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CPG
Terms modified by CPG Selected AbstractsThe role of inhibitory neurotransmission in locomotor circuits of the developing mammalian spinal cordACTA PHYSIOLOGICA, Issue 2 2009H. Nishimaru Abstract Neuronal circuits generating the basic coordinated limb movements during walking of terrestrial mammals are localized in the spinal cord. In these neuronal circuits, called central pattern generators (CPGs), inhibitory synaptic transmission plays a crucial part. Inhibitory synaptic transmission mediated by glycine and GABA is thought to be essential in coordinated activation of muscles during locomotion, in particular, controlling temporal and spatial activation patterns of muscles of each joint of each limb on the left and right side of the body. Inhibition is involved in other aspects of locomotion such as control of speed and stability of the rhythm. However, the precise roles of neurotransmitters and their receptors mediating inhibitory synaptic transmission in mammalian spinal CPGs remain unclear. Moreover, many of the inhibitory interneurones essential for output pattern of the CPG are yet to be identified. In this review, recent advances on these issues, mainly from studies in the developing rodent spinal cord utilizing electrophysiology, molecular and genetic approaches are discussed. [source] Paediatric emergency guidelines: Could one size fit all?EMERGENCY MEDICINE AUSTRALASIA, Issue 1 2009Sarah Dalton Abstract Objectives: The development of clinical practice guidelines (CPG) is a core task in EDs and CPGs are widely used. The process of CPGs development in Australian and New Zealand ED is unknown. We aim to describe this process in paediatric EDs and examine the feasibility of developing collaborative guidelines. Methods: A piloted questionnaire regarding CPG development, dissemination, implementation and evaluation was circulated to all 13 Paediatric Research in Emergency Departments International Collaborative (PREDICT) sites. Specific questions regarding feasibility of combined guidelines were included. Results: All PREDICT EDs participated in the survey. All used CPGs in EDs and 12/13 had ED-specific guidelines. EDs had an average of 77 guidelines with approximately 5 new guidelines generated annually. Staff at most sites (10/13) also accessed guidelines from external sources. Most hospitals (10/13) had a guideline committee, generally comprising of senior ED and general paediatric staff. Guidelines were usually written by committee members and 10/13 hospitals adopted modified external guidelines. An average committee met six times a year for 90 min and involved seven clinicians. Most sites did not have a project manager or dedicated secretarial support. Few hospitals included literature references (3/13) or levels of evidence (1/13) in their guidelines. Most did not consider implementation, evaluation or teaching packages. Most sites (10/13) supported the development of collaborative guidelines. Conclusions: Paediatric EDs expend significant resources to develop CPGs. Collaborative guidelines would likely decrease duplication of effort and increase the number of available, current and evidence-based CPGs. [source] Procedural sedation in children in the emergency department: A PREDICT studyEMERGENCY MEDICINE AUSTRALASIA, Issue 1 2009Meredith Borland Abstract Objective: To investigate current procedural sedation practice and compare clinical practice guidelines (CPG) for procedural sedation at Paediatric Research in Emergency Departments International Collaborative (PREDICT) sites. This will determine areas for improvement and provide baseline data for future multicentre studies. Methods: A questionnaire of specialist emergency physicians regarding demographics, general procedural sedation practice and specific sedation agents given to children. CPG for general sedation and sedation agents were obtained for each site. Results: Seventy-five (71%) useable surveys returned from 105 potential respondents. Most commonly used agents were nitrous oxide (N2O) (75, 100%), ketamine (total 72, 96%; i.v. 59, 83% and i.m. 22, 31%) and midazolam (total 68, 91%; i.v. 52, 81%, oral 47, 73%, intranasal 26, 41% and i.m. 6, 9%). Sedation was used for therapeutic and diagnostic procedures. Forty-three (57%) used formal sedation records and sedation checklists and thirty-one (41%) respondents reported auditing sedations. Four sites ran staff education and competency programmes. Nine sites had general sedation CPG, eight for ketamine, nine for N2O, eight for midazolam (four parenteral, five oral and six intranasal) and three for fentanyl. No site had a guideline for propofol administration. Conclusion: Procedural sedation in this research network commonly uses N2O, ketamine and midazolam for a wide range of procedures. Areas of improvement are the lack of guidelines for