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Implementation and Evaluation of Iron Deficiency Anemia Content in Prenatal Education Classes
Full text linkPurpose/Background
The purpose of this quality improvement project is to provide and increase educational awareness and knowledge regarding iron deficiency anemia (IDA) in pregnant patients at an urban primary care clinic in Memphis, TN. This project is intended to decrease the number of individuals with IDA in pregnancy while decreasing the occurrence of IDA-related complications in pregnancy. The study aimed to introduce a cost-effective approach to help decrease or eradicate complications related to IDA during pregnancy.
The World Health Organization (WHO) estimates the prevalence of anemia-complicating pregnancies to be more than 40 percent. Pregnant women with IDA residing in low and middle-income countries are at a higher risk of low birth weight, preterm birth, perinatal mortality, and neonatal mortality. Memphis is known as an urban, predominantly Black city, in which studies have shown that the prevalence of Black gravidas was \u3e15 percent in the first trimester, around 20 percent in the second trimester, and close to 50 percent in the third trimester. Introducing IDA educational sessions can beneficially impact Memphis maternal and infant mortality rates and the number of complications and interventions related to IDA.
Methods
Researchers collaborated with the Midwives at Regional One Health Center’s (ROH) Hollywood Primary Care Clinic in Memphis, TN, to educate 25 pregnant women. The participants were administered a pretest before reviewing the IDA content. After completion of the pretest, an infographic was given to and reviewed with the patient during a 10-minute session. After reviewing the infographic, the participant took a post-test. All women gave consent to participate in this study in their first trimester (before 13 weeks gestation), were 18 or older, and had no known blood disorders or medical conditions that interfere with liver function.
Results
The pretest/post-test showed a significant correlation between IDA educational sessions and increased awareness. The results show the benefits of education in increasing awareness to help prevent pregnant women in Memphis, TN, from developing IDA and related complications.
IDA educational sessions will continue to increase awareness amongst pregnant women. The likelihood of pregnant women complying with iron supplement regimens will steadily increase, thus decreasing the risk of IDA-related complications. Therefore, the results show that providing short educational sessions to mothers in their first trimester are not only cost-effective, but will also improve maternal and infant mortality rates, especially in underserved communities like Memphis, TN.
Implication in Nursing Practice
Pre- and post-tests will be administered before and after the iron deficiency anemia education session. The pre- and post-tests will be used to collect data regarding patient education on iron deficiency anemia in pregnancy before and after the education. This information will help determine if there is a correlation between patients receiving one-on-one education on iron deficiency anemia and their knowledge of patient compliance with iron supplementation. Once the education and data collection is completed, strengths and weaknesses should be identified for improvement throughout the project for more organized and efficient education
Strategies to Reduce Ventilator-Associated Pneumonia Incidence in Mechanically Ventilated Pediatric Critical Care Patients: A Scoping Review
Full text linkPurpose/Background
Ventilator-associated pneumonia (VAP) is a severe problem in pediatric intensive care units (PICUs), resulting in increased morbidity, mortality, duration of stay, and healthcare expenses. Traditional preventative measures are well-established, but the influence of ventilator filters in preventing VAP is unknown. The current evidence on the efficacy of VAP bundles and ventilator filters is variable and challenging to address. This scoping review aims to determine how VAP bundle compliance and ventilator filter utilization impact the incidence of VAP in mechanically ventilated pediatric critical care patients.
Methods
A scoping review was carried out per the Population, Concept, and Context (PCC) framework. We conducted a scoping literature review utilizing CINAHL and PubMed databases. 241 articles were initially identified and assessed, yielding 12 that met qualifying standards and were accepted. The Rapid Critical Appraisal (RCA) instrument from Ohio State University College of Nursing was used for data extraction, classification, and quality assessment. An outcome synthesis table and level of evidence table were used to synthesize the results.
