bluuebunny/crossref_metadata_2025 huggingface dataset:
A critical investigation of diffuse double layer changes in clay-electrolyte systems at high temperatures
Authors: AL-Bazali Talal
Published: August 2022

The objective of this work was to explore the impact of temperature on shale swelling and explain it in terms of diffuse double layer mechanics: Debye–Hückel length alterations. This was made possible through the use of a newly developed thermal linear swelling test. Moreover, the combined impact of temperature, dielectric constant of water and ionic strength (ionic concentration) of salt solutions on Debye–Hückel length and resultant shale swelling and shrinkage were investigated. For dilute solutions, results showed that the product of temperature and dielectric constant of water (T*εr) remained near constant for a wide range of temperature (25–90°C). Results suggest that the dielectric constant of water may have been reduced by both temperature and ionic strength of solution, all of which caused a greater reduction in Debye–Hückel length and subsequent shale shrinkage. As for saturated NaCl and CaCl2 solutions, shale exhibited swelling behaviour at moderate temperatures followed by shale shrinkage thereafter. This could be attributed to the development of repulsive forces between alike ions within diffuse double layer. At higher temperatures, the contribution of dielectric constant of water on lowering Debye–Hückel length may have softened the repulsion action produced by ions.
Structure and Growth of Century-Old White Pine Plantations in Saginaw Forest, Southeastern Michigan, USA
Authors: Kashian Daniel M , Barnes Burton V
Published: August 2022

Saginaw Forest in Ann Arbor, Michigan, includes the second-oldest eastern white pine plantation in the United States, with pioneering thinning experiments among the oldest in the country. With no additional silvicultural treatments occurring since at least the 1950s, we report on the current condition of four planting lots near their century mark to provide silvicultural, cultural, and historical perspectives. Stand density and tree diameter in 2017 were similar across the four lots, all having a significant number of trees > 50 cm diameter at breast height. Tree ring widths suggest that diameter growth was responsive to thinning treatments that occurred before 1955. Today, management geared towards site preservation as a cultural and historical landmark, with an emphasis on intensive invasive species and hardwood ingrowth control and native tree species regeneration, are likely more appropriate than a focus on silviculture.

Study Implications

Saginaw Forest in Ann Arbor, Michigan contains the second-oldest eastern white pine plantation in the United States. It underwent pioneering forest thinning experiments that pre-dated similar experiments in the oldest eastern white pine plantation at the Biltmore Estate in Asheville, North Carolina. Silvicultural treatments have not occurred since the 1950s, but the effects of historical thinning treatments are evident today across four planting lots. We summarize the current conditions of this important forestry site, noting a serious threat by invasive species and hardwood ingrowth that should be targeted as a means of preserving this important cultural and historical landmark.
Saving the Salmon: Examining the Cost-Effectiveness of Collaboration in Oregon
Authors: Mehdi Qasim , Nabatchi Tina
Published: August 2022

Environmental collaboration has become an increasingly common approach to the management of natural resources. Scholars and practitioners have tried to understand how collaborative structures impact performance using a multitude of single case studies and comparative studies. However, despite calls for the evaluation of collaborative performance, minimal quantitative research explores the connections between collaborative structures and performance using a large sample for analysis. We address this gap by carrying out fixed effects analysis that examines the impact of several structural variations, including collaboration form, number and representational diversity of participants, and contributions of in-kind resources, on the cost-effectiveness of collaborative watershed projects in Oregon. The data for this project come from the Oregon Watershed Restoration Inventory (OWRI). Our results indicate that collaboration form, participant numbers, and resource contributions affect cost-effectiveness, but representational diversity among participants does not. The findings from this article can help sponsoring and implementing agencies execute collaborative projects more cost-effectively. They also indicate the need for additional research exploring the relationship between collaborative structures, outputs, and outcomes.
Military Contributions to the Field of Medical Ultrasound
Authors: Bowers Gerald M
Published: August 2022

Medical ultrasound is based on the same principle of the piezoelectric effect as sound navigation and ranging, used by the world’s navies and maritime industry. Many of the early advances in sound navigation and ranging technology influenced landmark discoveries in diagnostic ultrasound made by military officers and defense department researchers.
X-ray morphology of cluster-mass haloes in self-interacting dark matter
Authors: Shen Xuejian , Brinckmann Thejs , Rapetti David , Vogelsberger Mark , Mantz Adam , Zavala Jesús , Allen Steven W
Published: August 2022

