bluuebunny/crossref_metadata_2025 huggingface dataset:
ToF-SIMS spectra of historical inorganic pigments: Lead-based pigments in negative polarity
Authors: Bouvier Caroline , Van Nuffel Sebastiaan , Brunelle Alain
Published: May 2024

ToF-SIMS is increasingly used to analyze cultural heritage materials because it can simultaneously detect organic and inorganic materials while mapping them on a surface. The precise identification of a pigment in a specific layer of a painting or of remaining color on a statue can inform about the technique used or the time of manufacture as well as expose possible forgeries when anachronistic ingredients are identified. Reference spectra are required to confidently identify a given pigment using ToF-SIMS. This database focuses on eight lead-based historical inorganic pigments, manufactured following traditional recipes. Lead pigments have been widely used in painting until the late 19th century. Here, the negative polarity ToF-SIMS reference spectra using a Bi3+ primary ion species are presented.
Distant small spot presentation in midair haptics using polyhedral reflector
Authors: Ariga Kentaro , Matsubayashi Atsushi , Makino Yasutoshi , Shinoda Hiroyuki
Published: May 2024

In midair haptics, ultrasound phased arrays are mainly used due to their high spatiotemporal controllability. The constraint on the presentation distance of phased arrays to form a focus can be mitigated by utilizing concave reflectors. This paper numerically examines the convergence of a surface approximated by multiple planes serving as a reflector, substituted for an ideal concave surface. A mirrored phased array produced by the planar segments forms a focus and concurrently creates interference among imaginary sources. A single-point convergence condition is derived that constrains the accuracy of the approximated reflector and the phased array size. As long as it satisfies the convergence condition, the approximated reflector can form a single focal point. Numerical simulations were conducted to confirm the validity of the convergence equation and the 5% tolerance of the segment size for the reflector deformation. An experimental campaign was also conducted and confirmed that the polyhedral reflector was able to form a single small focus by controlling the phase shift of the sound source.
Active biointegrated living electronics for managing inflammation
Authors: Shi Jiuyun , Kim Saehyun , Li Pengju , Dong Fuying , Yang Chuanwang , Nam Bryan , Han Chi , Eig Ethan , Shi Lewis L. , Niu Simiao , Yue Jiping , Tian Bozhi
Published: May 2024

Seamless interfaces between electronic devices and biological tissues stand to revolutionize disease diagnosis and treatment. However, biological and biomechanical disparities between synthetic materials and living tissues present challenges at bioelectrical signal transduction interfaces. We introduce the active biointegrated living electronics (ABLE) platform, encompassing capabilities across the biogenic, biomechanical, and bioelectrical properties simultaneously. The living biointerface, comprising a bioelectronics layout and a
Staphylococcus epidermidis
–laden hydrogel composite, enables multimodal signal transduction at the microbial-mammalian nexus. The extracellular components of the living hydrogels, prepared through thermal release of naturally occurring amylose polymer chains, are viscoelastic, capable of sustaining the bacteria with high viability. Through electrophysiological recordings and wireless probing of skin electrical impedance, body temperature, and humidity, ABLE monitors microbial-driven intervention in psoriasis.
Spontaneous weathering of natural minerals in charged water microdroplets forms nanomaterials
Authors: Spoorthi B. K. , Debnath Koyendrila , Basuri Pallab , Nagar Ankit , Waghmare Umesh V. , Pradeep Thalappil
Published: May 2024

In this work, we show that particles of common minerals break down spontaneously to form nanoparticles in charged water microdroplets within milliseconds. We transformed micron-sized natural minerals like quartz and ruby into 5- to 10-nanometer particles when integrated into aqueous microdroplets generated via electrospray. We deposited the droplets on a substrate, which allowed nanoparticle characterization. We determined through simulations that quartz undergoes proton-induced slip, especially when reduced in size and exposed to an electric field. This leads to particle scission and the formation of silicate fragments, which we confirmed with mass spectrometry. This rapid weathering process may be important for soil formation, given the prevalence of charged aerosols in the atmosphere.
Bridging two views of autism
Authors: Thorp H. Holden
Published: May 2024

Last week,
Science
,
Science Advances
, and
Science Translational Medicine
published an extensive set of papers from the PsychENCODE Consortium, a multi-institutional collaboration whose aim is to study the genetics of neuropsychiatric disorders such as bipolar disorder, autism spectrum disorder, and schizophrenia. The papers, collectively called PsychENCODE2, apply advances in single-cell and multi-omic technologies to postmortem brain tissue to elucidate factors that may help explain and develop treatments for neuropsychiatric conditions. The new insights gained from these considerable data will hopefully inspire new ways in which the clinical community can find common ground with researchers, something that is not always guaranteed in the contentious mental health field.
Legacy copper/nickel mine tailings potentially harbor novel iron/sulfur cycling microorganisms within highly variable communities
Authors: Chen Molly , Grégoire Daniel S. , Bain Jeffrey G. , Blowes David W. , Hug Laura A.
Published: May 2024

