statistically significant(P>0.05). Each group had 1 case of stoma ischemia, who both received the colostomy reconstructive surgery. The incidence of stoma edema was significantly higher in EPC group[35.3%(6/17) vs. 0, P<0.05). The early postoperative complications rate did not significantly different between the two groups[58.8%(10/17) vs. 27.8%(5/18), P>0.05]. The late postoperative complications rate was 22.2%(4/18) in IPC group, including 1 case of stoma prolapse, 1 case of stoma stenosis and 2 cases of parastomal hernia. No later postoperative complication occurred in EPC group. Extraperitoneal sigmoid colostomy is an easy and safe procedure with lower late complications as compared to internal peritoneal sigmoid colostomy.

Robust versus consistent variance estimators in marginal structural Cox models.

PubMed

Enders, Dirk; Engel, Susanne; Linder, Roland; Pigeot, Iris

2018-06-11

In survival analyses, inverse-probability-of-treatment (IPT) and inverse-probability-of-censoring (IPC) weighted estimators of parameters in marginal structural Cox models are often used to estimate treatment effects in the presence of time-dependent confounding and censoring. In most applications, a robust variance estimator of the IPT and IPC weighted estimator is calculated leading to conservative confidence intervals. This estimator assumes that the weights are known rather than estimated from the data. Although a consistent estimator of the asymptotic variance of the IPT and IPC weighted estimator is generally available, applications and thus information on the performance of the consistent estimator are lacking. Reasons might be a cumbersome implementation in statistical software, which is further complicated by missing details on the variance formula. In this paper, we therefore provide a detailed derivation of the variance of the asymptotic distribution of the IPT and IPC weighted estimator and explicitly state the necessary terms to calculate a consistent estimator of this variance. We compare the performance of the robust and consistent variance estimators in an application based on routine health care data and in a simulation study. The simulation reveals no substantial differences between the 2 estimators in medium and large data sets with no unmeasured confounding, but the consistent variance estimator performs poorly in small samples or under unmeasured confounding, if the number of confounders is large. We thus conclude that the robust estimator is more appropriate for all practical purposes. Copyright © 2018 John Wiley & Sons, Ltd.

Making the PACS workstation a browser of image processing software: a feasibility study using inter-process communication techniques.

PubMed

Wang, Chunliang; Ritter, Felix; Smedby, Orjan

2010-07-01

To enhance the functional expandability of a picture archiving and communication systems (PACS) workstation and to facilitate the integration of third-part image-processing modules, we propose a browser-server style method. In the proposed solution, the PACS workstation shows the front-end user interface defined in an XML file while the image processing software is running in the background as a server. Inter-process communication (IPC) techniques allow an efficient exchange of image data, parameters, and user input between the PACS workstation and stand-alone image-processing software. Using a predefined communication protocol, the PACS workstation developer or image processing software developer does not need detailed information about the other system, but will still be able to achieve seamless integration between the two systems and the IPC procedure is totally transparent to the final user. A browser-server style solution was built between OsiriX (PACS workstation software) and MeVisLab (Image-Processing Software). Ten example image-processing modules were easily added to OsiriX by converting existing MeVisLab image processing networks. Image data transfer using shared memory added <10ms of processing time while the other IPC methods cost 1-5 s in our experiments. The browser-server style communication based on IPC techniques is an appealing method that allows PACS workstation developers and image processing software developers to cooperate while focusing on different interests.

Conservation priorities of useful plants from different techniques of collection and analysis of ethnobotanical data.

PubMed

de Lucena, Reinaldo F P; Lucena, Camilla M; Araújo, Elcida L; Alves, Angelo G C; de Albuquerque, Ulysses P

2013-03-01

This study analyzes three methods of data analysis to verify which one would be more appropriate to get information aiming the conservation, selecting the use value (VU) inventory in situ and conservation property index (IPC). It was developed in in Northeast Brazil, via interviewed householders (46 informants). The VU was calculated considering only the effective use of plants; the inventory in situ was made through the frequency of species occurrence in homes; and the IPC combining ethnobotanical and phytossociological data. It was observed a similar cast of the indicated species by VU and inventory in situ, being different from the IPC cast. As this study sought to analyze the best technique for species identification which were needing conservationist actions, and obtained different results among the chosen methods. It has been suggested the use of methods that unite in their analysis both ethnobotanical and ecological aspects, like in the plants list from the priority index of conservation, which demonstrated to be more efficient to identify rare species in the local vegetation. The VU and the inventory in situ are more efficient to identify the most known and used species in the communities, however without analyzing these plants in the local vegetation.

Hospital infection prevention and control issues relevant to extensive floods.

PubMed

Apisarnthanarak, Anucha; Mundy, Linda M; Khawcharoenporn, Thana; Glen Mayhall, C

2013-02-01

The devastating clinical and economic implications of floods exemplify the need for effective global infection prevention and control (IPC) strategies for natural disasters. Reopening of hospitals after excessive flooding requires a balance between meeting the medical needs of the surrounding communities and restoration of a safe hospital environment. Postflood hospital preparedness plans are a key issue for infection control epidemiologists, healthcare providers, patients, and hospital administrators. We provide recent IPC experiences related to reopening of a hospital after extensive black-water floods necessitated hospital closures in Thailand and the United States. These experiences provide a foundation for the future design, execution, and analysis of black-water flood preparedness plans by IPC stakeholders.

Wood River recovery project -- speed and cooperation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Franczak, D.F.; Santschi, M.F.; Sander, S.

1998-12-31

A unit trip is a situation avoided by power generators because it affects their bottom line. The ability to recover from the trip quickly, and restore MW generation is the desired goal. However, what do you do if you lose your unit to a disastrous fire? How do you recover from this situation? This will be the subject of this paper describing such an event which affected the Illinois Power Company`s (IPC) operation. IPC`s Wood River Power Station suffered a disastrous fire which knocked out the Station`s only two operable units--4 and 5. The fire was the result of amore » coal mill explosion and damaged beyond repair, the units control systems and operating capabilities. A total of 488 MW in generating capacity was lost at a time when the IPC system required all available generation now, and in the foreseeable future. This paper will describe the event, the immediate mobilization efforts, and the challenges of recovering both units in the most expedient time frame possible. The keys to the success of the recovery project will be described in detail.« less

Clonal Type I Interferon–producing and Dendritic Cell Precursors Are Contained in Both Human Lymphoid and Myeloid Progenitor Populations

PubMed Central

Chicha, Laurie; Jarrossay, David; Manz, Markus G.

2004-01-01

Because of different cytokine responsiveness, surface receptor, and transcription factor expression, human CD11c− natural type I interferon–producing cells (IPCs) and CD11c+ dendritic cells were thought to derive through lymphoid and myeloid hematopoietic developmental pathways, respectively. To directly test this hypothesis, we used an in vitro assay allowing simultaneous IPC, dendritic cell, and B cell development and we tested lymphoid and myeloid committed hematopoietic progenitor cells for their developmental capacity. Lymphoid and common myeloid and granulocyte/macrophage progenitors were capable of developing into both functional IPCs, expressing gene transcripts thought to be associated with lymphoid lineage development, and into dendritic cells. However, clonal progenitors for both populations were about fivefold more frequent within myeloid committed progenitor cells. Thus, in humans as in mice, natural IPC and dendritic cell development robustly segregates with myeloid differentiation. This would fit with natural interferon type I–producing cell and dendritic cell activity in innate immunity, the evolutionary older arm of the cellular immune system. PMID:15557348

TIGAR contributes to ischemic tolerance induced by cerebral preconditioning through scavenging of reactive oxygen species and inhibition of apoptosis

PubMed Central

Zhou, Jun-Hao; Zhang, Tong-Tong; Song, Dan-Dan; Xia, Yun-Fei; Qin, Zheng-Hong; Sheng, Rui

2016-01-01

Previous study showed that TIGAR (TP53-induced glycolysis and apoptosis regulator) protected ischemic brain injury via enhancing pentose phosphate pathway (PPP) flux and preserving mitochondria function. This study was aimed to study the role of TIGAR in cerebral preconditioning. The ischemic preconditioning (IPC) and isoflurane preconditioning (ISO) models were established in primary cultured cortical neurons and in mice. Both IPC and ISO increased TIGAR expression in cortical neurons. Preconditioning might upregulate TIGAR through SP1 transcription factor. Lentivirus mediated knockdown of TIGAR significantly abolished the ischemic tolerance induced by IPC and ISO. ISO also increased TIGAR in mouse cortex and hippocampus and alleviated subsequent brain ischemia-reperfusion injury, while the ischemic tolerance induced by ISO was eliminated with TIGAR knockdown in mouse brain. ISO increased the production of NADPH and glutathione (GSH), and scavenged reactive oxygen species (ROS), while TIGAR knockdown decreased GSH and NADPH production and increased the level of ROS. Supplementation of ROS scavenger NAC and PPP product NADPH effectively rescue the neuronal injury caused by TIGAR deficiency. Notably, TIGAR knockdown inhibited ISO-induced anti-apoptotic effects in cortical neurons. These results suggest that TIGAR participates in the cerebral preconditioning through reduction of ROS and subsequent cell apoptosis. PMID:27256465

Molecular evolution of the enzymes involved in the sphingolipid metabolism of Leishmania: selection pressure in relation to functional divergence and conservation.

PubMed

Mandlik, Vineetha; Shinde, Sonali; Singh, Shailza

2014-06-21

Selection pressure governs the relative mutability and the conservedness of a protein across the protein family. Biomolecules (DNA, RNA and proteins) continuously evolve under the effect of evolutionary pressure that arises as a consequence of the host parasite interaction. IPCS (Inositol phosphorylceramide synthase), SPL (Sphingosine-1-P lyase) and SPT (Serine palmitoyl transferase) represent three important enzymes involved in the sphingolipid metabolism of Leishmania. These enzymes are responsible for maintaining the viability and infectivity of the parasite and have been classified as druggable targets in the parasite metabolome. The present work relates to the role of selection pressure deciding functional conservedness and divergence of the drug targets. IPCS and SPL protein families appear to diverge from the SPT family. The three protein families were largely under the influence of purifying selection and were moderately conserved baring two residues in the IPCS protein which were under the influence of positive selection. To further explore the selection pressure at the codon level, codon usage bias indices were calculated to analyze genes for their synonymous codon usage pattern. IPCS gene exhibited slightly lower codon bias as compared to SPL and SPT protein families. Evolutionary tracing of the proposed drug targets has been done with a viewpoint that the amino-acids lining the drug binding pocket should have a lower evolvability. Sites under positive selection (HIS20 and CYS30 of IPCS) should be avoided during devising strategies for inhibitor design.

Health economic evaluation of an infection prevention and control program: are quality and patient safety programs worth the investment?

PubMed

Raschka, Stefanie; Dempster, Linda; Bryce, Elizabeth

2013-09-01

The effect of regional consolidation of an infection prevention and control (IPC) program on reduction of selected health care-acquired infections (HAIs), the economic burden of these illnesses, and where the potential for greatest financial benefit in reducing infection rates lies was assessed. Cost-benefit analysis (in Canadian $) was used to evaluate the effectiveness of a regional IPC program in preventing incident cases of HAIs. The costs of managing these infections, as well as the operational costs of the IPC program were compared against reductions in HAI rates over a 4-year period. Benefits were calculated as cost avoided by reducing HAI cases year over year. The Health Authority spent more than $66.3 million managing 24,937 HAI cases over the 4-year evaluation period. Urinary tract infections, methicillin-resistant Staphylococcus aureus, and bacteremias incurred the greatest costs. A reduction of 4,739 HAI cases led to avoided costs of $9.1 million in 4 years; the IPC program budget was $6.7 million during this period. Regionalization of the IPC program with standardized policies, procedures, and initiatives led to a 19% reduction in selected HAIs over 4 years and a cost avoidance of at least $9 million. This was particularly evident in years 3 and 4 of the program when $7.2 million (79% of the total) savings were realized. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Correlation of Disturbed Sleep and Cancer Stress.

PubMed

Vander Wal, Gregory S; Lichstein, Kenneth L; Perkins, Cynthia K

2017-01-01

To illuminate the course of insomnia in the presence of an acute comorbidity, we examined the association between insomnia severity and breast cancer symptom severity over time and determined if this association varies with insomnia history and presleep arousal. Twenty-nine newly diagnosed breast cancer patients, who also exhibited insomnia, completed sleep diary and cancer symptom severity questionnaires every other week (total of 28 days) over 7 weeks, as well as baseline and postobservation measures. Participants were defined as having insomnia prior to cancer (IPC) or insomnia secondary to cancer (ISC) based on precancer sleep status. Insomnia and cancer symptom severity were strongly correlated at baseline but significantly declined over the evaluation period. Among ISC individuals, there was an association between sleep severity and cancer severity at baseline but not 7 weeks later. IPC individuals showed a consistent pattern of no significant association between sleep severity and cancer symptom severity. IPC had higher levels of cognitive presleep arousal than ISC. The current study documented the evolution of the relation between insomnia and breast cancer symptom severity over time and identified factors (premorbid insomnia and presleep hyperarousal) that may influence this association.

Field testing of linear individual pitch control on the two-bladed controls advanced research turbine

DOE PAGES

van Solingen, Edwin; Fleming, Paul A.; Scholbrock, Andrew; ...

2015-04-17

This paper presents the results of field tests using linear individual pitch control (LIPC) on the two-bladed Controls Advanced Research Turbine 2 (CART2) at the National Renewable Energy Laboratory (NREL). LIPC has recently been introduced as an alternative to the conventional individual pitch control (IPC) strategy for two-bladed wind turbines. The main advantage of LIPC over conventional IPC is that it requires, at most, only two feedback loops to potentially reduce the periodic blade loads. In previous work, LIPC was designed to implement blade pitch angles at a fixed frequency (e.g., the once-per-revolution (1P) frequency), which made it only applicablemore » in above-rated wind turbine operating conditions. In this study, LIPC is extended to below-rated operating conditions by gain scheduling the controller on the rotor speed. With this extension, LIPC and conventional IPC are successfully applied to the NREL CART2 wind turbine. Lastly, the field-test results obtained during the measurement campaign indicate that LIPC significantly reduces the wind turbine loads for both below-rated and above-rated operation.« less

Evaluating interhemispheric cortical responses to transcranial magnetic stimulation in chronic stroke: A TMS-EEG investigation.

PubMed

Borich, Michael R; Wheaton, Lewis A; Brodie, Sonia M; Lakhani, Bimal; Boyd, Lara A

2016-04-08

TMS-evoked cortical responses can be measured using simultaneous electroencephalography (TMS-EEG) to directly quantify cortical connectivity in the human brain. The purpose of this study was to evaluate interhemispheric cortical connectivity between the primary motor cortices (M1s) in participants with chronic stroke and controls using TMS-EEG. Ten participants with chronic stroke and four controls were tested. TMS-evoked responses were recorded at rest and during a typical TMS assessment of transcallosal inhibition (TCI). EEG recordings from peri-central gyral electrodes (C3 and C4) were evaluated using imaginary phase coherence (IPC) analyses to quantify levels of effective interhemispheric connectivity. Significantly increased TMS-evoked beta (15-30Hz frequency range) IPC was observed in the stroke group during ipsilesional M1 stimulation compared to controls during TCI assessment but not at rest. TMS-evoked beta IPC values were associated with TMS measures of transcallosal inhibition across groups. These results suggest TMS-evoked EEG responses can index abnormal effective interhemispheric connectivity in chronic stroke. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Direct numerical simulation of turbulent channel flow with spanwise alternatively distributed strips control

NASA Astrophysics Data System (ADS)

Ni, Weidan; Lu, Lipeng; Fang, Jian; Moulinec, Charles; Yao, Yufeng

2018-05-01

The effect of spanwise alternatively distributed strips (SADS) control on turbulent flow in a plane channel has been studied by direct numerical simulations to investigate the characteristics of large-scale streamwise vortices (LSSVs) induced by small-scale active wall actuation, and their potential in suppressing flow separation. SADS control is realized by alternatively arranging out-of-phase control (OPC) and in-phase control (IPC) wall actuations on the lower channel wall surface, in the spanwise direction. It is found that the coherent structures are suppressed or enhanced alternatively by OPC or IPC, respectively, leading to the formation of a vertical shear layer, which is responsible for the LSSVs’ presence. Large-scale low-speed region can also be observed above the OPC strips, which resemble large-scale low-speed streaks. LSSVs are found to be in a statistically-converged steady state and their cores are located between two neighboring OPC and IPC strips. Their motions contribute significantly to the momentum transport in the wall-normal and spanwise directions, demonstrating their potential ability to suppress flow separation.

Navigating the legal and ethical foundations of informed consent and confidentiality in integrated primary care.

PubMed

Hudgins, Cathy; Rose, Sandra; Fifield, Peter Y; Arnault, Steve

2013-03-01

This article describes findings from ongoing research and analysis of current literature in addition to discussions with leaders in the field, communications with lawyers and administrators of advocacy and government agencies pertaining to integrated primary care (IPC). Standards of care are established based on a myriad of factors, including professional codes of ethics, case law, state and federal laws, professional standards, existing best practices, current professional guidelines, administrative rules and regulations, and licensing board regulations. Regulations may differ for behavioral health and medical providers, posing challenges in IPC settings. This article provides a review of these regulations, particularly 42CFR Part 2, a federal law governing confidentiality for substance abuse programs, Health Insurance Portability and Accountability Act (HIPAA), and state laws relevant to patient care in IPC settings. On the basis of findings from the study, the authors make recommendations related to patient care practices concerning informed consent and release of information procedures, treatment and warm hand-off protocols, documentation and electronic record keeping, agreements with other providers, and billing. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Quantitative assessment of organizational culture within hospitals and its relevance to infection prevention and control strategies.

PubMed

Borg, M A; Waisfisz, B; Frank, U

2015-05-01

It has been suggested that organizational culture (OC) is an important driver of infection prevention and control (IPC) behaviour among healthcare workers. This study examined OC in seven European hospitals using a validated assessment tool based on Hofstede's model, and identified significant variations in OC scores. Hospitals with low prevalence of meticillin-resistant Staphylococcus aureus (MRSA) exhibited high scores for change facilitation and change readiness, whereas hospitals with high prevalence of MRSA exhibited low scores for these determinants. It is possible to use tools, available outside health care, to study OC within hospitals and gain better insight into IPC behaviour change strategies. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Monoamine Oxidases Regulate Telencephalic Neural Progenitors in Late Embryonic and Early Postnatal Development

PubMed Central

Cheng, Aiwu; Scott, Anna L.; Ladenheim, Bruce; Chen, Kevin; Ouyang, Xin; Lathia, Justin D.; Mughal, Mohamed; Cadet, Jean Lud; Mattson, Mark P.; Shih, Jean C.

2010-01-01

Monoamine neurotransmitters play major roles in regulating a range of brain functions in adults and increasing evidence suggests roles for monoamines in brain development. Here we show that mice lacking the monoamine metabolic enzymes MAO A and MAO B (MAO AB-deficient mice) exhibit diminished proliferation of neural stem cells (NSC) in the developing telencephalon beginning in late gestation [embryonic day (E) 17.5], a deficit that persists in neonatal and adult mice. These mice showed significantly increased monoamine levels and anxiety-like behaviors as adults. Assessments of markers of intermediate progenitor cells (IPC) and mitosis showed that NSC in the subventricular zone (SVZ), but not in the ventricular zone, are reduced in MAO AB-deficient mice. A developmental time course of monoamines in frontal cortical tissues revealed increased serotonin levels as early as E14.5, and a further large increase was found between E17.5 and postnatal day 2. Administration of an inhibitor of serotonin synthesis (parachlorophenylalanine) between E14.5 and E19.5 restored the IPC numbers and SVZ thickness, suggesting the role of serotonin in the suppression of IPC proliferation. Studies of neurosphere cultures prepared from the telencephalon at different embryonic and postnatal ages showed that serotonin stimulates proliferation in wild-type, but not in MAO AB-deficient, NSC. Together, these results suggest that a MAO-dependent long-lasting alteration in the proliferation capacity of NSC occurs late in embryonic development and is mediated by serotonin. Our findings reveal novel roles for MAOs and serotonin in the regulation of IPC proliferation in the developing brain. PMID:20702706

Beneficial effect of zinc chloride and zinc ionophore pyrithione on attenuated cardioprotective potential of preconditioning phenomenon in STZ-induced diabetic rat heart.

PubMed

Jamwal, Sumit; Kumar, Kushal; Reddy, B V Krishna

2016-05-01

Ischemic preconditioning (IPC) is well demonstrated to produce cardioprotection by phosphorylation and subsequent inactivation of glycogen synthase kinase-3β (GSk-3β) in the normal rat heart, but its effect is attenuated in the diabetic rat heart. This study was designed to investigate the effect of zinc chloride and zinc ionophore pyrithione (ZIP) on the attenuated cardioprotective potential of IPC in the diabetic rat heart. Diabetes mellitus (DM) was induced by a single intraperitoneal administration of streptozotocin (STZ) (50 mg/kg; i.p). The isolated perfused rat heart was subjected to 30 minutes of ischemia followed by 120 minutes of reperfusion. Myocardial infarct size was estimated by triphenyltetrazolium chloride (TTC) staining and cardiac injury was measured by estimating lactate dehydrogenase (LDH) and creatine kinase-MB (CK-MB) in the coronary effluent. Also, GSK-3β was measured and neutrophil accumulation was measured by estimating myeloperoxidase (MPO) levels. IPC significantly decreased the myocardial infarct size, the release of LDH and CK-MB, the GSK-3β levels and the MPO levels in the normal rat heart. Pre- and post-ischemic treatment with zinc chloride and zinc ionophore pyrithione (ZIP) in the normal and diabetic rat hearts significantly decreased the myocardial infarct size, the level of CK-MB and LDH in the coronary effluent and GSK-3β and MPO levels. Our results suggest that pharmacological preconditioning with zinc chloride and ZIP significantly restored the attenuated cardioprotective potential of IPC in the diabetic rat heart. © The Author(s) 2015.

RULES OF COMPETITIVE STIMULUS SELECTION IN A CHOLINERGIC ISTHMIC NUCLEUS OF THE OWL MIDBRAIN

PubMed Central

Asadollahi, Ali; Mysore, Shreesh P.; Knudsen, Eric I.

2011-01-01

In a natural scene, multiple stimuli compete for the control of gaze direction and attention. The nucleus isthmi pars parvocellularis (Ipc) is a cholinergic, midbrain nucleus that is reciprocally interconnected to the optic tectum, a structure known to be involved in the control of gaze and attention. Previous research has shown that the responses of many Ipc units to a visual stimulus presented inside the classical receptive field (RF) can be powerfully inhibited when the strength of a distant, competing stimulus becomes the stronger stimulus. This study investigated further the nature of competitive interactions in the Ipc of owls by employing two complementary protocols: in the first protocol, we measured the effects of a distant stimulus on responses to an RF stimulus located at different positions inside the RF; in the second protocol, we measured the effects of a distant stimulus on responses to RF stimuli of different strengths. The first protocol demonstrated that the effect of a competing stimulus is purely divisive: the competitor caused a proportional reduction in responses to the RF stimulus that did not alter either the location or sharpness of spatial tuning. The second protocol demonstrated that, for most units, the strength of this divisive inhibition is regulated powerfully by the relative strengths of the competing stimuli: inhibition was strong when the competitor was the stronger stimulus and weak when the competitor was the weaker stimulus. The data indicate that competitive interactions in the Ipc depend on feedback and a globally divisive inhibitory network. PMID:21508234

Stability and degradation of organic photovoltaics fabricated, aged, and characterized by the ISOS 3 inter-laboratory collaboration

NASA Astrophysics Data System (ADS)

Tanenbaum, David M.; Hermenau, Martin; Voroshazi, Eszter; Lloyd, Matthew T.; Galagan, Yulia; Zimmermann, Birger; Hösel, Markus; Dam, Henrik F.; Jørgensen, Mikkel; Gevorgyan, Suren; Kudret, Suleyman; Maes, Wouter; Lutsen, Laurence; Vanderzande, Dirk; Würfel, Uli; Andriessen, Ronn; Rösch, Roland; Hoppe, Harald; Lira-Cantu, Monica; Teran-Escobar, Gerardo; Dupuis, Aurélie; Bussière, Pierre-Olivier; Rivaton, Agnès.; Uzunoglu, Gülsah Y.; Germack, David; Andreasen, Birgitta; Madsen, Morten V.; Norrman, Kion; Bundgaard, Eva; Krebs, Frederik C.

2012-09-01

Seven distinct sets (n >= 12) of state of the art organic photovoltaic devices were prepared by leading research laboratories in a collaboration planned at the Third International Summit on Organic Photovoltaic Stability (ISOS-3). All devices were shipped to DTU and characterized simultaneously up to 1830 h in accordance with established ISOS-3 protocols under three distinct illumination conditions: accelerated full sun simulation; low level indoor fluorescent lighting; and dark storage with daily measurement under full sun simulation. Three nominally identical devices were used in each experiment both to provide an assessment of the homogeneity of the samples and to distribute samples for a variety of post soaking analytical measurements at six distinct laboratories enabling comparison at various stages in the degradation of the devices. Characterization includes current-voltage curves, light beam induced current (LBIC) imaging, dark lock-in thermography (DLIT), photoluminescence (PL), electroluminescence (EL), in situ incident photon-to-electron conversion efficiency (IPCE), time of flight secondary ion mass spectrometry (TOF-SIMS), cross sectional electron microscopy (SEM), UV visible spectroscopy, fluorescence microscopy, and atomic force microscopy (AFM). Over 100 devices with more than 300 cells were used in the study. We present here design of the device sets, results both on individual devices and uniformity of device sets from the wide range of characterization methods applied at different stages of aging under the three illumination conditions. We will discuss how these data can help elucidate the degradation mechanisms as well as the benefits and challenges associated with the unprecedented size of the collaboration.

Randomized Controlled Trial of Telephone-Delivered Cognitive Behavioral Therapy for Chronic Insomnia

PubMed Central

Arnedt, J. Todd; Cuddihy, Leisha; Swanson, Leslie M.; Pickett, Scott; Aikens, James; Chervin, Ronald D.

2013-01-01

Study Objectives: To compare the efficacy of telephone-delivered cognitive-behavioral therapy for insomnia to an information pamphlet control on sleep and daytime functioning at pretreatment, posttreatment, and 12-wk follow-up. Design: Randomized controlled parallel trial. Setting: N/A. Participants: Thirty individuals with chronic insomnia (27 women, age 39.1 ± 14.4 years, insomnia duration 8.7 ± 10.7 years). Interventions: Cognitive behavioral therapy for insomnia (CBTI) delivered in up to eight weekly telephone sessions (CBTI-Phone, n = 15) versus an information pamphlet control (IPC, n = 15). Measurements and Results: Sleep/wake diary, sleep-related questionnaires (Insomnia Severity Index, Pittsburgh Sleep Quality Index, 16-item Dysfunctional Beliefs and Attitudes about Sleep), and daytime symptom assessments (fatigue, depression, anxiety, and quality of life) were completed at pretreatment, posttreatment, and 12-wk follow-up. Linear mixed models indicated that sleep/wake diary sleep efficiency and total sleep time improved significantly at posttreatment in both groups and remained stable at 12-wk follow-up. More CBTI-Phone than IPC patients showed posttreatment improvements in unhelpful sleep-related cognitions (P < 0.001) and were classified as “in remission” from insomnia at follow-up (P < 0.05). Posttreatment effect sizes on most daytime symptoms were large (Cohen d = 0.8–2.5) for CBTI-Phone patients and small to moderate (Cohen d = -0.1–0.6) for IPC patients. All CBTI-Phone patients completed posttreatment and 12-wk follow-up assessments, but three IPC patients discontinued the study. Conclusions: The findings provide preliminary support for telephone-delivered CBTI in the treatment of chronic insomnia. Future larger-scale studies with more diverse samples are warranted. Some individuals with insomnia may also benefit from pamphlet-delivered CBTI with brief telephone support. Citation: Arnedt JT; Cuddihy L; Swanson LM; Pickett S; Aikens J; Chervin RD. Randomized controlled trial of telephone-delivered cognitive behavioral therapy for chronic insomnia. SLEEP 2013;36(3):353-362. PMID:23450712

Rapid assessment of Ebola infection prevention and control needs--six districts, Sierra Leone, October 2014.

PubMed

Pathmanathan, Ishani; O'Connor, Katherine A; Adams, Monica L; Rao, Carol Y; Kilmarx, Peter H; Park, Benjamin J; Mermin, Jonathan; Kargbo, Brima; Wurie, Alie H; Clarke, Kevin R

2014-12-12

As of October 31, 2014, the Sierra Leone Ministry of Health and Sanitation had reported 3,854 laboratory-confirmed cases of Ebola virus disease (Ebola) since the outbreak began in May 2014; 199 (5.2%) of these cases were among health care workers. Ebola infection prevention and control (IPC) measures are essential to interrupt Ebola virus transmission and protect the health workforce, a population that is disproportionately affected by Ebola because of its increased risk of exposure yet is essential to patient care required for outbreak control and maintenance of the country's health system at large. To rapidly identify existing IPC resources and high priority outbreak response needs, an assessment by CDC Ebola Response Team members was conducted in six of the 14 districts in Sierra Leone, consisting of health facility observations and structured interviews with key informants in facilities and government district health management offices. Health system gaps were identified in all six districts, including shortages or absence of trained health care staff, personal protective equipment (PPE), safe patient transport, and standardized IPC protocols. Based on rapid assessment findings and key stakeholder input, priority IPC actions were recommended. Progress has since been made in developing standard operating procedures, increasing laboratory and Ebola treatment capacity and training the health workforce. However, further system strengthening is needed. In particular, a successful Ebola outbreak response in Sierra Leone will require an increase in coordinated and comprehensive district-level IPC support to prevent ongoing Ebola virus transmission in household, patient transport, and health facility settings.

“Boosting” in Paralympic athletes with spinal cord injury: doping without drugs

PubMed Central

Mazzeo, Filomena; Santamaria, Stefania; Iavarone, Alessandro

2015-01-01

Summary The intentional activation of autonomic dysreflexia (AD, also called “boosting”), a practice sometimes used by athletes affected by spinal cord injury (SCI), is banned by the International Paralympic Committee (IPC). Although various studies have addressed doping and AD as separate issues, studies evaluating AD as a doping method are lacking. The aim of this brief review is to contribute to better understanding of the relationship between doping and AD. We conducted a literature search of the PubMed database (from 1994 onwards). The key search terms “autonomic dysreflexia” and “boosting” were cross-referenced with “sport performance”. The official Paralympic website was also viewed. AD is a potent sympathetic reflex, due to a massive release of noradrenaline, that results in marked vasoconstriction distal to the level of the lesion. Athletes with SCI often self-inflict physical suffering in order to induce this phenomenon, which carries high health risks (i.e., hypertension, cerebral hemorrhage, stroke and sudden death). Boosting is a practice that can be compared to doping methods and the IPC expressly prohibits it. Any deliberate attempt to induce AD, if detected, will lead to disqualification from the sporting event and subsequent investigation by the IPC Legal and Ethics Committee. PMID:26415788

Community perceptions of behaviour change communication interventions of the maternal neonatal and child health programme in rural Bangladesh: an exploratory study.

PubMed

Rahman, Atiya; Leppard, Margaret; Rashid, Sarawat; Jahan, Nauruj; Nasreen, Hashima E

2016-08-16

This qualitative study explored community perceptions of the components of the behaviour change communication (BCC) intervention of the BRAC Improving Maternal, Neonatal and Child Survival (IMNCS) programme in rural Bangladesh. Semi-structured interviews, key informant interviews, focus group discussions and informal group discussions were conducted to elicit community views on interpersonal communication (IPC), printed materials, entertainment education (EE) and mass media, specifically (a) acceptance of and challenges presented by different forms of media, (b) comprehensibility of terms; printed materials and entertainment education and (c) reported influence of BCC messages. IMNCS BCC interventions are well accepted by the community people. IPC is considered an essential aspect of everyday life and community members appreciate personal interaction with the BRAC community health workers. Printed materials assisted in comprehension and memorization of messages particularly when explained by community health workers (CHW) during IPC. Enactment of maternal, neonatal and child health (MNCH) narratives and traditional musical performances in EE helped to give deep insight into life's challenges and the decision making that is inherent in pregnancy, childbirth and childcare. EE also improved memorization of the messages. Some limitations were identified in design of illustrations which hampered message comprehension. Some respondents were unable to differentiate between pregnancy, delivery and postpartum danger signs. Furthermore some women were afraid to view the illustrations of danger signs as they believed seeing that might be associated with the development of these complications in their own lives. Despite these barriers, participants stated that the IMNCS BCC interventions had influenced them to take health promoting decisions and seek MNCH services. Community based maternal and newborn programmes should revise BCC interventions to strengthen IPC, using rigorously tested print materials as aids and stand-alone media. Messages about birth preparedness (especially savings), recognition of danger signs and immediate self-referral to biomedical health services should be carefully aligned and effectively delivered to women, men and older members of the community. Messaging should utilize gendered storyline and address the seasonal cycles of conception, birth, antenatal, post-natal care and childhood illnesses. Future research should identify how best to combine IPC, printed materials, traditional cultural forms, and incorporate use of social media and mass media in different field situations.

Re-Thinking Microbiology/Infection Control Education to Enhance the Practice-Readiness of Health Professional Students: More than Just a Curriculum Issue

ERIC Educational Resources Information Center

Cox, Jennifer L.; Simpson, Maree Donna; Letts, Will; Cavanagh, Heather

2015-01-01

Undergraduate education in the health professions is intended to produce competent health professional graduates. Infection prevention and control (IPC) is a necessary element of daily practice in many health professions, to safeguard patients and staff, however previous research has established poor knowledge and implementation of IPC precautions…

Brain vascular pericytes following ischemia have multipotential stem cell activity to differentiate into neural and vascular lineage cells.

PubMed

Nakagomi, Takayuki; Kubo, Shuji; Nakano-Doi, Akiko; Sakuma, Rika; Lu, Shan; Narita, Aya; Kawahara, Maiko; Taguchi, Akihiko; Matsuyama, Tomohiro

2015-06-01

Brain vascular pericytes (PCs) are a key component of the blood-brain barrier (BBB)/neurovascular unit, along with neural and endothelial cells. Besides their crucial role in maintaining the BBB, increasing evidence shows that PCs have multipotential stem cell activity. However, their multipotency has not been considered in the pathological brain, such as after an ischemic stroke. Here, we examined whether brain vascular PCs following ischemia (iPCs) have multipotential stem cell activity and differentiate into neural and vascular lineage cells to reconstruct the BBB/neurovascular unit. Using PCs extracted from ischemic regions (iPCs) from mouse brains and human brain PCs cultured under oxygen/glucose deprivation, we show that PCs developed stemness presumably through reprogramming. The iPCs revealed a complex phenotype of angioblasts, in addition to their original mesenchymal properties, and multidifferentiated into cells from both a neural and vascular lineage. These data indicate that under ischemic/hypoxic conditions, PCs can acquire multipotential stem cell activity and can differentiate into major components of the BBB/neurovascular unit. Thus, these findings support the novel concept that iPCs can contribute to both neurogenesis and vasculogenesis at the site of brain injuries. © 2015 AlphaMed Press.

Circadian and feeding cues integrate to drive rhythms of physiology in Drosophila insulin-producing cells.

PubMed

Barber, Annika F; Erion, Renske; Holmes, Todd C; Sehgal, Amita

2016-12-01

Circadian clocks regulate much of behavior and physiology, but the mechanisms by which they do so remain poorly understood. While cyclic gene expression is thought to underlie metabolic rhythms, little is known about cycles in cellular physiology. We found that Drosophila insulin-producing cells (IPCs), which are located in the pars intercerebralis and lack an autonomous circadian clock, are functionally connected to the central circadian clock circuit via DN1 neurons. Insulin mediates circadian output by regulating the rhythmic expression of a metabolic gene (sxe2) in the fat body. Patch clamp electrophysiology reveals that IPCs display circadian clock-regulated daily rhythms in firing event frequency and bursting proportion under light:dark conditions. The activity of IPCs and the rhythmic expression of sxe2 are additionally regulated by feeding, as demonstrated by night feeding-induced changes in IPC firing characteristics and sxe2 levels in the fat body. These findings indicate circuit-level regulation of metabolism by clock cells in Drosophila and support a role for the pars intercerebralis in integrating circadian control of behavior and physiology. © 2016 Barber et al.; Published by Cold Spring Harbor Laboratory Press.