certain agents, documentation, staff competency training and auditing processes. Multicentre research could close gaps in terms of age cut-offs, fasting times and optimal indications for various agents. [source] Application of Exchangeable Biochemical Reactors with Oxidase-Catalase-Co-immobilizates and Immobilized Microorganisms in a Microfluidic Chip-CalorimeterENGINEERING IN LIFE SCIENCES (ELECTRONIC), Issue 5 2008M. Leifheit Abstract Several methods for the quantitative detection of different compounds, e.g., L -amino acids, sugars or alcohols in liquid media were developed by application of an automatic measuring unit including a fluid chip-calorimeter FCC-21. For this purpose, enzymes were immobilized covalently on the inner and outer surface of CPG (controlled porous glass)-spherules with an outer diameter of 100,,m and filled into a micro flow-through reaction chamber (VR = 20,,L). The design of the measuring cell allows for easy insertion into the calorimeter device of a stored series of comfortably pre-fabricated measuring cells. These cells can be filled with different enzyme immobilizates. Different oxidases were used and co-immobilized with catalase for the improvement of the detection sensitivity. A signal amplification could be achieved up to a factor of 3.5 with this configuration. ,- D -glucose, ethanol and L -lysine could be detected in a range of 0.25,1.75,mM using glucose oxidase, alcohol oxidase and lysine oxidase. The group of oxidases in combination with the enzymatic catalysis of the intermediate H2O2 allows the quantitative detection of a large number of analytes. A good measurement and storage stability could be achieved for several weeks by this immobilization method. In addition to enzyme-based detection reactions, it was shown that living microorganisms can be immobilized in the reaction chamber. Thus, the system can be used as a whole-cell biosensor. The quantitative detection of phenol in the range of 10,100,,M could be performed using the actinomycete Rhodococcus sp. immobilized on glass beads by means of embedding into polymers. [source] Evidence for functional compartmentalization of trigeminal muscle spindle afferents during fictive mastication in the rabbitEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 4 2000K. -G. Abstract Primary afferent neurons innervating muscle spindles in jaw-closing muscles have cell bodies in the trigeminal mesencephalic nucleus (NVmes) that are electrically coupled and receive synapses. Each stem axon gives rise to a peripheral branch and a descending central branch. It was previously shown that some spikes generated by constant muscle stretch fail to enter the soma during fictive mastication. The present study examines whether the central axon is similarly controlled. These axons were functionally identified in anaesthetized and paralysed rabbits, and tonic afferent firing was elicited by muscle stretch. For the purpose of comparison, responses were recorded extracellularly both from the somatic region and from the central axon in the lateral brainstem. Two types of fictive masticatory movement patterns were induced by repetitive stimulation of the masticatory cortex and monitored from the trigeminal motor nucleus. Field potentials generated by spike-triggered averaging of action potentials from the spindle afferents were employed to determine their postsynaptic effects on jaw-closing motoneurons. Tonic firing of 32% NVmes units was inhibited during the jaw-opening phase, but spike frequency during closing was almost equal to the control rate during both types of fictive mastication. A similar inhibition occurred during opening in 83% of the units recorded along the central branch. However, firing frequency in these was significantly increased during closing in 94%, probably because of the addition of antidromic action potentials generated by presynaptic depolarization of terminals of the central branch. These additional spikes do not reach the soma, but do appear to excite motoneurons. The data also show that the duration and/or frequency of firing during the bursts varied from one pattern of fictive mastication to another. We conclude that the central axons of trigeminal muscle spindle afferents are functionally decoupled from their stem axons during the jaw-closing phase of mastication. During this phase, it appears that antidromic impulses in the central axons provide one of the inputs from the masticatory central pattern generator (CPG) to trigeminal motoneurons. [source] Multi-template approach to realize central pattern generators for artificial locomotion controlINTERNATIONAL JOURNAL OF CIRCUIT THEORY AND APPLICATIONS, Issue 4 2002Paolo Arena Abstract Biologically inspired control of artificial locomotion often makes use of the concept of central pattern generator (CPG), a network of neurons establishing the locomotion pattern within a