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1.
Pediatr Cardiol ; 42(2): 289-293, 2021 Feb.
Article in English | MEDLINE | ID: mdl-33048185

ABSTRACT

The objective of this study was to evaluate the safety and efficacy of combining transcatheter pulmonary valve replacement (TPVR) and electrophysiology (EP) procedures. A retrospective review was undertaken to identify TPVR and EP procedures that were concomitantly performed in the cardiac catheterization laboratory at University of Iowa Stead Family Children's Hospital from January 2011 to October 2019. Procedural and follow-up data were compared between patients who underwent TPVR and EP procedures in the same setting to those who received TPVR or EP procedure separately and that were similar in age and cardiac anatomy. A total of 8 patients underwent combined TPVR and EP procedures. One patient was excluded due to lack of adequate control, leaving seven study subjects (57% female; median age at time of procedure 16 years). The median follow-up time was 11.5 months (range 2-36 months). Patients who received combined TPVR and EP had shorter recovery times (combined: median 18.9 h; IQR 18.35-19.5 vs separate: median 27.98 h; IQR 21.42-39.25; p-value 0.031), shorter hospital length of stay (combined: median 27.5 h; IQR 26.47-31.4 vs separate: median 38.4 h; IQR 33.42-51.50; p-value 0.016), and a 51% reduction in total hospital charges (combined: median $171,640; IQR 135.43-219.22 vs separate: median $333,560 IQR 263.20-400.98; p-value 0.016). There were no significant differences in radiation dose or procedure time between the combined and control groups. The median radiation time for those who had the combination procedure was 30.5 min [IQR 29.6-47.9], and the median dose area product was 215 mGy [IQR 158-935]. In conclusion, combining TPVR and EP procedures is feasible, safe, and economically advantageous.


Subject(s)
Cardiac Catheterization/methods , Electrophysiologic Techniques, Cardiac/methods , Heart Diseases/surgery , Heart Valve Prosthesis Implantation/methods , Pulmonary Valve/surgery , Adolescent , Adult , Cardiac Surgical Procedures , Child , Combined Modality Therapy , Electrophysiologic Techniques, Cardiac/economics , Female , Heart Valve Prosthesis , Heart Valve Prosthesis Implantation/economics , Hospital Costs , Humans , Length of Stay , Male , Pulmonary Valve Insufficiency/surgery , Retrospective Studies , Tetralogy of Fallot/surgery , Treatment Outcome , Young Adult
2.
J Opt Soc Am A Opt Image Sci Vis ; 37(10): 1650-1656, 2020 Oct 01.
Article in English | MEDLINE | ID: mdl-33104612

ABSTRACT

In this work, we report experiments and a theoretical scheme of photon transport in the frequency domain of rigid turbid media. We have employed spectral multi-speckle intensity correlations to estimate optical properties as the transport mean free path and the absorption length of turbid systems. We propose a scheme based on the photon diffusion model using an effective path-length distribution in the backscattering configuration and take explicitly into account the particles scattering anisotropy parameter g. By studying rigid Teflon slabs and polymer matrices doped with polystyrene particles of different degrees of scattering anisotropy, we find that the proposed model adequately describes our experimental results. Our hypothesis for the diffuse transport of backscattered photons in the weak multiple scattering regime is further validated using a numerical simulation scheme of speckle dynamics, based on the Copula method.

3.
Pacing Clin Electrophysiol ; 41(11): 1428-1434, 2018 11.
Article in English | MEDLINE | ID: mdl-30151836

ABSTRACT

BACKGROUND: Patients with congenital heart disease require multiple procedures over their lifetime. These procedures increase cost and time commitment. Previous studies in the field of medicine have shown that combining procedures is an effective method to reduce cost and time. There has been no such study to evaluate the cost and efficiency of combining pediatric cardiac procedures. OBJECTIVE: The objective of this study was to compare the cost and time commitment of combined cardiac catheterization (cath) and electrophysiology (EP) outpatient procedures against separate cath and EP procedure. METHODS: Outpatient combination procedures performed in the pediatric cardiac cath lab from 2013 to 2016 were matched to a control population of two or three similar single outpatient procedures from 2009 to 2016 for patients of similar age and cardiac anatomy. Procedure duration, recovery duration, length of stay, equipment charges, physician charges, all other hospital charges, and total admission charges were analyzed. The two groups were compared using an unpaired t-test. RESULTS: A total of 92 subjects, 32 study subjects and 60 control subjects, were included in this study. Study group procedures had a significantly shorter recovery duration (P = 0.04) and length of stay (P = 0.01). Study group procedure duration trended shorter on average but statistically insignificant (P = 0.20). The total median savings for patients undergoing combined procedures in the study group was $13,181 (interquartile range $423.8-$26710). CONCLUSIONS: Combining cath and EP outpatient procedures reduces the time commitment and provides some economic advantage.


