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Functional Contentment model: Optimizing Quality of Life for Nursing Home Residents with Dementia

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International Journal of Clinical medicine 2019年第9期10卷 439-451页

作者： Daniel m. pierce marilyn R. Gugliucci Shirley A. Weaver matureCare Department of Primary Care University of New England College of Osteopathic Medicine Biddeford ME USA Division of Geriatrics Department of Primary Care University of New England College of Osteopathic Medicine Biddeford ME USA University of New England College of Osteopathic medicine (Retired) Biddeford ME USA

The Functional Contentment model (FCm) attains two objectives: 1) building a relationship focused plan of care for nursing home residents diagnosed with dementia;and 2) maximizing and maintaining older adults’ contentment, peace, and happiness while living in dementia care environments. There are three essential components within the FCm: 1) Person/Family Centered Care;2) Slow medicine;and 3) Team Care management. The principles of “Person/Family-Centered Care” are coupled with the philosophy of “Slow medicine,” and neither can exist without the engagement of “Team Care management.” In short, the FCm maximizes the older adult’s potential functioning in activities of daily living, cognition, gross and fine motor skills, communication, and physical well-being, while maintaining the highest possible level of contentment, peace, and happiness. This is accomplished through dynamically utilized professional modalities adapted to the changing needs of the older adult resident—pharmacologic, physical and occupational therapies, family education and involvement, dietary, spiritual, stimulating activities, as well as any individualized modality. The lead for operationalizing the Functional Contentment model is the nursing home medical director, whose key role is assuring a team approach to care including the older adult resident, the family, and all staff (dietary, housekeeping maintenance as well as care and administrative staff). The FCm is a culture change model that has implications in practice and policy for each nursing home.

关键词： Dementia Care Functional Contentment Nursing Home Person-Centered Care

Effects of Hemotech Blood Substitute on Platelets of Percutaneous Coronary Intervention Patients Ex Vivo

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Effects of Hemotech Blood Substitute on Platelets of Percuta...

molecular and epidemiologic characterization of Wilms tumor from Baghdad, Iraq

第十一届国际人工血液大会

作者： J Simoni C Roongsritong G Simoni JF moeller A Kumar m pierce GE meyerrose Texas Tech University Health Sciences Center LubbockTexasU.S.A.and HemoBioTechInc.DallasTexasU.S.A. Texas Tech University Health Sciences Center LubbockTexasU.S.A.and HemoBioTechInc.DallasTexasU.S.A. Texas Tech University Health Sciences Center LubbockTexasU.S.A.and HemoBioTechInc.DallasTexasU.S.A. Texas Tech University Health Sciences Center LubbockTexasU.S.A.and HemoBioTechInc.DallasTexasU.S.A. Texas Tech University Health Sciences Center LubbockTexasU.S.A.and HemoBioTechInc.DallasTexasU.S.A. Texas Tech University Health Sciences Center LubbockTexasU.S.A.and HemoBioTechInc.DallasTexasU.S.A. Texas Tech University Health Sciences Center LubbockTexasU.S.A.and HemoBioTechInc.DallasTexasU.S.A.

＜正＞Coronary Artery Disease（CAD）is the single largest killer of Americans,both males and females Every 26 seconds an American will suffer a coronary event such as a heart attack,and every minute someone will die from *** coronary intervention（PCI）,with balloon dilatation or stent implantation has revolutionized the treatment of *** recent years on

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World Journal of Pediatrics 2018年第6期14卷 585-593页

