•The COVID-19 pandemic challenged faculty to innovate with remote learning courses.•Since 1995, Faculty for Undergraduate Neuroscience workshops have created several important curricular ...recommendations.•Discipline-based education research has enhanced undergraduate science education.•Active learning and inclusive pedagogy heighten positive educational outcomes.
The dedication of undergraduate neuroscience faculty to their students could not have been more evident than what these educators demonstrated when the COVID-19 pandemic impacted colleges and universities across the United States. These faculty faced the crisis head-on to provide their students with exceptional instruction in virtual formats that many faculty had never used for instruction before the pandemic. This same tenacious attitude has been reflected in pedagogical efforts that undergraduate neuroscience faculty have undertaken since the mid-1990s. The challenges of providing cutting-edge neuroscience education to undergraduates in a dynamic field have produced a series of curricular designs and approaches that capitalize on discipline-based education research. This article reviews curricular models and pedagogical strategies aimed at enhancing the educational experiences of undergraduate neuroscience students whose lived experiences and academic backgrounds reflect the richly kaleidoscopic demographics of college students in the 21st century. The future of undergraduate neuroscience education is bright as faculty and their students collaborate on their journey of discovery in neuroscience.
Influenza and Viral Pneumonia Cavallazzi, Rodrigo; Ramirez, Julio A
Clinics in chest medicine,
12/2018, Letnik:
39, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Influenza and other respiratory viruses are commonly identified in patients with community-acquired pneumonia, hospital-acquired pneumonia, and in immunocompromised patients with pneumonia. ...Clinically, it is difficult to differentiate viral from bacterial pneumonia. Similarly, the radiological findings of viral infection are nonspecific. The advent of polymerase chain reaction testing has enormously facilitated the identification of respiratory viruses, which has important implications for infection control measures and treatment. Currently, treatment options for patients with viral infection are limited, but there is ongoing research on the development and clinical testing of new treatment regimens and strategies.
Influenza and Viral Pneumonia Cavallazzi, Rodrigo; Ramirez, Julio A
Infectious disease clinics of North America
38, Številka:
1
Journal Article
Recenzirano
Influenza and other respiratory viruses are commonly identified in patients with community-acquired pneumonia, hospital-acquired pneumonia, and in immunocompromised patients with pneumonia. ...Clinically, it is difficult to differentiate viral from bacterial pneumonia. Similarly, the radiological findings of viral infection are in general nonspecific. The advent of polymerase chain reaction testing has enormously facilitated the identification of respiratory viruses, which has important implications for infection control measures and treatment. Currently, treatment options for patients with viral infection are limited but there is ongoing research on the development and clinical testing of new treatment regimens and strategies.
The Confusion, Urea > 7 mM, Respiratory Rate ≥ 30 breaths/min, BP < 90 mm Hg (Systolic) or < 60 mm Hg (Diastolic), Age ≥ 65 Years (CURB-65) score and the Pneumonia Severity Index (PSI) are ...well-established clinical prediction rules for predicting mortality in patients hospitalized with community-acquired pneumonia (CAP). SARS-CoV-2 has emerged as a new etiologic agent for CAP, but the role of CURB-65 score and PSI have not been established.
How effective are CURB-65 score and PSI at predicting in-hospital mortality resulting from SARS-CoV-2 CAP compared with non-SARS-CoV-2 CAP? Can these clinical prediction rules be optimized to predict mortality in SARS-CoV-2 CAP by addition of procalcitonin and D-dimer?
Secondary analysis of two prospective cohorts of patients with SARS-CoV-2 CAP or non-SARS-CoV-2 CAP from eight adult hospitals in Louisville, Kentucky.
The in-hospital mortality rate was 19% for patients with SARS-CoV-2 CAP and 6.5% for patients with non-SARS-CoV-2 CAP. For the PSI score, receiver operating characteristic (ROC) curve analysis resulted in an area under the ROC curve (AUC) of 0.82 (95% CI, 0.78-0.86) and 0.79 (95% CI, 0.77-0.80) for patients with SARS-CoV-2 CAP and non-SARS-CoV-2 CAP, respectively. For the CURB-65 score, ROC analysis resulted in an AUC of 0.79 (95% CI, 0.75-0.84) and 0.75 (95% CI, 0.73-0.77) for patients with SARS-CoV-2 CAP and non-SARS-CoV-2 CAP, respectively. In SARS-CoV-2 CAP, the addition of D-dimer (optimal cutoff, 1,813 μg/mL) and procalcitonin (optimal cutoff, 0.19 ng/mL) to PSI and CURB-65 score provided negligible improvement in prognostic performance.
PSI and CURB-65 score can predict in-hospital mortality for patients with SARS-CoV-2 CAP and non-SARS-CoV-2 CAP comparatively. In patients with SARS-CoV-2 CAP, the inclusion of either D-dimer or procalcitonin to PSI or CURB-65 score did not improve the prognostic performance of either score. In patients with CAP, regardless of cause, PSI and CURB-65 score remain adequate for predicting mortality in clinical practice.