Subject(s)
Ambulatory Care/economics , Cardiac Catheterization/economics , Electrophysiologic Techniques, Cardiac/economics , Heart Defects, Congenital/therapy , Adolescent , Adult , Case-Control Studies , Combined Modality Therapy , Costs and Cost Analysis , Female , Humans , Length of Stay/statistics & numerical data , Male , Time Factors , Treatment Outcome
4.
Appl Opt ; 57(2): 208-216, 2018 Jan 10.
Article in English | MEDLINE | ID: mdl-29328165

ABSTRACT

We present a combined experimental, theoretical, and numerical study of photon transport and microscopic dynamics in rigid and drying turbid thin films. Our setup is based in multispeckle diffusing wave spectroscopy and is adapted for frequency sweep of the illuminating source. We apply our approach to simultaneously monitor the changes in optical properties and microscopic dynamics of turbid thin films of rutile TiO2 powder dispersed in ethanol during the full drying process. Accordingly, we introduce an extension of the photon diffusion model for spectral speckle intensity correlations to account for system microscopic dynamics. We find that our results are well described by the model, where parameters required as the time-dependent sample thickness and transport mean free path are obtained from experiments. Furthermore, our findings are validated by numerical simulations of speckle dynamics based on the copula scheme. We consider that our scheme could be useful in time-resolved physical characterization of time-evolving turbid thin systems.

5.
Analyst ; 142(7): 1157-1164, 2017 Mar 27.
Article in English | MEDLINE | ID: mdl-28262862

ABSTRACT

Environmental pollution by mercury in ambient water samples is a recognized problem worldwide. Sample preservation and transport to the laboratory lead to uncertain analytical results. This study outlines the development of a procedure for on-site electrodeposition of mercury from water samples on a screen-printed gold electrode (SPGE) using portable voltammetric techniques. Once in the laboratory, Hg is analyzed by laser ablation inductively coupled plasma-mass spectrometry (LA-ICPMS) in order to ensure that the required sensitivity and precision levels for environmental sample analysis are reached. A new ablation chamber was intentionally designed for the analysis of SPGE's gold electrode. This cell has a small internal volume of 15 cm3 and the SPGE device perfectly fits inside. This design assures signal stability, avoids elemental fractionation and reduces wash-out time to a few seconds, reducing the analysis time considerably. The proposed method is capable of measuring dissolved mercury at the ng L-1 level (quantification limit 200 ng L-1) with good precision (RSD < 7.6%). The proposed method was tested with the NCS ZC 76303 (NIM-GBW08603) Mercury in water Certified Reference Material.

7.
Appl Opt ; 55(31): 8806-8812, 2016 Nov 01.
Article in English | MEDLINE | ID: mdl-27828278

ABSTRACT

We describe the implementation of echo dynamic light scattering in a cross-correlation detection scheme, which enables the study of slow dynamics in moderately turbid colloidal systems by adapting a commercial light scattering device. Our setup combines a 3D cross-correlation detection scheme (3DDLS), which allows for suppression of multiple scattering, with the speckle echo technique for dynamic light scattering. The recorded cross-correlation echoes provide precise ensemble-averaged results that appropriately describe sample dynamics of ergodic and non-ergodic colloidal systems of different turbidities. Additionally, the high mechanical stability achieved in our setup makes possible an absolute estimation of the scattering intensity correlation function (ICF) directly from the height of echoes, thus making unnecessary any correction for imperfect rotation of the sample or of any ad hoc assumption regarding the correspondence between the absolute values of echo height and ICF. Furthermore, we find that zeroth-order echo height represents the coherence factor of the 3DDLS experiment.

