bluuebunny/crossref_metadata_2025 huggingface dataset:
Study on epoxy resin modified by hyperbranched polysiloxane containing active amino group and its properties
Authors: Xiao Mengting , Cai Haopeng
Published: April 2022

A novel phosphorous/silicon hybrid containing active amino was synthesized by bisphenol F epoxy resin modified by 0-(2,5-Dihydroxyphenyl)−10-hydro-9-oxa-10-phosphaphenanthrene-10-oxide (ODOPB) and hyperbranched polysiloxane (APTMS-HPSi). At first, APTMS-HPSi was synthesized by a simple reaction among aminoethylamino propyltrimethoxy silane (APTMS) and tripropylene glycol (TPG). ODOPB was used to modify bisphenol F epoxy resin. Then add different content of APTMS-HPSi to the phosphorus-containing modified epoxy resin (P-EP). Fourier Transform Infrared (FTIR) Spectroscopy was used to characterized the chemical structure of APTMS-HPSi. The effects of APTMS-HPSi content on key properties was systemically investigated. Results showed that the addition of APTMS-HPSi and ODOPB effectively improve the toughness and liquid oxygen compatibility. With the increase content of APTMS-HPSi, char yield and limited oxygen index (LOI) value of the cured resin increased, and the liquid oxygen sensitivity coefficient (IRS) decreased. The elongation at break was increased 45.32% by only 6wt% loading with APTMS-HPSi in epoxy resin, and at the same time the IRS of the modified resin was reduced from 7% to 0%. When the addition amount was 6wt%, the fracture elongation, impact strength and fracture toughness KIC were increased by 52.1%, 81.8% and 54.3% respectively. Therefore, adding phosphorus and hyperbranched polysiloxane to the resin can improve the liquid oxygen compatibility and toughness of the epoxy resin at the same time.
Micro-impulse and plasma plume produced by irradiating aluminum target with nanosecond laser pulses in double-pulse scheme
Authors: YU Chenghao , YE Jifei , ZHOU Weijing , CHANG Hao , GUO Wei
Published: April 2022

The micro-impulse generated by ablating an aluminum target in double-pulse laser bursts with different interpulse delays was investigated using a torsion pendulum. The plasma plume was simultaneously visualized using high-speed photography to analyze the coupling mechanism of the ablation impulse. The experiment was carried out using a pulsed laser with a pulse width of 8 ns and a wavelength of 1064 nm. The experimental results show that an impulse with an interpulse delay of 60 ns is roughly 60% higher than that with no delay between the two pulses, when the energy of both laser pulses is 50 mJ. Therefore, double-pulse schemes could enhance the ablation impulse under certain conditions. This is because the ablation of the first laser pulse changes the optical properties of the aluminum target surface, increasing the absorptivity. However, the ablation impulse is reduced with a time delay of 20 ns when the energy of both laser pulses is 100 mJ or 150 mJ. It can be concluded that the plasma produced by ablating the aluminum with the first pulse shields the second laser pulse. To summarize, the experimental results show that different delay times in a double-pulse scheme have a significant effect on the ablation impulse. The study provides a reference for the optimization of the parameters when laser ablation propulsion with a double-pulse scheme is applied in the fields of space debris removal, laser ablation thrusters, and so on.
ANN based approach for selective detection of breath acetone by using hybrid GO-FET sensor array
Authors: Thakur Uttam Narendra , Bhardwaj Radha , Ajmera Pawan K , Hazra Arnab
Published: April 2022

This research used hybrid graphene oxide (GO) field effect transistors (FETs) based sensor array to design an electronic nose (e-nose) for identifying exhaled breath acetone to diagnose diabetes mellitus through noninvasive route. Six back gated FET sensors were fabricated with hybrid channel of GO, WO3 and noble metals (Au, Pd and Pt) nanoparticles. The experiment was carried out by using four distinct forms of synthetic breath, each with a different level of interference. Linear discriminant analysis (LDA) and artificial neural networks (ANN) were utilized to classify and analyze the sensor response vector. In contrast, partial least square (PLS) and multiple linear regression (MLR) were used to evaluate the exact acetone concentration in synthetic breath. First, LDA was used to lower the dimensionality of the response vector, which was then provided as an input to the ANN model. ANN was performed with ten perceptrons model in the hidden layer and highest accuracy of 99.1% was achieved. Additionally, by using the loading plot of PLS, three sensors (Pt/WO3/GO, Pd/WO3/GO, and WO3/GO) had the ample use to predict the concentration of breath acetone. Moreover, the MLR approach with correlation coefficient (R2) of 0.9572 and root mean square error (RMSE) of 5.63% were used for obtaining the exact concentration of acetone. Consequently, e-nose with matrix of hybrid GO-FET sensors and pattern recognition algorithms (LDA, ANN, PLS and MLR) exhibited considerable ability in selective detection of acetone in synthetic breath.
Aduhelm, the Newly Approved Medication for Alzheimer Disease: What Epidemiologists Can Learn and What Epidemiology Can Offer
Authors: Glymour M Maria , Weuve Jennifer , Dufouil Carole , Mayeda Elizabeth Rose
Published: April 2022