lattice of neural activity. In this paper a new approach, based on cellular neural networks (CNNs), for the design of CPGs is presented. From a biological point of view this new approach includes an approximated chemical synapse realized and implemented in a CNN structure. This allows to extend the results, previously obtained with a reaction-diffusion-CNN (RD-CNN) for the locomotion control of a hexapod robot, to a more general class of artificial CPGs in which the desired locomotion pattern and the switching among patterns are realized by means of a spatio-temporal algorithm implemented in the same CNN structure. Copyright © 2002 John Wiley & Sons, Ltd. [source] Improved guideline adherence to pharmacotherapy of chronic systolic heart failure in general practice , results from a cluster-randomized controlled trial of implementation of a clinical practice guidelineJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2008Frank Peters-Klimm MD Abstract Rationale and aims, Clinical practice guidelines (CPG) reflect the evidence of effective pharmacotherapy of chronic (systolic) heart failure (CHF) which needs to be implemented. This study aimed to evaluate the effect of a new, multifaceted intervention (educational train-the-trainer course plus pharmacotherapy feedback = TTT) compared with standard education on guideline adherence (GA) in general practice. Method, Thirty-seven participating general practitioners (GPs) were randomized (18 vs. 19) and included 168 patients with ascertained symptomatic CHF [New York Heart Association (NYHA) II-IV]. Groups received CPG, the TTT intervention consisted of four interactive educational meetings and a pharmacotherapy feedback, while the control group received a usual lecture (Standard). Outcome measure was GA assessed by prescription rates and target dosing of angiotensin converting enzyme (ACE) inhibitors (ACE-I) or angiotensin receptor blockers (ARB), beta-blockers (BB) and aldosterone antagonists (AA) at baseline and 7-month follow-up. Group comparisons at follow-up were adjusted to GA, sex, age and NYHA stage at baseline. Results, Prescription rates at baseline (n = 168) were high (ACE-I/ARB 90, BB 79 and AA 29%) in both groups. At follow up (n = 146), TTT improved compared with Standard regarding AA (43% vs. 23%, P = 0.04) and the rates of reached target doses of ACE-I/ARB (28% vs. 15%, P = 0.04). TTT group achieved significantly higher mean percentages of daily target dose (52% vs. 42%, mean difference 10.3%, 95% CI 0.84,19.8, P = 0.03). Conclusion, Despite of pre-existing high GA in both groups and an active control group, the multifaceted intervention was effective in quality of care measured by GA. Further research is needed on the choice of interventions in different provider populations. [source] PNA synthesis using a novel Boc/acyl protecting group strategyJOURNAL OF PEPTIDE SCIENCE, Issue 8 2001Thomas Kofoed Abstract The synthesis of novel Boc/acyl protected monomers for the synthesis of peptide nucleic acid (PNA) is described. The oligomerization protocol using these new monomers has been optimized with regard to coupling reagents. The use of base-labile acyl protecting groups at the exocyclic amines of the heterocyclic bases (isobutyryl for guanine and benzoyl for adenine and cytosine) and a PAM-linked solid support offers an attractive alternative to the present procedures used in PNA synthesis. This strategy has been applied for the synthesis of a test 17mer PNA on both control pore glass (CPG) and a polystyrene MBHA support and was used in the preparation of PNA,DNA chimeras. Copyright © 2001 European Peptide Society and John Wiley & Sons, Ltd. [source] Health Care for the Homeless Assesses the Use of Adapted Clinical Practice GuidelinesJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 11 2005Aaron J. Strehlow RN, FNP-C COLUMN EDITOR: Mary Jo Goolsby This article describes a process of evaluating and adapting existing clinical practice guidelines (CPGs) for homeless individuals by different healthcare providers in multiple healthcare settings across the country. Data were collected using a standardized evaluation tool in nine sites across the United States. Clinicians completed an evaluation of the CPG after every use. Most clinicians used the CPG five times. Descriptive statistics were reported on the characteristics of the clinicians, and the utility of the guidelines and written comments. Clinicians had an average of 12 years of clinical experience, 8 years of which were specifically spent working with homeless individuals. Ninety-one percent of the clinicians practiced in urban settings. The majority of clinicians felt the adapted guidelines met evaluation criteria. The major weaknesses reported the delineation of outreach and case management activities. Results did not vary by clinicians' disciplines, years of experience, or any other