The oxidation of sulfide-bearing mine tailings catalyzed by acidophilic iron and sulfur-oxidizing bacteria releases toxic metals and other contaminants into soil and groundwater as acid mine drainage. Understanding the environmental variables that control the community structure and metabolic activity of microbes indigenous to tailings (especially the abiotic stressors of low pH and high dissolved metal content) is crucial to developing sustainable bioremediation strategies. We determined the microbial community composition along two continuous vertical gradients of Cu/Ni mine tailings at each of two tailings impoundments near Sudbury, Ontario. 16S rRNA amplicon data showed high variability in community diversity and composition between locations, as well as at different depths within each location. A temporal comparison for one tailings location showed low fluctuation in microbial communities across 2 years. Differences in community composition correlated most strongly with pore-water pH, Eh, alkalinity, salinity, and the concentration of several dissolved metals (including iron, but not copper or nickel). The relative abundances of individual genera differed in their degrees of correlation with geochemical factors. Several abundant lineages present at these locations have not previously been associated with mine tailings environments, including novel species predicted to be involved in iron and sulfur cycling.

IMPORTANCE

Mine tailings represent a significant threat to North American freshwater, with legacy tailings areas generating acid mine drainage (AMD) that contaminates rivers, lakes, and aquifers. Microbial activity accelerates AMD formation through oxidative metabolic processes but may also ameliorate acidic tailings by promoting secondary mineral precipitation and immobilizing dissolved metals. Tailings exhibit high geochemical variation within and between mine sites and may harbor many novel extremophiles adapted to high concentrations of toxic metals. Characterizing the unique microbiomes associated with tailing environments is key to identifying consortia that may be used as the foundation for innovative mine-waste bioremediation strategies. We provide an in-depth analysis of microbial diversity at four copper/nickel mine tailings impoundments, describe how communities (and individual lineages) differ based on geochemical gradients, predict organisms involved in AMD transformations, and identify taxonomically novel groups present that have not previously been observed in mine tailings.
Higher HIV-1 evolutionary rate is associated with cytotoxic T lymphocyte escape mutations in infants
Authors: Nazziwa Jamirah , Andrews Sophie M. , Hou Mimi M. , Bruhn Christian A. W. , Garcia-Knight Miguel A. , Slyker Jennifer , Hill Sarah , Lohman Payne Barbara , Moringas Dorothy , Lemey Philippe , John-Stewart Grace , Rowland-Jones Sarah L. , Esbjörnsson Joakim
Published: May 2024

Escape from cytotoxic T lymphocyte (CTL) responses toward HIV-1 Gag and Nef has been associated with reduced control of HIV-1 replication in adults. However, less is known about CTL-driven immune selection in infants as longitudinal studies of infants are limited. Here, 1,210
gag
and 1,264
nef
sequences longitudinally collected within 15 months after birth from 14 HIV-1 perinatally infected infants and their mothers were analyzed. The number of transmitted founder (T/F) viruses and associations between virus evolution, selection, CTL escape, and disease progression were determined. The analyses indicated that a paraphyletic-monophyletic relationship between the mother-infant sequences was common (80%), and that the HIV-1 infection was established by a single T/F virus in 10 of the 12 analyzed infants (83%). Furthermore, most HIV-1 CTL escape mutations among infants were transmitted from the mothers and did not revert during the first year of infection. Still, immune-driven selection was observed at approximately 3 months after HIV-1 infection in infants. Moreover, virus populations with CTL escape mutations in
gag
evolved faster than those without, independently of disease progression rate. These findings expand the current knowledge of HIV-1 transmission, evolution, and CTL escape in infant HIV-1 infection and are relevant for the development of immune-directed interventions in infants.

IMPORTANCE

Despite increased coverage in antiretroviral therapy for the prevention of perinatal transmission, paediatric HIV-1 infection remains a significant public health concern, especially in areas of high HIV-1 prevalence. Understanding HIV-1 transmission and the subsequent virus adaptation from the mother to the infant’s host environment, as well as the viral factors that affect disease outcome, is important for the development of early immune-directed interventions for infants. This study advances our understanding of vertical HIV-1 transmission, and how infant immune selection pressure is shaping the intra-host evolutionary dynamics of HIV-1.
Evolution of the pathogenic mold
Aspergillus fumigatus
on high copper levels identifies novel resistance genes
Authors: Handelman Mariana , Meir Zohar , Shadkchan Yona , Abo Kandil Ammar , Amano Orin , Mariscal Melani , López-Berges Manuel Sánchez , Osherov Nir
Published: May 2024

Aspergillus fumigatus
is the leading cause of severe mold infections in immunocompromised patients. This common fungus possesses innate attributes that allow it to evade the immune system, including its ability to survive the high copper (Cu) levels in phagosomes. Our previous work has revealed that under high Cu levels, the
A. fumigatus
transcription factor AceA is activated, inducing the expression of the copper exporter CrpA to expel excess Cu. To identify additional elements in Cu resistance, we evolved
A. fumigatus
wild-type and mutant Δ
aceA
or Δ
crpA
strains under increasing Cu concentrations. Sequencing of the resultant resistant strains identified both shared and unique evolutionary pathways to resistance. Reintroduction of three of the most common mutations in genes encoding Pma1 (plasma membrane H
+
-ATPase), Gcs1 (glutamate cysteine-ligase), and Cpa1 (carbamoyl-phosphate synthetase), alone and in combination, into wild-type
A. fumigatus
confirmed their additive role in conferring Cu resistance. Detailed analysis indicated that the
pma1
mutation L424I preserves Pma1 H
+
-ATPase activity under high Cu concentrations and that the
cpa1
mutation A37V confers a survival advantage to conidia in the presence of Cu. Interestingly, simultaneous mutations of all three genes did not alter virulence in infected mice. Our work has identified novel Cu-resistance pathways and provides an evolutionary approach for dissecting the molecular basis of
A. fumigatus
adaptation to diverse environmental challenges.

