Marked Reduction In Length Research Articles

Insight of Oxidative Stress, Ultrastructural Transformations, and Elemental Variations in Rice Seedlings Exposed to Boron Toxicity: Unraveling the Role of Fe-SOD in Boron Tolerance

Rice (Oryza sativa L.) seedlings differing in boron tolerance were grown in hydroponics containing varying boron concentration. (as boric acid) for 8 days. Yoshida Nutrient Solution (Yoshida et al.1976) served as control, whereas 0.5 mM boron (moderately toxic) and 1.5 mM boron (highly toxic). Boron excess (B) caused marked reduction in length, biomass and relative water content of the seedlings, with more reductions in B-sensitive cv. Malaviya-36 as compared with B-tolerant cv. Brown Gora. B-sensitive seedlings showed higher B uptake in roots and shoots compared to the tolerant. Scanning electron microscopy (SEM) revealed ultrastructural damage to the guard cells with excess boron. Energy dispersive X-ray analysis (EDXA) of rice leaves showed decline in concentration of P, S, Ca and Mg in seedlings on B treatment. Increased production of reactive oxygen species O2˙−, H2O2, lipid peroxides, alteration in activity of antioxidative enzymes and increased membrane permeability was observed in B treated seedlings compared to controls. Real time PCR analysis of stress regulatory genes indicated differential expression of SOD isoforms in the two sets of cultivars with B treatment. Interestingly seedlings of B-tolerant cultivar were characterized by higher level of expression of Fe-SOD and its further increased expression on B treatment. Results suggest that B toxicity involves ultrastructural and elemental changes, increased generation of ROS and altered antioxidative enzyme activities in rice seedlings and increased expression Fe-SOD isoform appears to be associated with B tolerance.

Implementation of the European Society of Cardiology 0/3-hour accelerated diagnostic protocol, using high sensitive troponin T: a clinical practice evaluation of safety and effectiveness involving 3003 patients with suspected acute coronary syndrome

BackgroundThere have been relatively few studies detailing the real-world effectiveness and safety of accelerated diagnostic protocols (ADP), using high sensitivity cardiac troponin (hs-cTn).ObjectiveTo analyse the safety and effectiveness of early...

Evaluation of a Pathway team for homeless mental health in-patients.

The Pathway model is an enhanced care coordination model for homeless people in hospital. We aimed to evaluate the first attempt to apply it on psychiatric wards, which started in 2015 in South London. We developed a logic model which expressed how the Pathway approach might work. Two predictions from this model were tested, using propensity scores and regression to estimate the effect of the intervention among people who were eligible for it. The Pathway team theorised that their interventions would reduce length of stay, improve housing outcomes and optimise the use of primary care - and, more tentatively, reduce readmission and emergency presentations. We were able to estimate effects on length of stay (-20.3 days; 95% CI -32.5 to -8.1; P = 0.0012) and readmission (a non-significant reduction). The marked reduction in length of stay, explicable in terms of the logic model, constitutes preliminary support for the Pathway model in mental health services.

Implementation of the ESC 0/3hour accelerated diagnostic protocol,utilising high sensitive troponin T, for suspected acute coronary syndrome:a study on clinical effectiveness involving 3016 patients

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): Liverpool University Hospitals NHS Foundation Trust Background There have been relatively few studies detailing the real-world effectiveness and safety of accelerated diagnostic protocols (ADP), using high sensitivity troponins (HSTN). Purpose To analyse the safety and effectiveness of early emergency room (ER) discharge following implementation of the ESC 0/3-hour ADP for suspected acute coronary syndromes (ACS) Method We prospectively studied 2 cohorts of consecutive suspected acute coronary syndromes (ACS) presentations to ER before (n = 1642) and after (n = 1376, 2 centres) implementation of the ESC 0/3-hour ADP incorporating limit of detection rule out. All index presentations with HSTNT (high sensitive troponin T) >99th percentile underwent independent two physician adjudication for MI (myocardial infarction) using all available data to six weeks. Safety was defined by both NPV (negative predictive value) and sensitivity for type 1 or type 2 MI for those with ER discharge and clinical effectiveness by percentage ER discharge. Results In the pre-implementation period there was a higher prevalence of MI. Discharge from ER increased by >100% to 56% of the cohort, when the ADP was implemented. This correlated with a marked reduction in length of stay overall and a more modest reduction for those discharged from ER (table) The greatly increased ER discharge was safe with no signal for hazard. Analysis of HSTNT values and ECGS revealed a maximum ER discharge rate of 69%, by applying the 0/3-hour protocol, implying potential for further increasing safe ER discharge. Conclusions Implementation of an ADP with HSTNs is safe and effective for early rule-out and discharge of suspected ACS. Further research into the shortfall between theoretical and actual early ER discharge achieved is warranted. DischargePre-implementation0/3hour ADP implementationP valuen16421376% male52.352.1nsAge (median)5855<0.001Index Type 1 or 2 MI prevalence (%)11.96<0.001% discharged from ER2756<0.001Median total length of stay (hours) {global population}16.37.1<0.001Median length of stay (hours)- discharged from ER6.25.4<0.001NPV for index type 1 or 2 MI (discharged from ER)99.399.7nsSensitivity index type 1 or 2 MI (discharged from ER)98.597.6ns

