Background
Coronary artery disease (CAD) is a leading cause of mortality following orthotopic liver transplant, yet there is no standardized protocol for pre-liver-transplant coronary artery disease ...assessment. The main objective of this study was to determine the agreement between 2 methods of cardiac risk assessment: dobutamine stress echocardiogram (DSE) and coronary calcium score (CCS) and to determine which test was best able to predict coronary calcification in low-risk patients.
Methods
A retrospective study was performed using the medical records of 436 patients who received cardiac clearance for a liver transplant. A total of 152 patients’ medical records were included based on the inclusion of patients who had received both DSE and CCS. A kappa coefficient was calculated to determine the agreement between the DSE and CCS results. In addition, the positive predictive values (PPVs) of both the CCS and DSE along with cardiac catheterization indicating abdominal occlusion were analyzed to compare the accuracy of the 2 tests.
Results
It was determined that there was a 12% agreement between DSE results and CCS. It was found that the DSE had a PPV of 56% and the CCS had a PPV of 80%.
Conclusion
From this data, it was concluded that there was no agreement between the results of the CCS and the DSE. While neither the CCS nor the DSE presents an optimal method of risk assessment, the CCS had a much higher PPV and was therefore determined to be the more accurate test.
Unlike traditional drift-tube ion mobility-mass spectrometry, traveling-wave ion mobility-mass spectrometry typically requires calibration in order to generate collision cross section (CCS) values. ...Although this has received a significant amount of attention for positive-ion mode analysis, little attention has been paid for CCS calibration in negative ion mode. Here, we provide drift-tube CCS values for M − H
−
ions of two calibrant series, polyalanine and polymalic acid, and evaluate both types of calibrants in terms of the accuracy and precision of the traveling-wave ion mobility CCS values that they produce.
Introduction of a novel negative mode calibrant and evaluation of calibration strategies for TWIM CCS determination.
4 Lessons in Leadership Walker, Chelsea
ASHA Leader,
02/2017, Letnik:
22, Številka:
2
Trade Publication Article
...delegating has a dual purpose: accomplishing tasks efficiently and keeping your team engaged. In his book "Turn the Ship Around," former Navy officer and leadership expert David Marquet talks ...about "broad guidance"- assigning tasks with guidelines, but allowing each team member to accomplish the task in their own way.
A 59-year-old woman presents with decreased appetite and abdominal pain. Her symptoms lead to lethargy and weakness. Abdominal pain is a common presentation in the primary care and emergency room ...setting. She was initially diagnosed with an abscess and treated with antibiotics and drainage. Upon further evaluation and cystoscopy she was discovered to have a urachal cyst. Urachal cysts are extremely rare and even more uncommon in adults, as it is usually diagnosed in children. It is an important diagnosis not to miss in the differential of adult abdominal pain as surgical intervention is often necessary for treatment. This case highlights urachal cyst as a rare and serious differential of adult abdominal pain.
Microbial natural products have been an invaluable resource for providing clinically relevant therapeutics for almost a century, including most of the commonly used antibiotics that are still in ...medical use today. In more recent decades, the need for new biotherapeutics has begun to grow, as multi-drug resistant pathogens continue to emerge, putting into question the long-term efficacy of many drugs that we routinely depend on to combat infectious diseases. To affect this growing medical crisis, new efforts are being applied to computationally mine the genomes of microorganisms for biosynthetic gene clusters that code for molecules possessing anti-microbial activities that circumvent known resistance mechanisms. To this end, cutting-edge software platforms have been developed that can identify, with high predictive accuracy, microbial genomes that code for natural products of potential interest. However, with such analyses comes the need to thoroughly vet each predicted gene cluster, to identify those high-value candidate molecules that are not associated with known resistance mechanisms. In this work, a new strategy was developed that involved cataloguing all known ‘self-resistance’ mechanisms encoded by natural product producing microorganisms, which protect the producer from the highly toxic effects of their secreted anti-microbial agents. This collection of resistance data was leveraged and used to engineer an automated software-based pipeline that interrogates biosynthetic gene clusters and relates them to previously identified resistance mechanisms. Gene clusters that are revealed to be independent of known resistance mechanisms can then be flagged for further chemical and biological study in the laboratory. Such in-depth interrogations of microbial genomes aim to help reveal the full biological repertoire of antibiotics yet to be discovered from microorganisms, and will lead to the development of the next generation of biotherapeutics to quell the growing medical crisis of antibiotic-resistance among human pathogenic organisms.