IMPORTANCE

Aspergillus fumigatus
is the most common mold infecting patients with weakened immunity. Infection is caused by the inhalation of mold spores into the lungs and is often fatal. In healthy individuals, spores are engulfed by lung immune cells and destroyed by a combination of enzymes, oxidants, and high levels of copper. However, the mold can protect itself by pumping out excess copper with specific transporters. Here, we evolved
A. fumigatus
under high copper levels and identified new genetic mutations that help it resist the toxic effects of copper. We studied how these mutations affect the mold’s ability to resist copper and how they impact its ability to cause disease. This is the first such study in a pathogenic mold, and it gives us a better understanding of how it manages to bypass our body’s defenses during an infection.
Clinical risk factors and outcomes of carbapenem-resistant
Escherichia coli
nosocomial infections in a Chinese teaching hospital: a retrospective study from 2013 to 2020
Authors: Kong Haifang , Hu Zhidong , Zhang Longtao , Chen Qianqian , Yang Ling , Li Jin , Tian Bin , Chai Yamin , Feng Xuequan
Published: May 2024

The emergence of carbapenem-resistant
Escherichia coli
strains poses a considerable challenge to global public health, and little is known about carbapenemase-producing
E. coli
strains in Tianjin, China. This study aimed to investigate the risk factors for infections with carbapenem-resistant
E. coli
(CREC) strains. This retrospective case–control study was conducted at a tertiary teaching hospital. A total of 134 CREC clinical isolates were collected from the General Hospital of Tianjin Medical University between 2013 and 2020. The control group was selected at a ratio of 1:1 from patients with nosocomial carbapenem-susceptible
E. coli
infection. Risk factors for nosocomial CREC infection and clinical outcomes were analyzed using univariate and multivariate analyses. Multivariate analysis revealed that cephalosporin exposure (odd ratio OR = 2.01), carbapenem exposure (OR = 1.96), glucocorticoid exposure (OR = 32.45), and surgical history (OR = 3.26) were independent risk factors for CREC infection. The in-hospital mortality rate in the CREC group was 29.1%, and age >65 years (OR = 3.19), carbapenem exposure (OR = 3.54), and central venous catheter insertion (OR = 4.19) were independent risk factors for in-hospital mortality in patients with CREC infections. Several factors were identified in the development of nosocomial CREC infections. The CREC isolates were resistant to most antibiotics. Reducing CREC mortality requires a comprehensive consideration of appropriate antibiotic use, underlying diseases, and invasive procedures.

IMPORTANCE

Escherichia coli
is an opportunistic pathogen that causes severe hospital-acquired infections. The spread of carbapenem-resistant
E. coli
is a global threat to public health, and only a few antibiotics are effective against these infections. Consequently, these infections are usually associated with poor prognosis and high mortality. Therefore, understanding the risk factors associated with the causes and outcomes of these infections is crucial to reduce their incidence and initiate appropriate therapies. In our study, several factors were found to be involved in nosocomial carbapenem-resistant
E. coli
(CREC) infections, and CREC isolates were resistant to most antibiotics. Reducing CREC mortality needs a comprehensive consideration of whether antibiotics are used appropriately, underlying diseases, and invasive interventions. These findings provide valuable evidence for the development of anti-infective therapy, infection prevention, and control of CREC-positive infections.
Basement, belt, and batholith: Bedrock geology of the Idaho Panhandle
Authors: Gaschnig* Richard , Lewis Reed S. , Buddington Andy , Mato Klementina
Published: May 2024

This trip explores the three main bedrock geology elements in the Idaho Panhandle region and the Priest River metamorphic complex: basement gneisses, the Belt Supergroup (Purcell Supergroup in Canada), and the Kaniksu batholith. The Priest River metamorphic complex includes two areas with Precambrian basement gneisses, informally termed the Pend Oreille and Cougar Gulch complexes. The Pend Oreille complex contains a 2.67 Ga orthogneiss and a 1.58 Ga orthogneiss, the latter notable for falling in the “North American magmatic gap” (NAMG) age range. The Cougar Gulch complex is dominated by ca. 1.86 Ga orthogneisses with ca. 2.67 Ga amphibolites. Overlying the basement rocks in both areas are thin graphitic quartzites that have been correlated with the Neihart quartzite and thick paragneiss sequences that have been correlated with the Prichard Formation of the Belt Supergroup.

