Benefits of Less Restrictive Regulation of Advance Practice Registered Nurses in Florida

Background

Advanced Practice Registered Nurses (APRNs) provide access to cost-effective, high quality care. APRNs are underutilized in states that restrict their practice. Removing restrictions could expand access to quality health care, cost-effectively relieve the physician shortage, and contribute economically.

DhhP,a Cyclic di-AMP Phosphodiesterase of Borrelia burgdorferi,Is Essential for Cell Growth and Virulence

Cyclic di-AMP (c-di-AMP) is a recently discovered second messenger in bacteria. Most of work on c-di-AMP signaling has been done in Gram-positive bacteria, firmicutes, and actinobacteria, where c-di-AMP signaling pathways affect potassium transport, cell wall structure, and antibiotic resistance. Little is known about c-di-AMP signaling in other bacteria. Borrelia burgdorferi, the causative agent of Lyme disease, is a spirochete that has a Gram-negative dual membrane. In this study, we demonstrated that B. burgdorferi BB0619, a DHH-DHHA1 domain protein (herein designated DhhP), functions as c-di-AMP phosphodiesterase. Recombinant DhhP hydrolyzed c-di-AMP to pApA in a Mn²⁺- or Mg²⁺-dependent manner. In contrast to c-di-AMP phosphodiesterases reported thus far, DhhP appears to be essential for B. burgdorferi growth both in vitro and in the mammalian host. Inactivation of the chromosomal dhhP gene could be achieved only in the presence of a plasmid-encoded inducible dhhP gene. The conditional dhhP mutant had a dramatic increase in intracellular c-di-AMP level in comparison to the isogenic wild-type strain. Unlike what has been observed in Gram-positive bacteria, elevated cellular c-di-AMP in B. burgdorferi did not result in an increased resistance to β-lactamase antibiotics, suggesting that c-di-AMP''s functions in spirochetes differ from those in Gram-positive bacteria. In addition, the dhhP mutant was defective in induction of the σ^S factor, RpoS, and the RpoS-dependent outer membrane virulence factor OspC, which uncovers an important role of c-di-AMP in B. burgdorferi virulence.     

乙酰半胱氨酸纳米活性炭缓释微囊对大鼠非酒精性脂肪性肝炎抗氧化作用的影响

目的 探讨乙酰半胱氨酸纳米活性碳缓释微囊（ACNAC）对非酒精性脂肪性肝炎（NASH）大鼠肝脏抗氧化能力的影响.方法 通过高脂饮食12周诱导建立NASH大鼠动物模型,分别给予ACNAC高、中、低每日不同剂量（800 mg/kg、400 mg/kg和200 mg/kg）与易善复（0.692 mg/kg）、乙酰半胱氨酸（400 mg/kg）连续灌胃8周后,检测血清生化指标、肝匀浆丙二醛（MDA）含量、总超氧化物歧化酶（SOD）活性、还原型谷胱甘肽（GSH）、谷胱甘肽过氧化物酶（GSH-Px）活性及肝脏病理指标.结果 ACNAC中剂量组与高脂组相比,血清ALT、AST明显下降（P＜0.01 、P ＜0.05）,且优于易善复组（P＜0.05）.血清TCHOL 、TG、LDL-C和CR检测结果差异虽无统计学意义,但其数值上ACNAC明显低于高脂组,且优于易善复组和NAC组.ACNAC高、中、低三组与高脂组相比,SOD活力明显升高（P ＜0.01） 、GSH含量明显升高（P＜0.01）,ACNAC中剂量组与高脂组比较GSH-PX活性明显升高（P＜0.05）但略低于易善复组（P＜0.01））.结论 相关剂量的乙酰半胱氨酸纳米活性炭缓释微囊可增强非酒精性脂肪性肝炎大鼠的抗氧化能力.     

HBV感染对FibroScan（R）实施受控衰减参数评价脂肪肝影响的研究

目的 评价HBV感染是否对FibroScan（R）实施受控衰减参数（CAP）有影响.方法 使用FibroScan-502机型对临床诊断非酒精性脂肪性肝病（NAFLD）患者、慢性乙型肝炎患者（CHB）及慢性乙肝合并脂肪肝（CHB合并NAFLD）患者进行肝脏脂肪含量（CAP值）测定.结果 579例CHB患者、124例CHB合并NAFLD患者和624例NAFLD患者FibroScan检查,FibroScan测定的CAP与BMI呈正相关（r=0.46,P=0.004）,而与血清HBV NDA载量、HBsAg载量以及HBeAg阳性与否无关;CHB组的CAP值（218.90 ＆#177;56.40 dB/m）显著低于NAFLD组（290.85＆#177;61.46 dB/m,P=0.00）,也低于CHB合并NAFLD组（284.93＆#177;64.70 dB/m,P=0.00）,而CHB合并NAFLD组的CAP值与NAFLD组间的差异无统计学意义（P=0.55）;血清高HBV DNA载量组的CAP值与低HBV DNA载量组间,高HBsAg载量的CAP值与低HBsAg载量组间,以及HBeAg阳性组的CAP值与HBeAg阴性组间差异均无统计学意义.结论 HBV感染不影响FibroScan测定的CAP值.     