Alzheimer disease (AD) is a progressive disorder common among older adults and culminating in profound cognitive impairments and high mortality risk. The US Food and Drug Administration (FDA) recently provided accelerated approval for Aduhelm, a medication for AD treatment. Aduhelm (Biogen Inc., Cambridge, Massachusetts) has been described as the first disease-modifying treatment for AD but has not been demonstrated to improve patients’ cognitive or functional outcomes. In this commentary, we describe why Aduhelm approval was controversial and aspects of the current evidence of special pertinence to epidemiologists. The FDA decision was based primarily on 2 randomized controlled trials (RCTs), both terminated early, with conflicting findings about the cognitive benefits of Aduhelm. Both RCTs showed important adverse effects of the medication. The FDA cited the documented reduction in brain amyloid, an AD biomarker hypothesized as a surrogate outcome, to justify accelerated approval. Despite lack of racial/ethnic diversity in the RCT participants, concerns about health disparities have been invoked to argue for public funding of this expensive medication. The Centers for Medicare and Medicaid Services recently made a “Coverage with Evidence Development” determination for Aduhelm and similar medications. We end by describing how innovative study designs could accelerate postapproval research and evaluate the proposed surrogate outcomes.
Divergent Adaptations in Autonomic Nerve Activity and Neuroimmune Signaling Associated With the Severity of Inflammation in Chronic Colitis
Authors: Stavely Rhian , Rahman Ahmed A , Sahakian Lauren , Prakash Monica D , Robinson Ainsley M , Hassanzadeganroudsari Majid , Filippone Rhiannon T , Fraser Sarah , Eri Rajaraman , Bornstein Joel C , Apostolopoulos Vasso , Nurgali Kulmira
Published: April 2022

Background

The autonomic nervous system (ANS) is thought to play a critical role in the anti-inflammatory reflex pathway in acute colitis via its interaction with the spleen and colon. Inflammation in the intestine is associated with a blunting of vagal signaling and increased sympathetic activity. As a corollary, methods to restore sympatho-vagal balance are being investigated as therapeutic strategies for the treatment of intestinal inflammation. Nevertheless, it is indefinite whether these autonomic signaling adaptations in colitis are detrimental or beneficial to controlling intestinal inflammation. In this study, models of moderate and severe chronic colitis are utilized to resolve the correlations between sympatho-vagal signaling and the severity of intestinal inflammation.

Methods

Spleens and colons were collected from Winnie (moderate colitis), Winnie-Prolapse (severe colitis), and control C57BL/6 mice. Changes to the size and histomorphology of spleens were evaluated. Flow cytometry was used to determine the expression of adrenergic and cholinergic signaling proteins in splenic B and T lymphocytes. The inflammatory profile of the spleen and colon was determined using a RT-PCR gene array. Blood pressure, heart rate, splanchnic sympathetic nerve and vagus nerve activity were recorded.

Results

Spleens and colons from Winnie and Winnie-Prolapse mice exhibited gross abnormalities by histopathology. Genes associated with a pro-inflammatory response were upregulated in the colons from Winnie and further augmented in colons from Winnie-Prolapse mice. Conversely, many pro-inflammatory markers were downregulated in the spleens from Winnie-Prolapse mice. Heightened activity of the splanchnic nerve was observed in Winnie but not Winnie-Prolapse mice. Conversely, vagal nerve activity was greater in Winnie-Prolapse mice compared with Winnie mice. Splenic lymphocytes expressing α1 and β2 adrenoreceptors were reduced, but those expressing α7 nAChR and producing acetylcholine were increased in Winnie and Winnie-Prolapse mice.

Conclusions

Sympathetic activity may correlate with an adaptive mechanism to reduce the severity of chronic colitis. The Winnie and Winnie-Prolapse mouse models of moderate and severe chronic colitis are well suited to examine the pathophysiology of progressive chronic intestinal inflammation.
The factorization method for inverse scattering by a two-layered cavity with conductive boundary condition
Authors: Ye Jianguo , Yan Guozheng
Published: April 2022

In this paper we consider the inverse scattering problem of determining the shape of a two-layered cavity with conductive boundary condition from sources and measurements placed on a curve inside the cavity. First, we show the well-posedness of the direct scattering problem by using the boundary integral equation method. Then, we prove that the factorization method can be applied to reconstruct the interface of the two-layered cavity from near-field data. Some numerical experiments are also presented to demonstrate the feasibility and effectiveness of the factorization method.
Localisations of Half-Closed Modules and the Unbounded Kasparov Product
Authors: van den Dungen Koen
Published: April 2022

In the context of the Kasparov product in unbounded $K\!K$-theory, a well-known theorem by Kucerovsky provides sufficient conditions for an unbounded Kasparov module to represent the (internal) Kasparov product of two other unbounded Kasparov modules. In this article, we discuss several improved and generalised variants of Kucerovsky’s theorem. First, we provide a generalisation that relaxes the positivity condition, by replacing the lower bound by a relative lower bound. Second, we also discuss Kucerovsky’s theorem in the context of half-closed modules, which generalise unbounded Kasparov modules to symmetric (rather than self-adjoint) operators. In order to deal with the positivity condition for such non-self-adjoint operators, we introduce a fairly general localisation procedure, which (using a suitable approximate unit) provides a “localised representative” for the $K\!K$-class of a half-closed module. Using this localisation procedure, we then prove several variants of Kucerovsky’s theorem for half-closed modules. A distinct advantage of the localised approach, also in the special case of self-adjoint operators (i.e., for unbounded Kasparov modules), is that the (global) positivity condition in Kucerovsky’s original theorem is replaced by a (less restrictive) “local” positivity condition, which is closer in spirit to the well-known Connes–Skandalis theorem in the bounded picture of $K\!K$-theory.
Sharing personal ECG time-series data privately
Authors: Bonomi Luca , Wu Zeyun , Fan Liyue
Published: April 2022

Objective

Emerging technologies (eg, wearable devices) have made it possible to collect data directly from individuals (eg, time-series), providing new insights on the health and well-being of individual patients. Broadening the access to these data would facilitate the integration with existing data sources (eg, clinical and genomic data) and advance medical research. Compared to traditional health data, these data are collected directly from individuals, are highly unique and provide fine-grained information, posing new privacy challenges. In this work, we study the applicability of a novel privacy model to enable individual-level time-series data sharing while maintaining the usability for data analytics.