The upper plate of the Priest River complex contains substantial exposures of only weakly metamorphosed Belt Supergroup. The Belt Supergroup is a very thick sequence of fine-grained clastic sedimentary rocks deposited in an intracontinental extensional setting between ca. 1.46 and 1.40 Ga. Its main formal divisions are the Prichard Formation, Ravalli Group, Piegan Group, and Missoula Group. The Prichard Formation consists of deep-water turbidites interlayered with contemporaneous mafic sills, whereas the other units of the Belt Supergroup accumulated in shallow-water environments. Both the Prichard Formation and Ravalli Group typically contain detrital zircons with ages in the NAMG that have long been interpreted to have originated on another previously connected continent block when North America was part of the Nuna supercontinent. The balance of evidence based on correlations with the basement units and study of Belt provenance strongly suggests that the Gawler craton of southern Australia was adjacent to this region in Nuna during deposition of early Belt units.

The Kaniksu batholith forms the bulk of both the upper and lower plates of the Priest River metamorphic complex. New U-Pb zircon dating indicates that most of the batholith was constructed between 120 and 100 Ma with much less magmatism continuing to 72 Ma. The batholith is the southern end of the Omineca Belt of the Canadian Cordillera and is compositionally diverse, with isotope data suggesting at least three different crustal source components involved in its genesis. The batholith appears to have formed well to the rear of the Cretaceous Cordilleran arc front (i.e., the Coast Mountains batholith), and was thus probably not directly related to subduction but instead likely formed through episodic crustal thickening.
Effect of Shear Loading Conditions on the Measured Strength of Ice Adhesion to Superhydrophobic Surfaces
Authors: Emelyanenko K. A. , Emelyanenko A. M. , Boinovich L. B.
Published: May 2024

Despite the significant interest of researchers, icing of aircraft, vehicles, ships, and equipment of offshore oil structures remains to be an urgent problem. This paper considers the factors that promote a decrease in the strength of the contact between ice and surfaces under an applied shear load. The main attention is focused on studying the influence of the rate of shear loading on the fracture of the interfacial contact between ice and superhydrophobic coatings. The strength of the adhesive contact under the conditions of controlled variations in the applied load is measured using a technique based on the detachment of ice from a surface under the influence of centrifugal force. The study is carried out for large ensembles of samples in the temperature range from −5 to −20°C, thereby making it possible to evaluate the influence of the quasi-liquid layer and the Rehbinder effect on a decrease in the shear adhesive strength. The results obtained indicate that the contact between ice and a superhydrophobic coating is fractured through a mixed viscous–brittle mechanism. In this case, a decrease in temperature or an increase in the loading rate causes a transition from the viscous to the brittle fracture. These results indicate a potential acceleration of ice shedding with an increase in the growth rate of the shear stress.
Association of the Achondroplasia Foramen Magnum Score and intraoperative neuromonitoring
Authors: Craven Claudia , Jankovic Ivana , Dyson Edward , Boyd Stewart G , D'Arco Felice , Cheung Moira Shang-Mei , Thompson Dominic
Published: May 2024

Introduction

Foramen magnum stenosis in achondroplasia carries a risk of sudden death. A proportion of these patients benefit from foramen magnum decompression (FMD). The Achondroplasia Foramen Magnum Score (AFMS) was developed to stratify those most at risk. We hypothesise that this score may be reflected in neurophysiological findings.

Methods

Patients with achondroplasia who had undergone FMD (n=20) were retrospectively grouped into AFMS 2, 3 and 4. Amplitude from tibialis anterior (TA) and the percentage change in somatosensory evoked potential (SSEP) latency after FMD were reported.

Results

Baseline motor evoked potential amplitudes for patients with AFMS=4 were significantly lower left (p=0.0017 and p=0.02 for right and left TA, respectively) compared with AFMS grades 2 and 3. Median reduction (% change) in SSEP latency (ms) after surgery was not significantly different in any of the patients.

Conclusions

This short report cross-references AFMS to intraoperative neuromonitoring. Baseline amplitudes were noticeably lower in the most severe AFMS group. This observation supports the notion that AFMS can help risk stratify patients and aid in surgical selection.
Achieving large-scale clinician adoption of AI-enabled decision support
Authors: Scott Ian A. , van der Vegt Anton , Lane Paul , McPhail Steven , Magrabi Farah
Published: May 2024

Computerised decision support (CDS) tools enabled by artificial intelligence (AI) seek to enhance accuracy and efficiency of clinician decision-making at the point of care. Statistical models developed using machine learning (ML) underpin most current tools. However, despite thousands of models and hundreds of regulator-approved tools internationally, large-scale uptake into routine clinical practice has proved elusive. While underdeveloped system readiness and investment in AI/ML within Australia and perhaps other countries are impediments, clinician ambivalence towards adopting these tools at scale could be a major inhibitor. We propose a set of principles and several strategic enablers for obtaining broad clinician acceptance of AI/ML-enabled CDS tools.
Clinical characteristics of recurrent non-arteritic retinal artery occlusion
Authors: Kim Hyeong Min , Woo Se Joon
Published: May 2024

Objectives

To investigate the recurrent non-arteritic retinal artery occlusion (RAO) in the same or opposite eye.

Methods

We searched the RAO registry at Seoul National University Bundang Hospital and included patients with recurrent RAO in the present study. Ophthalmic and systemic features were analysed to identify risk factors and visual outcomes.

