Purpose
While resuscitative endovascular balloon occlusion of the aorta (REBOA) is contraindicated in patients with aortic injuries, this technique may benefit poly-trauma patients with less extreme ...thoracic injuries. The purpose of this study was to characterize the effects of thoracic injury on hemodynamics during REBOA and the changes in pulmonary contusion over time in a swine model.
Methods
Twelve swine were anesthetized, instrumented, and randomized to receive either a thoracic injury with 5 impacts to the chest or no injury. All animals underwent controlled hemorrhage of 25% blood volume followed by 45 min of Zone 1 REBOA. Animals were then resuscitated with shed blood, observed during a critical care period, and euthanized after 6 h of total experimental time.
Results
There were no differences between the groups at baseline. The only difference after 6 h was a lower hemoglobin in the thoracic trauma group (8.4 ± 0.8 versus 9.4 ± 0.6 g/dL,
P
= 0.04). The average proximal mean arterial pressures were significantly lower in the thoracic trauma group during aortic occlusion 103 (98–108) versus 117 (115–124) mmHg,
P
= 0.04. There were no differences between the pulmonary contusion before REBOA and at the end of the experiment in size (402 ± 263 versus 356 ± 291 mL,
P
= 0.782) or density (− 406 ± 127 versus − 299 ± 175 HFU,
P
= 0.256).
Conclusions
Thoracic trauma blunted the proximal arterial pressure augmentation during REBOA but had minimal impacts on resuscitative outcomes. This initial study indicates that REBOA does not seem to exacerbate pulmonary contusion in swine, but blunt thoracic injuries may attenuate the expected rises in proximal blood pressure during REBOA.
To develop a method for targeting expression of genes to the full hematopoietic system, we have used transgenic mice to explore the transcriptional regulation of the vav gene, which is expressed ...throughout this compartment but rarely outside it. Previously, we showed that a cluster of elements surrounding its promoter could drive hematopoietic-specific expression of a bacterial lacZ reporter gene, but the expression was confined to lymphocytes and was sporadically silenced. Those limitations are ascribed here to the prokaryotic reporter gene. With a human CD4 (hCD4) cell surface reporter, the vav promoter elements drove expression efficiently and stably in virtually all nucleated cells of adult hematopoietic tissues but not notably in nonhematopoietic cell types. In multiple lines, hCD4 appeared on most, if not all, B and T lymphocytes, granulocytes, monocytes, megakaryocytes, eosinophils, and nucleated erythroid cells. Moreover, high levels appeared on both lineage-committed progenitors and the more primitive preprogenitors. In the fetus, expression was evident in erythroid cells of the definitive but not the primitive type. These results indicate that a prokaryotic sequence can inactivate a transcription unit and that the vav promoter region constitutes a potent transgenic vector for the entire definitive hematopoietic compartment.
There in increasing evidence for recent global insect declines. This is of major concern as insects play a critical role in ecosystem functionality and human food security. Even though environmental ...pollutants are known to reduce insect fertility, their potential effects on insect fitness remain poorly understood - especially for soil-dwelling species. Here, we show that fertility of soil-dwelling beetles, Aethina tumida, is reduced, on average, by half due to field-realistic neonicotinoid soil contaminations. In the laboratory, pupating beetles were exposed via soil to concentrations of the neonicotinoid thiamethoxam that reflect global pollution of agricultural and natural habitats. Emerged adult phenotypes and reproduction were measured, and even the lowest concentration reported from natural habitats reduced subsequent reproduction by 50%. The data are most likely a conservative estimate as the beetles were only exposed during pupation. Since the tested concentrations reflect ubiquitous soil pollution, the data reveal a plausible mechanism for ongoing insect declines. An immediate reduction in environmental pollutants is urgently required if our aim is to mitigate the prevailing loss of species biodiversity.
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•Field relevant soil contaminations of thiamethoxam impair beetle fertility.•Female adult egg laying rates were reduced by 50% even at the lowest concentration.•The data reveal a mechanistic explanation for recent declines in insect populations.•Reductions in soil pollution are urgently required to safeguard insect biodiversity.
This article describes the properties of the thermostable transparent polymer films (TSTPFs), their potential use in display and electronic applications, as well as the potential market size. The ...property targets for different types of applications including free standing and supported films then are discussed. The development focus in TSTPFs, especially colorless polyimides (CPIs) for organic light emitting diodes (OLEDs), is emphasized. Some thermally stable transparent polymers that have been developed by our company are discussed.