8.
J Chem Phys ; 143(4): 044902, 2015 Jul 28.
Article in English | MEDLINE | ID: mdl-26233159

ABSTRACT

We characterize the translational and rotational dynamics of birefringent spherical colloidal particles by depolarized light scattering in the far- and near-field regimes. For this purpose, we use depolarized dynamic light scattering and propose an extension of dynamic heterodyne near-field light scattering that takes into account the polarization state of the light. Such a combination of methods allows to access colloidal dynamics in an extended q-range and permits to evaluate different modes of particles motion in suspension. Furthermore, we obtain a good agreement between results from the far- and near-field approaches thus validating our proposal and opening the possibility to investigate simultaneously the subtle interplay between translational and rotational motions of anisotropic colloidal particles in length-scales from the order of the particle size to several interparticle distances.


Subject(s)
Anisotropy , Colloids/chemistry , Biochemical Phenomena , Diffusion , Light , Particle Size , Rotation , Scattering, Radiation
9.
J Biol Chem ; 288(8): 5389-97, 2013 Feb 22.
Article in English | MEDLINE | ID: mdl-23297398

ABSTRACT

Ubiquitination plays a key role in trafficking of the epithelial Na(+) channel (ENaC). Previous work indicated that ubiquitination enhances ENaC endocytosis and sorting to lysosomes for degradation. Moreover, a defect in ubiquitination causes Liddle syndrome, an inherited form of hypertension. In this work, we identified a role for USP8 in the control of ENaC ubiquitination and trafficking. USP8 increased ENaC current in Xenopus oocytes and collecting duct epithelia and enhanced ENaC abundance at the cell surface in HEK 293 cells. This resulted from altered endocytic sorting; USP8 abolished ENaC degradation in the endocytic pathway, but it had no effect on ENaC endocytosis. USP8 interacted with ENaC, as detected by co-immunoprecipitation, and it deubiquitinated ENaC. Consistent with a functional role for deubiquitination, mutation of the cytoplasmic lysines of ENaC reduced the effect of USP8 on ENaC cell surface abundance. In contrast to USP8, USP2-45 increased ENaC surface abundance by reducing endocytosis but not degradation. Thus, USP8 and USP2-45 selectively modulate ENaC trafficking at different steps in the endocytic pathway. Together with previous work, the data indicate that the ubiquitination state of ENaC is critical for the regulation of epithelial Na(+) absorption.


Subject(s)
Endopeptidases/physiology , Endosomal Sorting Complexes Required for Transport/physiology , Endosomes/metabolism , Epithelial Sodium Channels/metabolism , Ubiquitin Thiolesterase/physiology , Amiloride/pharmacology , Animals , Biotinylation , Cell Membrane/metabolism , DNA, Complementary/metabolism , Electrophysiology/methods , Endocytosis , Gene Expression Regulation , HEK293 Cells , Humans , Hypertension/metabolism , Models, Biological , Oocytes/metabolism , Protein Transport , Ubiquitin/metabolism , Xenopus
10.
Arch Med Res ; 55(1): 102916, 2024 01.
Article in English | MEDLINE | ID: mdl-38039802

ABSTRACT

Clavulanic acid (CLAV) is a non-antibiotic ß-lactam that has been used since the late 1970s as a ß-lactamase inhibitor in combination with amoxicillin, another ß-lactam with antibiotic activity. Its long-observed adverse reaction profile allows it to say that CLAV is a well-tolerated drug with mainly mild adverse reactions. Interestingly, in 2005, it was discovered that ß-lactams enhance the astrocytic expression of GLT-1, a glutamate transporter essential for maintaining synaptic glutamate homeostasis involved in several pathologies of the central nervous system (CNS). This finding, along with a favorable pharmacokinetic profile, prompted the appearance of several studies that intended to evaluate the effect of CLAV in preclinical disease models. Studies have revealed that CLAV can increase GLT-1 expression in the nucleus accumbens (NAcc), medial prefrontal cortex (PFC), and spinal cord of rodents, to affect glutamate and dopaminergic neurotransmission, and exert an anti-inflammatory effect by modulating the levels of the cytokines TNF-α and interleukin 10 (IL-10). CLAV has been tested with positive results in preclinical models of epilepsy, addiction, stroke, neuropathic and inflammatory pain, dementia, Parkinson's disease, and sexual and anxiety behavior. These properties make CLAV a potential therapeutic drug if repurposed. Therefore, this review aims to gather information on CLAV's effect on preclinical neurological disease models and to give some perspectives on its potential therapeutic use in some diseases of the CNS.


