Numerous investigators have suggested that dehydration may alter carbohydrate metabolism in muscle. Theoretically, altered glycolytic flux in exercising muscle could change the rate at which lactate ...accumulates in the blood and thus alter the onset of blood lactate accumulation. The purpose of this study was to investigate the effects of acute dehydration on blood lactate accumulation during incremental exercise. Six trained male subjects performed an incremental test to exhaustion on a cycle ergometer during which the work rate was increased by 30 W every three minutes. Ventilation (V
E
), gas exchange measures, and blood samples for lactate analysis were obtained every third minute during the test. The onset of blood lactate accumulation was defined as the VO
2
at which there was a systematic rise in blood lactate concentration. Subjects were tested twice, once in a normal state of hydration (N) and once after acute thermal dehydration (D). The treatment order was counterbalanced. Thermal dehydration (5% body weight loss) was induced by intermittent sauna exposure (65° C). The onset of blood lactate accumulation occurred at a significantly lower (P < 0.05) VO
2
during exercise in the D condition when compared to work in the N condition. Additionally blood lactate concentrations were significantly greater (P <0.05) in condition D when contrasted to condition N at work rates of 90, 120 and 150 W, and at all work rates greater than 180 W. These findings demonstrate that acute dehydration may alter blood lactate accumulation and the onset of blood lactate accumulation.
Objectives Compliant surfaces beneath a casualty diminish the quality of cardiopulmonary resuscitation (CPR) in clinical environments. To examine this issue in a sporting environment, we assessed ...chest compression quality and rescuer exertion upon compliant sports safety matting. Methods Twenty-seven advanced life support providers volunteered (13 male/14 female; mass = 79.0 ± 12.5 kg; stature = 1.77 ± 0.09 m). Participants performed 5 x 2 min, randomized bouts of continuous chest compressions on a mannequin, upon five surfaces: solid floor; low-compliance matting; low-compliance matting with a backboard; high-compliance matting; high-compliance matting with a backboard. Measures included chest compression depth and rate, percentage of adequate compressions, and rescuer heart rate and perceived exertion. Results Chest compression depth and rate were significantly lower upon high-compliance matting relative to other surfaces (p<0.05). The percentage of adequate compressions (depth greater than or equal to50 mm) was lowest upon high-compliance matting (40 ± 39%) versus low-compliance matting (60 ± 36%) and low-compliance matting with a backboard (59 ± 39%). Perceived exertion was significantly greater upon high-compliance matting versus floor, low-compliance matting, and low-compliance matting with a backboard (p<0.05). Conclusion Providers of CPR should be alerted to the detrimental effects of compliant safety matting in a sporting environment and prepare to alter the targeted compression depth and rescuer rotation intervals accordingly.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
At the 2008 inaugural meeting of the Consortium of Universities for Global Health (CUGH), participants discussed the rapid expansion of global health programs and the lack of standardized ...competencies and curricula to guide these programs. In 2013, CUGH appointed a Global Health Competency Subcommittee and charged this subcommittee with identifying broad global health core competencies applicable across disciplines.
The purpose of this paper is to describe the Subcommittee's work and proposed list of interprofessional global health competencies.
After agreeing on a definition of global health to guide the Subcommittee's work, members conducted an extensive literature review to identify existing competencies in all fields relevant to global health. Subcommittee members initially identified 82 competencies in 12 separate domains, and proposed four different competency levels. The proposed competencies and domains were discussed during multiple conference calls, and subcommittee members voted to determine the final competencies to be included in two of the four proposed competency levels (global citizen and basic operational level – program oriented).
The final proposed list included a total of 13 competencies across 8 domains for the Global Citizen Level and 39 competencies across 11 domains for the Basic Operational Program-Oriented Level.
There is a need for continued debate and dialog to validate the proposed set of competencies, and a need for further research to identify best strategies for incorporating these competencies into global health educational programs. Future research should focus on implementation and evaluation of these competencies across a range of educational programs, and further delineating the competencies needed across all four proposed competency levels.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Multiple models of clinical exposure to primary care exist within undergraduate medical education (UME) and graduate medical education (GME). In this narrative review, we explore the evidence behind ...these different models of exposure, their alignment with positive promoters of primary care careers, and the pros and cons of each. Without positive exposure to primary care during training, sustaining the future primary care work force becomes increasingly challenging. Here, we explore multiple models of clinical exposure in UME, including longitudinal integrated clerkships, primary care tracks, and primary care clerkships. Within GME, we will review the impact of primary care tracks, Area Health Education Centers, block scheduling models, and continuity clinic scheduling models. The goal of this narrative review is to allow educators to think broadly and intentionally about the array of models to develop positive primary care experiences and perceptions in training, ultimately sustaining the primary care workforce.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
This work presents a <inline-formula> <tex-math notation="LaTeX">{D} </tex-math></inline-formula>-band (110-170 GHz) receiver (RX) with integrated analog-to-digital converter (ADC) and phase-locked ...loop (PLL). The receiver front end (RXFE) consists of a coupled-line-based Guanella balun matching network, 140-GHz low-noise amplifier (LNA), and Cherry-Hooper (CH) amplifier providing <inline-formula> <tex-math notation="LaTeX">> </tex-math></inline-formula>20-GHz baseband bandwidth. A quadrature PLL provides I/Q local oscillator (LO) signals for down-conversion. Two 32-GS/s hybrid voltage- and time-domain ADCs digitize the RXFE output. The fully integrated 22-nm FinFET CMOS prototype achieves a peak data rate of 128 Gb/s using 16-QAM modulation with -15.2-dB EVM and consumes 246 mW for 1.95-pJ/b efficiency. The stand-alone RXFE without ADC provides 160-Gb/s data rates with -16.4-dB EVM and consumes 166 mW for 1.04-pJ/b efficiency.
The success in recent clinical trials using T cell receptor (TCR)-genetically engineered T cells to treat melanoma has encouraged the use of this approach toward other malignancies and viral ...infections. Although hepatitis C virus (HCV) infection is being treated with a new set of successful direct anti-viral agents, potential for virologic breakthrough or relapse by immune escape variants remains. Additionally, many HCV
+
patients have HCV-associated disease, including hepatocellular carcinoma (HCC), which does not respond to these novel drugs. Further exploration of other approaches to address HCV infection and its associated disease are highly warranted. Here, we demonstrate the therapeutic potential of PBL-derived T cells genetically engineered with a high-affinity, HLA-A2-restricted, HCV NS3:1406-1415-reactive TCR. HCV1406 TCR-transduced T cells can recognize naturally processed antigen and elicit CD8-independent recognition of both peptide-loaded targets and HCV
+
human HCC cell lines. Furthermore, these cells can mediate regression of established HCV
+
HCC in vivo. Our results suggest that HCV TCR-engineered antigen-reactive T cells may be a plausible immunotherapy option to treat HCV-associated malignancies, such as HCC.
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EMUNI, FZAB, GEOZS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UL, UM, UPUK, VKSCE, ZAGLJ
As universities increase their focus on global health‐related professional education, the need for specific competencies and outcomes to guide curriculum development is urgent. To address this need, ...the chair of the Education Committee of the Consortium of Universities for Global Health (CUGH) appointed a Subcommittee to determine if there is a need for broad global health core competencies applicable across disciplines, and if so, what those competencies should be. Based on that work, this paper (a) discusses the benefits of developing interprofessional and discipline‐specific global health competencies; (b) highlights themes that emerged from a preliminary review of existing related literature; and (c) reviews the process used to identify two levels of interprofessional global health competencies.
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