Nmnat2 attenuates amyloidogenesis as well as upregulates ADAM10 in AMPK activitydependent manner

Background Access to specialty palliative care delivery in the intensive care unit is inconsistent across institutions. The intensive care unit at the study institution uses a screening tool to identify patients likely to benefit from specialty palliative care, yet little is known about outcomes associated with the use of screening tools. Objective To identify outcomes associated with specialty palliative care referral among patients with critical illness. Methods Records of 112 patients with positive results on palliative care screening were retrospectively reviewed to compare outcomes between patients who received a specialty palliative care consult and those who did not. Primary outcome measures were length of stay, discharge disposition, and escalation of care. Results Sixty-five patients (58%) did not receive a palliative care consult. No significant differences were found in length of hospital or intensive care unit stay. Most patients who experienced mechanical ventilation did not receive a palliative care consultation (χ2 = 5.14, P = .02). Patients who were discharged to home were also less likely to receive a consult (χ2 = 4.1, P = .04), whereas patients who were discharged to hospice were more likely to receive a consult (χ2 = 19.39, P less then .001). Conclusions Unmet needs exist for specialty palliative care. Understanding the methods of identifying patients for specialty palliative care and providing them with such care is critically important. Future research is needed to elucidate the factors providers use in their decisions to order or defer specialty palliative care consultation.Standardized nursing practice based on the foundations of evidence-based practice leads to high-quality patient care and optimal outcomes. Despite knowing the benefits of evidence-based practice, health care organizations do not consistently make it the standard of care; thus, implementation of evidence-based practice at the system level continues to be challenging. This article describes the process adopted by a facility in the Southwest that took on the challenge of changing the organizational culture to incorporate evidence-based practice. The organization met the challenges by identifying perceived and actual barriers to successful implementation of evidence-based practice. The lack of standardized practice was addressed by developing a group of stakeholders including organizational leaders, clinical experts, and bedside providers. Changing the culture required a comprehensive process of document selection and development, education, and outcome evaluation. The ultimate aim was to implement an integrated system to develop practices and documents based on the best evidence to support patient outcomes.Background Patient-controlled analgesia is commonly used for adult patients requiring parenteral opioid analgesia in the postoperative setting. However, many patients are unable to use patient-controlled analgesia because of physical or cognitive limitations. Authorized agent-controlled analgesia, in which a nurse or family member activates the patient-controlled analgesia device, has been studied in the pediatric population but has received little attention in adults. Objective To evaluate the efficacy of authorized agent-controlled analgesia in critically ill adult patients. Methods A retrospective pilot study was conducted involving 46 patients who were placed on an authorized agent-controlled analgesia protocol in a mixed medical/surgical adult intensive care unit. Critical-Care Pain Observation Tool scores were abstracted for the 24 hours before and after initiation of authorized agent-controlled analgesia. Authorized agent-controlled analgesia was administered by nurses only. Results The mean (SD) change in pain score was -3.4 (2.0) (95% CI, -4.0 to -2.7), representing a 69% decrease in the mean (SD) pain score from before to after initiation of authorized agent-controlled analgesia (4.8 [1.8] vs 1.5 [1.6]; P less then .001). When the results were controlled for time, sedative administration, and opioid medication administration, the effect of authorized agent-controlled analgesia initiation on pain scores remained significant (P less then .001). Conclusions Use of authorized agent-controlled analgesia is associated with a reduction in pain in critically ill patients. Larger studies are warranted to confirm these findings.Topic Candidates waiting for lung transplant are sicker now than ever before. Extracorporeal membrane oxygenation has become useful as a bridge to lung transplant for these critically ill patients. Clinical relevance Critical care nurses must be prepared to care for the increasing number of lung transplant patients who require this advanced support method. Purpose of paper To provide critical care nurses with the foundational knowledge essential for delivering quality care to this high-acuity transplant patient population. Content covered This review describes the types of extracorporeal membrane oxygenation (venovenous and venoarterial), provides an overview of the indications and contraindications for extracorporeal membrane oxygenation, and discusses the role of clinical bedside nurses in the treatment of patients requiring extracorporeal membrane oxygenation as a bridge to lung transplant.Out-of-home care in childhood and adolescence has been shown to be associated with elevated risk for all-cause mortality in adulthood, with adverse socioeconomic, psychosocial, and health-related trajectories hypothesized to mediate this relationship. In the research letter by Batty and Hamer (Am J Epidemiol. XXXX;XXX(XX)XXXX-XXXX), the authors used data from the 1970 British birth cohort (n=8,581) to examine risk of biomarkers