Subject(s)
Anti-Bacterial Agents , beta-Lactams , Clavulanic Acid/therapeutic use , Clavulanic Acid/metabolism , Clavulanic Acid/pharmacology , Anti-Bacterial Agents/therapeutic use , beta-Lactams/metabolism , beta-Lactams/pharmacology , Nucleus Accumbens/metabolism , Glutamates/metabolism , Glutamates/pharmacology , Excitatory Amino Acid Transporter 2/metabolism
11.
Sci Rep ; 13(1): 10655, 2023 06 30.
Article in English | MEDLINE | ID: mdl-37391411

ABSTRACT

This study investigates the validity evidence of metrics used for the assessment of surgical skills for Manual Small Incision Cataract Surgery (MSICS) in a virtual reality simulator. MSICS surgery is a low-cost, low-technology cataract surgery technique, which is widely used in low- and middle-income countries. However, there is a lack of cataract surgeons globally, and efficient and evidence-based training of new surgeons is needed. In order to investigate the validity of simulator metrics, we included three groups of participants: (1) MSICS novices who were ophthalmologists with no cataract surgery experience, (2) MSICS novices who were experienced phacoemulsification cataract surgeons, but with no MSICS experience, and (3) experienced phacoemulsification and MSICS surgeons. The evaluation included 11 steps of the MSICS procedure, and all simulator metrics for those steps were reviewed. Of the 55 initial metrics, 30 showed high positive discriminative ability. A test passing score of 20 out of 30 was established, and one of 15 novices with no MSICS experience (mean score 15.5) and 7 out of 10 experienced MSICS surgeons (mean score 22.7) passed the test. We have developed and established validity evidence for a test for MSICS skills in a virtual reality simulator for future use in proficiency-based training and evidence-based testing of training interventions.


Subject(s)
Cataract Extraction , Cataract , Phacoemulsification , Surgical Wound , Virtual Reality , Humans , Computer Simulation
12.
Sci Rep ; 12(1): 12845, 2022 Jul 27.
Article in English | MEDLINE | ID: mdl-35902601

ABSTRACT

Deep learning architectures have transformed data analytics in geosciences, complementing traditional approaches to geological problems. Although deep learning applications in geosciences show encouraging signs, their potential remains untapped due to limited data availability and the required in-depth knowledge to provide a high-quality labeled dataset. We approached these issues by developing a novel style-based deep generative adversarial network (GAN) model, PetroGAN, to create the first realistic synthetic petrographic datasets across different rock types. PetroGAN adopts the architecture of StyleGAN2 with adaptive discriminator augmentation (ADA) to allow robust replication of statistical and esthetical characteristics and improve the internal variance of petrographic data. In this study, the training dataset consists of > 10,000 thin section images both under plane- and cross-polarized lights. Here, using our proposed novel approach, the model reached a state-of-the-art Fréchet Inception Distance (FID) score of 12.49 for petrographic images. We further observed that the FID values vary with lithology type and image resolution. The generated images were validated through a survey where the participants have various backgrounds and level of expertise in geosciences. The survey established that even a subject matter expert observed the generated images were indistinguishable from real images. This study highlights that GANs are a powerful method for generating realistic synthetic data in geosciences. Moreover, they are a future tool for image self-labeling, reducing the effort in producing big, high-quality labeled geoscience datasets. Furthermore, our study shows that PetroGAN can be applied to other geoscience datasets, opening new research horizons in the application of deep learning to various fields in geosciences, particularly with the presence of limited datasets.

13.
J Am Heart Assoc ; 11(9): e024375, 2022 05 03.
Article in English | MEDLINE | ID: mdl-35491986

ABSTRACT

Background There is limited information regarding the clinical use and effectiveness of IV sotalol in pediatric patients and patients with congenital heart disease, including those with severe myocardial dysfunction. A multicenter registry study was designed to evaluate the safety, efficacy, and dosing of IV sotalol. Methods and Results A total of 85 patients (age 1 day-36 years) received IV sotalol, of whom 45 (53%) had additional congenital cardiac diagnoses and 4 (5%) were greater than 18 years of age. In 79 patients (93%), IV sotalol was used to treat supraventricular tachycardia and 4 (5%) received it to treat ventricular arrhythmias. Severely decreased cardiac function by echocardiography was seen before IV sotalol in 7 (9%). The average dose was 1 mg/kg (range 0.5-1.8 mg/kg/dose) over a median of 60 minutes (range 30-300 minutes). Successful arrhythmia termination occurred in 31 patients (49%, 95% CI [37%-62%]) with improvement in rhythm control defined as rate reduction permitting overdrive pacing in an additional 18 patients (30%, 95% CI [19%-41%]). Eleven patients (16%) had significant QTc prolongation to >465 milliseconds after the infusion, with 3 (4%) to >500 milliseconds. There were 2 patients (2%) for whom the infusion was terminated early. Conclusions IV sotalol was safe and effective for termination or improvement of tachyarrhythmias in 79% of pediatric patients and patients with congenital heart disease, including those with severely depressed cardiac function. The most common dose, for both acute and maintenance dosing, was 1 mg/kg over ~60 minutes with rare serious complications.


