scholarly journals Co-enrolment to UK Critical Care Studies – A 2019 update

2020 ◽  
pp. 175114372097154
Author(s):  
Timothy Felton ◽  
Natalie Pattison ◽  
Simon Fletcher ◽  
Simon Finney ◽  
Tim Walsh ◽  
...  
Keyword(s):  
Critical Care ◽  
Health Research ◽  
Time Frame ◽  
High Quality Research ◽  
Deferred Consent ◽  
Ventilation Weaning ◽  
Trial Outcomes ◽  
Mechanical Ventilation Weaning ◽  
Short Time ◽  
Critical Care Trial

In 2013, a group of clinicians on behalf of the National Institute for Health Research, collaborated with ICU Steps to produce guidance about people being enrolled in more than one critical care trial. This is referred to as “co-enrolment” and can be where a person takes part in one study at the same time as another study (or one after the other in a short time-frame). For instance, being part of a study looking at sepsis drugs and a mechanical ventilation weaning study. The drivers for developing this guidance were a lack of any existing guidance, nationally and internationally, at that time, and a desire to ensure high quality research is conducted. The emphasis was on making trials as safe as possible for patients and ensuring robust trial outcomes. Critical care was seen to lead in this, with our exemplar guidance used across all health research. We wish to revisit this guidance now that there is more experience of coenrolment in critical care trials. There is also more awareness of different consent models, such as deferred consent (taking consent when a person is awake and able to give consent) and consultee consent (asking families or independent professionals to consent). Consenting to coenrolment is an important ethical consideration for the revision of this guidance.

scholarly journals A Survey of Mechanical Ventilation Weaning Practices in ICUs of Bangladesh

2021 ◽  
Vol 9 (1) ◽  
pp. 4-11
Author(s):  
Mohammad Omar Faruq ◽  
ASM Areef Ahsan ◽  
Kaniz Fatema ◽  
Fatema Ahmed ◽  
Amina Sultana ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Critical Care ◽  
Neuromuscular Disorders ◽  
Spontaneous Breathing Trial ◽  
For Profit ◽  
Ventilation Weaning ◽  
Cuff Leak ◽  
Cough Strength ◽  
Gag Reflex ◽  
Mechanical Ventilation Weaning

Objective : To determine mechanical ventilation discontinuation (weaning) practices in Bangladesh as there is currently no data available on this issue. Method : Analyzing the Survey on Bangladeshi respondents using questionnaire developed by and used by a pan Asian study where Bangladesh critical care physicians participated. Result : 40 physicians from 10 ICUs of Bangladesh participated. Majority of our participating doctors (62.5%) came from private for profit hospital. 19 out of 40 respondents were certified in critical care medicine. In our study spontaneous breathing trial (SBT) was liberally used with pressure support being used by 30% respondents. Most of the extubation trial took place during day. As criteria for extubation, respondents mainly considered consciousness and cooperation and along with gag reflex, cough strength, suction frequency and cuff leak at different times. Noninvasive ventilation (NIV) was commonly used for early extubation in cases of COPD, cardiogenic pulmonary edema, neuromuscular disorders, post-operative cases and obesity. Slightly less than half of respondents did not follow any sedation protocol and 42.5% followed weaning protocol. Protocolized weaning by nurses are not known to be practiced in Bangladesh. Conclusion : Weaning practices are diverse in Bangladeshi ICUs. Protoclized weaning is rarely practiced in Bangladesh. Bangladesh Crit Care J March 2021; 9(1): 4-11

scholarly journals Metode Penyapihan Ventilasi Mekanik Di Intensive Care Unit: Studi Literatur

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Sarinti Sarinti ◽  
Reni Sulung Utami ◽  
Awal Prasetyo
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Critical Care ◽  
Intensive Care ◽  
Critical Care Nursing ◽  
Literature Study ◽  
Ventilation Weaning ◽  
Mechanical Ventilation Weaning ◽  
Google Search ◽  
Care Nursing

