Michaelsenpatrick4300

Working in the pediatric intensive care unit (PICU) exposes nurses to intense and recurrent experiences with loss. Such experiences may result in unresolved grief or despair among these providers. Although previous studies have explored grief within the nursing profession, few have focused on grief following the death of children in the PICU, where sudden or traumatic deaths are more frequent. The aim of this study was to characterize the degree to which pediatric critical care (PCC) nurses experience symptoms of grief or distress following the suffering and/or death of a patient in the PICU.

An email invited PICU nurses at a large free standing children's hospital to complete an online survey with demographic questions and an open-ended, qualitative question about grief experiences. Research team members coded open-ended responses, using thematic content analysis. Final themes were further validated via member checking.

Of the 104 participants, most were Caucasian (96.3%), female (97%), bedside (83.5%)e grief and bereavement support programs for healthcare providers.

Existing literature has shown the importance of palliative home care to improve quality of life among end-stage patients. However, access to palliative home care remains an issue. This study explores factors associated with successful delivery of palliative home care in palliative patients.

A retrospective study was conducted among patients who were referred to the palliative care team for consultation at Lampang Hospital from April 2020 to March 2021. Data from electronic medical records, including successful delivery of palliative home care, age, gender, public health insurance, admission department, primary disease (cancer, non-cancer), presenting symptoms (pain, dyspnea), palliative performance scale score and morphine use, were retrieved. Multiple logistic regression analysis was applied to explore the association, adjusting for covariates.

A total of 370 patients were identified, with 88 (23.8%) receiving palliative home care. Results showed that being female, having low palliative performance scale score, morphine use, and having Civil Servant Medical Benefit Scheme insurance are associated with a higher chance of having access to palliative home care, compared with their counterparts.

Results of this study pointed out health disparities among palliative patients who required palliative home care. This information can be in part used to redesign palliative home care system with the aim of improving access to care and patients' and caregivers' quality of life as a consequence.

Results of this study pointed out health disparities among palliative patients who required palliative home care. This information can be in part used to redesign palliative home care system with the aim of improving access to care and patients' and caregivers' quality of life as a consequence.

Though the use of neoadjuvant therapy (NAT) is increasing in the setting of borderline resectable (BRPC) and locally advance pancreatic cancer (LAPC), the role of NAT in resectable pancreatic cancer (RPC) remains uncertain.

This is a narrative review, summarising the contemporary evidence and emerging studies comparing neoadjuvant therapy to upfront resection and adjuvant therapy in RPC.

Upfront resection followed by adjuvant chemotherapy is currently the standard of care for RPC. Though BRPC and LAPC have reported significant overall survival benefits with NAT, those results have yet to be translated to RPC. Downstaging is only reported in a small proportion of patients who receive NAT; most have stable disease and a small number have progression. Preliminary trial data have largely been consistent with that observed in the past whereby a modest improvement in R0 resection rates and pathological findings is observed with NAT, however rates of distant recurrence and overall survival remain similar to upfront resection. A significant proportion further fail to achieve resection due to the side effects, deconditioning and delays to surgery. Most international recommendations have been guided by non-randomised data sets and long-term data from emerging phase III trials are yet to be published.

Although we have observed improved R0 resection rates with NAT, this has yet to translate to a robust improvement in overall survival. Concerns regarding delays to resection, and limited response to NAT remain a topic of ongoing investigation.