作者： Hannah m.Phelps mazin F.Al-Jadiry Natasha m.Corbitt Janene m.pierce Bingshan Li Qiang Wei Raina R.Flores Hernan Correa Stefania Uccini Haydar Frangoul Adel R.Alsaadawi Safaa A.F.Al-Badri Amir F.Al-Darraji Raghad m.Al-Saeed Salma A.Al-Hadad Harold N.LovvornⅢ Vanderbilt University School of medicine 2215 Garland AvenueNashvilleTN 37232-9780USA Oncology Unit Children’s Welfare Teaching HospitalBaghdad University Medical CityBaghdadIraq Department of P ediatric Surgery Vanderbilt University Medical CenterNashvilleUSA Department of molecular Physiology and Bioph ysics Vanderbilt University School of MedicineNashvilleUSA Division of P ediatric Pathology Vanderbilt University Medical CenterNashvilleUSA Department of Clinical and molecular medicine Sapienza UniversityRomeItaly Division of P ediatric Hematology and Oncology Vanderbilt University Medical CenterNashvilleUSA Department of P athology Baghdad University Medical CityBaghdadIraq Oncology Unit Children’s Welfare Teaching HospitalWasit University College of MedicineWasitIraq

Background Wilms tumor (WT) is the most common childhood kidney cancer worldwide, yet its incidence and clinical behavior vary according to race and access to adequate healthcare resources. To guide and streamline therapy in the war-torn and resource-constrained city of Baghdad, Iraq, we conducted a first-ever molecular analysis of 20 WT specimens to characterize the biological features of this lethal disease within this challenged population. methods Next-generation sequencing of ten target genes associated with WT development and treatment resistance (WT1, CTNNB1, WTX, IGF2, CITED1, SIX2, p53, N-mYC, CRABP2, and TOP2A) was completed. Immunohistochemistry was performed for 6 marker proteins of WT (WT1, CTNNB1, NCAm, CITED1, SIX2, and p53). Patient outcomes were compiled. Results mutations were detected in previously described WT 'hot spots' (e.g., WT1 and CTNNB1) as well as novel loci that may be unique to the Iraqi population. Immunohistochemistry showed expression domains most typical of blastemal-predominant WT. Remarkably, despite the challenges facing families and care providers, only one child, with combined WT1 and CTNNB1 mutations, was confirmed dead from disease. median clinical follow-up was 40.5 months (range 6–78 months). Conclusions These data suggest that WT biology within a population of Iraqi children manifests features both similar to and unique from disease variants in other regions of the world. These observations will help to risk stratify WT patients living in this difficult environment to more or less intensive therapies and to focus treatment on cell-specific targets.

关键词： Iraq Low- and middle-income countries Next-generation sequencing Pediatric cancer Wilms tumor

Forecasting vulnerability of deep extraction level excavations to drawinduced cave loads

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Journal of Rock mechanics and Geotechnical Engineering 2019年第3期11卷 527-534页

作者： matthew E.pierce pierce Engineering

Block and panel caving methods are increasingly used for mining of large and strong orebodies at large depths below the ground surface (>1 km). This paper focuses on the production phase of caving when the extraction level is fully developed and subjected to the weight of overlying caved material. A limit equilibrium solution for estimation of cave loads is critically reviewed and combined with existing empirical tools in order to forecast extraction level performance under cave loading. The analysis results, presented in nomogram form, suggest that the risk of severe squeezing of extraction level tunnels does not increase with cave depths below 500-1000 m due to the beneficial effects of arching. Under normal extraction ratios (ER = ~50%), severe squeezing experienced from cave loads in deep mines appears to be unlikely in all but the weakest rock masses (σcm mPa, where σcm is the rock mass global strength), even with poor draw control or low drawpoint availability. The likelihood of severe squeezing is greater when large draw areas (HR = 50-75 m, where HR is the hydraulic radius) are combined with low drawpoint availability or poor draw control and locally higher extraction ratios (ER = ~75%), even in better quality rock (σcm = 5-10 mPa). The analysis results are back-analyzed with the extraction level performance before and after a doubling production of rate and draw area at the deep ore zone (DOZ) mine in Indonesia. The extraction level conditions predicted by the nomograms correlate well with the experience at the DOZ, in which extraction level damage increases significantly over the production rampup, accompanied by a significant drop in drawpoint availability.