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A computer-based method was developed for rapid and automatic identification of potential “frequent hitters”. These compounds show up as hits in many different biological assays covering a wide range ...of targets. A scoring scheme was elaborated from substructure analysis, multivariate linear and nonlinear statistical methods applied to several sets of one and two-dimensional molecular descriptors. The final model is based on a three-layered neural network, yielding a predictive Matthews correlation coefficient of 0.81. This system was able to correctly classify 90% of the test set molecules in a 10-times cross-validation study. The method was applied to database filtering, yielding between 8% (compilation of trade drugs) and 35% (Available Chemicals Directory) potential frequent hitters. This filter will be a valuable tool for the prioritization of compounds from large databases, for compound purchase and biological testing, and for building new virtual libraries.
Background Quality of acute surgical care in the US is threatened by a shortage of surgeons performing emergency procedures because of rising costs of uncompensated care, liability concerns, ...declining reimbursement, and lifestyle considerations. In July 2005, we restructured the general surgery service at our medical center into a hospitalist model to improve patient access to surgical care. Study Design We hypothesized that a surgical hospitalist program could improve timeliness of care, emergency department (ED) efficiency and physician satisfaction, resident supervision, continuity of care, and revenue generation. We reviewed our program after 1 year, including patient demographics, diagnosis, and time to consult. Results Three surgical hospitalists cared for 853 patients during 1 year. Patients ranged from 17 to 100 years of age and presented with abdominal pain (66%), infection (18%), malignancy (6%), hernia (4%), and trauma (3%). Fifty-seven percent of consults originated from the ED; 8% came from other surgeons. Mean time to consult was 20 minutes. A survey of ED physicians reported shorter ED length of stay, better patient satisfaction, improved professionalism and resident supervision, and better overall quality of care. Average waiting time for patients with acute appendicitis to undergo operation was reduced from 16 ± 10 hours to 8 ± 4 hours (p < 0.05). Forty-two percent of consults resulted in an operative procedure, and revenue increased as the number of billable consults rose by 190%. Conclusions The surgical hospitalist model provides a cost-effective way for general surgeons to provide timely and high-quality emergency surgical care and enhance patient and referring provider satisfaction.
Using a dual-task paradigm, the present investigation examined whether processes related to line orientation play a critical role in the production of the Poggendorff illusion. In Experiment
1
, we ...assessed the magnitude of the Poggendorff illusion under three different task conditions. In the single-task condition, participants were asked to report how they perceive the alignment of transversal lines in the Poggendorff figure. In two different dual-task conditions, the participants were asked to read aloud the time displayed on a digital or analogue clock while also performing the Poggendorff perception task. The method of constant stimuli was used to calculate the point of subjective equality (PSE) and bistability width values, which represent illusion strength and perceptual uncertainty, respectively. PSEs indicated that the magnitude of the illusion did not vary between single, dual-analogue, and dual-digital task conditions, which suggests that the additional demands placed by the dual tasks had no effect on the illusion strength. Perceptual uncertainty and clock-reading errors were greater in the dual-analogue task condition. Experiment
2
revealed that the analogue clockface was more difficult to read than the digital clockface. Based on these results, we conclude that having participants perform a secondary task does not influence the magnitude of the Poggendorff illusion.
•Typically developing (TD) siblings of children with ASD have unique support needs.•If their needs are consistently overlooked, the wellbeing of TD siblings can suffer.•TD siblings develop ...intrapersonal skills from their sibling relationship.•TD siblings report being closer to the sibling with ASD higher than parents assume.•TD siblings build novel social skills and awareness from their sibling relationship.
Background: Sibling perspectives on the experiences of families caring for an autistic child are often overlooked in autism research. While qualitative research on these lived experiences has grown, it continues to primarily focus on parent reports. Aims: This study explored how having a sibling with autism impacts the non-autistic siblings within a family systems framework. The goal of the current study was to expand the literature by exploring the impacts of autism on the sibling subsystem as reported by the parents and the non-autistic siblings themselves. Methods and Procedures: The researchers interviewed 15 non-autistic siblings (aged 7−17) and 15 parents of children with autism to understand the experience of growing up with a sibling with autism. Content analysis was used to develop the interview protocol and analyze responses. Parent and non-autistic sibling reports of both siblings' effects on each other's development are triangulated with existing research. Results: Findings indicate novel emotional skill-building occurs in non-autistic siblings, as well as some unique risk factors for internalizing and externalizing problems if non-autistic siblings' needs become deprioritized. Family stress, external relationships, intrapersonal and social skill development, and other implications of this unique relationship are discussed.