Results

Of the 850 patients in the non-arteritic RAO cohort, 11 (1.3%) experienced a second RAO recurrence, either in the same (5 patients; 0.6%) or opposite (6 patients; 0.7%) eye. The same eye group experienced an earlier recurrence (1–2 months, median 1 month) than the opposite eye group, where the time to recurrence was notably longer (8–66 months, median 22 months). Best corrected visual acuity (BCVA) in the same eye group decreased after the recurrence of RAO. In the same eye group, initial BCVA ranged from 20/200 to counting fingers (CF), while BCVA during RAO recurrence ranged from CF to hand motion. When RAO recurred in the opposite eye, the reduction in visual acuity was less severe than the reduction of the initial episode: initial episode ranged from 20/400 to light perception and recurrent episode ranged from 20/25 to 20/400. Patients exhibited varying degrees of carotid (81.8%) and cerebral (9.1%) artery occlusions. Additionally, one patient in each group (total 2 patients, 18.2%) experienced a stroke 6 months after RAO recurrence.

Conclusions

Since the RAO recurrences could lead to devastating visual impairment, it is essential to emphasise the importance of risk factor screening to patients while collaborating with neurologists and cardiologists.
Rapid implementation of blood pressure self-monitoring in pregnancy at a UK NHS Trust during the COVID-19 pandemic: a quality improvement evaluation
Authors: Lavallee Layla , Roman Cristian , Brace Emily , Mackillop Lucy , Yang Yaling , Cairns Alexandra , Dockree Samuel , Tarassenko Lionel , McManus Richard J , Wilson Hannah , Tucker Katherine
Published: May 2024

Background

This service evaluation describes the rapid implementation of self-monitoring of blood pressure (SMBP) into maternity care at a tertiary referral centre during the COVID-19 pandemic. It summarises findings, identifies knowledge gaps and provides recommendations for further research and practice.

Intervention

Pregnant and postpartum women monitored their blood pressure (BP) at home, with instructions on actions to take if their BP exceeded pre-determined thresholds. Some also conducted proteinuria self-testing.

Data collection and analysis

Maternity records, app data and staff feedback were used in interim evaluations to assess process effectiveness and guide adjustments, employing a Plan-Do-Study-Act and root cause analysis approach.

Results

Between March 2020 and August 2021, a total of 605 women agreed to self-monitor their BP, including 10 women with limited English. 491 registered for telemonitoring (81.2%). 21 (3.5%) took part in urine self-testing. Engagement was high and increased over time with no safety issues. Biggest concerns related to monitor supply and postnatal monitoring. In December 2020, SMBP was integrated into the standard maternity care pathway.

Conclusions

This project demonstrated successful integration of SMBP into maternity care. Early stakeholder engagement and clear guidance were crucial and community midwifery support essential. Supplying BP monitors throughout pregnancy and post partum could improve the service and fully digitised maternity records would aid data collection. More research is needed on SMBP in the postnatal period and among non-English speakers. These findings support efforts to implement app-supported self-monitoring and guide future research.
Enhancing patient safety: detection of in-hospital hazards and effect of training on detection (by training in a low-fidelity simulation Room of Improvement based on hospital-specific CIRS cases)
Authors: Graf Carina , Rüst Christoph Alexander , Koppenberg Joachim , Filipovic Miodrag , Hautz Wolf , Kaemmer Juliane , Pietsch Urs
Published: May 2024

Importance

Adequate situational awareness in patient care increases patient safety and quality of care. To improve situational awareness, an innovative, low-fidelity simulation method referred to as Room of Improvement, has proven effective in various clinical settings.

Objective

To investigate the impact after 3 months of Room of Improvement training on the ability to detect patient safety hazards during an intensive care unit shift handover, based on critical incident reporting system (CIRS) cases reported in the same hospital.

Methods

In this educational intervention, 130 healthcare professionals observed safety hazards in a Room of Improvement in a 2 (time 1 vs time 2)×2 (alone vs in a team) factorial design. The hazards were divided into immediately critical and non-critical.

Results

The results of 130 participants were included in the analysis. At time 1, no statistically significant differences were found between individuals and teams, either overall or for non-critical errors. At time 2, there was an increase in the detection rate of all implemented errors for teams compared with time 1, but not for individuals. The detection rate for critical errors was higher than for non-critical errors at both time points, with individual and group results at time 2 not significantly different from those at time 1. An increase in the perception of safety culture was found in the pre-post test for the questions whether the handling of errors is open and professional and whether errors are discussed in the team.

Discussion

Our results indicate a sustained learning effect after 12 weeks, with collaboration in teams leading to a significantly better outcome. The training improved the actual error detection rates, and participants reported improved handling and discussion of errors in their daily work. This indicates a subjectively improved safety culture among healthcare workers as a result of the situational awareness training in the Room of Improvement. As this method promotes a culture of safety, it is a promising tool for a well-functioning CIRS that closes the loop.
Quality improvement initiative to reduce Medical Adhesive Related Skin injury (MARSI) in very preterm babies admitted to neonatal intensive care unit
Authors: Kar Shrutiprajna , Jarain Veneza Zareen Lyngdoh , Karmakar Soumi , Devi Usha , Som Tapas Kumar , Mohanty Pankaj Kumar , Sahoo Tanushree , Sahoo Jagdish Prasad , Jeyaraman Saranya , Acharya Sangeeta
Published: May 2024

Introduction

Sick preterm neonates are most vulnerable to developing skin injuries. Despite sound knowledge and application of evidence-based practices for preventing medical adhesive-related skin injury (MARSI), the incidence of MARSI was 30 events per 1000 adhesive application days in our unit.

