ProPACC: Protocol for a Trial of Integrated Specialty Palliative Care for Critically Ill Older Adults.

Background: Each year, approximately one million older adults die in American intensive care units (ICUs) or survive with significant functional impairment. Inadequate symptom management, surrogates' psychological distress and inappropriate healthcare use are major concerns. Pioneering work by Dr.

The peripheral dopamine 2 receptor antagonist domperidone attenuates ethanol enhancement of dopamine levels in the nucleus accumbens.

Background: Dopamine neuron firing in the ventral tegmental area (VTA) and dopamine release in the nucleus accumbens have been implicated in reward learning. Ethanol is known to increase both dopamine neuron firing in the VTA and dopamine levels in the nucleus accumbens. Despite this, some discrepancies exist between the dose of ethanol required to enhance firing in vivo and ex vivo.

Right Atrial Appendage Thrombus in Atrial Fibrillation: A Case Report and Review of the Literature.

Atrial fibrillation (Afib) is the most common abnormal heart rhythm in adults and has become a significant public health concern affecting 2% to 3% of the population in Europe and North America. Left atrial appendage (LAA) thrombi is the source of 90% of left-sided cardiac thrombi in patients with Afib, which can cause stroke and other systemic vascular events. Right atrial appendage (RAA) thrombi formation in Afib is much less common but complications include pulmonary embolism or paradoxical migration across patent foramen ovale with risk of systemic embolization.

Cardiac Amyloidosis Presenting as Biventricular Systolic Heart Failure.

A previously healthy octogenarian presented with new onset heart failure symptoms. Comprehensive multimodality imaging including complete echocardiography with longitudinal strain analysis, cardiac magnetic resonance imaging (cMRI), nuclear medicine pyrophosphate (99-mcTcPYP) scan along with biomarker, monoclonal protein analysis, and fat pad biopsy confirmed diagnosis of transthyretin cardiac amyloidosis.

Strap Performance of N95 Filtering Facepiece Respirators After Multiple Decontamination Cycles.

The Battelle Critical Care Decontamination System™ (CCDS™) decontaminates N95 filtering facepiece respirators (FFRs) using vapor phase hydrogen peroxide (VPHP) for reuse when there is a critical supply shortage. The Battelle CCDS received an Emergency Use Authorization (EUA) from the US Food and Drug Administration (FDA) in March 2020. This research focused on evaluating the mechanical properties of the straps as an indicator of respirator fit.

Perceptions of Hyperoxemia and Conservative Oxygen Therapy in the Management of Acute Respiratory Failure.

Mechanically ventilated patients in the intensive care unit (ICU) are often managed to maximize oxygenation, yet hyperoxemia may be deleterious to some. Little is known about how ICU providers weigh tradeoffs between hypoxemia and hyperoxemia when managing acute respiratory failure. To define ICU providers' mental models for managing oxygenation for patients with acute respiratory failure and identify barriers and facilitators to conservative oxygen therapy.

Renal Cell Carcinoma with Right Ventricular Metastatic Spread: An Unusual Finding with Poor Prognosis.

• RCC is the most common type of renal cancer. • RCC is capable of passing through the renal vein into the IVC. • Surgical resection requiring cardiopulmonary bypass is currently the only curative treatment.

Generic Protocols for the Analytical Validation of Next-Generation Sequencing-Based ctDNA Assays: A Joint Consensus Recommendation of the BloodPAC's Analytical Variables Working Group.

Liquid biopsy, particularly the analysis of circulating tumor DNA (ctDNA), has demonstrated considerable promise for numerous clinical intended uses. Successful validation and commercialization of novel ctDNA tests have the potential to improve the outcomes of patients with cancer. The goal of the Blood Profiling Atlas Consortium (BloodPAC) is to accelerate the development and validation of liquid biopsy assays that will be introduced into the clinic.

Endocarditis with Perivalvular Abscess Presenting as Atrioventricular Block.

is an aerobic, Gram-negative bacillus first identified in 1819 (Yeung et al. 2018). infective endocarditis is extremely rare accounting for only 0.

A reference map of the human binary protein interactome.

Global insights into cellular organization and genome function require comprehensive understanding of the interactome networks that mediate genotype-phenotype relationships. Here we present a human 'all-by-all' reference interactome map of human binary protein interactions, or 'HuRI'. With approximately 53,000 protein-protein interactions, HuRI has approximately four times as many such interactions as there are high-quality curated interactions from small-scale studies.

Endocarditis caused by A rare presentation of an emerging opportunistic pathogen.

First isolated in 1943, () has historically been of little significance as it was considered a pathogen of low virulence noted to rarely infect immunocompromised hosts. However, over the last 30 years the prevalence of infection caused by the organism has increased significantly. Bacterial endocarditis from remains exceedingly rare with only a small number of reported cases in the literature.

Protein Interactomics by Two-Hybrid Methods.

Comprehensive identification of direct, physical interactions between biological macromolecules, such as protein-protein, protein-DNA, and protein-RNA interactions, is critical for our understanding of the function of gene products as well as the global organization and interworkings of various molecular machines within the cell. The accurate and comprehensive detection of direct interactions, however, remains a huge challenge due to the inherent structural complexity arising from various post-transcriptional and translational modifications coupled with huge heterogeneity in concentration, affinity, and subcellular location differences existing for any interacting molecules. This has created a need for developing multiple orthogonal and complementary assays for detecting various types of biological interactions.

Anticoagulation for the Pregnant Patient with a Mechanical Heart Valve, No Perfect Therapy: Review of Guidelines for Anticoagulation in the Pregnant Patient.