"Never at ease" - family carers within integrated palliative care: a multinational, mixed method study.

PubMed

Ateş, Gülay; Ebenau, Anne Frederieke; Busa, Csilla; Csikos, Ágnes; Hasselaar, Jeroen; Jaspers, Birgit; Menten, Johan; Payne, Sheila; Van Beek, Karen; Varey, Sandra; Groot, Marieke; Radbruch, Lukas

2018-03-01

Family carers manage a wide range of responsibilities in the lives and care of patients receiving palliative care. They fulfil multiple roles and perform activities within different settings. This has immediate consequences on family carers' every-day lives. According to literature, family carers in palliative care are both part of the formal and informal care network, but also persons in need of support. This article aims to investigate 1) burdens and rewards associated with family caregiving and 2) what family carers find helpful in their contact with professionals from integrated palliative care initiatives (IPC-i) and other services. Family carers looking after patients with cancer, chronic obstructive pulmonary disease or chronic heart failure were purposefully recruited at 22 IPC-i in Belgium, Germany, Hungary, the Netherlands and the United Kingdom in the course of the project "Patient-centred palliative care pathways in advanced cancer and chronic disease" (InSup-C). Semi-structured interviews (n = 156) and 87 quantitative questionnaires (CRA, POS, CANHELP Lite) were conducted with family carers. Interviews were analysed with transnationally agreed thematic codes (MAXQDA or NVivo). Statistical tests (SPSS) were carried out in accordance with the characteristic value of the items and distributions. On average, quantitative data showed moderate burden, but the qualitative findings indicated that this burden might be underrated. There is some evidence that IPC-i with well-developed professional care networks and communication systems relieved family carers' burden by direct and indirect interventions; e.g. provision of night shift nurses or psychological support. Needs of family carers were similar in all participating countries. However, in all countries IPC-i mostly offered one-off events for family carers, lacking systematic or institutionalised support structures. Data suggest that, most IPC-i did not pay enough attention to the needs of most family carers, and did not offer proactive care and access to supportive resources to them (e.g. training, respite care, access to resources). We recommend recognizing family carers as part of the 'unit of care' and partner in caregiving, to improve their knowledge about, and access to, and the support available.

A home-made system for IPCE measurement of standard and dye-sensitized solar cells.

PubMed

Palma, Giuseppina; Cozzarini, Luca; Capria, Ennio; Fraleoni-Morgera, Alessandro

2015-01-01

A home-made system for incident photon-to-electron conversion efficiency (IPCE) characterization, based on a double-beam UV-Vis spectrophotometer, has been set up. In addition to its low cost (compared to the commercially available apparatuses), the double-beam configuration gives the advantage to measure, autonomously and with no need for supplementary equipment, the lamp power in real time, compensating possible variations of the spectral emission intensity and quality, thus reducing measurement times. To manage the optical and electronic components of the system, a custom software has been developed. Validations carried out on a common silicon-based photodiode and on a dye-sensitized solar cell confirm the possibility to adopt this system for determining the IPCE of solar cells, including dye-sensitized ones.

Effect of an indwelling pleural catheter vs chest tube and talc pleurodesis for relieving dyspnea in patients with malignant pleural effusion: the TIME2 randomized controlled trial.

PubMed

Davies, Helen E; Mishra, Eleanor K; Kahan, Brennan C; Wrightson, John M; Stanton, Andrew E; Guhan, Anur; Davies, Christopher W H; Grayez, Jamal; Harrison, Richard; Prasad, Anjani; Crosthwaite, Nicola; Lee, Y C Gary; Davies, Robert J O; Miller, Robert F; Rahman, Najib M

2012-06-13

Malignant pleural effusion causes disabling dyspnea in patients with a short life expectancy. Palliation is achieved by fluid drainage, but the most effective first-line method has not been determined. To determine whether indwelling pleural catheters (IPCs) are more effective than chest tube and talc slurry pleurodesis (talc) at relieving dyspnea. Unblinded randomized controlled trial (Second Therapeutic Intervention in Malignant Effusion Trial [TIME2]) comparing IPC and talc (1:1) for which 106 patients with malignant pleural effusion who had not previously undergone pleurodesis were recruited from 143 patients who were treated at 7 UK hospitals. Patients were screened from April 2007-February 2011 and were followed up for a year. Indwelling pleural catheters were inserted on an outpatient basis, followed by initial large volume drainage, education, and subsequent home drainage. The talc group were admitted for chest tube insertion and talc for slurry pleurodesis. Patients completed daily 100-mm line visual analog scale (VAS) of dyspnea over 42 days after undergoing the intervention (0 mm represents no dyspnea and 100 mm represents maximum dyspnea; 10 mm represents minimum clinically significant difference). Mean difference was analyzed using a mixed-effects linear regression model adjusted for minimization variables. Dyspnea improved in both groups, with no significant difference in the first 42 days with a mean VAS dyspnea score of 24.7 in the IPC group (95% CI, 19.3-30.1 mm) and 24.4 mm (95% CI, 19.4-29.4 mm) in the talc group, with a difference of 0.16 mm (95% CI, −6.82 to 7.15; P = .96). There was a statistically significant improvement in dyspnea in the IPC group at 6 months, with a mean difference in VAS score between the IPC group and the talc group of −14.0 mm (95% CI, −25.2 to −2.8 mm; P = .01). Length of initial hospitalization was significantly shorter in the IPC group with a median of 0 days (interquartile range [IQR], 0-1 day) and 4 days (IQR, 2-6 days) for the talc group, with a difference of −3.5 days (95% CI, −4.8 to −1.5 days; P < .001). There was no significant difference in quality of life. Twelve patients (22%) in the talc group required further pleural procedures compared with 3 (6%) in the IPC group (odds ratio [OR], 0.21; 95% CI, 0.04-0.86; P = .03). Twenty-one of the 52 patients in the catheter group experienced adverse events vs 7 of 54 in the talc group (OR, 4.70; 95% CI, 1.75-12.60; P = .002). Among patients with malignant pleural effusion and no previous pleurodesis, there was no significant difference between IPCs and talc pleurodesis at relieving patient-reported dyspnea. isrctn.org Identifier: ISRCTN87514420.

Core Competencies in Integrative Pain Care for Entry-Level Primary Care Physicians.

PubMed

Tick, Heather; Chauvin, Sheila W; Brown, Michael; Haramati, Aviad

2015-11-01

The objective was to develop a set of core competencies for graduating primary care physicians in integrative pain care (IPC), using the Accreditation Council for Graduate Medical Education (ACGME) domains. These competencies build on previous work in competencies for integrative medicine, interprofessional education, and pain medicine and are proposed for inclusion in residency training. A task force was formed to include representation from various professionals who are involved in education, research, and the practice of IPC and who represent broad areas of expertise. The task force convened during a 1.5-day face-to-face meeting, followed by a series of surveys and other vetting processes involving diverse interprofessional groups, which led to the consensus of a final set of competencies. The proposed competencies focus on interprofessional knowledge, skills, and attitudes (KSAs) and are in line with recommendations by the Institute of Medicine, military medicine, and professional pain societies advocating the need for coordination and integration of services for effective pain care with reduced risk and cost and improved outcomes. These ACGME domain compatible competencies for physicians reflect the contributions of several disciplines that will need to be included in evolving interprofessional settings and underscore the need for collaborative care. These core competencies can guide the incorporation of KSAs within curricula. The learning experiences should enable medical educators and graduating primary care physicians to focus more on integrative approaches, interprofessional team-based, patient-centered care that use evidence-based, traditional and complementary disciplines and therapeutics to provide safe and effective treatments for people in pain. Wiley Periodicals, Inc.

Generation of high-yield insulin producing cells from human bone marrow mesenchymal stem cells.

PubMed

Jafarian, Arefeh; Taghikhani, Mohammad; Abroun, Saeid; Pourpak, Zahra; Allahverdi, Amir; Soleimani, Masoud

2014-07-01

Allogenic islet transplantation is a most efficient approach for treatment of diabetes mellitus. However, the scarcity of islets and long term need for an immunosuppressant limits its application. Recently, cell replacement therapies that generate of unlimited sources of β cells have been developed to overcome these limitations. In this study we have described a stage specific differentiation protocol for the generation of insulin producing islet-like clusters from human bone marrow mesenchymal stem cells (hBM-MSCs). This specific stepwise protocol induced differentiation of hMSCs into definitive endoderm, pancreatic endoderm and pancreatic endocrine cells that expressed of sox17, foxa2, pdx1, ngn3, nkx2.2, insulin, glucagon, somatostatin, pancreatic polypeptide, and glut2 transcripts respectively. In addition, immunocytochemical analysis confirmed protein expression of the above mentioned genes. Western blot analysis discriminated insulin from proinsulin in the final differentiated cells. In derived insulin producing cells (IPCs), secreted insulin and C-peptide was in a glucose dependent manner. We have developed a protocol that generates effective high-yield human IPCs from hBM-MSCs in vitro. These finding suggest that functional IPCs generated by this procedure can be used as a cell-based approach for insulin dependent diabetes mellitus.

Differentiating Dark Triad Traits Within and Across Interpersonal Circumplex Surfaces.

PubMed

Dowgwillo, Emily A; Pincus, Aaron L

2017-01-01

Recent discussions surrounding the Dark Triad (narcissism, psychopathy, and Machiavellianism) have centered on areas of distinctiveness and overlap. Given that interpersonal dysfunction is a core feature of Dark Triad traits, the current study uses self-report data from 562 undergraduate students to examine the interpersonal characteristics associated with narcissism, psychopathy, and Machiavellianism on four interpersonal circumplex (IPC) surfaces. The distinctiveness of these characteristics was examined using a novel bootstrapping methodology for computing confidence intervals around circumplex structural summary method parameters. Results suggest that Dark Triad traits exhibit distinct structural summary method parameters with narcissism characterized by high dominance, psychopathy characterized by a blend of high dominance and low affiliation, and Machiavellianism characterized by low affiliation on the problems, values, and efficacies IPC surfaces. Additionally, there was some heterogeneity in findings for different measures of psychopathy. Gender differences in structural summary parameters were examined, finding similar parameter values despite mean-level differences in Dark Triad traits. Finally, interpersonal information was integrated across different IPC surfaces to create profiles associated with each Dark Triad trait and to provide a more in-depth portrait of associated interpersonal dynamics. © The Author(s) 2016.

Fabrication of a biodegradable calcium polyphosphate/polyvinyl-urethane carbonate composite for high load bearing osteosynthesis applications.

PubMed

Ramsay, Scott D; Pilliar, Robert M; Santerre, J Paul

2010-07-01

The formation of biodegradable implants for use in osteosynthesis has been a major goal of biomaterials research for the past 2-3 decades. Self-reinforced polylactide systems represent the most significant success of this research to date, however, with elastic constants up to 12-15 GPa at best, they fail to provide the initial stiffness required of devices for stabilizing fractures of major load-bearing bones. Our research has investigated the use of calcium polyphosphate (CPP), an inorganic polymer in combination with polyvinyl-urethane carbonate (PVUC) organic polymers for such applications. Initial studies indicated that composite samples formed as interpenetrating phase composites (IPC) exhibited suitable as-made strength and stiffness, however, they displayed a rapid loss of properties when exposed to in vitro aging. An investigation to determine the mechanism of this accelerated in vitro degradation for the IPCs as well as to identify possible design changes to overcome this drawback was undertaken using a model IPC system. It was found that strong interfacial strength and minimal swelling of the PVUC are very important for obtaining and maintaining appropriate mechanical properties in vitro. (c) 2010 Wiley Periodicals, Inc.

Development of a Hand Held Thromboelastograph

DTIC Science & Technology

2015-01-01

documents will be referenced during the Entegrion PCM System design, verification and validation activities. EN 61010 -1:2010 (Edition3.0) Safety...requirements for electrical equipment for measurement, control, and laboratory use – Part 1: General requirements. EN 61010 -2-101:2002 Safety...IPC-A-610E Acceptability of Electronic Assemblies IPC 7711/21B Rework, Modification and Repair of Electronic Assemblies. IEC 62304:2006/AC:2008

Ischemic preconditioning enhances autophagy but suppresses autophagic cell death in rat spinal neurons following ischemia-reperfusion.

PubMed

Fan, Jin; Zhang, Zitao; Chao, Xie; Gu, Jun; Cai, Weihua; Zhou, Wei; Yin, Guoyong; Li, Qingqing

2014-05-08

Autophagy serves to eliminate damaged proteins and organelles under normal physiological conditions and can be accelerated by pathological stress, possibly as a cytoprotective mechanism. Brief periods of ischemia (ischemic preconditioning or IPC) can reduce neuronal death in response to subsequent severe ischemic insults. Ischemic preconditioning also induces autophagy, but the contribution of autophagy to IPC-associated neuroprotection remains unclear. We investigated the contribution of autophagy to IPC-mediated neuroprotection in rats subjected to ischemic spinal cord injury. Fifty adult rats were randomly assigned to either (1) a sham group receiving anesthesia and surgical preparation (n=5), (2) an ischemia/reperfusion (I/R) group (n=20) subjected to 0.5 h ischemia followed by 3, 6, 12, or 24 h reperfusion, (3) an IPC group receiving three cycles of 5 min ischemia followed by 5 min of reperfusion (n=5), or (4) an IPC+I/R group (n=20). Hematoxylin-eosin (HE) and immunohistochemical staining were performed to evaluate spinal neuron survival in the four treatment groups. Autophagic activity was investigated by electron microscopy and by immunohistochemical and Western blot analyses of the autophagosome marker LC3-II and the autophagy-associated BH3 protein Beclin-1. Changes in Bcl-2/Beclin-1 complex association and Bcl-2 phosphorylation (p-Bcl-2) were examined by co-immunoprecipitation and Western blot analyses. In the I/R group, LC3-II was significantly elevated after 3h of reperfusion, but declined significantly by 24 h. At 24 h, I/R rats exhibited extensive spinal damage and decreased neuronal survival. In the IPC+IR group, neuronal death was reduced and expression of LC3-II sustained throughout the 24 h reperfusion period. In the I/R group, expression of (inactive) p-Bcl-2(Ser70) was increased significantly during reperfusion and was accompanied by dissociation of the Bcl-2/Beclin-1 complex and increased Beclin-1 expression. Preconditioning inhibited these changes in p-Bcl-2, Beclin-1, and Bcl-2/Beclin-1 complex expression. Ischemic preconditioning appears to sustain the beneficial effects of autophagic lysosomal degradation during I/R while inhibiting autophagic cell death. Copyright © 2014 Elsevier B.V. All rights reserved.

Propulsion/flight control integration technology (PROFIT) design analysis status

NASA Technical Reports Server (NTRS)

Carlin, C. M.; Hastings, W. J.

1978-01-01

The propulsion flight control integration technology (PROFIT) program was designed to develop a flying testbed dedicated to controls research. The preliminary design, analysis, and feasibility studies conducted in support of the PROFIT program are reported. The PROFIT system was built around existing IPCS hardware. In order to achieve the desired system flexibility and capability, additional interfaces between the IPCS hardware and F-15 systems were required. The requirements for additions and modifications to the existing hardware were defined. Those interfaces involving the more significant changes were studied. The DCU memory expansion to 32K with flight qualified hardware was completed on a brassboard basis. The uplink interface breadboard and a brassboard of the central computer interface were also tested. Two preliminary designs and corresponding program plans are presented.

Effects of pesticides, polychlorinated biphenyls and metals on the growth and reproduction of Acanthamoeba castellanii

DOE Office of Scientific and Technical Information (OSTI.GOV)

Prescott, L.M.; Kubovec, M.K.; Tryggestad, D.

1977-07-01

The effects of pollutants (pesticides, PCB and metals) were studied in the free-living amoeba, Acanthamoeba castellanii. Eight pesticides were used--the insecticides dieldrin, aldrin and sevin, and the herbicides linuron, stam F-34, IPC, atrazine and simazine. It was shown that the sensitivity of A. castellanii to pesticides varied greatly. The population growth was inhibited by linuron, stam F-34, IPC, sevin and atrazine at a level of 10 mg/l. The polychlorinated biphenyl, Arochor 1254, had no significant effect at a concentration of 0.01 mg/l (10 ppb). The studies with metal ions showed that A. castellanii was unaffected by moderately high levels ofmore » Cu and Zn, but was sensitive to the presence of Pb and mercuric ions.« less

Using continuous intraoperative optical coherence tomography measurements of the aphakic eye for intraocular lens power calculation.

PubMed

Hirnschall, Nino; Norrby, Sverker; Weber, Maria; Maedel, Sophie; Amir-Asgari, Sahand; Findl, Oliver

2015-01-01

To include intraoperative measurements of the anterior lens capsule of the aphakic eye into the intraocular lens power calculation (IPC) process and to compare the refractive outcome with conventional IPC formulae. In this prospective study, a prototype operating microscope with an integrated continuous optical coherence tomography (OCT) device (Visante attached to OPMI VISU 200, Carl Zeiss Meditec AG, Germany) was used to measure the anterior lens capsule position after implanting a capsular tension ring (CTR). Optical biometry (intraocular lens (IOL) Master 500) and ACMaster measurements (Carl Zeiss Meditec AG, Germany) were performed before surgery. Autorefraction and subjective refraction were performed 3 months after surgery. Conventional IPC formulae were compared with a new intraoperatively measured anterior chamber depth (ACD) (ACDIntraOP) partial least squares regression (PLSR) model for prediction of the postoperative refractive outcome. In total, 70 eyes of 70 patients were included. Mean axial eye length (AL) was 23.3 mm (range: 20.6-29.5 mm). Predictive power of the intraoperative measurements was found to be slightly better compared to conventional IOL power calculations. Refractive error dependency on AL for Holladay I, HofferQ, SRK/T, Haigis and ACDintraOP PLSR was r(2)=-0.42 (p<0.0001), r(2)=-0.5 (p<0.0001), r(2)=-0.34 (p=0.010), r(2)=-0.28 (p=0.049) and r(2)<0.001 (p=0.866), respectively, ACDIntraOP measurements help to better predict the refractive outcome and could be useful, if implemented in fourth-generation IPC formulae. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Simulation of the infiltration process of a ceramic open-pore body with a metal alloy in semi-solid state to design the manufacturing of interpenetrating phase composites

NASA Astrophysics Data System (ADS)

Schomer, Laura; Liewald, Mathias; Riedmüller, Kim Rouven

2018-05-01

Metal-ceramic Interpenetrating Phase Composites (IPC) belong to a special subcategory of composite materials and reveal enhanced properties compared to conventional composite materials. Currently, IPC are produced by infiltration of a ceramic open-pore body with liquid metal applying high pressure and I or high temperature to avoid residual porosity. However, these IPC are not able to gain their complete potential, because of structural damages and interface reactions occurring during the manufacturing process. Compared to this, the manufacturing of IPC using the semi-solid forming technology offers great perspectives due to relative low processing temperatures and reduced mechanical pressure. In this context, this paper is focusing on numerical investigations conducted by using the FLOW-3D software for gaining a deeper understanding of the infiltration of open-pore bodies with semi-solid materials. For flow simulation analysis, a geometric model and different porous media drag models have been used. They have been adjusted and compared to get a precise description of the infiltration process. Based on these fundamental numerical investigations, this paper also shows numerical investigations that were used for basically designing a semi-solid forming tool. Thereby, the development of the flow front and the pressure during the infiltration represent the basis of the evaluation. The use of an open and closed tool cavity combined with various geometries of the upper die shows different results relating to these evaluation arguments. Furthermore, different overflows were designed and its effects on the pressure at the end of the infiltration process were investigated. Thus, this paper provides a general guideline for a tool design for manufacturing of metal-ceramic IPC using semi-solid forming.

Mesoporous inverse opal TiO2 film as light scattering layer for dye-sensitized solar cell.

PubMed

Jin, Mingshi; Kim, Sung Soo; Yoon, Minyoung; Li, Zhenghua; Lee, Yoon Yun; Kim, Ji Man

2012-01-01

The light harvesting efficiency of dye-sensitized solar cells was enhanced by using a scattering layer. Such as sphere type TiO2, inverse photonic crystal TiO2, hollow spherical TiO2. Among these materials, the TiO2 with inverse photonic crystal (IPC) structure, synthesized by self-assembly using spherical templates, has attracted much attention due to their photonic crystal characteristics and light scattering effects. However, when applied in the DSSCs, the surface area of IPC is very low that caused insufficient adsorption amount of dye molecules. In the present work, a scattering layer with mesoporous inverse photonic crystal (MIPC) TiO2 film was fabricated by the sol-gel reactions with surfactant-assisted sol-gel method using poly(methyl methacrylate) as the template and titanium (IV) isopropoxide as the TiO2 precursor. After removing the PMMA and surfactant, a highly ordered macroporous structure with mesopores were successfully obtained. The surface area and total pore volume of the MIPC were 82 m2/g and 0.31 cm3/g, respectively, which is much larger than those of the IPC. The DSSCs with the scattering layer of MIPC film exhibited 18 and 10% higher photo-conversion efficiency than those of cells only with a nano-crystalline TiO2 film and with scattering layer of IPC film. From UV-visible spectra of dye solutions, the MIPC film showed a higher amount of absorbed dye molecules than those of the reference and IPC films. Accordingly, an increase in the photo-current density through abundant adsorption of the dye, coupled with inherent light scattering ability can improve overall photo-conversion efficiency.

Point-spread Function Ramifications and Deconvolution of a Signal Dependent Blur Kernel Due to Interpixel Capacitive Coupling

NASA Astrophysics Data System (ADS)

Donlon, Kevan; Ninkov, Zoran; Baum, Stefi

2018-07-01

Interpixel capacitance (IPC) is a deterministic electronic coupling that results in a portion of the collected signal incident on one pixel of a hybridized detector array being measured in adjacent pixels. Data collected by light sensitive HgCdTe arrays which exhibit this coupling typically goes uncorrected or is corrected by treating the coupling as a fixed point-spread function. Evidence suggests that this IPC coupling is not uniform across different signal and background levels. This variation invalidates assumptions that are key in decoupling techniques such as Wiener Filtering or application of the Lucy–Richardson algorithm. Additionally, the variable IPC results in the point-spread function (PSF) depending upon a star’s signal level relative to the background level, among other parameters. With an IPC ranging from 0.68% to 1.45% over the full well depth of a sensor, as is a reasonable range for the H2RG arrays, the FWHM of the JWSTs NIRCam 405N band is degraded from 2.080 pix (0.″132) as expected from the diffraction pattern to 2.186 pix (0.″142) when the star is just breaching the sensitivity limit of the system. For example, When attempting to use a fixed PSF fitting (e.g., assuming the PSF observed from a bright star in the field) to untangle two sources with a flux ratio of 4:1 and a center to center distance of 3 pixels, flux estimation can be off by upwards of 1.5% with a separation error of 50 millipixels. To deal with this issue an iterative non-stationary method for deconvolution is here proposed, implemented, and evaluated that can account for the signal dependent nature of IPC.

N-Acetylglutaminoyl-S-farnesyl-L-cysteine (SIG-1191): an anti-inflammatory molecule that increases the expression of the aquaglyceroporin, aquaporin-3, in human keratinocytes.

PubMed

Fernández, José R; Webb, Corey; Rouzard, Karl; Voronkov, Michael; Huber, Kristen L; Stock, Jeffry B; Stock, Maxwell; Gordon, Joel S; Perez, Eduardo

2017-03-01

Isoprenylcysteine (IPC) small molecules were discovered as signal transduction modulating compounds ~25 years ago. More recently, IPC molecules have demonstrated antioxidant and anti-inflammatory properties in a variety of dermal cells as well as antimicrobial activity, representing a novel class of compounds to ameliorate skin conditions and disease. Here, we demonstrate a new IPC compound, N-acetylglutaminoyl-S-farnesyl-L-cysteine (SIG-1191), which inhibits UVB-induced inflammation blocking pro-inflammatory cytokine interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) production. To investigate further the previously reported hydrating potential of IPC compounds, SIG-1191 was tested for its ability to modulate aquaporin expression. Specifically, aquaporin 3 (AQP3) the most abundant aquaporin found in skin has been reported to play a key role in skin hydration, elasticity and barrier repair. Results show here for the first time that SIG-1191 increases AQP3 expression in both cultured normal human epidermal keratinocytes as well as when applied topically in a three-dimensional (3D) reconstructed human skin equivalent. Additionally, SIG-1191 dose dependently increased AQP3 protein levels, as determined by specific antibody staining, in the epidermis of the 3D skin equivalents. To begin to elucidate which signaling pathways SIG-1191 may be modulating to increase AQP3 levels, we used several pharmacological pathway inhibitors and determined that AQP3 expression is mediated by the Mitogen-activated protein kinase/Extracellular signal-regulated kinase kinase (MEK) pathway. Altogether, these data suggest SIG-1191 represents a new IPC derivative with anti-inflammatory activity that may also promote increased skin hydration based on its ability to increase AQP3 levels.

Simulation of the Plasma Density Evolution during Electron Cyclotron Resonance Heating at the T-10 Tokamak

NASA Astrophysics Data System (ADS)

Dnestrovskij, Yu. N.; Vershkov, V. A.; Danilov, A. V.; Dnestrovskij, A. Yu.; Zenin, V. N.; Lysenko, S. E.; Melnikov, A. V.; Shelukhin, D. A.; Subbotin, G. F.; Cherkasov, S. V.

2018-01-01

In ohmically heated (OH) plasma with low recycling, an improved particle confinement (IPC) mode is established during gas puffing. However, after gas puffing is switched off, this mode is retained only for about 100 ms, after which an abrupt phase transition into the low particle confinement (LPC) mode occurs in the entire plasma cross section. During such a transition, energy transport due to heat conduction does not change. The phase transition in OH plasma is similar to the effect of density pump-out from the plasma core, which occurs after electron cyclotron heating (ECH) is switched on. Analysis of the measured plasma pressure profiles in the T-10 tokamak shows that, after gas puffing in the OH mode is switched off, the plasma pressure profile in the IPC stage becomes more peaked and, after the peakedness exceeds a certain critical value, the IPC-LPC transition occurs. Similar processes are also observed during ECH. If the pressure profile is insufficiently peaked during ECH, then the density pump-out effect comes into play only after the critical peakedness of the pressure profile is reached. In the plasma core, the density and pressure profiles are close to the corresponding canonical profiles. This allows one to derive an expression for the particle flux within the canonical profile model and formulate a criterion for the IPC-LPC transition. The time evolution of the plasma density profile during phase transitions was simulated for a number of T-10 shots with ECH and high recycling. The particle transport coefficients in the IPC and LPC phases, as well as the dependences of these coefficients on the ECH power, are determined.

Inhibition of KV7 Channels Protects the Rat Heart against Myocardial Ischemia and Reperfusion Injury.

PubMed

Hedegaard, Elise R; Johnsen, Jacob; Povlsen, Jonas A; Jespersen, Nichlas R; Shanmuganathan, Jeffrey A; Laursen, Mia R; Kristiansen, Steen B; Simonsen, Ulf; Bøtker, Hans Erik

2016-04-01

The voltage-gated KV7 (KCNQ) potassium channels are activated by ischemia and involved in hypoxic vasodilatation. We investigated the effect of KV7 channel modulation on cardiac ischemia and reperfusion injury and its interaction with cardioprotection by ischemic preconditioning (IPC). Reverse-transcription polymerase chain reaction revealed expression of KV7.1, KV7.4, and KV7.5 in the left anterior descending rat coronary artery and all KV7 subtypes (KV7.1-KV7.5) in the left and right ventricles of the heart. Isolated hearts were subjected to no-flow global ischemia and reperfusion with and without IPC. Infarct size was quantified by 2,3,5-triphenyltetrazolium chloride staining. Two blockers of KV7 channels, XE991 [10,10-bis(4-pyridinylmethyl)-9(10H)-anthracenone] (10 µM) and linopirdine (10 µM), reduced infarct size and exerted additive infarct reduction to IPC. An opener of KV7 channels, flupirtine (10 µM) abolished infarct size reduction by IPC. Hemodynamics were measured using a catheter inserted in the left ventricle and postischemic left ventricular recovery improved in accordance with reduction of infarct size and deteriorated with increased infarct size. XE991 (10 µM) reduced coronary flow in the reperfusion phase and inhibited vasodilatation in isolated small branches of the left anterior descending coronary artery during both simulated ischemia and reoxygenation. KV7 channels are expressed in rat coronary arteries and myocardium. Inhibition of KV7 channels exerts cardioprotection and opening of KV7 channels abrogates cardioprotection by IPC. Although safety issues should be further addressed, our findings suggest a potential role for KV7 blockers in the treatment of ischemia-reperfusion injury. Copyright © 2016 by The American Society for Pharmacology and Experimental Therapeutics.

An unbiased X-ray sampling of stars within 25 parsecs of the Sun

NASA Technical Reports Server (NTRS)

Johnson, H. M.

1985-01-01

A search of all of the Einstein Observatory IPC and HRI fields for untargeted stars in the Woolley, et al., Catalogue of the nearby stars is reported. Optical data and IPC coordinates, flux density F sub x, and luminosity L sub x, or upper limits, are tabulated for 126 single or blended systems, and HRI results for a few of them. IPC luminosity functions are derived for the systems, for 193 individual stars in the systems (with L sub x shared equally among blended components), and for 63 individual M dwarfs. These stars have relatively large X-ray flux densities that are free of interstellar extinction, because they are nearby, but they are otherwise unbiased with respect to the X-ray properties that are found in a defined small space around the Sun.

Traumatic Vertebral Fractures and Concomitant Fractures of the Rib in Southwest China, 2001 to 2010

PubMed Central

Wang, Hongwei; Zhou, Yue; Ou, Lan; Li, Changqing; Liu, Jun; Xiang, Liangbi

2015-01-01

Abstract To our knowledge, the clinical characteristics of traumatic vertebral fractures and concomitant fractures of the rib (TVF-RF) have not been described in previous studies. To investigate the clinical characteristics of patients managed for TVF-RF. A retrospective study of 3142 patients who presented with traumatic vertebral fractures was performed. Two hundred twenty-six patients (7.2%) suffered from TVF-RF. Incidence rate ratios were then calculated with respect to the level of injury to the spine, the ASIA classification of neurological deficits and age. There were 171 male (75.7%) and 55 female (24.3%) patients with a mean age of 43.8 years. The most common mechanisms were falls from high heights in 81 cases and road traffic crashes in 67 cases. Right-sided rib injury occurred in 106 cases, left-sided injury occurred in 76 cases, and bilateral injury occurred in 44 cases. The most frequent location of the rib fractures was from the fourth rib to the ninth rib (70.3%, 510/725). Initial pulmonary complications (IPC) after trauma occurred in 116 cases (51.3%). The mortality rate for the entire group was 1.3% (3/226). The patients with thoracic vertebral fractures and neurological deficits had a higher frequency of multiple rib fractures and IPC than the other patients (P < 0.05). With the increased number of rib fractures, the frequency of IPC and mean intensive care unit (ICU) length of stay also increased. The rates of complications for patients with rib fractures were significantly different from those without rib fractures. We should pay much attention to the patients who presented with thoracic vertebral fractures and neurological deficits for minimizing further complications and mortality in such patients who had a higher frequency of multiple rib fractures and IPC than the other patients. PMID:26554809

Deep venous thrombosis prophylaxis in trauma: improved compliance with a novel miniaturized pneumatic compression device.

PubMed

Murakami, Maki; McDill, Tandace L; Cindrick-Pounds, Lori; Loran, David B; Woodside, Kenneth J; Mileski, William J; Hunter, Glenn C; Killewich, Lois A

2003-11-01

Intermittent pneumatic compression (IPC) devices prevent lower-extremity deep venous thrombosis (LEDVT) when used properly, but compliance remains an issue. Devices are frequently discontinued when patients are out of bed, and they are rarely used in emergency departments. Trauma patients are at high risk for LEDVT; however, IPCs are underused in this population because of compliance limitations. The hypothesis of this study was that a new miniaturized, portable, battery-powered pneumatic compression device improves compliance in trauma patients over that provided by a standard device. This was a prospective trial in which trauma patients (mean age, 46 years; revised trauma score, 11.7) were randomized to DVT prophylaxis with a standard calf-length sequential IPC device (SCD group) or a miniaturized sequential device (continuous enhanced-circulation therapy [CECT] group). The CECT device can be battery-operated for up to 6 hours and worn during ambulation. Timers attached to the devices, which recorded the time each device was applied to the legs and functioning, were used to quantify compliance. For each subject in each location during hospitalization, compliance rates were determined by dividing the number of minutes the device was functioning by the total minutes in that location. Compliance rates for all subjects were averaged in each location: emergency department, operating room, intensive care unit, and nursing ward. Total compliance rate in the CECT group was significantly higher than in the SCD group (77.7% vs. 58.9%, P =.004). Compliance in the emergency department and nursing ward were also significantly greater with the CECT device (P =.002 and P =.008 respectively). Previous studies have demonstrated that reduced compliance with IPC devices results in a higher incidence of LEDVT. Given its ability to improve compliance, the CECT may provide superior DVT prevention compared with that provided by standard devices.

A complete database for the Einstein imaging proportional counter

NASA Technical Reports Server (NTRS)

Helfand, David J.

1991-01-01

A complete database for the Einstein Imaging Proportional Counter (IPC) was completed. The original data that makes up the archive is described as well as the structure of the database, the Op-Ed analysis system, the technical advances achieved relative to the analysis of (IPC) data, the data products produced, and some uses to which the database has been put by scientists outside Columbia University over the past year.

Monolithic echo-less photoconductive switches as a high-resolution detector for terahertz time-domain spectroscopy

NASA Astrophysics Data System (ADS)

Maussang, K.; Palomo, J.; Manceau, J.-M.; Colombelli, R.; Sagnes, I.; Li, L. H.; Linfield, E. H.; Davies, A. G.; Mangeney, J.; Tignon, J.; Dhillon, S. S.

2017-04-01

Interdigitated photoconductive (iPC) switches are powerful and convenient devices for time-resolved spectroscopy, with the ability to operate both as sources and detectors of terahertz (THz) frequency pulses. However, reflection of the emitted or detected radiation within the device substrate itself can lead to echoes that inherently limit the spectroscopic resolution achievable for their use in time-domain spectroscopy (TDS) systems. In this work, we demonstrate a design of low-temperature-grown-GaAs (LT-GaAs) iPC switches for THz pulse detection that suppresses such unwanted echoes. This is realized through the growth of a buried multilayer LT-GaAs structure that retains its ultrafast properties, which, after wafer bonding to a metal-coated host substrate, results in an iPC switch with a metal plane buried at a subwavelength depth below the LT-GaAs surface. Using this device as a detector, and coupling it to an echo-less iPC source, enables echo-free THz-TDS and high-resolution spectroscopy, with a resolution limited only by the temporal length of the measurement governed by the mechanical delay line used. As a proof-of-principle, the 212-221 and the 101-212 rotational lines of water vapor have been spectrally resolved, demonstrating a spectral resolution below 10 GHz.

Generation of insulin-producing cells from human bone marrow-derived mesenchymal stem cells: comparison of three differentiation protocols.

PubMed

Gabr, Mahmoud M; Zakaria, Mahmoud M; Refaie, Ayman F; Khater, Sherry M; Ashamallah, Sylvia A; Ismail, Amani M; El-Badri, Nagwa; Ghoneim, Mohamed A

2014-01-01

Many protocols were utilized for directed differentiation of mesenchymal stem cells (MSCs) to form insulin-producing cells (IPCs). We compared the relative efficiency of three differentiation protocols. Human bone marrow-derived MSCs (HBM-MSCs) were obtained from three insulin-dependent type 2 diabetic patients. Differentiation into IPCs was carried out by three protocols: conophylline-based (one-step protocol), trichostatin-A-based (two-step protocol), and β -mercaptoethanol-based (three-step protocol). At the end of differentiation, cells were evaluated by immunolabeling for insulin production, expression of pancreatic endocrine genes, and release of insulin and c-peptide in response to increasing glucose concentrations. By immunolabeling, the proportion of generated IPCs was modest ( ≃ 3%) in all the three protocols. All relevant pancreatic endocrine genes, insulin, glucagon, and somatostatin, were expressed. There was a stepwise increase in insulin and c-peptide release in response to glucose challenge, but the released amounts were low when compared with those of pancreatic islets. The yield of functional IPCs following directed differentiation of HBM-MSCs was modest and was comparable among the three tested protocols. Protocols for directed differentiation of MSCs need further optimization in order to be clinically meaningful. To this end, addition of an extracellular matrix and/or a suitable template should be attempted.