Methods and materials

We propose a privacy-protecting method for sharing individual-level electrocardiography (ECG) time-series data, which leverages dimensional reduction technique and random sampling to achieve provable privacy protection. We show that our solution provides strong privacy protection against an informed adversarial model while enabling useful aggregate-level analysis.

Results

We conduct our evaluations on 2 real-world ECG datasets. Our empirical results show that the privacy risk is significantly reduced after sanitization while the data usability is retained for a variety of clinical tasks (eg, predictive modeling and clustering).

Discussion

Our study investigates the privacy risk in sharing individual-level ECG time-series data. We demonstrate that individual-level data can be highly unique, requiring new privacy solutions to protect data contributors.

Conclusion

The results suggest our proposed privacy-protection method provides strong privacy protections while preserving the usefulness of the data.
A New Record ofOrnithoica aequisentaand an Updated Checklist of Hippoboscidae, Nycteribiidae, and Streblidae in China
Authors: Wang Xueshuang , Zhou Ruobing , Lu Liang , Wang Chao , Liu Qiyong
Published: April 2022

Ornithoica aequisenta Maa 1966 (Diptera: Hippoboscidae) is recorded for the first time from a rodent from China. An updated checklist of louse flies including 21 genera and 52 species of Hippoboscoidea (Hippoboscidae, Nycteribiidae, and Streblidae) is presented for mainland China and Taiwan, including collection records and host species.
Survey and Phylogenetic Analysis of Leucocytozoon (Apicomplexa: Haemosporida) Parasites in Mississippi Black Flies (Diptera: Simuliidae)
Authors: Ber Jessica Lynn , Goddard Jerome , Nations Tina M , Outlaw Diana C
Published: April 2022

For several years, there have been continuous reports of black flies in Mississippi with evidence of transmission of Leucocytozoon spp. This study was conducted to determine the presence and diversity of Leucocytozoon spp. in black flies captured throughout Mississippi. Thirty-three collections, consisting of 346 specimens, were made during the 2-yr period (2015–2016) at 10 locations around the state. In addition to these systematic biweekly collections, 46 specimens were taken in 10 collections at four additional sites from 2009 to 2014, as well as 388 specimens taken in 14 collections during a severe black fly outbreak during March and April of 2018. Out of 186 pooled samples, 21 samples were positive for haemosporidian DNA. Eighteen of those samples were identified as Leucocytozoon spp. A phylogenetic tree was constructed using the novel sequences along with existing sequences from the MalAvi database. Results showed several of the sequences constructed in this study had high divergence from the existing sequences from the database.
Prevalence of Cockroaches, Bed Bugs, and House Mice in Low-Income Housing and Evaluation of Baits for Monitoring House Mouse Infestations
Authors: Abbar Salehe , Cooper Richard , Ranabhat Sabita , Pan Xiaodan , Sked Shannon , Wang Changlu
Published: April 2022

Pests are frequently found in homes, especially in apartment buildings in low-income communities. We investigated the prevalence and patterns of pest infestations in low-income communities in four cities (Jersey City, Linden, Paterson, Trenton) in New Jersey, USA. Resident interviews, visual inspections, and the placement of monitors were used to identify pest infestations. A total of 1,753 apartments from 19 buildings or building complexes were accessed. The infestation rates of cockroaches, bed bugs (Cimex lectularius L.), and house mice (Mus musculus domesticus Schwarz and Schwarz) were 37, 9, and 20%, respectively. Among apartments with cockroaches, 97.8, 2.5, and 0.8% had German cockroach [Blattella germanica (L.)], American cockroach [Periplaneta americana (L.)], and Oriental cockroach (Blatta orientalis L.), respectively. The percentage of residents who were aware of the presence of cockroaches, bed bugs, and house mice was 70.8, 55.3, and 56.8%, respectively. The prevalence of pest infestation was associated with resident ethnicity and gender. Among 856 interview responses, 78% implemented methods themselves to control pests in their homes in the past six months. Chocolate spread detected 99% of house mouse infestations and was much more sensitive than three commercial blank baits. Significant differences were also observed in the feeding preference of the three commercial blank baits.
Meta-Dracula: Contagion and the Colonial Gothic
Authors: Raza Kolb Anjuli Fatima
Published: April 2022

This essay, excerpted with permission from my recent book Epidemic Empire (University of Chicago Press, 2021) is about the colonial Gothic and the appearance therein of the paradigm of contagion as a metonym for political violence. I show how Bram Stoker’s Dracula, the most enduring and popular novel in this archive, is so capacious in its allegorical accommodations that it has been read as incorporating nearly every threat and monster of its own time and place, as well as those of its scenes of critical reception. More than indexing historical referents, I argue, the novel is a kind of allegory of allegories, producing new epistemes about multisystemic threats and carrying them forward into the crises of our own moment – global pandemic, terrorism, the collapse of empires. Following Fanon, who invokes the rich mythology of the vampire to point out colonial discourse’s specific habits of dehumanization, we can locate Dracula in an important archive of colonial writing that sets the ‘science’ of monsters on its infinite course and advances a reading practice that borrows from the surveillance apparatus and epidemic narrative strategies of colonial disease literature. Because of its extraordinary durability, Dracula is a crucial textual conduit in the transmission of minor ideas about the circulation of terror, rebellion, racialized bodies, foreign materials, and communicable disease from largely forgotten nineteenth-century texts and contexts into the common sense of late empire and late capitalism. Although Dracula is not a terribly self-conscious, systematically researched, or ideologically consistent text, it is decisive in its effects.
The prospects of finding tidal disruption events with 2.5-m Wide-Field Survey Telescope based on mock observations
Authors: Lin Zheyu , Jiang Ning , Kong Xu
Published: April 2022