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The clinical presentation of community-acquired pneumonia (CAP) can vary widely among patients. While many individuals with mild symptoms can be managed as outpatients with excellent outcomes, there ...is a distinct subgroup of patients who present with severe CAP. In these cases, the mortality rate can reach approximately 25% within 30 days and even up to 50% within a year. It is crucial to focus attention on these patients who are at higher risk. Among the various definitions of severe CAP found in the literature, one commonly used criterion is the requirement for admission to intensive care unit. Notable epidemiological characteristics of these patients include the impact of acute cardiovascular diseases on clinical outcomes and the enduring, independent effect of pneumonia on long-term outcomes. Factors such as pathogen virulence, the presence of comorbidities, and the host response are important contributors to the pathogenesis of severe CAP. In these patients, the host response may be dysregulated and compartmentalized. Gaining a better understanding of the epidemiology and pathogenesis of severe CAP will provide a foundation for the development of new therapies for this condition. This manuscript aims to review the definition, epidemiology, and pathogenesis of severe CAP, shedding light on important aspects that can aid in the improvement of patient care and outcomes.
Community-Acquired Pneumonia. Reply File, Thomas M; Ramirez, Julio A
The New England journal of medicine,
10/2023, Letnik:
389, Številka:
17
Journal Article
Understanding the burden of community-acquired pneumonia (CAP) is critical to allocate resources for prevention, management, and research. The objectives of this study were to define incidence, ...epidemiology, and mortality of adult patients hospitalized with CAP in the city of Louisville, and to estimate burden of CAP in the US adult population.
This was a prospective population-based cohort study of adult residents in Louisville, Kentucky, from 1 June 2014 to 31 May 2016. Consecutive hospitalized patients with CAP were enrolled at all adult hospitals in Louisville. The annual population-based CAP incidence was calculated. Geospatial epidemiology was used to define ecological associations among CAP and income level, race, and age. Mortality was evaluated during hospitalization and at 30 days, 6 months, and 1 year after hospitalization.
During the 2-year study, from a Louisville population of 587499 adults, 186384 hospitalizations occurred. A total of 7449 unique patients hospitalized with CAP were documented. The annual age-adjusted incidence was 649 patients hospitalized with CAP per 100000 adults (95% confidence interval, 628.2-669.8), corresponding to 1591825 annual adult CAP hospitalizations in the United States. Clusters of CAP cases were found in areas with low-income and black/African American populations. Mortality during hospitalization was 6.5%, corresponding to 102821 annual deaths in the United States. Mortality at 30 days, 6 months, and 1 year was 13.0%, 23.4%, and 30.6%, respectively.
The estimated US burden of CAP is substantial, with >1.5 million unique adults being hospitalized annually, 100000 deaths occurring during hospitalization, and approximately 1 of 3 patients hospitalized with CAP dying within 1 year.
Lower respiratory infections include acute bronchitis, influenza, community-acquired pneumonia, acute exacerbation of COPD and acute exacerbation of bronchiectasis. They are a major cause of death ...worldwide and often affect the most vulnerable: children, elderly and the impoverished. In this paper, we review the clinical presentation, diagnosis, severity assessment and treatment of adult outpatients with lower respiratory infections. The paper is divided into sections on specific lower respiratory infections, but we also dedicate a section to COVID-19 given the importance of the ongoing pandemic. Lower respiratory infections are heterogeneous entities, carry different risks for adverse events, and require different management strategies. For instance, while patients with acute bronchitis are rarely admitted to hospital and generally do not require antimicrobials, approximately 40% of patients seen for community-acquired pneumonia require admission. Clinicians caring for patients with lower respiratory infections face several challenges, including an increasing population of patients with immunosuppression, potential need for diagnostic tests that may not be readily available, antibiotic resistance and social aspects that place these patients at higher risk. Management principles for patients with lower respiratory infections include knowledge of local surveillance data, strategic use of diagnostic tests according to surveillance data, and judicious use of antimicrobials.
This paper introduces a time–frequency analytic method for the exact identification of wideband DQ impedance models oriented to harmonic stability of converter-driven systems with transmission line ...models with distributed and frequency-dependent parameters. Wideband models are of great importance in the analysis of harmonic stability over a broad range of frequencies. The transmission line is a crucial component in this regard, but it is not straightforward to incorporate it into the impedance model of AC power-electronics-based power systems. This has led to the use of lumped parameter models or models based on rational approximations. This article proposes a method to include this important element to the impedance model directly from its frequency domain model. Salient features of the proposed modeling approach include the frequency telegrapher’s equations with distributed and frequency-dependent parameters, exact delay models of PWM, control implementations of power electronics, and an exact steady-state computation using a balance method based on a hybrid time–frequency approach. The proposal avoids time-domain simulations, rational approximations, or the fast Fourier transform. A converter-driven system with transmission lines is used to validate the proposal and the results of the frequency scanning method conducted in OPAL-RT (ARTEMiS/EMTP-RV) and PSCAD/EMTDC support the effectiveness, speed, and accuracy.
•Accurate DQ impedance model of AC systems with frequency-dependent lines.•Impedance model, including lines, avoids rational and approximate models.•Steady state accurately computed using exact equations for lines and converters.•Characterization avoids time-domain simulations, FFTs, and analytical modeling.
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