In this work, a lightweight compliant glove that detects scratching using data from microtubular stretchable sensors on each finger and an inertial measurement unit (IMU) on the palm through a ...machine learning model is presented: the SensorIsed Glove for Monitoring Atopic Dermatitis (SIGMA). SIGMA provides the user and clinicians with a quantifiable way of assaying scratch as a proxy to itch. With the quantitative information detailing scratching frequency and duration, the clinicians would be able to better classify the severity of itch and scratching caused by atopic dermatitis (AD) more objectively to optimise treatment for the patients, as opposed to the current subjective methods of assessments that are currently in use in hospitals and research settings. The validation data demonstrated an accuracy of 83% of the scratch prediction algorithm, while a separate 30 min validation trial had an accuracy of 99% in a controlled environment. In a pilot study with children (
= 6), SIGMA accurately detected 94.4% of scratching when the glove was donned. We believe that this simple device will empower dermatologists to more effectively measure and quantify itching and scratching in AD, and guide personalised treatment decisions.
To model bolus dosing, infusion rate, and weaning rate on theoretical serum concentration of midazolam and pentobarbital used in the treatment of refractory status epilepticus (RSE).
One- and ...two-compartment in silico pharmacokinetic models of midazolam and pentobarbital.
Not applicable.
Not applicable.
We compared the model variables used in midazolam and pentobarbital protocols for standard RSE.
Standard RSE treatment protocols result in steady-state serum concentrations that are 6.2-9.0-fold higher for the one-compartment model and 2.3-4.7-fold higher for the two-compartment model. In the model, not including bolus doses delays the achievement of serum steady-state concentration by 0.5 and 2.7 hours for midazolam and pentobarbital, respectively. Abrupt discontinuation of these medications reduces modeled medication exposure by 1.1 and 6.4 hours, respectively.
Our in silico pharmacokinetic modeling of standard midazolam and pentobarbital dosing protocols for RSE suggests potential variables to optimize in future clinical studies.
Reflecting on an (auto)ethnographic study from the standpoint of a person of colour, this article uses the narrative myth of Gaia to analyze and structure the recollection of over 5 years of teaching ...people of colour at a large Canadian university and distill from them the character of pedagogical care. This article demonstrates how narrative metaphors offered the qualitative researcher an analytical tool to examine the networked webs of oppression conjoining personal lived experiences and experiences of students as a rich source of data for people of colour, excavating the nuanced socioemotional modalities that complicate marginalized instructors’ ability to provide pedagogical care for fellow marginalized students and the emotional labour required to resolve these tensions.
Mastering selective molecule trafficking across human cell membranes poses a formidable challenge in healthcare biotechnology while offering the prospect of breakthroughs in drug delivery, gene ...therapy, and diagnostic imaging. The cholera toxin B-subunit (CTB) has the potential to be a useful cargo transporter for these applications. CTB is a robust protein that is amenable to reengineering for diverse applications; however, protein redesign has mostly focused on modifications of the N- and C-termini of the protein. Exploiting the full power of rational redesign requires a detailed understanding of the contributions of the surface residues to protein stability and binding activity. Here, we employed Rosetta-based computational saturation scans on 58 surface residues of CTB, including the GM1 binding site, to analyze both ligand-bound and ligand-free structures to decipher mutational effects on protein stability and GM1 affinity. Complimentary experimental results from differential scanning fluorimetry and isothermal titration calorimetry provided melting temperatures and GM1 binding affinities for 40 alanine mutants among these positions. The results showed that CTB can accommodate diverse mutations while maintaining its stability and ligand binding affinity. These mutations could potentially allow modification of the oligosaccharide binding specificity to change its cellular targeting, alter the B-subunit intracellular routing, or impact its shelf-life and in vivo half-life through changes to protein stability. We anticipate that the mutational space maps presented here will serve as a cornerstone for future CTB redesigns, paving the way for the development of innovative biotechnological tools.
This systematic review of national or regional guidelines published in English aimed to better understand variance in pre-hospital and emergency department treatment of status epilepticus.
Systematic ...search of national or regional guidelines (January 2000 to February 2017) contained within PubMed and Google Scholar databases, and article reference lists. The search keywords were status epilepticus, prolonged seizure, treatment, and guideline.