Optical time-domain surveys have been the dominant means of hunting for rare tidal disruption events (TDEs) in the past decade and remarkably advanced the TDE study. Particularly, the Zwicky Transient Facility has opened the era of population studies, and the upcoming Large Survey of Space and Time at the Vera Rubin Observatory is believed to further revolutionize the field soon. Here, we present the prospects of finding TDEs with another powerful survey to be performed by 2.5-m Wide-Field Survey Telescope (WFST). The WFST, located in western China, will be the most advanced facility dedicated to optical time-domain surveys in the Northern hemisphere once commissioning. We choose to assess its TDE detectability on the basis of mock observations, which is hitherto closest to reality by taking into consideration site conditions, telescope parameters, survey strategy, and transient searching pipeline. Our mock observations on a 440-deg2 field (CosmoDC2 catalogue) show that 29 ± 6 TDEs can be robustly found per year if observed at u, g, r, and i bands with 30-s exposure every 10 days, in which a discovery is defined as ≥10 epochal detections in at least two filters. If the WFST survey is fully optimized for discovering TDEs, we would expect to identify 392 ± 74 TDEs every year, with the redshift up to z ∼ 0.8, which poses a huge challenge to follow-up resources.
High-contrast, high-angular resolution view of the GJ 367 exoplanet system
Authors: Brandner Wolfgang , Calissendorff Per , Frankel Neige , Cantalloube Faustine
Published: April 2022

We search for additional companions in the GJ 367 exoplanet system and aim to better constrain its age and evolutionary status. We analyse high-contrast direct imaging observations obtained with HST/NICMOS, VLT/NACO, and VLT/SPHERE. We investigate and critically discuss conflicting age indicators based on theoretical isochrones and models for Galactic dynamics. A comparison of GAIA EDR3 parallax and photometric measurements with theoretical isochrones suggests a young age ≤60 Myr for GJ 367. The star’s Galactic kinematics exclude membership to any nearby young moving group or stellar stream. Its highly eccentric Galactic orbit, however, is atypical for a young star. Age estimates considering Galactic dynamical evolution are most consistent with an age of 1–8 Gyr. We find no evidence for a significant mid-infrared excess in the WISE bands, suggesting the absence of warm dust in the GJ 367 system. The direct imaging data provide significantly improved detection limits compared to previous studies. At 530 mas (5 au) separation, the SPHERE data achieve a 5σ contrast of 2.6 × 10−6. The data exclude the presence of a stellar companion at projected separations ≥0.4 au. At projected separations ≥5 au we can exclude substellar companions with a mass ≥1.5 MJup for an age of 50 Myr, and ≥20 MJup for an age of 5 Gyr. By applying the stellar parameters corresponding to the 50 Myr isochrone, we derive a bulk density of ρplanet = 6.2 g cm−3 for GJ 367 b, which is 25 per cent smaller than a previous estimate.
High quality genome assembly of the anhydrobiotic midge provides insights on a single chromosome-based emergence of extreme desiccation tolerance
Authors: Yoshida Yuki , Shaikhutdinov Nurislam , Kozlova Olga , Itoh Masayoshi , Tagami Michihira , Murata Mitsuyoshi , Nishiyori-Sueki Hiromi , Kojima-Ishiyama Miki , Noma Shohei , Cherkasov Alexander , Gazizova Guzel , Nasibullina Aigul , Deviatiiarov Ruslan , Shagimardanova Elena , Ryabova Alina , Yamaguchi Katsushi , Bino Takahiro , Shigenobu Shuji , Tokumoto Shoko , Miyata Yugo , Cornette Richard , Yamada Takahiro G , Funahashi Akira , Tomita Masaru , Gusev Oleg , Kikawada Takahiro
Published: April 2022

Non-biting midges (Chironomidae) are known to inhabit a wide range of environments, and certain species can tolerate extreme conditions, where the rest of insects cannot survive. In particular, the sleeping chironomid Polypedilum vanderplanki is known for the remarkable ability of its larvae to withstand almost complete desiccation by entering a state called anhydrobiosis. Chromosome numbers in chironomids are higher than in other dipterans and this extra genomic resource might facilitate rapid adaptation to novel environments. We used improved sequencing strategies to assemble a chromosome-level genome sequence for P. vanderplanki for deep comparative analysis of genomic location of genes associated with desiccation tolerance. Using whole genome-based cross-species and intra-species analysis, we provide evidence for the unique functional specialization of Chromosome 4 through extensive acquisition of novel genes. In contrast to other insect genomes, in the sleeping chironomid a uniquely high degree of subfunctionalization in paralogous anhydrobiosis genes occurs in this chromosome, as well as pseudogenization in a highly duplicated gene family. Our findings suggest that the Chromosome 4 in Polypedilum is a site of high genetic turnover, allowing it to act as a ‘sandbox’ for evolutionary experiments, thus facilitating the rapid adaptation of midges to harsh environments.
Suppression of Hemp Powdery Mildew Using Root-Applied Silicon
Authors: Dixon Ed , Leonberger Kimberly , Amsden Bernadette , Szarka Desiree , Munir Misbakhul , Payee Wooiklee , Datnoff Lawrence , Tubana Brenda , Gauthier Nicole
Published: April 2022

