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排序方式: 共有1353条查询结果,搜索用时 31 毫秒
1.
Aaron R. Jensen Cory McLaughlin Carolyn F. Wong Katie McAuliff Avery B. Nathens Erica Barin Daniella Meeker Henri R. Ford Randall S. Burd Jeffrey S. Upperman 《American journal of surgery》2019,217(1):180-185
Background
Simulation-based training (SBT) for pediatric trauma resuscitation can improve team performance. The purpose of this study was to describe the nationwide trend in SBT use and barriers to SBT implementation.Methods
Trauma centers that participated in ACS TQIP Pediatric in 2016 (N?=?125) were surveyed about SBT use. Center characteristics and reported implementation barriers were compared between centers using and not using SBT.Results
Survey response rate was 75% (94/125) with 78% (73/94) reporting SBT use. The frequency of pediatric SBT use increased from 2014 to 2016 (median 5.5 vs 6.5 annual sessions, p?<?0.01). Funding barriers were negatively associated with number of annual SBT sessions (r?≤??0.34, p?<?0.05). Centers not using SBT reported lack of technical expertise (p?=?0.01) and lack of data supporting SBT (p?=?0.03) as significant barriers.Conclusions
Simulation use increased from 2014 to 2016, but significant barriers to implementation exist. Strategies to share resources and decrease costs may improve usage.Level of evidence
Level 3, epidemiological. 相似文献2.
Verrucous perforating collagenoma is an extremely rare variant of acquired perforating dermatosis that has been seldom described in literature. We present the case of an 18‐month‐old boy who presented with an erythematous plaque with a central keratotic plug on the leg. Histopathology revealed transepidermal elimination of collagen, consistent with a diagnosis of verrucous perforating collagenoma. 相似文献
3.
Viraj V Khetani Daniella E Portal Mansi R Shah Tina Mayer Eric A Singer 《World journal of clinical oncology》2020,11(8):541-562
Renal cell carcinomas (RCC) make up about 90% of kidney cancers, of which 80% are of the clear cell subtype. About 20% of patients are already metastatic at the time of diagnosis. Initial treatment is often cytoreductive nephrectomy, but systemic therapy is required for advanced RCC. Single agent targeted therapies are moderately toxic and only somewhat effective, leading to development of immunotherapies and combination therapies. This review identifies limitations of monotherapies for metastatic renal cell carcinoma, discusses recent advances in combination therapies, and highlights therapeutic options under development. The goal behind combining various modalities of systemic therapy is to potentiate a synergistic antitumor effect. However, combining targeted therapies may cause increased toxicity. The initial attempts to create therapeutic combinations based on inhibition of the vascular endothelial growth factor or mammalian target of rapamycin pathways were largely unsuccessful in achieving a profile of increased synergy without increased toxicity. To date, five combination therapies have been approved by the U.S. Food and Drug Administration, with the most recently approved therapies being a combination of checkpoint inhibition plus targeted therapy. Several other combination therapies are under development, including some in the phase 3 stage. The new wave of combination therapies for metastatic RCC has the potential to increase response rates and improve survival outcomes while maintaining tolerable side effect profiles. 相似文献
4.
Sara Y. Kim Sarah M. Kark Ryan T. Daley Sara E. Alger Daniella Rebouas Elizabeth A. Kensinger Jessica D. Payne 《Hippocampus》2020,30(8):829-841
Sleep and stress independently enhance emotional memory consolidation. In particular, theta oscillations (4–7 Hz) during rapid eye movement (REM) sleep increase coherence in an emotional memory network (i.e., hippocampus, amygdala, and prefrontal cortex) and enhance emotional memory. However, little is known about how stress during learning might interact with subsequent REM theta activity to affect emotional memory. In the current study, we examined whether the relationship between REM theta activity and emotional memory differs as a function of pre‐encoding stress exposure and reactivity. Participants underwent a psychosocial stressor (the Trier Social Stress Task; n = 32) or a comparable control task (n = 32) prior to encoding. Task‐evoked cortisol reactivity was assessed by salivary cortisol rise from pre‐ to post‐stressor, and participants in the stress condition were additionally categorized as high or low cortisol responders via a median split. During incidental encoding, participants studied 150 line drawings of negative, neutral, and positive images, followed by the complete color photo. All participants then slept overnight in the lab with polysomnographic recording. The next day, they were given a surprise recognition memory task. Results showed that memory was better for emotional relative to neutral information. Critically, these findings were observed only in the stress condition. No emotional memory benefit was observed in the control condition. In stressed participants, REM theta power significantly predicted memory for emotional information, specifically for positive items. This relationship was observed only in high cortisol responders. For low responders and controls, there was no relationship between REM theta and memory of any valence. These findings provide evidence that elevated stress at encoding, and accompanying changes in neuromodulators such as cortisol, may interact with theta activity during REM sleep to promote selective consolidation of emotional information. 相似文献
5.
