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Hendriksen Koefoed posted an update 6 months ago
In addition, cvBRS up-up (vagal activation) was reduced following binge alcohol consumption in stage N2 (21±3 vs. 15±3ms/mmHg, P=0.035) and REM (15 vs. 11 ms/mmHg, P=0.009). Binge alcohol consumption reduced cvBRS down-down (vagal withdrawal) in stage N2 (23±2 vs. 14±2ms/mmHg, P<0.001), SWS (20 vs. 14 ms/mmHg, P=0.022), and REM (14 vs. 10 ms/mmHg, P=0.006).
Evening binge alcohol consumption disrupts cardiac vagal tone and baroreflex function during nearly all sleep stages. These findings provide mechanistic insight into the potential role of binge drinking and alcohol abuse on cardiovascular risk.
Evening binge alcohol consumption disrupts cardiac vagal tone and baroreflex function during nearly all sleep stages. These findings provide mechanistic insight into the potential role of binge drinking and alcohol abuse on cardiovascular risk.
The optimal method for implementing hospital-level restrictions for antibiotics that carry a high risk of Clostridioides difficile infection has not been identified. We aimed to explore barriers and facilitators to implementing restrictions for fluoroquinolones and third/fourth-generation cephalosporins.
This mixed-methods study across a purposeful sample of 15 acute-care, geographically dispersed Veterans Health Administration hospitals included electronic surveys and semi-structured interviews (September 2018 to May 2019). Surveys on stewardship strategies were administered at each hospital and summarized with descriptive statistics. Interviews were performed with 30 antibiotic stewardship programme (ASP) champions across all 15 sites and 19 additional stakeholders at a subset of 5 sites; transcripts were analysed using thematic content analysis.
The most restricted agent was moxifloxacin, which was restricted at 12 (80%) sites. None of the 15 hospitals restricted ceftriaxone. Interviews identified diiffering opinions on the feasibility of implementing antibiotic restrictions for third/fourth-generation cephalosporins and fluoroquinolones. While the perceived barrier to implementing restrictions was frequently high, many hospitals were effectively using restrictions and reported few barriers to their use.
This study examined the feasibility and initial outcome of a time-limited and intensive format of Parent-Child Interaction Therapy (PCIT) for families of young children who have sustained a traumatic brain injury (TBI).
The nonrandomized open trial included 15 families with a child aged 2-5 years who had sustained a TBI and displayed clinically elevated levels of externalizing behavior problems. Families received clinic-based PCIT twice per week over an average of 6 weeks, with the exception of two families that received the same intensity and format of PCIT in the home.
Ten of the 14 families who completed the baseline assessment (71%) completed the intervention and post and follow-up assessments. On average, caregivers completed homework practice on 52% of the days in between sessions. Caregivers reported high acceptability and satisfaction following the intervention, as well as decreases in child externalizing and internalizing behavior problems at the post-assessment and 2-month follow-up.
Results of this open trial provide preliminary support for the feasibility of a time-limited and intensive format of PCIT for families of young children who have sustained a TBI and have elevated levels of behavior problems. This study highlights a promising intervention approach for improving domains commonly affected by early childhood TBI and preventing the development of more severe and persistent problems.
Results of this open trial provide preliminary support for the feasibility of a time-limited and intensive format of PCIT for families of young children who have sustained a TBI and have elevated levels of behavior problems. This study highlights a promising intervention approach for improving domains commonly affected by early childhood TBI and preventing the development of more severe and persistent problems.Little is known about the prevalence of antimicrobial resistant (AMR) bacteria in veal meat in the United States. We estimated the prevalence of bacterial contamination and AMR in various veal meats collected during the 2018 U.S. National Antimicrobial Resistance Monitoring System (NARMS) survey of retail outlets in nine states and compared to the frequency of AMR bacteria from other cattle sources sampled for NARMS. Additionally, we identified genes associated with resistance to medically important antimicrobials and gleaned other genetic details about the resistant organisms. Decitabine molecular weight The prevalence of Campylobacter, Salmonella, E. coli and Enterococcus in veal meats collected from grocery stores in nine states was 0% (0/358), 0.6% (2/358), 21.1% (49/232) and 53.5% (121/226) respectively, with ground veal posing the highest risk for contamination. Both Salmonella were resistant to at least one antimicrobial as were 65.3% (32/49) of E. coli and 73.6% (89/121) of Enterococcus isolates. Individual drug and multidrug (MDR) resistance levels were significantly higher (p less then 0.05) in E. coli and Enterococcus from retail veal compared to 2018 NARMS data from sampling dairy cattle ceca and retail ground beef. Whole genome sequencing (WGS) was conducted on select E. coli and Salmonella from veal. Cephalosporin resistance genes (blaCMY and blaCTX-M), macrolide resistance genes (mph), plasmid-mediated quinolone resistance genes (PMQR, qnr), and gyrA mutations were found. We also identified heavy metal resistance genes (HMRG) ter, ars, and mer, fieF, and gol, and disinfectant resistance genes (DRG) qac and emrE. An stx1a-containing E. coli was also found. Sequence types were highly varied among the nine E. coli isolates that were sequenced. Several plasmid types were identified in E. coli and Salmonella, with the majority (9/11) of isolates containing IncF. This study illustrates that veal meat is a carrier of AMR bacteria.
The Global Registry of Acute Coronary Events (GRACE) score is an established clinical risk stratification tool for patients with acute coronary syndromes (ACS). We developed and internally validated a model for 1-year all-cause mortality prediction in ACS patients.
Between 2009 and 2012, 2’168 ACS patients were enrolled into the Swiss SPUM-ACS Cohort. Biomarkers were determined in 1’892 patients and follow-up was achieved in 95.8% of patients. 1-year all-cause mortality was 4.3% (n = 80). In our analysis we consider all linear models using combinations of 8 out of 56 variables to predict 1-year all-cause mortality and to derive a variable ranking.
1.3% of 1’420’494’075 models outperformed the GRACE 2.0 Score. The SPUM-ACS Score includes age, plasma glucose, NT-proBNP, left ventricular ejection fraction (LVEF), Killip class, history of peripheral artery disease (PAD), malignancy, and cardio-pulmonary resuscitation. For predicting 1-year mortality after ACS, the SPUM-ACS Score outperformed the GRACE 2.0 Score which achieves a 5-fold cross-validated AUC of 0.