Diabetes is an epidemic of worldwide proportions caused by β-cell failure. Nutrient fluctuations and insulin resistance drive β-cells to synthesize insulin beyond their capacity for protein folding ...and secretion and thereby activate the unfolded protein response (UPR), an adaptive signalling pathway to promote cell survival upon accumulation of unfolded protein in the endoplasmic reticulum (ER). Protein kinase-like endoplasmic reticulum kinase (PERK) signals one component of the UPR through phosphorylation of eukaryotic initiation factor 2 on the α-subunit (eIF2α) to attenuate protein synthesis, thereby reducing the biosynthetic burden. β-Cells uniquely require PERK-mediated phosphorylation of eIF2α to preserve cell function. Unabated protein synthesis in β-cells is sufficient to initiate a cascade of events, including oxidative stress, that are characteristic of β-cell failure observed in type 2 diabetes. In contrast to acute adaptive UPR activation, chronic activation increases expression of the proapoptotic transcription factor CAAT/enhancer-binding protein homologous protein (CHOP). Chop deletion in insulin-resistant mice profoundly increases β-cell mass and prevents β-cell failure to forestall the progression of diabetes. The findings suggest an unprecedented link by which protein synthesis and/or misfolding in the ER causes oxidative stress and should encourage the development of novel strategies to treat diabetes.
A method, based on electrothermal vaporization (ETV) coupled to inductively coupled plasma optical emission spectrometry (ICP OES), has been optimized for direct solid sampling analysis of soda-lime ...glass-the most common type of industrially manufactured glass. This method allows fast and reliable quantification of the main elements-Al, Ca, K, Mg, Na, and Si-and trace elements-As, Ba, Cd, Ce, Co, Cr, Cu, Fe, Mn, Mo, Ni, (P), Pb, Sb, (Se), Sn, Sr, Ti, V, Zn, and Zr. In the presented ETV-ICP OES method, calibration is performed predominantly with matrix-free synthetic samples. This metrological advantage is normally not achieved with direct solid sampling methods and is one of the goals of the present study. In a certification interlaboratory comparison for the soda-lime glass CRM BAM-S005c, 2 out of 16 laboratories employed the ETV-ICP OES method. An improved analytical performance was obtained compared with the results of laboratories that used conventional liquid ICP OES. For both methods, the average relative deviations between the laboratory results and certified values as well as the average values of relative standard deviation were with a few exceptions <10%, in most cases even <5%, which indicated high trueness and precision. The limits of quantification of the trace elements by ETV-ICP OES were mostly <3 mg kg
−1
. Low subsample masses of 0.2-0.6 mg were used to avoid matrix effects. The optimized conditions consist of using CHF
3
as a modifier gas at a flow rate of 2.3 mL min
−1
, an ETV temperature program with a final temperature of 2530 °C, and use of graphite grit material in combination with a sample boat with a hemispherical cavity for the optimal release of the analytes.
ETV-ICP OES was successfully developed for elemental determination in glasses and validated by participation in certification for a glass standard.
Diabet. Med. 29, e249–e254 (2012)
Aims To evaluate the effectiveness of a family‐centred group education programme, in adolescents with Type 1 diabetes.
Methods Three hundred and five adolescents ...with Type 1 diabetes; age 13.1 ± 1.9 years, diabetes duration 5.6 ± 3.3 years, BMI 20.9 ± 3.7 kg/m2, HbA1c 78 ± 6 mmol/mol (9.3 ± 1.9%) were randomly allocated to the Families and Adolescents Communication and Teamwork Study (FACTS) diabetes education programme; (six 90‐min monthly sessions attended by parents and adolescents incorporating skills training and family teamwork) or conventional clinical care. Primary outcome was HbA1c at 18 months (12 months post‐intervention). Secondary outcomes were HbA1c at 9 months, psychosocial outcomes, adolescent quality of life, well‐being, family responsibility and insulin dose adjustment behaviours at 12 months (6 months post‐intervention) and episodes of severe hypoglycaemia and diabetic ketoacidois during the 12 months post‐intervention. All analyses are intention to treat.
Results Session attendance was poor with 48/158 families (30.4%) not attending any sessions and only 75/158 (47.5%) families attending ≥ 4 group education sessions. All biomedical and psychosocial outcomes were comparable between groups. At 18 months there was no significant difference in HbA1c in either group and no between‐group differences over time: intervention group 75 mmol/mol (9.0%) to 78 mmol/mol (9.3%), control group 77 mmol/mol (9.2%) to 80 mmol/mol (9.5%). Adolescents perceived no changes in parental input at 12 months.