characterization of acute-phase humoral immunity to monkeypox: use of immunoglobulin M enzyme-linked immunosorbent assay for detection of monkeypox infection during the 2003 North American outbreak

A monkeypox outbreak occurred in the United States in 2003. Patient's sera were sent to the Centers for Disease Control and Prevention as a part of outbreak response measures. Clinical and epidemiologic information was abstracted from the case investigation forms. Serum samples from patients were tested by using an immunoglobulin M (IgM)-capture and an IgG enzyme-linked immunosorbent assay ELISA against Orthopoxvirus antigen. The detection of antiviral IgG and IgM antibodies and the kinetics of the antiviral IgG and IgM antibody responses were evaluated. Patients were classified as confirmed, probable, or suspect cases or were excluded as cases based on laboratory test results and epidemiologic and clinical criteria. A total of 37 confirmed case patients with monkeypox were identified, and 116 patients were excluded as case patients based on molecular testing or insufficient epidemiology and clinical data to warrant classification as a suspect or probable case. Of 37 confirmed case patients, 36 had a known history (presence or absence) of smallpox vaccination. Of those, 29 of the 36 either had or developed an IgG response, while 34 of the 36 developed an IgM response, regardless of vaccination status. Serum collected > or =5 days for IgM detection or serum collected > or =8 days after rash onset for IgG detection was most efficient for the detection of monkeypox virus infection. IgM ELISA detects recent infection with orthopoxviruses and, in this case, recent infection with monkeypox virus. In addition, analysis of paired sera for IgG and IgM detected seroconversion, another indicator of recent infection. The ELISA results correlated with the virologic PCR and viral culture results, indicating its diagnostic capabilities for monkeypox and potentially other orthopoxvirus infections due to zoonotic transmission or bioterrorism events.     

针电极肌电信号AR模型参数与局部肌疲劳的相关定性关系

背景：研究肌肉的疲劳行为，对于神经肌肉系统的基础研究、残疾人的康复工程、理疗效果的客观评价、运动员的科学训练和工效学等都有广泛的应用价值。 目的：利用针电极肌电信号AR模型参数来研究局部肌疲劳，试图揭示局部肌疲劳过程与针电极肌电信号AR模型系数之间存在的定性关系。 设计：以人体针电极肌电信号为观察对象，分析肌电特征参数在局部肌疲劳过程中的变化规律。 单位：中国科学技术大学NML实验室。 对象：由中国科学技术大学NML实验室研制的肌电信号采集系统获得4例针电极肌电信号，挑选的4名志愿者均为健康男性，检测部位为胫前肌。 方法：根据随机信号参数模型理论，对针电极肌电信号进行建模，选取参数，研究肌肉疲劳过程中肌电信号的α1参数随时间的变化趋势。编程采用MATLAB语言工具箱的相关程序。 主要观察指标：针电极肌电信号的α1参数随着时间（疲劳过程）的增加而变化的趋势。 结果：人体的局部肌肉疲劳与从该肌肉检测的针电极肌电信号α1参数的变化趋势之间存在着一种相关关系，即针电极肌电信号的α1参数随着时间（疲劳过程）的增加有增大的趋势。 结论：针电极肌电信号的α1参数随着时间（疲劳过程）的增加有增大的趋势，利用这种关系就能够较好的对肌肉疲劳的状态进行评价。     

阿尔茨海默病的非匹配负波的实验研究

目的非匹配负波可反映大脑皮层早期预处理的指标,探讨阿尔茨海默病(Alzheimerdisease,AD)患者非匹配负波(mismatchnegativity,MMN)的变异特征。方法应用美国NicoletSpirit脑诱发电位仪,对34例AD患者和36例健康老人的MMN作了检测。结果AD组波形不规则,MMN-Ⅰ型(延迟型)尤甚。与正常老人组相比,AD组MMN潜伏期延迟(P<0.05),本组患者P300潜伏期虽也有延长,但差异未达显著性(P>0.05)。与正常老人组比较,AD组MMN波幅以及P300波幅均同时降低,差异均有极显著性意义(均P<0.01)。结论初步认为MMN是反映AD患者认知功能的一种脑电生理检测工具。