Powdery mildew (Golovinomyces spadiceus) is the most common disease of greenhouse cannabis. Most hemp grown for cannabinoid production is propagated by cuttings or started from feminized seed in greenhouses and then moved outdoors, while most marijuana and some hemp are grown entirely indoors. To determine the effects of silicon on powdery mildew in the greenhouse, silicon was applied to hemp roots in a peat-based soilless mix and evaluated for plant uptake and disease suppression over a 6-week period. This study confirmed that there was a negative linear relationship between percent silicon accumulation in leaf tissue and the percent powdery mildew per leaf area. Mildew severity in the upper canopy was significantly reduced at 300 kg/ha of silicon, while 600 kg/ha was needed for the mid canopy. Results confirmed that silicon may be a useful tool for the integrated management of powdery mildew. As the cannabis market expands, silicon can serve as a viable option for greenhouse growers, especially for plants grown in soils or soilless mixes low or limiting in soluble silicon.
Benign Neonatal Hemangiomatosis
Authors: Miller Austinn C. , Gordon Elliott S. , Peterson Christy R. , Cohen David J. , Bowe Andrew C.
Published: April 2022

Background:

Benign neonatal hemangiomatosis (BNH) is a rare, self-limiting subtype of infantile hemangiomas (IHs), in which infants with multiple cutaneous hemangiomas lack visceral involvement. Other subtypes of IHs exist that may mimic BNH and can be life-threatening depending on hemangioma location and size.

Clinical Findings:

At birth, a 295/7-week preterm female presented with several pinhead-sized pink papules distributed throughout her body. At 10 days of age, the patient had 12 enlarged domed-shaped red papules in a generalized distribution throughout her body. Over several weeks, the number and size of the domed-shaped red papules continued to increase to a total of 26 located on the head, chest, abdomen, back, legs and arms. They were of firm consistency with both smooth and lobulated surfaces.

Primary Diagnosis:

A diagnosis of BNH was made after extensive workup did not reveal any extracutaneous hemangiomas.

Interventions:

Due to the lack of extracutaneous involvement and low-risk location/size of hemangiomas in our patient, no interventions were pursued and an observation-only approach was implemented.

Outcomes:

The patient remained stable while followed up over 8 months, with the size of the hemangiomas only increasing slightly in proportion to the patient's natural body growth.

Practice Recommendations:

Given the life-threatening nature of certain hemangioma subtypes, it is important to implement a proper workup and subtype diagnosis as early as possible in any infant with multiple hemangiomas.
The Work of Mothering in the NICU
Authors: Ringham Cathy , McNeil Deborah , Benzies Karen M.
Published: April 2022

Background:

Integrating parents into the care of their infants in the neonatal intensive care unit (NICU) is vital for both parents and infants. Yet, parents are often not fully involved in important decision-making and care, even when practices are family- and patient-centered. Alberta Family Integrated Care (FICare) is a model of care designed to support integration of parents into their infant's care.

Purpose:

The aim of this study was to describe and examine how mothers' work was coordinated by institutional processes when participating in Alberta FICare.

Methods:

We used institutional ethnography to analyze written entries in Alberta FICare parent journals to show points of tension mothers experienced in the NICU.

Results:

We illustrated the institutional activities that intersect with parental work of being present in the NICU. We argue that the journal text and the primary discourses that mothers are tuned to organize the way they knew and thought about their infant. Managing everyday NICU rules, navigating constant and unexpected changes, and the work of feeding their infant created tension. Mothers focused on milk supply, weight gain, and transition from gavage to nipple feeds. We show how mothers' activities were coordinated by practices that prioritize progression toward discharge rather than supporting them through the roller coaster of emotions and practical challenges of being present in the NICU.

Implications for Practice:

This illustration of institutional systems and processes may assist practitioners to understand the barriers mothers face when caring for their infants in the NICU.
Cardiovascular Protection Associated With Cilostazol, Colchicine, and Target of Rapamycin Inhibitors
Authors: Adeva-Andany María M. , Fernández-Fernández Carlos , Carneiro-Freire Natalia , Castro-Quintela Elvira , Vila-Altesor Matilde , González-Lucán Manuel
Published: April 2022

