bluuebunny/crossref_metadata_2025 huggingface dataset:
Endotracheal Intubation Performance in Novices: Comparing the Training Effect Resulting From Two Airway Management Training Simulators
Authors: Roach Victoria A , Traina David J , Hananel David M , Speich Jason R , Norfleet Jack E , Sweet Robert M
Published: August 2024

Introduction

Between 2011 and 2014, the Combat Casualty Training Consortium research study sought to evaluate all aspects of combat casualty care, including mortality, with a special focus on the incidence and causes of potentially preventable deaths among American combat fatalities. This study identified a major training gap in critical airway management. Because of the high rate of morbidity and mortality associated with poor or incorrect airway management, an effort to address this training gap was necessary.

Materials and Methods

This experiment compared the training using the Advanced Joint Airway Management System, a novel high-fidelity airway simulator, relative to one of the most utilized simulators for endotracheal intubation (ETI) via a parallel group randomized control trial design. Before training, participants (n = 19) attempted an ETI on a cadaver using direct laryngoscopy. Performance during the attempt was recorded and scored by trained blinded raters. Participants were then randomly allocated to either novel or conventional training. Post-training, participants completed a second ETI under the same parameters. Analysis was completed via 2 × 2 mixed analysis of variance for (1) ETI Score, (2) Errors, (3) Critical Failures, and (4) Duration, across both the pre- and post-training tests and between the two groups.

Results

A priori power analysis required a total sample size of 84 participants in this experimental design. Consequently, this study is under-powered to reach statistical significance. Scores for all trainees did improve with training, yet analyses did not reveal a difference in overall ETI score between the novel and conventional training group, at baseline or at the post-training test (P = .249).

Conclusion

The Advanced Joint Airway Management System simulator presents a training effect that is comparable to the conventional training model. However, given this study’s small sample size, these results must be considered preliminary and further research is merited to draw firm conclusions about its impact on trainee performance. Future studies engaging larger cohorts of trainees and exploring the other capabilities of the Advanced Joint Airway Management System (cricothyroidotomy, needle chess decompression) are needed to further examine the educational potential of this novel airway management training system.
Penetration Thresholds of Porcine Limbs for Low Sectional Density Projectiles in High-Rate Impact
Authors: LeSueur Joseph , Koser Jared , Hampton Carolyn , Kleinberger Michael , Pintar Frank A
Published: August 2024

Introduction

With similar prevalence to injuries from fires, stings, and natural disasters, soft tissue injuries may occur from fireworks, industrial accidents, or other explosives. Surgeons are less familiar with treating high-velocity penetration from small debris, which may increase the chance of infection and subsequent fatality. Penetration risk curves have been developed to predict V50, the velocity with 50% probability of penetration, for various sized projectiles. However, there has been limited research using nonmetallic materials to achieve lower density projectiles less than 1 g cm−2, such as sand or rocks.

Material and Methods

To emulate the size and density of these energized particles, 14 ball bearings of stainless steel, silicon nitride, or Delrin acetal plastic ranging from 1.59 mm (1/16”) to 9.53 mm (3/8”) with sectional densities between 0.3 g cm−2 and 5  g cm−2 were launched toward porcine legs at a range of velocities to determine the penetration thresholds. High-speed videography was captured laterally at 40 kHz and impact velocity was captured using a physics-based tracking software. A generalized linear model with repeated measures and a logit link function was used to predict probability of penetration for each projectile. A total of 600 impacts were conducted to achieve at least 15 penetrating impacts for each projectile over a range of velocities.

Results

Higher impact velocities were required to penetrate the skin as sectional density of the projectile decreased, and the relationship between velocity and sectional density exhibited an exponential relationship (V50, $ = 184.6*S{D^{ - 0.385}}$, R2 = 0.95) with substantial change for nonlinearity in sectional densities ranging from 0.3 g cm−2 to 1  g cm−2. Compared to previous studies, the empirical relationship was consistent in the linear region (2-5  g cm−2), and novel experimentation filled in the gaps for sectional densities less than 1  g cm−2, which expressed more nonlinearity than previously estimated. For low-density projectiles with diameters of 1.59 (1/16”) or 3.18 (1/8”), 32 impacts were lodged into the epidermis but did not penetrate through the dermis; however, penetration was defined as displacement into or through the dermis.

Conclusions

These experimental results may be used to develop and validate finite element simulations of low-density projectile impacts to address complex, multivariate loading conditions for the development of protective clothing to reduce wounding and subsequent infection rates.
Characterizing and Modeling Ovine Hide and Costal Cartilage for Use in Modeling High-Rate Non-Penetrating Blunt Impact
Authors: Thomas Patricia K , Caffrey Juliette M , Koya Bharath , von Kleeck III B Wade , Weaver Caitlin M , Kleinberger Michael , Gayzik F Scott
Published: August 2024

Introduction

High-rate non-penetrating blunt impacts to the thorax, such as from impacts to protective equipment, can lead to a wide range of thoracic injuries. These injuries can include rib fractures, lung contusions, and abdominal organ contusions. Ovine animals have been used to study such impacts, in a variety of ways, including in silico. To properly model these impacts in silico, it is imperative that the tissues impacted are properly characterized. The objective of this study is to characterize and validate two tissues impacted that are adjacent to the point of impact—costal cartilage and hide. Heretofore, these materials have not been characterized for use in computational models despite their nearly immediate engagement in the high-rate, non-penetrating loading environment.

