• Craft Smith posted an update 4 hours, 26 minutes ago

    Hepatosplanchnic and pulmonary vasculatures constitute synapomorphic, highly comparable networks integrated with the external environment. Given functionality related to obligatory requirements of “feeding and breathing,” these organs are subject to constant environmental challenges entailing infectious risk, antigenic and xenobiotic exposures. Host responses to these stimuli need to be both protective and tightly regulated. These functions are facilitated by dualistic, high-low pressure blood supply of the liver and lungs, as well as tolerogenic characteristics of resident immune cells and signaling pathways. Dysregulation in hepatosplanchnic and pulmonary blood flow, immune responses, and microbiome implicate common pathogenic mechanisms across these vascular networks. Hepatosplanchnic diseases, such as cirrhosis and portal hypertension, often impact lungs and perturb pulmonary circulation and oxygenation. The reverse situation is also noted with lung disease resulting in hepatic dysfunction. Others, and we, have described common features of dysregulated cell signaling during liver and lung inflammation involving extracellular purines (e.g., ATP, ADP), either generated exogenously or endogenously. These metabokines serve as danger signals, when released by bacteria or during cellular stress and cause proinflammatory and prothrombotic signals in the gut/liver-lung vasculature. Dampening of these danger signals and organ protection largely depends upon activities of vascular and immune cell-expressed ectonucleotidases (CD39 and CD73), which convert ATP and ADP into anti-inflammatory adenosine. However, in many inflammatory disorders involving gut, liver, and lung, these protective mechanisms are compromised, causing perpetuation of tissue injury. We propose that interventions that specifically target aberrant purinergic signaling might prevent and/or ameliorate inflammatory disorders of the gut/liver and lung axis.Tracking systems in people with dementia in long-term care – Update of an integrative review Abstract. Background This article is an update of the article by Hülsken-Giesler et al. (2019) and describes the latest findings on tracking systems in inpatient long-term care.

    The research question also follows on from the underlying article and again deals with the application of tracking systems and their consequences for residents and nursing staff.

    A systematic literature search in the databases MEDLINE via PubMed and CINAHL as well as a hand search for the period starting in August 2017 was performed. Ipatasertib clinical trial The included literature was evaluated by two independent persons regarding content and methodology.

    In addition to deductive categories from the underlying work, further inductive categories could be formed and thus ethical and implementation aspects could be included.

    Since the first analysis, the focus in nursing science studies on the use of tracking systems in inpatient long-term care has shifted to ethical aspects. Also, the successful and long-term integration into care practice is now relevant.

    Since the first analysis, the focus in nursing science studies on the use of tracking systems in inpatient long-term care has shifted to ethical aspects. Also, the successful and long-term integration into care practice is now relevant.Introduction Anaplasmosis, a tick-borne illness caused by Anaplasma phagocytophilum (AP), presents with nonspecific clinical symptoms including fever and headache and is often accompanied by laboratory abnormalities of leukopenia, thrombocytopenia and mildly elevated liver function tests (LFTs). Laboratory confirmation of acute infection occurs with nucleic acid amplification (NAAT) testing. This retrospective cohort study aimed to develop a clinical decision support algorithm to aid in decision-making about test ordering. Methods A dataset was constructed with AP NAAT results and time-adjacent complete blood count and LFT results for adult patients tested for AP in a 12.5-year period. A second, smaller dataset matched each patient with a positive AP NAAT to two patients with negative tests. Chart review for clinical symptoms was performed on this smaller dataset. A decision tree algorithm was deployed to identify patient clusters with negative AP NAAT results. Results 137/1204 (11%) patients tested positive by NAAT for AP. In the larger, laboratory-only dataset (n=1204), patients with a platelet count > 177 x 10^3/mcL and age 188 x 10^3/mcL and no fever or chills also did not have positive AP NAAT (58/402, 14%, p less then 0.05). Conclusion We generated two decision trees that can help determine the utility of AP NAAT using readily available clinical and laboratory data. These have the potential to significantly reduce unnecessary AP testing.Lactococcus lactis has great potential for high-yield production of mannitol, which has not yet been fully realized. In this study, we characterize how the mannitol genes in L. lactis are organized and regulated and use this information to establish efficient mannitol production. Although the organization of the mannitol genes in L. lactis was similar to that in other Gram-positive bacteria, mtlF and mtlD, encoding the enzyme IIA component (EIIAmtl) of the mannitol phosphotransferase system (PTS) and the mannitol-1-phosphate dehydrogenase, respectively, were separated by a transcriptional terminator, and the mannitol genes were found to be organized in two transcriptional units an operon comprising mtlA, encoding the enzyme IIBC component (EIIBCmtl) of the mannitol PTS, mtlR, encoding a transcriptional activator, and mtlF, as well as a separately expressed mtlD gene. The promoters driving expression of the two transcriptional units were somewhat similar, and both contained predicted catabolite responsive elemerapeutic and food applications. Until now, to achieve mannitol production in L. lactis with significant titer and yield, it has been necessary to introduce and express foreign genes, which precludes the use of such strains in foods, due to their recombinant status. In this study, we systematically characterize how the mannitol genes in L. lactis are regulated and demonstrate how this impacts mannitol production capability. We harnessed this information and managed to establish efficient mannitol production without introducing foreign genes.