PURPOSE: Excessive tachycardia in resuscitated septic shock patients can impair hemodynamics and worsen patient outcome. We investigated whether heart rate (HR) control can be achieved without increased vasopressor requirements using the titratable highly selective, ultra-short-acting β1-blocker landiolol. METHODS: This randomized, open-label, controlled trial was conducted at 20 sites in 7 European countries from 2018 to 2022 and investigated the efficacy and safety of landiolol in adult patients with septic shock and persistent tachycardia. Patients were randomly assigned to receive either landiolol along with standard treatment (n = 99) or standard treatment alone (n = 101). The combined primary endpoint was HR response (i.e., HR within the range of 80-94 beats per minute) and its maintenance without increasing vasopressor requirements during the first 24 h after treatment start. Key secondary endpoints were 28-day mortality and adverse events. RESULTS: Out of 196 included septic shock patients, 98 received standard treatment combined with landiolol and 98 standard treatment alone. A significantly larger proportion of patients met the combined primary endpoint in the landiolol group than in the control group (39.8% [39/98] vs. 23.5% [23/98]), with a between-group difference of 16.5% (95% confidence interval [CI]: 3.4-28.8%; p = 0.013). There were no statistically significant differences between study groups in tested secondary outcomes and adverse events. CONCLUSION: The ultra-short-acting beta-blocker landiolol was effective in reducing and maintaining HR without increasing vasopressor requirements after 24 h in patients with septic shock and persistent tachycardia. There were no differences in adverse events and clinical outcomes such as 28-day mortality vs. standard of care. The results of this study, in the context of previous trials, do not support a treatment strategy of stringent HR reduction (< 95 bpm) in an unselected septic shock population with persistent tachycardia. Further investigations are needed to identify septic shock patient phenotypes that benefit clinically from HR control.
- MeSH
- Middle Aged MeSH
- Humans MeSH
- Urea * analogs & derivatives therapeutic use pharmacology MeSH
- Morpholines * therapeutic use pharmacology MeSH
- Aged MeSH
- Shock, Septic * drug therapy complications physiopathology MeSH
- Heart Rate * drug effects MeSH
- Tachycardia * drug therapy physiopathology complications MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Randomized Controlled Trial MeSH
- Geographicals
- Europe MeSH
Recent advances in AI-based methods have revolutionized the field of structural biology. Concomitantly, high-throughput sequencing and functional genomics have generated genetic variants at an unprecedented scale. However, efficient tools and resources are needed to link disparate data types-to 'map' variants onto protein structures, to better understand how the variation causes disease, and thereby design therapeutics. Here we present the Genomics 2 Proteins portal ( https://g2p.broadinstitute.org/ ): a human proteome-wide resource that maps 20,076,998 genetic variants onto 42,413 protein sequences and 77,923 structures, with a comprehensive set of structural and functional features. Additionally, the Genomics 2 Proteins portal allows users to interactively upload protein residue-wise annotations (for example, variants and scores) as well as the protein structure beyond databases to establish the connection between genomics to proteins. The portal serves as an easy-to-use discovery tool for researchers and scientists to hypothesize the structure-function relationship between natural or synthetic variations and their molecular phenotypes.
- MeSH
- Databases, Protein * MeSH
- Genetic Variation MeSH
- Genetic Testing methods MeSH
- Genomics * methods MeSH
- Protein Conformation MeSH
- Humans MeSH
- Proteins genetics chemistry MeSH
- Proteome genetics MeSH
- Amino Acid Sequence MeSH
- Software MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
We investigated neural correlates of Emotion Recognition Accuracy (ERA) using the Assessment of Contextualized Emotions (ACE). ACE infuses context by presenting emotion expressions in a naturalistic group setting and distinguishes between accurately perceiving intended emotions (signal), and bias due to perceiving additional, secondary emotions (noise). This social perception process is argued to induce perspective taking in addition to pattern matching in ERA. Thirty participants were presented with an fMRI-compatible adaptation of the ACE consisting of blocks of neutral and emotional faces in single and group-embedded settings. Participants rated the central character's expressions categorically or using scalar scales in consequent fMRI scans. Distinct brain activations were associated with the perception of emotional vs. neutral faces in the four conditions. Moreover, accuracy and bias scores from the original ACE task performed on another day were associated with brain activation during the scalar (vs. categorical) condition for emotional (vs. neutral) faces embedded in group. These findings suggest distinct cognitive mechanisms linked to each type of emotional rating and highlight the importance of considering cognitive bias in the assessment of social emotion perception.