Materials and Methods

Ovine costal cartilage and hide samples were procured from a local abattoir following USDA regulations. Costal cartilage samples were then cut into ASTM D638 Type V tensile coupons and compressive disks for testing. The cartilage tensile coupons were tested at 150 ε/s, and the compressive samples were tested at −150 ε/s. Identical coupons and disks were then simulated in LS-Dyna using a hyperelastic material model based on test data and experimental boundary conditions. Hide samples were shaved and cut into ASTM D638 Type V tensile coupons and validated in silico using identical boundary conditions and an Ogden rubber model based on test data.

Results

The structural responses of costal cartilage and hide are presented and exhibit typical behavior for biological specimens. The respective model fits in LS-Dyna were a hyperelastic- based “simplified rubber” for the costal cartilage and an Ogden rubber for the hide. The costal cartilage had a mean failure strain of 0.094 ± 0.040 in tension and −0.1755 ± 0.0642 in compression. The costal cartilage was also noted to have an order-of-magnitude difference in the stresses observed experimentally between the tensile and compressive experiments. Hide had a mean failure strain of 0.2358 ± 0.1362. The energies for all three simulations showed material stability.

Conclusions

Overall, we successfully characterized the mechanical behavior of the hide and costal cartilage in an ovine model. The data are intended for use in computational analogs of the ovine model for testing non-penetrating blunt impact in silico. To improve upon these models, rate sensitivity should be included, which will require additional mechanical testing.
Specialized Vaccine Care for Adverse Events Following Immunization and Impact on Vaccine Hesitancy in the Military Health System
Authors: Loran David A , Angelo Sophia , Ryan Margaret
Published: August 2024

Introduction

The World Health Organization identified vaccine hesitancy as one of the top 10 threats to global health. Vaccine hesitancy is defined as a delay in acceptance or refusal of vaccination despite the availability of vaccination services. Because vaccine safety concerns are important contributors to hesitancy, people who have experienced adverse events following immunization (AEFI) may be at especially high risk for subsequent vaccine hesitancy. The Defense Health Agency Immunization Healthcare Division (DHA IHD) provides specialized vaccine care to persons who have experienced AEFI. The impact of this specialized vaccine care on subsequent vaccine hesitancy has not been fully explored.

Materials and Methods

A cohort of patients (n= 146) was identified among those who received consultative care from DHA IHD clinicians for AEFI concerns between April 2017 and September 2022. Analyses were restricted to non-uniformed beneficiaries of the Military Health System (MHS). Uniformed beneficiaries of the MHS were excluded from this analysis since vaccination mandates preclude the use of vaccine uptake as a measure of vaccine hesitancy. Outcomes were evaluated by reviewing MHS vaccination records after initial AEFI consultation through January 2023. Vaccine acceptance was considered the inverse of hesitancy, and was defined by: (a) receipt of any subsequent vaccination, (b) receipt of seasonal influenza vaccine, (c) receipt of subsequent doses of the AEFI-associated vaccine, if clinically recommended, and (d) receipt of COVID-19 vaccine.

Results

A diverse group of patients with a wide range of AEFI concerns received specialized vaccine care from DHA IHD clinicians during this period. Among the cohort, 78% of patients received any subsequent vaccination, 55.2% received seasonal influenza vaccine, 57.8% received a subsequent dose of their AEFI-associated vaccine when the vaccine was clinically recommended, and 48.9% received COVID-19 vaccine. The proportion of patients who received influenza vaccine exceeded the reported rate of influenza vaccine uptake by the general population during this time period.

Conclusion

Specialized vaccine care after AEFI concerns was associated with relatively high acceptance of subsequent vaccinations. The experiences of DHA IHD clinicians, in providing specialized vaccine care to AEFI patients, may serve as a model for other organizations that are working to reduce vaccine hesitancy, even beyond the MHS.
Design and Development of a Powered Myoelectric Elbow Orthosis for Neuromuscular Injuries
Authors: Vignola Claudio , Bhat Sandesh G , Hollander Kevin , Kane Paul , Miller Emily , Martin William Brandon , Shin Alexander Y , Sugar Thomas G , Kaufman Kenton R
Published: August 2024

Introduction

Recovering from neuromuscular injuries or conditions can be a challenging journey that involves complex surgeries and extensive physical rehabilitation. During this process, individuals often rely on orthotic devices to support and enable movement of the affected limb. However, users have criticized current commercially available powered orthotic devices for their bulky and heavy design. To address these limitations, we developed a novel powered myoelectric elbow orthosis.