Marked Reduction in Length of Stay for Patients With Psychiatric Emergencies After Implementation of a Comanagement Model

Patients with psychiatric emergencies often spend excessive time in an emergency department (ED) due to limited inpatient psychiatric bed capacity. The objective was to compare traditional resident consultation with a new model (comanagement) to reduce length of stay (LOS) for patients with psychiatric emergencies. The costs of this model were compared to those of standard care. This was a before-and-after study conducted in the ED of an urban academic medical center without an inpatient psychiatry unit from January 1, 2007, through December 31, 2009. Subjects were all adult patients seen by ED clinicians and determined to be a danger to self or others or gravely disabled. At baseline, psychiatry residents evaluated patients and made therapeutic recommendations after consultation with faculty. The comanagement model was fully implemented in September 2008. In this model, psychiatrists directly ordered pharmacotherapy, regularly monitored effects, and intensified efforts toward appropriate disposition. Additionally, increased attending-level involvement expedited focused evaluation and disposition of patients. An interrupted time series analysis was used to study the effects of this intervention on LOS for all psychiatric patients transferred for inpatient psychiatric care. Secondary outcomes included mean number of hours on ambulance diversion per month and the mean number of patients who left without being seen (LWBS) from the ED. A total of 1,884 patient visits were considered. Compared to the preintervention phase, median LOS for patients transferred for inpatient psychiatric care decreased by about 22% (p < 0.0005, 95% confidence interval [CI] = 15% to 28%) in the postintervention phase. Ambulance diversion hours increased by about 40 hours per month (p = 0.008, 95% CI = 11 to 69 hours) and the mean number of patients who LWBS decreased by about 26 per month (p = 0.106; 95% CI = -60 to 5.9 visits per month) in the postintervention phase. A comanagement model was associated with a marked reduction in the LOS for this patient population.

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Minimally invasive surgical approach for the low back pain

The fact that minimally invasive surgery for the low back pain is considerably less traumatic has been documented by two broad categories consisted of intradiscal therapeutic and endoscopic procedures. A marked reduction in length of hospitalization has been noted in many cases. Surgeons should select the procedure, or combination of procedures, best suited to benefit of the patient.

Mortality trends for 23,505 Medicare patients hospitalized with heart failure in Northeast Ohio, 1991 to 1997

Background Clinical trials have identified major therapeutic advances for heart failure (HF), but the degree to which survival has improved among the general population of patients with HF is not known. This study analyzed mortality trends from 1991 to 1997 for 23,505 Medicare patients hospitalized with a first admission for HF at 29 Northeast Ohio hospitals. Methods We linked databases from the Cleveland Health Quality Choice (CHQC) program and Medicare to allow identification of first admissions for HF and death date. We adjusted for changes in admission illness severity using chart data from CHQC (eg, vital signs, do-not-resuscitate status, comorbid conditions, and laboratory results). Logistic regression was used to analyze trends in risk-adjusted mortality. Results At baseline (1991), crude inhospital, 30-day and 1-year mortality rates were 6.4%, 8.6% and 36.5%, respectively. Between 1991 and 1997, mean length of stay declined steeply from 9.2 days to 6.6 days ( P < .001 for trend). Risk-adjusted inhospital mortality also declined markedly (absolute-decline −3.7%, 95% CI −4.3 to −3.0), a 52.8% relative decrease. However, the decline in 30-day mortality was only −1.4% (95% CI −2.5 to −0.1, P < .05), a 15.3% relative decrease. The 1-year mortality declined −5.3% (95% CI −3.2 to −7.4, P < .001), a 14.6% relative decrease. Conclusions Long-term mortality for patients hospitalized with HF improved from 1991 to 1997, although mortality remains very high. The 30-day mortality declined far less than inhospital mortality, indicating that mortality shortly after discharge increased. This raises concerns that the marked reduction in length of stay is causing adverse consequences.