Subject(s)
Heart Defects, Congenital , Tachycardia, Supraventricular , Arrhythmias, Cardiac/complications , Arrhythmias, Cardiac/diagnosis , Arrhythmias, Cardiac/drug therapy , Child , Heart Defects, Congenital/complications , Humans , Infant , Registries , Sotalol/adverse effects , Tachycardia, Supraventricular/complications
14.
CJC Pediatr Congenit Heart Dis ; 1(1): 11-22, 2022 Feb.
Article in English | MEDLINE | ID: mdl-37969556

ABSTRACT

Background: Several medication choices are available for acute and prophylactic treatment of refractory supraventricular tachycardia (SVT) in infants. There are almost no controlled trials, and medication choices are not necessarily evidence based. Our objective was to report the effectiveness of management strategies for infant SVT. Methods: A registry of infants admitted to hospital with re-entrant SVT and no haemodynamically significant heart disease were prospectively followed at 11 international tertiary care centres. In addition, a systematic review of studies on infant re-entrant SVT in MEDLINE and EMBASE was conducted. Data on demographics, symptoms, acute and maintenance treatments, and outcomes were collected. Results: A total of 2534 infants were included: n = 108 from the registry (median age, 9 days [0-324 days], 70.8% male) and n = 2426 from the literature review (median age, 14 days; 62.3% male). Propranolol was the most prevalent acute (61.4%) and maintenance treatment (53.8%) in the Registry, whereas digoxin was used sparingly (4.0% and 3.8%, respectively). Propranolol and digoxin were used frequently in the literature acutely (31% and 33.2%) and for maintenance (17.8% and 10.1%) (P < 0.001). No differences in acute or prophylactic effectiveness between medications were observed. Recurrence was higher in the Registry (25.0%) vs literature (13.4%) (P < 0.001), and 22 (0.9%) deaths were reported in the literature vs none in the Registry. Conclusion: This was the largest cohort of infants with SVT analysed to date. Digoxin monotherapy use was rare amongst contemporary paediatric cardiologists. There was limited evidence to support one medication over another. Overall, recurrence and mortality rates on antiarrhythmic treatment were low.


Contexte: De nombreux choix de médicaments existent pour le traitement aigu et prophylactique de la tachycardie supraventriculaire (TSV) réfractaire chez les nourrissons. Or, il n'y a presque pas d'essais contrôlés à ce sujet, et les choix de médicaments ne sont pas nécessairement fondés sur des données probantes. Notre objectif était de faire état de l'efficacité des stratégies de prise en charge de la TSV chez les nourrissons. Méthodologie: Un registre des nourrissons admis à l'hôpital pour une TSV par réentrée, sans cardiopathie d'importance hémodynamique, a été tenu de façon prospective dans 11 centres de soins tertiaires à l'échelle mondiale. De plus, une revue systématique des études sur la TSV par réentrée chez le nourrisson a été effectuée dans MEDLINE et EMBASE. Des données sur les caractéristiques démographiques, les symptômes, les traitements aigus et d'entretien, et les résultats ont été recueillis. Résultats: Un total de 2 534 nourrissons ont été inclus : n = 108 du registre (âge médian de 9 jours [0-324 jours], 70,8 % de sexe masculin) et n = 2 426 de la revue de la littérature (âge médian de 14 jours; 62,3 % de sexe masculin). Le propranolol était le traitement de soins aigus (61,4 %) et d'entretien (53,8 %) le plus fréquent dans le registre, alors que la digoxine a été utilisée occasionnellement (respectivement dans 4,0 % et 3,8 % des cas). Dans la littérature, le propranolol et la digoxine étaient fréquemment utilisés en soins aigus (31 % et 33,2 %) et en traitement d'entretien (17,8 % et 10,1 %) (p < 0,001). Aucune différence n'a été observée entre les médicaments au chapitre de l'efficacité du traitement de soins aigus ou du traitement prophylactique. Le taux de récurrence était plus élevé dans le registre (25,0 %) que dans la littérature (13,4 %) (p < 0,001), et 22 (0,9 %) décès ont été signalés dans la littérature, mais aucun dans le registre. Conclusion: Il s'agit de la plus grande cohorte de nourrissons atteints de TSV analysée à ce jour. De nos jours, les cardiologues pédiatriques prescrivent rarement la digoxine en monothérapie. Peu de données probantes favorisent l'utilisation d'un médicament par rapport à l'autre. Dans l'ensemble, les taux de récurrence et de mortalité sous traitement antiarythmique étaient faibles.

