Airway Management in Austere Settings: Intubation Is Not Always the Best Option.

Management of the airway in austere environments can differ substantially from standard in-hospital airway management. Devices such as nasopharyngeal airways, oropharyngeal airways, endotracheal tubes, extraglottic airways, ventilators, and sedative and paralytic medications may not be available. Weather, scene hazards, difficulties of extrication, transport times, skill sets of rescuers, and availability of advanced equipment are highly variable.

Comparison of Commonly Carried Liquids Against Commercial Ultrasound Gel for Use in the Backcountry Setting.

Introduction: Point-of-care ultrasound (POCUS) is utilized in austere environments because it is lightweight, durable, battery powered, and portable. In austere settings, weight and space constraints are limitations to carrying dedicated ultrasound gel. Few studies have assessed commonly carried liquids as gel alternatives.

Neurocoagulation from a Mechanistic Point of View in the Central Nervous System.

Coagulation mechanisms are critical for maintaining homeostasis in the central nervous system (CNS). Thrombin, an important player of the coagulation cascade, activates protease activator receptors (PARs), members of the G-protein coupled receptor family. PAR1 is located on neurons and glia.

Clinical utilization of a sous vide device in the acute rewarming of frostbitten extremities.

The current standard of care for acute frostbite rewarming is the use of a circulating warm water bath at a temperature of 37 °C to 39 °C. There is no standardized method to achieve this. Manual management of a warm water bath can be inefficient and time consuming.

The Spatiotemporal Coupling: Regional Energy Failure and Aberrant Proteins in Neurodegenerative Diseases.

The spatial and temporal coordination of each element is a pivotal characteristic of systems, and the central nervous system (CNS) is not an exception. Glial elements and the vascular interface have been considered more recently, together with the extracellular matrix and the immune system. However, the knowledge of the single-element configuration is not sufficient to predict physiological or pathological long-lasting changes.

Witnessed Cardiac Arrest in a Hypothermic Avalanche Victim Completely Buried for 2 Hours.

A 34-y-old skier triggered a wind slab avalanche and was completely buried for over 2 h. After extrication by rescuers, the victim was breathing and conscious. Despite directions from the rescuers against standing up, the victim struggled to free himself and ultimately stood upright before collapsing in cardiac arrest.

A novel specific PERK activator reduces toxicity and extends survival in Huntington's disease models.

One of the pathways of the unfolded protein response, initiated by PKR-like endoplasmic reticulum kinase (PERK), is key to neuronal homeostasis in neurodegenerative diseases. PERK pathway activation is usually accomplished by inhibiting eIF2α-P dephosphorylation, after its phosphorylation by PERK. Less tried is an approach involving direct PERK activation without compromising long-term recovery of eIF2α function by dephosphorylation.

Constraining the p-Mode-g-Mode Tidal Instability with GW170817.

We analyze the impact of a proposed tidal instability coupling p modes and g modes within neutron stars on GW170817. This nonresonant instability transfers energy from the orbit of the binary to internal modes of the stars, accelerating the gravitational-wave driven inspiral. We model the impact of this instability on the phasing of the gravitational wave signal using three parameters per star: an overall amplitude, a saturation frequency, and a spectral index.

Theoretical volume profiles for conformational changes: Application to internal rotation of benzene ring in 1,12-dimethoxy-[12]-paracyclophane.

Identification of the transition state is an important step in the study of reaction kinetics and mechanisms. However, for non-rigid chemical systems where multiple viable reaction pathways may exist, enumeration of all possible transition states quickly becomes computationally expensive, if at all feasible. As an alternative approach, we recently proposed a methodology where the volumetric properties of a flexible reaction system are used to locate its transition state ensemble through a comparison of its theoretically determined volume profile and experimental activation volumes derived from high pressure kinetic data.

Genetic screening in patients with Retinoblastoma in Israel.

Retinoblastoma (Rb) is a childhood tumor (~1 in 20,000 live births) developing in the retina due to mutations in the RB1 gene. Identification of the oncogenic mutations in the RB1 gene is important for the clinical management and for genetic counseling to families with a child or a parent affected with the tumor. Here we present our experience in detecting the pathogenic mutations in blood samples, from 150 unrelated Rb patients and highlight the relevant counseling issues.

Theoretical volume profiles as a tool for probing transition states: folding kinetics.

The mechanism by which conformational changes, particularly folding and unfolding, occur in proteins and other biopolymers has been widely discussed in the literature. Molecular dynamics (MD) simulations of protein folding present a formidable challenge since these conformational changes occur on a time scale much longer than what can be afforded at the current level of computational technology. Transition state (TS) theory offers a more economic description of kinetic properties of a reaction system by relating them to the properties of the TS, or for flexible systems, the TS ensemble (TSE).

Reaction profiles and energy surfaces of compressed species.