关键词： Block caving Panel caving Extraction level Draw control Squeezing

Homotypic Vacuole Fusion Requires VTI11 and Is Regulated by Phosphoinositides

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molecular Plant 2014年第6期7卷 1026-1040页

作者： Sang Won Han maria Fernanda Rodriguez-Welsh marcela Rojas-pierce Department of Plant and microbial Biology North Carolina State University Raleigh NC 27695 USA

most plant cells contain a large central vacuole that is essential to maintain cellular turgor. We report a new mutant allele of VTI11 that implicates the SNARE protein VTI11 in homotypic fusion of protein storage and lytic vacuoles. Fusion of the multiple vacuoles present in vtill mutants could be induced by treatment with Wortmannin and LY294002, which are inhibitors of Phosphatidylinositol 3-Kinase （PI3K）. We provide evidence that Phosphatidylinositol 3-Phosphate （Ptdlns（3）P） regulates vacuole fusion in vtill mutants, and that fusion of these vacuoles requires intact microtubules and actin filaments. Finally, we show that Wortmannin also induced the fusion of guard cell vacuoles in fava beans, where vacuoles are naturally fragmented after ABA-induced stomata closure. These results suggest a ubiquitous role of phosphoinositides in vacuole fusion, both during the development of the large central vacuole and during the dynamic vacuole remodeling that occurs as part of stomata movements.

关键词： vacuole SNARE phosphoinositides membrane fusion Wortmannin.

mercury source zone identification using soil vapor sampling and analysis

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Frontiers of Environmental Science & Engineering 2015年第4期9卷 596-604页

作者： David WATSON Carrie mILLER Brian LESTER Kenneth LOWE George SOUTHWORTH mary Anna BOGLE Liyuan LIANG Eric pierce Environmental Sciences Division Oak Ridge National Laboratory PO Box 2008 MS 6038 Oak Ridge TN 37831 USA

Development and demonstration of reliable measurement techniques that can detect and help quantify the nature and extent of elemental mercury （Hg（0）） in the subsurface are needed to reduce uncertainties in the decision-making process and increase the effectiveness of remedial actions. We conducted field tests at the Y-12 National Security Complex in Oak Ridge, Tennessee, USA, to determine if sampling and analysis of Hg（0） vapors in the shallow subsurface （〈0.3 m depth） can be used to as an indicator of the location and extent of Hg（0） releases in the subsurface. We constructed a rigid polyvinyl chloride push probe assembly, which was driven into the ground. Soil gas samples were collected through a sealed inner tube of the assembly and were analyzed immediately in the field with a Lumex and/or Jerome Hg（0） analyzer. Time-series sampling showed that Hg vapor concentrations were fairly stable over time, suggesting that the vapor phase Hg（0） was not being depleted and that sampling results were not sensitive to the soil gas purge volume. Hg（0） vapor data collected at over 200 push probe locations at 3 different release sites correlated very well to areas of known Hg（0） contamination. Vertical profiling of Hg（0） vapor concentrations conducted at two locations provided information on the vertical distribution of Hg（0） contamination in the subsurface. We conclude from our studies that soil gas sampling and analysis can be conducted rapidly and inexpensively at large scales to help identify areas contaminated with Hg（0）.

关键词： push probe spill characterization mapping,gas

Lost in the Present: Anterograde Amnesia and medical Decision making Capacity

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Open Journal of medical Psychology 2014年第1期3卷 54-59页

作者： John mcKelvie Christopher A. pierce Thomas m. Dunn Philippe Weintraub Robert m. House Behavioral Health Service Denver Health Medical Center Denver USA Palm Desert VA Clinic VA Loma Linda Health Care System Palm Desert USA

Although there have been a limited number of case reports of human bilateral hippocampal injury, none of these have addressed the impact of such injuries on medical decision making capacity. The authors present a case of an elderly man with discrete bilateral hippocampal injury. As a result of his injury, the patient was hopelessly “lost in the present” and only retained the basic cognitive functions necessary to have decision making capacity for a limited period of time. He was unable to appreciate the nature of his injury, the potential risks involved in his decisions, and the recommended course of treatment longer than a few minutes. The patient’s resultant neurocognitive deficits left him lacking medical decision making capacity, a likely outcome for patients with persistent anterograde amnesia.