An alteration in extracellular matrix (ECM) production by vascular smooth muscle cells is a crucial event in the pathogenesis of vascular diseases such as aging-related, atherosclerosis and allograft vasculopathy. The human target of rapamycin (TOR) is involved in the synthesis of ECM by vascular smooth muscle cells. TOR inhibitors reduce arterial stiffness, blood pressure, and left ventricle hypertrophy and decrease cardiovascular risk in kidney graft recipients and patients with coronary artery disease and heart allograft vasculopathy. Other drugs that modulate ECM production such as cilostazol and colchicine have also demonstrated a beneficial cardiovascular effect. Clinical studies have consistently shown that cilostazol confers cardiovascular protection in peripheral vascular disease, coronary artery disease, and cerebrovascular disease. In patients with type 2 diabetes, cilostazol prevents the progression of subclinical coronary atherosclerosis. Colchicine reduces arterial stiffness in patients with familial Mediterranean fever and patients with coronary artery disease. Pathophysiological mechanisms underlying the cardioprotective effect of these drugs may be related to interactions between the cytoskeleton, TOR signaling, and cyclic adenosine monophosphate (cAMP) synthesis that remain to be fully elucidated. Adult vascular smooth muscle cells exhibit a contractile phenotype and produce little ECM. Conditions that upregulate ECM synthesis induce a phenotypic switch toward a synthetic phenotype. TOR inhibition with rapamycin reduces ECM production by promoting the change to the contractile phenotype. Cilostazol increases the cytosolic level of cAMP, which in turn leads to a reduction in ECM synthesis. Colchicine is a microtubule-destabilizing agent that may enhance the synthesis of cAMP.
Influencing Factors for Cardiometabolic Risk in Korean Adolescents Based on 2010–2015 Data From the Korea National Health and Nutrition Examination Survey
Authors: Lee Yeo Jin , Hwang Seon Young
Published: April 2022

Background

High academic stress and physical inactivity in Korean adolescents increase cardiometabolic risk factors, such as obesity, making it crucial to identify the factors influencing their risk.

Objective

Our aims were to determine differences in the prevalence of metabolic syndrome and its 5 components in Korean adolescents according to gender and to identify the influencing factors for cardiometabolic risk (individual risk factor ≥ 1).

Methods

Data related to adolescents from the Korean National Health and Nutrition Examination Survey (2010–2015) were assessed. Bivariate analyses to compare distribution and logistic regression analyses to examine the influencing factors were performed.

Results

Cardiometabolic risk (≥1 risk factor) was found in 33.2% and 32.6% of male and female adolescents, respectively, and metabolic syndrome (≥3 risk factors) was found in 2.0% and 2.3%, respectively. Among male adolescents, cardiometabolic risk was 1.66 times higher for the group that did not perform strength exercises (P = .007). For female adolescents, the cardiometabolic risk was 2.44 times higher in 16- to 18-year-olds than in 12- to 15-year-olds (P < .001) and 1.50 times higher in the non–aerobic-exercise group (P = .030). Central obesity (waist-to-height ratio ≥ 0.47) increased cardiometabolic risk by 5.71 and 13.91 times in male and female adolescents, respectively (P < .001).

Conclusion

To reduce cardiometabolic risk profiles and future cardiovascular risk in Korean adolescents, school-based physical activity programs should be actively provided not only for students with central obesity but also for students who lack aerobic or strength exercises.
Effect of a Home-Based Mobile Health App Intervention on Physical Activity Levels in Patients With Heart Failure
Authors: Saleh Zyad T. , Elshatarat Rami A. , Elhefnawy Khadega Ahmed , Helmi Elneblawi Nora , Abu Raddaha Ahmad H. , Al-Za'areer Majed S. , Mofdy Almarwani Abdulaziz , Alzahrani Naif S. , Aqel Ahmad A. , Shawashi Tagreed O. , Tayeh Mohammad
Published: April 2022

Background

The use of mobile health applications (apps) is an effective strategy in supporting patients' self-management of heart failure (HF) in home settings, but it remains unclear whether they can be used to reduce sedentary behaviors and increase overall physical activity levels.

Aim

The aims of this study were to determine the effect of an 8-week home-based mobile health app intervention on physical activity levels and to assess its effects on symptom burden and health-related quality of life.

Method

In this study, we collected repeated-measures data from 132 participants with HF (60.8 ± 10.47 years) randomized into a usual care group (n = 67) or an 8-week home-based mobile health app intervention group (n = 65). The intervention was tailored to decrease the time spent in sedentary behavior and to increase the time spent in physical activities performed at light or greater intensity levels. Physical activity levels were monitored for 2 weeks before the intervention and during the 8-week intervention using the Samsung mobile health app. Heart failure symptom burden and health-related quality of life were assessed at baseline, 2 weeks from baseline assessment, and immediately post intervention.

Results

At week 8, all participants in the intervention group demonstrated an increase in the average daily step counts above the preintervention counts (range of increase: 2351–7925 steps/d). Only 29 participants (45%) achieved an average daily step count of 10 000 or higher by week 6 and maintained their achievement to week 8 of the intervention. Repeated-measures analysis of variance showed a significant group-by-time interaction, indicating that the intervention group had a greater improvement in physical activity levels, symptom burden, and health-related quality of life than the usual care group.

Conclusion

Home-based mobile health app–based interventions can increase physical activity levels and can play an important role in promoting better HF outcomes.
Persistent Rhinovirus Infection in a Child With Leukemia
Authors: Özbek Siddiqui Duygu , Bedir Demirdağ Tuğba , Karamercan Sirma , Kirkiz Kayali Serap , Kaya Zühre , Koçak Ülker
Published: April 2022

Human Rhinovirus (HRV) is one of the most common pathogens causing acute respiratory tract infections in infants and children. Several reports suggest that HRV has the potential to cause chronic infection after an acute viral infection in an immunosuppressed patient. Although chronic HRV infection has been reported in lung transplant recipients, patients with hypogammaglobulinemia and cystic fibrosis, the duration and severity of HRV infection remain unclear. In this study, we present a case of persistent HRV infection in a stem cell transplanted leukemia patient. This report raises several questions regarding the risk factors, duration, and severity of persistent HRV infection in acute leukemia patients, which warrants prospective and longitudinal studies.
A Clinical Nurse Specialist–Led Quality Improvement Initiative to Identify Barriers to Adherence to a Bundle for Central Line Maintenance
Authors: Harlan Melissa Dawn , Kennell Jamilyn Sue , Lucas Wendy , Ren Dianxu , Tuite Patricia K.
Published: April 2022

Purpose

This clinical nurse specialist–led quality improvement project identified barriers to adherence to a bundle for central line maintenance and examined the relationship between increased bundle adherence and central line–associated bloodstream infections.

