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Look at Burnout Between Anesthesiologists Working in Tibet, The far east: Elevation and also Perspective.
Some antimicrobial peptides (AMPs) and membrane fusion-catalyzing peptides (FPs) stabilize bicontinuous inverted cubic (QII) phases. Previous authors proposed a topological rationale since AMP-induced pores, fusion intermediates, and QII phases all have negative Gaussian curvature (NGC), peptides which produce NGC in one structure also do it in another. This assumes that peptides change the curvature energy of the lipid membranes. Here I test this with a Helfrich curvature energy model. First, experimentally, I show that lipid systems often used to study peptide NGC have NGC without peptides at higher temperatures. To determine the net effect of an AMP on NGC, the equilibrium phase behavior of the host lipids must be determined. Second, the model shows that AMPs must make large changes in the curvature energy to stabilize AMP-induced pores. Peptide-induced changes in elastic constants affect pores and QII phase differently. Changes in spontaneous curvature affect them in opposite ways. The observed correlation between QII phase stabilization and AMP activity doesn't show that AMPs act by lowering pore curvature energy. A different rationale is proposed. In theory, AMPs could simultaneously stabilize QII phase and pores by drastically changing two particular elastic constants. This could be tested by measuring AMP effects on the individual constants. I propose experiments to do that. Unlike AMPs, FPs must make only small changes in the curvature energy to catalyze fusion. It they act in this way, their fusion activity should correlate with their ability to stabilize QII phases.Cellular membranes are fundamental building blocks regulating an extensive repertoire of biological functions. These structures contain lipids and membrane proteins that are known to laterally self-aggregate in the plane of the membrane, forming defined membrane nanoscale domains essential for protein activity. Membrane rafts are described as heterogeneous, dynamic, and short-lived cholesterol- and sphingolipid-enriched membrane nanodomains (10-200 nm) induced by lipid-protein and lipid-lipid interactions. selleck products Those membrane nanodomains have been extensively characterized using model membranes and in silico methods. However, despite the development of advanced fluorescence microscopy techniques, undoubted nanoscale visualization by imaging techniques of membrane rafts in the membrane of unperturbed living cells is still uncompleted, increasing the skepticism about their existence. Here, we broadly review recent biochemical and microscopy techniques used to investigate membrane rafts in living cells and we enumerate persistent open questions to answer before unlocking the mystery of membrane rafts in living cells.
To identify prenatal and neonatal predictors of short-bowel-syndrome related intestinal failure (SBS-IF) in gastroschisis.

This retrospective study included all patients with gastroschisis born between 2000 and 2017 who were enrolled in our home parenteral nutrition (PN) program, and all patients with gastroschisis born in our institution who survived two weeks, during the same time period. Prenatal ultrasound features, neonatal status, anatomic features, oral feeding and PN dependency were analyzed.

Among 180 patients, 35 required long-term PN (SBS-IF group) and 145 acquired full oral feeding within 6 months (OF group). The mean follow-up was 7.9 years [1.6-17.5] and 5.0 years [0.1-18.2], respectively. Both bowel-matting (OR=14.23 [1.07-16.7] (P = .039)) and secondarily diagnosed atresia or stenosis (OR=17.78 [3.13-100.98] (p=0.001)) were independent postnatal predictors of SBS-IF. Eighteen children (51% of the SBS-IF group) were still dependent on artificial nutrition at last follow-up. SBS-IF patients who achieved full oral feeding had a median residual small-bowel length of 74 cm [51-160] vs. 44 cm [10-105] for those still dependent on artificial nutrition (p=0.02). Initial residual small bowel length of > 50 centimeters was the best predictive cut-off for nutritional autonomy with a sensitivity of 67% and a specificity of 100%.

Bowel-matting, complex gastroschisis and secondary intestinal obstruction were associated with SBS-IF in gastroschisis. For SBS-IF patients, small bowel length > 50 cm was predictive of secondary nutritional autonomy.
50 cm was predictive of secondary nutritional autonomy.
To assess for possible missed hypothyroidism in very low birthweight (VLBW) infants whose initial newborn screening (NBS) was within normal reference range.

We analyzed serum TSH obtained at 36 weeks corrected gestational age or at hospital discharge if earlier (Retest TSH) in VLBW infants in the Neonatal Intensive Care Unit in order to determine the prevalence and factors associated with Retest TSH >5 mU/L, a concentration requiring close follow-up for hypothyroidism. Utility of alternative cut-offs for NBS TSH was also assessed.

A total of 398 infants, median gestational age 29 (range 22-36) weeks, birthweight 1138 (470-1498) g, were included in this study. Retest TSH was obtained at 49.5 (12-137) days after birth. Median Retest TSH was 3.1 (0.5-27.9) mU/L. Seventy-three (18.3%) of the cohort had Retest TSH > 5 mU/L. Adjusting NBS cut-off to >15 or >10 mU/L identified <50% of infants with TSH > 5 mU/L, resulting in 6% false positives and >70% false negatives. Multiple regression modeling indicated that 35% of variance in Retest TSH value was explained by NBS TSH concentration, birthweight, and gestational age, all P < .01.

Retesting for hypothyroidism at 36 weeks CGA in VLBW infants with normal NBS could identify infants who require ongoing surveillance until thyroid function has been definitively ascertained. Adjusting NBS TSH cutoffs is not a valid option for identifying potential hypothyroidism in VLBW infants because of lack of sensitivity and, unacceptable false positive and false negative rates.
Retesting for hypothyroidism at 36 weeks CGA in VLBW infants with normal NBS could identify infants who require ongoing surveillance until thyroid function has been definitively ascertained. Adjusting NBS TSH cutoffs is not a valid option for identifying potential hypothyroidism in VLBW infants because of lack of sensitivity and, unacceptable false positive and false negative rates.
To describe the impact of COVID-19 on the neonatology workforce, focusing on professional and domestic workloads.

