Outcomes of traumatically injured patients after nighttime transfer from the intensive care unit.

Background: Prior studies have associated nighttime transfer of patients from the intensive care unit (ICU) with increased morbidity. This study sought to examine this relationship in traumatically injured patients, as this has not been previously performed.

Methods: A retrospective review of traumatically injured patients admitted to a Level I Trauma Center's ICU from January 2021 to September 2022 was performed.

Live-cell three-dimensional single-molecule tracking reveals modulation of enhancer dynamics by NuRD.

To understand how the nucleosome remodeling and deacetylase (NuRD) complex regulates enhancers and enhancer-promoter interactions, we have developed an approach to segment and extract key biophysical parameters from live-cell three-dimensional single-molecule trajectories. Unexpectedly, this has revealed that NuRD binds to chromatin for minutes, decompacts chromatin structure and increases enhancer dynamics. We also uncovered a rare fast-diffusing state of enhancers and found that NuRD restricts the time spent in this state.

Use of electronic cigarettes among U.S. Military service members - prevalence and associated risk factors.

Background: Decreased physical fitness, loss of vision and hearing, and increased risk of chronic diseases are significant primary and secondary implications associated with the health of U.S. Military Service members who use tobacco, including electronic cigarettes.

Continued Relevance of Initial Temperature Measurement in Trauma Patients.

Objectives: Hypothermia occurs in 30-50% of severely injured trauma patients and is associated with multiple metabolic derangements and worsened outcomes. However, hypothermia continues to be under-diagnosed which leads to inadequate triage and treatment in trauma patients. Our study set out to determine if hypothermia is an independent predictor of mortality in trauma patients.

Synchronous Upper Intestinal Neurofibromas and Duodenal Periampullary Well-Differentiated Neuroendocrine Tumor Associated With Neurofibromatosis 1.

Neurofibromatosis type I (NF1) is an autosomal dominant genetic disorder associated with characteristic skin findings, as well as a fourfold increase in risk of malignancy. NF1 patient malignancies commonly include the central and peripheral nervous system, but these patients are also at high risk of developing gastrointestinal (GI) tumors. While most often these GI tumors are benign upper GI neurofibromas; clinicians should have a high suspicion for malignant tumors, degeneration into a malignant peripheral nerve sheath tumor or less common associated malignancies such as well-differentiated neuroendocrine tumor (formerly carcinoid tumor), when patients present with multiple GI tumors.

Preoperative Smoking Cessation as a Durable Form of Long-Term Smoking Cessation.

Smokers who undergo total joint arthroplasty (TJA) face increased rates of medical and surgical complications that can be reduced by preoperative smoking cessation. We investigated the long-term durability of preoperative smoking cessation among TJA patients. Twenty-seven TJA patients who were identified as having an active history of smoking at the preoperative appointment before TJA consented to telephone survey about their perioperative and current smoking status.

The Extended Congress: Reimagining scientific meetings after the COVID-19 pandemic.

This article was migrated. The article was marked as recommended. The COVID-19 pandemic has profoundly impacted the medical meetings planned for 2020.

Incorporating pulse wave velocity into model-based pulse contour analysis method for estimation of cardiac stroke volume.

Background And Objectives: Stroke volume (SV) and cardiac output (CO) are important metrics for hemodynamic management of critically ill patients. Clinically available devices to continuously monitor these metrics are invasive, and less invasive methods perform poorly during hemodynamic instability. Pulse wave velocity (PWV) could potentially improve estimation of SV and CO by providing information on changing vascular tone.

When Civilians Deploy With the Military.

Each year, thousands of civilian workers deploy with active duty service members to support contingency operations, often in harsh environmental conditions. Occupational health nurses aware of these challenges can implement programs to protect the health and safety of this at-risk worker population.

Updated Tuberculosis Screening Guidelines for Health Care Personnel.

Updated Centers for Disease Control and Prevention (CDC) guidelines for tuberculosis (TB) screening of U.S. health care personnel may change practice.

Accurate end systole detection in dicrotic notch-less arterial pressure waveforms.

Identification of end systole is often necessary when studying events specific to systole or diastole, for example, models that estimate cardiac function and systolic time intervals like left ventricular ejection duration. In proximal arterial pressure waveforms, such as from the aorta, the dicrotic notch marks this transition from systole to diastole. However, distal arterial pressure measures are more common in a clinical setting, typically containing no dicrotic notch.

Clinically applicable model-based method, for physiologically accurate flow waveform and stroke volume estimation.

Background And Objectives: Cardiovascular dysfunction can be more effectively monitored and treated, with accurate, continuous, stroke volume (SV) and/or cardiac output (CO) measurements. Since direct measurements of SV/CO are highly invasive, clinical measures are often discrete, or if continuous, can require recalibration with a discrete SV measurement after hemodynamic instability. This study presents a clinically applicable, non-additionally invasive, physiological model-based, SV and CO measurement method, which does not require recalibration during or after hemodynamic instability.

Blood pressure waveform contour analysis for assessing peripheral resistance changes in sepsis.