Project Description

Oncology and critical care nurses were surveyed to identify barriers to adherence to a bundle for central line maintenance. Targeted initiatives based on survey responses were implemented focusing on antimicrobial bathing, increasing confidence in an evidence-based bundle, and its ability to reduce infections. Adherence and central line–associated bloodstream infection rates were monitored at baseline and at 3, 9, and 15 months post intervention.

Outcomes

Adherence to bundle elements improved post intervention in 4 areas in critical care units: correctly labeling catheter dressings, maintaining an occlusive dressing, clamping unused catheter lumens, and daily antimicrobial bathing. In oncology units, adherence improved in clamping unused lumens and daily antimicrobial bathing. At 9 months post intervention, infection rates decreased from 6.08 to 1.48 in critical care units and 3.13 to 0.30 in oncology units.

Conclusions

Identifying unit-specific barriers to adherence to bundles for central line maintenance and implementing targeted initiatives to reduce barriers increase adherence and prevent central line infections.
Autologous Gluteal Augmentation with Parasacral Perforator-Pedicled Propeller Flaps
Authors: Bekara Farid , Chaput Benoit , Ciucur Elena , de Boutray Marie , Boccara David , Bertheuil Nicolas , Herlin Christian
Published: April 2022

Background:

De-epithelialized flaps have been used in gluteal contouring over the last three decades, but most improve the projection rather than the upper quadrants. The authors provide a detailed description of their method of gluteal augmentation using parasacral perforator-pedicled propeller flaps. This technique achieves a volumetric increase and maximal buttock projection at the midlevel and in the medial half of the buttocks.

Methods:

Between January and December of 2019, a series of 18 patients on whom a lower body lift with a parasacral perforator-pedicled propeller flap had been performed by the senior author (F.B.) were prospectively evaluated. Postoperatively, the satisfaction rate was assessed using a 10-point analog scale (1 = unsatisfied, 10 = very satisfied) by the patient and by two independent surgeons based on photographs taken 1 year after surgery.

Results:

Eighteen patients underwent this procedure. Their mean age was 32.2 ± 5.6 years (range, 24 to 40 years). The mean flap length was 20.3 cm, their mean width was 10.4 cm, and the mean thickness was 3.4 cm. The authors noted only two minor complications, one seroma and two skin dehiscences that healed without surgery. The rate of satisfaction as assessed by the patients was 8.3 out of 10 (±1.1), and by surgeons, 7.9 and 8.1.

Conclusion:

This article describes a gluteal autoaugmentation flap technique using parasacral perforator-pedicled propeller flaps to increase projection and volume in the inferomedial gluteal region after lower body lift.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
A Rare Pitfall in Bone Mineral Densitometry
Authors: Araz Mine , Sutcu Gizem , Surucu Kara llknur , Eminoglu Tuba , Ozkan Elgin
Published: April 2022

We report a rare case of type 3 Gaucher disease presenting with calcified mesenteric lymph nodes that interfere with bone mineral densitometric measurements.
Multicystic Biliary Hamartoma With Xanthogranulomatous Inflammation on 18F-FDG PET/CT
Authors: Shono Nahomi , Otomi Yoichi , Otsuka Hideki , Shinya Takayoshi , Harada Masafumi
Published: April 2022

A 70-year-old man with a liver tumor was pathologically diagnosed with multicystic biliary hamartoma with xanthogranulomatous inflammation. Plain CT revealed an inhomogeneous low-density liver tumor, measuring 43 × 35 mm. Dynamic contrast-enhanced CT revealed a cyst, measuring approximately 15 mm, with a ring-shaped enhancement, within the tumor. There was delayed enhancement on the outer portion of the tumor. Mild peripheral bile duct dilation was also observed. 18F-FDG PET/CT showed focal high uptake with an SUVmax of 5.2 near the cyst. The findings of this case mimicked that of intrahepatic cholangiocellular carcinoma.
Extranodal NK/T-Cell Lymphoma With Widespread Cutaneous and Subcutaneous Involvement on 18F-FDG PET/CT
Authors: Filizoglu Nuh , Ozguven Salih , Ones Tunc , Turoglu Halil Turgut , Erdil Tanju Yusuf
Published: April 2022

Nasal-type extranodal natural killer/T-cell lymphoma is an aggressive rare type of lymphoma that mostly affects the nasal cavity and adjacent areas. However, some patients can present with distant nodal or extranodal involvement including the Waldeyer ring, gastrointestinal tract, genitourinary organs, lung, thyroid, skin, or adrenal glands. Herein, we present a unique case of extranodal natural killer/T-cell lymphoma with widespread cutaneous and subcutaneous involvement on 18F-FDG PET/CT.
A Novel Method for Establishing Functional Change in Older Adults With Cognitive Impairment
Authors: González David A. , Resch Zachary J. , Gonzales Mitzi M. , Soble Jason R.
Published: April 2022

Objective:

The aim was to set syndrome stage-specific (eg, cognitively unimpaired, severe dementia) metrics for functional change.

Methods:

We selected 18,097 individuals who participated in 2 National Alzheimer’s Coordinating Center visits between June 2005 and May 2020, with completed collateral rating of functioning on activities of daily living assessed by the Functional Activities Questionnaire.

