Svenssonzimmerman1813
and by setting out definite specifications of time points, such as time of admission.
Analyzing time stamps in hospital administrative data may provide valuable information on treatment processes while clinical staff may be released from separate documentation tasks. However, the results of this study indicate that the reliability of time stamps is affected by implausible entries and several uncertainties. The quality of time stamp documentation in German hospital administrative data might be improved by setting incentives for correct documentation and by setting out definite specifications of time points, such as time of admission.
Routinedaten von Krankenkassen sind als Datenquelle mittlerweile gut etabliert. Hinsichtlich der Verallgemeinerbarkeit der Ergebnisse bei Analysen mit Daten einer Krankenkasse treten Fragen der Repräsentativität der Versichertenpopulation auf, insbesondere da nicht alle Studien auf soziodemografische Merkmale adjustieren. Diese Arbeit untersucht mittels deskriptiver Analyse, ob und inwieweit sich die Sozialstruktur der Versichertenpopulation der AOK Niedersachsen von der Sozialstruktur der Allgemeinbevölkerung und der sozialversicherungspflichtig Beschäftigten in Niedersachsen (NDS) und in der Bundesrepublik (BRD) unterscheiden.
Die Datengrundlage bilden pseudonymisierte Daten der AOK NDS, die Beschäftigtenstatistik der Bundesagentur für Arbeit und der Bevölkerungsstand in NDS und der BRD. Die Versichertenpopulation wird an zwei Stichtagen 31.12.2012 und 31.12.2017 hinsichtlich der Geschlechter-und Altersstruktur mit der Bevölkerung in NDS und der BRD verglichen. Anschließend werden die Daten der sozialvelso difficult without taking socio-economic characteristics into account.
To improve the utilization of amplitude-integrated electroencephalography (aEEG) in a neonatal unit by improving aEEG documentation, aEEG knowledge and pattern recognition ability of neonatal staff.
A quality improvement (QI) program comprising two plan-do-study-act (PDSA) cycles was conducted in a level 3 neonatal intensive care unit. The first cycle was focused on improving aEEG documentation with the primary outcome indicator being compliance with aEEG documentation. The second cycle was focused on aEEG interpretation in a healthcare professional education program with the outcome indicators being accuracy of seizure identification on aEEG and change in conventional EEGs (EEG) performed. Other outcome indicators included accuracy in identification of background pattern, sleep-wake cycles and artefacts. Process indicators included improvement in aEEG-related knowledge.
First PDSA cycle - lectures on aEEG interpretation, a bedside key and documentation form. Second PDSA cycle - online aEEG education pack, detailed aEEG guideline.
There was a significant improvement in aEEG documentation after the implementation of both PDSA cycles. 7 of the 46 patients (15.2%) had isolated electrographic seizures which would not have been identified in the pre-aEEG monitoring era. There was an increase in the number of patients with EEGs done, but a steady decrease in number of EEGs per patient.
With the successful application of standardized QI methods, improvements in outcome indicators such as correct aEEG pattern recognition and improved coverage of at risk infants with EEGs were observed. Our QI measures were associated with improvement in aEEG pattern recognition.
With the successful application of standardized QI methods, improvements in outcome indicators such as correct aEEG pattern recognition and improved coverage of at risk infants with EEGs were observed. Our QI measures were associated with improvement in aEEG pattern recognition.
To 1) estimate the total pool of neonatal therapists and the average number represented in each US-based NICU, and 2) investigate the relationships between the number and type of neonatal therapy team members to NICU/hospital, population, and therapy factors.
This study used several methods of data collection (surveys, phone calls, website searches) that were combined to establish a comprehensive list of factors across each NICU in the US.
We estimate 2333 neonatal therapy FTEs, with 4232 neonatal therapists covering those FTEs in the US. Among 564 NICUs, 432 (76%) had a dedicated therapy team, 103 (18%) had PRN therapy coverage only, and 35 (6%) had no neonatal therapy team. Having a dedicated therapy team was more likely in level IV (n=112; 97%) and III (n=269; 83%) NICUs compared to level II NICUs (n=51; 42%) (p<0.001). Having a dedicated therapy team was related to having more NICU beds (p<0.001), being part of a free-standing children's hospital or children's hospital within a hospital (p<0.001), and being part of an academic medical center or community hospital (p<0.001). Having a dedicated therapy team was more common in the Southeast, Midwest, Southwest, and West (p=0.001), but was not related to the proportion of the community living in poverty or belonging to racial/ethnic minorities (p>0.05). Linsitinib in vivo There was an average of 17 beds per neonatal therapy FTE, a good marker of therapy coverage based on NICU size. Three-hundred US-based NICUs (22%) had at least one Certified Neonatal Therapist (CNT) in early 2020, with CNT presence being more likely in higher acuity NICUs (59% of Level IV NICUs had at least one CNT).
Understanding the composition of neonatal therapy teams at different hospitals across the US can drive change to expand neonatal therapy aimed at optimizing outcomes of high-risk families.