Rapid spread of complex change: a case study in inpatient palliative care.

PubMed

Della Penna, Richard; Martel, Helene; Neuwirth, Esther B; Rice, Jennifer; Filipski, Marta I; Green, Jennifer; Bellows, Jim

2009-12-29

Based on positive findings from a randomized controlled trial, Kaiser Permanente's national executive leadership group set an expectation that all Kaiser Permanente and partner hospitals would implement a consultative model of interdisciplinary, inpatient-based palliative care (IPC). Within one year, the number of IPC consultations program-wide increased almost tenfold from baseline, and the number of teams nearly doubled. We report here results from a qualitative evaluation of the IPC initiative after a year of implementation; our purpose was to understand factors supporting or impeding the rapid and consistent spread of a complex program. Quality improvement study using a case study design and qualitative analysis of in-depth semi-structured interviews with 36 national, regional, and local leaders. Compelling evidence of impacts on patient satisfaction and quality of care generated 'pull' among adopters, expressed as a remarkably high degree of conviction about the value of the model. Broad leadership agreement gave rise to sponsorship and support that permeated the organization. A robust social network promoted knowledge exchange and built on an existing network with a strong interest in palliative care. Resource constraints, pre-existing programs of a different model, and ambiguous accountability for implementation impeded spread. A complex, hospital-based, interdisciplinary intervention in a large health care organization spread rapidly due to a synergy between organizational 'push' strategies and grassroots-level pull. The combination of push and pull may be especially important when the organizational context or the practice to be spread is complex.

Making Infection Prevention Education Interactive Can Enhance Knowledge and Improve Outcomes: Results from the Targeted Infection Prevention (TIP) study

PubMed Central

Koo, Evonne; McNamara, Sara; Lansing, Bonnie; Olmsted, Russell N.; Rye, Ruth Anne; Fitzgerald, Thomas; Mody, Lona

2016-01-01

Objectives To assess effectiveness of an interactive educational program in increasing knowledge of key infection prevention and control (IPC) principles with emphasis on indwelling device care, hand hygiene and multi-drug resistant organisms (MDROs) among nursing home (NH) healthcare personnel (HCP). Methods We conducted a multi-modal randomized-controlled study involving HCP at 12 NHs. Ten comprehensive and interactive modules covered common IPC topics. We compared: a) intervention and control scores to assess differences in pre-test scores as a result of field interventions; b) pre- and post-test scores to assess knowledge gain and c) magnitude of knowledge gain based on job categories. Results 4,962 tests were returned over the course of the intervention with 389–633 HCP/module. Participants were mostly female certified nursing assistants (CNAs). Score improvement was highest for modules emphasizing hand hygiene, urinary catheter care and MDROs (15.6%, 15.95%, and 22.0%, respectively). After adjusting for cluster study design, knowledge scores were significantly higher after each educational module, suggesting the education delivery method was effective. When compared to CNAs, nursing and rehabilitation personnel scored significantly higher in their knowledge tests. Conclusion Our intervention significantly improved IPC knowledge in HCP, especially for those involved in direct patient care. This increase in knowledge along with preemptive barrier precautions and active surveillance has enhanced resident safety by reducing MDROs and infections in high-risk NH residents. PMID:27553671

A complete public archive for the Einstein IPC

NASA Technical Reports Server (NTRS)

Helfand, David J.

1993-01-01

This report documents progress made in the period 29 September 1992 and 28 September 1993, on the project described in our proposal 'A Complete Public Archive for the Einstein IPC,' which was approved under the Astrophysics Data Program last year. All of the principal first-year objectives were achieved and we expect to continue our efforts over the next two years toward the goal of transferring the entire activity to the HEASARC.

Designing Security-Hardened Microkernels For Field Devices

NASA Astrophysics Data System (ADS)

Hieb, Jeffrey; Graham, James

Distributed control systems (DCSs) play an essential role in the operation of critical infrastructures. Perimeter field devices are important DCS components that measure physical process parameters and perform control actions. Modern field devices are vulnerable to cyber attacks due to their increased adoption of commodity technologies and that fact that control networks are no longer isolated. This paper describes an approach for creating security-hardened field devices using operating system microkernels that isolate vital field device operations from untrusted network-accessible applications. The approach, which is influenced by the MILS and Nizza architectures, is implemented in a prototype field device. Whereas, previous microkernel-based implementations have been plagued by poor inter-process communication (IPC) performance, the prototype exhibits an average IPC overhead for protected device calls of 64.59 μs. The overall performance of field devices is influenced by several factors; nevertheless, the observed IPC overhead is low enough to encourage the continued development of the prototype.

Impact of communication strategies to increase knowledge, acceptability, and uptake of a new Woman's Condom in urban Lusaka, Zambia: study protocol for a randomized controlled trial.

PubMed

Pinchoff, Jessie; Chowdhuri, Rachna Nag; Taruberekera, Noah; Ngo, Thoai D

2016-12-13

Globally, 220 million women experience an unmet need for family planning. A newly designed female condom, the Woman's Condom (WC), has been developed featuring an improved design. It is the first dual-protection, female-initiated contraceptive that is a premium, higher price point product. However, market availability alone will not increase uptake. In February 2016 the WC will be distributed with a strong media campaign and interpersonal communication (IPC) outreach intervention. The impact of these on knowledge, acceptability, and use of the WC will be measured. A baseline survey of 2314 randomly selected 18- to 24-year-old sexually active men and women has been conducted. The WC and mass media will be introduced throughout 40 urban wards in and surrounding Lusaka, Zambia. The baseline survey will serve as a quasi-control arm to determine the impact of introducing the WC with mass media. Half of the wards will be randomly allocated to additionally receive the IPC intervention. A single-blind randomized controlled trial will determine the impact of the IPC intervention on knowledge, uptake, and use of the WC. After one year, another 2314 individuals will be randomly selected to participate in the endline survey. We hypothesize that (1) the distribution and media campaign of the WC will increase overall condom use in selected urban wards, and specifically use of the WC; (2) the IPC intervention will significantly impact knowledge, acceptability, and use of the WC. The primary outcome measures are use of the WC, use of any condom, and willingness to use the WC. Secondary outcomes include measures of knowledge, acceptability, and choice of contraception. Odds ratios will be estimated to measure the effect of the intervention on the outcomes with 95% confidence intervals. All analyses will be based on the intention-to-treat principle. Increasing uptake of dual prevention measures (such as the WC) may reduce incidence of sexually transmitted infections/HIV and unplanned pregnancies. It is important to ensure young, urban adults have access to new contraceptive methods; and, understanding how mass media and IPC impact contraceptive knowledge, acceptability, and use is critical to reduce unmet need. AEARCTR-0000899 . Registered on 26 October 2015.

Electrophysiological heterogeneity of pacemaker cells in the rabbit intercaval region, including the SA node: insights from recording multiple ion currents in each cell.

PubMed

Monfredi, Oliver; Tsutsui, Kenta; Ziman, Bruce; Stern, Michael D; Lakatta, Edward G; Maltsev, Victor A

2018-03-01

Cardiac pacemaker cells, including cells of the sinoatrial node, are heterogeneous in size, morphology, and electrophysiological characteristics. The exact extent to which these cells differ electrophysiologically is unclear yet is critical to understanding their functioning. We examined major ionic currents in individual intercaval pacemaker cells (IPCs) sampled from the paracristal, intercaval region (including the sinoatrial node) that were spontaneously beating after enzymatic isolation from rabbit hearts. The beating rate was measured at baseline and after inhibition of the Ca 2+ pump with cyclopiazonic acid. Thereafter, in each cell, we consecutively measured the density of funny current ( I f ), delayed rectifier K + current ( I K ) (a surrogate of repolarization capacity), and L-type Ca 2+ current ( I Ca,L ) using whole cell patch clamp . The ionic current densities varied to a greater extent than previously appreciated, with some IPCs demonstrating very small or zero I f . The density of none of the currents was correlated with cell size, while I Ca,L and I f densities were related to baseline beating rates. I f density was correlated with I K density but not with that of I Ca,L . Inhibition of Ca 2+ cycling had a greater beating rate slowing effect in IPCs with lower I f densities. Our numerical model simulation indicated that 1) IPCs with small (or zero) I f or small I Ca,L can operate via a major contribution of Ca 2+ clock, 2) I f -Ca 2+ -clock interplay could be important for robust pacemaking function, and 3) coupled I f - I K function could regulate maximum diastolic potential. Thus, we have demonstrated marked electrophysiological heterogeneity of IPCs. This heterogeneity is manifested in basal beating rate and response to interference of Ca 2+ cycling, which is linked to I f . NEW & NOTEWORTHY In the present study, a hitherto unrecognized range of heterogeneity of ion currents in pacemaker cells from the intercaval region is demonstrated. Relationships between basal beating rate and L-type Ca 2+ current and funny current ( I f ) density are uncovered, along with a positive relationship between I f and delayed rectifier K + current. Links are shown between the response to Ca 2+ cycling blockade and I f density.

A novel duplex real time quantitative reverse transcription polymerase chain reaction for rubella virus with armored RNA as a noncompetitive internal positive control.

PubMed

Zhao, Lihong; Li, Ruiying; Liu, Aihua; Zhao, Shuping

2015-07-01

The objective of this study was to build and apply a duplex real time quantitative reverse transcription-polymerase chain reaction (RT-PCR) for rubella virus. Firstly, a 60-bp-long armored RV RNA was constructed in the laboratory. Secondly, a duplex real time RT-PCR assay was established. Thirdly, the 60-bp-long armored RV RNA was used as an internal positive control (IPC) for the duplex real time RT-PCR. And finally the duplex real time RT-PCR assay was applied to detect RV RNA in clinical specimens. The in-house assay has a high amplification efficiency (0.99), a high analytical sensitivity (200 copies/mL), and a good reproducibility. The diagnostic specificity and sensitivity of the in-house assay were both 100%, due to the monitoring of the armored RV RNA IPC. Therefore, the in-house duplex real time quantitative RT-PCR assay is a specific, sensitive, reproducible and accurate assay for quantitation of RV RNA in clinical specimens. And noncompetitive armored RV RNA IPC can monitor RT-PCR inhibition and prevent false-negative and inaccurate results in the real time detection system. Copyright © 2015 Elsevier B.V. All rights reserved.

Statistical analysis plan for the Pneumatic CompREssion for PreVENting Venous Thromboembolism (PREVENT) trial: a study protocol for a randomized controlled trial.

PubMed

Arabi, Yaseen; Al-Hameed, Fahad; Burns, Karen E A; Mehta, Sangeeta; Alsolamy, Sami; Almaani, Mohammed; Mandourah, Yasser; Almekhlafi, Ghaleb A; Al Bshabshe, Ali; Finfer, Simon; Alshahrani, Mohammed; Khalid, Imran; Mehta, Yatin; Gaur, Atul; Hawa, Hassan; Buscher, Hergen; Arshad, Zia; Lababidi, Hani; Al Aithan, Abdulsalam; Jose, Jesna; Abdukahil, Sheryl Ann I; Afesh, Lara Y; Dbsawy, Maamoun; Al-Dawood, Abdulaziz

2018-03-15

The Pneumatic CompREssion for Preventing VENous Thromboembolism (PREVENT) trial evaluates the effect of adjunctive intermittent pneumatic compression (IPC) with pharmacologic thromboprophylaxis compared to pharmacologic thromboprophylaxis alone on venous thromboembolism (VTE) in critically ill adults. In this multicenter randomized trial, critically ill patients receiving pharmacologic thromboprophylaxis will be randomized to an IPC or a no IPC (control) group. The primary outcome is "incident" proximal lower-extremity deep vein thrombosis (DVT) within 28 days after randomization. Radiologists interpreting the lower-extremity ultrasonography will be blinded to intervention allocation, whereas the patients and treating team will be unblinded. The trial has 80% power to detect a 3% absolute risk reduction in the rate of proximal DVT from 7% to 4%. Consistent with international guidelines, we have developed a detailed plan to guide the analysis of the PREVENT trial. This plan specifies the statistical methods for the evaluation of primary and secondary outcomes, and defines covariates for adjusted analyses a priori. Application of this statistical analysis plan to the PREVENT trial will facilitate unbiased analyses of clinical data. ClinicalTrials.gov , ID: NCT02040103 . Registered on 3 November 2013; Current controlled trials, ID: ISRCTN44653506 . Registered on 30 October 2013.

[Concentration of cysteine proteinase inhibitors in urine, amniotic fluid and serum from women in pregnancy complicated by EPH-gestosis].

PubMed

Karmowski, A; Sobiech, K A; Kertyńska, I; Terpiłowski, L; Słowińska-Lisowska, M; Pałczyński, B; Malik, B

2000-10-01

Cysteine proteinase inhibitors (IPC) concentration was measured by the modified Barrett method using papaine in urine, amniotic fluid and serum obtained from the healthy labored women and from labored women in pregnancy complicated by EPH-gestosis. It was noticed the statistically significant increase in the IPC concentration in the material from the pregnant women with EPH-gestosis comparing to the women, which pregnancy had the physiologically normal course.

Detection of Nicotiana DNA in Tobacco Products Using a Novel Multiplex Real-Time PCR Assay.

PubMed

Korchinski, Katie L; Land, Adrian D; Craft, David L; Brzezinski, Jennifer L

2016-07-01

Establishing that a product contains tobacco is a requirement for the U.S. Food and Drug Administration's regulation and/or prosecution of tobacco products. Therefore, a multiplex real-time PCR method was designed to determine if Nicotiana (tobacco) DNA is present in tobacco products. The PCR method simultaneously amplifies a 73 bp fragment of the cytochrome P450 monoxygenase CYP82E4 gene and 66 bp fragment in the nia-1 gene for nitrate reductase, which are detected using dual-labeled TaqMan probes. The assay is capable of detecting approximately 7.8 pg purified tobacco DNA, with a similar sensitivity for either gene target while incorporating an internal positive control (IPC). DNA was extracted from prepared tobacco products-including chewing tobacco, pipe tobacco, and snuff-or from the cut fill (no wrapper) of cigarettes and cigars. Of the 13 products analyzed, 12 were positive for both tobacco-specific markers and the IPC. DNA was also extracted from the fill of five varieties of herbal cigarettes, which were negative for both tobacco-specific gene targets and positive for the IPC. Our method expands on current assays by introducing a multiplex reaction, targeting two sequences in two different genes of interest, incorporating an IPC into the reaction, and lowering the LOD and LOQ while increasing the efficiency of the PCR.

Weak e+e- lines from internal pair conversion observed in collisions of 238U with heavy nuclei

NASA Astrophysics Data System (ADS)

Heinz, S.; Berdermann, E.; Heine, F.; Joeres, O.; Kienle, P.; Koenig, I.; Koenig, W.; Kozhuharov, C.; Leinberger, U.; Rhein, M.; Schröter, A.; Tsertos, H.

1998-01-01

We present the results of a Doppler-shift correction to the measured e+e- sum-energy spectra obtained from e+e- coincidence measurements in 238U +206Pb and 238U +181Ta collisions at beam energies close to the Coulomb barrier, using an improved experimental setup at the double-Orange spectrometer of GSI. Internal-Pair-Conversion (IPC) e+e- pairs from discrete nuclear transitions of a moving emitter have been observed following Coulomb excitation of the 1.844 MeV (E1) transition in 206Pb and neutron transfer to the 1.770 MeV (M1) transition in 207Pb. In the collision system 238U +181Ta, IPC transitions were observed from the Ta-like as well as from the U-like nuclei. In all systems the Doppler-shift corrected e+e- sum-energy spectra show weak lines at the energies expected from the corresponding γ ray spectra with cross sections being consistent with the measured excitation cross sections of the γ lines and the theoretically predicted IPC coefficients. No other than IPC e+e- sum-energy lines were found in the measured spectra. The transfer cross sections show a strong dependence on the distance of closest approach (Rmin), thus signaling also a strong dependence on the bombarding energy close to the Coulomb barrier.

Descriptive epidemiology of Paralympic sports injuries.

PubMed

Webborn, Nick; Emery, Carolyn

2014-08-01

Paralympic sports have seen an exponential increase in participation since 16 patients took part in the first Stoke Mandeville Games on the opening day of the 1948 London Olympic Games. More than 4,000 athletes took part in the London 2012 Paralympic Games. Few sporting events have seen such rapid evolution. This rapid pace of change also has meant challenges for understanding the injury risks of participation, not only because of the variety of sports, impairment types, the evolution of adapted equipment but also because of the inclusion of additional impairment types and development of new sports over time. Early studies were limited in scope but patterns of injuries are slowly emerging within Winter and Summer Paralympic sports. The IPC's London 2012 study is the largest to date with a prospective cohort study involving 49,910 athlete-days. The results identified large differences across sports and highlighted the need for longitudinal sport specific studies rather than solely games-time studies. This will require collaboration with international sports federations to examine injury patterns and risk factors for injury in this population to appropriately inform injury prevention strategies. Further studies will also need to address the impact of sporting participation, injury, and future health. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Capacity of English NHS hospitals to monitor quality in infection prevention and control using a new European framework: a multilevel qualitative analysis

PubMed Central

Iwami, Michiyo; Ahmad, Raheelah; Castro-Sánchez, Enrique; Birgand, Gabriel; Johnson, Alan P; Holmes, Alison

2017-01-01

Objective (1) To assess the extent to which current English national regulations/policies/guidelines and local hospital practices align with indicators suggested by a European review of effective strategies for infection prevention and control (IPC); (2) to examine the capacity of local hospitals to report on the indicators and current use of data to inform IPC management and practice. Design A national and local-level analysis of the 27 indicators was conducted. At the national level, documentary review of regulations/policies/guidelines was conducted. At the local level data collection comprised: (a) review of documentary sources from 14 hospitals, to determine the capacity to report performance against these indicators; (b) qualitative interviews with 3 senior managers from 5 hospitals and direct observation of hospital wards to find out if these indicators are used to improve IPC management and practice. Setting 2 acute English National Health Service (NHS) trusts and 1 NHS foundation trust (14 hospitals). Participants 3 senior managers from 5 hospitals for qualitative interviews. Primary and secondary outcome measures As primary outcome measures, a ‘Red-Amber-Green’ (RAG) rating was developed reflecting how well the indicators were included in national documents or their availability at the local organisational level. The current use of the indicators to inform IPC management and practice was also assessed. The main secondary outcome measure is any inconsistency between national and local RAG rating results. Results National regulations/policies/guidelines largely cover the suggested European indicators. The ability of individual hospitals to report some of the indicators at ward level varies across staff groups, which may mask required improvements. A reactive use of staffing-related indicators was observed rather than the suggested prospective strategic approach for IPC management. Conclusions For effective patient safety and infection prevention in English hospitals, routine and proactive approaches need to be developed. Our approach to evaluation can be extended to other country settings. PMID:28115331

Developing Interactive Antimicrobial Stewardship and Infection Prevention Curricula for Diverse Learners: A Tailored Approach.

PubMed

Nori, Priya; Madaline, Theresa; Munjal, Iona; Bhar, Shubha; Guo, Yi; Seo, Susan K; Porrovecchio, Andrea; Gancher, Elizabeth; Nosanchuk, Joshua; Pirofski, Liise-Anne; Ostrowsky, Belinda

2017-01-01

To impart principles of antimicrobial stewardship (AS) and infection prevention and control (IPC), we developed a curriculum tailored to the diverse aptitudes of learners at our medical center. We integrated case-based modules, group learning activities, smartphone applications (apps), decision support tools, and prescription audit and feedback into curricula of the medical school, medicine residency program, infectious diseases (ID) fellowship program, and hospital medicine program operations. Interventions were implemented in 2012-2016 using a quasi-experimental before-and-after study design, and this was assessed using pre- and postintervention surveys or audit of antibiotic prescriptions. Over 180 medical students participated in the AS and IPC seminars. After smartphone app introduction, 69% reported using the app as their preferred source of antibiotic information. Approximately 70% of students felt comfortable prescribing antibiotics for a known infection compared with 40% at baseline ( P = .02), and approximately 83% were able to identify the appropriate personal protective equipment for specific scenarios. Approximately 99% agreed that they have a role in promoting patient safety and preventing healthcare-associated infections as medical students. At 20 months, appropriateness of trainee antibiotic prescriptions increased by 20% ( P < .01). Almost all ID fellows indicated that the AS and IPC seminar was a vital training supplement. Uptake of internist antibiotic recommendations using AS decision support tools was approximately 70%. All 5 interventions addressed learning objectives and knowledge gaps and are applicable across a range of environments. Evaluating long-term impact of our curriculum is the focus of future study.

Cell type dependent morphological adaptation in polyelectrolyte hydrogels governs chondrogenic fate.

PubMed

Raghothaman, Deepak; Leong, Meng Fatt; Lim, Tze Chiun; Wan, Andrew C A; Ser, Zheng; Lee, Eng Hin; Yang, Zheng

2016-04-04

Repair of critical-size articular cartilage defects typically involves delivery of cells in biodegradable, 3D matrices. Differences in the developmental status of mesenchymal stem cells (MSCs) and terminally differentiated mature chondrocytes might be a critical factor in engineering appropriate 3D matrices for articular cartilage tissue engineering. This study examined the relationship between material-driven early cell morphological adaptations and chondrogenic outcomes, by studying the influence of aligned collagen type I (Col I) presentation on chondrocytes and MSC in interfacial polyelectrolyte complexation (IPC)-based hydrogels. In the absence of Col I, both chondrocytes and MSCs adopted rounded cell morphology and formed clusters, with chondrocyte clusters favoring the maintenance of hyaline phenotype, while MSC clusters differentiated to fibro-superficial zone-like chondrocytes. Encapsulated chondrocytes in IPC-Col I hydrogel adopted a fibroblastic morphology forming fibro-superficial zone-like phenotype, which could be reversed by inhibiting actin polymerization using cytochalasin D (CytD). In contrast, adoption of fibroblastic morphology by encapsulated MSCs in IPC-Col I facilitated superior chondrogenesis, generating a mature, hyaline neocartilage tissue. CytD treatment abrogated the elongation of MSCs and brought about a single cell-like state, resulting in insignificant chondrogenic differentiation, underscoring the essential requirement of providing matrix environments that are amenable to cell-cell interactions for robust MSC chondrogenic differentiation. Our study demonstrates that MSCs and culture-expanded chondrocytes favour differential microenvironmental niches and emphasizes the importance of designing biomaterials that meet cell type-specific requirements, in adopting chondrocyte or MSC-based approaches for regenerating hyaline, articular cartilage.

Model-based reasoning for power system management using KATE and the SSM/PMAD

NASA Technical Reports Server (NTRS)

Morris, Robert A.; Gonzalez, Avelino J.; Carreira, Daniel J.; Mckenzie, F. D.; Gann, Brian

1993-01-01

The overall goal of this research effort has been the development of a software system which automates tasks related to monitoring and controlling electrical power distribution in spacecraft electrical power systems. The resulting software system is called the Intelligent Power Controller (IPC). The specific tasks performed by the IPC include continuous monitoring of the flow of power from a source to a set of loads, fast detection of anomalous behavior indicating a fault to one of the components of the distribution systems, generation of diagnosis (explanation) of anomalous behavior, isolation of faulty object from remainder of system, and maintenance of flow of power to critical loads and systems (e.g. life-support) despite fault conditions being present (recovery). The IPC system has evolved out of KATE (Knowledge-based Autonomous Test Engineer), developed at NASA-KSC. KATE consists of a set of software tools for developing and applying structure and behavior models to monitoring, diagnostic, and control applications.

Water absorption and moisture permeation properties of chitosan/poly(acrylamide-co-itaconic acid) IPC films.

PubMed

Bajpai, M; Bajpai, S K; Jyotishi, Pooja

2016-03-01

In this work, aqueous solutions of chitosan (Ch) and [poly(acrylamide(AAm)-co-itaconicacid(IA)] have been mixed to yield Ch/poly(AAm-co-IA) Inter-polyelectrolyte complex (IPC) films. The films were characterized by FTIR, X-ray diffraction (XRD) and thermo gravimetric analysis (TGA). There was remarkable increase in the crystalline nature of IPC films. The films were investigated for their water absorption capacity in the physiological fluid (PF) of pH 7.4 at 37 °C. The amount of IA present in the film forming solutions affected the water absorption behavior of the resulting films. The dynamic water uptake data were interpreted by various kinetic models. The effect of pH on the swelling ratio (SR) indicated that the films showed highest swelling in lower as well as higher pH media. The water vapor transmission rates (WVTR) were obtained in the range of 6000-6645 g/m(2)/day. Copyright © 2015 Elsevier B.V. All rights reserved.

The Drosophila cytokine Unpaired 2 regulates physiological homeostasis by remotely controlling Insulin secretion

PubMed Central

Rajan, Akhila; Perrimon, Norbert

2012-01-01

In Drosophila the fat body (FB), a functional analog of the vertebrate adipose tissue, is the 'nutrient sensor' that conveys the nutrient status to the insulin producing cells (IPCs) in the fly brain to release insulin-like peptides (Dilps). Dilp secretion in turn regulates energy balance and promotes systemic growth. We identify Unpaired2 (Upd2), a protein with similarities to type I cytokines, as a secreted factor produced by the FB in the ‘fed’ state. When upd2 function is perturbed specifically in the FB, it results in a systemic reduction in growth and alters energy metabolism. Upd2 activates JAK/STAT signaling in a population of GABAergic neurons that project onto the IPCs. This activation relieves the inhibitory tone of the GABAergic neurons on the IPCs, resulting in the secretion of Dilps. Strikingly, we find that human Leptin, can rescue the upd2 mutant phenotypes, suggesting that Upd2 is the functional homolog of Leptin. PMID:23021220

Metropolitan transportation management center : a case study : Boston Central Artery/Tunnel Integrated Project control system : responding to incidents rapidly and effectively

DOT National Transportation Integrated Search

1999-10-01

The following case study provides a snapshot of the Boston Central Artery/Tunnel Integration Project Control System (IPCS) operations control center. It follows the outline provided in the companion document, Metropolitan Transportation Management Ce...

Knockout mutations of insulin-like peptide genes enhance sexual receptivity in Drosophila virgin females.

PubMed

Watanabe, Kazuki; Sakai, Takaomi

2016-01-01

In the fruitfly Drosophila melanogaster, females take the initiative to mate successfully because they decide whether to mate or not. However, little is known about the molecular and neuronal mechanisms regulating sexual receptivity in virgin females. Genetic tools available in Drosophila are useful for identifying molecules and neural circuits involved in the regulation of sexual receptivity. We previously demonstrated that insulin-producing cells (IPCs) in the female brain are critical to the regulation of female sexual receptivity. Ablation and inactivation of IPCs enhance female sexual receptivity, suggesting that neurosecretion from IPCs inhibits female sexual receptivity. IPCs produce and release insulin-like peptides (Ilps) that modulate various biological processes such as metabolism, growth, lifespan and behaviors. Here, we report a novel role of the Ilps in sexual behavior in Drosophila virgin females. Compared with wild-type females, females with knockout mutations of Ilps showed a high mating success rate toward wild-type males, whereas wild-type males courted wild-type and Ilp-knockout females to the same extent. Wild-type receptive females retard their movement during male courtship and this reduced female mobility allows males to copulate. Thus, it was anticipated that knockout mutations of Ilps would reduce general locomotion. However, the locomotor activity in Ilp-knockout females was significantly higher than that in wild-type females. Thus, our findings indicate that the high mating success rate in Ilp-knockout females is caused by their enhanced sexual receptivity, but not by improvement of their sex appeal or by general sluggishness.

A modified method of insulin producing cells' generation from bone marrow-derived mesenchymal stem cells.

PubMed

Czubak, Paweł; Bojarska-Junak, Agnieszka; Tabarkiewicz, Jacek; Putowski, Lechosław

2014-01-01

Type 1 diabetes mellitus is a result of autoimmune destruction of pancreatic insulin producing β-cells and so far it can be cured only by insulin injection, by pancreas transplantation, or by pancreatic islet cells' transplantation. The methods are, however, imperfect and have a lot of disadvantages. Therefore new solutions are needed. The best one would be the use of differentiated mesenchymal stem cells (MSCs). In the present study, we investigated the potential of the bone marrow-derived MSCs line for in vitro differentiation into insulin producing cells (IPSs). We applied an 18-day protocol to differentiate MSCs. Differentiating cells formed cell clusters some of which resembled pancreatic islet-like cells. Using dithizone we confirmed the presence of insulin in the cells. What is more, the expression of proinsulin C-peptide in differentiated IPCs was analyzed by flow cytometry. For the first time, we investigated the influence of growth factors' concentration on IPCs differentiation efficiency. We have found that an increase in the concentration of growth factors up to 60 ng/mL of β-FGF/EGF and 30 ng/mL of activin A/β-cellulin increases the percentage of IPCs. Further increase of growth factors does not show any increase of the percentage of differentiated cells. Our findings suggest that the presented protocol can be adapted for differentiation of insulin producing cells from stem cells.

Protein kinase C epsilon regulates mitochondrial pools of Nampt and NAD following resveratrol and ischemic preconditioning in the rat cortex

PubMed Central

Morris-Blanco, Kahlilia C; Cohan, Charles H; Neumann, Jake T; Sick, Thomas J; Perez-Pinzon, Miguel A

2014-01-01

Preserving mitochondrial pools of nicotinamide adenine dinucleotide (NAD) or nicotinamide phosphoribosyltransferase (Nampt), an enzyme involved in NAD production, maintains mitochondrial function and confers neuroprotection after ischemic stress. However, the mechanisms involved in regulating mitochondrial-localized Nampt or NAD have not been defined. In this study, we investigated the roles of protein kinase C epsilon (PKCɛ) and AMP-activated protein kinase (AMPK) in regulating mitochondrial pools of Nampt and NAD after resveratrol or ischemic preconditioning (IPC) in the cortex and in primary neuronal-glial cortical cultures. Using the specific PKCɛ agonist ψɛRACK, we found that PKCɛ induced robust activation of AMPK in vitro and in vivo and that AMPK was required for PKCɛ-mediated ischemic neuroprotection. In purified mitochondrial fractions, PKCɛ enhanced Nampt levels in an AMPK-dependent manner and was required for increased mitochondrial Nampt after IPC or resveratrol treatment. Analysis of intrinsic NAD autofluorescence using two-photon microscopy revealed that PKCɛ modulated NAD in the mitochondrial fraction. Further assessments of mitochondrial NAD concentrations showed that PKCɛ has a key role in regulating the mitochondrial NAD+/nicotinamide adenine dinucleotide reduced (NADH) ratio after IPC and resveratrol treatment in an AMPK- and Nampt-dependent manner. These findings indicate that PKCɛ is critical to increase or maintain mitochondrial Nampt and NAD after pathways of ischemic neuroprotection in the brain. PMID:24667915

A volume-limited ROSAT survey of extreme ultraviolet emission from all nondegenerate stars within 10 parsecs

NASA Technical Reports Server (NTRS)

Wood, Brian E.; Brown, Alexander; Linsky, Jeffrey L.; Kellett, Barry J.; Bromage, Gordon E.; Hodgkin, Simon T.; Pye, John P.

1994-01-01

We report the results of a volume-limited ROSAT Wide Field Camera (WFC) survey of all nondegenerate stars within 10 pc. Of the 220 known star systems within 10 pc, we find that 41 are positive detections in at least one of the two WFC filter bandpasses (S1 and S2), while we consider another 14 to be marginal detections. We compute X-ray luminosities for the WFC detections using Einstein Imaging Proportional Counter (IPC) data, and these IPC luminosities are discussed along with the WFC luminosities throughout the paper for purposes of comparison. Extreme ultraviolet (EUV) luminosity functions are computed for single stars of different spectral types using both S1 and S2 luminosities, and these luminosity functions are compared with X-ray luminosity functions derived by previous authors using IPC data. We also analyze the S1 and S2 luminosity functions of the binary stars within 10 pc. We find that most stars in binary systems do not emit EUV radiation at levels different from those of single stars, but there may be a few EUV-luminous multiple-star systems which emit excess EUV radiation due to some effect of binarity. In general, the ratio of X-ray luminosity to EUV luminosity increases with increasing coronal emission, suggesting that coronally active stars have higher coronal temperatures. We find that our S1, S2, and IPC luminosities are well correlated with rotational velocity, and we compare activity-rotation relations determined using these different luminosities. Late M stars are found to be significantly less luminous in the EUV than other late-type stars. The most natural explanation for this results is the concept of coronal saturation -- the idea that late-type stars can emit only a limited fraction of their total luminosity in X-ray and EUV radiation, which means stars with very low bolometric luminosities must have relatively low X-ray and EUV luminosities as well. The maximum level of coronal emission from stars with earlier spectral types is studied also. To understand the saturation levels for these stars, we have compiled a large number of IPC luminosities for stars with a wide variety of spectral types and luminosity classes. We show quantitatively that if the Sun were completely covered with X-ray-emitting coronal loops, it would be near the saturation limit implied by this compilation, supporting the idea that stars near upper limits in coronal activity are completely covered with active regions.

Interprofessional communication and teambuilding using applied improvisational exercises.

PubMed

Campbell, Candace

2014-01-01

According to The Joint Commission (TJC), the most frequently cited root cause of sentinel events is ineffective communication or miscommunication (TJC, 2002, 2012). The need to improve communication among health care professionals is a high priority because of the serious consequences of poor communication for everyone involved, on both personal and corporate levels. Applied improvisational exercises (AlEs) comprise a strategy for enhancing interprofessional communication (IPC). This article asks: What are the challenges inherent in IPC and teambuilding in the health care setting, and how can AIE help bridge the communication gap?

Lessons learned from a privacy breach at an academic health science centre.

PubMed

Malonda, Jacqueline; Campbell, Janice; Crivianu-Gaita, Daniela; Freedman, Melvin H; Stevens, Polly; Laxer, Ronald M

2009-01-01

In 2007, the Hospital for Sick Children experienced a serious privacy breach when a laptop computer containing the personal health information of approximately 3,000 patients and research subjects was stolen from a physician-researcher's vehicle. This incident was reported to the information and privacy commissioner of Ontario (IPC). The IPC issued an order that required the hospital to examine and revise its policies, practices and research protocols related to the protection of personal health information and to educate staff on privacy-related matters.

Pedagog II Realization.

DTIC Science & Technology

1979-12-01

BE2 CD66 ALl SGG/110(14) 5/AS2 SGG/79(14) AMI 110(13) 5/AU2 78(16) NI KRIRF/lll(2) ANl PRIRF/lll(l) ARI IPC/lll(ll) 7/BPl IPC/144(4) ASI KRF/106(9...KRS 6034 Read a character from the keyboard/reader buffer. The keyboard/reader flag is set when the operation is completed. KIE 6035 Enable the...keyboard/ reader flag is a 1. KCC 6032 Clear the AC and the keyboard/reader flag. KRS 6034 Read a character from the keyboard/reader buffer. The keyboard

Developing Interactive Antimicrobial Stewardship and Infection Prevention Curricula for Diverse Learners: A Tailored Approach

PubMed Central

Madaline, Theresa; Munjal, Iona; Bhar, Shubha; Guo, Yi; Seo, Susan K.; Porrovecchio, Andrea; Gancher, Elizabeth; Nosanchuk, Joshua; Pirofski, Liise-anne; Ostrowsky, Belinda

2017-01-01

Abstract Background. To impart principles of antimicrobial stewardship (AS) and infection prevention and control (IPC), we developed a curriculum tailored to the diverse aptitudes of learners at our medical center. Methods. We integrated case-based modules, group learning activities, smartphone applications (apps), decision support tools, and prescription audit and feedback into curricula of the medical school, medicine residency program, infectious diseases (ID) fellowship program, and hospital medicine program operations. Interventions were implemented in 2012–2016 using a quasi-experimental before-and-after study design, and this was assessed using pre- and postintervention surveys or audit of antibiotic prescriptions. Results. Over 180 medical students participated in the AS and IPC seminars. After smartphone app introduction, 69% reported using the app as their preferred source of antibiotic information. Approximately 70% of students felt comfortable prescribing antibiotics for a known infection compared with 40% at baseline (P = .02), and approximately 83% were able to identify the appropriate personal protective equipment for specific scenarios. Approximately 99% agreed that they have a role in promoting patient safety and preventing healthcare-associated infections as medical students. At 20 months, appropriateness of trainee antibiotic prescriptions increased by 20% (P < .01). Almost all ID fellows indicated that the AS and IPC seminar was a vital training supplement. Uptake of internist antibiotic recommendations using AS decision support tools was approximately 70%. Conclusions. All 5 interventions addressed learning objectives and knowledge gaps and are applicable across a range of environments. Evaluating long-term impact of our curriculum is the focus of future study. PMID:28748196

Outcome of strict implementation of infection prevention control measures during an outbreak of Middle East respiratory syndrome.