We surveyed US neonatologists in December 2020 regarding the impact on professional and domestic work during the pandemic. We estimated associations between changes in time spent on types of professional and domestic work and demographic variables with multivariable logistic regression analyses.

Of 758 participants, 67.6% were women. A higher proportion of women than men were in the younger age group (63.3%, 29.3%), held no leadership position (61.4%, 46.3%), had dependents at home (68.8%, 56.3%), did not have a partner or other adult at home (10.6%, 3.2%), and had an employed partner (88.1%, 64.6%; P<.01 for all). A higher proportion of women than men reported a decrease in time spent on scholarly work (35.0%, 29.0%, P=.02) and career development (44.2%, 34.9%, P<.01). A higher proportion of women than men reported spending more time caring for children (74.2%, 55.8%, P<0.01). Reduced time spent on career development was associated with younger age (aOR=2.21; 95% CI, 1.20, 4.08) and number of dependents (aOR=1.21; 95% CI, 1.01, 1.45). Women were more likely to report an increase in time spent time doing domestic work (aOR=1.53; 95% CI, 1.07, 2.19) and a reduction in time on self-care (aOR=0.49; 95% CI, 0.29, 0.81).

COVID-19 impacts the neonatology workforce significantly, disproportionately affecting younger, parent, and women physicians. Targeted interventions are needed to support post-pandemic career recovery and advance physician contributions to the field.
COVID-19 impacts the neonatology workforce significantly, disproportionately affecting younger, parent, and women physicians. Targeted interventions are needed to support post-pandemic career recovery and advance physician contributions to the field.
To evaluate a precise definition of a clinically significant cardiopulmonary event (CSCPE) on the hospital length of stay (LOS), medical provider satisfaction and discharge complications.

This is a single-center, observational study that included 139 infants before, and 134 infants after the new definition was implemented in December 2017. Retrospective data collected November 2015 to November 2017 (before) was compared with prospective data from June 2018 to July 2020 (after). Outcome measures were the proportion of infants waiting to outgrow CSCPE, LOS, provider satisfaction with the definition and discharge complications. Multivariate regression modeling was used to evaluate variables on LOS and PMA at discharge.

The proportion waiting to outgrow CSCPE decreased from 68.4% to 31.7% (P < .0001). LOS was similar between groups; however, multivariate analysis correcting for gestational age and reason awaiting discharge estimated 3.5 days (95% CI of 1.4-5.8 days, p=0.0017) decrease in length of stay and 0.92 weeks (CI 0.29-1.56, p=0.005) younger postmenstrual age (PMA) at discharge in the post-CD group. There was no difference in the number of readmissions or emergency room visits for apnea or deaths. Provider satisfaction improved with discharge planning following the implementation of the definition.

We developed an alternate definition for a CSCPE that decreased the proportion of infants waiting to outgrow a CSCPE but not LOS. There was no difference in the number of readmissions or emergency room visits for apnea or deaths and provider satisfaction in management and discharge planning was greater.
We developed an alternate definition for a CSCPE that decreased the proportion of infants waiting to outgrow a CSCPE but not LOS. There was no difference in the number of readmissions or emergency room visits for apnea or deaths and provider satisfaction in management and discharge planning was greater.
To examine the prevalence of the double burden of malnutrition and its associated factors among adolescents in rural China.

A birth cohort of adolescents born to women in northwestern China who participated in a double-blind, randomized, controlled trial of micronutrient supplementation during pregnancy from August 2002 to January 2006 was enrolled. Follow-up was conducted from June to December 2016.

A total of 2115 participants were analyzed (median age 12 years; IQR±1), the majority of whom were male (59.7%). The nutritional status distribution was 17.72% underweight, 8.62% overweight, 0.96% obese, and 2.58% stunted. Girls were less likely to be overweight/obese (RRR=0.67, 95% CI= 0.48-0.92) but more likely to be underweight (RRR=1.65, 95% CI=1.25-2.17) or stunted (RRR=2.26, 95% CI=1.21-4.22). Children of underweight mothers (RRR=1.63, 95% CI= 1.19-2.25) with a history of small-for-gestational-age (SGA) (RRR=1.64, 95% CI= 1.14-2.36) or described as being a "picky eater" (RRR=1.53, 95% CI= 1.18-1.99) had a higher risk of being underweight. Children whose fathers' education was primary or below (RRR=2.25, 95% CI= 1.11-4.59), with maternal height <150.1 cm (RRR=2.46, 95% CI= 1.12-5.39), or who had underweight mothers (RRR=2.80, 95% CI= 1.37-5.72) had a higher likelihood of stunting. Overweight/obesity was associated with high and middle household wealth (RRR=1.62, 95% CI= 1.14-2.32), overweight mothers (RRR=1.86, 95% CI= 1.25-2.78), and picky eating (RRR=0.62, 95% CI= 0.46-0.84).

Malnutrition (undernutrition and overweight/obesity) is common in rural Chinese adolescents and is associated with perinatal, genetic and economic conditions.
Malnutrition (undernutrition and overweight/obesity) is common in rural Chinese adolescents and is associated with perinatal, genetic and economic conditions.
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