Understanding the composition of neonatal therapy teams at different hospitals across the US can drive change to expand neonatal therapy aimed at optimizing outcomes of high-risk families.Plants have a long history of use for their medicinal properties. The complexity of botanical extracts presents unique challenges and necessitates the application of innovative approaches to correctly identify and quantify bioactive compounds. For this study, we used untargeted metabolomics to explore the antimicrobial activity of Rumex crispus (yellow dock), a member of the Polygonaceae family used as an herbal remedy for bacterial infections. Ultra-performance liquid chromatography coupled with high resolution mass-spectrometry (UPLC-MS) was used to identify and quantify the known antimicrobial compound emodin. In addition, we used biochemometric approaches to integrate data measuring antimicrobial activity from R. crispus root starting material and fractions against methicillin-resistant Staphylococcus aureus (MRSA) with UPLC-MS data. Our results support the hypothesis that multiple constituents, including the anthraquinone emodin, contribute to the antimicrobial activity of R. crispus against MRSA.
This study aimed to validate the use of Ca-apt-1, an RNA aptamer, that we generated previously as a probe for immunostaining of
in rat tongue paraffin-fixed tissue sections MATERIAL AND METHODS The performance of Ca-apt-1 as a detector molecule was compared with that of anti-
polyclonal antibody (PcAb), which was used as a positive control. Immunostaining images were visualized by light microscopy and were analyzed by using ImageJ software.
Microscopic results demonstrated that Ca-apt-1 specifically recognized and immunostained
cells of rat tongue candidiasis, with a specificity comparable to that of PcAb. ImageJ analysis showed that the area (pixels) detected by Ca-apt-1 was wider than that detected by the antibody. This indicates that the binding affinity of Ca-apt-1 toward
was better than that of PcAb on paraffin-embedded tissues.
This study demonstrates that Ca-apt-1 can be used as a probe for immunostaining of fixed tissue sections for oral candidiasis diagnosis.
This study demonstrates that Ca-apt-1 can be used as a probe for immunostaining of fixed tissue sections for oral candidiasis diagnosis.Despite the huge efforts globally underway for preventing or limiting the spread of severe acute respiratory coronavirus disease 2 (SARS-CoV-2), the coronavirus disease 2019 (COVID-19) pandemic outbreak appears still virtually unstoppable. As for many other infectious diseases, COVID-19 vaccination has now become crucial for limiting viral spread, especially for averting hospitalizations, need for intensive care, and fatal outcome. Nonetheless, as for other vaccines, COVID-19 vaccination is not completely free from side effects. Among the adverse events that have been reported after receiving COVID-19 vaccination, special emphasis has been given to an unexpected number of thrombocytopenic episodes with or without thrombotic complications, especially in recipients of adenovirus-based COVID-19 vaccines. Along with a specific clinical presentation, encompassing "atypical" thrombosis (especially cerebral venous [sinus] thrombosis, CVT) more prevalent in young female subjects, this new syndrome called vaccine-induced thrombocytopenia and thrombosis (VITT) is characterized by, and thereby diagnosed for, the presence of three paradigmatic laboratory abnormalities, i.e., low platelet count (0.5 mg/L), accompanied by a positive test for anti-PF4 (platelet factor 4) antibodies assayed with ELISA (enzyme-linked immunosorbent assay) techniques. Timely identification of these important abnormalities by both clinicians and laboratory professional is essential for early diagnosis and management of VITT, since the outcome of this condition may be fatal in half or even more of effected patients with severe disease. Therefore, this narrative review aims to review here the epidemiology, pathogenesis, clinical, and laboratory characteristics of VITT and other COVID-19 vaccine-associated thrombocytopenias.The cardinal pathology of coronavirus disease 2019 (COVID-19) is a primary infection of pulmonary tract cells by severe acute respiratory syndrome coronavirus 2, provoking a local inflammatory response, often accompanied by cytokine storm and acute respiratory distress syndrome, especially in patients with severe disease. Systemic propagation of the disease may associate with thrombotic events, including deep vein thrombosis, pulmonary embolism, and thrombotic microangiopathy, which are important causes of morbidity and mortality in patients with COVID-19. This narrative review describes current knowledge of the pathophysiological mechanisms of COVID-19-associated coagulopathy, with focus on prothrombotic changes in hemostatic mediators, including plasma levels of clotting factors, natural anticoagulants, components of fibrinolytic system, and platelets. It will also highlight the central role of endothelial cells in COVID-19-associated coagulopathy. This narrative review discusses also potential therapeutic strategies for managing thrombotic complications. Awareness by medical experts of contributors to the pathogenesis of thrombotic events in COVID-19 is imperative to develop therapeutics not limited to regular anticoagulants. Instituting cooperation among medical personnel and researchers may lessen this novel virus' impact now, and in the event of recurrence.Hypercoagulability and vascular injury, which characterize morbidity in COVID-19 disease, are frequently observed in the skin. Several pathomechanisms, such as inflammation caused by angiotensin-converting enzyme 2-mediated uptake into endothelial cells or SARS-CoV-2-initiated host immune responses, contribute to microthrombus formation and the appearance of vascular skin lesions. Besides pathophysiologic mechanisms observed in the skin, this review describes the clinical appearance of cutaneous vascular lesions and their association with COVID-19 disease, including acro-ischemia, reticular lesions, and cutaneous small vessel vasculitis. Clinicians need to be aware that skin manifestations may be the only symptom in SARS-CoV-2 infection, and that inflammatory and thrombotic SARS-CoV-2-driven processes observed in multiple organs and tissues appear identically in the skin as well.
