Biochemical dissection of a fungal highly reducing polyketide synthase condensing region reveals basis for acyl group selection.

Fungal highly reducing polyketide synthases (hrPKSs) are remarkable multidomain enzymes that catalyse the biosynthesis of a diverse range of structurally complex compounds. During biosynthesis, the ketosynthase (KS) and acyltransferase (AT) domains of the condensing region are visited by the acyl carrier protein (ACP) domain during every cycle, catalysing chain priming and elongation reactions. Despite their significance, our comprehension of how these steps contribute to biosynthetic fidelity remains poorly understood.

Evaluation of current practice for penicillin allergy labeling using the PEN-FAST tool.

Inaccurate penicillin allergy labeling may deter healthcare providers from initiating appropriate therapy and contribute to antibiotic resistance. In a rural urgent care setting, the current practice of penicillin allergy labeling was evaluated using the PEN-FAST tool. The results confirm opportunity to further evaluate and improve current practice for allergy assessment.

Changes observed in urine microbiology following replacement of long-term urinary catheters: need to modify UTI guidelines in the UK?

Aims: Bacteria adherent to long-term urinary catheters (LTUC) may give misleading urine culture results. Guidelines in the USA recommend changing LTUC before urine collection to diagnose UTI and before commencing appropriate antimicrobial treatment. However, in the UK there is no such guidance.

Patterned auditory stimulation and suck dynamics in full-term infants.

Aim: To determine whether patterned auditory stimuli, designed to mimic the natural burst-pause pattern evident in non-nutritive suck (NNS) with variations to the intraburst frequency, alter infants' NNS and cardiorespiratory patterning.

Methods: Sixteen healthy full-term infants participated in this study. Infants were fitted with electrocardiogram electrodes and a respiratory belt to measure cardiorespiratory patterning.

Innovations in Behavioral Intervention Preparation for Paraprofessionals Working with Children with Autism Spectrum Disorder.

Given the empirically validated success of behavioral intervention based on applied behavior analysis for individuals with autism spectrum disorder and other developmental disabilities, the demand for knowledgeable and skilled paraprofessional teaching staff is very high. Unfortunately, there currently exists a widely recognized shortage of such practitioners. This paper describes the development of an online training program aimed at preparing paraprofessionals for face-to-face training and supervision, as part of a solution to the growing demand.

Intravenous lipid emulsion in the emergency department: a systematic review of recent literature.

Background: Intravenous lipid emulsion (ILE) has been broadly attempted in the resuscitation of neurologic and cardiac toxic drug overdoses, however, the role of ILE in the emergency department is poorly defined.

Objective: This review aims to identify recent literature on the use of ILE in humans as an antidote and to familiarize emergency providers with the indications, availability, dosing recommendations, and adverse reactions associated with ILE use.

Methods: A systemic literature search of MEDLINE, EMBASE, and major toxicology conference abstracts was performed for human cases using ILE as an antidote with documented clinical outcomes through January 2014.

Myocarditis.

Myocarditis is an inflammatory disease of the heart that can cause devastating disease in otherwise healthy children. Inciting agents such as viral infection cause direct damage to the myocardial cells, which triggers an inflammatory response that enhances myocardial toxicity and associated morbidity. Severe cases typically present with respiratory distress and cardiovascular collapse, whereas subclinical cases are unnoticed by the medical community.

THE ESSENTIAL ROLE OF THE COM IN THE MANAGEMENT OF SLEEP-DISORDERED BREATHING: A LITERATURE REVIEW AND DISCUSSION.

The origins of Orofacial Myofunctional Therapy began in the early 1960's by orthodontists who recognized the importance of functional nasal breathing, proper swallowing, and more ideal oral rest postures. Re-patterning these functions through myofunctional therapy assisted with better orthodontic outcomes and improved stability. Experts in orofacial myology have concluded that improper oral rest postures and tongue thrusting may be the result of hypertrophy of the lymphatic tissues in the upper airway.