Materials and Methods

The orthosis incorporates 3 mechanisms: a solenoid brake, a Bowden cable-powered constant torque elbow mechanism, and an extension limiter. The device controller and battery are in a backpack to reduce the weight on the affected arm. We performed extensive calculations and testing to ensure that the orthosis could withstand at least 15 Nm of elbow torque. We developed a custom software effectively control the orthosis, enhancing its usability and functionality. A certified orthotist fitted a subject who had undergone a gracilis free functioning muscle transfer surgery with the device. We studied the subject under Mayo clinic IRB no. 20-006849 and obtained objective measurements to assess the orthosis’s impact on upper extremity functionality during daily activities.

Results

The results are promising since the orthosis significantly improved elbow flexion range of motion by 40° and reduced compensatory movements at the shoulder (humerothoracic joint) by 50°. Additionally, the subject was able to perform tasks which were not possible before, such as carrying a basket with weights, highlighting the enhanced functionality provided by the orthosis.

Conclusion

In brief, by addressing the limitations of existing devices, this novel powered myoelectric elbow orthosis offers individuals with neuromuscular injuries/conditions improved quality of life. Further research will expand the patient population and control mechanisms.
Risks for Enlisted Navy Divers Compared to Other Enlisted Sailors: An Examination of Illnesses That May Be Associated With Exposure to Contaminated Water Diving
Authors: Maguire Brian J , Hughes Linda M , Sellers Andrew J
Published: August 2024

Introduction

Illnesses among Navy divers degrade readiness, decrease manpower levels, and increase costs for medical care. Prior research has shown that Navy divers have high rates of the types of illnesses that might be because of diving in contaminated water. The objectives of this study were to examine medical records of U.S. Navy Sailors from 2016 to 2022 and determine if divers have higher incidence rates of health conditions that might be associated with contaminated water diving compared to non-divers.

Materials and Methods

For this retrospective cohort study, we used data from the Defense Medical Epidemiology Database (DMED). The DMED is operated by the Armed Forces Health Surveillance Division and uses data from the Defense Manpower Data Center to classify occupations. The DMED provides free online access to a de-identified subset of data contained within the Defense Medical Surveillance System.

The population was U.S. Navy enlisted males, aged 25 to 29 years. Divers were compared to non-divers using 8 selected diagnoses that may reasonably be associated with diving in contaminated water.

Results

During the study period, the database contained a total of 5,474 diver and 827,406 non-diver person-years. Of the 8 diagnoses, the ones with the largest number of cases for divers were upper respiratory infections with 128 and ear disorders with 62. The relative risks (RRs) for divers compared to non-divers were higher for otitis externa (RR = 1.44; confidence interval = 1.03, 2.01) and for ear disorders (RR = 1.15; confidence interval = 0.89, 1.47); for the other 6 diagnoses, the divers had lower rates than the non-divers.

Conclusions

The high RRs found for otitis externa and ear disorders support the need to devote resources to better understand the reasons for these higher risks and to develop, test, and implement targeted risk-reduction strategies. Future studies should attempt to link verified contaminated water exposures with adverse health outcomes and calculate risks based on criteria such as age and dive factors.
Is Posterior Cervical Foraminotomy Better Than Fusion for Warfighters?: A Biomechanical Study
Authors: Choi Hoon , Purushothaman Yuvaraj , Ozobu Ifeanyichukwu , Yoganandan Narayan
Published: August 2024

Introduction

Cervical spondylosis in the warfighter is a common musculoskeletal problem and can be career-ending especially if it requires fusion. Head-mounted equipment and increased biomechanical forces on the cervical spine have resulted in accelerated cervical spine degeneration. Current surgical gold standard is anterior cervical discectomy and fusion (ACDF). Posterior cervical foraminotomy (PCF) is a nonfusion surgical alternative, and this can be effective in alleviating radiculopathy from foraminal stenosis caused by disc-osteophyte complex. Biomechanical studies have not been done to analyze motion associated with military aircrew personnel following PCF. The aim of this study was to compare the biomechanical responses of the effects of ACDF and PCF with different grades of facet resection under simulated military aircrew conditions using range of motion, disc pressure, and facet loads at the index and adjacent levels.

Materials and Methods

A validated 3D finite element model of the human cervical spinal column was used to simulate various graded PCF and ACDF. All surgical simulations were performed at the most commonly operated level (C5-C6) in warfighters. Pure moment loading under flexion, extension, and lateral bending, and in vivo follower force of 75 N were applied to the intact spine. Hybrid loading protocol was used to achieve 134 degrees of combined flexion-extension and 83 degrees of lateral bending in intact and surgical models to reflect military loading conditions. Segmental motions, disc pressure, and facet load were obtained and normalized with respect to the intact model to quantify the biomechanical effect.

Results

Anterior cervical discectomy and fusion decreased range of motion at the index and increased motion at the adjacent levels, while all graded PCF responses had an opposite trend: increased motion at the index and decreased motion at adjacent levels. The magnitude of changes depended on the level of resection, spinal level, and loading mode. Disc pressure increased at the index level and decreased at the adjacent levels after PCF. These changes were exaggerated with increasing extent of facet resection. Facet load increased at the index level after PCF especially with extension and right (contralateral) lateral bending. Complete facetectomy led to facet load increases greater than ACDF at the adjacent levels in both flexion and extension.