Latar belakang : Pasien di ICU ( Intensive Care Unit ) yang membutuhkan bantuan ventilasi mekanik hampir mencapai 30% dari total pasien. Ventilasi mekanik yang digunakan dalam jangka panjang dapat meningkatkan resiko terjadinya mortalitas, dan ventilator associated pneumonia sehingga diperlukan perencanaan penyapihan yang tepat.  Tujuan : Studi literatur ini bertujuan untuk mengidentifikasi metode penyapihan pasien dari ventilasi mekanik di ICU. Metode : Penelusuran literatur dilakukan melalui database Google scholar dan Google search dengan menggunakan kata kunci weaning mechanical ventilation, weaning protocol, critical care nursing. Literatur yang digunakan dari tahun 1997-2015 dalam bentuk full text. Literatur yang sesuai kriteria inklusi dan eksklusi dianalisis secara narasi. Hasil: Penelusuran mendapatkan 7 artikel penelitian yang menunjukkan metode penyapihan pasien dari ventilasi mekanik. Metode penyapihan dari ke 7 artikel tersebut adalah metode protokol dan non protokol. Metode non protokol misalnya physician direct weaning ( PDW ) dan collaboration weaning plan ( CWP ). Metode penyapihan dengan protokol antara lain : nurse` protokol directed weaning ( NPDW ) dan protokol base weaning ( PBW ). Kesimpulan : Metode penyapihan protokol menunjukkan hasil lebih efektif dibandingkan metode non protokol. Kata Kunci: Penyapihan Ventilasi Mekanik, Protokol Penyapihan, Keperawatan Kritis Methode of Weaning from Mechanical Ventilation in Intensive Care Unit : Study Literature ABSTRACT Back ground : patients in the ICU who require mechanical ventilation assistance almost 30% of the total patients. Mechanical ventilation is used in the long term can increase the risk of mortality and ventilator associated pneumonia so that proper planning is necessary weaning. Objectives : the literature study aims to identify methods of weaning patients from mechanical ventilation in the ICU. Methods : the literature study search pass through by Google scholar and Google search using keywords weaning mechanical ventilation, weaning protocol, critical care nursing. Literature is used from the year 1997-2015 in the form of full text. Appropriate literature inclusion and exclusion criteria were analyzed narrative. Results : search get 7 articles studies showing methods of weaning patients from mechanical ventilation. Method of weaning to the article 7 is the method protocol and non-protocol. Methods of non protocols eg physician-direct weaning ( PDW ) and collaboration weaning plan ( CWP ). Methods of weaning protocols include: nurse` protocol directed weaning (NPDW) and protocols base weaning ( PBW ). Conclusion : the method of weaning protocol shows the results more effective than non - protocol methods Key word : weaning mechanical ventilation; weaning protocol; critical care nursing

scholarly journals Polyethylene Migration from Food Packaging on Cheese Detected by Raman and Infrared (ATR/FT-IR) Spectroscopy

Materials ◽  
2021 ◽  
Vol 14 (14) ◽  
pp. 3872
Author(s):  
Klytaimnistra Katsara ◽  
George Kenanakis ◽  
Zacharias Viskadourakis ◽  
Vassilis M. Papadakis
Keyword(s):  
Vibrational Spectroscopy ◽  
Food Packaging ◽  
Time Frame ◽  
Low Density Polyethylene ◽  
Low Density ◽  
Ft Ir ◽  
Comparative Results ◽  
Short Time ◽  
And Storage ◽  
Ft Ir Spectroscopy

For multiple years, food packaging migration has been a major concern in food and health sciences. Plastics, such as polyethylene, are continuously utilized in food packaging for preservation and easy handling purposes during transportation and storage. In this work, three types of cheese, Edam, Kefalotyri and Parmesan, of different hardness were studied under two complementary vibrational spectroscopy methods, ATR-FTIR and Raman spectroscopy, to determine the migration of low-density polyethylene from plastic packaging to the surface of cheese samples. The experimental duration of this study was set to 28 days due to the degradation time of the selected cheese samples, which is clearly visible after 1 month in refrigerated conditions at 4 °C. Raman and ATR-FTIR measurements were performed at a 4–3–4–3 day pattern to obtain comparative results. Initially, consistency/repeatability measurement tests were performed on Day0 for each sample of all cheese specimens to understand if there is any overlap between the characteristic Raman and ATR-FTIR peaks of the cheese with the ones from the low-density polyethylene package. We provide evidence that on Day14, peaks of low-density polyethylene appeared due to polymeric migration in all three cheese types we tested. In all cheese samples, microbial outgrowth started to develop after Day21, as observed visually and under the bright-field microscope, causing peak reverse. Food packaging migration was validated using two different approaches of vibrational spectroscopy (Raman and FT-IR), revealing that cheese needs to be consumed within a short time frame in refrigerated conditions at 4 °C.

