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"Wells, Robert E"
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What's so special about planet Earth?
An introduction to the life-sustaining properties of Earth.
Book
The use of peripheral nerve blocks at the elbow for carpal tunnel release
This case report illustrates that median, radial, and ulnar nerve blocks at the elbow provides anesthesia for ambulatory carpal tunnel release surgery. This report discusses 3 patients with medical conditions, including vascular access problems and morbid obesity, which made nerve blocks at the elbow advantageous compared with other anesthetic techniques. Peripheral nerve blocks at the elbow were done before surgery in a block room, so the patients spent less time in the operating room. Nerve blocks at the elbow are effective anesthesia for hand procedures with no patient requiring further local anesthetic injection and opioids for pain or expressing any discomfort during surgery. The blocks are easy to perform and set up quickly, and using long-acting local anesthetics, elbow blocks provide postoperative pain control for approximately 10 hours. The nerve blocks at the elbow facilitate the perioperative process by being done out of the operating room and providing prolonged pain control without the need for opioids, so nausea may be avoided.
Journal Article
'Woof, Woof'-Editor Wells
Your letter of March 29, to hand and very sorry indeed to note that you take exception to an article in our May issue captioned. \"WRITE AND BLACK MIX UNDER A HARLEM MOON.\"
Newspaper Article
Chuckling Undertaker
ATLANTA-- I notice in an article in this morning's Constitution that Rep. Ward Edwards of Butler, \"chuckled\" as he remarked that the ambulance service provided by funeral homes was \"a public relations service.\" This represented his debate on the floor of the House on the Bill...
Newspaper Article
The GTCP331 Auxiliary Power Unit for the Next Generation Commercial Transports
The Model GTCP331 Auxiliary Power Unit (APU) is designed to meet the stringent demands of the next generation of commercial jet transports. The APU provides compressed air for cabin air conditioning, main engine starting, standby hydraulic power (via a turbopump) and inflight anti-icing, as well as electrical power for both ground and flight operation. The GTCP331 will provide low cost of ownership, fuel efficiency and environmentally pleasing operation in the new Airbus A.300/A.310 and Boeing 767/757 aircraft. This paper presents information related to various aspects of the GTCP331 APU program. Specifically, data related to the configuration and power class selection, propulsion engine heritage design details, and development highlights are presented. The interrelationship of the APU to other aircraft systems and the role of the APU digital Controller in assuring efficient and safe operation are discussed.
Journal Article
Host Transcriptional Response to Influenza and Other Acute Respiratory Viral Infections – A Prospective Cohort Study
To better understand the systemic response to naturally acquired acute respiratory viral infections, we prospectively enrolled 1610 healthy adults in 2009 and 2010. Of these, 142 subjects were followed for detailed evaluation of acute viral respiratory illness. We examined peripheral blood gene expression at 7 timepoints: enrollment, 5 illness visits and the end of each year of the study. 133 completed all study visits and yielded technically adequate peripheral blood microarray gene expression data. Seventy-three (55%) had an influenza virus infection, 64 influenza A and 9 influenza B. The remaining subjects had a rhinovirus infection (N = 32), other viral infections (N = 4), or no viral agent identified (N = 24). The results, which were replicated between two seasons, showed a dramatic upregulation of interferon pathway and innate immunity genes. This persisted for 2-4 days. The data show a recovery phase at days 4 and 6 with differentially expressed transcripts implicated in cell proliferation and repair. By day 21 the gene expression pattern was indistinguishable from baseline (enrollment). Influenza virus infection induced a higher magnitude and longer duration of the shared expression signature of illness compared to the other viral infections. Using lineage and activation state-specific transcripts to produce cell composition scores, patterns of B and T lymphocyte depressions accompanied by a major activation of NK cells were detected in the acute phase of illness. The data also demonstrate multiple dynamic gene modules that are reorganized and strengthened following infection. Finally, we examined pre- and post-infection anti-influenza antibody titers defining novel gene expression correlates.
Journal Article
Opposing roles of hepatic stellate cell subpopulations in hepatocarcinogenesis
Hepatocellular carcinoma (HCC), the fourth leading cause of cancer mortality worldwide, develops almost exclusively in patients with chronic liver disease and advanced fibrosis
1
,
2
. Here we interrogated functions of hepatic stellate cells (HSCs), the main source of liver fibroblasts
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, during hepatocarcinogenesis. Genetic depletion, activation or inhibition of HSCs in mouse models of HCC revealed their overall tumour-promoting role. HSCs were enriched in the preneoplastic environment, where they closely interacted with hepatocytes and modulated hepatocarcinogenesis by regulating hepatocyte proliferation and death. Analyses of mouse and human HSC subpopulations by single-cell RNA sequencing together with genetic ablation of subpopulation-enriched mediators revealed dual functions of HSCs in hepatocarcinogenesis. Hepatocyte growth factor, enriched in quiescent and cytokine-producing HSCs, protected against hepatocyte death and HCC development. By contrast, type I collagen, enriched in activated myofibroblastic HSCs, promoted proliferation and tumour development through increased stiffness and TAZ activation in pretumoural hepatocytes and through activation of discoidin domain receptor 1 in established tumours. An increased HSC imbalance between cytokine-producing HSCs and myofibroblastic HSCs during liver disease progression was associated with increased HCC risk in patients. In summary, the dynamic shift in HSC subpopulations and their mediators during chronic liver disease is associated with a switch from HCC protection to HCC promotion.
Subpopulations of cytokine-producing and myofibroblastic hepatic stellate cells, identified by single-cell RNA sequencing, protect against or promote the development of hepatocellular carcinoma via high expression of hepatocyte growth factor or type I collagen, respectively..
Journal Article