indicators. Clients and clinicians providing primary care to homeless individuals may benefit from utilizing Health Care for the Homeless Clinicians' Network adapted CPGs to assure quality, evidenced-based care to a vulnerable population. [source] Integrating Evidence-Based Practice in Nurse Practitioner EducationJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 12 2004APRN-C, FAANP, Mary Jo Goolsby EdD ABSTRACT This column normally focuses on a specific clinical practice guideline (CPG). This month's column deviates from that practice to demonstrate how evidence-based practice (EBP) was integrated into the nurse practitioner (NP) curriculum at the University of Texas at Austin School of Nursing. Processes of EBP were linked to student clinical assignments across core NP clinical courses, culminating in a student-published CPG. When students research and analyze available scientific evidence for a CPG, they learn to critically evaluate and logically organize knowledge for use in clinical practice, and those critical-thinking skills can lead to improved clinical reasoning and decision making. [source] Evaluation and Treatment of Hyperthyroidism and HypothyroidismJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 10 2004ANP-C, FAANP, Mary Jo Goolsby EdD ABSTRACT This month's clinical practice guideline (CPG) review is on the diagnosis and treatment of hyperthyroidism and hypothyroidism as provided by the American Association of Clinical Endocrinologists. An estimated 27 million Americans have thyroid disease, and about 13 million of them are undiagnosed. The risk of thyroid disease increases with age, and women are seven times more likely than men to develop thyroid problems. Unfortunately, thyroid symptoms are usually very nonspecific and should be kept in the differential diagnosis of many clinical complaints. The format of this month's column is a little different because we received two independent manuscripts, each of which had merit. We made a decision to present both points of view and deleted repetitive material. This is an example of variable approaches one can take with reviewing and critiquing CPGs. [source] Integrating the Principles of Evidence-Based Practice: Testing and DiagnosisJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 1 2004APRN-C, Mary Jo Goolsby EdD ABSTRACT The intention of the clinical practice guideline (CPG) column has included increasing readers' familiarity with the range of available evidence-based recommendations, while stimulating dialogue regarding application of those recommendations in practice. This column introduces the first article in a series of three written to describe a framework in which the principles of evidence-based practice can be applied. This article uses a clinical scenario to illustrate considerations relevant to the selection and application of a CPG in practice. [source] Diagnosis and Treatment of Heel PainJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 11 2003ANP-C, FAANP, Mary Jo Goolsby EdD The American College of Foot and Ankle Surgeons (ACFAC) clinical practice guideline (CPG) summarizes the literature on the assessment and diagnosis of heel pain. The framework classifies heel pain depending on whether the cause is mechanical, neurological, arthritic, traumatic, or from another origin. Treatment strategies are included for the most common form of heel pain that are caused by mechanical problems. [source] Policy on Acute Toxic Ingestion or Dermal or Inhalation ExposureJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 7 2003ANP-C FAANP, Mary Jo Goolsby EdD ABSTRACT Many nurse practitioners (NPs) practice in emergency and urgent-care settings, and fir more practical remote settings. NPs in each of these settings should be familiar with the assessment, stabilization, and treatment of patients who seek treatment for suspected intentional or accidental poisoning. This month's Clinical practice guideline (CPG) column reviews the "Clinical Policy for the Initial Approach to Patients Presenting With Acute Toxic Ingestion or Dermal or Inhalation Exposure." SUMMARY The ACEP "Clinical Policy for the Initial Approach to Patients Presenting With Acute Toxic Ingestion or Dermal or Inhalation Exposure" includes several helpful resources. In addition to recommending specific clinical actions in response to patient variables, the document includes a table identifying the antidote for many of the most commonly ingested drugs. These include digoxin, iron, opioids, salicylates, acetaminophen, and tricyclic antidepressants. The table also includes both the adult and pediatric dose of each listed antidote. A quick reference is included. This form can be used to guide the history, physical examination, and subsequent actions for treating patients with acute toxic ingestion or dermal or inhalation exposure. Finally, there is a quality assurance form to guide