Quality Improvement Toolkits: Recommendations for Development.

A burgeoning number of toolkits dedicated to improving health care exist but development guidance is lacking. The authors convened a panel of health care stakeholders, including developers, purchasers, users, funders, and disseminators of toolkits. The panel was informed by a literature review that analyzed 44 publications and 27 toolkits.

Using Learning Communities to Support Adoption of Health Care Innovations.

Background: Diffusion of innovations can be a slow process, posing a major challenge to quality improvement in health care. Learning communities can provide a rich, collaborative environment that supports the adoption of health care innovations and motivates organizational change. From 2014-2016, the Agency for Healthcare Research and Quality (AHRQ) Health Care Innovations Exchange established and supported three learning communities focused on adopting innovations in three high-priority areas: (1) advancing the practice of patient- and family-centered care in hospitals, (2) promoting medication therapy management for at-risk populations, and (3) reducing non-urgent emergency services.

The role of empathy in experiencing vicarious anxiety.

With depictions of others facing threats common in the media, the experience of vicarious anxiety may be prevalent in the general population. However, the phenomenon of vicarious anxiety-the experience of anxiety in response to observing others expressing anxiety-and the interpersonal mechanisms underlying it have not been fully investigated in prior research. In 4 studies, we investigate the role of empathy in experiencing vicarious anxiety, using film clips depicting target victims facing threats.

Effects of pre-exercise feeding on serum hormone concentrations and biomarkers of myostatin and ubiquitin proteasome pathway activity.

Purpose: The aim of the study was to examine the acute effects of pre-exercise ingestion of protein, carbohydrate, and a non-caloric placebo on serum concentrations of insulin and cortisol, and the intramuscular gene expression of myostatin- and ubiquitin proteasome pathway (UPP)-related genes following a bout of resistance exercise.

Methods: Ten untrained college-aged men participated in three resistance exercise sessions (3 × 10 at 80 % 1RM for bilateral hack squat, leg press, and leg extension) in a cross-over fashion, which were randomly preceded by protein, carbohydrate, or placebo ingestion 30 min prior to training. Pre-supplement/pre-exercise, 2 h and 6 h post-exercise muscle biopsies were obtained during each session and analyzed for mRNA fold changes in myostatin (MSTN), activin IIB, follistatin-like 3 (FSTL3), SMAD specific E3 ubiquitin protein ligase 1 (SMURF1), forkhead box O3, F-box protein 32 (FBXO32), and Muscle RING-finger protein-1, with beta-actin serving as the housekeeping gene.

Myogenic mRNA markers in young and old human skeletal muscle prior to and following sequential exercise bouts.

This study examined how multiple bouts of conventional resistance training affected the mRNA expression of transcripts and a protein associated with satellite cell activity in human skeletal muscle. Ten younger men (means ± SE; age, 21.0 ± 0.

Effects of age on serum hormone concentrations and intramuscular proteolytic signaling before and after a single bout of resistance training.

This study examined mRNA expression patterns for atrogin-1 and muscle ring finger-1 (MuRF-1) before and 24 hours after a resistance training bout. Furthermore, basal, 5-minute and 24-hour postexercise serum concentrations of cortisol and insulin like growth factor-1 (IGF-1) and the relationships between these hormones and the genetic expression patterns of atrogin-1 and MuRF-1 were examined. Younger and older men completed a resistance exercise bout consisting of 3 × 10 repetitions at 80% of their predetermined 1 repetition maximum for Smith squat, leg press and leg extension.

Effects of a mineral antioxidant complex on clinical safety, body water, lactate response, and aerobic performance in response to exhaustive exercise.

Background: This investigation examined the safety and efficacy of a silica-based mineral antioxidant complex (MAC) that has been suggested to influence body water and buffer lactate.

Methods: In a double-blind, randomized crossover design, male participants completed testing for 3 conditions: water only (baseline), rice flour (placebo), and MAC supplementation. Participants visited the laboratory on 5 occasions: familiarization, baseline, Testing Day 1, washout, and Testing Day 2.

IGF-1 splice variant and IGF-1 peptide expression patterns in young and old human skeletal muscle prior to and following sequential exercise bouts.

Genes and proteins involved in insulin-like growth factor (IGF)-1 signaling are thought to be differentially expressed in older versus younger mammalian skeletal muscle following acute exercise. The purpose of this study was to examine how multiple bouts of conventional resistance training meant to elicit hypertrophy affect the mRNA expression of IGF-1EA and IGF-1EC (MGF) as well as the expression of total IGF-1 peptides in human skeletal muscle. Ten younger (18-25 years) and 10 older (60-75 years) males completed three sequential workouts (M, W, F) consisting of nine sets of lower body exercises with ten repetitions per set at an intensity of 80% of one repetition maximum.

Molecular attributes of human skeletal muscle at rest and after unaccustomed exercise: an age comparison.