Although we have observed improved R0 resection rates with NAT, this has yet to translate to a robust improvement in overall survival. Concerns regarding delays to resection, and limited response to NAT remain a topic of ongoing investigation.With the price-competitiveness of solar and wind power, hydrogen technologies may be game changers for a cleaner, defossilized, and sustainable energy future. H2 can indeed be produced in electrolyzers from water, stored for long periods, and converted back into power, on demand, in fuel cells. The feasibility of the latter process critically depends on the discovery of cheap and efficient catalysts able to replace platinum group metals at the anode and cathode of fuel cells. Bioinspiration can be key for designing such alternative catalysts. Here we show that a novel class of iron-based catalysts inspired from the active site of [FeFe]-hydrogenase behave as unprecedented bidirectional electrocatalysts for interconverting H2 and protons efficiently under near-neutral aqueous conditions. Such bioinspired catalysts have been implemented at the anode of a functional membrane-less H2/O2 fuel cell device.Ginseng is a very famous Chinese herbal medicine with various pharmacological effects. Ginsenosides, the main effective compounds of ginseng, show favorable biological activities in the central nervous system (CNS), but the protein targets of ginsenosides in brain tissues have not been clarified clearly. First, we screened proteins that interact with ginsenosides by mass spectrometry-based drug affinity responsive target stability (DARTS) and cellular thermal shift assay (CETSA). Then, we identified and confirmed adenylate kinase 5 (AK5) as a target protein of ginsenosides by biolayer interferometry (BLI), isothermal titration calorimetry (ITC), and molecular docking. Finally, an enzyme activity kit was used to determine the effect of 20(S)-protopanaxadiol (PPD), a ginseng saponin metabolite, on AK5 activities in vivo and in vitro. We screened out seven overlapping target proteins by proteomics of DARTS and CETSA. DSS Crosslinker The BLI direct action assays showed that the direct interaction of PPD with AK5 was higher compared to the parental ginsenosides. Subsequently, BLI kinetic analysis and ITC assay showed that PPD specifically bound to AK5. Furthermore, key amino acid mutations predicted by molecular docking decreased the affinity between PPD and AK5. Enzyme activity assays showed that PPD increased AK5 activities in vivo and in vitro. The above-mentioned findings indicated that AK5 is a protein target of ginsenoside in the brain and PPD is considered to be a small-molecular activator of AK5, which can improve comprehension of the molecular mechanisms of ginseng pharmacological effects in the CNS and further develop AK5 activators based on the dammarane-type triterpenoid structure.Sac7d belongs to the hyperthermophilc chromosomal protein family, and it is very stable with regard to heat and acidic environments. Unlike many other DNA-protein complexes, the present one is a nonspecific complexation where two amino acids (AA), VAL26 and MET29, are found to intercalate into the same base pair of DNA. Here, we have carried out multiple short molecular dynamic simulations to calculate the distribution of nonspecific protein-DNA aggregates to find the most probable state, which was subsequently used to construct the free energy landscape of protein intercalation into DNA. Analysis of trajectories along the minimum free energy path revealed mechanistic details such as rotation of the protein, simultaneous intercalation of two amino acids, and bending/kinking of the DNA. Moreover, the results indicate a strong interdependency between the intercalating amino acids such that the deintercalation of one AA leads to a spontaneous deintercalation of the other.Electrochromic devices (ECDs) are in high demand for many applications; however, there is no ideal method to achieve the full recycling of the substrate and the functional layer in ECDs. Currently, it is still challenging to access ECDs with excellent electrochromic property, good degradability, and facile recycling capability. In this study, high-performance ECDs are successfully fabricated by using poly(3,4-ethylene dioxythiophene)poly(styrenesulfonate) as the functional layer and transparent gelatin film (TGF) derived from pigskin as the substrate. Compared with PET films or PET-based ECDs, the optical transmittance of TGF and the coloration efficiency of our ECDs could be increased by 3.2 and 41.4%, respectively, showing a great potential to replace conventional plastic-based ECDs. Furthermore, the TGF not only showed good biodegradability but also could be regenerated via a simple process without the loss of desirable properties. In addition, the functional layer and substrate can be easily separated in water due to the adjusted interactions of the interface and the unique property of gelatin, which may open a new path for fabricating green electronics.In view of the fact that the blood-brain barrier (BBB) prevents the transport of imaging probes and therapeutic agents to the brain and thus hinders the diagnosis and treatment of brain-related disorders, methods of circumventing this problem (e.g., ultrasound-mediated nanoparticle delivery) have drawn much attention. Among the related techniques, focused ultrasound (FUS) is a favorite means of enhancing drug delivery via transient BBB opening. Photoacoustic brain imaging relies on the conversion of light into heat and the detection of ultrasound signals from contrast agents, offering the benefits of high resolution and large penetration depth. The extensive versatility and adjustable physicochemical properties of nanoparticles make them promising therapeutic agents and imaging probes, allowing for successful brain imaging and treatment through the combined action of ultrasound and nanoparticulate agents. FUS-induced BBB opening enables nanoparticle-based drug delivery systems to efficiently access the brain. Moreover, photoacoustic brain imaging using nanoparticle-based contrast agents effectively visualizes brain morphologies or diseases. Herein, we review the progress in the simultaneous use of nanoparticles and ultrasound in brain research, revealing the potential of ultrasound-mediated nanoparticle delivery for the effective diagnosis and treatment of brain disorders.Drugs are often metabolized to reactive intermediates that form protein adducts. Adducts can inhibit protein activity, elicit immune responses, and cause life-threatening adverse drug reactions. The masses of reactive metabolites are frequently unknown, rendering traditional mass spectrometry-based proteomics approaches incapable of adduct identification. Here, we present Magnum, an open-mass search algorithm optimized for adduct identification, and Limelight, a web-based data processing package for analysis and visualization of data from all existing algorithms. Limelight incorporates tools for sample comparisons and xenobiotic-adduct discovery. We validate our tools with three drug/protein combinations and apply our label-free workflow to identify novel xenobiotic-protein adducts in CYP3A4. Our new methods and software enable accurate identification of xenobiotic-protein adducts with no prior knowledge of adduct masses or protein targets. Magnum outperforms existing label-free tools in xenobiotic-protein adduct discovery, while Limelight fulfills a major need in the rapidly developing field of open-mass searching, which until now lacked comprehensive data visualization tools.