15.
Blood ; 114(12): 2497-505, 2009 Sep 17.
Article in English | MEDLINE | ID: mdl-19608749

ABSTRACT

The mouse Lupo (I282N) mutation in proline-serine-threonine phosphatase-interacting protein 2 (PSTPIP2) leads to reduced expression of PSTPIP2 that is associated with a macrophage-mediated autoinflammatory disease. Another mutation in PSTPIP2, L98P, termed chronic multifocal osteomyelits (cmo), leads to a disease in mice that resembles chronic recurrent multifocal osteomyelits in humans. The cellular basis of cmo disease was investigated. cmo disease develops independently of lymphocytes and is cured by bone marrow transplantation. Macrophages, mast cells, and osteoclasts from cmo mice fail to express detectable PSTPIP2 protein. Asymptomatic Pstpip2(cmo/cmo) mice have increased circulating levels of macrophage inflammatory protein 1-alpha and interleukin-6, and their macrophages exhibit increased production of these inflammatory mediators, which is normalized by retroviral expression of wild-type PSTPIP2. Spleens of asymptomatic cmo mice contain increased numbers of macrophage precursors, and cmo mice mobilize more macrophage precursors in response to a sterile inflammatory stimulus. Signal transducer and activator of transcription 1 is elevated in cmo splenic macrophages, which also exhibit increased colony-stimulating factor-1-stimulated proliferation and increased extracellular signal-regulated kinase 1/2 phosphorylation. PSTPIP2 overexpression in macrophages leads to the opposite phenotype. Thus, PSTPIP2 deficiency causes both an expansion of macrophage progenitors and increased responsiveness of mature macrophages to activating stimuli, which together prime the organism for exaggerated and sustained responses leading to autoinflammatory disease.


Subject(s)
Adaptor Proteins, Signal Transducing/physiology , Autoimmune Diseases/immunology , Cytoskeletal Proteins/physiology , Osteomyelitis/immunology , Animals , Autoimmune Diseases/pathology , Blotting, Western , Cell Proliferation/drug effects , Chemokine CCL3/metabolism , Chronic Disease , Disease Models, Animal , Female , Flow Cytometry , Hematopoietic Stem Cells/pathology , Immunity, Innate/physiology , Immunoenzyme Techniques , Immunoprecipitation , Inflammation/immunology , Inflammation/pathology , Interleukin-6/metabolism , Macrophage Colony-Stimulating Factor/metabolism , Macrophages/immunology , Macrophages/metabolism , Male , Mice , Mice, Inbred BALB C , Mitogen-Activated Protein Kinase 1/metabolism , Mitogen-Activated Protein Kinase 3/metabolism , Myeloid Cells/metabolism , Osteomyelitis/pathology , Phosphorylation , Retroviridae/genetics , STAT1 Transcription Factor/metabolism , Thioglycolates/pharmacology
16.
Appl Biosaf ; 26(3): 113-122, 2021 Sep 01.
Article in English | MEDLINE | ID: mdl-36035545

ABSTRACT

Background: Risk assessment is a critical tool for evaluating emerging pathogens such as severe acute respiratory syndrome coronavirus 2 because of the limited available information about pathogens and the diseases they cause. Industries adopt unique frameworks for risk assessment, for example, the ISO 35001:2019 biorisk management for laboratories and other related organizations provide tools to identify, assess, control, and monitor risks associated with hazardous biological materials. Industries such as aerospace are known as high-reliability organizations (HROs) because these must balance high-risk operations with minimal catastrophic outcomes. HROs focus on five core principles: preoccupation with failure, reluctance to simplify, sensitivity to operations, resilience, and deference to expertise to evaluate and manage risk. Results: In the present discussion, practices described in the ISO 35001 standard and the HRO model are applied to the current challenges faced by laboratories worldwide. Laboratories processing known or unknown coronavirus disease 2019 (COVID-19) samples, testing COVID-19 vaccine candidates, propagating severe acute respiratory syndrome-associated coronavirus-2, or validating diagnostic assays benefit from implementing such practices. Principles extrapolated from the HRO also help illustrate the importance of the end-to-end processes to ensure successful outcomes. Summary: Workplace safety is enhanced by the involvement of all stakeholders, from top leadership to front-line workers. High-quality outcomes as measured by a lack of incidents, accidents, injuries, or near misses are the positive consequences of strictly following standard operating procedures and timely communication of risks and pitfalls. Adopting a systematic framework to identify and manage risks posed by emerging pathogens results in increased workplace safety and higher quality processes and products.