Conclusions

Posterior cervical foraminotomy is a motion-preserving implant-free surgical alternative to ACDF for warfighters with cervical radiculopathy after failure of conservative management. The treating surgeon must pay close attention to the extent of facet resection to avoid potential spinal instability and future disc and facet degeneration after PCF. Posterior cervical foraminotomy can be more advantageous than ACDF in terms of adjacent segment degeneration, motion preservation, reoperation rate, surgical cost, and retention of warfighters.
Auditory System Injury on the Battlefield—Solutions for Point-of-Injury and Prolonged Casualty Care: A DOTmLPF-P Analysis
Authors: Merkley John Andrew , Lovelace Suheily , Boudin-George Amy , Gates Kathy
Published: August 2024

Introduction

“Good hearing” (DoDI 6030.03 6.5&6.6) is a combat multiplier, critical to service members’ lethality and survivability on the battlefield. Exposure to an explosive blast or high-intensity continuous noise is common in operational settings with the potential to compromise both hearing and vestibular health and jeopardize safety and high-level mission performance. The Joint Trauma System Acoustic Trauma Clinical Practice Guideline was published in 2018, providing recommendations for the assessment and treatment of aural blast injuries and acoustic trauma in the forward deployed environment. Combat care capabilities responsive to current threat environments emphasize prolonged casualty care. Despite recommendations, auditory system health has not been assessed routinely or in its entirety on the battlefield. This is due primarily to the large footprint of an audiometric booth and to the heavy logistical burden of providing high-quality, comprehensive auditory system (including vestibular) examinations in the combat environment.

Materials and Methods

The Defense Health Agency Hearing Center of Excellence has completed a Doctrine, Organization, Training, Materiel, Leadership & Education, Personnel, Facilities, and Policy (DOTmLPF-P) analysis of battlefield auditory system assessment and treatment, using 67 existing DoD documents and artifacts related to operational medicine.

Results

Our analysis found that acoustic trauma is generally not addressed in any of the DOTmLPF-P domains. We recommend that auditory system assessment and treatment be incorporated across the continuum of care on the battlefield. This should be addressed through Prolonged Field Care and Tactical Combat Casualty Care guidance and in all Tactical Combat Casualty Care training programs. Equipment sets should be modified to include boothless technology and associated materiel for auditory system assessment. Policy and Doctrine changes would be required to mandate and support the implementation of these services. Uniformed audiologists should be added to the organizational structure at role 3 or higher to provide direct patient care; consult with other health care providers and commanders; develop and support enforcement of noise hazard guidelines; track hearing readiness; and, when necessary, provide specialized hearing protection devices that can compensate for hearing loss.

Conclusions

These recommendations aim to help the DoD bring about necessary assessments and interventions for acoustic trauma so that service members can have better hearing outcomes and maintain critical auditory system function on the battlefield.
Formal Methods for Establishing Simulation Interoperability for Military Health System Applications
Authors: Davis Nichole K , Byrne Ryan , Gupta Raj K , Santago II Anthony , Tolk Andreas
Published: August 2024

Introduction

Advancements in information technology have facilitated information exchange practices within the Military Health System (MHS), enabling “systems of systems” approaches that broaden and coordinate the set of capabilities available to enhance patient outcomes. This is applicable for MHS modeling and simulation (M&S) applications as well. Learning from successful approaches applied in current interoperability solutions used in the military helps to ensure interoperability practices yield trusted compositions of simulations.

Materials and Methods

The use of formal methods provides the rigor necessary to unambiguously communicate these approaches across the MHS community. Here, 3 formal methods are proposed to ensure the harmonization of models and alignment of M&S data needed for simulation interoperability for MHS applications.

Results

To clarify considerations relevant for establishing simulation interoperability, the proposed formal methods are examined within a notional example of an injury sustained because of blast exposure. The first method applies the principles of semiotics, addressing the coding of information via syntax and semantics, to understand how to align and transform data across simulations within a composition. The second method applies the concepts of well-specified co-simulations, and the use of different techniques, tools, and algorithms to address the composition and synchronization of M&S components. The third method applies the mathematical branch of model theory to codify expert knowledge about concepts, assumptions, and constraints to ensure conceptual alignment within the simulation composition.

Conclusions

Biomedical research must contend with complexity inherent to computational human body modeling, enlisting expert knowledge from multiple domains supporting the development of cross-disciplinary research tools that resolve research foci and associated differences in underlying theories, methods, and applied tools. This is closely related to the broader context of digital engineering for military systems engineering.
GTRpmix: A Linked General Time-Reversible Model for Profile Mixture Models
Authors: Banos Hector , Wong Thomas K F , Daneau Justin , Susko Edward , Minh Bui Quang , Lanfear Robert , Brown Matthew W , Eme Laura , Roger Andrew J
Published: August 2024

