University of North Carolina at Wilmington

About: University of North Carolina at Wilmington is a education organization based out in Wilmington, North Carolina, United States. It is known for research contribution in the topics: Population & Poison control. The organization has 3329 authors who have published 6797 publications receiving 186308 citations.

The Comprehensive Post-Acute Stroke Services (COMPASS) study: Design and methods for a cluster-randomized pragmatic trial

Abstract: Patients discharged home after stroke face significant challenges managing residual neurological deficits, secondary prevention, and pre-existing chronic conditions. Post-discharge care is often fragmented leading to increased healthcare costs, readmissions, and sub-optimal utilization of rehabilitation and community services. The COMprehensive Post-Acute Stroke Services (COMPASS) Study is an ongoing cluster-randomized pragmatic trial to assess the effectiveness of a comprehensive, evidence-based, post-acute care model on patient-centered outcomes. Forty-one hospitals in North Carolina were randomized (as 40 units) to either implement the COMPASS care model or continue their usual care. The recruitment goal is 6000 patients (3000 per arm). Hospital staff ascertain and enroll patients discharged home with a clinical diagnosis of stroke or transient ischemic attack. Patients discharged from intervention hospitals receive 2-day telephone follow-up; a comprehensive clinic visit within 2 weeks that includes a neurological evaluation, assessments of social and functional determinants of health, and an individualized COMPASS Care Plan™ integrated with a community-specific resource database; and additional follow-up calls at 30 and 60 days post-stroke discharge. This model is consistent with the Centers for Medicare and Medicaid Services transitional care management services provided by physicians or advanced practice providers with support from a nurse to conduct patient assessments and coordinate follow-up services. Patients discharged from usual care hospitals represent the control group and receive the standard of care in place at that hospital. Patient-centered outcomes are collected from telephone surveys administered at 90 days. The primary endpoint is patient-reported functional status as measured by the Stroke Impact Scale 16. Secondary outcomes are: caregiver strain, all-cause readmissions, mortality, healthcare utilization, and medication adherence. The study engages patients, caregivers, and other stakeholders (including policymakers, advocacy groups, payers, and local community coalitions) to advise and support the design, implementation, and sustainability of the COMPASS care model. Given the high societal and economic burden of stroke, identifying a care model to improve recovery, independence, and quality of life is critical for stroke survivors and their caregivers. The pragmatic trial design provides a real-world assessment of the COMPASS care model effectiveness and will facilitate rapid implementation into clinical practice if successful. Clinicaltrials.gov: NCT02588664 ; October 23, 2015.

Impact of Low-Intensity Hurricanes on Regional Economic Activity

Abstract: Although low-intensity hurricanes cause far less structural damage than high-intensity hurricanes, these weaker hurricanes do impact regional economic activity through “business interruption.” Because the strike frequencies of low-intensity hurricanes are orders of magnitude greater than those of stronger storms, the cumulative impact of frequent “business interruption” may be significant. Using Chamber of Commerce survey data, we estimate industry-specific business interruption losses for three low-intensity hurricanes striking the Wilmington, N.C., region. The average, per-storm regional impacts of business interruption, including direct, indirect, and induced impacts, are equivalent to between 0.8 and 1.23% of annual regional output, between 1.11 and 1.63% of regional employment, and between 1.21 and 1.81% of annual indirect business taxes. While these per-storm losses may appear small, the high strike frequencies of low-intensity hurricanes produce a cumulative (in expectation) impact equivalent to a ...

Complexes of Greatly Enhanced Thermodynamic Stability and Metal Ion Size-Based Selectivity, Formed by the Highly Preorganized Non-Macrocyclic Ligand 1,10-Phenanthroline-2,9-dicarboxylic Acid. A Thermodynamic and Crystallographic Study

Abstract: The metal ion-complexing properties of 1,10-phenanthroline-2,9-dicarboxylic acid (PDA) are reported. The protonation constants (pK1 = 4.75, pK2 = 2.53) and formation constants (log K1) for PDA with Mg(II) (3.53), Ca(II) (7.3), Sr(II) (5.61), Ba(II) (5.43), La(III) (13.5), Gd(III) (16.1), Zn(II) (11.0), Cd(II) (12.8), Pb(II) (11.4), and Cu(II) (12.8) were determined by UV−vis spectroscopy in 0.1 M NaClO4 at 25 °C. The log K1 values for most of these metal ions were high enough that they were not displaced from their PDA complexes even at pH 2. The log K1 values were determined using the UV spectra to monitor the competition with EDTA (or DTPA; EDTA = ethylendiamine tetraacetic acid, DTPA = diethylenetriamine pentaacetic acid) as a function of pH according to the equilibrium: M(EDTA) + PDA + nH+ = M(PDA) + EDTAHn. The log K1 values indicate that the rigid extended aromatic backbone of PDA leads to high levels of ligand preorganization and selectivity toward large metal ions (e.g., Ca(II), Cd(II), Gd(III)) ...

Lysyl-Phosphatidylglycerol Attenuates Membrane Perturbation Rather than Surface Association of the Cationic Antimicrobial Peptide 6W-RP-1 in a Model Membrane System: Implications for Daptomycin Resistance

Abstract: The presence of the cationic phospholipid lysyl-phosphatidylglycerol (lysyl-PG) in staphylococcal cytoplasmic membranes has been linked to increased resistance to cationic compounds, including antibiotics such as daptomycin as well as host defense antimicrobial peptides. We investigated the effects of lysyl-PG on binding of 6W-RP-1, a synthetic antimicrobial peptide, to lipid vesicles and on peptide-induced membrane permeabilization. Unexpectedly, physiological lysyl-PG concentrations only minimally reduced membrane binding of 6W-RP-1. In contrast, 6W-RP-1-induced dye leakage was severely inhibited by lysyl-PG, suggesting that lysyl-PG primarily impacts membrane defect formation.