Vascular surgical society of great britain and ireland: integrated care pathways for vascular surgery

BACKGROUND: Integrated care pathways (ICPs) represent a multidisciplinary approach to clinical patient care. METHODS: A 1-year prospective trial of the use of ICPs for elective vascular surgical procedures was undertaken. A multidisciplinary group constructed ICPs for patients admitted for open repair of abdominal aortic aneurysm, carotid endarterectomy or femoropopliteal bypass grafting. Patient management followed ICPs on a daily basis with signatures required to confirm that each action had been taken. Variances from the ICPs were carefully recorded. Audit of variance data allowed subsequent revision of the ICPs and hence provision of the best possible nursing and clinical practice. METHODS: A total of 33 patients were entered into the study; 16 had a femoropopliteal bypass graft, eight carotid endarterectomy and nine open repair of an abdominal aortic aneurysm. ICPs were well received by patients and staff. They improved communication, promoted an appreciation of each health group's role in patient care, increased nursing autonomy, reduced calls to junior medical staff, improved patient education and confidence, and caused a marked reduction in length of hospital stay. Overall, patients were discharged 13 per cent earlier after open abdominal aortic aneurysm repair, 22 per cent earlier after carotid endarterectomy and 38 per cent earlier after femoropopliteal bypass grafting. CONCLUSION: ICPs have clear benefits. They improve overall clinical efficiency and enhance clinical governance. Successful use of ICPs depends upon 'clinical champions' and effective project management. Sufficient resources and training are essential.

Mortality Following Hip Fracture Before and After Implementation of the Prospective Payment System

Recent studies of patients with hip fractures from two hospitals have suggested that the marked reduction in length of stay that occurred following implementation of the Medicare prospective payment system (PPS) resulted in decreased quality of care for these patients. To assess whether this change influenced mortality, we studied patients with hip fractures aged 65 years or older from a 20% sample of Michigan Medicare enrollees. There were 2130 such patients in the 2 years preceding (October 1981 through September 1983) and 2238 in the 2 years following (October 1984 through September 1986) implementation of PPS. Although the demographic characteristics of patients with hip fractures did not change after PPS, the mean length of stay (95% confidence interval) decreased by 4.4 (4.1 to 4.7) days. However, mortality in the year following the fracture did not change: 23.2% before PPS, 23.7% after PPS; rate difference of 0.5% (-2.0 to 3.0). This finding was consistently present within subgroups defined by patient demographic characteristics. Furthermore, when the analysis was restricted to patients treated in those hospitals with the greatest reduction in average length of stay following PPS (7.5 days, or 35%), there was no significant change in 1-year mortality. For those patients who were enrolled in Medicaid and not in a nursing home at the time of the fracture, there was no increase in the rate of nursing home residence 1 year after the fracture. Thus, the findings of this population-based study suggest that the key outcomes of postfracture mortality and nursing home residence were not affected by the implementation of PPS.

Comparison of the effects of excess vitamin A and high oxygen tension on in vitro epiphyseal plate growth. I. Morphologic response.

Epihyseal plate organ cultures grown in medium containing excess vitamin A (100 USP units/ml) showed marked reduction in the length of the cartilage component of the explant, progressive loss of acid mucopolysaccharide stainability of the cartilage matrix, loss of the zone of hypertrophic cells followed by the loss of all zoning, an accumulation of cells at the bone-cartilage junction, and eventual detachment of the cartilage from the bone. Epsilon partially reversed these effects. Explants grown in 90% oxygen showed no reduction in the length of the cartilage component, a progressive loss of acid mucopolysaccharide stainability of the cartilage matrix narrowing and eventual loss of the zone of hypertrophic cells, an accumulation of an acellular, PAS-positive debris at the bone-cartilage junction, and marked reduction in length of the bone component of the explant. EACA and chloroquine partially reversed these effects.

Length of Life of the Sexes in Nasonia Vitripennis (Walker) (Hymenoptera, Pteromalidae) Under Conditions of Starvation

ABSTRACT At relative humidities of 65 and 100% the mean length of life of virgin or mated females of Nasonia vitripennis is greater than that of the males under similar conditions. The sexes showed no significant difference in their respiratory rates, as measured by Warburg manometer or Macfadyen’s continuous recording respirometer. An examination of the organs of fed and starved individuals of both sexes showed that the only major change in the organs of starved individuals which can have any bearing on the length of life is the marked reduction in length of the ovaries resulting from resorption of the mature eggs. It is suggested that the resorbed eggs supply the female with the nutriment which enables it to outlive the male when both are starved.

The prenatal growth and natal involution of the human uterus.

The human uterus undergoes a marked reduction in length and weight in the first few weeks following birth. This was first described by Lyubetski,1 and later, independently, by Bayer2 and by Conte.3 This reduction takes place through hypoplasia and hypotrophy of the uterine muscle, together with a disappearance of the marked natal hyperemia of the organ. It is supposed to be caused by the withdrawal at birth of a hormone produced by the placenta, the ovary or the tissues of both of these structures, (Aschner,4 Herrmann,5 Fellner,6, 7 Frank,8, 9 and others.) Little is known of the fetal growth of the uterus which precedes this natal reduction. The present study is based upon a total of 207 observations on the length of the uterus, 89 of fetal uteri, 62 of uteri of infants stillborn or dying within 48 hours after birth, and 56 uteri of children over 2 days and under 1 year of age.A graphic analysis of this material is shown in the accompanying figure, in which the mean uterus length for 5 cm. intervals of to...