Profile mixture models capture distinct biochemical constraints on the amino acid substitution process at different sites in proteins. These models feature a mixture of time-reversible models with a common matrix of exchangeabilities and distinct sets of equilibrium amino acid frequencies known as profiles. Combining the exchangeability matrix with each profile generates the matrix of instantaneous rates of amino acid exchange for that profile. Currently, empirically estimated exchangeability matrices (e.g. the LG matrix) are widely used for phylogenetic inference under profile mixture models. However, these were estimated using a single profile and are unlikely optimal for profile mixture models. Here, we describe the GTRpmix model that allows maximum likelihood estimation of a common exchangeability matrix under any profile mixture model. We show that exchangeability matrices estimated under profile mixture models differ from the LG matrix, dramatically improving model fit and topological estimation accuracy for empirical test cases. Because the GTRpmix model is computationally expensive, we provide two exchangeability matrices estimated from large concatenated phylogenomic-supermatrices to be used for phylogenetic analyses. One, called Eukaryotic Linked Mixture (ELM), is designed for phylogenetic analysis of proteins encoded by nuclear genomes of eukaryotes, and the other, Eukaryotic and Archaeal Linked mixture (EAL), for reconstructing relationships between eukaryotes and Archaea. These matrices, combined with profile mixture models, fit data better and have improved topology estimation relative to the LG matrix combined with the same mixture models. Starting with version 2.3.1, IQ-TREE2 allows users to estimate linked exchangeabilities (i.e. amino acid exchange rates) under profile mixture models.
Pregnant Women’s Receipt of Comprehensive Guideline Recommended Antenatal Care for Smoking
Authors: Licata Milly , Doherty Emma , Farragher Eva , Desmet Clare , Lecathelinais Christophe , Tully Belinda , Wiggers John , Kingsland Melanie , Daly Justine
Published: August 2024

Introduction

Antenatal clinical guidelines recommend antenatal care providers routinely assess the smoking status of all pregnant women at the first antenatal visit and, for women who are current smokers, provide cessation support at the first and all subsequent visits. This study aimed to assess women’s receipt of comprehensive guideline-recommended care for smoking during pregnancy and the maternal and service characteristics associated with such care.

Aims and Methods

A telephone survey was conducted with women who were recently pregnant and received antenatal care from public maternity services in one Australian local health district.

Results

Of the 514 participants, 9% were smokers when they found out they were pregnant. Of these, 47% continued smoking until giving birth. Almost all participants (96%) were asked about their smoking status at their first antenatal visit. Among pregnant smokers, 76% were asked about their smoking at subsequent visits, 73% were advised to quit, 62% were provided with information or advice to assist in quitting, 24% were offered nicotine replacement therapy, and 38% were offered a referral to Quitline. A third of maternal smokers reported receiving all elements of guideline-recommended care. No associations were found between maternal and service characteristics and receipt of care for smoking.

Conclusions

Guideline recommended routine assessment and care for smoking in pregnancy may be less than optimal, particularly for smoking cessation interventions with strong evidence of effectiveness—NRT and quitlines. Identification of barriers and implementation of strategies to increase the offer and uptake of these services by women is required.

Implications

This study is the first to examine pregnant women’s reported receipt of comprehensive guideline-recommended care for maternal smoking. The findings indicate that a significant proportion of pregnant women attending public maternity services are not receiving comprehensive care and that many are not being offered evidence-based interventions to assist them to quit. Barriers to comprehensive care delivery need to be identified and addressed if the potential for smoking interventions delivered in this setting to impact smoking rates in pregnancy is to be realized.
À bout de souffle
Authors: Biltereyst Daniel
Published: August 2024

Few films have garnered as much scholarly and critical acclaim as Jean-Luc Godard’s À bout de souffle (Breathless, 1959). Revered as one of the most influential works in postwar European modernist cinema, Godard’s debut feature stands alongside cinematic landmarks such as Roberto Rossellini’s Roma città aperta (Rome Open City, 1949), Federico Fellini’s La dolce vita (1960) and Otto e mezzo (1963), and Ingmar Bergman’s Persona (1966). Alongside François Truffaut’s Les 400 coups (The 400 Blows, 1959) and Alain Resnais’s Hiroshima mon amour (1959), Godard’s groundbreaking film played a pivotal role in heralding the arrival of the French Nouvelle Vague, or New Wave. This cinematic movement sparked a revolution among filmmakers, both within France and beyond its borders, challenging traditional narrative conventions and elevating the filmmaker to the status of an auteur. As one of the most iconic films of the New Wave and European auteur cinema of the 1950s and 1960s, À bout de souffle left an indelible mark on subsequent generations of filmmakers. Its innovative techniques, unconventional narrative style, and exploration of rebellious youth culture, cinephilia, American culture, and modernity continue to inspire directors across different decades through homage, direct references, and indirect influences. The film’s legacy is evident in numerous articles, monographs, volumes, documentaries, and film essays, with Mark Cousins’s monograph The Story of Film (2004) and his monumental documentary series, The Story of Film: An Odyssey (2011), serving as notable examples, highlighting its impact on filmmakers worldwide, including John Cassavetes, Arthur Penn, Martin Scorsese, Quentin Tarantino, and others in the United States, as well as in India, Italy, Japan, Poland, and Senegal. The breadth of literature dedicated to this film is expansive and varied, ranging from passing mentions in volumes celebrating cinematic classics to comprehensive, book-length analyses devoted solely to unraveling its complexities and significance. This body of work encompasses a diverse array of formats, including essays, scholarly articles, interviews, monographs, multiauthored collections, online blogs, and commentaries on both the script and the film itself, alongside exhibition catalogues. As a seminal work in the history of world cinema, À bout de souffle has firmly entrenched itself in critical and scholarly discourse for more than six decades, transcending the confines of Godard studies. It continues to offer fresh perspectives on its position within Jean-Luc Godard’s oeuvre, its place within modern cinema, and its enduring influence on global cinema, as well as its nuanced exploration of, and commentary on, themes ranging from modernity to Western society and colonialism.
AGAMOUS-LIKE 24 senses continuous inductive photoperiod in the inflorescence meristem to promote anthesis in chrysanthemum
Authors: Liu Xuening , Han Mingzheng , Jiang Tianhua , Liu Lei , Luo Jiayi , Lu Ying , Zhao Yafei , Jiang Cai-Zhong , Gao Junping , Hong Bo , Ma Chao
Published: August 2024