Both experiment and first principles calculations unequivocally indicate that properties of elements and their compounds undergo a tremendous transformation at ultrahigh pressures exceeding 1 Mbar due to the fact that the difference between intra- and intermolecular interactions disappears under such conditions. Yet, even at much milder pressures of 50-300 kbar, when molecules still retain their individual identity, their chemical properties and reactivity change dramatically. Since kinetics and mechanisms of condensed-phase reactions are described in terms of their potential energy (PES) or Gibbs energy (GES) surfaces, chemical effects of high pressure can be assessed through analysis of pressure-induced deformations of GES of solvated reaction systems.

Left Ventricular Energy Model Predicts Adverse Events in Women With Suspected Myocardial Ischemia: Results From The NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE) Study.

Objectives: To assess the prognostic value of a left ventricular energy-model in women with suspected myocardial ischemia.

Background: The prognostic value of internal energy utilization (IEU) of the left ventricle in women with suspected myocardial ischemia is unknown.

Methods: Women (n=227, mean age 59±12 years, range 31-86), with symptoms of myocardial ischemia, underwent myocardial perfusion imaging (MPI) assessment for regional perfusion defects along with measurement of ventricular volumes separately by gated Single Photon Emission Computed Tomography (SPECT) (n= 207) and magnetic resonance imaging (MRI) (n=203).

Partition, sorption and structure activity relation study of dialkoxybenzenes that modulate insect behavior.

Some dialkoxybenzenes are promising new insect control agents. These compounds mimic naturally occurring odorants that modulate insect behavior. Before applying these compounds, however, their persistence and biodegradability at the application site and in the environment should be understood.

Engineered vascular beds provide key signals to pancreatic hormone-producing cells.

The mechanisms underlying early islet graft failure are not entirely clear, but are thought to involve ischemic injury due to delayed vascularization. We hypothesize that blood vessels play an active role in cell-cell communications supporting islet survival and engraftment. To test this hypothesis and to uncouple endothelial cell (EC)-generated signaling stimuli from their nutritional and gas exchange functions, we developed three dimensional (3D) endothelial vessel networks in engineered pancreatic tissues prepared from islets, fibroblasts and ECs.

Physical activity, hormone replacement therapy, and the presence of coronary calcium in midlife women.

Background: Atherosclerotic calcification is a risk factor for cardiovascular events, independent of other traditional risk factors. Studies of the relation of menopausal hormone therapy to cardiovascular events have had inconsistent results, and often have been confounded by lifestyle behaviors and the "healthy user" effect. The authors evaluated the cross-sectional association of hormone therapy use with the presence and severity of atherosclerosis in postmenopausal women, independent of lifestyle factors, including diet and physical activity levels.

Molecular dynamics calculation of molecular volumes and volumes of activation.

Experimentally, the effects of pressure on reaction rates are described by their pressure derivatives, known as volumes of activation. Transition state theory directly links activation volumes to partial molar volumes of reactants and transition states. We discuss a molecular dynamics method for the accurate calculation of molecular volumes, within which the volumes of molecular species are obtained as a difference between the volumes of pure solvent and solvent with a single molecule inserted.

Molecular dynamics calculation of activation volumes.

We propose a novel approach toward calculating activation and reaction volumes based on MD simulations of reaction systems. The accuracy of the calculated volumes, verified by the comparison to the experimental data, is suitable for quantitative analysis of the experimental volumes of activations in terms of structural parameters of the corresponding transition states.

Prognostic value of global MR myocardial perfusion imaging in women with suspected myocardial ischemia and no obstructive coronary disease: results from the NHLBI-sponsored WISE (Women's Ischemia Syndrome Evaluation) study.

Objectives: The purpose of this study was to assess the prognostic value of global magnetic resonance (MR) myocardial perfusion imaging (MPI) in women with suspected myocardial ischemia and no obstructive (stenosis <50%) coronary artery disease (CAD).

Background: The prognostic value of global MR-MPI in women without obstructive CAD remains unknown.

Methods: Women (n = 100, mean age 57 ± 11 years, age range 31 to 76 years), with symptoms of myocardial ischemia and with no obstructive CAD, as assessed by coronary angiography, underwent MR-MPI and standard functional assessment.

A faint type of supernova from a white dwarf with a helium-rich companion.

Supernovae are thought to arise from two different physical processes. The cores of massive, short-lived stars undergo gravitational core collapse and typically eject a few solar masses during their explosion. These are thought to appear as type Ib/c and type II supernovae, and are associated with young stellar populations.

Diagnostic accuracy of 64 multidetector computed tomographic angiography in peripheral vascular disease.

Background: Previous studies of multidetector CT (MDCT) of the lower extremities for the detection of peripheral vascular disease showed high diagnostic accuracy but were performed with older generation systems.

Objective: The purpose of this study was to evaluate the diagnostic accuracy of 64 MDCT for the detection of hemodynamically significant disease within the lower extremity peripheral vasculature as compared to digital subtraction angiography (DSA).

Methods: Twenty-eight consecutive patients with symptomatic lower extremity intermittent claudication and an abnormal ankle-brachial index (ABI; less than 0.