Results
The scoping review included data from various Level I to VII studies, highlighting the importance of ventilator filters and VAP bundles. Although VAP bundles were consistently shown to reduce the incidence of VAP, the effects of HEPA filters varied in research findings. No literature discussed the direct correlation between HEPA filters and VAP incidence. This review concluded that the implementation of VAP bundles was consistent with a decrease in the duration of mechanical ventilation, hospital stay, ventilator-associated pneumonia incidence rates, mortality rates, and economic cost.
Implications for Nursing Practice
Ventilator filters, especially the HEPA variants, can stop disease spread. Numerous studies revealed modest reductions, underscoring the necessity for context-specific research. Since there are limitations due to the variability of patient demographics and interventions among studies, future research should adopt standardized methodologies to improve generalizability and identify the most effective preventative treatments for ventilator-associated pneumonia in pediatric critical care
Medication Assisted Therapy and first episode psychosis: Evaluating treatment and readmission rates
Full text linkBackground The Centers for Disease Control and Prevention (CDC) found that each day more than 140 U.S. residents die from drug overdoses, specifically due to opioids. Due to this, alternatives were created to reduce overdoses and ensure safety. Medication assistance therapy (MAT) is an effective form of treatment for people with substance use disorders and is defined as the use of medication in conjunction with counseling or therapy for the treatment of substance use disorders. The efficacy of MAT is used adjunctively with psychotropic medications compared to using no MAT and using psychotropic medications alone with individuals who are experiencing first-episode psychosis and have a co-occurring substance use disorder with an overall goal to reduce hospital re-admissions and psychosis.
Methods Many sources such as Google Scholar, EBSCO, Elsevier, and the University of Tennessee Health Science Center (UTHSC)’s electronic library. All articles that were chosen were critically appraised via rapid critical appraisal to identify the type of evidence and study such as randomized control trials, cohort studies, and systematic reviews. strategically selected articles that also had recommendations to treat substance use disorder and first-episode psychosis.
Results Many articles came to the same conclusion that for a patient who is experiencing their first episode of psychosis and MAT treatment with psychotropics is initiated at this time, the overall patient outcomes in terms of hospital readmission rates and quality of life are better. There were inconclusive results on hospital admission rates likely due to the nature of the patients that researchers are dealing with for these studies.
Conclusion To conclude, it is apparent that the correlation between substance use disorder and psychiatric illness is complex and difficult to treat concurrently. More research is needed to fully understand its efficacy when used adjunctively with psychotropic medications in individuals experiencing first-episode psychosis
Targeting Coenzyme A Biosynthesis for Antifungal Development.
Full text linkAn estimated 1.5 million people die each year from invasive fungal infections (IFIs) involving dissemination to the deeper organs via the bloodstream, with estimated healthcare costs of over $7 billion in the U.S. alone. Collectively, several Candida species account for more than 75% of disseminated fungal infections in the U.S., with attributable mortality rates ranging 35-75%. Unfortunately, the prospect of curing these infections is limited by the modest efficacy of the available antifungal drugs: the azoles, echinocandins, and amphotericin B. Approximately one-third of patients with disseminated Candida infections are non-responsive to treatment with the azoles, and favorable response rates are just 52-73% for the echinocandins and just 62% for amphotericin B. As such, there is an urgent need for development of new antifungal drugs with improved clinical efficacy.
Coenzyme A (CoA) is a universal and essential cofactor for several key metabolic pathways including fatty acid oxidation and synthesis, the tricarboxylic acid cycle, and sterol biosynthesis. Nearly all organisms must synthesize their own CoA from pantothenic acid (vitamin B5-PA) through a five-step sequence of reactions requiring ATP and cysteine. Several bacterial species can take up exogenous PA through the PanF transporter, or produce it de novo from beta-alanine and pantoate, in a reaction catalyzed by pantothenate synthetase (PS). Similarly, the model yeast, Saccharomyces cerevisiae, can acquire exogenous PA through the pantothenate symporter (Fen2p) or synthesize it de novo using PS, encoded by the PAN6 gene. In contrast, mammalian cells lack the enzymes required for endogenous PA production, instead depending upon a sodium-driven multivitamin transporter to import from exogenous sources. Thus, this has raised interest in exploiting the fundamental difference in physiology to develop pathogen-selective antimicrobial agents targeting enzymes involved in PA production. Pantothenate kinase (PanK), encoded by the CAB1 gene in S. cerevisiae, catalyzes the first step in the conversion of PA to CoA. PanK has been confirmed to be essential for the viability of S. cerevisiae as well as several bacterial species. However, the CoA biosynthetic pathway is not well characterized in one of the most medically important human fungal pathogens, C. albicans. Therefore, we sought to investigate the importance of pantothenate uptake, synthesis, and conversion to CoA for C. albicans survival and virulence.