17.
Cureus ; 13(3): e13642, 2021 Mar 01.
Article in English | MEDLINE | ID: mdl-33824795

ABSTRACT

Mass casualty incidents such as those that are being experienced during the novel coronavirus disease (COVID-19) pandemic can overwhelm local healthcare systems, where the number of casualties exceeds local resources and capabilities in a short period of time. The influx of patients with lung function deterioration as a result of COVID-19 has strained traditional ventilator supplies. To bridge the gap during ventilator shortages and to help clinicians triage patients, manual resuscitator devices can be used to deliver respirations to a patient requiring breathing support. Bag-valve mask (BVM) devices are ubiquitous in ambulances and healthcare environments, however require a medical professional to be present and constantly applying compression to provide the patient with respirations. We developed an automated manual resuscitator-based emergency ventilator-alternative (AMREV) that provides automated compressions of a BVM in a repetitive manner and is broadly compatible with commercially-available BVM devices approximately 5 inches (128 mm) in diameter. The AMREV device relieves the medical professional from providing manual breathing support and allows for hands-free operation of the BVM. The AMREV supports the following treatment parameters: 1) adjustable tidal volume (V T ), 2) positive end-expiratory pressure (PEEP) (intrinsic and/or external), 3) 1:1 inspiratory: expiratory ratio, and 4) a controllable respiratory rate between 10-30 breaths per minute. The relationship between the inherent resistance and compliance of the lung and the delivered breaths was assessed for the AMREV device. Adjustable V T of 110-700 ml was achieved within the range of simulated lung states. A linear increase in mean airway pressure (P aw ), from 10-40 cmH2O was observed, as the resistance and compliance on the lung model moved from normal to severe simulated disease states. The AMREV functioned continuously for seven days with less than 3.2% variation in delivered V T and P aw . Additionally, the AMREV device was compatible with seven commercially-available BVM setups and delivered consistent V T and P aw within 10% between models. This automated BVM-based emergency-use resuscitator can provide consistent positive pressure, volume-controlled ventilation over an extended duration when a traditional ventilator is not available. True ventilator shortages may lead to manual resuscitators devices such as the AMREV being the only option for some healthcare systems during the COVID-19 pandemic.

18.
Clin Physiol Funct Imaging ; 39(4): 240-245, 2019 Jul.
Article in English | MEDLINE | ID: mdl-30770644

ABSTRACT

INTRODUCTION: Endothelial dysfunction is considered the first step in the development of atherosclerosis. Flow-mediated dilation (FMD) has been the most common assessment of endothelial function in research but it has failed in obtaining a widespread use in clinical settings due to a lack of standardization and a large inter-subject variability. Normalization of FMD to endothelial shear stress (ESS) has been proposed to solve its technical limitations. However, studies have not considered the characteristic of the blood flow during FMD under pulsatile conditions in their ESS estimations. METHODS: A total of 26 young healthy subjects (15 females and 11 males) underwent FMD testing. Microhematocrit measurement was used to determine blood viscosity (µ). ESS was calculated by Womersley's approximation, ESS = µ*2K*Velocity/Diameter, where K is a function of Womersley's parameter (α). Blood flow patterns were determined by critical Reynolds number. Statistical analysis included repeated measures ANOVA to detect ESS differences during FMD until peak dilation. Significance was established at P≤0.05. RESULTS: The mean (SD) FMD% and time to peak dilation were 7·4 (3·1) % and 35 (9·3) seconds, respectively. ESS was significantly reduced during FMD until peak dilation (P<0·001). Turbulent blood flow was the only pattern observed until peak dilation in 96·15% of the sample. CONCLUSION: Peak FMD dilation in a young healthy population is triggered mostly by high-ESS under turbulent flow conditions. Due to the pulsatile nature of blood flow and the appearance of a turbulent pattern during FMD, ESS should be estimated by Womersley's approximation rather than Poiseuille's law.