During the floral transition, many plant species including chrysanthemum (Chrysanthemum morifolium) require continuous photoperiodic stimulation for successful anthesis. Insufficient photoperiodic stimulation results in flower bud arrest or even failure. The molecular mechanisms underlying how continuous photoperiodic stimulation promotes anthesis are not well understood. Here, we reveal that in wild chrysanthemum (Chrysanthemum indicum), an obligate short-day (SD) plant, floral evocation is not limited to SD conditions. However, SD signals generated locally in the inflorescence meristem (IM) play a vital role in ensuring anthesis after floral commitment. Genetic analyses indicate that the florigen FLOWERING LOCUS T-LIKE3 (CiFTL3) plays an important role in floral evocation, but a lesser role in anthesis. Importantly, our data demonstrate that AGAMOUS-LIKE 24 (CiAGL24) is a critical component of SD signal perception in the IM to promote successful anthesis, and that floral evocation and anthesis are two separate developmental events in chrysanthemum. We further reveal that the central circadian clock component PSEUDO-RESPONSE REGULATOR 7 (CiPRR7) in the IM activates CiAGL24 expression in response to SD conditions. Moreover, our findings elucidate a negative feedback loop in which CiAGL24 and SUPPRESSOR OF OVEREXPRESSION OF CO 1 (CiSOC1) modulate LEAFY (CiLFY) expression. Together, our results demonstrate that the CiPRR7–CiAGL24 module is vital for sustained SD signal perception in the IM to ensure successful anthesis in chrysanthemum.
The association between infant sleep, cognitive, and psychomotor development: a systematic review
Authors: Butler Bryan , Burdayron Rebecca , Mazor Goder Gil , Lewis Clara , Vendette Mélanie , Khoury Bassam , Pennestri Marie-Hélène
Published: August 2024

Study Objectives

To synthesize findings of original articles examining the association between sleep–wake patterns of typically developing infants aged 0 to 18 months and cognitive and psychomotor development.

Methods

A systematic search strategy was used to identify articles assessing the association between infant sleep (0 to 18 months) and cognitive/psychomotor development (Medline, PsycINFO, and SCOPUS). Of 7136 articles screened, 22 articles met inclusion criteria, and the results were subsequently synthesized. A quality assessment was conducted, and studies were categorized as “poor,” “fair,” or “good.”

Results

Out of 22 studies, 2 found exclusively significant associations (SAs) between infant sleep and cognitive/psychomotor development, 2 found no SAs and 17 found mixed results (MRs). Studies with exclusively significant results used a single sleep variable and single timepoint designs. Studies finding MRs or no SAs used multiple sleep, developmental variables, or multi-timepoint designs. Eight out of 10 studies and 7 out of 8 studies investigating nocturnal and total sleep duration, respectively, found no SA with developmental outcomes. While 63% of studies were rated as having good methodological quality, all studies but one had an estimated power of less than 0.80.

Conclusions

Findings of this review do not support conclusive associations between sleep–wake patterns in infancy and cognitive/psychomotor development. This conclusion contrasts with the literature in older populations, questioning if the association between sleep and development is of a different nature in infancy, potentially because of brain maturation. More studies including larger samples will be needed to clarify the presence or absence of such an association.
What radio waves tell us about sleep!
Authors: He Hao , Li Chao , Ganglberger Wolfgang , Gallagher Kaileigh , Hristov Rumen , Ouroutzoglou Michail , Sun Haoqi , Sun Jimeng , Westover M Brandon , Katabi Dina
Published: August 2024

