155155 research outputs found
Sort by
Feasibility of quality indicators on prehospital advanced airway management in a physician-staffed emergency medical service: survey-based assessment of the provider point of view.
Get PDFOBJECTIVE
We aimed to determine the feasibility of quality indicators (QIs) for prehospital advanced airway management (PAAM) from a provider point of view.
DESIGN
The study is a survey based feasibility assessment following field testing of QIs for PAAM.
SETTING
The study was performed in two physician staffed emergency medical services in Switzerland.
PARTICIPANTS
42 of the 44 emergency physicians who completed at least one case report form (CRF) dedicated to the collection of the QIs on PAAM between 1 January 2019 and 31 December 2021 participated in the study.
INTERVENTION
The data required to calculate the 17 QIs was systematically collected through a dedicated electronic CRF.
PRIMARY AND SECONDARY OUTCOME MEASURES
Primary outcomes were provider-related feasibility criteria: relevance and acceptance of the QIs, as well as reliability of the data collection. Secondary outcomes were effort to collect specific data and to complete the CRF.
RESULTS
Over the study period, 470 CRFs were completed, with a median of 11 per physician (IQR 4-17; range 1-48). The median time to complete the CRF was 7 min (IQR 3-16) and was considered reasonable by 95% of the physicians. Overall, 75% of the physicians assessed the set of QIs to be relevant, and 74% accepted that the set of QIs assessed the quality of PAAM. The reliability of data collection was rated as good or excellent for each of the 17 QIs, with the lowest rated for the following 3 QIs: duration of preoxygenation, duration of laryngoscopy and occurrence of desaturation during laryngoscopy.
CONCLUSIONS
Collection of QIs on PAAM appears feasible. Electronic medical records and technological solutions facilitating automatic collection of vital parameters and timing during the procedure could improve the reliability of data collection for some QIs. Studies in other services are needed to determine the external validity of our results
Identification of a Binding Site for Small Molecule Inhibitors Targeting Human TRPM4
Get PDFTransient receptor potential (TRP) melastatin 4 (TRPM4) protein is a calcium-activated monovalent cation channel associated with various genetic and cardiovascular disorders. The anthranilic acid derivative NBA is a potent and specific TRPM4 inhibitor, but its binding site in TRPM4 has been unknown, although his information is crucial for drug development targeting TRPM4. We determined the cryo-EM structures of full-length human TRPM4 embedded in native lipid nanodiscs in an unbound, a state bound to NBA, and a new anthranilic acid derivative known as IBA-bound state. We found that the small molecules NBA and IBA were bound in a pocket formed between the S3, S4, and TRP helices and the S4-S5 linker of TRPM4. Our structural data and results from patch clamp experiments enable validation of a binding site for small molecule inhibitors, paving the way for further drug development targeting TRPM4
Long-term Ocular Outcomes in Congenital Toxoplasmosis Treated Perinatally.
No full textBACKGROUND
Congenital toxoplasmosis (CT) can be accompanied by serious organ manifestations, particularly retinochoroiditis, and may occur throughout life. We aimed to monitor long-term ocular prognosis in a large French cohort of patients with CT and its changes over time in the context of mandatory prenatal screening (since 1992) and incidence decrease since 2008.
METHODS
Patients with CT diagnosed between 1987 and 2021 were prospectively included and followed for up to 35 years. The effect of the period of conception on the risk of first retinochoroiditis has been tested using a flexible extension of the Cox model. Incidence rates of retinochoroiditis were estimated.
RESULTS
A total of 646 infected live born children were followed for a median of 12 years (range, 0.5-35); 187 patients (29%) had at least 1 ocular lesion (first at a median age of 5 years; range, 0-26 years) with peaks at 7 and 12 years. Early maternal infection and the presence of nonocular signs at birth were associated with a higher risk of retinochoroiditis, whereas delayed diagnosis of CT (after birth versus before or at birth) was associated with a lower risk (13% decrease for each additional month after birth; P = .01). A period effect for the risk of developing retinochoroiditis in patients born after 2008 was not detected.