PubMed

El Bushra, Hassan E; Al Arbash, Hussain A; Mohammed, Mutaz; Abdalla, Osman; Abdallah, Mohamed N; Al-Mayahi, Zayid K; Assiri, Abdallah M; BinSaeed, Abdulaziz A

2017-05-01

The objective of this retrospective cohort study was to assess the impact of implementation of different levels of infection prevention and control (IPC) measures during an outbreak of Middle East respiratory syndrome (MERS) in a large tertiary hospital in Saudi Arabia. The setting was an emergency room (ER) in a large tertiary hospital and included primary and secondary MERS patients. Rapid response teams conducted repeated assessments of IPC and monitored implementation of corrective measures using a detailed structured checklist. We ascertained the epidemiologic link between patients and calculated the secondary attack rate per 10,000 patients visiting the ER (SAR/10,000) in 3 phases of the outbreak. In phase I, 6 primary cases gave rise to 48 secondary cases over 4 generations, including a case that resulted in 9 cases in the first generation of secondary cases and 21 cases over a chain of 4 generations. During the second and third phases, the number of secondary cases sharply dropped to 18 cases and 1 case, respectively, from a comparable number of primary cases. The SAR/10,000 dropped from 75 (95% confidence interval [CI], 55-99) in phase I to 29 (95% CI, 17-46) and 3 (95% CI, 0-17) in phases II and III, respectively. The study demonstrated salient evidence that proper institution of IPC measures during management of an outbreak of MERS could remarkably change the course of the outbreak. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Outcomes from building system courseware for teaching and testing in a discipline-based human structure curriculum.

PubMed

Reilly, Frank D

2011-01-01

This study investigated the educational benefits of system-based lecture notes and interactive learning objects in a peripheral nervous system component of a traditional first-year medical school human anatomy course. The impetus for the investigation was anecdotal evidence suggesting enhanced learner satisfaction with the learning resources. Retrospective review of existing data from 2006 to 2009 was undertaken to quantify (1) the effects of Web-based system courseware on examination item performance, and (2) differences among learner opinions regarding the benefit level of the five different types of interactive learning objects as evaluated by instructional design questionnaires. Interactive patient-based case studies (IPCS) and review games (Games), simulated interactive patients (SIP), flashcards, and unit quizzes (Quizzes) developed in-house have been peer-reviewed and published in MedEdPORTAL. Statistics included one-way analysis of variance, Tukey's post hoc test, and power meta-analysis (d). Examination item analysis scores remained significantly higher (P ≤ 0.05; d = 0.3938) for learners receiving the instructional treatment incorporating system-based lecture notes and interactive learning objects than for those not receiving this treatment. Using questionnaires with a five-point Likert scale, students reported favorably on the benefit level of all learning objects. They rated the SIP and IPCS significantly higher (P ≤0.05) and games significantly lower (P ≤ 0.05) than in previous years, indicating a change in learner preferences. This study reaffirms that online system-based instructional techniques improve student examination performance and overall student satisfaction. Learners indicated stronger preferences for SIP and IPCS over exercises encouraging passive memorization of anatomical content. Copyright © 2011 American Association of Anatomists.

Colon delivery of budesonide: evaluation of chitosan-chondroitin sulfate interpolymer complex.

PubMed

Kaur, Gurpreet; Rana, Vikas; Jain, Subheet; Tiwary, Ashok K

2010-03-01

The present study was aimed at formulating tablets comprising of coating susceptible to microbial enzyme degradation for releasing budesonide in the colon. Tablets prepared by using Avicel pH 102 as diluent and Eudragit L100-55 as binder were coated to a weight gain of 10% w/w employing aqueous mixtures containing chitosan (CH) and chondroitin sulfate (CS). The interpolymer complex between CH and CS was characterized using Fourier transform infrared (FTIR) and differential scanning calorimetery (DSC) studies. The tablets were evaluated for release of budesonide through in vitro in vivo studies. Formation of bonds between -COO(-) and -OSO3(-) groups of CS and -NH3+ groups of CH was evident in the FTIR spectra of these interpolymer complexed (IPC) films. The DSC thermograms of these films revealed one endothermic transition between 190 degrees C and 205 degrees C, suggesting the formation of new bonds in the IPC. The pH sensitive swelling exhibited by these films was observed to be a function of CH concentration. Tablets coated with aqueous mixtures containing 40:60 or 50:50 ratio of CH/CS totally prevented the release of budesonide in pH 1.2 buffer. The peaks (FTIR) and endothermic transitions (DSC) characteristic of interpolymer complexation were observed to remain unaffected after sequential exposure of the films to pH 1.2 and pH 7.4 buffer IP. This proved the versatility of these IPC films for colon delivery. C (max) of 1,168.99 and 1,174.2 ng/mL, respectively, at 12 and 8 h post-oral dosing of tablets coated with 40:60 or 50:50 ratio of CH/CS was observed in rats. The aqueous CH/CS (40:60) coating could provide a facile method for delivering budesonide to the colon.

Capacity of English NHS hospitals to monitor quality in infection prevention and control using a new European framework: a multilevel qualitative analysis.

PubMed

Iwami, Michiyo; Ahmad, Raheelah; Castro-Sánchez, Enrique; Birgand, Gabriel; Johnson, Alan P; Holmes, Alison

2017-01-23

(1) To assess the extent to which current English national regulations/policies/guidelines and local hospital practices align with indicators suggested by a European review of effective strategies for infection prevention and control (IPC); (2) to examine the capacity of local hospitals to report on the indicators and current use of data to inform IPC management and practice. A national and local-level analysis of the 27 indicators was conducted. At the national level, documentary review of regulations/policies/guidelines was conducted. At the local level data collection comprised: (a) review of documentary sources from 14 hospitals, to determine the capacity to report performance against these indicators; (b) qualitative interviews with 3 senior managers from 5 hospitals and direct observation of hospital wards to find out if these indicators are used to improve IPC management and practice. 2 acute English National Health Service (NHS) trusts and 1 NHS foundation trust (14 hospitals). 3 senior managers from 5 hospitals for qualitative interviews. As primary outcome measures, a 'Red-Amber-Green' (RAG) rating was developed reflecting how well the indicators were included in national documents or their availability at the local organisational level. The current use of the indicators to inform IPC management and practice was also assessed. The main secondary outcome measure is any inconsistency between national and local RAG rating results. National regulations/policies/guidelines largely cover the suggested European indicators. The ability of individual hospitals to report some of the indicators at ward level varies across staff groups, which may mask required improvements. A reactive use of staffing-related indicators was observed rather than the suggested prospective strategic approach for IPC management. For effective patient safety and infection prevention in English hospitals, routine and proactive approaches need to be developed. Our approach to evaluation can be extended to other country settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The effect of teacher quality on the achievement of students in Integrated Physics and Chemistry

NASA Astrophysics Data System (ADS)

Alexander, Rima

For many years, researchers, policy makers, and the education community have explored various school variables and their impact on student achievement (Darling-Hammond, 2000; Ferguson and Womack 1993; Ferguson and Ladd 1996; Rice, 2003; Rockoff, 2003; Rowan, Chiang, and Miller 1997; Sanders and Horn, 1996; Wright Horn and Sanders, 1997). Invariably, the issue of teacher quality arises. Teacher quality is the single most influential factor under school control that affects student achievement (Darling-Hammond, 2000; Rice, 2003; Rockoff, 2003; Sanders and Horn, 1996; Wright Horn and Sanders, 1997). Generally, students taught by highly qualified teachers perform better on standardized tests than students with less qualified teachers (Ferguson and Womack 1993; Ferguson and Ladd 1996; Rowan, Chiang, and Miller 1997). Previous research indicates that teachers indeed matter for the improvement of student achievement, but getting good measures of what is meant by teacher quality is a continuing challenge (Goldhaber, 2002). The purpose of this study was to describe the effect of teacher quality on the achievement of students in Integrated Physics and Chemistry (IPC). In order to achieve this purpose, this study addressed the following research question: chemistry and physics teachers compare to the achievement of students taught by less-qualified IPC teachers? A causal-comparative methodology was employed to address this research question. The independent variable was teacher quality---highly-qualified or less qualified. The teacher attributes that were examined in this study are: (1) teachers' educational background; (2) content knowledge; (3) pedagogical knowledge; and (4) certification. The dependent variable was student achievement in integrated physics and chemistry, as measured by an end-of-course IPC District Assessment of Curriculum, IPC DAC. Descriptive statistics were computed for the independent variable in the study. A Chi Square was performed on the data, utilizing SPSS version 12.0.1 software. Next a test of statistical significance was done to determine whether the null hypothesis could be rejected; and whether or not the research hypothesis could be accepted. Since this is a causal comparative design with only two groups in which student achievement was measured by a test that will yield raw scores, a Chi Square was conducted to determine whether the pass rates of the two groups of students based on obtained and expected percentages were statistically significantly different A Chi Square value of 4.29 was obtained, which indicates that the pass rate for students of highly-qualified teachers was statistically significantly higher than for students of less-qualified teachers. For the purpose of this study a criterion value of (p<.05) was used.

Automated Patent Categorization and Guided Patent Search using IPC as Inspired by MeSH and PubMed.

PubMed

Eisinger, Daniel; Tsatsaronis, George; Bundschus, Markus; Wieneke, Ulrich; Schroeder, Michael

2013-04-15

Document search on PubMed, the pre-eminent database for biomedical literature, relies on the annotation of its documents with relevant terms from the Medical Subject Headings ontology (MeSH) for improving recall through query expansion. Patent documents are another important information source, though they are considerably less accessible. One option to expand patent search beyond pure keywords is the inclusion of classification information: Since every patent is assigned at least one class code, it should be possible for these assignments to be automatically used in a similar way as the MeSH annotations in PubMed. In order to develop a system for this task, it is necessary to have a good understanding of the properties of both classification systems. This report describes our comparative analysis of MeSH and the main patent classification system, the International Patent Classification (IPC). We investigate the hierarchical structures as well as the properties of the terms/classes respectively, and we compare the assignment of IPC codes to patents with the annotation of PubMed documents with MeSH terms.Our analysis shows a strong structural similarity of the hierarchies, but significant differences of terms and annotations. The low number of IPC class assignments and the lack of occurrences of class labels in patent texts imply that current patent search is severely limited. To overcome these limits, we evaluate a method for the automated assignment of additional classes to patent documents, and we propose a system for guided patent search based on the use of class co-occurrence information and external resources.

Device Cleaning and Infection Control in Aerosol Therapy.

PubMed

O'Malley, Catherine A

2015-06-01

Aerosol delivery equipment used to administer inhaled medications includes the nebulizer, positive expiratory pressure devices added to the nebulizer, and valved holding chambers (spacers). These devices are semi-critical medical devices, and as such, infection prevention and control (IPC) guidelines recommend that they be cleaned, disinfected, rinsed with sterile water, and air-dried. There is confusion surrounding the care of aerosol devices because of inconsistencies in the various published IPC guidelines, lack of a standard of practice among institutions and respiratory therapists (RTs), and manufacturer's instructions for use of these devices are not always compatible with guidelines or practice. Challenges lie in awareness of IPC guidelines and establishing a standard for the care of aerosol delivery devices among all stakeholders/manufacturers, governments, vendors, and users. The latest IPC guideline from the Cystic Fibrosis Foundation, reviewed and endorsed by the Society for Healthcare Epidemiology of America and the Association for Professionals in Infection Control, has a recommendation for disposable nebulizers and a recommendation for reusable nebulizers. Reusable nebulizers should be cleaned, disinfected, rinsed with sterile water (if using a cold disinfectant), and air-dried between uses. The mouthpiece/mask of disposable nebulizers should be wiped with an alcohol pad, the residual volume should be rinsed out with sterile water after use, and the nebulizer should be replaced every 24 h. The RT plays a significant and responsible role in providing and teaching aerosol therapy to patients. The RT and all stakeholders need to work together to provide a standard of care for the safe use of aerosol delivery devices. Copyright © 2015 by Daedalus Enterprises.

Hippocampal-targeted Theta-burst Stimulation Enhances Associative Memory Formation.

PubMed

Tambini, Arielle; Nee, Derek Evan; D'Esposito, Mark

2018-06-19

The hippocampus plays a critical role in episodic memory, among other cognitive functions. However, few tools exist to causally manipulate hippocampal function in healthy human participants. Recent work has targeted hippocampal-cortical networks by performing TMS to a region interconnected with the hippocampus, posterior inferior parietal cortex (pIPC). Such hippocampal-targeted TMS enhances associative memory and influences hippocampal functional connectivity. However, it is currently unknown which stages of mnemonic processing (encoding or retrieval) are affected by hippocampal-targeted TMS. Here, we examined whether hippocampal-targeted TMS influences the initial encoding of associations (vs. items) into memory. To selectively influence encoding and not retrieval, we performed continuous theta-burst TMS before participants encoded object-location associations and assessed memory after the direct effect of stimulation dissipated. Relative to control TMS and baseline memory, pIPC TMS enhanced associative memory success and confidence. Item memory was unaffected, demonstrating a selective influence on associative versus item memory. The strength of hippocampal-pIPC functional connectivity predicted TMS-related memory benefits, which was mediated by parahippocampal and retrosplenial cortices. Our findings indicate that hippocampal-targeted TMS can specifically modulate the encoding of new associations into memory without directly influencing retrieval processes and suggest that the ability to influence associative memory may be related to the fidelity of hippocampal TMS targeting. Our results support the notion that pIPC TMS may serve as a potential tool for manipulating hippocampal function in healthy participants. Nonetheless, future work combining hippocampal-targeted continuous theta-burst TMS with neuroimaging is needed to better understand the neural basis of TMS-induced memory changes.

Infection prevention and control of Clostridium difficile: a global review of guidelines, strategies, and recommendations

PubMed Central

Balsells, Evelyn; Filipescu, Teodora; Kyaw, Moe H.; Wiuff, Camilla; Campbell, Harry; Nair, Harish

2016-01-01

Background Clostridium difficile is the leading cause of health care–associated infections. Given the high incidence of C. difficile infection (CDI) and the lack of primary prevention through immunization, health care professionals should be aware of the most current guidance, as well as strengths and limitations of the evidence base underpinning this guidance. Methods We identified publicly available national or organizational guidelines related to CDI infection and prevention control (IPC) published between 2000 and 2015 and for any health care setting through an internet search using the Google search engine. We reviewed CDI–targeted IPC recommendations and describe the assessment of evidence in available guidelines. Results We identified documents from 28 countries/territories, mainly from acute care hospitals in North America, the Western Pacific, and Europe (18 countries). We identified only a few specific recommendations for long–term care facilities (LTCFs) and from countries in South America (Uruguay and Chile), South East Asia (Thailand), and none for Africa or Eastern Mediterranean. Of 10 IPC areas, antimicrobial stewardship was universally recognized as essential and supported by high quality evidence. Five other widely reported “strong” recommendations were: effective environment cleaning (including medical equipment), case isolation, use of personal protective equipment, surveillance, and education. Several unresolved and emerging issues were documented and currently available evidence was classified mainly as of mixed quality. Conclusion Our review underlines the need for targeted CDI IPC guidelines in several countries and for LTCFs. International harmonisation on the assessment of the evidence for best practices is needed as well as more robust evidence to support targeted recommendations. PMID:28028434

Intermittent pneumatic compression to prevent venous thromboembolism in patients with high risk of bleeding hospitalized in intensive care units: the CIREA1 randomized trial.

PubMed

Vignon, Philippe; Dequin, Pierre-François; Renault, Anne; Mathonnet, Armelle; Paleiron, Nicolas; Imbert, Audrey; Chatellier, Delphine; Gissot, Valérie; Lhéritier, Gwenaelle; Aboyans, Victor; Prat, Gwenael; Garot, Denis; Boulain, Thierry; Diehl, Jean-Luc; Bressollette, Luc; Delluc, Aurélien; Lacut, Karine

2013-05-01

Venous thromboembolism (VTE) is a frequent and serious problem in intensive care units (ICU). Anticoagulant treatments have demonstrated their efficacy in preventing VTE. However, when the bleeding risk is high, they are contraindicated, and mechanical devices are recommended. To date, mechanical prophylaxis has not been rigorously evaluated in any trials in ICU patients. In this multicenter, open-label, randomized trial with blinded evaluation of endpoints, we randomly assigned 407 patients with a high risk of bleeding to receive intermittent pneumatic compression (IPC) associated with graduated compression stockings (GCS) or GCS alone for 6 days during their ICU stay. The primary endpoint was the occurrence of a VTE between days 1 and 6, including nonfatal symptomatic documented VTE, or death due to a pulmonary embolism, or asymptomatic deep vein thrombosis detected by ultrasonography systematically performed on day 6. The primary outcome was assessed in 363 patients (89.2%). By day 6, the incidence of the primary outcome was 5.6% (10 of 179 patients) in the IPC + GCS group and 9.2% (17 of 184 patients) in the GCS group (relative risk 0.60; 95% confidence interval 0.28-1.28; p = 0.19). Tolerance of IPC was poor in only 12 patients (6.0%). No intergroup difference in mortality rate was observed. With the limitation of a low statistical power, our results do not support the superiority of the combination of IPC + GCS compared to GCS alone to prevent VTE in ICU patients at high risk of bleeding.

The application of automated operations at the Institutional Processing Center

NASA Technical Reports Server (NTRS)

Barr, Thomas H.

1993-01-01

The JPL Institutional and Mission Computing Division, Communications, Computing and Network Services Section, with its mission contractor, OAO Corporation, have for some time been applying automation to the operation of JPL's Information Processing Center (IPC). Automation does not come in one easy to use package. Automation for a data processing center is made up of many different software and hardware products supported by trained personnel. The IPC automation effort formally began with console automation, and has since spiraled out to include production scheduling, data entry, report distribution, online reporting, failure reporting and resolution, documentation, library storage, and operator and user education, while requiring the interaction of multi-vendor and locally developed software. To begin the process, automation goals are determined. Then a team including operations personnel is formed to research and evaluate available options. By acquiring knowledge of current products and those in development, taking an active role in industry organizations, and learning of other data center's experiences, a forecast can be developed as to what direction technology is moving. With IPC management's approval, an implementation plan is developed and resources identified to test or implement new systems. As an example, IPC's new automated data entry system was researched by Data Entry, Production Control, and Advance Planning personnel. A proposal was then submitted to management for review. A determination to implement the new system was made and elements/personnel involved with the initial planning performed the implementation. The final steps of the implementation were educating data entry personnel in the areas effected and procedural changes necessary to the successful operation of the new system.

Infection prevention and control of Clostridium difficile: a global review of guidelines, strategies, and recommendations.

PubMed

Balsells, Evelyn; Filipescu, Teodora; Kyaw, Moe H; Wiuff, Camilla; Campbell, Harry; Nair, Harish

2016-12-01

Clostridium difficile is the leading cause of health care-associated infections. Given the high incidence of C. difficile infection (CDI) and the lack of primary prevention through immunization, health care professionals should be aware of the most current guidance, as well as strengths and limitations of the evidence base underpinning this guidance. We identified publicly available national or organizational guidelines related to CDI infection and prevention control (IPC) published between 2000 and 2015 and for any health care setting through an internet search using the Google search engine. We reviewed CDI-targeted IPC recommendations and describe the assessment of evidence in available guidelines. We identified documents from 28 countries/territories, mainly from acute care hospitals in North America, the Western Pacific, and Europe (18 countries). We identified only a few specific recommendations for long-term care facilities (LTCFs) and from countries in South America (Uruguay and Chile), South East Asia (Thailand), and none for Africa or Eastern Mediterranean. Of 10 IPC areas, antimicrobial stewardship was universally recognized as essential and supported by high quality evidence. Five other widely reported "strong" recommendations were: effective environment cleaning (including medical equipment), case isolation, use of personal protective equipment, surveillance, and education. Several unresolved and emerging issues were documented and currently available evidence was classified mainly as of mixed quality. Our review underlines the need for targeted CDI IPC guidelines in several countries and for LTCFs. International harmonisation on the assessment of the evidence for best practices is needed as well as more robust evidence to support targeted recommendations.

Automated Patent Categorization and Guided Patent Search using IPC as Inspired by MeSH and PubMed

PubMed Central

2013-01-01

Document search on PubMed, the pre-eminent database for biomedical literature, relies on the annotation of its documents with relevant terms from the Medical Subject Headings ontology (MeSH) for improving recall through query expansion. Patent documents are another important information source, though they are considerably less accessible. One option to expand patent search beyond pure keywords is the inclusion of classification information: Since every patent is assigned at least one class code, it should be possible for these assignments to be automatically used in a similar way as the MeSH annotations in PubMed. In order to develop a system for this task, it is necessary to have a good understanding of the properties of both classification systems. This report describes our comparative analysis of MeSH and the main patent classification system, the International Patent Classification (IPC). We investigate the hierarchical structures as well as the properties of the terms/classes respectively, and we compare the assignment of IPC codes to patents with the annotation of PubMed documents with MeSH terms. Our analysis shows a strong structural similarity of the hierarchies, but significant differences of terms and annotations. The low number of IPC class assignments and the lack of occurrences of class labels in patent texts imply that current patent search is severely limited. To overcome these limits, we evaluate a method for the automated assignment of additional classes to patent documents, and we propose a system for guided patent search based on the use of class co-occurrence information and external resources. PMID:23734562

Evidence of increment of efficiency of the Mexican Stock Market through the analysis of its variations

NASA Astrophysics Data System (ADS)

Coronel-Brizio, H. F.; Hernández-Montoya, A. R.; Huerta-Quintanilla, R.; Rodríguez-Achach, M.

2007-07-01

It is well known that there exist statistical and structural differences between the stock markets of developed and emerging countries. In this work, and in order to find out if the efficiency of the Mexican Stock Market has been changing over time, we have performed and compared several analyses of the variations of the Mexican Stock Market index (IPC) and Dow Jones industrial average index (DJIA) for different periods of their historical daily data. We have analyzed the returns autocorrelation function (ACF) and used detrended fluctuation analysis (DFA) to study returns variations. We also analyze the volatility, mean value and standard deviation of both markets and compare their evolution. We conclude from the overall result of these studies, that they show compelling evidence of the increment of efficiency of the Mexican Stock Market over time. The data samples analyzed here, correspond to daily values of the IPC and DJIA for the period 10/30/1978-02/28/2006.

Enhanced Charge Separation Efficiency in Pyridine-Anchored Phthalocyanine-Sensitized Solar Cells by Linker Elongation.

PubMed

Ikeuchi, Takuro; Agrawal, Saurabh; Ezoe, Masayuki; Mori, Shogo; Kimura, Mutsumi

2015-11-01

A series of zinc phthalocyanine sensitizers (PcS22-24) having a pyridine anchoring group are designed and synthesized to investigate the structural dependence on performance in dye-sensitized solar cells. The pyridine-anchor zinc phthalocyanine sensitizer PcS23 shows 79 % incident-photon to current-conversion efficiency (IPCE) and 6.1 % energy conversion efficiency, which are comparable with similar phthalocyanine dyes having a carboxylic acid anchoring group. Based on DFT calculations, the high IPCE is attributed with the mixture of an excited-state molecular orbital of the sensitizer and the orbitals of TiO2 . Between pyridine and carboxylic acid anchor dyes, opposite trends are observed in the linker-length dependence of the IPCE. The red-absorbing PcS23 is applied for co-sensitization with a carboxyl-anchor organic dye D131 that has a complementary spectral response. The site-selective adsorption of PcS23 and D131 on the TiO2 surface results in a panchromatic photocurrent response for the whole visible-light region of sun light. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Identifying protein complexes based on brainstorming strategy.

PubMed

Shen, Xianjun; Zhou, Jin; Yi, Li; Hu, Xiaohua; He, Tingting; Yang, Jincai

2016-11-01

Protein complexes comprising of interacting proteins in protein-protein interaction network (PPI network) play a central role in driving biological processes within cells. Recently, more and more swarm intelligence based algorithms to detect protein complexes have been emerging, which have become the research hotspot in proteomics field. In this paper, we propose a novel algorithm for identifying protein complexes based on brainstorming strategy (IPC-BSS), which is integrated into the main idea of swarm intelligence optimization and the improved K-means algorithm. Distance between the nodes in PPI network is defined by combining the network topology and gene ontology (GO) information. Inspired by human brainstorming process, IPC-BSS algorithm firstly selects the clustering center nodes, and then they are separately consolidated with the other nodes with short distance to form initial clusters. Finally, we put forward two ways of updating the initial clusters to search optimal results. Experimental results show that our IPC-BSS algorithm outperforms the other classic algorithms on yeast and human PPI networks, and it obtains many predicted protein complexes with biological significance. Copyright © 2016 Elsevier Inc. All rights reserved.

Searching bioremediation patents through Cooperative Patent Classification (CPC).

PubMed

Prasad, Rajendra

2016-03-01

Patent classification systems have traditionally evolved independently at each patent jurisdiction to classify patents handled by their examiners to be able to search previous patents while dealing with new patent applications. As patent databases maintained by them went online for free access to public as also for global search of prior art by examiners, the need arose for a common platform and uniform structure of patent databases. The diversity of different classification, however, posed problems of integrating and searching relevant patents across patent jurisdictions. To address this problem of comparability of data from different sources and searching patents, WIPO in the recent past developed what is known as International Patent Classification (IPC) system which most countries readily adopted to code their patents with IPC codes along with their own codes. The Cooperative Patent Classification (CPC) is the latest patent classification system based on IPC/European Classification (ECLA) system, developed by the European Patent Office (EPO) and the United States Patent and Trademark Office (USPTO) which is likely to become a global standard. This paper discusses this new classification system with reference to patents on bioremediation.

Integrating Vocational Interests, Competencies, and Interpersonal Dispositions in Middle School Children

ERIC Educational Resources Information Center

Sodano, Sandro M.

2011-01-01

Vocational interests and interpersonal dispositions have been well researched in adults from the perspectives of Holland's RIASEC (1997) model of interests and the Interpersonal Circumplex (IPC), respectively. Few studies have applied either model to children and no studies have examined their overlap in children. A vector fitting procedure was…

Mapping patent classifications: portfolio and statistical analysis, and the comparison of strengths and weaknesses.

PubMed

Leydesdorff, Loet; Kogler, Dieter Franz; Yan, Bowen

2017-01-01

The Cooperative Patent Classifications (CPC) recently developed cooperatively by the European and US Patent Offices provide a new basis for mapping patents and portfolio analysis. CPC replaces International Patent Classifications (IPC) of the World Intellectual Property Organization. In this study, we update our routines previously based on IPC for CPC and use the occasion for rethinking various parameter choices. The new maps are significantly different from the previous ones, although this may not always be obvious on visual inspection. We provide nested maps online and a routine for generating portfolio overlays on the maps; a new tool is provided for "difference maps" between patent portfolios of organizations or firms. This is illustrated by comparing the portfolios of patents granted to two competing firms-Novartis and MSD-in 2016. Furthermore, the data is organized for the purpose of statistical analysis.

The Contribution of the Inferior Parietal Cortex to Spoken Language Production

ERIC Educational Resources Information Center

Geranmayeh, Fatemeh; Brownsett, Sonia L. E.; Leech, Robert; Beckmann, Christian F.; Woodhead, Zoe; Wise, Richard J. S.

2012-01-01

This functional MRI study investigated the involvement of the left inferior parietal cortex (IPC) in spoken language production (Speech). Its role has been apparent in some studies but not others, and is not convincingly supported by clinical studies as they rarely include cases with lesions confined to the parietal lobe. We compared Speech with…

Phonetic difficulty and stuttering in English

PubMed Central

Howell, Peter; Au-Yeung, James; Yaruss, Scott; Eldridge, Kevin

2007-01-01

Previous work has shown that phonetic difficulty affects older, but not younger, speakers who stutter and that older speakers experience more difficulty on content words than function words. The relationship between stuttering rate and a recently-developed index of phonetic complexity (IPC, Jakielski, 1998) was examined in this study separately for function and content words for speakers in 6-11, 11 plus-18 and 18 plus age groups. The hypothesis that stuttering rate on the content words of older speakers, but not younger speakers, would be related to the IPC score was supported. It is argued that the similarity between results using the IPC scores with a previous analysis that looked at late emerging consonants, consonant strings and multiple syllables (also conducted on function and content words separately), validates the former instrument. In further analyses, the factors that are most likely to lead to stuttering in English and their order of importance were established. The order found was consonant by manner, consonant by place, word length and contiguous consonant clusters. As the effects of phonetic difficulty are evident in teenage and adulthood, at least some of the factors may have an acquired influence on stuttering (rather than an innate universal basis, as the theory behind Jakielski's work suggests). This may be established in future work by doing cross-linguistic comparisons to see which factors operate universally. Disfluency on function words in early childhood appears to be responsive to factors other than phonetic complexity. PMID:17342878

Large impact of reorganization energy on photovoltaic conversion due to interfacial charge-transfer transitions.

PubMed

Fujisawa, Jun-ichi

2015-05-14

Interfacial charge-transfer (ICT) transitions are expected to be a novel charge-separation mechanism for efficient photovoltaic conversion featuring one-step charge separation without energy loss. Photovoltaic conversion due to ICT transitions has been investigated using several TiO2-organic hybrid materials that show organic-to-inorganic ICT transitions in the visible region. In applications of ICT transitions to photovoltaic conversion, there is a significant problem that rapid carrier recombination is caused by organic-inorganic electronic coupling that is necessary for the ICT transitions. In order to solve this problem, in this work, I have theoretically studied light-to-current conversions due to the ICT transitions on the basis of the Marcus theory with density functional theory (DFT) and time-dependent DFT (TD-DFT) calculations. An apparent correlation between the reported incident photon-to-current conversion efficiencies (IPCE) and calculated reorganization energies was clearly found, in which the IPCE increases with decreasing the reorganization energy consistent with the Marcus theory in the inverted region. This activation-energy dependence was systematically explained by the equation formulated by the Marcus theory based on a simple excited-state kinetic scheme. This result indicates that the reduction of the reorganization energy can suppress the carrier recombination and enhance the IPCE. The reorganization energy is predominantly governed by the structural change in the chemical-adsorption moiety between the ground and ICT excited states. This work provides crucial knowledge for efficient photovoltaic conversion due to ICT transitions.

Phase I of a National Phenological Assessment

NASA Astrophysics Data System (ADS)

Betancourt, J. L.; Henebry, G. M.

2009-12-01

Phenology is the gateway to climatic effects on both managed and unmanaged ecosystems. Adaptation to climatic variability and change will require integration of phenological data and models with climatic forecasts at seasonal to decadal timescales. We propose a scoping study to identify, formulate, and refine approaches to the first National Phenological Assessment (NPA) for the U.S. The NPA should be viewed as a data product of the USA-National Phenology Network that will help guide future phenological monitoring and research at the national level. We envision three main objectives for the first NPA: 1) Establish a suite of indicators of phenological change (IPCs) at regional to continental scales, following the Heinz Center model for such national assessments; 2) Using sufficiently long and broad-scale time series of IPCs and legacy phenological data, assess phenological responses to what many scientists are calling the early stages of anthropogenic climate change, specifically the abrupt advance in spring onset in the late 1970’s/early 1980’s 3) Project large-scale phenological changes into 21st Century using GCM and RCM model realizations. Toward this end we see the following tasks as critical preliminary work to plan the first NPA: a) Identify, evaluate, and refine IPCs based on indices developed from standard weather observations, streamflow and other hydrological observations (e.g., center of mass, lake freeze/thaw, etc.), plant and animal phenology observations from legacy datasets, remote sensing datastreams, flux tower observations, and GCM and RCM model realizations; b) Evaluate covariability between IPCs, legacy phenological data, and large-scale modes of climate variability to help detection and attribution of supposed secular trends and development of short and long-lead forecasts for phenological variations; c) identify, evaluate, and refine optimal methods for quantifying what constitutes significant statistical and ecological change in phenological indicators, given uncertainties in both data and methods and defined range of natural variability; d) identify, evaluate, and refine key questions of natural resource managers regarding phenological indicators for monitoring and adaptive management of habitats and wildlife, given the spectrum of management objectives on federal, state, and private lands.

Interpenetrating phase ceramic/polymer composite coatings: Fabrication and characterization

NASA Astrophysics Data System (ADS)

Craig, Bradley Dene

The goals of this thesis research were to fabricate interpenetrating phase composite (IPC) ceramic/polymer coatings and to investigate the effect of the interconnected microstructure on the physical and wear properties of the coatings. IPC coatings with an interpenetrating phase microstructure were successfully fabricated by first forming a porous ceramic with an interconnected microstructure using a chemical bonding route (mainly reacting alpha-alumina (0.3 mum) with orthophosphoric acid to form a phosphate bond). Porosity within these ceramic coatings was easily controlled between 20 and 50 vol. % by phosphoric acid addition, and was measured by a new porosity measurement technique (thermogravimetric volatilization of liquids, or TVL) which was developed. The resulting ceramic preforms were infiltrated with a UV and thermally curable cycloaliphatic epoxide resin and cured. This fabrication route resulted in composite coatings with thicknesses ranging from ˜1mum to 100 mum with complete filling of open pore space. The physical properties of the composite coatings, including microhardness, flexural modulus and wear resistance, were evaluated as a function of processing variables, including orthophosphoric acid content and ceramic phase firing temperature, which affected the microstructure and interparticulate bonding between particles in the coatings. For example, microhardness increased from ˜30 on the Vicker's scale to well over 200 as interparticulate bonding was increased in the ceramic phase. Additionally, Taber wear resistance in the best TPC coatings was found to approach that of fully-densified alumina under certain conditions. Several factors were found to influence the wear mechanism in the IPC coating materials. Forming strong connections between ceramic particles led to up to an order of magnitude increase in the wear resistance. Additionally, coating microhardness and ceramic/polymer interfacial strength were studied and found to be important in determining the wear mechanism and wear resistance of IPC composite coatings. A qualitative theory for wear mechanisms in these coatings was developed. Finally, a series of transparent coatings were developed via a similar processing route, using smaller (˜90 nm) boehmite particles instead of 0.3 mum alpha-alumina. Physical property control was found to mimic that found in opaque coatings, and showed increasing surface adsorption characteristics with increasing phosphoric acid content.

Ischemic preconditioning negatively regulates plenty of SH3s-mixed lineage kinase 3-Rac1 complex and c-Jun N-terminal kinase 3 signaling via activation of Akt.

PubMed

Zhang, Q-G; Han, D; Xu, J; Lv, Q; Wang, R; Yin, X-H; Xu, T-L; Zhang, G-Y

2006-12-01

Activation of Akt/protein kinase B has been recently reported to play an important role in ischemic tolerance. We here demonstrate that the decreased protein expression and phosphorylation of phosphatase and tensin homolog deleted from chromosome 10 (PTEN) underlie the increased Akt-Ser-473 phosphorylation in the hippocampal CA1 subfield in ischemic preconditioning (IPC). Co-immunoprecipitation analysis reveals that Akt physically interacts with Rac1, a small Rho family GTPase required for mixed lineage kinase 3 (MLK3) autophosphorylation, and both this interaction and Rac1-Ser-71 phosphorylation induced by Akt are promoted in preconditioned rats. In addition, we show that Akt activation results in the disassembly of the plenty of SH3s (POSH)-MLK3-Rac1 signaling complex and down-regulation of the activation of MLK3/c-Jun N-terminal kinase (JNK) pathway. Akt activation results in decreased serine phosphorylation of 14-3-3, a cytoplasmic anchor of Bax, and prevents ischemia-induced mitochondrial translocation of Bax, release of cytochrome c, and activation of caspase-3. The expression of Fas ligand is also decreased in the CA1 region. Akt activation protects against apoptotic neuronal death as shown in TUNEL staining following IPC. Intracerebral infusion of LY294002 before IPC reverses the increase in Akt phosphorylation and the decrease in JNK signaling activation, as well as the neuroprotective action of IPC. Our results suggest that activation of pro-apoptotic MLK3/JNK3 cascade can be suppressed through activating anti-apoptotic phosphoinositide 3-kinase/Akt pathway induced by a sublethal ischemic insult, which provides a functional link between Akt and the JNK family of stress-activated kinases in ischemic tolerance.