A Candida albicans fen2∆/∆ mutant was viable in vitro and virulent in a mouse model of disseminated infection. In contrast, the growth of C. albicans strains with doxycycline repressible expression of PAN6 (PTETO-PAN6) or CAB1 (PTETO-CAB1), was arrested in the presence of doxycycline, even in medium supplemented with pantothenate. Furthermore, overexpression of C. albicans FEN2 was not sufficient to restore growth of PTETO-PAN6 even in the presence of PA. This suggests that C. albicans is unable to uptake sufficient exogenous PA to support growth. Moreover, neither strain was virulent in doxycycline treated mice. Collectively, these results establish that Cab1p and Pan6p are essential for C. albicans survival and virulence, and therefore, are valid targets for antifungal development.
To facilitate the discovery of Pan6p or Cab1p inhibitors, we validated high-throughput compatible screening assays. Target-based whole-cell and biochemical screens identified small molecules that specifically target C. albicans Cab1p or Pan6p. This includes a compound that targets CaCab1p and has broad spectrum antifungal activity as well as in vivo efficacy. In addition, we solved the first eukaryotic pantothenate synthetase crystal structure, C. albicans PS, to support identification and optimization of compounds that specifically interact with the fungal protein in an effort to expand development of novel antifungal therapies with improved patient outcomes
Review Of mPGES-1 Inhibitors Based On The Benzoxazole And Its Isostere Scaffold For The Treatment Of Inflammatory Diseases
Full text linkThe vital role of the prostanoid pathway in inflammation, pain, cancer, Alzheimer’s and many other diseases has attracted the drug discovery community to discover targets for therapeutic development. Although existing non-steroidal anti-inflammatory drugs (NSAIDs) inhibiting cyclooxygenases (COX) are widely used, the side effects of these NSAIDs limit the ling time medication. Microsomal prostaglandin E synthase-1 (mPGES-1) is an attractive target that is overexpressed during inflammations, and it could be a safe alternative to NSAIDs for treating inflammatory diseases.Since the discovery of mPGES-1 in 1997, many inhibitors have been developed since 2001. Only a few compounds were able to make it to clinical trials, and only two molecules are in phase II clinical trials. Among the mPGES-1 inhibitors, benzoxazole, indole, and benzimidazole are the most explored chemical scaffolds, especially benzimidazole. One of the two inhibitors in the clinical trials is based on this scaffold. Here, we provide a review of mPGES-1\u27s role in inflammation and inhibitors based on these scaffolds that are reported in the literature
Biomechanical Outcomes of Distinct TKA Surgical Alignments and Implant Designs
Full text linkIntroduction. Total knee arthroplasty (TKA) has advanced over the past two decades from traditional post-operative neutral alignment methods with an overall goal of implant longevity to ones that are more personalized to better replicate individual native knee kinematics. Personalizing TKA knee kinematics to better replicate a patient’s native knee kinematics has evolved in response to a reported 20% dissatisfaction by patients with their TKA. These personalization advancements include innovations in surgical alignment techniques include the kinematic alignment (KA) and joint line obliquity (JLO) restoration, in contrast to the mechanical alignment (MA) technique that places everyone into the same mold. Additionally, implant designs have progressed to asymmetrical condylar geometry that restrict medial compartment anterior-posterior translation, simulating natural knee kinematics better than symmetrical tibial and femoral condylar geometries. This dissertation presents three studies, the first of which examines three-dimensional knee joint moment differences between MA and KA techniques. The second study assesses the impact of JLO restoration on frontal plane lower extremity joint moments. The third study explores how implant designs and surgical alignment techniques influence sagittal plane joint moments and muscle activation patterns during stair negotiation.