scholarly journals Mechanical ventilation weaning issues can be counted on the fingers of just one hand: part 2

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Luigi Vetrugno ◽  
Alessandro Brussa ◽  
Giovanni Maria Guadagnin ◽  
Daniele Orso ◽  
Francesco De Lorenzo ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Hand Part ◽  
Ventilation Weaning ◽  
Mechanical Ventilation Weaning

scholarly journals Breeding Strategies to Improve Miscanthus as a Sustainable Source of Biomass for Bioenergy and Biorenewable Products

Agronomy ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. 673 ◽  
Author(s):  
John Clifton-Brown ◽  
Kai-Uwe Schwarz ◽  
Danny Awty-Carroll ◽  
Antonella Iurato ◽  
Heike Meyer ◽  
...  
Keyword(s):  
Significant Contribution ◽  
Perennial Grass ◽  
Time Frame ◽  
Eastern Asia ◽  
Germplasm Collections ◽  
Naturally Occurring ◽  
Wide Range ◽  
Yield Quality ◽  
Short Time ◽  
Commercial Expansion

Miscanthus, a C4 perennial grass native to Eastern Asia, is being bred to provide biomass for bioenergy and biorenewable products. Commercial expansion with the clonal hybrid M. × giganteus is limited by low multiplication rates, high establishment costs and drought sensitivity. These limitations can be overcome by breeding more resilient Miscanthus hybrids propagated by seed. Naturally occurring fast growing indigenous Miscanthus species are found in diverse environments across Eastern Asia. The natural diversity provides for plant breeders, the genetic resources to improve yield, quality, and resilience for a wide range of climates and adverse abiotic stresses. The challenge for Miscanthus breeding is to harness the diversity through selections of outstanding wild types, parents, and progenies over a short time frame to deploy hybrids that make a significant contribution to a world less dependent on fossil resources. Here are described the strategies taken by the Miscanthus breeding programme at Aberystwyth, UK and its partners. The programme built up one of the largest Miscanthus germplasm collections outside Asia. We describe the initial strategies to exploit the available genetic diversity to develop varieties. We illustrate the success of combining diverse Miscanthus germplasm and the selection criteria applied across different environments to identify promising hybrids and to develop these into commercial varieties. We discuss the potential for molecular selections to streamline the breeding process.

Physicians declining patient enrollment in a critical care trial: a case study in thromboprophylaxis

2013 ◽  
Vol 39 (12) ◽  
pp. 2115-2125 ◽  
Author(s):  
D. Cook ◽  
◽  
Y. Arabi ◽  
N. D. Ferguson ◽  
D. Heels-Ansdell ◽  
...  
Keyword(s):  
Critical Care ◽  
Patient Enrollment ◽  
Critical Care Trial

Ranking the explanatory power of factors associated with worldwide new Covid-19 cases

2021 ◽  
Author(s):  
Aristides Moustakas
Keyword(s):  
Explanatory Power ◽  
Interdisciplinary Approach ◽  
Time Frame ◽  
Variance Partitioning ◽  
Total Variance ◽  
Disease Spread ◽  
Spatial Spread ◽  
Global Pandemic ◽  
Governmental Intervention ◽  
Short Time

Abstract Disease spread is a complex phenomenon requiring an interdisciplinary approach. Covid-19 exhibited a global spatial spread in a very short time frame resulting in a global pandemic. Data of new Covid-19 cases per million were analysed worldwide at the spatial scale of a country and time replicated from the end of December 2019 to late May 2020. Data driven analysis of epidemiological, economic, public health, and governmental intervention variables was performed in order to select the optimal variables in explaining new Covid-19 cases across all countries in time. Sequentially, hierarchical variance partitioning of the optimal variables was performed in order to quantify the independent contribution of each variable in the total variance of new Covid-19 cases per million. Results indicated that from the variables available new tests per thousand explained the vast majority of the total variance in new cases (51.6%) followed by the governmental stringency index (15.2%). Availability of hospital beds per 100k inhabitants explained 9% extreme poverty explained 8.8%, hand washing facilities 5.3%, the fraction of the population aged 65 or older explained 3.9%, and other disease prevalence (cardiovascular diseases plus diabetes) explained 2.9%. The percentage of smokers within the population explained 2.6% of the total variance, while population density explained 0.6%.

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