Submaximal Exercise Pulmonary Gas Exchange in Left Heart Disease Patients With Different Forms of Pulmonary Hypertension.

PubMed

Taylor, Bryan J; Smetana, Michael R; Frantz, Robert P; Johnson, Bruce D

2015-08-01

We determined whether pulmonary gas exchange indices during submaximal exercise are different in heart failure (HF) patients with combined post- and pre-capillary pulmonary hypertension (PPC-PH) versus HF patients with isolated post-capillary PH (IPC-PH) or no PH. Pulmonary hemodynamics and pulmonary gas exchange were assessed during rest and submaximal exercise in 39 HF patients undergoing right heart catheterization. After hemodynamic evaluation, patients were classified as having no PH (n = 11), IPC-PH (n = 12), or PPC-PH (n = 16). At an equivalent oxygen consumption, end-tidal CO2 (PETCO2) and arterial oxygen saturation (SaO2) were greater in no-PH and IPC-PH versus PPC-PH patients (36.1 ± 3.2 vs. 31.7 ± 4.5 vs. 26.2 ± 4.7 mm Hg and 97 ± 2 vs. 96 ± 3 vs. 91 ± 1%, respectively). Conversely, dead-space ventilation (VD/VT) and the ventilatory equivalent for carbon dioxide (V˙(E)/V˙CO2 ratio) were lower in no-PH and IPC-PH versus PPC-PH patients (0.37 ± 0.05 vs. 0.38 ± 0.04 vs. 0.47 ± 0.03 and 38 ± 5 vs. 42 ± 8 vs. 51 ± 8, respectively). The exercise-induced change in V(D)/V(T), V˙(E)/V˙CO2 ratio, and PETCO2 correlated significantly with the change in mean pulmonary arterial pressure, diastolic pressure difference, and transpulmonary pressure gradient in PPC-PH patients only. Noninvasive pulmonary gas exchange indices during submaximal exercise are different in HF patients with combined post- and pre-capillary PH compared with patients with isolated post-capillary PH or no PH. Copyright © 2015 Elsevier Inc. All rights reserved.

Solar hydrogen production using epitaxial SrTiO 3 on a GaAs photovoltaic

DOE PAGES

Kornblum, L.; Fenning, D. P.; Faucher, J.; ...

2016-12-22

We demonstrate an oxide-stabilized III–V photoelectrode architecture for solar fuel production from water in neutral pH. For this tunable architecture we demonstrate 100% Faradaic efficiency for hydrogen evolution, and incident photon-to-current efficiencies (IPCE) exceeding 50%. High IPCE for hydrogen evolution is a consequence of the low-loss interface achieved via epitaxial growth of a thin oxide on a GaAs solar cell. Developing optimal energetic alignment across the interfaces of the photoelectrode using well-established III–V technology is key to obtaining high performance. This advance constitutes a critical milestone towards efficient, unassisted fuel production from solar energy.

Infection prevention and control self-audit: just a tick box exercise?

PubMed Central

2013-01-01

The National Health Service (NHS) in England continues to experience ongoing change in order to complete the transition to the new delivery system outlined in Liberating the NHS (Department of Health, 2010a). Treating and caring for patients in a safe environment and protecting them from acquiring avoidable infections remains a high priority and a central quality improvement component within the outcome Indicator set for 2013/14 (NHS Commissioning Board, 2012a). Infection prevention and control practitioners will be required to use a range of innovative quality improvement strategies to facilitate engagement with clinicians and meet the challenges that lie ahead for the NHS. The purpose of this paper is to report on the implementation of an infection prevention and control self-audit (IPCSA) project within general practice. The aim of the project was to empower practice staff to become actively involved with an infection prevention and control (IPC) audit in order to support the development of an IPC quality improvement culture within general practice teams. The paper outlines the methodology used to implement self-audit. The findings suggest that IPCSA can be used as an effective alternative to an IPC nurse-led infection prevention and control audit. PMID:28989357

Infection prevention and control self-audit: just a tick box exercise?

PubMed

Gorrell, Michelle

2014-03-01

The National Health Service (NHS) in England continues to experience ongoing change in order to complete the transition to the new delivery system outlined in Liberating the NHS (Department of Health, 2010a). Treating and caring for patients in a safe environment and protecting them from acquiring avoidable infections remains a high priority and a central quality improvement component within the outcome Indicator set for 2013/14 (NHS Commissioning Board, 2012a). Infection prevention and control practitioners will be required to use a range of innovative quality improvement strategies to facilitate engagement with clinicians and meet the challenges that lie ahead for the NHS. The purpose of this paper is to report on the implementation of an infection prevention and control self-audit (IPCSA) project within general practice. The aim of the project was to empower practice staff to become actively involved with an infection prevention and control (IPC) audit in order to support the development of an IPC quality improvement culture within general practice teams. The paper outlines the methodology used to implement self-audit. The findings suggest that IPCSA can be used as an effective alternative to an IPC nurse-led infection prevention and control audit.

Calcination/dissolution chemistry development Fiscal year 1995

DOE Office of Scientific and Technical Information (OSTI.GOV)

Delegard, C.H.

1995-09-01

The task {open_quotes}IPC Liaison and Chemistry of Thermal Reconstitution{close_quotes} is a $300,000 program that was conducted in Fiscal Year (FY) 1995 with U.S. Department of Energy (DOE) Office of Research and Development (EM-53) Efficient Separations and Processing Crosscutting Program supported under technical task plan (TTP) RL4-3-20-04. The principal investigator was Cal Delegard of the Westinghouse Hanford Company (WHC). The task encompassed the following two subtasks related to the chemistry of alkaline Hanford Site tank waste: (1) Technical Liaison with the Institute of Physical Chemistry of the Russian Academy of Science (IPC/RAS) and its research into the chemistry of transuranic elementsmore » (TRU) and technetium (Tc) in alkaline media. (2) Laboratory investigation of the chemistry of calcination/dissolution (C/D) (or thermal reconstitution) as an alternative to the present reference Hanford Site tank waste pretreatment flowsheet, Enhanced Sludge Washing (ESW). This report fulfills the milestone for the C/D subtask to {open_quotes}Provide End-of-Year Report on C/D Laboratory Test Results{close_quotes} due 30 September 1995. A companion report, fulfilling the milestone to provide an end-of-year report on the IPC/RAS liaison, also has been prepared.« less

An X-ray method for detecting substructure in galaxy clusters - Application to Perseus, A2256, Centaurus, Coma, and Sersic 40/6

NASA Technical Reports Server (NTRS)

Mohr, Joseph J.; Fabricant, Daniel G.; Geller, Margaret J.

1993-01-01

We use the moments of the X-ray surface brightness distribution to constrain the dynamical state of a galaxy cluster. Using X-ray observations from the Einstein Observatory IPC, we measure the first moment FM, the ellipsoidal orientation angle, and the axial ratio at a sequence of radii in the cluster. We argue that a significant variation in the image centroid FM as a function of radius is evidence for a nonequilibrium feature in the intracluster medium (ICM) density distribution. In simple terms, centroid shifts indicate that the center of mass of the ICM varies with radius. This variation is a tracer of continuing dynamical evolution. For each cluster, we evaluate the significance of variations in the centroid of the IPC image by computing the same statistics on an ensemble of simulated cluster images. In producing these simulated images we include X-ray point source emission, telescope vignetting, Poisson noise, and characteristics of the IPC. Application of this new method to five Abell clusters reveals that the core of each one has significant substructure. In addition, we find significant variations in the orientation angle and the axial ratio for several of the clusters.

Impact of a malaria intervention package in schools on Plasmodium infection, anaemia and cognitive function in schoolchildren in Mali: a pragmatic cluster-randomised trial

PubMed Central

Rouhani, Saba; Diarra, Seybou; Saye, Renion; Bamadio, Modibo; Jones, Rebecca; Traore, Diahara; Traore, Klenon; Jukes, Matthew CH; Thuilliez, Josselin; Brooker, Simon; Roschnik, Natalie; Sacko, Moussa

2017-01-01

Background School-aged children are rarely targeted by malaria control programmes, yet the prevalence of Plasmodium infection in primary school children often exceeds that seen in younger children and could affect haemoglobin concentration and school performance. Methods A cluster-randomised trial was carried out in 80 primary schools in southern Mali to evaluate the impact of a school-based malaria intervention package. Intervention schools received two interventions sequentially: (1) teacher-led participatory malaria prevention education, combined with distribution of long-lasting insecticidal nets (LLINs), followed 7 months later at the end of the transmission season by (2) mass delivery of artesunate and sulfadoxine-pyrimethamine administered by teachers, termed intermittent parasite clearance in schools (IPCs). Control schools received LLINs as part of the national universal net distribution programme. The impact of the interventions on malaria and anaemia was evaluated over 20 months using cross-sectional surveys in a random subset of 38 schools(all classes), with a range of cognitive measures (sustained attention, visual search, numeracy, vocabulary and writing) assessed in a longitudinal cohort of children aged 9–12 years in all 80 schools. Results Delivery of a single round of IPCs was associated with dramatic reductions in malaria parasitaemia (OR 0.005, 95% CI 0.002 to 0.011, p<0.001) and gametocyte carriage (OR 0.02, 95% CI 0.00 to 0.17, p<0.001) in intervention compared with control schools. This effect was sustained for 6 months until the beginning of the next transmission season. IPCs was also associated with a significant decrease in anaemia (OR 0.56, 95% CI 0.40 to 0.78, p=0.001), and increase in sustained attention (difference +0.23, 95% CI 0.10 to 0.36, p<0.001). There was no evidence of impact on other cognitive measures. Conclusion The combination of malaria prevention education, LLINs and IPCs can reduce anaemia and improve sustained attention of school children in areas of highly seasonal transmission. These findings highlight the impact of asymptomatic malaria infection on cognitive performance in schoolchildren and the benefit of IPCs in reducing this burden. Additionally, malaria control in schools can help diminish the infectious reservoir that sustains Plasmodium transmission. PMID:29081992

Three subsystems of the inferior parietal cortex are differently affected in mild cognitive impairment.

PubMed

Liang, Peipeng; Wang, Zhiqun; Yang, Yanhui; Li, Kuncheng

2012-01-01

The Inferior parietal cortex (IPC), including the intraparietal sulcus (IPS), angular gyrus (AG), and supramarginal gyrus (SG), plays an important role in episodic memory, and is considered to be one of the specific neuroimaging markers in predicting the conversion of mild cognitive impairment (MCI) to Alzheimer's disease (AD). However, it is still unclear whether the connectivity of the IPC is impaired in MCI patients. In the present study, we used resting state fMRI to examine the functional connectivity of the three subdivisions of the IPC in MCI patients after controlling the impact of regional grey matter atrophy. It was found that, using IPS, AG, and SG as seeds of functional connectivity, three canonical functional networks could be correspondingly traced, i.e., executive control network (ECN), default mode network (DMN), and salience network (SN), and the three networks are differently altered in MCI patients. In contrast to the healthy controls, it was found that in MCI patients: 1) AG connectivity was significantly reduced within the DMN; 2) IPS showed decreased connectivity with the right inferior frontal gyrus while showing increased connectivity with the left frontal regions within the ECN; and 3) SG displayed decreased connectivity with a distribution of regions including the frontal and parietal regions, and increased connectivity with some sub-cortical areas within the SN. Moreover, the connectivity within the three networks was correlated with episodic memory and general cognitive impairment in MCI patients. These results extend well beyond the DMN, and further suggest that MCI is associated with alteration of large-scale functional brain networks.

Phenolic Content and Antioxidant Activity during the Development of 'Brookfield' and 'Mishima' Apples.

PubMed

Stanger, Mayara C; Steffens, Cristiano A; Soethe, Cristina; Moreira, Marcelo A; do Amarante, Cassandro V T

2017-05-03

The aim of this study was to characterize the changes in the contents of total (TPC) and individual (IPC) phenolic compounds, the total antioxidant activity (TAA) in the peel and pulp, and total anthocyanins (TAN) in the peel during the development of the fruits of 'Brookfield' and 'Mishima' apple trees. 'Brookfield' apples were harvested from the 49th to the 138th days after full bloom (DAFB) and 'Mishima' apples from the 45th to the 172th DAFB. In the pulp, the IPC, TPC, and TAA rapidly reduced at 75 and 79 DAFB for the 'Brookfield' and 'Mishima' apples, respectively, and then remained constant until commercial maturity. In the peel of 'Brookfield' apples there was a reduction in the TPC and TAA at 79 DAFB. The quercetin 3-galactoside, epicatechin, and procyanidin B2 contents reduced up to 107 DAFB with a subsequent increase in the values at commercial maturity. In the peel of 'Mishima' apples there was a reduction in the TPC, TAA, epicatechin, and procyanidin B1 and B2 contents at 130 DAFB, with a subsequent increase until commercial maturity. The TAN content in the peel increased during the 2 and 4 weeks prior to commercial maturity for 'Brookfield' and 'Mishima' apples, respectively. In the pulp and peel of both cultivars there was a reduction in the IPC, TPC, and TAA as the development proceeded. On nearing commercial maturity, there was an increase in the contents of quercetin 3-galactoside, epicatechin, procyanidin B2, and TAN in the peel for both cultivars.

Remote ischemic preconditioning with a specialized protocol activates the non-neuronal cardiac cholinergic system and increases ATP content in the heart.

PubMed

Oikawa, Shino; Mano, Asuka; Takahashi, Rina; Kakinuma, Yoshihiko

2015-11-01

Ischemic preconditioning (IPC) renders the targeted organ resistant to prolonged ischemic insults, leading to organoprotection. Among several means to achieve IPC, we reported that remote ischemic preconditioning (RIPC) activates the non-neuronal cardiac cholinergic system (NNCCS) to accelerate de novo ACh synthesis in cardiomyocytes. In the current study, we aimed to optimize a specific protocol to most efficiently activate NNCCS using RIPC. In this study, we elucidated that the protocol with 3 min of ischemia repeated three times increased cardiac ChAT expression (139.2 ± 0.4%; P < 0.05) as well as ACh (14.2 ± 2.0× 10(-8) M; P< 0.05) and ATP content (2.13 ± 0.19 μmol/g tissue; P < 0.05) in the heart. Moreover, in the specific protocol, several characteristic responses against energy starvation and for obtaining adequate energy were observed; therefore, it is suggested that RIPC evokes a robust response by the heart to activate NNCCS through the modification of energy metabolism. Copyright © 2015 Elsevier B.V. All rights reserved.

A randomized controlled trial of manual therapy and pneumatic compression for recovery from prolonged running - an extended study.

PubMed

Heapy, Amanda M; Hoffman, Martin D; Verhagen, Heidie H; Thompson, Samuel W; Dhamija, Pavitra; Sandford, Fiona J; Cooper, Mary C

2018-03-07

Manual therapy (MT) and intermittent pneumatic compression (IPC) are recovery methods used by endurance athletes with little evidence supporting effectiveness. This randomized controlled trial evaluated effectiveness of four daily post-race treatments of a specific MT protocol and IPC compared with supine rest on recovery following an ultramarathon among 56 ultramarathoners. Groups were comparable across all characteristics examined, including post-race plasma creatine kinase concentration. Subject completed timed 400 m runs before the race and on days three, five, seven and 14 post- race, and also provided muscle pain and soreness ratings and fatigue scores immediately before and after treatments, and during the 14 days post- race. Daily subjective measures and 400 m run times were not improved by either treatment, but both treatments reduced (p < .05) muscular fatigue scores acutely after treatment following the race and on post-race day 1, and MT improved (p < .05) muscle pain and soreness acutely following the race.

MG53 participates in ischaemic postconditioning through the RISK signalling pathway

PubMed Central

Zhang, Yan; Lv, Fengxiang; Jin, Li; Peng, Wei; Song, Ruisheng; Ma, Jianjie; Cao, Chun-Mei; Xiao, Rui-Ping

2011-01-01

Aims Recent studies show that ischaemic postconditioning (PostC), similar to the well-established ischaemic preconditioning (IPC), confers cardioprotection against ischaemia/reperfusion (IR) injury, and both IPC and PostC can activate the reperfusion injury salvage kinase (RISK) pathway and the survivor activating factor enhancement (SAFE) pathway. PostC is clinically more attractive because of its therapeutic application at the predictable onset of reperfusion. Our previous studies have demonstrated that MG53 is a primary component of the IPC machinery. Here, we investigated the potential role of MG53 in PostC-mediated myocardial protection and explored the underlying mechanism. Methods and results Using Langendorff perfusion, we investigated IR injury in wild-type (wt) and MG53-deficient (mg53−/−) mouse hearts with or without PostC. IR-induced myocardial damage was markedly exacerbated in mg53−/− hearts compared with wt controls. PostC protected wt hearts against IR-induced myocardial infarction, myocyte necrosis, and apoptosis, but failed to protect mg53−/− hearts. The loss of PostC protection in mg53−/− hearts was attributed to selectively impaired PostC-activated RISK signalling. Mechanistically, MG53 is required for the interaction between caveolin 3 (CaV3) and the p85 subunit of phosphoinositide 3-kinase (p85-PI3K) and PostC-mediated activation of the RISK pathway. Importantly, a structure–function study revealed that the MG53 tripartite motif (TRIM) domain (aa1–284) physically interacted with CaV3 but not p85-PI3K, whereas the MG53 SPRY domain (aa285–477) interacted with p85-PI3K but not CaV3, indicating that MG53 binds to CaV3 and p85 at its N- and C-terminus, respectively. Conclusions We conclude that MG53 participates in PostC-mediated cardioprotection largely through tethering CaV3 and PI3K and subsequent activation of the RISK pathway. PMID:21285295

Neuronal factors determining high intelligence.

PubMed

Dicke, Ursula; Roth, Gerhard

2016-01-05

Many attempts have been made to correlate degrees of both animal and human intelligence with brain properties. With respect to mammals, a much-discussed trait concerns absolute and relative brain size, either uncorrected or corrected for body size. However, the correlation of both with degrees of intelligence yields large inconsistencies, because although they are regarded as the most intelligent mammals, monkeys and apes, including humans, have neither the absolutely nor the relatively largest brains. The best fit between brain traits and degrees of intelligence among mammals is reached by a combination of the number of cortical neurons, neuron packing density, interneuronal distance and axonal conduction velocity--factors that determine general information processing capacity (IPC), as reflected by general intelligence. The highest IPC is found in humans, followed by the great apes, Old World and New World monkeys. The IPC of cetaceans and elephants is much lower because of a thin cortex, low neuron packing density and low axonal conduction velocity. By contrast, corvid and psittacid birds have very small and densely packed pallial neurons and relatively many neurons, which, despite very small brain volumes, might explain their high intelligence. The evolution of a syntactical and grammatical language in humans most probably has served as an additional intelligence amplifier, which may have happened in songbirds and psittacids in a convergent manner. © 2015 The Author(s).

The faint X-ray sources in and out of omega Centauri: X-ray observations and optical identifications

NASA Technical Reports Server (NTRS)

Cool, Adrienne M.; Grindlay, Jonathan E.; Bailyn, Charles D.; Callanan, Paul J.; Hertz, Paul

1995-01-01

We present the results of an observation of the globular cluster omega Cen (NGC 5139) with the Einstein high-resolution imager (HRI). Of the five low-luminosity X-ray sources toward omega Cen which were first identified with the Einstein imaging proportional counter (IPC) (Hertz and Grindlay 1983a, b), two are detected in the Einstein HRI observation: IPC sources A and D. These detections provide source positions accurate to 3 sec-4 sec; the positions are confirmed in a ROSAT HRI observation reported here. Using CCD photometry and spectroscopy, we have identified both sources as foreground dwarf M stars with emission lines (dMe). The chance projection of two Mde stars within approximately 13 min of the center of omega Cen is not extraordinary, given the space density of these stellar coronal X-ray sources. We discuss the possible nature of the three as yet unidentified IPC sources toward omega Cen, and consider the constraints that the Einstein observations place on the total population of X-ray sources in this cluster. The integrated luminosity from faint X-ray sources in omega Cen appears to be low relative to both the old open cluster M67 and the post-core-collapse globular, NGC 6397.

Neural Correlates of Explicit Social Judgments on Vocal Stimuli

PubMed Central

Hensel, Lukas; Bzdok, Danilo; Müller, Veronika I.; Zilles, Karl; Eickhoff, Simon B.

2015-01-01

Functional neuroimaging research on the neural basis of social evaluation has traditionally focused on face perception paradigms. Thus, little is known about the neurobiology of social evaluation processes based on auditory cues, such as voices. To investigate the top-down effects of social trait judgments on voices, hemodynamic responses of 44 healthy participants were measured during social trait (trustworthiness [TR] and attractiveness [AT]), emotional (happiness, HA), and cognitive (age, AG) voice judgments. Relative to HA and AG judgments, TR and AT judgments both engaged the bilateral inferior parietal cortex (IPC; area PGa) and the dorsomedial prefrontal cortex (dmPFC) extending into the perigenual anterior cingulate cortex. This dmPFC activation overlapped with previously reported areas specifically involved in social judgments on ‘faces.’ Moreover, social trait judgments were expected to share neural correlates with emotional HA and cognitive AG judgments. Comparison of effects pertaining to social, social–emotional, and social–cognitive appraisal processes revealed a dissociation of the left IPC into 3 functional subregions assigned to distinct cytoarchitectonic subdivisions. In total, the dmPFC is proposed to assume a central role in social attribution processes across sensory qualities. In social judgments on voices, IPC activity shifts from rostral processing of more emotional judgment facets to caudal processing of more cognitive judgment facets. PMID:24243619

Social Franchising and a Nationwide Mass Media Campaign Increased the Prevalence of Adequate Complementary Feeding in Vietnam: A Cluster-Randomized Program Evaluation123

PubMed Central

Rawat, Rahul; Nguyen, Phuong Hong; Tran, Lan Mai; Hajeebhoy, Nemat; Nguyen, Huan Van; Baker, Jean; Frongillo, Edward A; Ruel, Marie T; Menon, Purnima

2017-01-01

Background: Rigorous evaluations of health system–based interventions in large-scale programs to improve complementary feeding (CF) practices are limited. Alive & Thrive applied principles of social franchising within the government health system in Vietnam to improve the quality of interpersonal counseling (IPC) for infant and young child feeding combined with a national mass media (MM) campaign and community mobilization (CM). Objective: We evaluated the impact of enhanced IPC + MM + CM (intensive) compared with standard IPC + less-intensive MM and CM (nonintensive) on CF practices and anthropometric indicators. Methods: A cluster-randomized, nonblinded evaluation design with cross-sectional surveys (n = ∼500 children aged 6–23.9 mo and ∼1000 children aged 24–59.9 mo/group) implemented at baseline (2010) and endline (2014) was used. Difference-in-difference estimates (DDEs) of impact were calculated for intent-to-treat (ITT) analyses and modified per-protocol analyses (MPAs; mothers who attended the social franchising at least once: 62%). Results: Groups were similar at baseline. In ITT analyses, there were no significant differences between groups in changes in CF practices over time. In the MPAs, greater improvements in the intensive than in the nonintensive group were seen for minimum dietary diversity [DDE: 6.4 percentage points (pps); P < 0.05] and minimum acceptable diet (8.0 pps; P < 0.05). Significant stunting declines occurred in both intensive (7.1 pps) and nonintensive (5.4 pps) groups among children aged 24–59.9 mo, with no differential decline. Conclusions: When combined with MM and CM, an at-scale social franchising approach to improve IPC, delivered through the existing health care system, significantly improved CF practices, but not child growth, among mothers who used counseling services at least once. A greater impact may be achieved with strategies designed to increase service utilization. This trial was registered at clinicaltrials.gov as NCT01676623. PMID:28179488

Social Franchising and a Nationwide Mass Media Campaign Increased the Prevalence of Adequate Complementary Feeding in Vietnam: A Cluster-Randomized Program Evaluation.

PubMed

Rawat, Rahul; Nguyen, Phuong Hong; Tran, Lan Mai; Hajeebhoy, Nemat; Nguyen, Huan Van; Baker, Jean; Frongillo, Edward A; Ruel, Marie T; Menon, Purnima

2017-04-01

Background: Rigorous evaluations of health system-based interventions in large-scale programs to improve complementary feeding (CF) practices are limited. Alive & Thrive applied principles of social franchising within the government health system in Vietnam to improve the quality of interpersonal counseling (IPC) for infant and young child feeding combined with a national mass media (MM) campaign and community mobilization (CM). Objective: We evaluated the impact of enhanced IPC + MM + CM (intensive) compared with standard IPC + less-intensive MM and CM (nonintensive) on CF practices and anthropometric indicators. Methods: A cluster-randomized, nonblinded evaluation design with cross-sectional surveys ( n = ∼500 children aged 6-23.9 mo and ∼1000 children aged 24-59.9 mo/group) implemented at baseline (2010) and endline (2014) was used. Difference-in-difference estimates (DDEs) of impact were calculated for intent-to-treat (ITT) analyses and modified per-protocol analyses (MPAs; mothers who attended the social franchising at least once: 62%). Results: Groups were similar at baseline. In ITT analyses, there were no significant differences between groups in changes in CF practices over time. In the MPAs, greater improvements in the intensive than in the nonintensive group were seen for minimum dietary diversity [DDE: 6.4 percentage points (pps); P < 0.05] and minimum acceptable diet (8.0 pps; P < 0.05). Significant stunting declines occurred in both intensive (7.1 pps) and nonintensive (5.4 pps) groups among children aged 24-59.9 mo, with no differential decline. Conclusions: When combined with MM and CM, an at-scale social franchising approach to improve IPC, delivered through the existing health care system, significantly improved CF practices, but not child growth, among mothers who used counseling services at least once. A greater impact may be achieved with strategies designed to increase service utilization. This trial was registered at clinicaltrials.gov as NCT01676623.

Comparison of ion-pair chromatography and capillary zone electrophoresis for the assay of organic acids as markers of abnormal metabolism.

PubMed

Wang, Shu-Ping; Liao, Chiou-Shyi

2004-10-08

The abnormal organic acids in urine are closely related with physiological metabolism. To determinate the low-molecular-mass metabolites in human biological fluids, although there were some previous reports by both of capillary electrophoresis and ion-exchange high-performance liquid chromatography, but it was rarely found by reverse phase of liquid chromatography using ion pair reagent. The objective of this study was aimed to suggest and compare two methods, an additional chromatographic method-ion-pair chromatography (IPC) and a sharp capillary zone electrophoresis (CZE), to determinate organic acids, acting as the abnormal metabolic markers, namely uric acid, orotic acid, pyruvic acid, alpha-ketoglutaric acid, fumaric acid, and hippuric acid. The proposed method of IPC possessed both the extreme stability for column and the good results of reproducibility, linearity and detection limit. The optimum mobile phase was 22% methanol and 10 mM tetra-n-butyl ammonium hydrogen sulfate (pH 4) by gradient elution. As well as the optimum condition of CZE was 5% acetonitrile and 0.5 mM CTAB in phosphate buffer. From the results, CZE showed better recovery and sharp lucid electropherogram. Finally, the two proposed analytical methods were applied to assay human urine with direct and spiked analysis. CZE showed good potency to overcome the sample-to sample variation with standard deviation less than 10%. By comparison results of urinary spiked analysis between IPC and CZE by statistical paired t-test, the results were evaluated no significant difference under P < 0.05. The quantitative linearity of both methods was fitted in application of clinical biological analysis even with 50-fold dilution.

Factors affecting the lung perfused blood volume in patients with intrapulmonary clots after anti-coagulation therapy.

PubMed

Okada, Munemasa; Masuda, Yu; Nakashima, Yoshiteru; Nomura, Takafumi; Nakao, Sei; Suga, Kazuyoshi; Kido, Shoji; Matsunaga, Naofumi

2015-08-01

Factors affecting the improvement in the lung perfused blood volume (LPBV) were evaluated based on the presence of intrapulmonary clots (IPCs) after anti-coagulation therapy using 64-slice dual-energy CT. 96 patients exhibiting venous thromboembolism underwent initial and repeated LPBV examinations between December 2008 and July 2014. Fifteen patients were excluded due to pulmonary comorbidities, and a total of 81 patients were included in this study. Acute pulmonary embolism (PE) was diagnosed in 46 of the patients (56.7%). LPBV images were three-dimensionally reconstructed with two threshold ranges: 1-120 HU (V120) and 1-5 HU (V5), and the relative value of V5 per V120 expressed as %V5. These values were subsequently compared with indicators of the severity of PE, such as the D-dimer level, heart rate and CT measurements. This study was approved by the local ethics committee. In patients with IPCs, the D-dimer, V5 and %V5values were significantly larger (p≤0.01) in the initial LPBV, although these differences disappeared in subsequent LPBV after treatment. The right ventricular (RV) diameter, RV/left ventricular (RV/LV) diameter ratio and %V5 values were also significantly reduced, whereas the V5 value did not significantly decrease (p=0.07), but V120 value significantly increased (p<0.001) after treatment. However, in patients with IPCs the change rate in %V5 [(subsequent-initial)/initial %V5] showed a better correlation with that in V5 (r=0.94, p<0.001) rate than that in V120 (r=0.19, p=0.19) after treatment. Increased whole lung perfusion (V120) and a decreased low perfusion volume (V5) affect the improvement in the %V5 values after treatment. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The CfA Einstein Observatory extended deep X-ray survey

NASA Technical Reports Server (NTRS)

Primini, F. A.; Murray, S. S.; Huchra, J.; Schild, R.; Burg, R.

1991-01-01

All IPC exposures in the Einstein Extended Deep X-ray Survey program have been reanalyzed. The current survey covers about 2.3 sq deg with a typical limiting sensitivity of about 5 x 10 to the -14th ergs/sq cm/s in the energy range from 0.8-3.5 keV. A total of 25 IPC sources are detected above a threshold of 4.5 sigma. A total of 18 are detected independently in the HRI, leading to the identification of six with stars and 11 with extragalactic objects. The remaining sources are classified as extragalactic. The population of identified extragalactic objects is dominated by QSOs, with one or two possible clusters. The basic conclusions of the original survey remain unchanged.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Palma, Giuseppina; Cozzarini, Luca; Capria, Ennio

A home-made system for incident photon-to-electron conversion efficiency (IPCE) characterization, based on a double-beam UV-Vis spectrophotometer, has been set up. In addition to its low cost (compared to the commercially available apparatuses), the double-beam configuration gives the advantage to measure, autonomously and with no need for supplementary equipment, the lamp power in real time, compensating possible variations of the spectral emission intensity and quality, thus reducing measurement times. To manage the optical and electronic components of the system, a custom software has been developed. Validations carried out on a common silicon-based photodiode and on a dye-sensitized solar cell confirm themore » possibility to adopt this system for determining the IPCE of solar cells, including dye-sensitized ones.« less

Stability and Change of Social Goals in Adolescence

PubMed Central

Trucco, Elisa M.; Wright, Aidan G. C.; Colder, Craig R.

2013-01-01

Objective This study provides a comprehensive analysis of continuity and change in social goals using the interpersonal circumplex (IPC) model across adolescence (ages 11 – 16). Five complementary definitions of stability were examined: structural, rank-order, absolute, individual, and ipsative. Method Data were taken from a longitudinal study of early adolescent problem behavior. Social goals were assessed during each wave with data collection occurring at three annual intervals (Wave 1, ages 10-12). A community sample of adolescents (n = 387) was recruited. Adolescents were evenly split on gender and a majority (82.7%) was White. Results Results suggest a modest increase in stability across social goals; yet, significant interindividual heterogeneity. Although levels of Agentic and Communal factors increase over time, these patterns were driven by decreases in the Submissive and Separate octants. Conclusions This offers evidence for the utility of examining lower-order facets of interpersonal dispositions as it provides a nuanced picture of adolescent personality development. Furthermore, findings suggest that change and continuity in social goals may both be relevant in this developmental period. The difficulty is accounting for trait stability as well as change, and the IPC model may be particularly useful for meeting this challenge. PMID:23998889

Demethylation of induced pluripotent stem cells from type 1 diabetic patients enhances differentiation into functional pancreatic β cells.

PubMed

Manzar, Gohar S; Kim, Eun-Mi; Zavazava, Nicholas

2017-08-25

Type 1 diabetes (T1D) can be managed by transplanting either the whole pancreas or isolated pancreatic islets. However, cadaveric pancreas is scarcely available for clinical use, limiting this approach. As such, there is a great need to identify alternative sources of clinically usable pancreatic tissues. Here, we used induced pluripotent stem (iPS) cells derived from patients with T1D to generate glucose-responsive, insulin-producing cells (IPCs) via 3D culture. Initially, T1D iPS cells were resistant to differentiation, but transient demethylation treatment significantly enhanced IPC yield. The cells responded to high-glucose stimulation by secreting insulin in vitro The shape, size, and number of their granules, as observed by transmission electron microscopy, were identical to those found in cadaveric β cells. When the IPCs were transplanted into immunodeficient mice that had developed streptozotocin-induced diabetes, they promoted a dramatic decrease in hyperglycemia, causing the mice to become normoglycemic within 28 days. None of the mice died or developed teratomas. Because the cells are derived from "self," immunosuppression is not required, providing a much safer and reliable treatment option for T1D patients. Moreover, these cells can be used for drug screening, thereby accelerating drug discovery. In conclusion, our approach eliminates the need for cadaveric pancreatic tissue.

Insulin signaling misregulation underlies circadian and cognitive deficits in a Drosophila fragile X model.

PubMed

Monyak, R E; Emerson, D; Schoenfeld, B P; Zheng, X; Chambers, D B; Rosenfelt, C; Langer, S; Hinchey, P; Choi, C H; McDonald, T V; Bolduc, F V; Sehgal, A; McBride, S M J; Jongens, T A

2017-08-01

Fragile X syndrome (FXS) is an undertreated neurodevelopmental disorder characterized by low intelligence quotent and a wide range of other symptoms including disordered sleep and autism. Although FXS is the most prevalent inherited cause of intellectual disability, its mechanistic underpinnings are not well understood. Using Drosophila as a model of FXS, we showed that select expression of dfmr1 in the insulin-producing cells (IPCs) of the brain was sufficient to restore normal circadian behavior and to rescue the memory deficits in the fragile X mutant fly. Examination of the insulin signaling (IS) pathway revealed elevated levels of Drosophila insulin-like peptide 2 (Dilp2) in the IPCs and elevated IS in the dfmr1 mutant brain. Consistent with a causal role for elevated IS in dfmr1 mutant phenotypes, the expression of dfmr1 specifically in the IPCs reduced IS, and genetic reduction of the insulin pathway also led to amelioration of circadian and memory defects. Furthermore, we showed that treatment with the FDA-approved drug metformin also rescued memory. Finally, we showed that reduction of IS is required at different time points to rescue circadian behavior and memory. Our results indicate that insulin misregulation underlies the circadian and cognitive phenotypes displayed by the Drosophila fragile X model, and thus reveal a metabolic pathway that can be targeted by new and already approved drugs to treat fragile X patients.

Three-dimensional hot electron photovoltaic device with vertically aligned TiO2 nanotubes.

PubMed

Goddeti, Kalyan C; Lee, Changhwan; Lee, Young Keun; Park, Jeong Young

2018-05-09

Titanium dioxide (TiO 2 ) nanotubes with vertically aligned array structures show substantial advantages in solar cells as an electron transport material that offers a large surface area where charges travel linearly along the nanotubes. Integrating this one-dimensional semiconductor material with plasmonic metals to create a three-dimensional plasmonic nanodiode can influence solar energy conversion by utilizing the generated hot electrons. Here, we devised plasmonic Au/TiO 2 and Ag/TiO 2 nanodiode architectures composed of TiO 2 nanotube arrays for enhanced photon absorption, and for the subsequent generation and capture of hot carriers. The photocurrents and incident photon to current conversion efficiencies (IPCE) were obtained as a function of photon energy for hot electron detection. We observed enhanced photocurrents and IPCE using the Ag/TiO 2 nanodiode. The strong plasmonic peaks of the Au and Ag from the IPCE clearly indicate an enhancement of the hot electron flux resulting from the presence of surface plasmons. The calculated electric fields and the corresponding absorbances of the nanodiode using finite-difference time-domain simulation methods are also in good agreement with the experimental results. These results show a unique strategy of combining a hot electron photovoltaic device with a three-dimensional architecture, which has the clear advantages of maximizing light absorption and a metal-semiconductor interface area.