Heart valve replacement with a mechanical valve requires lifelong anticoagulation. Guidelines currently recommend using a vitamin K antagonist (VKA) such as warfarin. Given the teratogenic effects of VKAs, it is often favorable to switch to heparin-derived therapies in pregnant patients since they do not cross the placenta.

A Rare Report of Infectious Emphysematous Aortitis Secondary to without Prior Vascular Intervention.

The term "mycotic aneurysm" was first used by Osler in 1882 to describe a mushroom-shaped aneurysm in subacute bacterial endocarditis. Mycotic aneurysms account for only 2.6% of all aneurysms of the aorta.

Neurodevelopmental outcomes in infants undergoing general anesthesia.

Purpose: Preclinical data strongly suggest that all agents used for general anesthesia (GA) have detrimental effects on the developing brain. However, clinical data are unclear. The purpose of this study was to use a cohort of infants who underwent GA and understand their neurodevelopmental outcomes.

Widespread Expansion of Protein Interaction Capabilities by Alternative Splicing.

While alternative splicing is known to diversify the functional characteristics of some genes, the extent to which protein isoforms globally contribute to functional complexity on a proteomic scale remains unknown. To address this systematically, we cloned full-length open reading frames of alternatively spliced transcripts for a large number of human genes and used protein-protein interaction profiling to functionally compare hundreds of protein isoform pairs. The majority of isoform pairs share less than 50% of their interactions.

Horizontal transfer of entire genomes via mitochondrial fusion in the angiosperm Amborella.

We report the complete mitochondrial genome sequence of the flowering plant Amborella trichopoda. This enormous, 3.9-megabase genome contains six genome equivalents of foreign mitochondrial DNA, acquired from green algae, mosses, and other angiosperms.

Physical and genetic associations of the Irc20 ubiquitin ligase with Cdc48 and SUMO.

A considerable percentage of the genome is dedicated to the ubiquitin-proteasome system, with the yeast genome predicted to encode approximately 100 ubiquitin ligases (or E3s), and the human genome predicted to encode more than 600 E3s. The most abundant class of E3s consists of RING finger-containing proteins. Although many insights have been obtained regarding the structure and catalytic mechanism of the E3s, much remains to be learned about the function of the individual E3s.

Viable viral efficiency of N95 and P100 respirator filters at constant and cyclic flow.

The growing threat of an influenza pandemic presents a unique challenge to healthcare workers, emergency responders, and the civilian population. The Occupational Safety and Health Administration (OSHA) recommends National Institute for Occupational Safety and Health (NIOSH)-approved respirators to provide protection against infectious airborne viruses in various workplace settings. The filtration efficiency of selected NIOSH-approved particulate N95 and P100 filtering facepiece respirators (FFRs) and filter cartridges was investigated against the viable MS2 virus, a non-pathogenic bacteriophage, aerosolized from a liquid suspension.

The "fossilized" mitochondrial genome of Liriodendron tulipifera: ancestral gene content and order, ancestral editing sites, and extraordinarily low mutation rate.

Background: The mitochondrial genomes of flowering plants vary greatly in size, gene content, gene order, mutation rate and level of RNA editing. However, the narrow phylogenetic breadth of available genomic data has limited our ability to reconstruct these traits in the ancestral flowering plant and, therefore, to infer subsequent patterns of evolution across angiosperms.

Results: We sequenced the mitochondrial genome of Liriodendron tulipifera, the first from outside the monocots or eudicots.

Reaerosolization of MS2 bacteriophage from an N95 filtering facepiece respirator by simulated coughing.

The supply of N95 filtering facepiece respirators (FFRs) may not be adequate to match demand during a pandemic outbreak. One possible strategy to maintain supplies in healthcare settings is to extend FFR use for multiple patient encounters; however, contaminated FFRs may serve as a source for the airborne transmission of virus particles. In this study, reaerosolization of virus particles from contaminated FFRs was examined using bacteriophage MS2 as a surrogate for airborne pathogenic viruses.

Global population structure of Aspergillus terreus inferred by ISSR typing reveals geographical subclustering.

Background: Aspergillus terreus causes invasive aspergillosis (IA) in immunocompromised individuals and can be the leading cause of IA in certain medical centers. We examined a large isolate collection (n = 117) for the presence of cryptic A. terreus species and employed a genome scanning method, Inter-Simple Sequence Repeat (ISSR) PCR to determine A.

The rice miniature inverted repeat transposable element mPing is an effective insertional mutagen in soybean.

Insertional mutagenesis of legume genomes such as soybean (Glycine max) should aid in identifying genes responsible for key traits such as nitrogen fixation and seed quality. The relatively low throughput of soybean transformation necessitates the use of a transposon-tagging strategy where a single transformation event will produce many mutations over a number of generations. However, existing transposon-tagging tools being used in legumes are of limited utility because of restricted transposition (Ac/Ds: soybean) or the requirement for tissue culture activation (Tnt1: Medicago truncatula).

Gorgeous mosaic of mitochondrial genes created by horizontal transfer and gene conversion.

The best known outcome of horizontal gene transfer (HGT) is the introduction of novel genes, but other outcomes have been described. When a transferred gene has a homolog in the recipient genome, the native gene may be functionally replaced (and subsequently lost) or partially overwritten by gene conversion with transiently present foreign DNA. Here we report the discovery, in two lineages of plant mitochondrial genes, of novel gene combinations that arose by conversion between coresident native and foreign homologs.