Thesis
Master of Science (MSc)
It would be hard to imagine a world where we could no longer use the antibiotics we are routinely being prescribed for common bacterial infections. Currently, we are in an era where this thought could become a reality. Although we have been able to discover antibiotics in the past from soil dwelling microbes, this approach to discovery is being constantly challenged. At the same time, the bacteria are getting smarter in their ways to evade antibiotics, in the form of resistance, or self-protection mechanisms. As such is it essential to devise methods which can predict the potential for resistance to the antibiotics we use early in the discovery and isolation process. By using what we have learned in the past about how bacteria protect themselves for antibiotics, we can to stay one step ahead of them as we continue to search for new sources of antibiotics from bacteria.
Substantial research efforts are under way to optimize the production of composites enhanced by the incorporation of nanomaterial fillers such as multiwall carbon nanotubes (MWCNTs). It is therefore ...critical to develop robust methods to detect and characterize MWCNTs in nanocomposites to measure product performance and potential risks from release of the MWCNTs. In this study, the effectiveness of X-ray photoelectron spectroscopy (XPS), Raman spectroscopy, and scanning electron microscopy (SEM) methods is assessed on a series of MWCNT-epoxy nanocomposites samples. A general trend of positive correlation between signal intensity and MWCNT mass loading was observed by both Raman spectroscopy and XPS. Raman spectroscopy was capable of detecting MWCNTs at the lowest nominal concentration tested (0.01%), while for XPS, MWCNTs were detected down to a threshold of approximately 0.5%. Analysis of the same locations of two nanocomposite samples with nominal MWCNT mass fractions of 0.3% and 1% using Raman chemical imaging and SEM revealed a similar detectability of MWCNT clusters and with the higher mass loading sample having a greater number of MWCNT-rich domains. Overall, these results show a good comparability among the different techniques and therefore provide comprehensive, nondestructive microscopy methods to characterize nanocomposites.
Display omitted
The Dark Triad of socially aversive personality traits (narcissism, Machiavellianism, and psychopathy) may be linked with emotional deficits, including the use of less effective emotion regulation ...processes. In this meta-analysis, we identify 20 sources (n = 23 samples, k = 83 effect sizes, NTotal = 4487) examining the association of the Dark Triad domains and facets with emotion regulation processes of reappraisal (thought to be effective) and expressive suppression (thought to be ineffective). In line with our hypotheses, we found that both primary and secondary psychopathy were significantly associated with lower use of reappraisal (ρ = −0.18 and − 0.29 respectively, k = 3 to 4), and higher use of expressive suppression (ρ = 0.23 and 0.19 respectively, k = 9 to 10). There were no significant associations of either regulation process with Machiavellianism, total narcissism, or grandiose narcissism. However, vulnerable narcissism was significantly associated with higher use of expressive suppression (ρ = 0.37, k = 2), as hypothesized. Results are discussed in relation to how they may inform our understanding of the emotional deficits of the dark triad, and we emphasise the importance of considering dark personality at the facet rather than the domain level.
The Functional Movement Screen: a reliability study Teyhen, Deydre S; Shaffer, Scott W; Lorenson, Chelsea L ...
The journal of orthopaedic and sports physical therapy,
06/2012, Letnik:
42, Številka:
6
Journal Article
Recenzirano
Odprti dostop
Reliability study.
To determine intrarater test-retest and interrater reliability of the Functional Movement Screen (FMS) among novice raters.
The FMS is used by various examiners to assess movement ...and predict time-loss injuries in diverse populations (eg, youth to professional athletes, firefighters, military service members) of active participants. Unfortunately, critical analysis of the reliability of the FMS is currently limited to 1 sample of active college-age participants.