Detection of two fungal biocontrol agents against root-knot nematodes by RAPD markers.

PubMed

Zhu, Ming Liang; Mo, Ming He; Xia, Zhen Yuan; Li, Yun Hua; Yang, Shu Jun; Li, Tian Fei; Zhang, Ke Qin

2006-05-01

The strain ZK7 of Pochonia chlamydosporia var. chlamydosporia and IPC of Paecilomyces lilacinus are highly effective in the biological control against root-knot nematodes infecting tobacco. When applied, they require a specific monitoring method to evaluate the colonization and dispersal in soil. In this work, the randomly amplified polymorphic DNA (RAPD) technique was used to differentiate between the two individual strains and 95 other isolates, including isolates of the same species and common soil fungi. This approach allowed the selection of specific fragments of 1.2 kb (Vc1200) and 2.0 kb (Vc2000) specific for ZK7, 1.4 kb (P1400) and 0.85 kb (P850) specific for IPC, using the random Primers OPL-02, OPD-05, OPD-05 and OPC-11, respectively. These fragments were cloned, sequenced, and used to design sequence-characterized amplification region (SCAR) primers specific for the two strains. In classical polymerase chain reaction (PCR), with serial dilution of ZK7 and IPC pure culture DNAs template, the detection limits of these oligonucleotide SCAR-PCR primers were found to be 10, 1000, 500, 100 pg, respectively. In the dot blotting, digoxigenin (DIG)-labeled amplicons from these four primers specifically recognized the corresponding fragments in the DNAs template of these two strains. The detection limit of these amplicons were 0.2, 0.2, 0.5, 0.5 mug, respectively.

IPC two-color analysis of x ray galaxy clusters

NASA Technical Reports Server (NTRS)

White, Raymond E., III

1990-01-01

The mass distributions were determined of several clusters of galaxies by using X ray surface brightness data from the Einstein Observatory Imaging Proportional Counter (IPC). Determining cluster mass distributions is important for constraining the nature of the dark matter which dominates the mass of galaxies, galaxy clusters, and the Universe. Galaxy clusters are permeated with hot gas in hydrostatic equilibrium with the gravitational potentials of the clusters. Cluster mass distributions can be determined from x ray observations of cluster gas by using the equation of hydrostatic equilibrium and knowledge of the density and temperature structure of the gas. The x ray surface brightness at some distance from the cluster is the result of the volume x ray emissivity being integrated along the line of sight in the cluster.

Pseudotannins Self-assembled into Antioxidant Complexes

PubMed Central

Cheng, H. A.; Drinnan, C. T.; Pleshko, N.; Fisher, O. Z.

2015-01-01

Natural tannins are attractive as building blocks for biomaterials due to their antioxidant properties and ability to form interpolymer complexes (IPCs) with other macromolecules. One of the major challenges to tannin usage in biomedical applications is their instability at physiological conditions and a lack of control over the purity and reactivity. Herein, we report the synthesis and characterization of tannin-like polymers with controlled architecture, reactivity, and size. These pseudotannins were synthesized by substituting linear dextran chains with gallic, resorcylic, and protocatechuic pendant groups to mimic the structure of natural hydrolysable tannins. We demonstrate that these novel materials can self-assemble to form reductive and colloidally stable nanoscale and microscale particles. Specifically, the synthesis, turbidity, particle size, antioxidant power, and cell uptake of IPCs derived from pseudotannins and poly(ethylene glycol) was evaluated. PMID:26313262

Pseudotannins self-assembled into antioxidant complexes.

PubMed

Cheng, H A; Drinnan, C T; Pleshko, N; Fisher, O Z

2015-10-21

Natural tannins are attractive as building blocks for biomaterials due to their antioxidant properties and ability to form interpolymer complexes (IPCs) with other macromolecules. One of the major challenges to tannin usage in biomedical applications is their instability at physiological conditions and a lack of control over the purity and reactivity. Herein, we report the synthesis and characterization of tannin-like polymers with controlled architecture, reactivity, and size. These pseudotannins were synthesized by substituting linear dextran chains with gallic, resorcylic, and protocatechuic pendant groups to mimic the structure of natural hydrolysable tannins. We demonstrate that these novel materials can self-assemble to form reductive and colloidally stable nanoscale and microscale particles. Specifically, the synthesis, turbidity, particle size, antioxidant power, and cell uptake of IPCs derived from pseudotannins and poly(ethylene glycol) was evaluated.

Short-term remote ischemic preconditioning is not associated with improved blood pressure and exercise capacity in young adults.

PubMed

Banks, Laura; Wells, Greg D; Clarizia, Nadia A; Jean-St-Michel, Emilie; McKillop, Adam L; Redington, Andrew N; McCrindle, Brian W

2016-08-01

We sought to determine whether a 9-day remote ischemic preconditioning (IPC) causes improvements in exercise performance, energetics, and blood pressure. Ten participants (mean age 24 ± 4 years) had no changes in aerobic capacity (preintervention: 38 ± 10 mL/(kg·min)(-1) vs. postintervention: 38 ± 10 mL/(kg·min)(-1)), blood pressure (preintervention: 112 ± 7/66 ± 6 mm Hg vs. postintervention: 112 ± 10/62 ± 5 mm Hg), cardiac phosphocreatinine-to-adenosine-triphosphate ratio (preintervention: 2.1 ± 0.5 vs. postintervention: 2.3 ± 0.4), and postexercise skeletal muscle phosphocreatine recovery (preintervention: 34 ± 11 s vs. postintervention: 31 ± 11 s). Short-term remote IPC may be ineffective in improving these outcomes.

A Reduction in Delay Discounting by Using Episodic Future Imagination and the Association with Episodic Memory Capacity

PubMed Central

Hu, Xiaochen; Kleinschmidt, Helena; Martin, Jason A.; Han, Ying; Thelen, Manuela; Meiberth, Dix; Jessen, Frank; Weber, Bernd

2017-01-01

Delay discounting (DD) refers to the phenomenon that individuals discount future consequences. Previous studies showed that future imagination reduces DD, which was mediated by functional connectivity between medial prefrontal valuation areas and a key region for episodic memory (hippocampus). Future imagination involves an initial period of construction and a later period of elaboration, with the more elaborative latter period recruiting more cortical regions. This study examined whether elaborative future imagination modulated DD, and if so, what are the underlying neural substrates. It was assumed that cortical areas contribute to the modulation effect during the later period of imagination. Since future imagination is supported by episodic memory capacity, we additionally hypothesize that the neural network underlying the modulation effect is related to individual episodic memory capacity. Twenty-two subjects received an extensive interview on personal future events, followed by an fMRI DD experiment with and without the need to perform elaborative future imagination simultaneously. Subjects' episodic memory capacity was also assessed. Behavioral results replicate previous findings of a reduced discount rate in the DD plus imagination condition compared to the DD only condition. The behavioral effect positively correlated with: (i) subjective value signal changes in midline brain structures during the initial imagination period; and (ii) signal changes in left prefrontoparietal areas during the later imagination period. Generalized psychophysiological interaction (gPPI) analyses reveal positive correlations between the behavioral effect and functional connectivity among the following areas: right anterior cingulate cortex (ACC) and left hippocampus; left inferior parietal cortex (IPC) and left hippocampus; and left IPC and bilateral occipital cortices. These changes in functional connectivity are also associated with episodic memory capacity. A hierarchical multiple regression indicates that the model with both the valuation related signal changes in the right ACC and the imagination related signal changes in the left IPC best predicts the reduction in DD. This study illustrates interactions between the left hippocampus and multiple cortical regions underlying the modulation effect of elaborative episodic future imagination, demonstrating, for the first time, empirical support for a relation to individual episodic memory capacity. PMID:28105009

A Reduction in Delay Discounting by Using Episodic Future Imagination and the Association with Episodic Memory Capacity.

PubMed

Hu, Xiaochen; Kleinschmidt, Helena; Martin, Jason A; Han, Ying; Thelen, Manuela; Meiberth, Dix; Jessen, Frank; Weber, Bernd

2016-01-01

Delay discounting (DD) refers to the phenomenon that individuals discount future consequences. Previous studies showed that future imagination reduces DD, which was mediated by functional connectivity between medial prefrontal valuation areas and a key region for episodic memory (hippocampus). Future imagination involves an initial period of construction and a later period of elaboration, with the more elaborative latter period recruiting more cortical regions. This study examined whether elaborative future imagination modulated DD, and if so, what are the underlying neural substrates. It was assumed that cortical areas contribute to the modulation effect during the later period of imagination. Since future imagination is supported by episodic memory capacity, we additionally hypothesize that the neural network underlying the modulation effect is related to individual episodic memory capacity. Twenty-two subjects received an extensive interview on personal future events, followed by an fMRI DD experiment with and without the need to perform elaborative future imagination simultaneously. Subjects' episodic memory capacity was also assessed. Behavioral results replicate previous findings of a reduced discount rate in the DD plus imagination condition compared to the DD only condition. The behavioral effect positively correlated with: (i) subjective value signal changes in midline brain structures during the initial imagination period; and (ii) signal changes in left prefrontoparietal areas during the later imagination period. Generalized psychophysiological interaction (gPPI) analyses reveal positive correlations between the behavioral effect and functional connectivity among the following areas: right anterior cingulate cortex (ACC) and left hippocampus; left inferior parietal cortex (IPC) and left hippocampus; and left IPC and bilateral occipital cortices. These changes in functional connectivity are also associated with episodic memory capacity. A hierarchical multiple regression indicates that the model with both the valuation related signal changes in the right ACC and the imagination related signal changes in the left IPC best predicts the reduction in DD. This study illustrates interactions between the left hippocampus and multiple cortical regions underlying the modulation effect of elaborative episodic future imagination, demonstrating, for the first time, empirical support for a relation to individual episodic memory capacity.

Quantum Dots for Solar Cell Application

NASA Astrophysics Data System (ADS)

Poudyal, Uma

Solar energy has been anticipated as the most important and reliable source of renewable energy to address the ever-increasing energy demand. To harvest solar energy efficiently, diverse kinds of solar cells have been studied. Among these, quantum dot sensitized solar cells have been an interesting group of solar cells mainly due to tunable, size-dependent electronic and optical properties of quantum dots. Moreover, doping these quantum dots with transition metal elements such as Mn opens avenue for improved performance of solar cells as well as for spin based technologies. In this dissertation, Mn-doped CdSe QDs (Mn-CdSe) have been synthesized by Successive Ionic Layer Adsorption and Reaction (SILAR) method. They are used in solar cells to study the effect of Mn doping in the performance of solar cells. Incident photon to current-conversion efficiency (IPCE) is used to record the effect of Mn-doping. Intensity modulated photovoltage and photocurrent spectroscopy (IMVS/PS) has been used to study the carrier dynamics in these solar cells. Additionally, the magnetic properties of Mn-CdSe QDs is studied and its possible origin is discussed. Moreover, CdS/CdSe QDs have been used to study the effect of liquid, gel and solid electrolyte in the performance and stability of the solar cells. Using IPCE spectra, the time decay measurements are presented and the possible reactions between the QD and the electrolytes are explained.

38 CFR 76.1 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... veteran for participation in a sport sanctioned by the United States Paralympics. The IPC standards are... at the Department of Veterans Affairs, Office of Regulation Policy and Management (02REG), Room 1063B...

38 CFR 76.1 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... veteran for participation in a sport sanctioned by the United States Paralympics. The IPC standards are... at the Department of Veterans Affairs, Office of Regulation Policy and Management (02REG), Room 1063B...

38 CFR 76.1 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... veteran for participation in a sport sanctioned by the United States Paralympics. The IPC standards are... at the Department of Veterans Affairs, Office of Regulation Policy and Management (02REG), Room 1063B...

38 CFR 76.1 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... veteran for participation in a sport sanctioned by the United States Paralympics. The IPC standards are... at the Department of Veterans Affairs, Office of Regulation Policy and Management (02REG), Room 1063B...

Hermite Polynomials and the Inverse Problem for Collisionless Equilibria

NASA Astrophysics Data System (ADS)

Allanson, O.; Neukirch, T.; Troscheit, S.; Wilson, F.

2017-12-01

It is long established that Hermite polynomial expansions in either velocity or momentum space can elegantly encode the non-Maxwellian velocity-space structure of a collisionless plasma distribution function (DF). In particular, Hermite polynomials in the canonical momenta naturally arise in the consideration of the 'inverse problem in collisionless equilibria' (IPCE): "for a given macroscopic/fluid equilibrium, what are the self-consistent Vlasov-Maxwell equilibrium DFs?". This question is of particular interest for the equilibrium and stability properties of a given macroscopic configuration, e.g. a current sheet. It can be relatively straightforward to construct a formal solution to IPCE by a Hermite expansion method, but several important questions remain regarding the use of this method. We present recent work that considers the necessary conditions of non-negativity, convergence, and the existence of all moments of an equilibrium DF solution found for IPCE. We also establish meaningful analogies between the equations that link the microscopic and macrosopic descriptions of the Vlasov-Maxwell equilibrium, and those that solve the initial value problem for the heat equation. In the language of the heat equation, IPCE poses the pressure tensor as the 'present' heat distribution over an infinite domain, and the non-Maxwellian features of the DF as the 'past' distribution. We find sufficient conditions for the convergence of the Hermite series representation of the DF, and prove that the non-negativity of the DF can be dependent on the magnetisation of the plasma. For DFs that decay at least as quickly as exp(-v^2/4), we show non-negativity is guaranteed for at least a finite range of magnetisation values, as parameterised by the ratio of the Larmor radius to the gradient length scale. 1. O. Allanson, T. Neukirch, S. Troscheit & F. Wilson: From one-dimensional fields to Vlasov equilibria: theory and application of Hermite polynomials, Journal of Plasma Physics, 82, 905820306, 2016 2. O. Allanson, S. Troscheit & T. Neukirch: The inverse problem for collisionless plasma equilibria (invited paper for IMA Journal of Applied Mathematics, under review)

Rabies Situation in Cambodia

PubMed Central

Ly, Sowath; Buchy, Philippe; Heng, Nay Yim; Ong, Sivuth; Chhor, Nareth; Bourhy, Hervé; Vong, Sirenda

2009-01-01

Background Rabies, a fatal but preventable zoonosis, is a major public health problem in developing countries. In Cambodia the disease burden is largely underestimated because patients with encephalitis following dog bites are rarely hospitalized and die at home. Since 1998 Institut Pasteur in Cambodia (IPC), Phnom Penh has been the only source of free post-exposure prophylaxis (PEP) and post-mortem diagnosis. Methods The 1998–2007 data compiled by IPC was analyzed to describe all treated patients for PEP, results of human testing and confirmed rabies cases, and results of animal testing. From dog bites' characteristics, we defined a suspected rabid dog bite injury (SRDBI) in humans as a bite that was unprovoked, from a dog that died spontaneously, or from a dog that was reported sick. We applied a deterministic probability model to estimate 2007 rabies human mortality nationwide from the estimated incidence of rabid dog bites, the body distribution of bite wounds, and the probability of PEP access. Results During 1998–2007, 124,749 patients received PEP at IPC (average 12,470; range 8,907–14,475), and 63 fatal human cases presenting with encephalitis following a dog bite were reported, in which 73% were confirmed positive for rabies by direct immunofluorescence assay or by reverse-transcriptase polymerase chain reaction. During 1998–2007, IPC tested 1,255 animal brain samples; 1,214 (97%) were from dogs including 610 (49%) positive samples. In 2007, 14,475 patients received PEP (100 PEP/100,000 people in Cambodia) including 95% who resided in Phnom Penh (615 PEP/100,000) or five neighboring provinces. The predictive model estimated 810 human rabies deaths would occur in 2007 (95%confidence interval [CI] 394–1,607), an incidence of 5.8/100,000 (95% CI 2.8–11.5). Conclusions Access to PEP is only sufficient for Phnom Penh residents. In 2007, the estimated rabies related mortality exceeded that of malaria and that of dengue. A national rabies control program is needed to improve surveillance and access to PEP, and to initiate vaccination campaigns in dogs. PMID:19907631

Development of New Photovoltaic Devices Based on Multi Wall Carbon Nanotubes and Nanoparticles

DTIC Science & Technology

2013-03-01

response is registered in all the photon spectral range studied. The new kind of Graetzel-like solar cell device was built without dye and TiO2 , showing...response is registered in all the photon spectral range studied. - The new kind of Graetzel (DSSC, Dye Synthesized Solar Cell ) built without Dye and TiO2 ...an IPCE up to 20%. 15. SUBJECT TERMS EOARD, organic solar cells , photovoltaics, carbon nanotubes 16. SECURITY CLASSIFICATION

The effect of curriculum changes and instructional techniques on science-reasoning skills among high school students

NASA Astrophysics Data System (ADS)

Newman, Joan T.

Any change, particularly on a large scale like a sequence change in a district with 75,000 students, is difficult. However, with the advent of the new TAKS science test and the new requirements for high school graduation in the state of Texas, educators and students alike are engaged in innovative educational approaches to meet these requirements. This study investigated a different, non-traditional science sequence to investigate relationships among secondary core-science course sequencing, student science-reasoning performance, and classroom pedagogy. The methodology adopted in the study led to a deeper understanding of the successes and challenges faced by teachers in teaching conceptual physics and chemistry to 8 th and 9th grade students. The qualitative analysis suggested a difference in pedagogy employed by middle and high school science teachers and a need for secondary science teachers to enhance their content knowledge and pedagogical skills, as well as change their underlying attitudes and beliefs about the abilities of students. The study examined scores of 495 randomly chosen students following three different matriculation patterns within one large independent school district. The study indicated that students who follow a sequence with 9th grade IPC generally increase their science-reasoning skills as demonstrated on the 10th grade TAKS science test when these scores are compared with those of students who do not have 9th grade IPC in the science sequence.

[Effect of Corynebacterium non diphtheriae on functional activity and apoptosis of macrophages].

PubMed

Kharseeva, G G; Voronina, N A; Tiukavkina, S Iu

2014-01-01

Determine the ability of Corynebacterium non diphtheriae to induce phagocytosis and apoptosis of macrophages and evaluate regulatory effect of nuetrophilokines (NPK) induced by Corynebacterium non diphtheriae on these processes. The ability of Corynebacterium non diphtheriae, isolated from upper respiratory tract, skin and urogenital tract (UGT) were studied for the ability to induce phagocytosis and apoptosis of mice macrophages (MP; in vitro during staining by May-Grunwald with additional staining by Romanowsky-Giemsa) before and after the addition of NPK induced by Corynebacterium non diphtheriae. Phagocytic index (PI) was the same for all the Corynebacterium non diphtheriae species, phagocytic number (PN) and index of phagocytosis completion (IPC)--were minimal relative to corynebacteria isolated from UGT. All the studied corynebacteria species induced MP apoptosis; the most pronounced apoptogenic effect was detected in Corynebacterium pseudotuberculosis isolated from UGT. NPK increased PN against corynebacteria isolated from the studied biotopes, IPC--only during studies of corynebacteria isolated from skin. The effect of NPK resulted in a reduction of apoptogenic effect for almost all the Corynebacterium non diphtheriae, regardless of the isolation location. A pronounced apoptogenic effect and insufficiency of phagocytosis processes induced by corynebacteria are the means of realization of Corynebacterium non diphtheriae pathogenic effect. NPK use is possible for immune correction of immune deficiency conditions developing against the background of diseases determined by Corynebacterium non diphtheriae.

Interprofessional education in dental education: An international perspective.

PubMed

Davis, J M; Janczukowicz, J; Stewart, J; Quinn, B; Feldman, C A

2018-03-01

Interprofessional collaborative care (IPC) is defined as working within and across healthcare disciplines and is considered essential to achieve a more inclusive, patient-centred care, provide a means to support patient safety and address global healthcare provider shortages. Interprofessional education (IPE) provides the knowledge and experience students need to achieve these goals. ADEE/ADEA held a joint international meeting 8-9 May 2017, with IPE being one of four topic areas discussed. The highly interactive workshop format, where "everyone was an expert," supported discussion, sharing and creative problem-solving of over seventy-one participants from twenty-nine countries. IPE participants broke out into five groups over a two-day period discussing three main areas: challenges and barriers to implementing IPE within their institution or country; discussion of successful models of introducing and assessing IPE initiatives, and exploring best practices and next steps for implementation for each group member. A mind-mapping model was used to graphically display participants' thoughts and suggestions. Key themes, revealed through the visual mind maps and discussion, included the following: IPE should lead to and enhance patient-centred care; student involvement is key to IPE success; faculty development and incentives can facilitate adoption and implementation of IPE; the role of a "champion" and leadership structure and commitment is important to move IPE forward; and IPE must be tailored to the unique issues found in each country. Overall, there was a high level of interest to continue both collaboration and discussion to learn from others beyond the London meeting. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

40 CFR 180.319 - Interim tolerances.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Herbicide 0.2 Beet, sugar Isopropyl carbanilate (IPC) Herbicide 5.0 Alfalfa, hay; clover, hay; and grass, hay 2.0 Alfalfa, forage; clover, forage; and grass, forage 0.1 Flax, seed; lentil; lettuce, head and...

40 CFR 180.319 - Interim tolerances.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Herbicide 0.2 Beet, sugar Isopropyl carbanilate (IPC) Herbicide 5.0 Alfalfa, hay; clover, hay; and grass, hay 2.0 Alfalfa, forage; clover, forage; and grass, forage 0.1 Flax, seed; lentil; lettuce, head and...

Evidence for heterogeneity of astrocyte de-differentiation in vitro: astrocytes transform into intermediate precursor cells following induction of ACM from scratch-insulted astrocytes.

PubMed

Yang, Hao; Qian, Xin-Hong; Cong, Rui; Li, Jing-wen; Yao, Qin; Jiao, Xi-Ying; Ju, Gong; You, Si-Wei

2010-04-01

Our previous study definitely demonstrated that the mature astrocytes could undergo a de-differentiation process and further transform into pluripotential neural stem cells (NSCs), which might well arise from the effect of diffusible factors released from scratch-insulted astrocytes. However, these neurospheres passaged from one neurosphere-derived from de-differentiated astrocytes possessed a completely distinct characteristic in the differentiation behavior, namely heterogeneity of differentiation. The heterogeneity in cell differentiation has become a crucial but elusive issue. In this study, we show that purified astrocytes could de-differentiate into intermediate precursor cells (IPCs) with addition of scratch-insulted astrocyte-conditioned medium (ACM) to the culture, which can express NG2 and A2B5, the IPCs markers. Apart from the number of NG2(+) and A2B5(+) cells, the percentage of proliferative cells as labeled with BrdU progressively increased with prolonged culture period ranging from 1 to 10 days. Meanwhile, the protein level of A2B5 in cells also increased significantly. These results revealed that not all astrocytes could de-differentiate fully into NSCs directly when induced by ACM, rather they generated intermediate or more restricted precursor cells that might undergo progressive de-differentiation to generate NSCs.

Morphological analysis of GeTe in inline phase change switches

DOE Office of Scientific and Technical Information (OSTI.GOV)

King, Matthew R., E-mail: matthew.king2@ngc.com; Department of Materials Science and Engineering, North Carolina State University, Raleigh, North Carolina 27695; El-Hinnawy, Nabil

2015-09-07

Crystallization and amorphization phenomena in indirectly heated phase change material-based devices were investigated. Scanning transmission electron microscopy was utilized to explore GeTe phase transition processes in the context of the unique inline phase change switch (IPCS) architecture. A monolithically integrated thin film heating element successfully converted GeTe to ON and OFF states. Device cycling prompted the formation of an active area which sustains the majority of structural changes during pulsing. A transition region on both sides of the active area consisting of polycrystalline GeTe and small nuclei (<15 nm) in an amorphous matrix was also observed. The switching mechanism, determined bymore » variations in pulsing parameters, was shown to be predominantly growth-driven. A preliminary model for crystallization and amorphization in IPCS devices is presented.« less

A novel input-parasitic compensation technique for a nanopore-based CMOS DNA detection sensor

NASA Astrophysics Data System (ADS)

Kim, Jungsuk

2016-12-01

This paper presents a novel input-parasitic compensation (IPC) technique for a nanopore-based complementary metal-oxide-semiconductor (CMOS) DNA detection sensor. A resistive-feedback transimpedance amplifier is typically adopted as the headstage of a DNA detection sensor to amplify the minute ionic currents generated from a nanopore and convert them to a readable voltage range for digitization. But, parasitic capacitances arising from the headstage input and the nanopore often cause headstage saturation during nanopore sensing, thereby resulting in significant DNA data loss. To compensate for the unwanted saturation, in this work, we propose an area-efficient and automated IPC technique, customized for a low-noise DNA detection sensor, fabricated using a 0.35- μm CMOS process; we demonstrated this prototype in a benchtop test using an α-hemolysin ( α-HL) protein nanopore.

Accumulating Evidence for the Association and Shared Pathogenic Mechanisms between Psoriasis and Cardiovascular–Related Co-morbidities

PubMed Central

Shlyankevich, Julia; Mehta, Nehal N.; Krueger, James G.; Strober, Bruce; Gudjonsson, Johann E.; Qureshi, Abrar A.; Tebbey, Paul W.; Kimball, Alexandra Boer

2014-01-01

The International Psoriasis Council (IPC), a global non-profit organization dedicated to advancing psoriasis research and treatment, led an initiative to better define the association of various cardiometabolic comorbidities with psoriasis. In November 2013, a workshop was held in Boston, MA. By assembling a panel of global dermatology, immunology and cardiovascular experts, the objective was to better define the current status of the science that explains the association of psoriasis with various cardiometabolic-related comorbidities. IPC has played a historical role in associating psoriasis with various comorbidities by integrating multidisciplinary expertise to advance the scientific and clinical knowledge through publications and clinical trials. This report synthesizes the current understanding of psoriasis with various cardiometabolic risk factors by exploring the potential shared pathogenic mechanisms and genetic connectivity. PMID:25149424

[Application of reversed-phase ion-pair chromatography for universal estimation of octanol-water partition coefficients of acid, basic and amphoteric drugs].

PubMed

Zhu, Hui; Yang, Ri-Fang; Yun, Liu-Hong; Jiang, Yu; Li, Jin

2009-09-01

This paper is to establish a reversed-phase ion-pair chromatography (RP-IPC) method for universal estimation of the octanol/water partition coefficients (logP) of a wide range of structurally diverse compounds including acidic, basic, neutral and amphoteric species. The retention factors corresponding to 100% water (logk(w)) were derived from the linear part of the logk'/phi relationship, using at least four isocratic logk' values containing different organic compositions. The logk(w) parameters obtained were close to the corresponding logP values obtained with the standard "shake flask" methods. The mean deviation for test drugs is 0.31. RP-IPC with trifluoroacetic acid as non classic ion-pair agents can be applicable to determine the logP values for a variety of drug-like molecules with increased accuracy.

Control of interfacial charge-transfer interaction of dye and p-CuI in solid-state dye-sensitized solar cells

NASA Astrophysics Data System (ADS)

Moribe, Shinya; Kato, Naohiko; Higuchi, Kazuo; Mizumoto, Katsuyoshi; Toyoda, Tatsuo

2017-04-01

We systematically investigated the photovoltaic and absorption characteristics of solid-state dye-sensitized solar cells with CuI to elucidate the impact of the interaction between the dye and CuI. For the ruthenium complex N719, the incident photon-to-current conversion efficiency (IPCE) on the longer-wavelength side decreased owing to the change of the metal-to-ligand charge transfer (CT) of N719 due to the interaction between the thiocyanate groups of N719 and CuI. In contrast, when D149 — which included rhodanine groups — was used, the interaction with CuI and the resultant CT increased the IPCE. The results provide a new strategy for improving the photovoltaic performance by controlling the interfacial CT between the dye and CuI.

Environmental scan of infection prevention and control practices for containment of hospital-acquired infectious disease outbreaks in acute care hospital settings across Canada.

PubMed

Ocampo, Wrechelle; Geransar, Rose; Clayden, Nancy; Jones, Jessica; de Grood, Jill; Joffe, Mark; Taylor, Geoffrey; Missaghi, Bayan; Pearce, Craig; Ghali, William; Conly, John

2017-10-01

Ward closure is a method of controlling hospital-acquired infectious diseases outbreaks and is often coupled with other practices. However, the value and efficacy of ward closures remains uncertain. To understand the current practices and perceptions with respect to ward closure for hospital-acquired infectious disease outbreaks in acute care hospital settings across Canada. A Web-based environmental scan survey was developed by a team of infection prevention and control (IPC) experts and distributed to 235 IPC professionals at acute care sites across Canada. Data were analyzed using a mixed-methods approach of descriptive statistics and thematic analysis. A total of 110 completed responses showed that 70% of sites reported at least 1 outbreak during 2013, 44% of these sites reported the use of ward closure. Ward closure was considered an "appropriate," "sometimes appropriate," or "not appropriate" strategy to control outbreaks by 50%, 45%, and 5% of participants, respectively. System capacity issues and overall risk assessment were main factors influencing the decision to close hospital wards following an outbreak. Results suggest the use of ward closure for containment of hospital-acquired infectious disease outbreaks in Canadian acute care health settings is mixed, with outbreak control methods varying. The successful implementation of ward closure was dependent on overall support for the IPC team within hospital administration. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

PATHOPHYSIOLOGICAL CONSEQUENCES OF TAT-HKII PEPTIDE ADMINISTRATION ARE INDEPENDENT OF IMPAIRED VASCULAR FUNCTION AND ENSUING ISCHEMIA

PubMed Central

Nederlof, Rianne; Xie, Chaoqin; Eerbeek, Otto; Koeman, Anneke; Milstein, Dan MJ; Hollmann, Markus W; Mik, Egbert G; Warley, Alice; Southworth, Richard; Akar, Fadi G.; Zuurbier, Coert J

2013-01-01

Rationale We have shown that partial dissociation of HKII from mitochondria in the intact heart using low dose (200 nM) TAT-HKII prevents the cardioprotective effects of ischemic preconditioning (IPC) whereas high-dose (10 μM) TAT-HKII administration results in rapid myocardial dysfunction, mitochondrial depolarization and disintegration. In this issue of Circulation Research, Pasdois et al argue that the deleterious effects of TAT-HKII administration on cardiac function are likely due to vasoconstriction and ensuing ischemia. Objective To investigate whether altered vascular function and ensuing ischemia recapitulate the deleterious effects of TAT-HKII in intact myocardium. Methods and Results Using a variety of complementary techniques, including mitochondrial membrane potential (ΔΨm) imaging, high-resolution optical action potential (AP) mapping, analysis of lactate production, NADH epifluorescence, lactate dehydrogenase (LDH) release, and electron microscopy, we provide direct evidence that refutes the notion that acute myocardial dysfunction by high-dose TAT-HKII peptide administration is a consequence of impaired vascular function. Moreover, we demonstrate that low-dose TAT-HKII treatment, which abrogates the protective effects of IPC, is not associated with ischemia or ischemic-injury. Conclusions Our findings challenge the notion that the effects of TAT-HKII are attributable to impaired vascular function and ensuing ischemia; thereby, lending further credence to the role of mitochondria bound HKII as a critical regulator of cardiac function, ischemia-reperfusion (IR) injury, and cardioprotection by IPC. PMID:23329797

Environmental assessment and investment strategies of provincial industrial sector in China — Analysis based on DEA model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Juan, E-mail: wangjuan_tju@163.com; Zhao, Tao; Zhang, Xiaohu

As an energy-intensive industry, the industrial sector consumes 70% of energy consumption and causes serious environmental pollution in China. Also, the government emphasized the promotion of R&D investment in the industrial sector in China's National Plan on Climate Change (2014–2020). It is meaningful and contributes to assessing energy and environmental performance, as well as R&D and industrial pollution control (IPC) investment strategies of China's industrial sector. A non-radial DEA model, as with natural and managerial disposability, was adopted to evaluate this from provincial and regional perspectives during the 2008–2012 period. Energy and environmental performance was evaluated by unified efficiency undermore » natural disposability (UEN), unified efficiency under managerial disposability (UEM), and unified efficiency under natural and managerial disposability (UENM). The empirical results indicated that Shandong and Hainan were efficient under natural and managerial disposability, while other provinces had the potential to improve their energy and environmental performance. The number of provinces that was fit for investments of R&D and IPC increased from 2008 to 2010, then decreased in 2011 and 2012. In spite of this, many provincial industrial sectors should make efforts to reduce pollution by investment on technology. Tianjin, Heilongjiang, Jiangxi and Henan were especially the best investment objects because investments of R&D and IPC turned to be effective for them during the whole study period. Moreover, western China had the highest average UENM, followed by eastern China and central China. Eastern China and central China were rewarding to expand investments. Coal consumption was the main factor to negatively affect unified efficiency whereas the increase in economic development level was primarily responsible for the improvement of unified efficiency. According to the results, differentiated suggestions to further improve energy and environmental performance were proposed.« less

Protection of adult rat cardiac myocytes from ischemic cell death: role of caveolar microdomains and delta-opioid receptors.

PubMed

Patel, Hemal H; Head, Brian P; Petersen, Heidi N; Niesman, Ingrid R; Huang, Diane; Gross, Garrett J; Insel, Paul A; Roth, David M

2006-07-01

The role of caveolae, membrane microenvironments enriched in signaling molecules, in myocardial ischemia is poorly defined. In the current study, we used cardiac myocytes prepared from adult rats to test the hypothesis that opioid receptors (OR), which are capable of producing cardiac protection in vivo, promote cardiac protection in cardiac myocytes in a caveolae-dependent manner. We determined protein expression and localization of delta-OR (DOR) using coimmunohistochemistry, caveolar fractionation, and immunoprecipitations. DOR colocalized in fractions with caveolin-3 (Cav-3), a structural component of caveolae in muscle cells, and could be immunoprecipitated by a Cav-3 antibody. Immunohistochemistry confirmed plasma membrane colocalization of DOR with Cav-3. Cardiac myocytes were subjected to simulated ischemia (2 h) or an ischemic preconditioning (IPC) protocol (10 min ischemia, 30 min recovery, 2 h ischemia) in the presence and absence of methyl-beta-cyclodextrin (MbetaCD, 2 mM), which binds cholesterol and disrupts caveolae. We also assessed the cardiac protective effects of SNC-121 (SNC), a selective DOR agonist, on cardiac myocytes with or without MbetaCD and MbetaCD preloaded with cholesterol. Ischemia, simulated by mineral oil layering to inhibit gas exchange, promoted cardiac myocyte cell death (trypan blue staining), a response blunted by SNC (37 +/- 3 vs. 59 +/- 3% dead cells in the presence and absence of 1 muM SNC, respectively, P < 0.01) or by use of the IPC protocol (35 +/- 4 vs. 62 +/- 3% dead cells, P < 0.01). MbetaCD treatment, which disrupted caveolae (as detected by electron microscopy), fully attenuated the protective effects of IPC or SNC, resulting in cell death comparable to that of the ischemic group. By contrast, SNC-induced protection was not abrogated in cells incubated with cholesterol-saturated MbetaCD, which maintained caveolae structure and function. These findings suggest a key role for caveolae, perhaps through enrichment of signaling molecules, in contributing to protection of cardiac myocytes from ischemic damage.

The noble gas xenon induces pharmacological preconditioning in the rat heart in vivo via induction of PKC-ɛ and p38 MAPK

PubMed Central

Weber, Nina C; Toma, Octavian; Wolter, Jessica I; Obal, Detlef; Müllenheim, Jost; Preckel, Benedikt; Schlack, Wolfgang

2004-01-01

Xenon is an anesthetic with minimal hemodynamic side effects, making it an ideal agent for cardiocompromised patients. We investigated if xenon induces pharmacological preconditioning (PC) of the rat heart and elucidated the underlying molecular mechanisms. For infarct size measurements, anesthetized rats were subjected to 25 min of coronary artery occlusion followed by 120 min of reperfusion. Rats received either the anesthetic gas xenon, the volatile anesthetic isoflurane or as positive control ischemic preconditioning (IPC) during three 5-min periods before 25-min ischemia. Control animals remained untreated for 45 min. To investigate the involvement of protein kinase C (PKC) and p38 mitogen-activated protein kinase (MAPK), rats were pretreated with the PKC inhibitor calphostin C (0.1 mg kg−1) or the p38 MAPK inhibitor SB203580 (1 mg kg−1). Additional hearts were excised for Western blot and immunohistochemistry. Infarct size was reduced from 50.9±16.7% in controls to 28.1±10.3% in xenon, 28.6±9.9% in isoflurane and to 28.5±5.4% in IPC hearts. Both, calphostin C and SB203580, abolished the observed cardioprotection after xenon and isoflurane administration but not after IPC. Immunofluorescence staining and Western blot assay revealed an increased phosphorylation and translocation of PKC-ɛ in xenon treated hearts. This effect could be blocked by calphostin C but not by SB203580. Moreover, the phosphorylation of p38 MAPK was induced by xenon and this effect was blocked by calphostin C. In summary, we demonstrate that xenon induces cardioprotection by PC and that activation of PKC-ɛ and its downstream target p38 MAPK are central molecular mechanisms involved. Thus, the results of the present study may contribute to elucidate the beneficial cardioprotective effects of this anesthetic gas. PMID:15644876

Anti-plasmodial activity of Norcaesalpin D and extracts of four medicinal plants used traditionally for treatment of malaria.