Methods. The first aim of this dissertation examined the influence of surgical alignment techniques and restoration of joint line obliquity on knee joint biomechanics. The first study analyzed the surgical alignment techniques (Aim 1, hypothesis 1a), and the second study analyzed the restoration of joint line obliquity (Aim 1, hypothesis 1b). For the first study (Aim 1, hypothesis 1a), a total of 28 patients (14 MA; 14 KA) performed five stair ascent and descent trails. Kinematics and kinetics were recorded using a three-stair instrumented staircase (1000 Hz, AMTI Inc., Watertown, MA) and an 8-camera motion capture system (200 Hz, OptiTrack, NaturalPoint Inc, MA) using an AI-based reconstruction software (Theia Markerless, Inc., Kingston, ON). Visual 3D calculated three-dimensional knee joint moments, and custom software (MATLAB) was used to find peak knee joint moments in each plane. Six independent sample t-tests or Wilcoxon-Signed Rank tests in case of non-normality were conducted to determine the effect of surgical alignment technique (MA and KA) during each task (stair ascent and descent) on independent variables. Cohen’s d was used to quantify effect size magnitude and were interpreted as follows: small, d 0.8. SAS 9.5 software (Version 9.5, SAS Institute Inc., Cary, NC) was used to perform all statistical analyses. The second study (Aim 1, hypothesis 1b) included 52 patients (30 unrestored; 22 restored) who completed ten stair ascent and descent trials. The same data collection setup was used as above for kinematics, kinetics and data analysis on frontal plane lower extremity moments. Independent sample t-tests or Wilcoxon-Signed Rank tests in case of non-normality were conducted to determine the effect of the restoration of JLO (Restored and Unrestored) during each task (stair ascent and descent) on peak frontal plane lower extremity joint moments. Aim 2 quantified the influence of implant designs on knee joint biomechanics during a stair negotiation task. The third study (Aim 2), split a total of 52 patients into four groups based on the surgical alignment technique utilized during surgery (MA or KA), and implant design (Attune, Medacta or Persona) utilized during surgery. These patients had the following implant and surgical techniques: 14 Attune MA, 14 Attune KA, 14 Persona MA, and 10 Medacta KA. Each participant performed five overground walking, stair ascent and stair descent trails. Surface electromyography (EMG, 2000 Hz, Delsys Inc, Natick, MA) was collected from the rectus femoris (RF) and bicep femoris (BF). Sagittal plane lower extremity joint moments were calculated using a six-degree-of-freedom model in Visual 3D (HAS-Motion, Kingston, Ontario, Canada). Peak extension joint moments, EMG mean activation and burst duration were calculated using custom software (MATLAB, MathWorks Inc., Natick, MA). A one-way repeated measures of analysis of variance was used to evaluate the effects of three types of implant designs on sagittal plane moments during stair ascent and descent. In the presence of a significant main effect of implant designs on independent variables was found, a Tukey’s post hoc analysis was conducted. Further, six independent sample t-tests or Wilcoxon-Signed Rank tests in case of non-normality were conducted to determine the effect of surgical alignment technique during each task on independent variables.
Results. The first study found patients displaying a more personalized knee joint alignment (KA) demonstrated greater three-dimensional knee joint moments to negotiate the stairs (Aim 1, hypothesis 1a). The second study found the restoration of joint line obliquity from the surgical alignment did not significantly influence frontal plane lower extremity joint moments (Aim 1, hypothesis 1b). The third study found surgical alignment techniques and not implant designs influenced knee extension joint moments to negotiate the stairs, where the KA technique resulted in greater knee joint extension moments compared to the MA technique to negotiate the stairs. Surgical alignment techniques influenced knee flexor activations, where the MA technique resulted in greater knee flexor activation patterns to descend the stairs. Implant designs influenced the knee flexor mean activation to descend the stairs where potentially greater anterior-posterior translation restriction inherent within the implant design led to reduced knee flexor average activation (Aim 2).