for mortality in adults with a history of out-of-home care. While markers of inflammation, glucose metabolism, and lipids were less favourable in the exposed vs. unexposed, differences between groups were small and were completely attenuated after adjustment. This study raises important issues regarding the design and conceptualization of future studies on the long-term outcomes of out-of-home care recipients. Such studies require more detailed information on duration of care, type of care setting, and reasons for care, all of which could affect outcome risk. Since duration of follow-up is long, and attrition likely, authors should consider use of novel analytic techniques to account for selection bias, such as inverse probability weighting. Finally, a "chain-of-risk" approach to understanding outcomes may be warranted, since risk is likely explained by accumulation of and prolonged exposure to adverse socioeconomic, psychosocial, and health risks.As spatial languages, sign languages rely on spatial cognitive processes that are not involved for spoken languages. Interlocutors have different visual perspectives of the signer's hands requiring a mental transformation for successful communication about spatial scenes. It is unknown whether visual-spatial perspective-taking (VSPT) or mental rotation (MR) abilities support signers' comprehension of perspective-dependent American Sign Language (ASL) structures. A total of 33 deaf ASL adult signers completed tasks examining nonlinguistic VSPT ability, MR ability, general ASL proficiency (ASL-Sentence Reproduction Task [ASL-SRT]), and an ASL comprehension test involving perspective-dependent classifier constructions (the ASL Spatial Perspective Comprehension Test [ASPCT] test). Scores on the linguistic (ASPCT) and VSPT tasks positively correlated with each other and both correlated with MR ability; however, VSPT abilities predicted linguistic perspective-taking better than did MR ability. ASL-SRT scores correlated with ASPCT accuracy (as both require ASL proficiency) but not with VSPT scores. Therefore, the ability to comprehend perspective-dependent ASL classifier constructions relates to ASL proficiency and to nonlinguistic VSPT and MR abilities.Background Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are found widespread in drinking water, foods, food packaging materials and other consumer products. Several PFAS have been identified as endocrine-disrupting chemicals based on their ability to interfere with normal reproductive function and hormonal signalling. Experimental models and epidemiologic studies suggest that PFAS exposures target the ovary and represent major risks for women's health. selleck Objective and rationale This review summarises human population and toxicological studies on the association between PFAS exposure and ovarian function. Search methods A comprehensive review was performed by searching PubMed. Search terms included an extensive list of PFAS and health terms ranging from general keywords (e.g. ovarian, reproductive, follicle, oocyte) to specific keywords (including menarche, menstrual cycle, menopause, primary ovarian insufficiency/premature ovarian failure, steroid hormones), based on the authors' knowledge of the topic d to ensure the temporality of PFAS exposure and health endpoints and to minimise the possibility of reverse causality.The splicing of tRNA introns is a critical step in pre-tRNA maturation. In archaea and eukaryotes, tRNA intron removal is catalyzed by the tRNA splicing endonuclease (TSEN) complex. Eukaryotic TSEN is comprised of four core subunits (TSEN54, TSEN2, TSEN34 and TSEN15). The human TSEN complex additionally co-purifies with the polynucleotide kinase CLP1; however, CLP1's role in tRNA splicing remains unclear. Mutations in genes encoding all four TSEN subunits, as well as CLP1, are known to cause neurodegenerative disorders, yet the mechanisms underlying the pathogenesis of these disorders are unknown. Here, we developed a recombinant system that produces active TSEN complex. Co-expression of all four TSEN subunits is required for efficient formation and function of the complex. We show that human CLP1 associates with the active TSEN complex, but is not required for tRNA intron cleavage in vitro. Moreover, RNAi knockdown of the Drosophila CLP1 orthologue, cbc, promotes biogenesis of mature tRNAs and circularized tRNA introns (tricRNAs) in vivo. Collectively, these and other findings suggest that CLP1/cbc plays a regulatory role in tRNA splicing by serving as a negative modulator of the direct tRNA ligation pathway in animal cells.Anastomotic leakage is one of the most severe complications after esophagectomy and is associated with increased postoperative morbidity and mortality. Several projects ranging from small retrospective studies to large collaborations have aimed to identify potential pre- and perioperative risk factors and to improve the diagnostic processes and management. Despite the increase in available literature, many aspects of anastomotic leakage are still debated, without the existence of widely accepted guidelines. The purpose of this review is to provide a cutting edge overview of the recent literature regarding the definition and classification of anastomotic leakage, risk factors, novel diagnostic modalities, and emerging therapeutic options for treatment and prevention of anastomotic leakage following esophagectomy.This article comments on Jana Lunerová, Veit Herklotz, Melanie Laudien, Radka Vozárová, Marco Groth, Aleš Kovařík and Christiane M. Ritz, Asymmetrical canina meiosis is accompanied by the expansion of a pericentromeric satellite in non-recombining univalent chromosomes in the genus Rosa, Annals of Botany, Volume 125, Issue 7, 4 June 2020, Pages 1025–1038, https//doi.org/10.1093/aob/mcaa028