CONCLUSIONS
Despite prenatal screening and prolonged perinatal treatment, retinochoroiditis is not a rare event in French patients with CT and can occur well into adulthood, with peak incidences at 7 and 12 years of age. It rarely causes severe damage but warrants regular follow-up into adulthood
Leveraging Halogen Interactions for a Supramolecular Nanotube.
No full textWe demonstrate the formation of supramolecular nanotubes from molecular triangles in a single crystal by balancing the hydrogen bonds and halogen interactions between individual macrocycles. Thereby, we template the supramolecular nanotube growth by intermolecular interactions encoded directly in the macrocycles instead of those provided by the crystallization solvent. Ultimately, we show that replacing bromines for iodines in the macrocycle is necessary to achieve this supramolecular organization by enhancing the strength of the halogen interactions and concomitant reduction of the detrimental hydrogen bonds. We investigated the nature and the interplay of the individual intermolecular interactions by analysis of the experimental single crystal data and quantum chemical calculations. This work enriches the available toolbox of interactions to construct supramolecular nanotubes, and will aid and abet the development of rationally-designed materials with a long-range 1D organization
Occlusal characteristics in modern humans with tooth agenesis.
Get PDFNon-syndromic permanent tooth agenesis affects a significant proportion of the population, especially if third molars are considered. Although tooth agenesis has been linked to a smaller craniofacial size, reduced facial convexity and a shorter skeletal face, the occlusal characteristics of individuals with tooth agenesis remain largely unexplored. Therefore, this study investigated potential associations between tooth agenesis and metric occlusal traits in 806 individuals (491 with 4.1 missing teeth per subject, including third molars, and 315 without any tooth agenesis). Dentoskeletal morphology was defined through anatomical landmarks on pre-treatment cephalometric radiographs. Multivariate regression models, adjusted for sex and age, showed that tooth agenesis was significantly associated with a reduced overjet, an increased interincisal angle, and shorter upper and lower dental arch lengths, but not with overbite. Moreover, apart from reduced tooth length and dentoalveolar effects, as the number of missing teeth increased the upper front teeth were progressively retruded according to the craniofacial complex and to the face. Thus, tooth agenesis has a substantial influence on dental and occlusal characteristics, as well as on the sagittal position and inclination of anterior teeth. These findings emphasize the necessity for personalized, multidisciplinary approaches in individuals with multiple agenesis to successfully meet treatment goals
Seismic stratigraphy and sediment cores reveal lake-level fluctuations in Lake Iznik (NW Turkey) over the past ~70 ka
Get PDFOur study aims to understand the palaeohydrological history of Lake Iznik and unravel the complex interplay between climatic, tectonic, and environmental factors that have shaped this Turkish basin. Through the analysis of seismic stratigraphy and sediment cores, we reveal a significant lowstand, indicating a lake level 60 m lower than today at ~70 ka BP. Subsequently, a major phase of stepwise transgression is evidenced by 13 buried palaeoshorelines between ~70–45 ka BP. From 45 to ~10 ka cal BP, strong currents controlled the sedimentation in the lake, as evidenced by the occurrence of contourite drifts. Between ~14–10 ka cal. BP, a major lowstand indicating a drier climate interrupted the current-controlled sedimentation regime. From ~10 ka cal. BP, the subsequent increase in lake level occurred at the same time as the reconnection between the Mediterranean and Black Seas. Archaeological evidence, including submerged structures of a basilica, establishes a link between lake-level changes and human settlement during the last millennium. The level of Lake Iznik has since continued to fluctuate due to climate change, tectonic events, and human activity
Data sources:
BORIS Portal Bern Open Repository and I...BAF-Online: Proceedings of the Berner Al...HASBonline – Hefte zur Archäologie des M...Informationswissenschaft: Theorie, Metho...Jahrbuch Diakonie SchweizJournal of Eye Movement ResearchJournal of Radiation Oncology Informatic...BOP SerialsVersants. Revista suiza de literaturas r...BORIS ThesesAccess Repository Dashboard
Do you manage Bern Open Repository and Information System (BORIS)? Access insider analytics, issue reports and manage access to outputs from your repository in the CORE Repository Dashboard!