Conclusion. Aim 1, hypothesis 1a demonstrated that that the KA technique exhibited greater three-dimensional peak knee joint moments to negotiate the stairs. Due to the lack of difference in joint line, reduced trunk lean and preserving soft tissue structures in the KA technique, potentially the KA technique allows patients to move within the frontal plane instead of an avoidance strategy shown in the MA technique. Aim 1, hypothesis 1b indicated that JLO restoration does not affect frontal plane joint moments during stair negotiation. Thus, JLO restoration may not impact patient satisfaction post-surgery. Aim 2 revealed that while surgical alignment techniques affect sagittal plane joint moments, implant designs do not. Specifically, the KA TKA technique led to greater knee extension moments compared to the MA TKA technique. Implant designs influenced knee flexor activation where less inherent mechanical AP stability designs require greater knee flexor activation to provide knee joint stability
Representation of Nouns and Verbs During Play Between Caregivers and Children with Developmental Language Disorder
Full text linkPurpose. This project compared how children and caregivers use gestures and objects to contribute to the representation of nouns and verbs during play interactions between children with developmental language disorder (DLD) and their caregivers. Observations were used to determine if there was any differentiation in how children or caregivers used gestures and/or objects when nouns and verbs were presented within the play context.
Methods. Observations of parent-child dyads were recorded at a local children’s museum. All dyads included children with DLD between four and six years of age. The child and caregiver’s use of gestures and objects within the interaction were coded within each recording.
Results. Children’s use of various gestures (deictic or iconic) and different forms of interaction with objects impacted the word type modeled by their caregivers. Caregivers also differentiated how they paired gestures and objects when they were presenting nouns or verbs during the interactions.
Conclusion. The results of this project show that the child’s gestural and object use impacts whether they are exposed to nouns or verbs. These results also show caregivers differentiate their gestural and object use when modeling nouns and verbs. These observations indicate further investigation into the various contextual factors that influence how children with and without DLD learn verbs is warranted
Examining How Non-Antifungal Medications Impact Host-Fungal Interactions
Full text linkInvasive fungal infections (IFIs) are estimated to kill 1.5 million people each year with mortality rates remaining high (around 30-70%), despite the availability of three major classes of antifungal drugs. Furthermore, millions more suffer debilitating infections of the mucosal membranes or destructive subcutaneous mycoses. One of the most common IFIs is invasive candidiasis, mostly commonly caused by Candida albicans infections, with mortality rates of approximately 30%. In addition, the population of susceptible individuals and the incidences of both mucosal and systemic mycoses continue to rise due to the widespread use of broad-spectrum antibacterial agents, cancer chemotherapies, and the immune suppressive regimes necessary for organ transplantation, as well as the ongoing HIV and type 2 diabetes pandemics. The azoles remain the most important and widely used class of antifungal treatment for invasive C. albicans infections, acting through the inhibition of ergosterol biosynthesis. The polyenes, such as amphotericin B, damage the plasma membrane through direct interactions with ergosterol, while the echinocandins disrupt cell wall biosynthesis through inhibition of β-1,3 glucan synthase. However, despite multiple classes of antifungals available to treat invasive candidiasis, treatment failure rates are alarmingly high, being approximately 30%. Certainly, the increasing incidence of acquired drug resistance, as well as the emergence of species with intrinsic resistance to each of these agents, undoubtedly contributes to the high frequency of treatment failure for invasive candidiasis. However, as many as two-thirds of clinical treatment failures occur in the absence of microbiological drug