Background: This paper proposes a methodology for helping bridge the gap between the complex waveform information frequently available in an intensive care unit and the simple, lumped values favoured for rapid clinical diagnosis and management. This methodology employs a simple waveform contour analysis approach to compare aortic, femoral and central venous pressure waveforms on a beat-by-beat basis and extract lumped metrics pertaining to the pressure drop and pressure-pulse amplitude attenuation as blood passes through the various sections of systemic circulation.

Results: Validation encompasses a comparison between novel metrics and well-known, analogous clinical metrics such as mean arterial and venous pressures, across an animal model of induced sepsis.

Hexavalent Chromium.

Hexavalent chromium [Cr(VI)] is a chemical used in many industries and has the potential to cause negative health effects. Occupational health nurses can intervene to protect workers from the health hazards associated with Cr(VI).

Structural characterization of four different naturally occurring porcine collagen membranes suitable for medical applications.

Collagen is the main structural element of connective tissues, and its favorable properties make it an ideal biomaterial for regenerative medicine. In dental medicine, collagen barrier membranes fabricated from naturally occurring tissues are used for guided bone regeneration. Since the morphological characteristics of collagen membranes play a crucial role in their mechanical properties and affect the cellular behavior at the defect site, in-depth knowledge of the structure is key.

How practitioners integrate decision triggers with existing metrics in conservation monitoring.

Decision triggers are defined thresholds in the status of monitored variables that indicate when to undertake management, and avoid undesirable ecosystem change. Decision triggers are frequently recommended to conservation practitioners as a tool to facilitate evidence-based management practices, but there has been limited attention paid to how practitioners are integrating decision triggers into existing monitoring programs. We sought to understand whether conservation practitioners' use of decision triggers was influenced by the type of variables in their monitoring programs.

Pre-ejection period, the reason why the electrocardiogram Q-wave is an unreliable indicator of pulse wave initialization.

Objective: Pulse wave velocity measurements are an indicator of arterial stiffness and possible cardiovascular dysfunction. It is usually calculated by measuring the pulse transit time (PTT) over a known distance through the arteries. In animal studies, reliable PTT measures can be obtained using two pressure catheters.

The Rho regulator Myosin IXb enables nonlymphoid tissue seeding of protective CD8 T cells.

T cells are actively scanning pMHC-presenting cells in lymphoid organs and nonlymphoid tissues (NLTs) with divergent topologies and confinement. How the T cell actomyosin cytoskeleton facilitates this task in distinct environments is incompletely understood. Here, we show that lack of Myosin IXb (Myo9b), a negative regulator of the small GTPase Rho, led to increased Rho-GTP levels and cell surface stiffness in primary T cells.

Persistent organic pollutants (POPs) in blood and blubber of common bottlenose dolphins (Tursiops truncatus) at three northern Gulf of Mexico sites following the Deepwater Horizon oil spill.

Common bottlenose dolphins (Tursiops truncatus), including those impacted by the 2010 Deepwater Horizon (DWH) oil spill, inhabit the coastal and estuarine waters of the northern Gulf of Mexico (GoM). In response to the spill, dolphin health assessments conducted in Barataria Bay, Louisiana - a site that experienced heavy and prolonged oiling - uncovered a high prevalence of health abnormalities and individuals in poor body condition. Although the health effects observed were suggestive of petroleum toxicity, a lack of pre-spill information regarding dolphin health raises the possibility that other environmental factors may have contributed to the adverse health of dolphins in this oil-impacted area.

Proof of concept non-invasive estimation of peripheral venous oxygen saturation.

Background: Pulse oximeters continuously monitor arterial oxygen saturation. Continuous monitoring of venous oxygen saturation (SvO) would enable real-time assessment of tissue oxygen extraction (OE) and perfusion changes leading to improved diagnosis of clinical conditions, such as sepsis.

Methods: This study presents the proof of concept of a novel pulse oximeter method that utilises the compliance difference between arteries and veins to induce artificial respiration-like modulations to the peripheral vasculature.

Improved pressure contour analysis for estimating cardiac stroke volume using pulse wave velocity measurement.

Background: Pressure contour analysis is commonly used to estimate cardiac performance for patients suffering from cardiovascular dysfunction in the intensive care unit. However, the existing techniques for continuous estimation of stroke volume (SV) from pressure measurement can be unreliable during hemodynamic instability, which is inevitable for patients requiring significant treatment. For this reason, pressure contour methods must be improved to capture changes in vascular properties and thus provide accurate conversion from pressure to flow.

What Can Pharmacological Models of Retinal Degeneration Tell Us?

Animal models with pharmacologically induced retinal degeneration including sodium iodate (NaIO3) and N-methyl-N-nitrosourea (MNU) have been extensively used in ophthalmic research to investigate retinal degeneration. NaIO3 induces degeneration of the retinal pigment epithelium (RPE) followed by photoreceptor (PRC) cell death, mimicking features of age-related macular degeneration. In contrast, MNU leads to rapid destruction of the PRCs only, enabling the use of the MNU model to investigate degeneration induced in retinitis pigmentosa.