Sixty-four active-duty service members (mean ± SD age, 25.2 ± 3.8 years; body mass index, 25.1 ± 3.1 kg/m2) without a history of injury were enrolled. Participants completed the 7 component tests of the FMS in a counterbalanced order. Each component test was scored on an ordinal scale (0 to 3 points), resulting in a composite score ranging from 0 to 21 points. Intrarater test-retest reliability was assessed between baseline scores and those obtained with repeated testing performed 48 to 72 hours later. Interrater reliability was based on the assessment from 2 raters, selected from a pool of 8 novice raters, who assessed the same movements on day 2 simultaneously. Descriptive statistics, weighted kappa (κw), and percent agreement were calculated on component scores. Intraclass correlation coefficients (ICCs), standard error of the measurement, minimal detectable change (MDC95), and associated 95% confidence intervals (CIs) were calculated on composite scores.
The average ± SD score on the FMS was 15.7 ± 0.2 points, with 15.6% (n = 10) of the participants scoring less than or equal to 14 points, the recommended cutoff for predicting time-loss injuries. The intrarater test-retest and interrater reliability of the FMS composite score resulted in an ICC3,1 of 0.76 (95% CI: 0.63, 0.85) and an ICC2,1 of 0.74 (95% CI: 0.60, 0.83), respectively. The standard error of the measurement of the composite test was within 1 point, and the MDC95 values were 2.1 and 2.5 points on the 21-point scale for interrater and intrarater reliability, respectively. The interrater agreement of the component scores ranged from moderate to excellent (κw = 0.45-0.82).
Among novice raters, the FMS composite score demonstrated moderate to good interrater and intrarater reliability, with acceptable levels of measurement error. The measures of reliability and measurement error were similar for both intrarater reliability that repeated the assessment of the movement patterns over a 48-to-72-hour period and interrater reliability that had 2 raters assess the same movement pattern simultaneously. The interrater agreement of the FMS component scores was good to excellent for the push-up, quadruped, shoulder mobility, straight leg raise, squat, hurdle, and lunge. Only 15.6% (n = 10) of the participants were identified to be at risk for injury based on previously published cutoff values.
We have demonstrated previously that the intravenous delivery of multipotent adult progenitor cells (MAPC) after traumatic brain injury affords neuroprotection via interaction with splenocytes, ...leading to an increase in systemic anti-inflammatory cytokines. We hypothesize that the observed modulation of the systemic inflammatory milieu is related to T regulatory cells and a subsequent increase in the locoregional neuroprotective M2 macrophage population.
C57B6 mice were injected with intravenous MAPC 2 and 24 hours after controlled cortical impact injury. Animals were euthanized 24, 48, 72, and 120 hours after injury. In vivo, the proportion of CD4(+)/CD25(+)/FOXP3(+) T-regulatory cells were measured in the splenocyte population and plasma. In addition, the brain CD86(+) M1 and CD206(+) M2 macrophage populations were quantified. A series of in vitro co-cultures were completed to investigate the need for direct MAPC:splenocyte contact as well as the effect of MAPC therapy on M1 and M2 macrophage subtype apoptosis and proliferation.
Significant increases in the splenocyte and plasma T regulatory cell populations were observed with MAPC therapy at 24 and 48 hours, respectively. In addition, MAPC therapy was associated with an increase in the brain M2/M1 macrophage ratio at 24, 48 and 120 hours after cortical injury. In vitro cultures of activated microglia with supernatant derived from MAPC:splenocyte co-cultures also demonstrated an increase in the M2/M1 ratio. The observed changes were secondary to an increase in M1 macrophage apoptosis.
The data show that the intravenous delivery of MAPC after cortical injury results in increases in T regulatory cells in splenocytes and plasma with a concordant increase in the locoregional M2/M1 macrophage ratio. Direct contact between the MAPC and splenocytes is required to modulate activated microglia, adding further evidence to the central role of the spleen in MAPC-mediated neuroprotection.
PDF