356 articles were retrieved and 13 were selected according to the inclusion criteria. In all six pre-hospital guidelines, the preferred route of medication administration was to use alternatives to the intravenous route: all recommended buccal and intranasal midazolam; three also recommended intramuscular midazolam, and five recommended using rectal diazepam. All 11 emergency department guidelines described three phases in therapy. Intravenous medication, by phase, was indicated as such: initial phase – ten/11 guidelines recommended lorazepam, and eight/11 recommended diazepam; second phase – most (ten/11) guidelines recommended phenytoin, but other options were phenobarbital (nine/11), valproic acid (six/11), and either fosphenytoin or levetiracetam (each four/11); third phase – four/11 guidelines included the choice of repeating second phase therapy, whereas the other guidelines recommended using a variety of intravenous anesthetic agents (thiopental, midazolam, propofol, and pentobarbital).
All of the guidelines share a similar framework for management of status epilepticus. The choice in route of administration and drug type varied across guidelines. Hence, the adoption of a particular guideline should take account of local practice options in health service delivery.
Esta análise sistemática de diretrizes nacionais ou regionais publicadas em inglês tem como objetivo entender melhor a diferença no tratamento do estado de mal epiléptico pré-hospitalar e no departamento de emergência.
Pesquisa sistemática de diretrizes nacionais ou regionais (janeiro de 2000 a fevereiro de 2017) contidas nas base de dados do Pubmed e do Google Acadêmico e listas de referência de artigos. As palavras-chave da busca foram estado de mal epiléptico, convulsão prolongada, tratamento e diretriz.
356 artigos foram identificados, e 13 foram selecionados de acordo com os critérios de inclusão. Em todas as seis diretrizes pré-hospitalares, o caminho preferencial de administração da medicação foi utilizar alternativas à via intravenosa: todas recomendaram midazolam bucal e intranasal; três também recomendaram midazolam intramuscular; e cinco recomendaram utilizar o diazepam via retal. Todas as 11 diretrizes de departamento de emergência descreveram três fases na terapia. No que diz respeito à medicação intravenosa, por fase, temos: fase inicial – 10/11 diretrizes recomendaram lorazepam e 8/11 recomendaram diazepam; segunda fase – a maioria (10/11) das diretrizes recomendou fenitoína, porém outras opções foram fenobarbital (9/11), ácido valpróico (6/11) e fosfenitoína ou levetiracetam (individualmente, 4/11); terceira fase – 4/11 diretrizes incluíram a opção de repetir a terapia da segunda fase, ao passo que as outras diretrizes recomendaram utilizar diversos agentes anestésicos intravenosos (tiopental, midazolam, propofol e pentobarbital).
Todas as diretrizes compartilham uma estrutura semelhante para manejo do estado de mal epiléptico. A escolha da via de administração e do tipo de medicamento variou em todas as diretrizes. Assim, a adoção de uma diretriz específica deve levar em consideração as opções da prática local na prestação de serviços de saúde.
•Broken coral colony number is correlated with number of divers visiting.•Branching and plate-like corals are susceptible to diver damages.•Composition change of coral substrate has been taking place ...in Hong Kong.•Popular dive sites should be zoned as “no-go” areas for training divers.
We conducted the first quantitative assessment of coral breakage along a gradient of diving activities in Hong Kong, the most densely populated city in southern China. A survey of six 1×25m transects at seven sites revealed a total of 81 broken corals, among which 44% were branching, 44% plate-like and 12% massive. There were 3–19 broken colonies per site. At most study sites, the percentage of broken corals exceeded the recommended no-action threshold of 4%, suggesting that management intervention is justified. There was a significant positive correlation between the number of broken coral colonies and the number of divers visiting the site. The branching Acropora and the plate-like Montipora suffered from much higher frequency of damage than their relative abundance, raising the concern that the cumulative impact of such differential susceptibility to breakage may affect coral community composition.
It is estimated that from 2015 to 2025, the Global Multiplayer Online Game (MMOG) market will be growing at a compound annual growth rate of 10.2%. However, rapid market changes have shortened the ...lifespan of many MMOGs. This market phenomenon may demotivate prospective market players and thus decelerate the market growth. To address the lifespan issue, we conducted a netnographic case study on 'TalesRunner', which has successfully operated for longer than many other MMOGs. Based on the data from over 5.2 million messages from its official forum, as well as data from different secondary sources, we established a lifecycle model of MMOG in conjunction with the Technology-Organization-Environment (TOE) framework and offered theoretical implications for both MMOG and lifecycle theory.
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