Conclusion Poor attendance of group education sessions delivered in routine clinics was a major challenge. More personalized educational approaches may be required to support and motivate families who are struggling to integrate the demands of intensive insulin regimens into their daily lives.
One of the weighty curb to electric vehicles (EV) acceptability is their constraints when performing long-distance trips. Even if improvements made on fast charging technology enable to recover up to ...300 km range in 20 minutes, the low density of this kind of infrastructure and the variability in their availability can lead to significant waiting times for users. In this context, it is useful to provide users with information about the availability of charging stations to facilitate the use of EVs. In this article, we present a vehicle/infrastructure communication system. EVs ask charging stations for estimated waiting times at a specific time. Stations calculate these estimates based on notifications of intention to charge received from other vehicles. Thanks to this information, vehicles will be able to optimize their journey. This system has the advantages of being easily scalable because it is distributed, simple and only require the sharing of little personal information. However, the stations on the route may have different charging powers and prices. This raises the question of the criteria for optimizing these trips, depending on whether users favor the cost or the duration of the trip. In this article, we examine this tradeoff using multi-objective optimization and Pareto fronts, as well as the impact of such a communication system on recharge decisions.
In supplementary work to the one published earlier, experiments with SF
6
, NF
3
, CF
4
and H
2
as new modifier gases for the matrix studied were performed. Our investigations were continued to ...improve the described analytical method and to achieve additional insights into the mechanism of analyte release. Our new survey is split in two parts. At first fluorinating modifiers were used to investigate the behaviour of a variety of trace elements (Ag, Al, As, Au, Bi, Cd, Co, Cr, Fe, Mg, Mn, Ni, P, Pb, Sb, Se, Si, Sn, Te, Ti, Zn and Zr). Most of them (exceptions Au, Se, and Te) could be effectively released from the copper matrix by thermo-halogenation reactions and by partial sub-sample evaporation. Using SF
6
and NF
3
as modifier gases, low limits of quantification (LOQs) were achieved for the 19 well released trace elements (typical ≤0.1 mg kg
−1
). Most elements (exceptions Ag, Mg, and Ni) could be calibrated by using aqueous calibration solutions without any sample pretreatment. For the trace determination of Se, Te, and Au, a further analytical method of ETV-ICP OES is described in the second part based on thermo-hydrogenation reactions by using a hydrogen/argon mixture as a modifier gas. The determination of Se and Te with very high analytical performance (LOQ < 0.1 mg kg
−1
) can either be carried out in a second analytical step succeeding the halogenation procedure, or the sub-sample is directly treated with H
2
without previous halogenation procedure whereby the sub-sample can either be partially or totally evaporated. In this case some other analytes (Ag, Au, As, Bi, Cd, Fe, Mg, Ni, Pb, Sb, Sn, and Zn) can additionally be quantified simultaneously with Se and Te.
Experiments with SF
6
, NF
3
, CF
4
and H
2
as new modifier gases for the matrix studied were performed. Pre-treatment steps of sub-samples (
e.g.
, roasting) can now be omitted; the scope of application was enlarged to Au and hydride forming elements (such as Se, Te).
Two digestion-free methods for trace analysis of boron nitride based on graphite furnace atomic absorption spectrometry (GFAAS) and electrothermal vaporization inductively coupled plasma spectrometry ...optical emission (ETV-ICP-OES) using direct solid sampling have been developed and applied to the determination of Al, Ca, Cr, Cu, Fe, Mg, Mn, Si, Ti and Zr in four boron nitride materials in concentration intervals of 1–23, 54–735, 0.05–21, 0.005–1.3, 1.6–112, 4.5–20, 0.03–1.8, 6–46, 38–170 and 0.4–2.3 μg g
−
1
, respectively. At optimized experimental conditions, with both methods, effective in-situ analyte/matrix separation was achieved and calibration could be performed using calibration curves measured with aqueous standard solutions. In solid sampling GFAAS, before sampling, the platform was covered with graphite powder and, for determination of Si, also the Pd/Mg(NO
3)
2 modifier was used. In the determination of all analyte elements by solid sampling ETV-ICP-OES, Freon R12 was added to argon carrier gas. For solid sampling GFAAS and ETV-ICP-OES, the achievable limits of detection were within 5 (Cu)–130 (Si) ng g
−
1
and 8 (Cu)–200 (Si) ng g
−
1
, respectively. The results obtained by these two methods for four boron nitride materials of different purity grades are compared each with the other and with those obtained in analysis of digests by ICP-OES. The performance of the two solid sampling methods is compared and discussed.