Both distribution-based (ie, regression-based reliable change indices) and anchor-based (ie, typical change associated with advancing a syndromal stage for clinically meaningful difference) methods were applied for individuals classified as: unimpaired cognition, mild cognitive impairment, mild dementia, moderate dementia, or severe dementia.

Results:

There were marked differences in the distribution of functional ratings depending on their syndromal stage. There were also differences in the functional change associated with advancing across different syndromal stages. These informed stage-specific metrics for reliable change indices and clinically meaningful differences.

Conclusions:

Our indices provide a hitherto unavailable method that allows clinicians to determine whether observed functional change is reliable or meaningful based on syndromal stage.
Statewide Episode Spending Variation of Mastectomy for Breast Cancer
Authors: Hughes Tasha M , Ellsworth Brandon , Berlin Nicholas L , Sinco Brandy , Bredbeck Brooke , Baskin Alison , Wang Ton , Nathan Hari , Dossett Lesly A
Published: April 2022

BACKGROUND:

Centralizing complex cancer operations, such as pancreatectomy and esophagectomy, has been shown to increase value, largely due to reduction in complications. For high-volume operations with low complication rates, it is unknown to what degree value varies between facilities, or by what mechanism value may be improved. To identify possible opportunities for value enhancement for such operations, we sought to describe variations in episode spending for mastectomy with a secondary aim of identifying patient- and facility-level determinants of variation.

STUDY DESIGN:

Using the Michigan Value Collaborative risk-adjusted, price-standardized claims data, we evaluated mean spending for patients undergoing mastectomy at 74 facilities (n = 7,342 patients) across the state of Michigan. Primary outcomes were 30- and 90-day episode spending. Using linear mixed models, facility- and patient-level factors were explored for association with spending variability.

RESULTS:

Among 7,342 women treated across 74 facilities, mean 30-day spending by facility ranged from $11,129 to $20,830 (median $14,935). Ninety-day spending ranged from $17,303 to $31,060 (median $23,744). Patient-level factors associated with greater spending included simultaneous breast reconstruction, bilateral surgery, length of stay, and readmission. Among women not undergoing reconstruction, variation persisted, and length of stay, bilateral surgery, and readmission were all associated with increased spending.

CONCLUSION:

Michigan hospitals have significant variation in spending for mastectomy. Reducing length of stay through wider adoption of same-day discharge for mastectomy and reducing the frequency of bilateral surgery may represent opportunities to increase value, without compromising patient safety or oncologic outcomes.
Delphi Consensus on Intraoperative Technical/Surgical Aspects to Prevent Surgical Site Infection after Colorectal Surgery
Authors: Ruiz-Tovar Jaime , Boermeester Marja A , Bordeianou Liliana , Chang George J , Gorgun Emre , Justinger Christoph , Lawson Elise H , Leaper David J , Mahmoud Najjia N , Mantyh Christopher , McGee Michael F , Nfonsam Valentine , Rubio-Perez Ines , Wick Elizabeth C. , Hedrick Traci L
Published: April 2022

BACKGROUND:

Previous studies have focused on the development and evaluation of care bundles to reduce the risk of surgical site infection (SSI) throughout the perioperative period. A focused examination of the technical/surgical aspects of SSI reduction during CRS has not been conducted. This study aimed to develop an expert consensus on intraoperative technical/surgical aspects of SSI prevention by the surgical team during colorectal surgery (CRS).

STUDY DESIGN:

In a modified Delphi process, a panel of 15 colorectal surgeons developed a consensus on intraoperative technical/surgical aspects of SSI prevention undertaken by surgical personnel during CRS using information from a targeted literature review and expert opinion. Consensus was developed with up to three rounds per topic, with a prespecified threshold of ≥70% agreement.

RESULTS:

In 3 Delphi rounds, the 15 panelists achieved consensus on 16 evidence-based statements. The consensus panel supported the use of wound protectors/retractors, sterile incision closure tray, preclosure glove change, and antimicrobial sutures in reducing SSI along with wound irrigation with aqueous iodine and closed-incision negative pressure wound therapy in high-risk, contaminated wounds.

CONCLUSIONS:

Using a modified Delphi method, consensus has been achieved on a tailored set of recommendations on technical/surgical aspects that should be considered by surgical personnel during CRS to reduce the risk of SSI, particularly in areas where the evidence base is controversial or lacking. This document forms the basis for ongoing evidence for the topics discussed in this article or new topics based on newly emerging technologies in CRS.
Ethics of Educating American Global Surgeons: An Approach to Conscientious Training on the Individual, Departmental, and Institutional Levels
Authors: Sherif Youmna A , Choudhury Taslima , Makasa Emmanuel , Rosengart Todd K , Davis Rachel W , Kaseje Neema
Published: April 2022

Global surgery is a medical field dedicated to the facilitation of timely access to safe, affordable, and high-quality surgical healthcare worldwide, including support for necessary surgery and anesthesia infrastructure. Standard surgical training in the US does not provide necessary exposure to the range of surgical operations and nontechnical skills critical to practice in resource-limited contexts. Therefore, academic medical institutions have sought to bridge this training gap by establishing global surgery-focused rotations, fellowships, and integrated global surgery residencies. However, the presence of trainees pursuing education for careers in resource-variable settings presents an added layer of ethical complexity that must be carefully considered on the individual, programmatic, and institutional level. This article reviews the complexities relevant to global surgery trainees across these levels and offers potential mechanisms for addressing these ethical challenges.