PubMed

Nondo, Ramadhani Selemani Omari; Moshi, Mainen Julius; Erasto, Paul; Masimba, Pax Jessey; Machumi, Francis; Kidukuli, Abdul Waziri; Heydenreich, Matthias; Zofou, Denis

2017-03-24

Malaria is an old life-threatening parasitic disease that is still affecting many people, mainly children living in sub-Saharan Africa. Availability of effective antimalarial drugs played a significant role in the treatment and control of malaria. However, recent information on the emergence of P. falciparum parasites resistant to one of the artemisinin-based combination therapies suggests the need for discovery of new drug molecules. Therefore, this study aimed to evaluate the antiplasmodial activity of extracts, fractions and isolated compound from medicinal plants traditionally used in the treatment of malaria in Tanzania. Dry powdered plant materials were extracted by cold macerations using different solvents. Norcaesalpin D was isolated by column chromatography from dichloromethane root extract of Caesalpinia bonducella and its structure was assigned based on the spectral data. Crude extracts, fractions and isolated compound were evaluated for antiplasmodial activity against chloroquine-sensitive P. falciparum (3D7), chloroquine-resistant P. falciparum (Dd2, K1) and artemisinin-resistant P. falciparum (IPC 5202 Battambang, IPC 4912 Mondolkiri) strains using the parasite lactate dehydrogenase assay. The results indicated that extracts of Erythrina schliebenii, Holarrhena pubescens, Dissotis melleri and C. bonducella exhibited antiplasmodial activity against Dd2 parasites. Ethanolic root extract of E. schliebenii had an IC 50 of 1.87 μg/mL while methanolic and ethanolic root extracts of H. pubescens exhibited an IC 50  = 2.05 μg/mL and IC 50  = 2.43 μg/mL, respectively. Fractions from H. pubescens and C. bonducella roots were found to be highly active against K1, Dd2 and artemisinin-resistant parasites. Norcaesalpin D from C. bonducella root extract was active with IC 50 of 0.98, 1.85 and 2.13 μg/mL against 3D7, Dd2 and IPC 4912-Mondolkiri parasites, respectively. Antiplasmodial activity of norcaesalpin D and extracts of E. schliebenii, H. pubescens, D. melleri and C. bonducella reported in this study requires further attention for the discovery of antimalarial lead compounds for future drug development.

Protocol of the Australasian Malignant Pleural Effusion-2 (AMPLE-2) trial: a multicentre randomised study of aggressive versus symptom-guided drainage via indwelling pleural catheters.

PubMed

Azzopardi, Maree; Thomas, Rajesh; Muruganandan, Sanjeevan; Lam, David C L; Garske, Luke A; Kwan, Benjamin C H; Rashid Ali, Muhammad Redzwan S; Nguyen, Phan T; Yap, Elaine; Horwood, Fiona C; Ritchie, Alexander J; Bint, Michael; Tobin, Claire L; Shrestha, Ranjan; Piccolo, Francesco; De Chaneet, Christian C; Creaney, Jenette; Newton, Robert U; Hendrie, Delia; Murray, Kevin; Read, Catherine A; Feller-Kopman, David; Maskell, Nick A; Lee, Y C Gary

2016-07-05

Malignant pleural effusions (MPEs) can complicate most cancers, causing dyspnoea and impairing quality of life (QoL). Indwelling pleural catheters (IPCs) are a novel management approach allowing ambulatory fluid drainage and are increasingly used as an alternative to pleurodesis. IPC drainage approaches vary greatly between centres. Some advocate aggressive (usually daily) removal of fluid to provide best symptom control and chance of spontaneous pleurodesis. Daily drainages however demand considerably more resources and may increase risks of complications. Others believe that MPE care is palliative and drainage should be performed only when patients become symptomatic (often weekly to monthly). Identifying the best drainage approach will optimise patient care and healthcare resource utilisation. A multicentre, open-label randomised trial. Patients with MPE will be randomised 1:1 to daily or symptom-guided drainage regimes after IPC insertion. Patient allocation to groups will be stratified for the cancer type (mesothelioma vs others), performance status (Eastern Cooperative Oncology Group status 0-1 vs ≥2), presence of trapped lung (vs not) and prior pleurodesis (vs not). The primary outcome is the mean daily dyspnoea score, measured by a 100 mm visual analogue scale (VAS) over the first 60 days. Secondary outcomes include benefits on physical activity levels, rate of spontaneous pleurodesis, complications, hospital admission days, healthcare costs and QoL measures. Enrolment of 86 participants will detect a mean difference of VAS score of 14 mm between the treatment arms (5% significance, 90% power) assuming a common between-group SD of 18.9 mm and a 10% lost to follow-up rate. The Sir Charles Gairdner Group Human Research Ethics Committee has approved the study (number 2015-043). Results will be published in peer-reviewed journals and presented at scientific meetings. ACTRN12615000963527; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Ambivalence About Interpersonal Problems and Traits Predicts Cross-Situational Variability of Social Behavior.

PubMed

Erickson, Thane M; Newman, Michelle G; Peterson, Jessica; Scarsella, Gina

2015-08-01

Multiple theoretical perspectives suggest that maladjusted personality is characterized by not only distress, but also opposing or "ambivalent" self-perceptions and behavioral lability across social interactions. However, the degree to which ambivalence about oneself predicts cross-situational variability in social behavior has not been examined empirically. Using the interpersonal circumplex (IPC) as a nomological framework, the present study investigated the extent to which endorsing opposing or "ambivalent" tendencies on IPC measures predicted variability in social behavior across a range of hypothetical interpersonal scenarios (Part 1; N = 288) and naturalistic social interactions (Part 2; N = 192). Ambivalent responding for interpersonal problems and traits was associated with measures of distress, maladaptive interpersonal tendencies, and greater variability of social behavior across both hypothetical and daily social interactions, though more consistently for interpersonal problems. More conservative tests suggested that ambivalence predicted some indexes of behavioral variability even when accounting for mean levels and squared means of social behaviors, vector length, gender, and depressive symptoms. Results suggest that processes theorized as typifying personality disorder may apply more broadly to personality maladjustment occurring outside of clinical samples. © 2014 Wiley Periodicals, Inc.

The dependence of the soft X ray spectral slope with radio property, luminosity, and redshift, for a large sample of AGN from the Einstein IPC data base

NASA Technical Reports Server (NTRS)

Brunner, H.; Worrall, D. M.; Wilkes, Belinda J.; Elvis, Martin

1989-01-01

The dependence of the soft X-ray spectral slope on radio, optical and X-ray properties, and on redshift are reported for a large sample of Active Galactic Nuclei (AGN). The sample includes 317 optically and radio-selected AGN from a preliminary version of the Einstein Imaging Proportional Counter (IPC) quasar and AGN data base. The main results are: the difference in X-ray slope between radio-loud and radio-quiet AGN were confirmed for an independent and much larger sample of sources; a difference in X-ray slope between flat and steep radio spectrum AGN is observed only in high luminosity sub-sample; in flat radio spectrum AGNs there is an indication for a dependence of the X-ray spectral index on X-ray luminosity redshift and alpha sub 0x.

The x ray properties of a large, uniform QSO sample: Einstein observations of the LBQS

NASA Technical Reports Server (NTRS)

Margon, B.; Anderson, S. F.; Xu, X.; Green, P. J.; Foltz, C. B.

1992-01-01

Although there are large numbers of Quasi Stellar Objects (QSO's) now observed in X rays, extensive X-ray observations of uniformly selected, 'complete' QSO samples are more rare. The Large Bright QSO Survey (LBQS) consists of about 1000 objects with well understood properties, most brighter than B = 18.8 and thus amenable to X-ray detections in relatively brief exposures. The sample is thought to be highly complete in the range 0.2 less than z less than 3.3, a significantly broader interval than many other surveys. The Einstein IPC observed 150 of these objects, mostly serendipitously, during its lifetime. We report the results of an analysis of these IPC data, considering not only the 20 percent of the objects we find to have positive X-ray detections, but also the ensemble X-ray properties derived by 'image stacking'.

The Einstein Slew Survey

NASA Technical Reports Server (NTRS)

Elvis, Martin; Plummer, David; Schachter, Jonathan; Fabbiano, G.

1992-01-01

A catalog of 819 sources detected in the Einstein IPC Slew Survey of the X-ray sky is presented; 313 of the sources were not previously known as X-ray sources. Typical count rates are 0.1 IPC count/s, roughly equivalent to a flux of 3 x 10 exp -12 ergs/sq cm s. The sources have positional uncertainties of 1.2 arcmin (90 percent confidence) radius, based on a subset of 452 sources identified with previously known pointlike X-ray sources (i.e., extent less than 3 arcmin). Identifications based on a number of existing catalogs of X-ray and optical objects are proposed for 637 of the sources, 78 percent of the survey (within a 3-arcmin error radius) including 133 identifications of new X-ray sources. A public identification data base for the Slew Survey sources will be maintained at CfA, and contributions to this data base are invited.

[The treatment of postpartum depression with interpersonal psychotherapy and interpersonal counseling].

PubMed

Stuart, Scott; Clark, Elizabeth

2008-01-01

Perinatal depression is a prevalent disorder with a high degree of morbidity for both mother and infant. There are now empirically validated treatments for both postpartum depression and depression during pregnancy. Among these is Interpersonal Psychotherapy (IPT), which has been shown to be effective for postpartum depression across the spectrum of mild to severe depression. In fact, the limited evidence of efficacy for medication and concern about medication side effects have led some to suggest that IPT should be the first line treatment for depressed breastfeeding women. There are similar concerns about medication usage during pregnancy. Recent clinical and research experience also suggest that Interpersonal Counseling (IPC) may be effective for selected postpartum women as well. IPC, an abbreviated form of IPT, appears to be effective for mild to moderate depression, and has the potential advantage of being more amenable to delivery in primary care or OB settings.

Evaluating the interpersonal content of the MMPI-2-RF Interpersonal Scales.

PubMed

Ayearst, Lindsay E; Sellbom, Martin; Trobst, Krista K; Bagby, R Michael

2013-01-01

Convergence between the MMPI-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008) interpersonal scales and 2 interpersonal circumplex (IPC) measures was examined. University students (N = 405) completed the MMPI-2 and 2 IPC measures, the Interpersonal Adjectives Scales Revised Big Five Version (IASR-B5; Trapnell & Wiggins, 1990) and the Inventory of Interpersonal Problems Circumplex (IIP-C; Horowitz, Alden, Wiggins, & Pincus, 2000). Internal consistency was adequate for 3 of the 6 scales investigated. The majority of scales were located in their hypothesized locations, although magnitude of correlations was somewhat weaker than anticipated, partly owing to restricted range from using a healthy sample. The expected pattern of correlations that defines a circular matrix was demonstrated, lending support for the convergent and discriminant validity of the MMPI-2-RF interpersonal scales with respect to the assessment of interpersonal traits and problems.

Acute oxygenation changes on ischemic foot of a novel intermittent pneumatic compression device and of an existing sequential device in severe peripheral arterial disease

PubMed Central

2014-01-01

Background Intermittent pneumatic compression (IPC) improves haemodynamics in peripheral arterial disease (PAD), but its effects on foot perfusion were scarcely studied. In severe PAD patients we measured the foot oxygenation changes evoked by a novel intermittent IPC device (GP), haemodynamics and compliance to the treatment. Reference values were obtained by a sequential foot-calf device (SFC). Methods Twenty ischemic limbs (Ankle-Brachial Index = 0.5 ± 0.2) of 12 PAD patients (7 male, age: 74.5 ± 10.8 y) with an interval of 48 ± 2 hours received a 35 minute treatment in supine position with two IPC devices: i) a Gradient Pump (GP), which slowly inflates a single thigh special sleeve and ii) an SFC (ArtAssist®, ACI Medical, San Marcos, CA, USA), which rapidly inflates two foot-calf sleeves. Main outcome measure: changes of oxygenated haemoglobin at foot (HbO2foot) by continuous near-infrared spectroscopy recording and quantified as area-under-curve (AUC) for periods of 5 minutes. Other measures: haemodynamics by echo-colour Doppler (time average velocity (TAV) and blood flow (BF) in the popliteal artery and in the femoral vein), patient compliance by a properly developed form. Results All patients completed the treatment with GP, 9 with SFC. HbO2foot during the working phase, considered as average value of the 5 minutes periods, increased with GP (AUC 458 ± 600 to 1216 ± 280) and decreased with SFC (AUC 231 ± 946 to −1088 ± 346), significantly for most periods (P < 0.05). The GP treatment was associated to significant haemodynamic changes from baseline to end of the treatment (TAV = 10.2 ± 3.3 to 13.5 ± 5.5 cm/sec, P = 0.004; BF = 452.0 ± 187.2 to 607.9 ± 237.8 ml/sec, P = 0.0001), not observed with SFC (TAV = 11.2 ± 3.4 to 11.8 ± 4.3 cm/sec; BF = 513.8 ± 203.7 to 505.9 ± 166.5 ml/min, P = n.s.). GP obtained a higher score of patient compliance (P < 0.0001). Conclusions A novel IPC thigh device, unlike a traditional SFC device, increased foot oxygenation in severe PAD, together with favourable haemodynamic response and high compliance to the treatment under the present experimental conditions. PMID:24684834

Enhanced photoelectrochemical performance and photocatalytic activity of ZnO/TiO2 nanostructures fabricated by an electrostatically modified electrospinning

NASA Astrophysics Data System (ADS)

Ramos, Pierre G.; Flores, Edson; Sánchez, Luis A.; Candal, Roberto J.; Hojamberdiev, Mirabbos; Estrada, Walter; Rodriguez, Juan

2017-12-01

In this work, ZnO/TiO2 nanostructures were fabricated by an electrostatically modified electrospinning technique using zinc acetate and commercially available TiO2-P25, polyvinyl alcohol, and a solvent. The ZnO/TiO2 nanostructures were fabricated on fluorine-doped tin oxide (FTO) glass substrate by electrospinning of aqueous solution containing different amounts of zinc acetate. The TiO2-P25 nanoparticles were immobilized within zinc acetate/PVA nanofibers. The precursor nanofibers obtained were converted into polycrystalline ZnO and ZnO/TiO2 by calcination at 600 °C. The structure and morphology of the obtained nanostructures were characterized by X-ray diffraction and field emission scanning electron microscopy, respectively. It was found that the TiO2-P25 nanoparticles were attached to the ZnO nanostructures, and the mean diameter of the nanoparticles forming the nanostructures ranged from 31 to 52 nm with increasing the amount of zinc acetate. The incident photon-to-current efficiency (IPCE) spectra of the fabricated nanostructures were measured in a three-electrode cell. The photocatalytic activities of ZnO and ZnO/TiO2 nanostructures were evaluated toward the decomposition of methyl orange. The obtained results evidenced that the coupling of TiO2 with ZnO enhanced the IPCE and improved the photocatalytic activity of ZnO. Particularly, the ZnO/TiO2 nanostructures fabricated with a zinc acetate-to-PVA ratio of 2:3 exhibited the highest IPCE and photocatalytic activity.

Determination of the Spectral Index in the Fission Spectrum Energy Regime

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, Amy Sarah

2016-05-16

Neutron reaction cross sections play a vital role in tracking the production and destruction of isotopes exposed to neutron fluence. They are central to the process of reconciling the initial and final atom inventories. Measurements of irradiated samples by radiochemical methods in tangent with an algorithm are used to evaluate the fluence a sample is exposed to over the course of the irradiation. This algorithm is the Isotope Production Code (IPC) created and used by the radiochemistry data assessment team at Los Alamos National Laboratory (LANL). An integral result is calculated by varying the total neutron fluence seen by amore » sample. A sample, irradiated in a critical assembly, will be exposed to a unique neutron flux defined by the neutron source and distance of the sample from the source. Neutron cross sections utilized are a function of the hardness of the neutron spectrum at the location of irradiation. A spectral index is used an indicator of the hardness of the neutron spectrum. Cross sections fit forms applied in IPC are collapsed from a LANL 30-group energy structure. Several decades of research and development have been performed to formalize the current IPC cross section library. Basis of the current fission spectrum neutron reaction cross section library is rooted in critical assembly experiments performed from the 1950’s through the early 1970’s at LANL. The focus of this report is development of the spectral index used an indicator of the hardness of the neutron spectrum in the fission spectrum energy regime.« less

Process control charts in infection prevention: Make it simple to make it happen.

PubMed

Wiemken, Timothy L; Furmanek, Stephen P; Carrico, Ruth M; Mattingly, William A; Persaud, Annuradha K; Guinn, Brian E; Kelley, Robert R; Ramirez, Julio A

2017-03-01

Quality improvement is central to Infection Prevention and Control (IPC) programs. Challenges may occur when applying quality improvement methodologies like process control charts, often due to the limited exposure of typical IPs. Because of this, our team created an open-source database with a process control chart generator for IPC programs. The objectives of this report are to outline the development of the application and demonstrate application using simulated data. We used Research Electronic Data Capture (REDCap Consortium, Vanderbilt University, Nashville, TN), R (R Foundation for Statistical Computing, Vienna, Austria), and R Studio Shiny (R Foundation for Statistical Computing) to create an open source data collection system with automated process control chart generation. We used simulated data to test and visualize both in-control and out-of-control processes for commonly used metrics in IPC programs. The R code for implementing the control charts and Shiny application can be found on our Web site (https://github.com/ul-research-support/spcapp). Screen captures of the workflow and simulated data indicating both common cause and special cause variation are provided. Process control charts can be easily developed based on individual facility needs using freely available software. Through providing our work free to all interested parties, we hope that others will be able to harness the power and ease of use of the application for improving the quality of care and patient safety in their facilities. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Infection prevention and control practice for Crimean-Congo hemorrhagic fever-A multi-center cross-sectional survey in Eurasia.

PubMed

Fletcher, Tom E; Gulzhan, Abuova; Ahmeti, Salih; Al-Abri, Seif S; Asik, Zahide; Atilla, Aynur; Beeching, Nick J; Bilek, Heval; Bozkurt, Ilkay; Christova, Iva; Duygu, Fazilet; Esen, Saban; Khanna, Arjun; Kader, Çiğdem; Mardani, Masoud; Mahmood, Faisal; Mamuchishvili, Nana; Pshenichnaya, Natalia; Sunbul, Mustafa; Yalcin, Tuğba Y; Leblebicioglu, Hakan

2017-01-01

Crimean Congo Hemorrhagic Fever (CCHF) is a life threatening acute viral infection that presents significant risk of nosocomial transmission to healthcare workers. Evaluation of CCHF infection prevention and control (IP&C) practices in healthcare facilities that routinely manage CCHF cases in Eurasia. A cross-sectional CCHF IP&C survey was designed and distributed to CCHF centers in 10 endemic Eurasian countries in 2016. Twenty-three responses were received from centers in Turkey, Pakistan, Russia, Georgia, Kosovo, Bulgaria, Oman, Iran, India and Kazakhstan. All units had dedicated isolation rooms for CCHF, with cohorting of confirmed cases in 15/23 centers and cohorting of suspect and confirmed cases in 9/23 centers. There was adequate personal protective equipment (PPE) in 22/23 facilities, with 21/23 facilities reporting routine use of PPE for CCHF patients. Adequate staffing levels to provide care reported in 14/23 locations. All centers reported having a high risk CCHFV nosocomial exposure in last five years, with 5 centers reporting more than 5 exposures. Education was provided annually in most centers (13/23), with additional training requested in PPE use (11/23), PPE donning/doffing (12/23), environmental disinfection (12/23) and waste management (14/23). Staff and patient safety must be improved and healthcare associated CCHF exposure and transmission eliminated. Improvements are recommended in isolation capacity in healthcare facilities, use of PPE and maintenance of adequate staffing levels. We recommend further audit of IP&C practice at individual units in endemic areas, as part of national quality assurance programs.

When the user is not the chooser: learning from stakeholder involvement in technology adoption decisions in infection control.

PubMed

Ahmad, R; Kyratsis, Y; Holmes, A

2012-07-01

Health systems need efficient and effective innovation decisions to provide maximum benefit to patients, particularly in a climate of financial constraints. Although evidence-based innovations exist for helping to address healthcare-associated infections, the uptake and implementation of these is highly variable and in some cases very slow. To investigate innovation adoption decisions and implementation processes from an organizational perspective, focusing on the implications of stakeholder involvement during the innovation process. Thirty-eight technology adoption decisions and implementation processes were examined through 121 qualitative interviews in 12 National Health Service healthcare organizations across England. Stakeholder involvement varied across organizations with decisions highly exclusive to the infection prevention and control (IPC) team, to highly inclusive of wider organizational members. The context, including organizational culture, previous experience, and logistical factors influenced the level of stakeholder engagement. The timing of stakeholder involvement in the process impacted on: (i) the range of innovations considered; (ii) the technologies selected, and (iii) the success of technology implementation. Cases of non-adoption, discontinued adoption, and of successful implementation are presented to share learning. The potential benefits of stakeholder involvement for 'successful' innovation adoption are presented including a goal-oriented framework for involvement. Key stakeholder involvement can lead to innovation adoption and implementation compatible with structural and cultural contexts, particularly when involvement crosses the phases of initiation, decision-making and implementation. Involving members of the wider healthcare organization can raise the profile of IPC and reinforce efforts to make IPC everybody's business. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Ion-pair chromatography coupled to inductively coupled plasma-mass spectrometry (IPC-ICP-MS) as a method for thiomolybdate speciation in natural waters.

PubMed

Lohmayer, Regina; Reithmaier, Gloria Maria Susanne; Bura-Nakić, Elvira; Planer-Friedrich, Britta

2015-03-17

Molybdenum precipitates preferentially under reducing conditions; therefore, its occurrence in sediment records is used as an indicator of paleoredox conditions. Although thiomolybdates (MoO4-xSx(2-) with x = 1-4) supposedly are necessary intermediates in the process of molybdenum precipitation under anoxic conditions, there is no information about their abundance in natural environments, because of a lack of element-specific methods with sufficiently low detection limits. Here, we optimized ion-pair chromatographic separation for coupling to an inductively coupled plasma-mass spectrometry detector (IPC-ICP-MS). 2-Propanol (10%-25% gradient) replaced the previously used acetonitrile (25%-75%) as the solvent, to reduce the carbon load into the plasma. In synthetic solutions, formation of thiomolybdates was found to occur spontaneously in the presence of excess sulfide and the degree of thiolation was highest at pH 7. Excess hydroxyl led to a transformation of thiomolybdates to molybdate. Under acidic to neutral conditions, precipitation of molybdenum and hydrolysis of tetrathiomolybdate were observed. Flash-freezing was found to be suitable to stabilize tetrathiomolybdate, with <4% transformation over more than two months. High ionic strengths matrices (>2 mM) negatively affected the detection of molybdate, which eluted mainly in the dead volume, but had no negative effect on higher thiolated molybdates. Detection limits were ∼10 nM. With the newly developed IPC-ICP-MS method, thiomolybdates were found to form spontaneously in euxinic marine waters after adding a molybdate spike and occur naturally in sulfidic geothermal waters.

Infection prevention and control practice for Crimean-Congo hemorrhagic fever—A multi-center cross-sectional survey in Eurasia

PubMed Central

Gulzhan, Abuova; Ahmeti, Salih; Al-Abri, Seif S.; Asik, Zahide; Atilla, Aynur; Beeching, Nick J.; Bilek, Heval; Bozkurt, Ilkay; Christova, Iva; Duygu, Fazilet; Esen, Saban; Khanna, Arjun; Kader, Çiğdem; Mardani, Masoud; Mahmood, Faisal; Mamuchishvili, Nana; Pshenichnaya, Natalia; Sunbul, Mustafa; Yalcin, Tuğba Y.; Leblebicioglu, Hakan

2017-01-01

Background Crimean Congo Hemorrhagic Fever (CCHF) is a life threatening acute viral infection that presents significant risk of nosocomial transmission to healthcare workers. Aim Evaluation of CCHF infection prevention and control (IP&C) practices in healthcare facilities that routinely manage CCHF cases in Eurasia. Methods A cross-sectional CCHF IP&C survey was designed and distributed to CCHF centers in 10 endemic Eurasian countries in 2016. Results Twenty-three responses were received from centers in Turkey, Pakistan, Russia, Georgia, Kosovo, Bulgaria, Oman, Iran, India and Kazakhstan. All units had dedicated isolation rooms for CCHF, with cohorting of confirmed cases in 15/23 centers and cohorting of suspect and confirmed cases in 9/23 centers. There was adequate personal protective equipment (PPE) in 22/23 facilities, with 21/23 facilities reporting routine use of PPE for CCHF patients. Adequate staffing levels to provide care reported in 14/23 locations. All centers reported having a high risk CCHFV nosocomial exposure in last five years, with 5 centers reporting more than 5 exposures. Education was provided annually in most centers (13/23), with additional training requested in PPE use (11/23), PPE donning/doffing (12/23), environmental disinfection (12/23) and waste management (14/23). Conclusions Staff and patient safety must be improved and healthcare associated CCHF exposure and transmission eliminated. Improvements are recommended in isolation capacity in healthcare facilities, use of PPE and maintenance of adequate staffing levels. We recommend further audit of IP&C practice at individual units in endemic areas, as part of national quality assurance programs. PMID:28886039

38 CFR 77.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... appropriate individuals; and (3) Coordination, Paralympic classification of athletes, athlete assessment... grant under this part. International Paralympic Committee (IPC) means the global governing body of the Paralympic movement. Large-scale adaptive sports program means (1) An adaptive sports program of a National...

Family physicians who provide intrapartum care and those who do not

PubMed Central

Klein, Michael C.; Kaczorowski, Janusz; Tomkinson, Jocelyn; Hearps, Stephen; Baradaran, Nazli; Brant, Rollin

2011-01-01

Abstract Objective To examine FPs’ attitudes toward birth for those providing intrapartum care (IPC) and those providing only antepartum care (APC). Design National, cross-sectional Web- and paper-based survey. Setting Canada. Participants A total of 897 Canadian FPs: 503 providing both IPC and APC (FPIs), 252 providing only APC but who previously provided IPC (FPPs), and 142 providing only APC who never provided IPC (FPNs). Main outcome measures Respondents’ views (measured on a 5-point Likert scale) on routine electronic fetal monitoring, epidural analgesia, routine episiotomy, doulas, pelvic floor benefits of cesarean section, approaches to reducing cesarean section rates, maternal choice and the mother’s role in her own child’s birth, care providers’ fears of vaginal birth for themselves or their partners, and safety by mode or place of birth. Results Results showed that FPIs and FPPs were more likely than FPNs were to take additional training or advanced life support courses. The FPIs consistently demonstrated more positive attitudes toward vaginal birth than did the other 2 groups. The FPPs and FPNs showed significantly more agreement with use of routine electronic fetal monitoring and routine epidural analgesia (P < .001). The FPIs displayed significantly more acceptance of doulas (P < .001) and more disagreement with the pelvic floor benefits of cesarean section than other FPs did (P < .001). The FPIs were significantly less fearful of vaginal birth for themselves or their partners than were FPPs and FPNs (P < .001). All FP groups agreed on rejection of elective cesarean section, in the absence of indications, for themselves or their partners and on support for vaginal birth in the presence of uterine scar. While all FP groups supported licensed midwifery, three-quarters thought home birth was more dangerous than hospital birth and showed ambivalence toward birth plans. Only 7.8% of FPIs would choose obstetricians for their own or their partners’ maternity care. Conclusion The FPIs had a more positive, evidence-based view of birth. It is likely that FPs providing only APC are influencing women in their practices toward a relatively negative view of birth before referral to obstetricians, FPIs, or midwives for the actual birth. The relatively negative views of birth held by FPs providing only APC need to be addressed in family practice education and in continuing education. PMID:21490345

Family physicians who provide intrapartum care and those who do not: very different ways of viewing childbirth.

PubMed

Klein, Michael C; Kaczorowski, Janusz; Tomkinson, Jocelyn; Hearps, Stephen; Baradaran, Nazli; Brant, Rollin

2011-04-01

To examine FPs' attitudes toward birth for those providing intrapartum care (IPC) and those providing only antepartum care (APC). National, cross-sectional Web- and paper-based survey. Canada. A total of 897 Canadian FPs: 503 providing both IPC and APC (FPIs), 252 providing only APC but who previously provided IPC (FPPs), and 142 providing only APC who never provided IPC (FPNs). Respondents' views (measured on a 5-point Likert scale) on routine electronic fetal monitoring, epidural analgesia, routine episiotomy, doulas, pelvic floor benefits of cesarean section, approaches to reducing cesarean section rates, maternal choice and the mother's role in her own child's birth, care providers' fears of vaginal birth for themselves or their partners, and safety by mode or place of birth. Results showed that FPIs and FPPs were more likely than FPNs were to take additional training or advanced life support courses. The FPIs consistently demonstrated more positive attitudes toward vaginal birth than did the other 2 groups. The FPPs and FPNs showed significantly more agreement with use of routine electronic fetal monitoring and routine epidural analgesia (P < .001). The FPIs displayed significantly more acceptance of doulas (P < .001) and more disagreement with the pelvic floor benefits of cesarean section than other FPs did (P < .001). The FPIs were significantly less fearful of vaginal birth for themselves or their partners than were FPPs and FPNs (P < .001). All FP groups agreed on rejection of elective cesarean section, in the absence of indications, for themselves or their partners and on support for vaginal birth in the presence of uterine scar. While all FP groups supported licensed midwifery, three-quarters thought home birth was more dangerous than hospital birth and showed ambivalence toward birth plans. Only 7.8% of FPIs would choose obstetricians for their own or their partners' maternity care. The FPIs had a more positive, evidence-based view of birth. It is likely that FPs providing only APC are influencing women in their practices toward a relatively negative view of birth before referral to obstetricians, FPIs, or midwives for the actual birth. The relatively negative views of birth held by FPs providing only APC need to be addressed in family practice education and in continuing education.

Engaging primary care practitioners in quality improvement: making explicit the program theory of an interprofessional education intervention

PubMed Central

2013-01-01

Background The scientific literature continues to advocate interprofessional collaboration (IPC) as a key component of primary care. It is recommended that primary care groups be created and configured to meet the healthcare needs of the patient population, as defined by patient demographics and other data analyses related to the health of the population being served. It is further recommended that the improvement of primary care services be supported by the delivery of feedback and performance measurements. This paper describes the theory underlying an interprofessional educational intervention developed in Quebec’s Montérégie region (Canada) for the purpose of improving chronic disease management in primary care. The objectives of this study were to explain explicitly the theory underlying this intervention, to describe its components in detail and to assess the intervention’s feasibility and acceptability. Method A program impact theory-driven evaluation approach was used. Multiple sources of information were examined to make explicit the theory underlying the education intervention: 1) a literature review and a review of documents describing the program’s development; 2) regular attendance at the project’s committee meetings; 3) direct observation of the workshops; 4) interviews of workshop participants; and 5) focus groups with workshop facilitators. Qualitative data collected were analysed using thematic analysis. Results The theoretical basis of the interprofessional education intervention was found to be work motivation theory and reflective learning. Five themes describing the workshop objectives emerged from the qualitative analysis of the interviews conducted with the workshop participants. These five themes were the importance of: 1) adopting a regional perspective, 2) reflecting, 3) recognizing gaps between practice and guidelines, 4) collaborating, and 5) identifying possible practice improvements. The team experienced few challenges implementing the intervention. However, the workshop’s acceptability was found to be very good. Conclusion Our observation of the workshop sessions and the interviews conducted with the participants confirmed that the objectives of the education intervention indeed targeted the improvement of interprofessional collaboration and quality of care. However, it is clear that a three-hour workshop alone cannot lead to major changes in practice. Long-term interventions are needed to support this complex change process. PMID:23514278

A TIERED APPROACH TO PERFORMING UNCERTAINTY ANALYSIS IN CONDUCTING EXPOSURE ANALYSIS FOR CHEMICALS

EPA Science Inventory

The WHO/IPCS draft Guidance Document on Characterizing and Communicating Uncertainty in Exposure Assessment provides guidance on recommended strategies for conducting uncertainty analysis as part of human exposure analysis. Specifically, a tiered approach to uncertainty analysis ...

MODEL HARMONIZATION POTENTIAL AND BENEFITS

EPA Science Inventory

The IPCS Harmonization Project, which is currently ongoing under the auspices of the WHO, in the context of chemical risk assessment or exposure modeling, does not imply global standardization. Instead, harmonization is thought of as an effort to strive for consistency among appr...

Blastema cells derived from New Zealand white rabbit's pinna carry stemness properties as shown by differentiation into insulin producing, neural, and osteogenic lineages representing three embryonic germ layers.

PubMed

Saeinasab, Morvarid; Matin, Maryam M; Rassouli, Fatemeh B; Bahrami, Ahmad Reza

2016-05-01

Stem cells (SCs) are known as undifferentiated cells with self-renewal and differentiation capacities. Regeneration is a phenomenon that occurs in a limited number of animals after injury, during which blastema tissue is formed. It has been hypothesized that upon injury, the dedifferentiation of surrounding tissues leads into the appearance of cells with SC characteristics. In present study, stem-like cells (SLCs) were obtained from regenerating tissue of New Zealand white rabbit's pinna and their stemness properties were examined by their capacity to differentiate toward insulin producing cells (IPCs), as well as neural and osteogenic lineages. Differentiation was induced by culture of SLCs in defined medium, and cell fates were monitored by specific staining, RT-PCR and flow cytometry assays. Our results revealed that dithizone positive cells, which represent IPCs, and islet-like structures appeared 1 week after induction of SLCs, and this observation was confirmed by the elevated expression of Ins, Pax6 and Glut4 at mRNA level. Furthermore, SLCs were able to express neural markers as early as 1 week after retinoic acid treatment. Finally, SLCs were able to differentiate into osteogenic lineage, as confirmed by Alizarin Red S staining and RT-PCR studies. In conclusion, SLCs, which could successfully differentiate into cells derived from all three germ layers, can be considered as a valuable model to study developmental biology and regenerative medicine.

Deliberating Tarceva: A case study of how British NHS managers decide whether to purchase a high-cost drug in the shadow of NICE guidance.

PubMed

Hughes, David; Doheny, Shane

2011-11-01

This paper examines audio-recorded data from meetings in which NHS managers decide whether to fund high-cost drugs for individual patients. It investigates the work of a Welsh individual patient commissioning (IPC) panel responsible for sanctioning the purchase of 'un-commissioned' treatments for exceptional cases. The case study presented highlights the changing rationales used for approving or denying a cancer drug, Tarceva, during a period when NICE first suggested it was not cost effective, but then changed its position in a final technology appraisal recommending use when the cost did not exceed that of an alternative product. Our data show how decisions taken in the shadow of NICE guidance remain complex and subject to local discretion. Guidance that takes time to prepare, is released in stages, and relates to particular disease stages, must be interpreted in the context of particular cases. The case-based IPC panel discourse stands in tension with the standardised population-based recommendations in guidance. Panel members, who based their decisions on the central notions of 'efficacy' and 'exceptionality', often struggled to apply NICE information on cost-effectiveness to their deliberations on efficacy (clinical effectiveness). The case study suggests that the complex nature of decision making makes standardization of outcomes very difficult to achieve, so that local professional judgement is likely to remain central to health care rationing at this level. Copyright © 2011 Elsevier Ltd. All rights reserved.

Expectations impact short-term memory through changes in connectivity between attention- and task-related brain regions.

