An update on beverage consumption patterns and caffeine intakes in a representative sample of the US population.

Caffeine is a popular stimulant, predominantly consumed from beverages. The caffeinated beverage marketplace is continually evolving resulting in considerable interest in understanding the impact caffeinated beverages have on levels of intakes. Therefore, estimates of caffeine intakes in the U.

A Pilot Study to Explore the Effect of Long Acting Injectable Antipsychotics on Aggression.

Objectives: To explore the effect of switching from an oral antipsychotic to a long-acting injectable (LAI) antipsychotic on aggression, in terms of the changes of verbal and physical aggression, interventions required, self-injurious behavior, use of seclusion or restraint, antipsychotic medication refusal, and use of antipsychotics as needed (PRN).

Methods: This was a retrospective chart review at a long-term state forensic psychiatric facility. Patients treated with an oral antipsychotic for at least 6 months and then switched to a LAI antipsychotic for an additional 6 months during an 80-month period were included.

Impact of COVID-19 quarantines on clozapine-induced constipation: Experience of utilizing a clozapine-induced constipation protocol at a state forensic psychiatric facility.

Objective: Since 2017, Fulton State Hospital (FSH) has implemented a clozapine-induced constipation protocol. In March 2020, FSH initiated unit quarantines to minimize the spread of coronavirus disease (COVID-19). The objective of this study was to evaluate the impact of these quarantines on medical referrals for constipation, the Bristol Stool Chart ratings, utilization of as-needed (PRN) laxatives, and adherence rates with scheduled constipation medication regimens.

Impaired Discrimination of Electrocutaneous Stimulation in the Paretic Hand of Stroke Survivors.

Artificial sensory feedback via electrocutaneous stimulation can be used to assist or rehabilitate stroke survivors with sensory deficits. Conveying the magnitude of tactile stimuli is an important aspect of artificial sensory feedback. Here, we explore how stroke-related sensory deficits impact the ability of electrocutaneous stimulation to convey the magnitude of tactile stimuli.

Fibrinogen Early In Severe Trauma studY (FEISTY): results from an Australian multicentre randomised controlled pilot trial.

Haemorrhage is a major cause of death in severe trauma. Fibrinogen plays a critical role in maintaining haemostasis in traumatic haemorrhage, and early replacement using fibrinogen concentrate (FC) or cryoprecipitate (Cryo) is recommended by several international trauma guidelines. Limited evidence supports one product over the other, with widespread geographic and institutional variation in practice.

A portable, programmable, multichannel stimulator with high compliance voltage for noninvasive neural stimulation of motor and sensory nerves in humans.

Most neural stimulators do not have a high enough compliance voltage to pass current through the skin. The few stimulators that meet the high compliance voltage necessary for transcutaneous stimulation are typically large benchtop units that are not portable, and the stimulation waveforms cannot be readily customized. To address this, we present the design and validation of a portable, programmable, multichannel, noninvasive neural stimulator that can generate three custom bipolar waveforms at ± 150 V with microsecond temporal resolution.

Sensitive real-time on-line estimator for oxygen transfer rates in fermenters.

Recombinant Escherichia coli grown in large-scale fermenters are used extensively to produce plasmids and biopharmaceuticals. One method commonly used to control culture growth is predefined glucose feeding, often an exponential feeding profile. Predefined feeding profiles cannot adjust automatically to metabolic state changes, such as the metabolic burden associated with recombinant protein expression or high-cell density associated stresses.

Ubiquitylation by Rab40b/Cul5 regulates Rap2 localization and activity during cell migration.

Cell migration is a complex process that involves coordinated changes in membrane transport and actin cytoskeleton dynamics. Ras-like small monomeric GTPases, such as Rap2, play a key role in regulating actin cytoskeleton dynamics and cell adhesions. However, how Rap2 function, localization, and activation are regulated during cell migration is not fully understood.

A Bionic Hand for Semi-Autonomous Fragile Object Manipulation via Proximity and Pressure Sensors.

Multiarticulate bionic hands are now capable of recreating the endogenous movements and grip patterns of the human hand, yet amputees continue to be dissatisfied with existing control strategies. One approach towards more dexterous and intuitive control is to create a semi-autonomous bionic hand that can synergistically aid a human with complex tasks. To that end, we have developed a bionic hand that can automatically detect and grasp nearby objects with minimal force using multi-modal fingertip sensors.

Diamond-Blackfan Anemia: A Case Report and Review of the Literature.

We report a case of a male neonate delivered urgently via cesarean at thirty-five 5/7 weeks gestation for non-reassuring fetal monitoring who was found to have severe anemia at birth that could not be explained by acute blood loss. He was born to a 24-year-old mother, whose pregnancy was complicated by abnormal ultrasound findings, including a radial ray defect and fetal growth restriction. Trio rapid whole-exome sequencing (rWES) confirmed Diamond-Blackfan anemia in both the neonate and mother.

Teaching Autonomic Cardiovascular Pharmacology to Medical Students: An Innovative Worksheet Approach.

This article was migrated. The article was marked as recommended. Autonomic (ANS) pharmacology is a fundamental part of any medical education curriculum and presents unique learning challenges.