The ability to assess sleep at home, capture sleep stages, and detect the occurrence of apnea (without on-body sensors) simply by analyzing the radio waves bouncing off people’s bodies while they sleep is quite powerful. Such a capability would allow for longitudinal data collection in patients’ homes, informing our understanding of sleep and its interaction with various diseases and their therapeutic responses, both in clinical trials and routine care. In this article, we develop an advanced machine-learning algorithm for passively monitoring sleep and nocturnal breathing from radio waves reflected off people while asleep. Validation results in comparison with the gold standard (i.e. polysomnography; n = 880) demonstrate that the model captures the sleep hypnogram (with an accuracy of 80.5% for 30-second epochs categorized into wake, light sleep, deep sleep, or REM), detects sleep apnea (AUROC = 0.89), and measures the patient’s Apnea–Hypopnea Index (ICC = 0.90; 95% CI = [0.88, 0.91]). Notably, the model exhibits equitable performance across race, sex, and age. Moreover, the model uncovers informative interactions between sleep stages and a range of diseases including neurological, psychiatric, cardiovascular, and immunological disorders. These findings not only hold promise for clinical practice and interventional trials but also underscore the significance of sleep as a fundamental component in understanding and managing various diseases.
Recent progress in modeling and treating diabetes using stem cell-derived islets
Authors: Maestas Marlie M , Bui Maggie H , Millman Jeffrey R
Published: August 2024

Stem cell-derived islets (SC-islets) offer the potential to be an unlimited source of cells for disease modeling and the treatment of diabetes. SC-islets can be genetically modified, treated with chemical compounds, or differentiated from patient derived stem cells to model diabetes. These models provide insights into disease pathogenesis and vulnerabilities that may be targeted to provide treatment. SC-islets themselves are also being investigated as a cell therapy for diabetes. However, the transplantation process is imperfect; side effects from immunosuppressant use have reduced SC-islet therapeutic potential. Alternative methods to this include encapsulation, use of immunomodulating molecules, and genetic modification of SC-islets. This review covers recent advances using SC-islets to understand different diabetes pathologies and as a cell therapy.
Silencing CircHIPK3 improves sevoflurane-explore learning and memory dysfunction and nerve damage via enhancing miR-338-3p
Authors: Li Xiuli , Li Xuefei , Liang Yinan
Published: August 2024

Background

Sevoflurane (Sev), a widely used volatile anesthetic, can cause neurotoxicity, and impair learning and memory.

Objective

This study investigates the role and mechanisms of circHIPK3 in Sev-exposed neurotoxicity and learning and memory impairment.

Methods

SD rats and hippocampal neuronal cells were exposed to Sev. RT-qPCR analysis of circHIPK3 and miR-338-3p levels. MWM test was performed to examine the behavioral changes in rats. The levels of circHIPK3 and miR-338-3p levels were investigated using RT-qPCR. ELISA assay to analyze the expression of pro-inflammatory factors. CCK-8, flow cytometry, and commercial ROS assay kits were analyzed to detect cell viability, apoptosis, and ROS production. DLR and RIP assays validate circHIPK3 binding to miR-338-3p.

Results

Sev increased circHIPK3 expression in rat hippocampal tissue as well as in neuronal cells but decreased miR-338-3p levels compared to controls. circHIPK3 binding to miR-338-3p. Furthermore, silencing of circHIPK3 rats attenuated Sev-induced decline in learning and memory functions . silencing circHIPK3 also reduced Sev-induced secretion of inflammatory factors in rat and neuronal cells. Reducing circHIPK3 partially reversed the Sev-induced decrease in cell viability, increased apoptosis, and overproduction of ROS. However, the inhibitory effect of circHIPK3 on Sev neurotoxicity was restored upon downregulation of miR-338-3p.

Conclusion

Collectively, silencing circHIPK3 alleviates Sev exposure-induced learning and memory deficits and neurotoxicity by enhancing miR-338-3p expression.
Immunolocalization and Ultrastructure Show Ingestion of Cry Protein Expressed in Glycine max by Heterodera glycines and Its Mode of Action
Authors: Berg R. Howard , Kahn Theodore W. , McCarville Michael T. , Williams Jayme , Czymmek Kirk J. , Daum Julia
Published: August 2024

Great interest exists in developing a transgenic trait that controls the economically important soybean ( Glycine max) pest, soybean cyst nematode (SCN, Heterodera glycines), due to its adaptation to native resistance. Soybean plants expressing the Bacillus thuringiensis delta-endotoxin, Cry14Ab, were recently demonstrated to control SCN in both growth chamber and field testing. In that communication, ingestion of the Cry14Ab toxin by SCN second stage juveniles (J2s) was demonstrated using fluorescently labeled Cry14Ab in an in vitro assay. Here, we show that consistent with expectations for a Cry toxin, Cry14Ab has a mode of action unique from the native resistance sources Peking and PI 88788. Further, we demonstrate in planta the ingestion and localization of the Cry14Ab toxin in the midgut of nematodes feeding on roots expressing Cry14Ab using immunogold labeling and transmission electron microscopy. We observed immunolocalization of the toxin and resulting intestinal damage primarily in the microvillus-like structure (MvL)-containing region of the midgut intestine but not in nematodes feeding on roots lacking toxin. This demonstrated that Cry14Ab was taken up by the J2 SCN, presumably through the feeding tube within the plant root cell that serves as its feeding site. This suggests that relatively large proteins can be taken up through the feeding tube. Electron microscopy showed that Cry14Ab caused lysis of the midgut MvL membrane and eventual degradation of the MvL and the lysate, forming particulate aggregates. The accumulated electron-dense aggregate in the posterior midgut intestine was not observed in SCN in nonCry14Ab-expressing plants.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Psychotherapy Skills for Psychiatric Mental Health Nurse Practitioner Students in the Age of Competency-Based Education
Authors: Kent Kelsey G.
Published: August 2024