Aims and objectives

We aimed to reduce the median MARSI rate from the existing 30 per 1000 MARSI days to <5 per 1000 MARSI over 5 months from June 2023 to October 2023.

Material & methods

With the point-of-care quality improvement (QI) approach, a prospective study was planned to reduce the incidence of MARSI among sick very preterm newborns (<32 weeks gestational age) and eventually improve overall skin condition during hospital stay. Sequential Plan—Do—Study—Act cycles were implemented based on the identified risk factors recognised during recurring team discussions.

Results

We demonstrated a reduction in the MARSI rate from 30 events per 1000 adhesive applications (during baseline assessment) to zero events per 1000 adhesive applications at the end of the study period. It was temporally related to the assessment of skin risk stratification at admission using a validated tool, regular assessment of neonatal skin condition score based on the skin risk stratification, and reinforcement of MARSI prevention bundle by application of barrier spray. Awareness regarding ‘skin injury prevention’ bundles was continually generated among healthcare professionals. The MARSI rate remained <5 events per adhesive application in the sustenance phase over 6 months.

Conclusion

Implementing evidence-based skin care practices resulted in a significant reduction in iatrogenic cutaneous injury events in very preterm neonates.
Assessing nourishment problems at a hospital: what can we learn from them?
Authors: Clausen Mette Kring , Bogh Søren Bie , Schmidt-Petersen Mathilde , Morsø Lars
Published: May 2024

Introduction

Patient safety is a high priority in the Danish health care system, including that hospital patients get the proper nutrition during their stay. A Nutrition Committee at Odense University Hospital is responsible for policy regarding nourishment at the hospital. If patients experience suboptimal treatment, i.e. improper nourishment, in the Danish health care system, they have the right to file a complaint. These complaints enable the improvement potentials based on the patients’ first hand experiences. Therefore, our aim was to examine the nutrition complaint pattern and to get a deeper understanding of the context surrounding nutrition problems, allowing the extraction of learning potentials.

Methods

We analysed complaints submitted to Odense University Hospital between 2018 and 2022 using the Healthcare Complaint Analysis Tool. The complaints were categorised into categories, levels of severity and overall patient harm. The complaints containing a high-severity nutrition problem were read through and thematised into aspects not defined in the Healthcare Complaint Analysis Tool.

Results

Between 2018 and 2022, 60 complaint cases containing 89 nutrition problems were filed to Odense University Hospital. Most (58.3%) of these were filed by the patients’ relatives. The nutrition problems were mostly of low severity (56.2%), while 23.6% were severe, and 20.2% were very severe. The reading of 18 very severe nutrition complaints revealed a cascade of problems triggered by the nutrition problem in six cases. Moreover, we saw that two high-severity nutrition problems led to catastrophic harm.

Discussion

A low proportion of nutrition problems may express an underestimation regarding nourishment at the hospital. A patient’s threshold may not be exceeded by suboptimal nutrition and therefore does not file a complaint. However, complaints contain important insights contributing to wider learning, given that improvements at the hospital so far are based on clinicians’ reporting, overlooking the patient perspective.
CareFirst-FundLater (CareFFuL): an end-of-life home care quality improvement project
Authors: Morrison Jo , Robinson Fiona , Witney Ally , Greene Helen , Marks Clare , Davis Charles
Published: May 2024

Previous work found referrals for end-of-life care are made late in the dying process and assessment processes for care funding, through continuing healthcare fast-track funding often inhibit people being able to die at home. The average time to discharge was 6.3 days and 29% died in hospital, as median survival was only 15 days.

We aimed to support discharge to home within 1 day by December 2023 for patients, wishing to die at home, referred to the end-of-life discharge team in a medium-sized district general hospital in Southwest England.

In phase 1, we identified 13 people on a patient-by-patient basis, learning from obstacles. Barriers identified included sourcing of equipment, communication between teams and clunky paperwork. Median time to discharge was 2 days (range within 24 hours to 8 days) with 2/13 (15.4%) dying prior to discharge. In phase 2, we extended the pilot, and 104 patients were identified; 94 people were discharged to home, with a median of wait of 1 day (range 0–7) to discharge, and 10 (9.6%) died prior to discharge (median 1 day; range 0–4). Median survival from discharge for the 94 who achieved their wishes to go home to die was 9 days (range 1–205 days). Only 26/94 (27.7%) people survived more than 30 days.

