Writing and Publishing Scientific Articles
5-6
There are many possible causes of a relationship between hospital volume and mechanical ventilation outcome among patients receiving critical care. High-volume hospitals may improve outcomes by implementing a broad range of best practices, including higher nurse-to-patient ratios, multidisciplinary care teams, a ventilation strategy involving a low tidal volume for lung injury, and protocols for sedation, weaning, and glycemic control. 25 – 30 Clinicians at high-volume hospitals may also gain experience in the care of the critically ill, which could translate into improved rates of survival. More experienced as opposed to less experienced clinicians may be better at recognizing and treating the complications of critical illness or may be better at translating evidence into practice. (FromKahn JM et al. Hospital volume and the outcomes of mechanical ventilation. N Engl J Med 355:41 – 50, 2006.) Since elevated serum RBP4 levels lead to insulin resistance in mice, 9 our observations raise the possibility that the serum RBP4 level might contribute to systemic insulin resistance in humans. In mice, increased serum RBP4 levels impair postreceptor insulin signaling at the level of phosphoinositide-3 kinase in muscle and enhance the expression of phosphoenolpyruvate carboxykinase in liver. 9 Therefore, increased serum RBP4 levels in humans might contribute to impaired insulin-stimulated glucose uptake in muscle and elevated hepatic glucose production, both of which are characteristic of type 2 diabetes. 1 Regions near the RBP4 locus on human chromosome 10q have been linked to hyperinsulinemia or early onset of type 2 diabetes in 2 populations, a finding consistent with a pathogenic role for RBP4 in insulin resistance and type 2 diabetes. 32,33 (FromGraham TE et al. Retinol-binding protein 4 and insulin resistance in lean, obese, and diabetic subjects. N Engl J Med 354:2552 – 2563, 2006.) If your study included several experiments, you will also use the Discussion to explain how the findings of the individual experiments relate to each other and what they mean when considered together. Here’s an example: [Preceding paragraph: The in vivo activity of AMG 706 is attributed to its activity against all VEGFRs tested. . . .] The high selectivity of AMG 706 is evidenced by the lack of activity against a variety of other kinases tested. Furthermore, no activity against bFGF-induced HUVEC proliferation was observed, implying that AMG 706 does not inhibit the receptor for bFGF or any downstream kinases or other proteins that mediate the proliferative signals of bFGF. Examination of the physiologic response of established tumors to treatment with
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