关键词： Bilateral Hippocampal Injury Anterograde Amnesia Capacity medical Decision making Capacity Episodic memory Prospective Brain

Unique mR Findings in a Case Series of Two Symptomatic Patients with Peliosis Hepatis

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Open Journal of Radiology 2014年第1期4卷 79-84页

作者： Drew pierce Christopher S. Davis Paul m. Bloomston Zarine K. Shah Department of Radiology Ohio State University Wexner Medical Center Columbus USA Department of Surgery Ohio State University Wexner Medical Center Columbus USA

Purpose: The aim of this report is to describe the unusual mR imaging characteristics observed in two patients with biopsy-proven peliosis hepatis. Imaging findings using gadoxetate disodium (Eovist) as the contrast agent in a patient with peliosis hepatis are presented for the first time. methods: This is a retrospective review of the mRI findings in two patients reviewed independently by two specialized abdominal imaging radiologists. The radiological findings were correlated with clinical history and histopathology. Results: Peliosis hepatis is a rare clinical and radiological entity that is often a diagnostic dilemma due to its non-specific clinical characteristics. Unusual imaging characteristics in this rare entity make diagnosis even more challenging. Conclusions: Improved understanding of the imaging characteristics of peliosis hepatis may prevent unnecessary and potentially dangerous biopsies in select patients with peliosis hepatis. This requires a high index of suspicion for practicing radiologists due to the rarity of this disease.

关键词： Peliosis Hepatis magnetic Resonance Imaging Hepatic lesions Liver Disease Gadoxetate Disodium

Short Communication: Effect of Timing of Introduction to Pasture Post Calving and Supplementation with <i>Saccharomyces cerevisiae</i>on milk Fatty Acid Profiles in Early Lactation Dairy Cows

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Food and Nutrition Sciences 2013年第9期4卷 45-50页

作者： Karina mary pierce Radwan m. Alibrahim Rafael Alejandro Palladino Stephen Joseph Whelan Finbar John mulligan Arasco Feeds Riyadh KSA Department of Animal Production University of Buenos Aires Buenos Aires City Argentina School of Agriculture and Food Science University College Dublin Dublin Ireland School of Veterinary medicine University College Dublin Dublin Ireland.

There is increased public awareness of the effect of dietary fatty acid (FA) profile on human health. Therefore, when devising nutritional management strategies for dairy cows it is important to evaluate the effects of said strategies on the FA profile of the milk. This experiment investigates the effects of two early PP nutritional management strategies (Nm);abrupt introduction to pasture (AP) or a total mixed ration for 21 d followed by a gradual introduction to pasture over 7 d (GP), with (Y) or without (C) live yeast (YS) on milk fatty acid (FA) profile. Forty multiparous dairy cows were assigned to one of four dietary treatments in a two (AP vs. GP) by two (Y vs. C) factorial, randomized block design. The experiment was conducted from d 1 to 70 PP. Pasture, TmR and concentrate samples were taken weekly to assess the chemical and FA composition. milk yield was recorded daily and individual milk samples were collected weekly to determine milk FA composition. There was no interaction between Nm strategy and YS supplementation on milk FA. Similarly, YS supplementation did not affect milk FA profile. However, GP had higher concentrations of C10 (P = 0.04), C12 (P = 0.01), C14 (P = 0.02) and medium chain FA (P = 0.02) vs. AP. Whereas AP had higher concentrations of the FA cis-9, C18:1 (P mposition of the milk produced when compared to the milk from a dairy cow gradually introduced to pasture.

关键词： Fatty Acid Dairy Cow Nutrition Post-Partum