Rapid decision-making and structures to support home-based end-of-life care can support more people to die in their preferred place of care, by using a community-based rapid response team instead of, or in parallel with continuing healthcare fast-track funding referral applications. Current pathways and funding models are not fit for purpose in an urgent care scenario when we have only one chance to get it right.
Global research priorities for intrauterine suction and sponge tools for postpartum haemorrhage management in low-income and middle-income countries: a modified Delphi approach
Authors: Walker Dilys , Shin Linda , Santos Nicole , Butrick Elizabeth , Durocher Jill , Miller Suellen , Amsalu Ribka , Wanyoro Anthony
Published: May 2024

Introduction

Postpartum haemorrhage (PPH) remains the leading cause of maternal mortality and morbidity globally. Innovative PPH management tools have emerged using suction and sponge tamponade but currently lack substantial evidence. Broader understanding and collaborative research prioritisation are needed, especially in low-income and middle-income countries (LMICs), where the burden of PPH-related mortality is highest. We aimed to describe the current state of evidence and to solicit stakeholder input to identify research priorities related to emerging tools for PPH management.

Methods

We used a four-phase modified Delphi approach to identify research priorities for emerging suction and sponge tools. In phase 1, we conducted a literature review and key informant interviews (KIIs) with 19 stakeholders. In phase 2, we distributed an online survey, receiving 66 responses. In phase 3, we virtually convened an expert panel of stakeholders (n=24) and a separate midwife-only focus group to discuss preliminary results and draft research questions. In phase 4, we surveyed our expert panel (n=37) for prioritisation of research questions. Surveys were disseminated via Research Electronic Data Capture while KIIs and the expert convening were held virtually.

Results

Participants included clinicians, researchers, policy-makers, funders and tool developers from high-income and LMIC settings. The prioritisation process narrowed our focus from six tools to four, all of which were top-ranked priorities in phase 4. Stakeholders emphasised efficacy research in comprehensive emergency obstetric and newborn care facilities. Stakeholders stressed the importance of understanding adverse event risks. The urgency in conducting research on cost, provider ease of use and acceptability and patient experience differed between individuals from high-income versus LMIC settings.

Conclusion

All four tools prioritised in this process have the potential to improve PPH management in LMICs. A coordinated research agenda is necessary to confirm safety and efficacy and to determine which tools are most appropriate for specific LMIC settings.
ZFYVE19 deficiency: a ciliopathy involving failure of cell division, with cell death
Authors: Yang Jing , Zhang Ya-Nan , Wang Ren-Xue , Hao Chen-Zhi , Qiu Yiling , Chi Hao , Luan Wei-Sha , Tang HongYi , Zhang Xiu-Juan , Sun XuXu , Sheps Jonathan A , Ling Victor , Cao Muqing , Wang Jian-she
Published: May 2024

Background and aims

Variants inZFYVE19underlie a disorder characterised by progressive portal fibrosis, portal hypertension and eventual liver decompensation. We aim to create an animal model to elucidate the pathogenic mechanism.

Methods

Zfyve19knockout (Zfyve19−/−) mice were generated and exposed to different liver toxins. Their livers were characterised at the tissue, cellular and molecular levels. Findings were compared with those in wild-type mice and in ZFYVE19-deficient patients.ZFYVE19knockout and knockdown retinal pigment epithelial-1 cells and mouse embryonic fibroblasts were generated to study cell division and cell death.

Results

TheZfyve19−/−mice were normal overall, particularly with respect to hepatobiliary features. However, when challenged with α-naphthyl isothiocyanate,Zfyve19−/−mice developed changes resembling those in ZFYVE19-deficient patients, including elevated serum liver injury markers, increased numbers of bile duct profiles with abnormal cholangiocyte polarity and biliary fibrosis. Failure of cell division, centriole and cilia abnormalities, and increased cell death were observed in knockdown/knockout cells. Increased cell death and altered mRNA expression of cell death-related signalling pathways was demonstrated in livers fromZfyve19−/−mice and patients. Transforming growth factor-β (TGF-β) and Janus kinase-Signal Transducer and Activator of Transcription 3 (JAK-STAT3) signalling pathways were upregulated in vivo, as were chemokines such as C-X-C motif ligands 1, 10 and 12.

Conclusions

Our findings demonstrated that ZFYVE19 deficiency is a ciliopathy with novel histological features. Failure of cell division with ciliary abnormalities and cell death activates macrophages and may thus lead to biliary fibrosis via TGF-β pathway in the disease.
Span of control and well-being outcomes among hospital frontline managers: too much to handle?
Authors: Hansen Ane-Kathrine Lundberg , Jacobsen Christian Bøtcher , Dalgaard Vita Ligaya
Published: May 2024

Purpose

To examine the consequences of broader spans of control for well-being outcomes among frontline managers.

Method

Healthcare managers were surveyed in collaboration with the Central Denmark Region. The response rate was 74.5%. Using regression analysis, we investigate how span of control is associated with outcomes related to well-being understood as perceived stress, burnout, job satisfaction, satisfaction with the work environment, intention to quit their current job and work–life balance.

Findings

Span of control may be an important factor in establishing well-being among frontline managers in the Danish hospital sector on several parameters. Span of control is associated the strongest with work–life balance and intention to quit, least but significantly with perceived stress and not significantly with burnout.