chart reviews. Many of the attributes of a well-developed guideline are identified in the report. The authors clearly identify the situations for which the recommendations are intended as well as those in which they do not apply. For instance, the guidance is not intended for use when patients are unstable and stabilization is the primary focus. It is also not intended for cases of radiation, parenteral, or eye exposure or of food poisoning. The authors describe the process used to develop the recommendations and identify the strength of the evidence on which each recommendation is based. The role of provider judgment in application of the guidance is addressed. Prior to its dissemination, the CPG was subjected to external review by dinical experts. This ACEP policy has applicability for the growing number of NPs working in emergency and urgent cafe settings as well as for those who must provide front line emergency care in remote settings. It provides a framework for responding to acute toxic exposures and provides several useful resources to assist the clinician in responding to situations in which accidental or intentional poisoning is suspected. [source] Policy on Acute Toxic Ingestion or Dermal or Inhalation ExposureJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 7 2003ANP-C, FAANP, Mary Jo Goolsby EdD ABSTRACT Many nurse practitioners (NPs) practice in emergency and urgent-care settings, and far more practice in remote settings. NPs in each of these settings should be familiar with the assessment, stabilization, and treatment of patients who seek treatment for suspected intentional or accidental poisoning. This month's clinical practice guideline (CPG) column reviews the "Clinical Policy for the Initial Approach to Patients Presenting With Acute Toxic Ingestion or Dermal or Inhalation Exposure." [source] Parameters for the Treatment of Urticaria and AngioedemaJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 11 2002APRN-C, Mary Jo Goolsby EdD This month's CPG column reviews "The Diagnosis and Management of Urticaria: a Practice Parameter Part I: Acute Urticaria/Angioedema and Part II: Chronic Urticaria/Angioedema." As many as 15%-24% of the U.S. population may experience at least one episode of urticaria and/or angioedema in their lifetime. Evaluation and treatment is dependent on whether the urticaria/angioedema is acute or chronic because they are fundamentally different disorders. Acute urticaria is frequently self-limited and usually caused by an allergic reaction to an identifiable agent. Chronic urticaria is usually due to an endogenous cause, one that is difficult to identify and to treat. Due to the magnitude, potential seriousness and chronicity of urticaria and angioedema, this CPG should be quite useful to nurse practitioners in a variety of settings. [source] National Kidney Foundation Guidelines for Chronic Kidney Disease: Evaluation, Classification, and StratificationJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 6 2002APRN-C, Mary Jo Goolsby EdD Chronic kidney disease is becoming more prevalent in the United States. The National Kidney Foundation has recently published a new set of guidelines to assist clinicians in providing earlier detection and treatment of kidney disease to minimize the progression to end-stage renal disease. As approximately 11% of the adult population has some degree of kidney disease, this new CPG should be applicable in many settings. [source] Clinical Practice Guideline: Screening and Diagnosing AutismJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 12 2001APRN-C, Mary Jo Goolsby EdD The clinical practice guideline (CPG) reviewed in this month's column concerns the screening and diagnosis of autism. Autism is the third most common developmental disability and affects more than 1 in 500 children, or nearly 400,000 people in the United States, in some form. Primary care providers of children, including pediatric nurse practitioners (PNPs) and family nurse practitioners (FNPs), should reasonably expect to care for at least one child with autism (CWA). The American Academy of Neurology (AAN) has therefore developed guidelines to help healthcare providers facilitate the early identification of children with autism. [source] American College of Radiology Appropriateness CriteriaJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 7 2001APRN-C, Mary Jo Goolsby EdD The Clinical Practice Guideline (CPG) series provides an overview of one CPG each month. The overview includes a brief summary of the guideline's content, as well as the identification of some factors by which the author has critiqued it. The first article in the series reviewed the steps of CPG critique. Subsequent columns have described CPGs related to viral upper respiratory illnesses, tobacco dependence, menopause and perimenopause, and musculoskeletal evaluation. The document described