Svetla Slavova Daniella Bradley O'Brien Kathleen Creppage Dan Dao Anna Fondario Elizabeth Haile Beth Hume Thomas W. Largo Claire Nguyen Jennifer C. Sabel Dagan Wright Members of the Council of State Territorial Epidemiologists Overdose Subcommittee 《Public health reports (Washington, D.C. : 1974)》2015,130(4):339-342
6.
7.
Giovanne B. Diniz Daniella S. Battagello Marianne O. Klein Bianca S. M. Bono Jozélia G. P. Ferreira Livia C. Motta-Teixeira Jessica C. G. Duarte Françoise Presse Jean-Louis Nahon Antoine Adamantidis Melissa J. Chee Luciane V. Sita Jackson C. Bittencourt 《Journal of neuroscience research》2020,98(10):2045-2071
Melanin-concentrating hormone (MCH) is a ubiquitous vertebrate neuropeptide predominantly synthesized by neurons of the diencephalon that can act through two G protein-coupled receptors, called MCHR1 and MCHR2. The expression of Mchr1 has been investigated in both rats and mice, but its synthesis remains poorly described. After identifying an antibody that detects MCHR1 with high specificity, we employed immunohistochemistry to map the distribution of MCHR1 in the CNS of rats and mice. Multiple neurochemical markers were also employed to characterize some of the neuronal populations that synthesize MCHR1. Our results show that MCHR1 is abundantly found in a subcellular structure called the primary cilium, which has been associated, among other functions, with the detection of free neurochemical messengers present in the extracellular space. Ciliary MCHR1 was found in a wide range of areas, including the olfactory bulb, cortical mantle, striatum, hippocampal formation, amygdala, midline thalamic nuclei, periventricular hypothalamic nuclei, midbrain areas, and in the spinal cord. No differences were observed between male and female mice, and interspecies differences were found in the caudate-putamen nucleus and the subgranular zone. Ciliary MCHR1 was found in close association with several neurochemical markers, including tyrosine hydroxylase, calretinin, kisspeptin, estrogen receptor, oxytocin, vasopressin, and corticotropin-releasing factor. Given the role of neuronal primary cilia in sensing free neurochemical messengers in the extracellular fluid, the widespread distribution of ciliary MCHR1, and the diverse neurochemical populations who synthesize MCHR1, our data indicate that nonsynaptic communication plays a prominent role in the normal function of the MCH system. 相似文献
8.
Neuhaus Zipora Feiga Gutvirtz Gil Pariente Gali Wainstock Tamar Landau Daniella Sheiner Eyal 《Archives of gynecology and obstetrics》2020,301(1):143-149
Archives of Gynecology and Obstetrics - To evaluate the long-term pediatric neuropsychiatric morbidity of children born to obese patients. A population-based cohort analysis was performed comparing... 相似文献
9.
Jason M. Gauthier M. Shea Harrison Alexander S. Krupnick Andrew E. Gelman Daniel Kreisel 《Immunological reviews》2019,292(1):194-208
Regulatory T cells (Treg) have proven to be a powerful immunologic force in nearly every organ system and hold therapeutic potential for a wide range of diseases. Insights gained from non‐transplant pathologies, such as infection, cancer, and autoimmunity, are now being translated to the field of solid organ transplantation, particularly for livers and kidneys. Recent insights from animal models of lung transplantation have established that Tregs play a vital role in suppressing rejection and facilitating tolerance of lung allografts, and such discoveries are being validated in human studies and preclinical trials. Given that long‐term outcomes following lung transplantation remain profoundly limited by chronic rejection, Treg therapy holds the potential to significantly improve patient outcomes and should be aggressively investigated. 相似文献