Subject(s)
Brachial Artery/physiology , Endothelium, Vascular/physiology , Pulsatile Flow , Vasodilation , Adolescent , Adult , Blood Flow Velocity , Brachial Artery/diagnostic imaging , Endothelium, Vascular/diagnostic imaging , Female , Healthy Volunteers , Humans , Male , Models, Cardiovascular , Regional Blood Flow , Time Factors , Young Adult
19.
Data Brief ; 26: 104505, 2019 Oct.
Article in English | MEDLINE | ID: mdl-31667268

ABSTRACT

The data presented in this article are related to the research article entitled "Solar domestic hot water regulation in the Latin American residential sector with the implementation of the Energy Performance of Buildings Directive: The case of Chile" (López-Ochoa et al., 2019), which evaluates the possibility of adapting Spanish solar domestic hot water regulations in Chile, with the objective of presenting the potential impact of the Energy Performance of Buildings Directive in Latin America. This dataset was made publicly available to show the possible energy savings with the thermal solar systems proposed to enable the use of these data by other researchers as well as designers, installers and decision-makers.

20.
J Anim Sci ; 97(3): 1185-1197, 2019 Mar 01.
Article in English | MEDLINE | ID: mdl-30590717

ABSTRACT

Study objectives were to determine the effects of chromium (Cr) propionate (Cr propionate 0.04%; 0.5 g/kg of feed to deliver 200 parts per billion Cr/d; KemTRACE Cr, Kemin Industries, Inc., Des Moines, IA) on growth performance, metabolism, and health biomarkers in heat-stressed and nutrient-restricted pigs. Crossbred barrows (n = 96; 105 ± 1 kg BW) were enlisted in an experiment conducted in two replicates, blocked by initial BW, and randomly assigned to one of six dietary-environmental treatments: (i) thermoneutral (TN) and fed ad libitum a control diet (TNCtl), (ii) TN and fed ad libitum a Cr supplemented diet (TNCr), (iii) TN and pair-fed a control diet (PFCtl), (iv) TN and pair-fed a Cr supplemented diet (PFCr), (v) heat stress (HS) and ad libitum fed a control diet (HSCtl), or (vi) HS and ad libitum fed a Cr supplemented diet (HSCr). The study consisted of three experimental periods (P). During P0 (5 d), all pigs were housed in TN conditions (21.3 ± 0.1 °C, 56.8 ± 0.3% relative humidity [RH]) and fed the control diet ad libitum. During P1 (5 d), pigs were fed their respective dietary treatments ad libitum and kept in TN conditions. During P2 (35 d), HSCtl and HSCr-treated pigs were fed ad libitum and exposed to progressive cyclical HS conditions (27 to 31 °C, 50 ± 0.3% RH), while TNCtl, TNCr, PFCtl, and PFCr pigs remained in TN conditions and were fed ad libitum or pair-fed to their respective HSCtl and HSCr counterparts to eliminate the confounding effects of dissimilar feed intake. Overall, HS pigs had increased (P < 0.01) rectal temperature, skin temperature, and respiration rate (0.3 °C, 3.8 °C, and 32 breaths per minute, respectively) relative to TN pigs. Overall, HS decreased ADFI and ADG (20 and 21%, respectively; P < 0.01) compared with TN controls. Final BW tended to be increased in HSCr (2.7 kg, P = 0.06) compared with HSCtl pigs. Similarly, ADG tended to be increased during P2 in HSCr relative to HSCtl-treatment (0.77 vs. 0.72 kg/d; P = 0.10). There were no effects of Cr on most production parameters, but ADFI tended to be increased in Cr relative to Ctl-fed pigs (3.19 vs. 3.09 kg/d; P = 0.08). No effects of Cr supplementation were detected on circulating glucose, insulin, NEFA, cholesterol, triglycerides, or lipopolysaccharide binding protein. However, blood neutrophils were increased in HSCr (37%; P < 0.01) relative to HSCtl pigs. In summary, these results suggest Cr supplementation may benefit growth performance during HS.


Subject(s)
Biomarkers/metabolism , Dietary Supplements , Heat-Shock Response/drug effects , Propionates/pharmacology , Swine/physiology , Animals , Body Temperature/drug effects , Diet/veterinary , Random Allocation , Respiratory Rate/drug effects , Skin Temperature/drug effects , Swine/growth & development , Swine/immunology
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