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Extracorporeal membrane oxygenation within CPR (ECPR) may improve survival for refractory out-of-hospital cardiac arrest (OHCA). We developed a prehospital, emergency department (ED), and hospital-based clinical and educational protocol to improve the key variable of time-to-ECPR (TTE).
In a single urban health region we involved key prehospital, clinical, and administrative stakeholders over a 2-year period, to develop a regional ECPR program with destination to a single urban tertiary care hospital. We developed clear and reproducible inclusion criteria and processes, including measures of program efficiency. We conducted seminars and teaching modules to paramedics and hospital-based clinicians including monthly simulator sessions, and performed detailed reviews of each treated case in the form of report cards. In this before-and-after study we compared patients with ECPR attempted prior to, and after, protocol implementation. The primary outcome was TTE, defined as the time of initial professional CPR to establishment of extracorporeal circulation. We compared the median TTE for patients in the two groups using the Wilcoxon signed rank test.
Four patients were identified prior to the protocol and managed in an ad hoc basis; for nine patients the protocol was utilized. Overall favourable neurological outcomes among ECPR-treated patients were 27%. The median TTE was 136 minutes (IQR 98 - 196) in the pre-protocol group, and 60 minutes (IQR 49 - 81) minutes in the protocol group (p=0.0165).
An organized clinical and educational protocol to initiate ECPR for patients with OHCA is feasible and significantly reduces the key benchmark of time-to-ECPR flows.
Thalamic glutamine loss and grey matter reduction suggest
neurodegeneration in first-episode schizophrenia, but the duration is
To observe glutamine and glutamate levels, grey matter volumes and social
functioning in patients with schizophrenia followed to 80 months after
Grey matter volumes and proton magnetic resonance spectroscopy
metabolites in left anterior cingulate and left thalamus were measured in
17 patients with schizophrenia before medication and 10 and 80 months
after diagnosis. Social functioning was assessed with the Life Skills
Profile Rating Scale (LSPRS) at 80 months.
The sum of thalamic glutamate and glutamine levels decreased over 80
months, and correlated inversely with the LSPRS. Thalamic glutamine and
grey matter loss were significantly correlated in frontal, parietal,
temporal and limbic regions.
Brain metabolite loss is correlated with deteriorated social functioning
and grey matter losses in schizophrenia, consistent with
Plant genetic resources are vital in safeguarding and increasing crop production and enhancing human nutrition, particularly in a Man-dominated world. Crop genetic resources are currently under threat of loss for various reasons. Conservation as seed is the most common and practicable method of preserving plant genetic resources. The International Board for Plant Genetic Resources (IBPGR), in cooperation with gene-banks around the world, has created a global network of base-collections. In order to minimize losses of stock in the gene-banks, standards were developed in 1985 and base-collections were assessed against them.
Progressive volumetric changes in the brains of people with schizophrenia have been attributed to a number of factors.
To determine whether glutamatergic changes in patients with schizophrenia correlated with grey-matter losses during the first years of illness.
Left anterior cingulate and thalamic glutamatergic metabolite levels and grey-matter volumes were examined in 16 patients with first-episode schizophrenia before and after 10 months and 30 months of antipsychotic treatment and in 16 healthy participants on two occasions 30 months apart.
Higher than normal glutamine levels were found in the anterior cingulate and thalamus of never-treated patients. Thalamic levels of glutamine were significantly reduced after 30 months. Limited grey-matter reductions were seen in patients at 10 months followed by widespread grey-matter loss at 30 months. Parietal and temporal lobe grey-matter loss was correlated with thalamic glutamine loss.
Elevated glutamine levels in never-treated patients followed by decreased thalamic glutamine and grey-matter loss in connected regions could indicate either neurodegeneration or a plastic response to reduced subcortical activity.
The National Academy of Sciences — National Research Council (NAS-NRC) twin panel, created nearly 50 years ago, had twin zygosity determined primarily via a similarity questionnaire that has been estimated to correctly classify at least 95% of twins. In the course of a study on the genetics of healthy ageing in the NAS-NRC twins, DNA was collected for genome-wide scanning and zygosity confirmation was examined in 343 participating pairs. The sample was supplemented from two other studies using NAS-NRC twins where one or both co-twins were suspected to have Alzheimer disease or another dementia, or Parkinson's disease. Overall 578 twin pairs with DNA were analyzed. Zygosity assignment for 96.8% (519/536) was confirmed via questionnaire. Among 42 pairs whose questionnaire responses were inconclusive for assigning zygosity, 50% were found to be monozygous (MZ) and 50% were dizygous (DZ). There was some evidence for greater misclassification of presumed DZ pairs in the healthy ageing study where participation favored pairs who were similar in having a favorable health history and willingness to volunteer without any element of perceived risk for a specific disease influencing participation.
—Infochemicals play an important role in the biology of many insect species. An understanding of their role in plant-herbivore-carnivore interactions can be used in the development of tools for the enhancement of environmentally benign alternatives to synthetic pesticides. This review discusses how chemical information mediates ecological interactions between organisms and the role of infochemicals in integrated pest management. Infochemicals can be used in pest monitoring and in pest control, through mating disruption, mass trapping and to aggregate herbivores at delivery sites for biological control agents. Particular emphasis is placed on the potential of using pheromones and kairomones in the management of the banana weevil, Cosmopolites sordidus (Germar) (Coleoptera: Curculionidae), a pest in plantations of East African highland banana and plantain in most banana-growing regions of the world. Cosmopolites sordidus produces an aggregation pheromone that attracts both males and females. This pheromone has been identified and synthesised and is being recommended as an effective agent in the trapping and control of the weevil. The synergism between banana plant extracts (kairomones) and the synthetic pheromone in attracting C. sordidus should be better exploited. Future research areas that can provide information for the development of an infochemical-based trapping system for the management of C. sordidus are discussed.
An unusual case of an adult female with anorexia nervosa, who developed a retropharyngeal abscess, is presented. This case is reported both because of the paucity of reports on retropharyngeal abscess and because of the dramatic unusual aetiology.
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