in this month's clinical practice guideline column is actually a set of recommendations ranking the appropriateness of specific radiologie imaging or therapeutic options for particular conditions or presentations. The American College of Radiology Appropriateness Criteria provides a very valuable resource when ordering diagnostic imaging procedures. [source] Use of PSA Measurement in PracticeJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 6 2001APRN-C, Mary Jo Goolsby EdD The Clinical Practice Guideline (CPG) series provides an overview of one CPG each month. The overview includes a brief summary of the guideline's content, as well as the identification of some factors by which the author has critiqued it. The first article in the series reviewed the steps of CPG critique. Subsequent columns have described CPGs related to viral upper respiratory illnesses, tobacco dependence, menopause and perimenopause, and musculoskeletal evaluation. This month, the column describes a CPG titled: Prostate-Specific Antigen (PSA) Best Practice Policy, from the American Urological Association (AUA). As prostate cancer is the leading cause of cancer deaths among U.S. men, this set of recommendations should have wide application. [source] Evaluating Acute Musculoskeletal ComplaintsJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 5 2001Mary Jo Goolsby EdD Clinical practice guidelines (CPG) are now widely available summarizing large amounts of scientific evidence and providing specific recommendations for the evaluation, diagnosis, and management of varied health problems. In order to take advantage of the available CPGs in clinical practice, providers must be aware of their existence and be able to critique them for scientific merit and relevance to specific clinical settings. This ongoing series is designed to provide a brief review of a different CPG each month. This month, the CPG reviewed addresses the evaluation of an extremely common set of complaints: musculoskeletal symptoms. The document emphasizes the importance of a thorough history and physical for these presentations and indicates when specific diagnostic studies and/or consultations are warranted. [source] Viral Upper Respiratory InfectionsJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 2 2001APRN-C, Mary Jo Goolsby EdD Clinical practice guidelines (CPG) hold great potential for providing a summary of large volumes of clinical evidence and a related set of practical recommendations. Nurse practitioners should become aware of the range of available CPGs and methods by which they can be evaluated for use. Appropriate evaluation of CPGs should include their overall reliability and validity, as well as their applicability in specific situations. This article is part of an ongoing series presenting individual CPGs. [source] Evaluating and Applying Clinical Practice GuidelinesJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 1 2001APRN-C, Mary Jo Goolsby EdD Clinical practice guidelines (CPG) hold great potential for providing a summary of large volumes of clinical evidence and a related set of practical recommendations. Nurse practitioners should become aware of the range of available CPGs and methods by which they can be evaluated for use. Appropriate evaluation of CPGs should include their overall reliability and validity, as well as their applicability in specific situations. This article provides an overview of an appropriate evaluation method and serves as an introduction to future columns presenting individual CPGs. [source] Verifying the RTE model: ortho-positronium lifetime measurement on controlled pore glassesPHYSICA STATUS SOLIDI (C) - CURRENT TOPICS IN SOLID STATE PHYSICS, Issue 10 2007S. Thraenert Abstract In porous media, the vacuum lifetime of ortho-positronium (o-Ps) of , = 142 ns can be reduced markedly by pick-off annihilation (interaction with electrons of the host material). So the o-Ps lifetime is determined by the pore size which can be extracted by utilising approved models like the Tao-Eldrup model for pore sizes smaller than 1 nm and the Tokyo model or RTE model for larger pore sizes. The RTE model contains an explicit temperature dependence of the o-Ps lifetime. Experiments on controlled pore glasses (CPG) with different pore sizes (2-70 nm) at different temperatures (50-500 K) were performed to verify the RTE model. A general agreement for T = 300 K could be found. The temperature dependence of the lifetime, especially for low temperatures, could not be approved sufficiently. (© 2007 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Endogenous extracellular serotonin modulates the spinal locomotor network of the neonatal mouseTHE JOURNAL OF PHYSIOLOGY, Issue 1 2010Mary J. Dunbar Serotonin (5-HT) can potently activate and modulate spinal locomotor circuits in a variety of species. Many of these findings have been