As the field of nursing moves toward competency-based education, faculty need to adapt teaching and learning strategies to meet standards for assessing core behaviors of graduate psychiatric mental health nurse practitioner students. This article reviews a psychotherapy skills-based learning assignment at Frontier Nursing University that was adapted to meet developing competency-based learning standards. The assignment utilizes prerecorded video scenarios to provide students with opportunities to reinforce psychotherapy skills during didactic coursework. Assessment is conducted via an analytic rubric and specific feedback is given to each student in writing.
Trauma-Informed Care in Nursing Curricula: Development of a Simulation-Based Educational Framework to Guide Health Professions
Authors: Guest Heather , Miller Cathy L.
Published: August 2024

AIM

This research aimed to uncover elements of a comprehensive, trauma-informed (TI) multidisciplinary health professions simulation framework to improve the delivery of care to traumatized patients.

BACKGROUND

Trauma is a pervasive public health problem requiring a TI approach. Simulation is an evidence-based teaching strategy that advances knowledge and clinical reasoning. There is a lack of scientifically based simulation education models addressing the delivery of TI care for the health professions.

METHOD

A Delphi study utilizing a panel of experts was conducted to identify the most critical elements of a simulation framework.

RESULTS

Phase one identified 10 content areas and 111 subcontent areas. Phase two analysis revealed 99 percent of the 111 subcontent areas achieved expert consensus.

CONCLUSION

This Delphi study provides the first scientifically based framework to guide the development of a comprehensive, TI, multidisciplinary simulation framework to recognize trauma survivors and subsequently display concern and respect.
Using Systematic Desensitization to Create a Mindfulness Activity for Nursing Students With Test Anxiety
Authors: Collins Allison
Published: August 2024

Undergraduate nursing students are voicing high levels of test anxiety within their learning environments. The purpose of this study was to examine the impact of a mindfulness intervention, using systematic desensitization, on community college nursing students’ test anxiety. Data were collected and analyzed with a sample of 107 students randomly selected for a control and intervention group. The intervention group, which listened to a mindfulness podcast while using muscle relaxation, had significantly lower post-intervention test anxiety scores (p <. 001) than the control group. Systematic desensitization is a type of mindfulness that nursing students can use to decrease test anxiety.
Autoantibody testing in myositis: an update
Authors: McMorrow Fionnuala K. , Anwyll Natalie , Tansley Sarah L.
Published: August 2024

Purpose of review

This review aims to provide an update on myositis autoantibody testing strategies. We have focussed on the reliability and usefulness of different myositis autoantibody detection methods, including commonly used solid phase immunoassays and newer discovery techniques.

Recent findings

Several studies have highlighted the limitations of currently available immunoassays, particularly when used in populations with low pretest probability and without supporting clinical evidence. While many autoantibodies, such as anti-Jo1, are detected with high sensitivity and specificity, the low incidence of myositis autoantibodies in tested populations reduces their positive predictive value. The low sensitivity of line immunoassays to detect key myositis autoantibodies, including anti-TIF1γ and rarer antisynthetase autoantibodies, is a concern.

Myositis autoantibodies are widely accepted as important clinical tools, and hence, there is a significant demand for reliable, accessible, and affordable detection methods. False positives and negative results have the potential to impact on patient care, particularly for malignancy and lung disease associated autoantibodies. Increased availability of myositis autoantibody testing has led to a rise in requests from a broader range of clinicians. It is critically important that clinicians are aware of specific limitations of tests and interpret results in the context of clinical findings.
A Cross-Sectional Analysis of Factors Promoting Intergenerational Resilience in Adolescent Youth With Refugee Status
Authors: Hoffman Sarah J. , Vukovich Maria M. , Peterson Barbara L. , Fulkerson Jayne A. , Gewirtz Abigail H. , Fredkove Windy M. , Davis Amanda , Gaugler Joseph E.
Published: August 2024

Background:

Adolescent youth occupy a critical and complex position in refugee families who resettle in a third country.

Objectives:

We examined the potential impact of health- and family-related factors on the social and behavioral adjustment outcomes of refugee adolescent youth.

Methods:

Situated within an explanatory sequential mixed methods study, we used unadjusted and adjusted multinomial logistic regression to identify trauma, health, and socioecological characteristics of war-affected families associated with social and behavioral adjustment in 72 Karen adolescent youth resettled in the United States.

Results:

Factors related to the health and well-being of war-affected families, including parent mental and physical health, youth-reported family function, housing, and parent employment demonstrated important associations with youth adjustment.

Conclusion:

These findings, originating within the complex dynamics of resettled war-affected families, demonstrated the interconnectedness of adolescent and parent experiences and opportunities to advance resilience in youth navigating integration and supporting their families through those same processes.