ECMO During a Pandemic: A COVID-19 Quality Improvement Process.

Extracorporeal membrane oxygenation is a modified form of cardiopulmonary bypass and a complex adult critical care therapy. No evidence appears to exist on sustaining relevant quality nursing standards during a pandemic. The aim for this quality improvement process was to address nursing provision in real time related to extracorporeal membrane oxygenation in a pandemic, providing fundamentals for future readiness. The Ishikawa fishbone diagram and a Plan-Do-Study-Act cycle were methods used. Process changes included implementation of a communication algorithm, an alternative nursing care model, increased nursing staffing and leadership visibility, use of perfusion services for nursing task support, and minimized nursing documentation. Changes applied were successful. We recommend increasing nursing staffing volume and support resources, applying a communication algorithm, and minimizing documentation requirements. These strategies are generalizable to other clinical nursing areas in similar pandemics or disasters.

Laminar and temporal expression dynamics of coding and noncoding RNAs in the mouse neocortex.

The hallmark of the cerebral neocortex is its organization into six layers, each containing a characteristic set of cell types and synaptic connections. The transcriptional events involved in laminar development and function still remain elusive. Here, we employed deep sequencing of mRNA and small RNA species to gain insights into transcriptional differences among layers and their temporal dynamics during postnatal development of the mouse primary somatosensory neocortex. We identify a number of coding and noncoding transcripts with specific spatiotemporal expression and splicing patterns. We also identify signature trajectories and gene coexpression networks associated with distinct biological processes and transcriptional overlap between these processes. Finally, we provide data that allow the study of potential miRNA and mRNA interactions. Overall, this study provides an integrated view of the laminar and temporal expression dynamics of coding and noncoding transcripts in the mouse neocortex and a resource for studies of neurodevelopment and transcriptome.