obtained by applying serotonin exogenously to the isolated spinal cord of in vitro preparations, which has the drawback of indiscriminately activating extrasynaptic receptors and neurons. To investigate the role of endogenously released serotonin in modulating locomotor networks, the selective serotonin reuptake inhibitor citalopram was used. Fictive locomotion was elicited by either electrical stimulation of the brainstem or the sacral 4 (S4) dorsal root. The addition of 20 ,m of citalopram caudal to thoracic segment 5 (T5) had an overall inhibitory effect on the lumbar central pattern generator (CPG). Left,right and flexor,extensor coupling were significantly decreased, and there was also a phase shift in the flexor,extensor relationship. In addition, there was a significant decrease in burst amplitude. These effects were observed during both afferent and brainstem evoked fictive locomotion. When citalopram was added in the presence of 5-HT1A and 5-HT1B antagonists, the inhibitory effects were largely reversed. The remaining excitatory effects were mediated by 5-HT7 and 5-HT2 receptors. These results suggest that endogenous 5-HT release can modulate locomotor-like activity early in neonatal development. [source] Reclassification of unexplained stillbirths using clinical practice guidelinesAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 3 2009Elizabeth HEADLEY Background: Twenty-eight per cent of stillbirths in Australia remain unexplained. A clinical practice guideline (CPG) produced by the Perinatal Society of Australia and New Zealand (PSANZ) Perinatal Mortality Special Interest Group is in use to assist clinicians in the investigation and audit of perinatal deaths. Aims: To describe in a tertiary hospital using the PSANZ stillbirth investigation guidelines: (i) the distribution and classification of stillbirths, and (ii) the compliance with suggested stillbirth core investigations. Methods: Retrospective cohort of all stillbirths delivered between November 2005 and March 2008. Stillbirths were defined as no sign of life on delivery at , 20 weeks gestation or 400 g birthweight if gestation is unknown. Data were collected via the hospital Perinatal Mortality Audit Committee (PMAC). Cause of death was classified by the PSANZ Perinatal Death Classification. Results: There were 86 stillbirths (rate 7.2 per 1000 births). The percentage of unexplained stillbirths was 34% and 13% before and after CPG investigations, respectively. Unexplained stillbirths had the highest compliance with the recommended investigations. The initial cause of death documented on the death certificate was changed by the PMAC in 19 cases. The investigations most likely to prompt a change in the cause of death classification were autopsy and placental pathology. Conclusions: The percentage of unexplained stillbirths is lower than the national average in a hospital using the Perinatal Mortality Audit Guidelines. However, overall compliance is low, suggesting a targeted approach to investigation is used by clinicians despite a policy that aims to be non-selective. Autopsy and placental examination are the most useful investigations in assisting formal classification of cause of death. [source] Oral administration of a tri-therapy for central pattern generator activation in paraplegic mice: Proof-of-concept of efficacyBIOTECHNOLOGY JOURNAL, Issue 4 2010Pierre A. Guertin Dr. Abstract Spinal cord injury (SCI) is a neurological condition, for which no cure exists, typically leading to an immediate and irreversible loss of sensory and voluntary motor functions accompanied by significant health problems. We conducted proof-of-concept experiments aimed at assessing efficacy upon oral administration of a novel combination therapy for central pattern generator (CPG) activation and corresponding locomotor movement generation in completely paraplegic animals. Co-administration orally (by gavage) of buspirone, levodopa and carbidopa was found to dose-dependently induce episodes of steady weight-bearing stepping in low-thoracic (Th9/10) spinal cord-transected (Tx) mice (with no other form of assistance or training). Robust hindlimb stepping with weight-bearing capabilities was induced with the tri-therapy but not with clinically relevant doses of these compounds administered separately. These results provide evidence suggesting that this drug combination may be ideally suited to constitute a first-in-class therapy (CPG activator) for locomotor activity induction in chronic SCI individuals, given that efficacy was shown using commercially available brain-permeable small molecules, already known as safe for the treatment of various neurological indications. [source] A preliminary study of the seed anatomy of ZingiberaceaeBOTANICAL JOURNAL OF THE LINNEAN SOCIETY, Issue 1-2 2000JING-PING LIAO Seeds in Zingiberaceae comprise an aril, seed