- MeSH
- Adult MeSH
- Emotions * physiology MeSH
- Humans MeSH
- Magnetic Resonance Imaging * MeSH
- Brain Mapping * MeSH
- Young Adult MeSH
- Brain * physiology diagnostic imaging MeSH
- Facial Recognition physiology MeSH
- Social Perception * MeSH
- Photic Stimulation methods MeSH
- Facial Expression * MeSH
- Bias MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
OBJECTIVE: Prepregnancy optimization of cardiovascular function may reduce the risk of pre-eclampsia. We aimed to assess the feasibility and effect of preconception cardiovascular monitoring, exercise, and beetroot juice on cardiovascular parameters in women planning to conceive. DESIGN AND METHOD: Prospective single-site, open-label, randomized controlled trial. Thirty-two women, aged 18-45 years, were allocated into one of four arms (1 : 1 : 1 : 1): exercise, beetroot juice, exercise plus beetroot juice and no intervention for 12 weeks. Blood pressure (BP) was measured at home daily. Cardiac output ( CO ) and total peripheral resistance (TPR) were assessed via bio-impedance. RESULTS: Twenty-nine out of 32 (91%) participants completed the study. Adherence to daily BP and weight measurements were 81% and 78%, respectively ( n = 29). Eight out of 15 (53%) of participants did not drink all the provided beetroot juice because of forgetfulness and taste. After 12 weeks, exercise was associated with a reduction in standing TPR (-278 ± 0.272 dynes s cm -5 , P < 0.05), and an increase in standing CO (+0.88 ± 0.71 l/min, P < 0.05). Exercise and beetroot juice together was associated with a reduction in standing DBP ( 7 ± 6 mmHg, P < 0.05), and an increase in standing CO (+0.49 ± 0.66 l/min, P < 0.05). The control group showed a reduction in standing TPR ( 313 ± 387 dynes s cm -5 ) and standing DBP ( 8 ± 5mmHg). All groups gained weight. CONCLUSION: Exercise and beetroot juice in combination showed a signal towards improving cardiovascular parameters. The control group showed improvements, indicating that home measurement devices and regular recording of parameters are interventions in themselves. Nevertheless, interventions before pregnancy to improve cardiovascular parameters may alter the occurrence of hypertensive conditions during pregnancy and require further investigation in adequately powered studies.
- MeSH
- Exercise physiology MeSH
- Nitrates * MeSH
- Double-Blind Method MeSH
- Hypertension * MeSH
- Blood Pressure MeSH
- Humans MeSH
- Dietary Supplements MeSH
- Prospective Studies MeSH
- Pregnancy MeSH
- Check Tag
- Humans MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
Anti-N-methyl D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune disorder characterized by IgG antibodies targeting NMDAR. The prevalence is remarkably higher in women and some develop the condition during pregnancy. While immunotherapies have shown good outcomes for pregnant mothers and their infants, the impact on early neurodevelopment remains elusive. This study investigates the effects of anti-NMDAR antibody on the development of primary cortical cultures. Anti-NMDAR antibody was administered to the cultures at day in vitro 5 for the following 5 days to assess dendritic branching and arbor complexity, and at day in vitro 14 for measuring the expression of brain-derived neurotrophic factor (BDNF) and synaptic proteins. Immature cultured neurons treated with anti-NMDAR antibody exhibited impaired dendritic branching and arbor complexity. Interestingly, BDNF expression was unaffected in mature neurons. Additionally, GluN1 expression, a mandatory NMDAR subunit, was significantly reduced, while no significant alterations were observed in PSD-95, gephyrin and synaptophysin expression. These findings shed light on the structural and synaptic impacts of anti-NMDAR antibody on immature neurons, providing evidence for their consequences in early neuronal development.