resistance. A variety of factors, such as inadequate drug distribution to the site of infection or the severity of a patient’s immune dysfunction, have been proposed to contribute to this phenomenon—however, little evidence is available to support these arguments. One factor that has been overlooked is the influence of other medications taken by the patient on the fungal pathogen itself. This is especially pertinent due to the fundamental similarities between fungal and mammalian cells as eukaryotic organisms, fungi and mammals share similar cell biology and highly conserved signaling pathways. Accordingly, drugs designed to induce a physiological or biochemical response in humans may stimulate a similar response within fungal cells. These similarities have been previously exploited as the basis to identify existing drugs with antifungal activity or those that enhance the activity of currently approved antifungals. However, reciprocal efforts to systematically identify pharmacotherapies that diminish the efficacy of antifungal drugs have largely been unstudied. As such, it is possible that there are non-antifungal medications that have yet to be identified that can alter C. albicans physiology by increasing antifungal tolerance, which can ultimately diminish therapy efficacy. This is important to consider given that the number of individuals within the population receiving more than one medication has grown dramatically in recent years, and those at greatest risk of developing life-threatening fungal infections usually receive a multitude of drugs to treat a variety of underlying conditions. In accordance, we identified a variety of structurally and functionally diverse antagonists which antagonize azole and echinocandin activity on C. albicans growth, as well as drugs that alter sensitivity to the cell wall stressor Congo red. These include several drugs often taken by patients at risk for invasive candidiasis infections. One medication of interest, the anti-psychotic aripiprazole, was consistently identified as an antagonist for all screens tested, and was found to be Tac1p-dependent for azole tolerance, a zinc cluster transcription factor commonly found with gain-of-function mutations in azole resistant isolates. Surprisingly, while we observed that aripiprazole did not alter fluconazole efficacy in a disseminated mouse model of candidiasis, drug treated mice succumbed to infection earlier than untreated mice. This indicates that aripiprazole appears to alter disease progression, which can drastically impact antifungal therapy efficacy. However, we noted this interaction was dependent upon the host immune state, as this was not observed in immunosuppressed mice. Further testing revealed that during macrophage challenges, aripiprazole supplementation alters production of key pro-inflammatory cytokines such as TNF-α and IL-1β. These results suggest aripiprazole changes the host-pathogen interaction. Overall, the work in this study provides a proof-of-principle that non-antifungal drugs can alter C. albicans physiology as well as the host-pathogen interaction, and further research is warranted into better understanding how this may impact antifungal therapy efficacy
Targeting Multiple Aspects of Neuroinflammation for Epilepsy
Full text linkEpilepsy is considered as one of the most prevailing neurological conditions and worldwide approximately 65 million people are suffering from epilepsy. It has complex mechanistic features and is manifested by unprovoked seizures. There are over 30 antiseizure drugs (ASDs) available to treat seizures, however, about one-third of people with epilepsy continue to experience seizures that are resistant to treatment. These ASDs primarily focus on the relief of seizure symptoms but are unable to treat the underlying pathophysiological mechanisms such as neuroinflammation which causes exacerbation of seizure activity and contributes to the devastating consequences of seizures. Researchers showed a crucial connection between seizures and neuroinflammation, worsening each other and causing a critical cycle that impacts neuronal damage and neuronal activity. Reduction in neuroinflammation has been shown to decrease seizure activity and neurodegeneration which indicates neuroinflammation might offer a potential to prevent epilepsy and associated comorbidities.