PubMed

Sinke, Christopher; Forkmann, Katarina; Schmidt, Katharina; Wiech, Katja; Bingel, Ulrike

2016-05-01

Over the recent years, neuroimaging studies have investigated the neural mechanisms underlying the influence of expectations on perception. However, it seems equally reasonable to assume that expectations impact cognitive functions. Here we used fMRI to explore the role of expectations on task performance and its underlying neural mechanisms. 43 healthy participants were randomly assigned to two groups. Using verbal instructions, group 1 was led to believe that pain enhances task performance while group 2 was instructed that pain hampers their performance. All participants performed a Rapid-Serial-Visual-Presentation (RSVP) Task (target detection and short-term memory component) with or without concomitant painful heat stimulation during 3T fMRI scanning. As hypothesized, short-term memory performance showed an interaction between painful stimulation and expectation. Positive expectations induced stronger neural activation in the right inferior parietal cortex (IPC) during painful stimulation than negative expectation. Moreover, IPC displayed differential functional coupling with the left inferior occipital cortex under pain as a function of expectancy. Our data show that an individual's expectation can influence cognitive performance in a visual short-term memory task which is associated with activity and connectivity changes in brain areas implicated in attentional processing and task performance. Copyright © 2016. Published by Elsevier Ltd.

Effects of oral iron(III) hydroxide polymaltose complex supplementation on hemoglobin increase, cognitive function, affective behavior and scholastic performance of adolescents with varying iron status: a single centre prospective placebo controlled study.

PubMed

Devaki, Pallaki Baby; Chandra, Ranjit K; Geisser, Peter

2009-01-01

To assess the effects of iron supplementation on iron status, cognitive function, affective behavior and scholastic performance in adolescents with varying iron status. Adolescents of both sexes with varying iron status were allocated to four treatment groups by using inclusion criteria. Three of the four groups (iron deficient anemic, iron deficient and control supplement) received iron(III) hydroxide polymaltose complex (IPC, Maltofer) containing 100 mg of elemental iron 6 days a week for 8 months, while the fourth group (control placebo) was given a placebo. Hematological parameters, cognitive function, affective behavior and scholastic performance were assessed at baseline, 4 months and 8 months of supplementation. Cognitive and scholastic performance test scores for the three supplemented groups increased from baseline to 4 months and from 4 months to 8 months (with concomitant increases in hematological parameters), whereas no increase was observed in the placebo group. No increase was seen in affective behavior scores for any of the groups during or after supplementation. IPC supplementation for eight months yielded significant improvements in cognitive function and scholastic performance in Indian adolescents with and without iron deficiency and anemia.

Parent Health Literacy and Communication With Diabetes Educators in a Pediatric Diabetes Clinic: A Mixed Methods Approach.

PubMed

Howe, Carol J; Cipher, Daisha J; LeFlore, Judy; Lipman, Terri H

2015-01-01

Low health literacy is associated with poor communication between adults and providers, but little is known about how parents' health literacy influences communication in pediatric encounters. We examined how parent health literacy affected communication between parents and diabetes educators in a pediatric diabetes clinic. A mixed methods study was conducted including a cross-sectional survey of 162 parents and semi-structured interviews with a subsample of 24 parents of a child with Type 1 diabetes. Parent and child characteristics, parents' report of quality of communication, and parent health literacy were assessed. Logistic regression was performed to determine associations between health literacy and 4 subscales of the Interpersonal Processes of Care (IPC) survey; directed content analyses of interview data were completed. Although health literacy was not significantly associated with the IPC subscales, results from directed content analyses revealed different communication experiences for parents by health literacy classification. Low health literate parents were confused by diabetes jargon, preferred hands-on teaching, and wished for information to be communicated in simple language, broken down into key points, and repeated. Parents with adequate health literacy wanted comprehensive information communicated through ongoing dialogue. Findings indicate that learner-driven curricula may be most appropriate for diabetes education.

Analysis and interpretation of diffuse x-ray emission using data from the Einstein satellite

NASA Technical Reports Server (NTRS)

Helfand, David J.

1991-01-01

An ambitious program to create a powerful and accessible archive of the HEAO-2 Imaging Proportional Counter (IPC) database was outlined. The scientific utility of that database for studies of diffuse x ray emissions was explored. Technical and scientific accomplishments are reviewed. Three papers were presented which have major new scientific findings relevant to the global structure of the interstellar medium and the origin of the cosmic x ray background. An all-sky map of diffuse x ray emission was constructed.

Einstein x ray observations of the core of the Shapley Supercluster in northern Centaurus

NASA Technical Reports Server (NTRS)

Breen, Jeffrey; Raychaudhury, Somak; Forman, William; Jones, Christine

1994-01-01

We present Einstein x ray observations of the core of the Shapley Supercluster, one of the richest and densest known mass concentrations in the local (z less than 0.1) universe. We used Imaging Proportional Counter (IPC) observations supplemented with data from the Einstein Slew Survey to determine the locations and structure of mass concentrations in the region. An x ray map composed of IPC observations of the central (10 deg x 10 deg) region of the Shapley Supercluster is presented. We present evidence that the X-ray clusters observed within 5 deg of the core of the supercluster are on average brighter than those of corresponding richness class distributed throughout the sky. However, we measure no significant difference in the galaxy formation efficiency of these cluster of galaxies compared to other, more isolated clusters. We also find one previously uncataloged cluster-sized mass concentration in the core of the Shapley Supercluster. This new cluster, 'SC 1327-312', is relatively x ray bright (F(sub x) = 1.1 + or - 0.2 x 10(exp -11) erg sec(exp -1) cm(exp -2)) and L(sub x) = 1.1 + or - 0.2 x 10(exp 44) erg sec(exp -1) within 10 minutes, assuming z = 0.0477, H(sub 0) = 50, q(sub 0) = 0). As SC 1327-312 lies well within an Abell radius of the richness R = 4 cluster Shapley 8 (A3558), we suggest it may contribute to an artificially high galaxy count and richness classification for shapley 8. From slew data, we estimate an x ray luminosity for Shapley 8 which is just half the mean luminosity of the four other R = 4 clusters observed by the IPC, further suggesting the richness classification to be an overestimate.

Concept of turbines for ultrasupercritical, supercritical, and subcritical steam conditions

NASA Astrophysics Data System (ADS)

Mikhailov, V. E.; Khomenok, L. A.; Pichugin, I. I.; Kovalev, I. A.; Bozhko, V. V.; Vladimirskii, O. A.; Zaitsev, I. V.; Kachuriner, Yu. Ya.; Nosovitskii, I. A.; Orlik, V. G.

2017-11-01

The article describes the design features of condensing turbines for ultrasupercritical initial steam conditions (USSC) and large-capacity cogeneration turbines for super- and subcritical steam conditions having increased steam extractions for district heating purposes. For improving the efficiency and reliability indicators of USSC turbines, it is proposed to use forced cooling of the head high-temperature thermally stressed parts of the high- and intermediate-pressure rotors, reaction-type blades of the high-pressure cylinder (HPC) and at least the first stages of the intermediate-pressure cylinder (IPC), the double-wall HPC casing with narrow flanges of its horizontal joints, a rigid HPC rotor, an extended system of regenerative steam extractions without using extractions from the HPC flow path, and the low-pressure cylinder's inner casing moving in accordance with the IPC thermal expansions. For cogeneration turbines, it is proposed to shift the upper district heating extraction (or its significant part) to the feedwater pump turbine, which will make it possible to improve the turbine plant efficiency and arrange both district heating extractions in the IPC. In addition, in the case of using a disengaging coupling or precision conical bolts in the coupling, this solution will make it possible to disconnect the LPC in shifting the turbine to operate in the cogeneration mode. The article points out the need to intensify turbine development efforts with the use of modern methods for improving their efficiency and reliability involving, in particular, the use of relatively short 3D blades, last stages fitted with longer rotor blades, evaporation techniques for removing moisture in the last-stage diaphragm, and LPC rotor blades with radial grooves on their leading edges.

Chest Tube Drainage of the Pleural Space: A Concise Review for Pulmonologists.

PubMed

Porcel, José M

2018-04-01

Chest tube insertion is a common procedure usually done for the purpose of draining accumulated air or fluid in the pleural cavity. Small-bore chest tubes (≤14F) are generally recommended as the first-line therapy for spontaneous pneumothorax in non-ventilated patients and pleural effusions in general, with the possible exception of hemothoraces and malignant effusions (for which an immediate pleurodesis is planned). Large-bore chest drains may be useful for very large air leaks, as well as post-ineffective trial with small-bore drains. Chest tube insertion should be guided by imaging, either bedside ultrasonography or, less commonly, computed tomography. The so-called trocar technique must be avoided. Instead, blunt dissection (for tubes >24F) or the Seldinger technique should be used. All chest tubes are connected to a drainage system device: flutter valve, underwater seal, electronic systems or, for indwelling pleural catheters (IPC), vacuum bottles. The classic, three-bottle drainage system requires either (external) wall suction or gravity ("water seal") drainage (the former not being routinely recommended unless the latter is not effective). The optimal timing for tube removal is still a matter of controversy; however, the use of digital drainage systems facilitates informed and prudent decision-making in that area. A drain-clamping test before tube withdrawal is generally not advocated. Pain, drain blockage and accidental dislodgment are common complications of small-bore drains; the most dreaded complications include organ injury, hemothorax, infections, and re-expansion pulmonary edema. IPC represent a first-line palliative therapy of malignant pleural effusions in many centers. The optimal frequency of drainage, for IPC, has not been formally agreed upon or otherwise officially established. Copyright©2018. The Korean Academy of Tuberculosis and Respiratory Diseases.

Chest Tube Drainage of the Pleural Space: A Concise Review for Pulmonologists

PubMed Central

2018-01-01

Chest tube insertion is a common procedure usually done for the purpose of draining accumulated air or fluid in the pleural cavity. Small-bore chest tubes (≤14F) are generally recommended as the first-line therapy for spontaneous pneumothorax in non-ventilated patients and pleural effusions in general, with the possible exception of hemothoraces and malignant effusions (for which an immediate pleurodesis is planned). Large-bore chest drains may be useful for very large air leaks, as well as post-ineffective trial with small-bore drains. Chest tube insertion should be guided by imaging, either bedside ultrasonography or, less commonly, computed tomography. The so-called trocar technique must be avoided. Instead, blunt dissection (for tubes >24F) or the Seldinger technique should be used. All chest tubes are connected to a drainage system device: flutter valve, underwater seal, electronic systems or, for indwelling pleural catheters (IPC), vacuum bottles. The classic, three-bottle drainage system requires either (external) wall suction or gravity (“water seal”) drainage (the former not being routinely recommended unless the latter is not effective). The optimal timing for tube removal is still a matter of controversy; however, the use of digital drainage systems facilitates informed and prudent decision-making in that area. A drain-clamping test before tube withdrawal is generally not advocated. Pain, drain blockage and accidental dislodgment are common complications of small-bore drains; the most dreaded complications include organ injury, hemothorax, infections, and re-expansion pulmonary edema. IPC represent a first-line palliative therapy of malignant pleural effusions in many centers. The optimal frequency of drainage, for IPC, has not been formally agreed upon or otherwise officially established. PMID:29372629

The Internship Preparation Camp at the University of Maryland.

PubMed

Bontempo, Laura J; Frayha, Neda; Dittmar, Philip C

2017-01-01

Specialty-specific 'boot camps' boost the competence and confidence of medical school graduates as they prepare to enter a residency programme. We sought to evaluate the efficacy of a specialty-neutral Internship Preparation Camp (IPC) that we developed and made available to senior medical students at our medical school. The primary goal of the IPC is to educate students in the cognitive and procedural skills that are applicable to postgraduate year 1 trainees in all fields of specialisation. The curriculum was developed through input from senior medical students and faculty from multiple specialties. The course used small-group sessions and skills labs led by distinguished speakers from various professions (medicine, nursing and pharmacy) to teach senior medical students the information and skills common to the needs of all new physicians, regardless of the specialty they have chosen. The course was presented across 3 half-days and was offered just prior to graduation. Of 166 possible participants, 65 attended the course; 39 (60%) of them completed evaluations immediately following the course and 29 (45%) of participants completed a follow-up evaluation 3 months later. All respondents reported increased confidence in caring for patients in all subject areas taught. In the follow-up survey, 82% of respondents reported using information learned during the course on an hourly, daily or weekly basis in their care of patients. A specialty-neutral IPC is of benefit to its attendees, regardless of the medical specialty in which they train. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

SU-F-T-107: Correlations Between Dosimetric Indices of Pharyngeal Constrictors and Proximal Esophagus with Associated Patient-Reported Outcomes Six Months After Radiation Therapy for Head and Neck Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chera, B; Price, A; Kostich, M

Purpose: To compare the correlations between different dosimetric indices derived from the pharyngeal constrictor muscles and proximal esophagus with patient-reported difficulty in swallowing 6 months post radiotherapy using a novel patient reported outcome version of CTCAE (PRO-CTCAE). Methods: Forty-three patients with oropharyngeal squamous cell carcinoma were treated on a prospective multi-institutional study. All patients received de-intensified 60 Gy intensity modulated radiotherapy. We investigated correlations of individual patient dosimetric data of the superior (SPC), middle (MPC), inferior (IPC) pharyngeal constrictor muscles, the superior esophagus (SES), and the inferior esophagus (IES) to their self-reported 6 month post-treatment swallowing difficulty responses. Mild (≥more » Grade 1) swallowing difficulty responses were used as the clinical endpoint indicating response. The predictive efficacy of Dmean and dose-volume (VD) points were assessed through the area under the Receiver Operating Characteristic curve (ROC) and Odds Ratio (OR). Results: The SES and SPC had more favorable area under the curves (AUC) for the Dmean (0.62 and 0.70) while the Dmean to the IPC, MPC, and IES produced suboptimal AUCs (0.42, 0.48, and 0.52). Additionally, over the range of VD, the V54 and V55 for the SES and SPC demonstrated the highest AUCs: AUC(SES) = 0.76–0.73 and AUC(SPC) = 0.72–0.69, respectively. The IES, IPC, and MPC had worse AUC results over the range of VD. An optimal OR can be found when V54 = 96% for the SPC, where OR = 3.96 (1.07–14.62). Conclusion: The V45 and V55 of the SES and SPC had the highest correlation to the clinical endpoint compared to the commonly used dosimetric index, Dmean for both the esophagus and constrictor muscles. The reported dosimetric data demonstrates that new dosimetric indices may need to be considered in the setting of dose de-escalation and self-reported outcomes.« less

Impacts on Breastfeeding Practices of At-Scale Strategies That Combine Intensive Interpersonal Counseling, Mass Media, and Community Mobilization: Results of Cluster-Randomized Program Evaluations in Bangladesh and Viet Nam

PubMed Central

Menon, Purnima; Nguyen, Phuong Hong; Saha, Kuntal Kumar; Tran, Lan Mai; Sanghvi, Tina; Hajeebhoy, Nemat; Afsana, Kaosar; Haque, Raisul; Frongillo, Edward A.; Ruel, Marie T.; Rawat, Rahul

2016-01-01

Background Despite recommendations supporting optimal breastfeeding, the number of women practicing exclusive breastfeeding (EBF) remains low, and few interventions have demonstrated implementation and impact at scale. Alive & Thrive was implemented over a period of 6 y (2009–2014) and aimed to improve breastfeeding practices through intensified interpersonal counseling (IPC), mass media (MM), and community mobilization (CM) intervention components delivered at scale in the context of policy advocacy (PA) in Bangladesh and Viet Nam. In Bangladesh, IPC was delivered through a large non-governmental health program; in Viet Nam, it was integrated into government health facilities. This study evaluated the population-level impact of intensified IPC, MM, CM, and PA (intensive) compared to standard nutrition counseling and less intensive MM, CM, and PA (non-intensive) on breastfeeding practices in these two countries. Methods and Findings A cluster-randomized evaluation design was employed in each country. For the evaluation sample, 20 sub-districts in Bangladesh and 40 communes in Viet Nam were randomized to either the intensive or the non-intensive group. Cross-sectional surveys (n ~ 500 children 0–5.9 mo old per group per country) were implemented at baseline (June 7–August 29, 2010, in Viet Nam; April 28–June 26, 2010, in Bangladesh) and endline (June 16–August 30, 2014, in Viet Nam; April 20–June 23, 2014, in Bangladesh). Difference-in-differences estimates (DDEs) of impact were calculated, adjusting for clustering. In Bangladesh, improvements were significantly greater in the intensive compared to the non-intensive group for the proportion of women who reported practicing EBF in the previous 24 h (DDE 36.2 percentage points [pp], 95% CI 21.0–51.5, p < 0.001; prevalence in intensive group rose from 48.5% to 87.6%) and engaging in early initiation of breastfeeding (EIBF) (16.7 pp, 95% CI 2.8–30.6, p = 0.021; 63.7% to 94.2%). In Viet Nam, EBF increases were greater in the intensive group (27.9 pp, 95% CI 17.7–38.1, p < 0.001; 18.9% to 57.8%); EIBF declined (60.0% to 53.2%) in the intensive group, but less than in the non-intensive group (57.4% to 40.6%; DDE 10.0 pp, 95% CI −1.3 to 21.4, p = 0.072). Our impact estimates may underestimate the full potential of such a multipronged intervention because the evaluation lacked a “pure control” area with no MM or national/provincial PA. Conclusions At-scale interventions combining intensive IPC with MM, CM, and PA had greater positive impacts on breastfeeding practices in Bangladesh and Viet Nam than standard counseling with less intensive MM, CM, and PA. To our knowledge, this study is the first to document implementation and impacts of breastfeeding promotion at scale using rigorous evaluation designs. Strategies to design and deliver similar programs could improve breastfeeding practices in other contexts. Trial registration ClinicalTrials.gov NCT01678716 (Bangladesh) and NCT01676623 (Viet Nam) PMID:27780198

Impacts on Breastfeeding Practices of At-Scale Strategies That Combine Intensive Interpersonal Counseling, Mass Media, and Community Mobilization: Results of Cluster-Randomized Program Evaluations in Bangladesh and Viet Nam.

PubMed

Menon, Purnima; Nguyen, Phuong Hong; Saha, Kuntal Kumar; Khaled, Adiba; Kennedy, Andrew; Tran, Lan Mai; Sanghvi, Tina; Hajeebhoy, Nemat; Baker, Jean; Alayon, Silvia; Afsana, Kaosar; Haque, Raisul; Frongillo, Edward A; Ruel, Marie T; Rawat, Rahul

2016-10-01

Despite recommendations supporting optimal breastfeeding, the number of women practicing exclusive breastfeeding (EBF) remains low, and few interventions have demonstrated implementation and impact at scale. Alive & Thrive was implemented over a period of 6 y (2009-2014) and aimed to improve breastfeeding practices through intensified interpersonal counseling (IPC), mass media (MM), and community mobilization (CM) intervention components delivered at scale in the context of policy advocacy (PA) in Bangladesh and Viet Nam. In Bangladesh, IPC was delivered through a large non-governmental health program; in Viet Nam, it was integrated into government health facilities. This study evaluated the population-level impact of intensified IPC, MM, CM, and PA (intensive) compared to standard nutrition counseling and less intensive MM, CM, and PA (non-intensive) on breastfeeding practices in these two countries. A cluster-randomized evaluation design was employed in each country. For the evaluation sample, 20 sub-districts in Bangladesh and 40 communes in Viet Nam were randomized to either the intensive or the non-intensive group. Cross-sectional surveys (n ~ 500 children 0-5.9 mo old per group per country) were implemented at baseline (June 7-August 29, 2010, in Viet Nam; April 28-June 26, 2010, in Bangladesh) and endline (June 16-August 30, 2014, in Viet Nam; April 20-June 23, 2014, in Bangladesh). Difference-in-differences estimates (DDEs) of impact were calculated, adjusting for clustering. In Bangladesh, improvements were significantly greater in the intensive compared to the non-intensive group for the proportion of women who reported practicing EBF in the previous 24 h (DDE 36.2 percentage points [pp], 95% CI 21.0-51.5, p < 0.001; prevalence in intensive group rose from 48.5% to 87.6%) and engaging in early initiation of breastfeeding (EIBF) (16.7 pp, 95% CI 2.8-30.6, p = 0.021; 63.7% to 94.2%). In Viet Nam, EBF increases were greater in the intensive group (27.9 pp, 95% CI 17.7-38.1, p < 0.001; 18.9% to 57.8%); EIBF declined (60.0% to 53.2%) in the intensive group, but less than in the non-intensive group (57.4% to 40.6%; DDE 10.0 pp, 95% CI -1.3 to 21.4, p = 0.072). Our impact estimates may underestimate the full potential of such a multipronged intervention because the evaluation lacked a "pure control" area with no MM or national/provincial PA. At-scale interventions combining intensive IPC with MM, CM, and PA had greater positive impacts on breastfeeding practices in Bangladesh and Viet Nam than standard counseling with less intensive MM, CM, and PA. To our knowledge, this study is the first to document implementation and impacts of breastfeeding promotion at scale using rigorous evaluation designs. Strategies to design and deliver similar programs could improve breastfeeding practices in other contexts. ClinicalTrials.gov NCT01678716 (Bangladesh) and NCT01676623 (Viet Nam).

An Einstein Observatory SAO-based catalog of B-type stars

NASA Technical Reports Server (NTRS)

Grillo, F.; Sciortino, S.; Micela, G.; Vaiana, G. S.; Harnden, F. R., Jr.

1992-01-01

About 4000 X-ray images obtained with the Einstein Observatory are used to measure the 0.16-4.0 keV emission from 1545 B-type SAO stars falling in the about 10 percent of the sky surveyed with the IPC. Seventy-four detected X-ray sources with B-type stars are identified, and it is estimated that no more than 15 can be misidentified. Upper limits to the X-ray emission of the remaining stars are presented. In addition to summarizing the X-ray measurements and giving other relevant optical data, the present extensive catalog discusses the reduction process and analyzes selection effects associated with both SAO catalog completeness and IPC target selection procedures. It is concluded that X-ray emission, at the level of Lx not less than 10 exp 30 ergs/s, is quite common in B stars of early spectral types (B0-B3), regardless of luminosity class, but that emission, at the same level, becomes less common, or nonexistent, in later B-type stars.

Weighted sum of gray gases model optimization for numerical investigations of processes inside pulverized coal-fired furnaces

NASA Astrophysics Data System (ADS)

Crnomarkovic, Nenad; Belosevic, Srdjan; Tomanovic, Ivan; Milicevic, Aleksandar

2017-12-01

The effects of the number of significant figures (NSF) in the interpolation polynomial coefficients (IPCs) of the weighted sum of gray gases model (WSGM) on results of numerical investigations and WSGM optimization were investigated. The investigation was conducted using numerical simulations of the processes inside a pulverized coal-fired furnace. The radiative properties of the gas phase were determined using the simple gray gas model (SG), two-term WSGM (W2), and three-term WSGM (W3). Ten sets of the IPCs with the same NSF were formed for every weighting coefficient in both W2 and W3. The average and maximal relative difference values of the flame temperatures, wall temperatures, and wall heat fluxes were determined. The investigation showed that the results of numerical investigations were affected by the NSF unless it exceeded certain value. The increase in the NSF did not necessarily lead to WSGM optimization. The combination of the NSF (CNSF) was the necessary requirement for WSGM optimization.

PAF-Myc-Controlled Cell Stemness Is Required for Intestinal Regeneration and Tumorigenesis.

PubMed

Kim, Moon Jong; Xia, Bo; Suh, Han Na; Lee, Sung Ho; Jun, Sohee; Lien, Esther M; Zhang, Jie; Chen, Kaifu; Park, Jae-Il

2018-03-12

The underlying mechanisms of how self-renewing cells are controlled in regenerating tissues and cancer remain ambiguous. PCNA-associated factor (PAF) modulates DNA repair via PCNA. Also, PAF hyperactivates Wnt/β-catenin signaling independently of PCNA interaction. We found that PAF is expressed in intestinal stem and progenitor cells (ISCs and IPCs) and markedly upregulated during intestinal regeneration and tumorigenesis. Whereas PAF is dispensable for intestinal homeostasis, upon radiation injury, genetic ablation of PAF impairs intestinal regeneration along with the severe loss of ISCs and Myc expression. Mechanistically, PAF conditionally occupies and transactivates the c-Myc promoter, which induces the expansion of ISCs/IPCs during intestinal regeneration. In mouse models, PAF knockout inhibits Apc inactivation-driven intestinal tumorigenesis with reduced tumor cell stemness and suppressed Wnt/β-catenin signaling activity, supported by transcriptome profiling. Collectively, our results unveil that the PAF-Myc signaling axis is indispensable for intestinal regeneration and tumorigenesis by positively regulating self-renewing cells. Copyright © 2018 Elsevier Inc. All rights reserved.

Neural changes associated with semantic processing in healthy aging despite intact behavioral performance.

PubMed

Lacombe, Jacinthe; Jolicoeur, Pierre; Grimault, Stephan; Pineault, Jessica; Joubert, Sven

2015-10-01

Semantic memory recruits an extensive neural network including the left inferior prefrontal cortex (IPC) and the left temporoparietal region, which are involved in semantic control processes, as well as the anterior temporal lobe region (ATL) which is considered to be involved in processing semantic information at a central level. However, little is known about the underlying neuronal integrity of the semantic network in normal aging. Young and older healthy adults carried out a semantic judgment task while their cortical activity was recorded using magnetoencephalography (MEG). Despite equivalent behavioral performance, young adults activated the left IPC to a greater extent than older adults, while the latter group recruited the temporoparietal region bilaterally and the left ATL to a greater extent than younger adults. Results indicate that significant neuronal changes occur in normal aging, mainly in regions underlying semantic control processes, despite an apparent stability in performance at the behavioral level. Copyright © 2015 Elsevier Inc. All rights reserved.

A GLOBAL PERSPECTIVE ON ENDOCRINE DISRUPTION, WITH COMMENTS ON THE US EXPERIENCE

EPA Science Inventory

The last two decades have witnessed a growing concern for chemicals that have the potential to adversely affect the normal functioning of the endocrine system. The International Programme on Chemical Safety (IPCS) of the World Health Organization has recently reviewed the curren...

Prevention of VTE in Nonorthopedic Surgical Patients

PubMed Central

Garcia, David A.; Wren, Sherry M.; Karanicolas, Paul J.; Arcelus, Juan I.; Heit, John A.; Samama, Charles M.

2012-01-01

Background: VTE is a common cause of preventable death in surgical patients. Methods: We developed recommendations for thromboprophylaxis in nonorthopedic surgical patients by using systematic methods as described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines. Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in this supplement. Results: We describe several alternatives for stratifying the risk of VTE in general and abdominal-pelvic surgical patients. When the risk for VTE is very low (< 0.5%), we recommend that no specific pharmacologic (Grade 1B) or mechanical (Grade 2C) prophylaxis be used other than early ambulation. For patients at low risk for VTE (∼1.5%), we suggest mechanical prophylaxis, preferably with intermittent pneumatic compression (IPC), over no prophylaxis (Grade 2C). For patients at moderate risk for VTE (∼3%) who are not at high risk for major bleeding complications, we suggest low-molecular-weight heparin (LMWH) (Grade 2B), low-dose unfractionated heparin (Grade 2B), or mechanical prophylaxis with IPC (Grade 2C) over no prophylaxis. For patients at high risk for VTE (∼6%) who are not at high risk for major bleeding complications, we recommend pharmacologic prophylaxis with LMWH (Grade 1B) or low-dose unfractionated heparin (Grade 1B) over no prophylaxis. In these patients, we suggest adding mechanical prophylaxis with elastic stockings or IPC to pharmacologic prophylaxis (Grade 2C). For patients at high risk for VTE undergoing abdominal or pelvic surgery for cancer, we recommend extended-duration, postoperative, pharmacologic prophylaxis (4 weeks) with LMWH over limited-duration prophylaxis (Grade 1B). For patients at moderate to high risk for VTE who are at high risk for major bleeding complications or those in whom the consequences of bleeding are believed to be particularly severe, we suggest use of mechanical prophylaxis, preferably with IPC, over no prophylaxis until the risk of bleeding diminishes and pharmacologic prophylaxis may be initiated (Grade 2C). For patients in all risk groups, we suggest that an inferior vena cava filter not be used for primary VTE prevention (Grade 2C) and that surveillance with venous compression ultrasonography should not be performed (Grade 2C). We developed similar recommendations for other nonorthopedic surgical populations. Conclusions: Optimal thromboprophylaxis in nonorthopedic surgical patients will consider the risks of VTE and bleeding complications as well as the values and preferences of individual patients. PMID:22315263

Effect of annealing temperature on VO2(M)/ITO film nanomaterials for thermochromic smart windows application and study its contact angle

NASA Astrophysics Data System (ADS)

Shaban, Mohamed; Rabia, Mohamed; Ezzat, Sara; Mansour, Naglaa; Saeed, Ebtisam; Sayyah, Said M.

2018-01-01

Metastable phase VO2(B) film coated ITO glass was prepared using cyclic potentiometric device utilizing VOSO4 and H2SO4 solution. The optimum conditions for the deposition of the nanostructured VO2(B) film were determined using cathodic peak current density (Ipc) values. Ipc values increase with increasing both VOSO4 and H2SO4 concentrations and then decrease with further increasing the concentrations. Also, monoclinic phase VO2(M)/ITO film was prepared from VO2(B)/ITO film under the effect of annealing temperatures from 550°C to 750°C. Different analyses have been carried out to confirm the chemical, morphological, and crystal structure of the nanostructured VO2(M)/ITO film. From the XRD analysis, the crystallinity increases with the increasing of annealing temperature from 550°C to 750°C. The optical transmittance spectrum was ˜97% for the film annealed at 650°C. Also, the critical thermochromic temperature (Tc) of the optimized film was ˜47.5°C that measured using cooling and heating modes. Finally, the wettability of the VO2(M)/ITO film at different annealing temperature (550°C to 750°C) was studied, in which the contact angle increases from 81 deg to 92 deg with increasing annealing temperatures from 550°C to 750°C, respectively.

Optimization of absorption bands of dye-sensitized and perovskite tandem solar cells based on loss-in-potential values.

PubMed

Sobuś, Jan; Ziółek, Marcin

2014-07-21

A numerical study of optimal bandgaps of light absorbers in tandem solar cell configurations is presented with the main focus on dye-sensitized solar cells (DSSCs) and perovskite solar cells (PSCs). The limits in efficiency and the expected improvements of tandem structures are investigated as a function of total loss-in-potential (V(L)), incident photon to current efficiency (IPCE) and fill factor (FF) of individual components. It is shown that the optimal absorption onsets are significantly smaller than those derived for multi-junction devices. For example, for double-cell devices the onsets are at around 660 nm and 930 nm for DSSCs with iodide based electrolytes and at around 720 nm and 1100 nm for both DSSCs with cobalt based electrolytes and PSCs. Such configurations can increase the total sunlight conversion efficiency by about 35% in comparison to single-cell devices of the same VL, IPCE and FF. The relevance of such studies for tandem n-p DSSCs and for a proposed new configuration for PSCs is discussed. In particular, it is shown that maximum total losses of 1.7 V for DSSCs and 1.4 V for tandem PSCs are necessary to give any efficiency improvement with respect to the single bandgap device. This means, for example, a tandem n-p DSSC with TiO2 and NiO porous electrodes will hardly work better than the champion single DSSC. A source code of the program used for calculations is also provided.

Venous thromboembolism in women undergoing pelvic reconstructive surgery with mechanical prophylaxis alone.

PubMed

Montoya, T Ignacio; Leclaire, Edgar L; Oakley, Susan H; Crane, Andrea K; Mcpencow, Alexandra; Cichowski, Sara; Rahn, David D

2014-07-01

The objective of this study was determine the frequency of symptomatic perioperative venous thromboembolism (VTE) and risk factor(s) associated with VTE occurrence in women undergoing elective pelvic reconstructive surgery using only intermittent pneumatic compression (IPC) for VTE prophylaxis. A multi-center case-cohort retrospective review was conducted at six clinical sites over a 66-month period. All sites utilize IPC as standard VTE prophylaxis for urogynecological surgery. VTE cases occurring during the same hospitalization and up to 6 weeks postoperatively were identified by ICD9 code query. Four controls were temporally matched to each case. Information collected included demographics, medical history, route of surgery, operative time, and intraoperative characteristics. Univariate and multivariate backward stepwise logistic regression analyses were performed to identify potential risk factors for VTE. Symptomatic perioperative VTE was diagnosed in 27 subjects from a cohort of 10,627 women who underwent elective urogynecological surgery (0.25 %). Univariate analysis identified surgical route (laparotomy vs others), type of surgery ("major" vs "minor"), history of gynecological cancer, surgery time, and patient age as risk factors for VTE (P < 0.05). Multivariate analysis identified increased frequency of VTE with laparotomy, age ≥ 70, and surgery duration ≥ 5 h. In our study cohort, the frequency of symptomatic perioperative VTE was low. Laparotomy, age ≥ 70 years, and surgery duration ≥ 5 h were associated with VTE occurrence.

Tell me twice: A multi-study analysis of the functional connectivity between the cerebrum and cerebellum after repeated trait information.

PubMed

Van Overwalle, Frank; Heleven, Elien; Ma, Ning; Mariën, Peter

2017-01-01

This multi-study analysis (6 fMRI studies; 142 participants) explores the functional activation and connectivity of the cerebellum with the cerebrum during repeated behavioral information uptake informing about personality traits of different persons. The results suggest that trait repetition recruits activity in areas belonging to the mentalizing and executive control networks in the cerebrum, and the executive control areas in the cerebellum. Cerebral activation was observed in the executive control network including the posterior medial frontal cortex (pmFC), the bilateral prefrontal cortex (PFC) and bilateral inferior parietal cortex (IPC), in the mentalizing network including the bilateral middle temporal cortex (MTC) extending to the right superior temporal cortex (STC), as well as in the visual network including the left cuneus (Cun) and the left inferior occipital cortex. Moreover, cerebellar activation was found bilaterally in lobules VI and VII belonging to the executive control network. Importantly, significant patterns of functional connectivity were found linking these cerebellar executive areas with cerebral executive areas in the medial pmFC, the left PFC and the left IPC, and mentalizing areas in the left MTC. In addition, connectivity was found between the cerebral areas in the left hemisphere involved in the executive and mentalizing networks, as well as with their homolog areas in the right hemisphere. The discussion centers on the role of these cerebello-cerebral connections in matching internal predictions generated by the cerebellum with external information from the cerebrum, presumably involving the sequencing of behaviors. Copyright © 2016 Elsevier Inc. All rights reserved.

Effect of Within-Category Spacing on Free Recall

ERIC Educational Resources Information Center

Borges, Marilyn A.; Mandler, George

1972-01-01

Contrary to previous experiments which found recall with blocked spacing always superior to recall with random" spacings, these experiments found that total recall was a function of two independent factors: (a) category representation, and (b) items per category represented (IPC). Both factors are dependent upon within-category spacing.…

The Einstein All-Sky Slew Survey

NASA Technical Reports Server (NTRS)

Elvis, Martin S.

1992-01-01

The First Einstein IPC Slew Survey produced a list of 819 x-ray sources, with f(sub x) approximately 10(exp -12) - 10(exp -10) erg/sq cm s and positional accuracy of approximately 1.2 feet (90 percent radius). The aim of this program was to identify these x-ray sources.

Einstein Observations of Galactic supernova remnants

NASA Technical Reports Server (NTRS)

Seward, Frederick D.

1990-01-01

This paper summarizes the observations of Galactic supernova remnants with the imaging detectors of the Einstein Observatory. X-ray surface brightness contours of 47 remnants are shown together with gray-scale pictures. Count rates for these remnants have been derived and are listed for the HRI, IPC, and MPC detectors.

Skin sensitization in chemical risk assessment: Report of aWHO/IPCS international workshop focusing on dose–responseassessment

EPA Science Inventory

An international workshop was held in 2006 to evaluate experimental techniques for hazard identification and hazard characterization of sensitizing agents in terms of their ability to produce data, including dose–response information, to inform risk assessment. Human testing to i...

Economic Perspectives of Technological Progress: New Dimensions for Forecasting Technology

ERIC Educational Resources Information Center

Twiss, Brian

1976-01-01

Discusses the causal relationship between the allocation of financial resources and technological growth. Argues that economic constraints are becoming an important determinant of technological progress that must be incorporated into technology forecasting techniques. (Available from IPC (America) Inc., 205 East 42 Street, New York, NY 10017;…