coat, perispenn, endosperm, embryo, and micropylar and chalazal region. The seed coat is derived from the outer integument, and can be divided into cxotesta, mcsotesta and endotesta; the mesotesta is further subdivided into hypodcrmis, translucent cell layer and pigmented cell layer. The micropylar region includes a micropylar collar and operculum; in some taxa it also includes a caruncle-like structure or a stalk-like structure. A chalazal pigmented cell group (CPG), endotcstal gap, diaphragm and the course of raphe bundle in the chalazal region may be of systematic significance in some species. There are two types of endotesta in the family: parenchymatous (in tribes Hedychieae, Zingibereae and Globbeae) and sclerenchymatous (in Alpineae). The exception is Pommereschea lacknen, which is placed in Alpineae but has the parenchymatous type of endotesta. For this and other reasons this taxon should be transferred to another tribe. On the basis of seed characters, Hedychieae, Zingibereae and Globbeae are apparently closely related, although Hedychieae and Zingibereae differ from Globbeae which has a multiple-layered exotestal epidermis. Seeds of most Zingibereae have a peculiar carunclelike structure at the base of the seed which forms the expanding part beyond the micropylar collar. Zingiberaceae and Costaceae are connected through tribe Alpineae with a sclerenchymatous type of endotesta. [source] Impact of Human Factor Design on the Use of Order Sets in the Treatment of Congestive Heart FailureACADEMIC EMERGENCY MEDICINE, Issue 11 2007Stewart Reingold MD Background Although standardized physician order sets are often part of quality improvement projects, the specific design elements contributing to increased adoption and compliance with use often are not considered. Objectives To evaluate the impact of human factor design elements on congestive heart failure (CHF) order set utilization, and compliance with recommended CHF clinical practice guidelines (CPG). Methods This was a descriptive retrospective medical record review of adult patients who were admitted from our emergency department with the primary diagnosis of CHF. We collected data on acuity and CPG parameters before and after the introduction of a new CHF order set. The new orders were succinct and visually well organized, with narrative information to encourage use of CPG. Results Eighty-seven patients were studied before, and 84 after, the introduction of new orders. There were no differences in the use of the order sets based on patient acuity before or after the intervention. Order set use significantly increased by the first postintervention interval (POST) and reached 72% (95% confidence interval [CI] = 52% to 86%) during the third POST, compared with a baseline utilization of 9% (95% CI = 5% to 17%; p < 0.001). Compliance with CPG for angiotensin-converting enzyme reached significance in the second POST and was maintained in the third at 83% (95% CI = 61% to 94%), compared with a baseline value of 25% (95% CI = 7% to 59%; p = 0.008). Intravenous nitroglycerin also increased significantly from the first POST and reached 78% (95% CI = 55% to 91%) in the third POST, compared with baseline of 12% (95% CI = 2% to 47%; p < 0.003). Furosemide dosing, systolic blood pressure reduction, and urine output did not significantly change. Conclusions Introduction of an order set for CHF with attention to human factor design elements significantly improved utilization of the orders and compliance with CPG. [source] Radiolysis of Confined Water: Hydrogen Production at a High Dose RateCHEMPHYSCHEM, Issue 12 2005Sophie Le Caër Dr. Abstract The production of molecular hydrogen in the radiolysis of dried or hydrated nanoporous controlled-pore glasses (CPG) has been carefully studied using 10 MeV electron irraditation at high dose rate. In all cases, the H2 yield increases when the pore size decreases. Moreover, the yields measured in dried materials are two orders of magnitude smaller than those obtained in hydrated glasses. This proves that the part of the H2 coming from the surface of the material is negligible in the hydrated case. Thus, the measured yields correspond to those of nanoconfined water. Moreover, these yields are not modified by the presence of potassium bromide, which is a hydroxyl radical scavenger. This experimental observation shows that the back reaction between H2 and HO. does not take place in such confined environments. These porous materials have been characterized before and after irradiation by means of Fourier-transform infrared (FT-IR) spectroscopy, electron paramagnetic resonance (EPR) and nuclear magnetic resonance (NMR) techniques, which helps to understand the elementary processes taking place in this type of environment, especially the protective effect of water on the surface in the case of hydrated glasses. [source] | |||||||||||||||||||||||||||||||