This study focuses on microsomal prostaglandin E synthase-1 (mPGES-1) which is the last step enzyme responsible for synthesizing prostaglandin E2 (PGE2), a key inflammatory mediator, a molecule that plays a central role in driving the inflammatory process. Previous studies have shown that seizure can induce mPGES-1 robustly in a prompt manner. Genetic deletion of mPGES-1 in mice demonstrated neuroprotection and reduction of seizures followed by chemoconvulsant seizures. This suggests the potential of mPGES-1 as a target to treat epilepsy and pharmacological inhibition of mPGES-1 might provide beneficial effects against neuroinflammation. In this study, PBCH, an mPGES-1 inhibitor was used in a pilocarpine-induced status epilepticus (SE) mice model. The treatment abolished SE-induced PGE2 levels in the brain and showed negligible effect on cyclooxygenases (COX) which validated the specificity of the inhibitor to mPGES-1. Inhibition of mPGES-1 after SE also diminished pro-inflammatory cytokines and reduced activation of glial cells in the hippocampus. In addition, treatment with PBCH largely 10 reduced neuronal damage across several brain regions. These results highlight the potential of pharmacological inhibition of mPGES-1 as an adjunctive treatment to mitigate SE-induced brain inflammation and injury, even after hours of the onset of SE
Following, another inflammatory pathway TLR4/NF-κB was explored which involved sialic acid- binding immunoglobulin-like lectin E (Siglec-E). As an immunosuppressive molecule, Siglec-E modulates inflammatory responses through interaction with sialic acid ligands. Siglec-E shows negative regulation on the TLR4 receptor which dampens the activation of NF-κB as well it also can dampen the activation of microglia to reduce inflammation. Recent studies suggest that Siglec-E might play a role in neurotoxicity, brain inflammation, and neuronal excitability. Thus, activation of Siglec-E could modulate inflammatory responses which potentially reduce the severity and progression of seizures. To investigate, we used several conventional seizure models including pentylenetetrazol (PTZ)-induced seizures, flurothyl-induced seizures, kainic acid- induced seizures, pilocarpine-induced seizures,6 Hz-induced seizures, and maximum electroshock seizures (MES). Interestingly we found inverse results, global genetic deletion of iglec-E increased seizure latency in PTZ-induced and flurothyl-induced seizures compared to wildtype (WT) mice. Electroencephalogram (EEG) measurements further confirmed and validated that Siglec-E knockout (KO) mice exhibited lower electrographic seizures in the PTZ-induced seizure model. Additionally, in kainic acid-induced and pilocarpine-induced seizures, Siglec-E KO mice displayed lower behavioral seizure scores. Similarly, 6 Hz-induced seizures and MES models showed lower seizure severity in KO mice. These results suggest that Siglec-E has a possible role in seizure generation and reduction of seizures in KO mice, indicating its potential as a therapeutic target for epilepsy.
Targeting mPGES-1 and modulating Siglec-E provide promising prospects for developing new effective treatments. These strategies are addressing both seizure control and underlying 11 neuroinflammation which could lead to more broad and effective treatment strategies for epilepsy and potentially might reveal additional therapeutic targets
Police Versus Non-Police Response to 988 Crisis Calls
Full text linkPurpose/Background
The 988 Suicide & Crisis Lifeline is a mental health-specific emergency line that became nationally available in July of 2022. This resource allows callers in crisis to connect with trained mental health professionals. Despite the initiation of this new dispatching service, there is still a significant shortage of trained mental health professionals to respond to these calls when they require emergency intervention. The present scoping review aims to determine whether non-police crisis responses correlate to improved outcomes when compared to police response as evidenced by reduced inpatient admissions, reduced arrests, and decreased presence of intrusive traumatic symptoms following intervention.
Methods
CINAHL and PubMed were searched using the University of Tennessee Health Science Center (UTHSC) library from September 2022 until November 2023. These search terms yielded 377 articles. Of those articles, only 335 were published in English, 200 were published after 2013, 198 had full-text publications available, and 21 were either a review or systematic review rather than an article or abstract. The remaining 21 articles were assessed using a Rapid Critical Appraisal tool. Ten articles remained after critical appraisal; the results of these articles were charted within the scoping review.
Results
This scoping review compared police versus non-police response to crisis calls. The synthesized results were obtained by critically appraising ten articles. This scoping review indicates that non-police response may result in the following improved patient outcomes: a decrease in involuntary hospital admission, arrest, and violence between the crisis caller and police. However, the shortage of quality experimental evidence limits the power of this indication.
Implications for Nursing Practice
The results of this scoping review indicate that non-police response to 988 calls may result in better patient outcomes. Due to this topic\u27s recency, nurses should advocate for more quality research to provide patients with the best possible evidence-based crisis response