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Background: A significant proportion of cardiac surgery intensive care unit (CSICU) patients require long-term ventilation, necessitating tracheostomy placement. The goal of this study was to evaluate the long-term postoperative outcomes and complications associated with percutaneous dilatational tracheostomy (PDT) in CSICU patients. Methods: All patients undergoing PDT after cardiac, thoracic, or vascular operations in the CSICU between January 1, 2013 and January 1, 2021 were identified. They were evaluated for mortality, decannulation time, and complications including bleeding, infection, and need for surgical intervention. Multivariable regression models were used to identify predictors of early decannulation and the complication rate. Results: Ninety-three patients were identified for this study (70 [75.3%] male and 23 [24.7%] female). Furthermore, 18.3% of patients had chronic obstructive pulmonary disease (COPD), 21.5% had history of stroke, 7.5% had end-stage renal disease, 33.3% had diabetes, and 59.1% were current smokers. The mean time from PDT to decannulation was 39 days. Roughly one-fifth (20.4%) of patients were on dual antiplatelet therapy and 81.7% had anticoagulation restarted 8 hours post-tracheostomy. Eight complications were noted, including 5 instances of bleeding requiring packing and 1 case of mediastinitis. There were no significant predictors of decannulation prior to discharge. Only COPD was identified as a negative predictor of decannulation at any point in time (hazard ratio, 0.28; 95% confidence interval, 0.08–0.95; p=0.04). Conclusion: Percutaneous tracheostomy is a safe and viable alternative to surgical tracheostomy in cardiac surgery ICU patients. Patients who undergo PDT have a relatively short duration of tracheostomy and do not have major post-procedural complications.

In this paper, I explore the use of long-term, hands-on learning activities for Classics courses. I will show that a carefully designed project can complement classroom lectures on Greek and Roman culture and contribute towards the development of students’ critical thinking and group work skills. As an example, I describe a successful hands-on learning project that I designed for my Ancient Greek Cities course at Monmouth College (USA). The students were tasked with researching and building an historically faithful, ancient Greek mudbrick building for the college's annual Classics Day event. With the success of this project in my class, I will show that Classics instructors can pursue similar long-term, hands-on learning activities for engaging students in ancient Greek and Roman culture and teaching essential skills.

Oak processionary moth (Thaumetopoea processionea) (OPM) Linnaeus, 1758 (Lepidoptera: Notodontidae) is a serious forestry pest and risk to public health in the UK. The economic and environmental cost of chemical pesticides in managing OPM has driven the need for sustainable, strategies which fit into integrated pest management frameworks, including the use of novel biocontrol methods such as conservation biocontrol.Carcelia iliaca Ratzeburg, 1840 (Diptera: Tachinidae), a specific parasitoid of OPM, is currently the main biocontrol agent of the UK OPM population. However, basic information on C. iliaca life history and rates of parasitism are currently lacking, partly driven by the risks OPM pose to human health, making both study and incorporation of biocontrol into management plans difficult.Here, we design and validate a molecular diagnostic assay based on loop‐mediated isothermal amplification (LAMP) to detect C. iliaca from OPM larval tissue samples collected in the field, overcoming the challenges of studying problematic invasive species such as these.To assess assay performance, diagnostic sensitivity, which was 91%, and specificity, which was 75%, are used alongside limit of detection (600 pg). We discuss the wider applications for LAMP as a cost‐effective tool for studying the natural enemies of insect pests which can be used to inform conservation biocontrol management strategies. [ABSTRACT FROM AUTHOR]

In this paper, I explore the use of long-term, hands-on learning activities for Classics courses. I will show that a carefully designed project can complement classroom lectures on Greek and Roman culture and contribute towards the development of students' critical thinking and group work skills. As an example, I describe a successful hands-on learning project that I designed for my Ancient Greek Cities course at Monmouth College (USA). The students were tasked with researching and building an historically faithful, ancient Greek mudbrick building for the college's annual Classics Day event. With the success of this project in my class, I will show that Classics instructors can pursue similar long-term, hands-on learning activities for engaging students in ancient Greek and Roman culture and teaching essential skills. [ABSTRACT FROM AUTHOR]

Context—Donor organs are a scarce gift. Additionally, transplantation is very expensive and the United States lacks universal health insurance for all citizens. These facts combine to make personal finance and insurance some of the criteria for wait listing at US transplant centers. Previous research has shown that the poor and the uninsured (as well as women and nonwhites) are less likely to receive a transplant. Living donor candidates are also limited by the US insurance system. Objective—To determine the effect of finance and insurance variables on access to transplant and living donation. Design—A qualitative descriptive study of ethics consultation data contained in a research registry approved by the institutional review board at California Pacific Medical Center. Setting and Participants—This study analyzes research registry data from a large community hospital in Northern California that serves patients from California, Oregon, and Nevada. The registry data are derived from transplant ethics consultations occurring between January 1, 2007, and June 30, 2009. Main Outcome Measure—This study explores the restriction of access to transplantation and of participation in living donation. Results—More than a quarter of all transplant ethics consultation reports described the restriction of transplant-related treatment for reasons rooted in finance or insurance. Individuals on the recipient side and on the donor side were hindered with regard to access. Insurance status and personal ability to pay significantly affect access to transplantation in the United States, and this theme is a frequent feature of ethics consultations at California Pacific Medical Center. [ABSTRACT FROM AUTHOR]

The central nervous system (CNS) has a highly complex biophysical and biochemical environment. Despite decades of intensive research, it is still an enormous challenge to restore its functions and regenerate lost or damaged CNS tissues. Current treatment strategies remain sub-optimal because of (1) the hostile microenvironment created post CNS injury, and (2) insufficient understanding of the pathophysiology of acute and chronic CNS diseases. Two-dimensional (2D) in vitro models have provided tremendous insights into a wide range of cellular interactions. However, they fail to recapitulate the complex cellular, topographical, biochemical, and mechanical stimuli found within the natural three-dimensional (3D) CNS. Also, the growing ethical needs to use fewer animals for research further necessitates 3D in vitro models to mimic all or part of the CNS. In this review, we critically appraise the status quo and design considerations of 3D in vitro neural disease and injury models that resemble in vivo conditions. This review mainly focuses on the most recent advances in tissue engineering techniques such as microfluidics, organs-on-a-chip and stem cell technology. Furthermore, we review recent models aiming to elucidate the underlying pathophysiology of CNS diseases. If armed with deeper understanding, it will be possible to develop high-throughput drug screening platforms and new treatments for CNS diseases and injuries.