Practical implications

We recommend that healthcare organisations consider whether it could be more optimal to reduce the span of control for some managers. Furthermore, we recommend that future studies pay attention to span of control and provide stronger causal evidence about its impact on healthcare workers.
Cardiac physiology and pathophysiology in pregnancy
Authors: Rizi Shekoofeh Saboktakin , Wiens Evan , Hunt Jennifer , Ducas Robin
Published: May 2024

Cardiovascular disease is the leading indirect cause of maternal morbidity and mortality, accounting for nearly one third of maternal deaths during pregnancy. The burden of cardiovascular disease in pregnancy is increasing, as are the incidence of maternal morbidity and mortality. Normal physiologic adaptations to pregnancy, including increased cardiac output and plasma volume, may unmask cardiac conditions, exacerbate previously existing conditions, or create de novo complications. It is important for care providers to understand the normal physiologic changes of pregnancy and how they may impact the care of patients with cardiovascular disease. This review outlines the physiologic adaptions during pregnancy and their pathologic implications for some of the more common cardiovascular conditions in pregnancy.
Thermal-based gender recognition using drones: advancing biometric recognition in challenging outdoor environments
Authors: Příhodová Kateřina , Jech Jakub
Published: May 2024

While biometric recognition typically uses features such as face, fingerprint, and iris to identify individuals, this study focuses on utilising specific characteristics to identify gender. The aim of this article is to propose a procedure for gender recognition under specific conditions. The specific condition addressed is outdoor area monitoring, which presents challenges such as varying lighting conditions and limited camera placement options. To tackle this, a proposed procedure utilises thermal images captured by the drone equipped with a thermal camera. The advantage of thermal images is their independence from ambient light conditions. The captured images are resized and processed using convolutional neural networks (CNNs) (AlexNet, VGG-16, VGG-19) for feature extraction and binary classification. A freely available database of thermal face images is used for training the CNNs, while a own created dataset of thermal images obtained by the drone is used for testing. The findings indicate that the optimised CNNs achieve classification accuracies of 82.4% (VGG-16), 82.9% (AlexNet), and 85.5% (VGG-19). The original contribution of this study lies in demonstrating the suitability of face thermal images obtained through drones for gender recognition purposes.
POST 21st CENTURY STUDIES OF PROPERTIES AND DYNAMICS OF SURFACES DEVELOPED THROUGH DIFFERENT PURE AND COMPETITIVE GROWTH MODELS IN 1+1 AND 2+1 DIMENSIONS: A REVIEW
Authors: NINORIA S. Z. , BANERJEE D.
Published: May 2024

With the advent of the semiconductor age and later the age of nanotechnology, the thin film and coating field have established their importance and reasons for doing in-depth studies. Different sophisticated physical techniques, like chemical vapor deposition, sputtering, evaporation, molecular beam epitaxy, etc., and the conventional spin coating or dip coating, have been employed to get thin films of specific materials/compounds. Of all these, physical techniques are particularly preferred for their ability to develop good quality thin film with high uniformity. In the field of experimental material science, there are tremendous efforts in thin film development and the study of their different properties. The properties include topological, electrical, electronic, optical, or other. At the same time, though less explored, there are developments of theoretical understanding regarding the basic mechanism of thin film growth by specific growth mechanism. In doing this, the basic mechanism of thin film growth has been categorized into different broad classes with specific features. The main features include the time dependence of interface width and values of different scaling exponents. Apart from these, studies also addressed different morphological, optical, or electrical properties of the as-grown thin films of specific material. This paper gathers the existing literature that reports the simulation-based theoretical studies related to thin film growth by different algorithms like random deposition, ballistic deposition, random deposition with surface relaxation, or their different combinations. Not only that, but the paper also summarizes different reports related to the simulation-based prediction of the material properties. As the topic is relatively new, the collection of reports added in the last 20 years has been considered.

The paper has different sections. Section  1 gives basic introductory ideas related to thin film development and its properties. Sections  2 and  3 , respectively, deal with the basics of different existing models and the basic steps involved in the simulation. Section  4 gathers the related results reported by various researchers, followed by a short discussion and final concluding remarks. Undoubtedly, this paper is the first review work in this field and thus will serve as an invaluable source of information for future workers.
EXPERIMENTAL INVESTIGATION INTO MAGNETORHEOLOGICAL FINISHING OF POLYMER VALVE SEAT SURFACE FOR BALL VALVE PERFORMANCE
Authors: ARORA KUNAL , UPPAL AMRINDER SINGH , SINGH ANANT KUMAR
Published: May 2024

A polymer valve seat is an essential component of ball valves. However, a gas pipeline valve leakage during the gas or oil transportation process causes major issues. Therefore, the fine finishing of the polymer valve seat is important. This work describes the effect of the magnetorheological finishing (MRF) process on the surface characteristics of the polymer valve seat. To achieve a finely finished polymer valve seat surface, the best process parametric combination of current, workpiece rotational, and tool rotational speed are obtained using the response surface methodology. The optimum process parameters are further used to enhance surface characteristics (including surface roughness, microhardness, and surface morphology) through fine finishing. Using the optimum process conditions, the surface roughness was reduced to 110[Formula: see text]nm from 570[Formula: see text]nm in 140[Formula: see text]min of finishing on a 4878[Formula: see text]mm2 surface area of the polymer valve seat. The circularity of the valve seat surface’s dimensional correctness is investigated further. The current MRF process can fine-finish the polymer valve seat surface consistently, resulting in improved surface characteristics and functional performance.