- MeSH
- Dendrites * drug effects metabolism MeSH
- Rats MeSH
- Cells, Cultured MeSH
- Membrane Proteins metabolism immunology MeSH
- Brain-Derived Neurotrophic Factor * metabolism MeSH
- Neurons * metabolism drug effects MeSH
- Disks Large Homolog 4 Protein metabolism MeSH
- Nerve Tissue Proteins immunology metabolism MeSH
- Receptors, N-Methyl-D-Aspartate * immunology MeSH
- Synaptophysin metabolism MeSH
- Carrier Proteins MeSH
- Animals MeSH
- Check Tag
- Rats MeSH
- Female MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
Východiská: Medikačné chyby sú častejšie hlásené z nemocničného prostredia. Avšak môžeme ich identifikovať aj v zariadeniach sociálnych služieb. Najčastejšie ide o nesprávne riedenie lieku, nesprávne uchovávanie lieku, podanie lieku v nesprávnej dávke a v nesprávnom čase, nesprávnu techniku podania lieku, podanie exspirovaného lieku. Výsledky výskumov dokazujú, že medikačné chyby sú globálnym problém verejného zdravia. Cieľ: identifikovať kritické miesta rizikového správania sa sestier v príprave a podávaní liekov pre os obyvateľom zariadenia sociálnych služieb. Súbor a metódy: Do súboru bolo zaradených 5 sestier s priemernou dĺžkou praxe v povolaní sestra 29,4 rokov. Uskutočnili sme priame pozorovanie v rozsahu piatich pracovných dní. Celkový počet pozorovaní bolo 675. Počet pozorovaných javov bol 9. Použili sme metódu frekvenčnej analýzy pozorovaných javov. Výsledky sme interpretovali ako priemerné relatívne skóre. Výsledky: Z analýzy dát vyplynulo zistenie, že kritickým miestom v príprave a v podávaní liekov per os v zariadení sociálnych služieb je kontrola nežiaducich účinkov liekov, poučenie osoby a kontrola užitia liekov. Najviac medikačných chýb sme zaznamenali v tretí pracovný deň. Záver: Odhalené rizikové správanie sa sestier v príprave a podávaní liekov sú výzvou pre zmeny v procesoch realizovaných v zariadení sociálnych služieb. Prospektívne je potrebné realizovať väčšie multicentrické štúdie
Backround: Medication errors are more commonly reported from the hospital setting. However, they can also be identified in social service settings. The most common are incorrect dilution of the medicine, incorrect storage of the medicine, administration of the medicine in the wrong dose and at the wrong time, incorrect technique of administration of the medicine, administration of exspirated medicine. Research findings show that medication errors are a global public health problem. Objective: Identify critical points of nurses' risky behaviors in the preparation and administration of medications to residents of a social service facility. Participants and methods: Five nurses with an average length of experience in the nursing profession of 29.4 years were included in the cohort. We conducted direct observation over a period of five working days. The total number of observations was 675. The number of observed phenomena was 9. We used the method of frequency analysis of observed phenomena. We interpreted the results as mean relative scores. Results: The data analysis revealed the finding that the critical point in the preparation and administration of per os medications in a social service facility is the control of adverse drug reactions, the instruction of the person, and the control of the use of medications. The highest number of medication errors were observed on the third working day. Conclusion: The revealed risky behaviors of nurses in the preparation and administration of medications are a challenge for changes in the processes implemented in the social services facility. Larger multicentre studies with longer observation periods are prospectively needed
Súčasťou poskytovania ošetrovateľskej starostlivosti v rámci zabezpečenia hygieny u pacienta počas hospitalizácie je starostlivosť o ústnu dutinu geriatrického pacienta. Cieľom príspevku je poukázať práve na špecifiká starostlivosti o ústnu dutinu, kedy je nevyhnutné posúdenie stavu pier, chrupu, slizníc, zubov a ďasien. Zhodnotenie sebestačnosti, schopnosti a zručnosti seniora pri vykonávaní hygieny ústnej dutiny má tiež svoje významné miesto v starostlivosti o ústa seniora. Poznaním príčin vzniku prejavov komplikácií v ústnej dutine dokáže ošetrujúci poskytnúť kvalitnú ošetrovateľskú starostlivosť, predchádzať orálnym ochoreniam a zvládať možný výskyt komplikácií vyplývajúcich z celkových ochorení.
Part of the provision of nursing care as part of ensuring hygiene for the patient during hospitalization is the care of the oral cavity of the geriatric patient. The aim of the paper is to point out the specifics of oral care, when it is necessary to assess the condition of the lips, teeth, mucous membranes, teeth and gums. The evaluation of the senior’s self-sufficiency, ability and skills in performing oral hygiene also has an important place in the care of the senior’s mouth. By knowing the causes of complications in the oral cavity, the caregiver can provide quality nursing care, prevent oral diseases and manage the possible occurrence of complications resulting from general diseases.