Background: During the onset of the coronavirus disease 2019 global pandemic, Schools of Nursing transitioned from the traditional clinical teaching and learning experiences to synchronous online ...learning. Method: As part of the Capstone experience in the second-degree, final semester course, students selected one clinical specialty area. Four full-time clinical faculty and five adjunct clinical instructors collaborated in flipped clinical lesson plans 3 weeks prior to the start of the semester. The lesson plan included three components: preconference, active learning, and postconference. Student evaluation of the experience was another critical component. Results: The student evaluation surveys supported that 95% of the respondents identified that the flipped clinical experience was a successful methodology to reinforce clinical concepts. Conclusion: The flipped clinical learning approach showed promise as an effective way to provide remote clinical instruction for students during public health emergencies, when shortage of clinical sites arise, or as a replacement for missed clinical hours. J Nurs Educ. 2021;60(9):534–537.
In order to further improve the high performance ceramic material BN it is necessary to advance its analytics. The quantitative determination of the nitrogen content as main component is compared by ...three methods: the carrier gas hot extraction, the LiOH fusion and the Kjeldahl method. Thereby specific methodical aspects are critically highlighted with respect to the trueness and precision of the nitrogen analysis. The “chemistry” plays a fundamental role in all methods. In the case of the instrumental analysis by CGHE important critical aspects are the calibration of CGHE measurements and the improvement of reproducibility which needs a much better understanding of the chemical reactions in the crucible. In case of the Kjeldahl method it is of decisive importance to apply an adequate high temperature of 260
°C for decomposition, whereas the melt-decomposition with LiOH is affected by melt additions.
Abstract
Introduction/Objective
Giant cell myocarditis (GCM) is a rare and aggressive inflammatory process that targets the myocardium and is often rapidly fatal. Most cases have been reported in ...young to middle aged adults with a slight male predominance. The etiology of this disease is largely unknown, however there is an association with multiple autoimmune disorders. Most patients present with rapidly progressive or fulminant heart failure, arrhythmias, heart block or sudden cardiac death. The incidence of GCM ranges from 0.007% to 0.051% and most cases are confirmed on autopsy examination. Here we present a case of GCM in a young female diagnosed on autopsy.
Methods/Case Report
A 37-year-old female presented with shortness of breath and chest pain for a 5-day duration. She had no past medical history and was otherwise well before the onset of symptoms. On admission, she was noted to have clinical findings consistent with heart failure and progressed to cardiogenic shock with ventricular arrhythmias within hours. Despite high dose corticosteroids and other supportive therapy, the patient remained in refractory, vasodilatory shock, in cardiac standstill and eventually died. Findings on autopsy included mild ventricular hypertrophy, petechial hemorrhages through out the atria and ventricles, as well as pulmonary edema and congestion. Microscopic examination showed a diffuse infiltrating pattern of inflammation within the heart, that was composed predominantly of lymphocytes, giant cells, scattered neutrophils, and eosinophils. The lymphocytes were CD3, CD4, CD8 positive and CD20 negative, consistent with a T-cell infiltrate. Gram and GMS stains were negative for bacterial and fungal microorganisms. Focal areas of necrosis without granuloma formation are also noted ruling out sarcoidosis.
Results (if a Case Study enter NA)
NA.
Conclusion
This case demonstrates a rapid manifestation of GCM in a previously healthy individual. GCM must be considered in the differential diagnosis when a young patient presents with cardiac symptoms. Early diagnosis and initiation of targeted therapy is critical for GCM patients' survival.
Creating a Long-Term Care New Nurse Residency Model Cadmus, Edna; Salmond, Susan W; Hassler, Linda J ...
The Journal of continuing education in nursing,
2016-May-01, 2016-05-00, 20160501, Letnik:
47, Številka:
5
Journal Article
Recenzirano
As the impact of health care reform continues to evolve, the movement of patients from acute to post-acute settings will continue to expand. Currently, the turnover and retention of RNs nationally in ...long-term care is at an all-time high, with a median turnover rate of 50% for RNs. Workforce instability is a prime contributor to poor patient outcomes, increased costs, and a dissatisfied nursing workforce. Therefore, the New Jersey Action Coalition determined that the Institute of Medicine's Future of Nursing: Leading Change, Advancing Health recommendation to implement nurse residency programs across settings would be a priority for New Jersey. A 12-month new nurse residency and preceptor program was developed and implemented in long-term care, with 37 new nurses and 37 preceptors. The design and implementation processes are described, as well as lessons learned along the journey. J Contin Educ Nurs. 2016;47(5):234-240.
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