Global uptake of the Humanitarian Accountability Partnership over its first ten years.

Introduction: Accountability in the delivery of humanitarian aid has become increasingly important and emphasized by the humanitarian community. The Humanitarian Accountability Partnership (HAP) was created in 2003 in order to improve accountability in the humanitarian sector. HAP acts as a self-regulatory body to the humanitarian system.

Characterizing the limited use of point-of-care ultrasound in Colombian emergency medicine residencies.

Background: Emergency medicine (EM) is a growing specialty in Colombia with five residency programs in the country. EM leadership is interested in incorporating point-of-care (POC) ultrasound into a standardized national EM residency curriculum. This study is a nationwide survey of Colombian EM residents designed to explore the current state of POC ultrasound use within EM residencies and examine specific barriers preventing its expansion.

mHealth in Sub-Saharan Africa.

Mobile phone penetration rates have reached 63% in sub-Saharan Africa (SSA) and are projected to pass 70% by 2013. In SSA, millions of people who never used traditional landlines now use mobile phones on a regular basis. Mobile health, or mHealth, is the utilization of short messaging service (SMS), wireless data transmission, voice calling, and smartphone applications to transmit health-related information or direct care.

Is there an association between radiologist turnaround time of emergency department abdominal CT studies and radiologic report quality?

The aim of this study was to assess for an association between radiologists' turnaround time (TAT) and report quality for emergency department (ED) abdominopelvic CT examinations. Reports of 60 consecutive ED abdominopelvic CT studies from five abdominal radiologists (300 total reports) were included. An ED radiologist, abdominal radiologist, and ED physician independently evaluated satisfaction with report content (1-10 scale), satisfaction with report clarity (1-10 scale), and extent to which the report advanced the patient on a previously published clinical spectrum scale (1-5 scale).

Global Emergency Medicine: a review of the literature from 2012.

Objectives: The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and grey literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a worldwide audience of academics and clinical practitioners.

Methods: This year, our search identified 4,818 articles written in six languages. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM.

Review of recently approved alternatives to anticoagulation with warfarin for emergency clinicians.

Background: Dabigatran and rivaroxaban are novel anticoagulants that have been approved for the prevention of thromboembolic events in atrial fibrillation. These medications are attractive to both patients and clinicians, as, unlike warfarin, they do not require laboratory monitoring or dietary restrictions. However, they carry bleeding risks similar to that of warfarin and are without a reliable reversal agent.

Recommendations for additional imaging on emergency department CT examinations: comparison of emergency- and organ-based subspecialty radiologists.

Purpose: Past studies have identified a high frequency of recommendations for additional imaging (RAI) for computed tomography (CT) studies performed in an emergency department (ED), thereby potentially contributing to increased imaging utilization and costs. The purpose of this study was to compare rates of RAI within the ED setting between ED-based and organ-based subspecialty radiologists.

Methods: We identified 600 ED CT studies, comprising 200 head, chest, and abdominal CT studies, split equally between cases reviewed by ED-based and organ-based radiologists.

Global emergency medicine: a review of the literature from 2011.

Objectives: The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of published and unpublished articles relevant to global emergency medicine (EM) to identify, review, and disseminate the most important research in this field to a wide audience of academics and practitioners.

Methods: This year, 7,924 articles written in seven languages were identified by our search. These articles were divided up among 20 reviewers for initial screening based on their relevance to the field of global EM.

Identification of current priorities for research in humanitarian action: proceedings of the First Annual UN OCHA Policy and Research Conference.

On December 12-13, 2011, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) hosted a humanitarian policy and research conference on the theme of "Risk, Adaptation and Innovation in Humanitarian Action." The four sessions of the conference covered humanitarian action in a changing world, adaptation and innovation in humanitarian action, humanitarian action in protracted and violent conflict, and effective humanitarian action. This special report contains summaries of presentations in each session and the conclusions resulting from the discussions throughout.