- MeSH
- Pemphigoid, Bullous etiology complications nursing prevention & control therapy MeSH
- Cheilitis etiology complications nursing prevention & control therapy MeSH
- Geriatric Nursing MeSH
- Candidiasis etiology complications nursing prevention & control therapy MeSH
- Leukoplakia etiology complications nursing prevention & control therapy MeSH
- Tongue Diseases etiology complications nursing prevention & control therapy MeSH
- Mouth Diseases etiology complications nursing prevention & control therapy MeSH
- Oral Hygiene MeSH
- Oral Health MeSH
- Aged MeSH
- Stomatitis etiology complications nursing therapy MeSH
- Mouth Mucosa pathology MeSH
- Check Tag
- Aged MeSH
Východiská: Jednou z možností kontroly efektívnosti modelu pregraduálneho vzdelávania v odbore ošetrovateľstvo je jeho hodnotenie absolventmi. Schopnosť kriticky posúdiť a zaujať objektívne stanovisko k obsahu a forme vzdelávania sa s odstupom času zvyšuje. Dôvodom sú postupne nadobudnuté praktické skúsenosti absolventov, pracovné podmienky, možnosti ďalšieho vzdelávania a i. Ošetrovateľstvo je profesijne orientovaný študijný program. Jadrom úspechu výkonu profesie je harmonizácia teórie a praxe. V minulosti veľa štúdií malo za cieľ prioritne analyzovať iba výučbu v klinických podmienkach. Sme toho názoru, že prediktorom autonómnej praxe v klinických podmienkach sú teoretické vedomosti, kvalitné vzdelávanie v laboratórnych podmienkach a vedenie mentorom. Je nesprávne tento vzťah podceniť. Cieľ: retrospektívne hodnotiť vybrané zložky modelu pregraduálneho vzdelávania v odbore ošetrovateľstvo. Súbor a metódy: Do výskumu bolo zapojených 176 absolventov – bakalárov v odbore ošetrovateľstvo. 38 (21,6 %) respondentov absolvovalo štúdium na odbornej vysokej škole a 138 (78,4 %) respondentov absolvovalo toto štúdium na univerzite. Dáta boli získané vybranými sekciami štandardizovaného dotazníka The Clinical Learning Environment, Supervision and Nurse Teacher scale (CLES+T test). Vnútornú konzistenciu dotazníka sme zisťovali pomocou Cronbachovej alfy. Respondenti svoj názor vyjadrili na 5 stupňovej Likertovej škále. Dotazník bol sprístupnený online za spolupráci Slovenskej komory sestier a pôrodných asistentiek (SK SaPA). Obdobie zberu dát: február-máj 2021. Výsledky boli spracované deskriptívnou štatistikou. Výsledky: Absolventi pozitívnejšie hodnotili teoretickú výučbu (skóre 3,88). Hodnotenie klinickej výučby absolventmi univerzít bolo skoro identické s absolventmi odborných vysokých škôl. Z analýzy dát klinickej výučby vyplynulo zistenie, že mentori neboli zdrojom spätnej väzby pre študenta, študenti sa nepovažovali za členov tímu. Výsledky preukázali vysokú prioritu roly mentora. Pozitívny interpersonálny vzťah medzi mentorom a študentom má podľa absolventov silný motivačný význam. Názory absolventov univerzít na pregraduálne vzdelávanie je porovnateľná s názormi absolventov odborných vysokých škôl. Celkove hodnotenie pregraduálneho vzdelávania dosahovalo priemerné skóre 3,56. Záver: Výsledky hodnotenia slovenských absolventov je porovnateľná s hodnotením študentov a absolventov ostatných európskych krajín patriacich k signatárom Európskeho vysokoškolského priestoru - European Higher Education Area (EHEA). To potvrdzuje vysoký štandard slovenských vysokých škôl, porov
Background: One way of checking the ef fectiveness of the undergraduate nursing education model is through its evaluation by graduates. The ability to critically assess and take an objective stance on the content and form of education increases with the passage of time. This is due to the graduates' practical experience, working conditions, opportunities for further education, etc. Nursing is a professionally oriented study programme. The harmonisation of theory and practice is at the heart of the success of the profession. In the past, many studies have had the priority of analysing only teaching in clinical settings. We believe that the predictors of autonomous practice in clinical settings are theoretical knowledge, quality education in laboratory settings, and mentor guidance. It is wrong to underestimate this relationship. Objective: to retrospectively evaluate selected components of the undergraduate nursing education model. Set and Methods: 176 undergraduate nursing students were included in the study. 38 (21.6%) of the respondents had completed their studies at a vocational college and 138 (78.4%) of the respondents had completed their studies at a university. Data were collected by selected sections of the standardized questionnaire The Clinical Learning Environment, Supervision and Nurse Teacher scale (CLES+T test). Internal consistency of the questionnaire was measured using Cronbach’s alpha. Respondents expressed their opinion on a 5-point Likert scale. The questionnaire was made available online with the cooperation of the Slovak Chamber of Nurses and Midwives (SK SaPA). Data collection period: February- -May 2021.The results were processed by descriptive statistics. Results: Graduates rated theoretical teaching more positively (score 3.88). The evaluation of clinical teaching by university graduates was almost identical to that of graduates of professional colleges. Analysis of the clinical teaching data 3/202464Suplementum revealed the finding that mentors were not a source of feedback for the student; students did not consider themselves as team members. The results demonstrated the high priority of the mentor role. The positive interpersonal relationship between mentor and student is considered by the alumni to have a strong motivational significance. The views of university graduates on undergraduate education is comparable to those of graduates of vocational colleges. The overall rating of undergraduate education achieved a mean score of 3. 56. Conclusion: the results of the evaluation of Slovak graduates is comparable to the evaluation of students and graduates of other European countries belonging to the signatories of the European Higher Education Area (EHEA). This confirms the high standard of Slovak higher education institutions, comparable