The current study examined muscle DNA and protein concentrations ([ ]) and the [RNA] (assumed to represent translational capacity), [RNA]:[DNA] (assumed to represent transcriptional efficiency) and [protein]:[RNA] (assumed to represent translational efficiency) in younger vs. older participants during a resting state. Further, changes in muscle [DNA], translational capacity, and transcriptional efficiency were analyzed 24 hours after an unaccustomed resistance exercise bout.

Effects of preexercise feeding on markers of satellite cell activation.

Purpose: The purpose of this study was to determine if consuming isoenergetic (25 g) doses of carbohydrate or protein versus a noncaloric placebo before conventional resistance training affected the myogenic expression of cell cycle-regulating genes as well as the muscle [DNA] acutely after exercise.

Methods: Ten untrained men (mean +/- SD: age = 22 +/- 4 yr, body mass = 77.8 +/- 8.

The expression of androgen-regulated genes before and after a resistance exercise bout in younger and older men.

This cross-sectional study examined aging and resistance exercise-related changes in intramuscular gene expression in younger (21.3 +/- 0.6 years, 84.

Efficacy and safety of a popular thermogenic drink after 28 days of ingestion.

Background: We have recently demonstrated that consuming a thermogenic drink (TD) acutely increases energy expenditure and serum markers of lipolysis in healthy, college-aged individuals. The purpose of this study was to determine if consuming TD over 28 days affects its acute thermogenic and lipolytic effects as well as body composition and clinical chemistry safety markers.

Methods: Sixty healthy, males (mean +/- SE; 23 +/- 1 years, 177 +/- 2 cm, 81.

Peroxisomes: biochemistry, molecular biology and genetic diseases- a video programme for teaching students.

Peroxisome proliferation in rodent liver is a good biochemical marker of toxicology for several classes of xenobiotics, including fibrates; phthalates and adipates; or chlorophenoxy-acetate, a herbicide. Research in peroxisomes provides a good example of the integration of fields related to basic sciences and biomedical and industrial health. A 25min video programme illustrates techniques involved in the characterization of purified peroxisomes (Fig.

Human HepG2 and rat Fao hepatic-derived cell lines show different responses to ciprofibrate, a peroxisome proliferator: analysis by flow cytometry.

Peroxisome proliferators, and especially hypolipidemic drugs such as ciprofibrate, are known to be hepatocarcinogens in rodents, but their effect in humans is controversial. In an attempt to investigate the effects of ciprofibrate at a cellular level, the analysis of individual whole cells was performed by flow cytometry on samples from two hepatic-derived cell lines: the rat Fao cell line and the human HepG2 cell line. The increase of light scatter signals in rat Fao cells treated for 3 days with ciprofibrate at 250 microM was related to modifications of intrinsic cellular parameters, such as size and cytoplasmic granularity.

Antley-Bixler syndrome: report of a patient and review of literature.

We report a patient with Antley-Bixler syndrome and review 13 patients from the literature. The cardinal features of this condition include craniosynostosis, severe mid-face hypoplasia, proptosis, choanal atresia/stenosis, frontal bossing, dysplastic ears, depressed nasal bridge, radiohumeral synostosis, long-bone fractures and femoral bowing, urogenital abnormalities and a normal karyotype. Early death was identified in 54% of the reported cases, usually due to respiratory complications.

Intravenous antiplatelet efficacy and safety of the platelet GPIIb/IIIa antagonist, DMP 728 in anesthetized dogs.

DMP 728, cyclo (D-2-aminobutyrate-N-Methyl-L-Arginyl-Glycyl-L-Aspartyl- 3-amino-methyl-benzoic acid) methanesulfonate salt, is a novel antiplatelet agent with high affinity and specificity for human and canine platelet GPIIb/IIIa (alpha 2/beta 3) receptors. DMP 728 demonstrated a potent antiplatelet efficacy in inhibiting ADP-induced platelet aggregation in either human or canine PRP with an IC50 of 0.046 and 0.

Effect of thrombin inhibitors on platelet functions: comparative analysis of DuP 714 and hirudin.

Since thrombin plays an important role in platelet-mediated arterial thrombosis, we have examined the antiplatelet activity of a synthetic thrombin inhibitor, DuP 714 (Ac-(D)Phe-Pro-boroArg), in comparison with that of the naturally occurring inhibitor hirudin. Hirudin was slightly more potent than DuP 714 in inhibiting thrombin-induced aggregation in washed human platelets (IC50s of 72 nM and 150 nM, respectively) and in inhibiting the secretion of plasminogen activator inhibitor-I from human platelets (IC50s of 300 nM and 900 nM, respectively). In contrast, DuP 714 was more potent than hirudin in inhibiting thrombin-induced [125I]fibrinogen binding to gel purified platelets, and in inhibiting thrombin-induced intracellular calcium mobilization in washed platelets.