12 TIPS for Implementing Peer Instruction in Medical Education.

This article was migrated. The article was marked as recommended. Peer Instruction (PI) is a vibrant instructional strategy, used successfully for over two decades in undergraduate physics and mathematics courses.

Adherence to Adjuvant Endocrine Therapy in Insured Black and White Breast Cancer Survivors: Exploring Adherence Measures in Patient Data.

Background: Adjuvant endocrine therapy (AET) is a critical therapy in that it improves survival in women with hormone receptor-positive (HR+) breast cancer (BC), but adherence to AET is suboptimal. The purpose of this study was to fill scientific gaps about predictors of adherence to AET among black and white women diagnosed with BC.

Objective: To assess AET adherence in black and white insured women using multiple measures, including one that uses an innovative statistical approach.

Clinical management practices of life-threatening asthma: an audit of practices in intensive care.

Objective: Lack of management guidelines for lifethreatening asthma (LTA) risks practice variation. This study aims to elucidate management practices of LTA in the intensive care unit (ICU).

Design: A retrospective cohort study.

Biospecimen donation among black and white breast cancer survivors: opportunities to promote precision medicine.

Purpose: Advances in precision medicine (PM) have potential to reduce and/or eliminate breast cancer disparities in both treatment and survivorship. However, compared to white Americans, black Americans are often underrepresented in genetic research. This report assessed factors that influence receipt of buccal cells via saliva kits.

Fibrinogen Early In Severe Trauma studY (FEISTY): study protocol for a randomised controlled trial.

Background: Haemorrhage is a leading cause of death in severe trauma. Fibrinogen plays a critical role in maintaining haemostasis in traumatic haemorrhage. Early fibrinogen replacement is recommended by several international trauma guidelines using either fibrinogen concentrate (FC) or cryoprecipitate (Cryo).

Fibrinogen in traumatic haemorrhage: A narrative review.

Haemorrhage in the setting of severe trauma is associated with significant morbidity and mortality. There is increasing awareness of the important role fibrinogen plays in traumatic haemorrhage. Fibrinogen levels fall precipitously in severe trauma and the resultant hypofibrinogenaemia is associated with poor outcomes.

Characteristics and outcomes of critically ill Aboriginal and/or Torres Strait Islander patients in North Queensland.

A retrospective cohort analysis of an admission database for the intensive care unit at The Townsville Hospital was undertaken to describe the characteristics and short-term outcomes of critically ill Aboriginal and Torres Strait Islander patients. The Townsville Hospital is the tertiary referral centre for Northern Queensland and services a region in which Aboriginal and Torres Strait Islander people constitute 9.6% of the population.

Toxic leukoencephalopathy in the intensive care unit.

In this article, we report two cases of acute toxic leukoencephalopathy to highlight this acute clinicoradiological syndrome as an important, although uncommon, consideration in the undifferentiated comatose patient who fails to wake following drug overdose or has unexplained neurology with a history of drug exposure. We then review the current literature and discuss potential differential diagnoses in this setting, along with proposed treatments for this condition. The cases presented demonstrate a more fulminant onset than previously well-defined acute toxic leukoencephalopathy subtypes and highlight the prognostic importance of magnetic resonance imaging in diagnosing a condition from which significant functional recovery seems possible.

Presence and attunement in health care: a view from infancy research.

In the nuanced exchange between mother and baby-with its exquisite attunement, which we now know creates neurobiological changes in both parties-we see a metaphor for the therapeutic relationship in health care. To the extent that the mother is fully present, the infant is not only regulated in the moment, but also learns to self-regulate. What is the power of the nurse's presence to heal and to increase the patient's participation in healing? And where does a nurse reach for this critical health care tool?

Assessing urinary levoglucosan and methoxyphenols as biomarkers for use in woodsmoke exposure studies.

A major contributor to particle concentrations in urban airsheds is domestic woodsmoke and smoke arising from wildfires or management burns. Particle concentrations in urban airsheds have been associated with a wide range of health effects. There has been little research into the contribution of biomass burning to studies of human health due to the complexity of attributing effects in the presence of multiple sources of pollutants and the variability in the nature and conditions of biomass burning.

Commentary on the Clinton health care plan.

The best that can be said for the plan is that it provides a roadmap for dialogue, and the worst that can be said is that it is a prescription for disaster, states this article. The author's major concern is that the Clinton plan would take away from consumers choice and control over their own health care. He fears that patient health care decisions will be placed in the hands of government-appointed boards, employers, or regional health alliances.

Two largest national alliances fine-tune strategies as health care environment changes. Interview by Howard J. Anderson.

The nation's two largest alliances of not-for-profit hospitals and systems are refining their roles for the 1990s. American Health Care Systems (AmHS) and Voluntary Hospitals of America (VHA) are moving away from strategies designed for competition in the marketplace of the 1980s, and toward helping their members change the way they deliver health care in their communities. While AmHS is promoting its health care reform proposal, VHA sees its existing 29 regional organizations of hospitals as a potential infrastructure for the development of community-based, integrated networks of care as envisioned in the AHA's reform plan.