We perform cosmological zoom-in simulations of 19 relaxed cluster-mass haloes with the inclusion of adiabatic gas in the cold dark matter (CDM) and self-interacting dark matter (SIDM) models. These clusters are selected as dynamically relaxed clusters from a parent simulation with $M_{\rm 200} \simeq (1\!-\!3)\times 10^{15}{\, \rm M_\odot }$. Both the dark matter and the intracluster gas distributions in SIDM appear more spherical than their CDM counterparts. Mock X-ray images are generated based on the simulations and are compared to the real X-ray images of 84 relaxed clusters selected from the Chandra and ROSAT archives. We perform ellipse fitting for the isophotes of mock and real X-ray images and obtain the ellipticities at cluster-centric radii of $r\simeq 0.1\!-\!0.2R_{\rm 200}$. The X-ray isophotes in SIDM models with increasing cross-sections are rounder than their CDM counterparts, which manifests as a systematic shift in the distribution function of ellipticities. Unexpectedly, the X-ray morphology of the observed non-cool-core clusters agrees better with SIDM models with cross-section $(\sigma /m)= 0.5\!-\!1\, {\rm cm}^2\, {\rm g}^{-1}$ than CDM and SIDM with $(\sigma /m)=0.1\, {\rm cm}^2\, {\rm g}^{-1}$. Our statistical analysis indicates that the latter two models are disfavoured at the $68{{\ \rm per\ cent}}$ confidence level (as conservative estimates). This conclusion is not altered by shifting the radial range of measurements or applying a temperature selection criterion. However, the primary uncertainty originates from the lack of baryonic physics in the adiabatic model, such as cooling, star formation and feedback effects, which still have the potential to reconcile CDM simulations with observations.
The effect of water and electron collisions in the rotational excitation of HF in comets
Authors: Loreau J , Faure A , Lique F
Published: August 2022

We present the first set of rate coefficients for the rotational excitation of the 7 lowest levels of hydrogen fluoride (HF) induced by collision with water molecules, the dominant collider in cometary comas, in the 5–150 K temperature range. The calculations are performed with a quantum statistical approach from an accurate rigid rotor ab initio interaction potential. Rate coefficients for excitation of HF by electron-impact are also computed, within the Born approximation, in the 10–10 000 K temperature range. These rate coefficients are then used in a simple non-local thermodynamic equilibrium (non-LTE) model of a cometary coma that also includes solar radiative pumping and radiative decay. We investigate the range of H2O densities that lead to non-LTE populations of the rotational levels of HF. We show that to describe the excitation of HF in comets, considering collisions with both water molecules and electrons is needed as a result of the large dipole of HF.
Approximate Bayesian Computation applied to the Diffuse Gamma-Ray Sky
Authors: Baxter Eric J , Christy J G , Kumar Jason
Published: August 2022

Many sources contribute to the diffuse gamma-ray background (DGRB), including star forming galaxies, active galactic nuclei, and cosmic ray interactions in the Milky Way. Exotic sources, such as dark matter annihilation, may also make some contribution. The photon counts-in-pixels distribution is a powerful tool for analysing the DGRB and determining the relative contributions of different sources. However, including photon energy information in a likelihood analysis of the counts-in-pixels distribution quickly becomes computationally intractable as the number of source types and energy bins increase. Here, we apply the likelihood-free method of approximate Bayesian computation (ABC) to the problem. We consider a mock analysis that includes contributions from dark matter annihilation in Galactic subhaloes as well as astrophysical backgrounds. We show that our results using ABC are consistent with the exact likelihood when energy information is discarded, and that significantly tighter parameter constraints can be obtained with ABC when energy information is included. ABC presents a powerful tool for analysing the DGRB and understanding its varied origins.
Effect of culture depth on the shell thickness of the blue mussel Mytilus edulis: a practical case study comparing direct and indirect methods of measurement
Authors: Gallardi Daria , Murray Harry M
Published: August 2022

Mytilus species have a fundamental role in coastal environments and constitute an important aquaculture resource. Their shell has a protective function and is affected by multiple factors, such as the size of the animal, density, environmental characteristics and presence of predators. It is crucial to accurately estimate shell thickness in order to understand the effects of the ever-changing environment on mussel physiology, morphology and ecology. This study compares a newly developed direct method for measuring shell thickness, using scanning electron microscopy (SEM), and a widely used indirect method (shell thickness index, STI), in the context of a practical case study of the blue mussel Mytilus edulis. In this study, STI did not appear as highly correlated to direct thickness measurement as in previous studies. This study also showed a weaker relationship between measured shell length and STI. In the case study, assessing the effect of culture depth on M. edulis growth and condition, STI showed a significant variation with depth, while SEM measured thickness did not. Therefore, the choice to use STI vs direct measurement of shell thickness drastically changed the results and interpretation of the case study. This work highlights the importance of a carefully designed method for measuring shell thickness and emphasizes that, before application, indirect methods should be quality controlled for the population studied. However, when high precision is needed for shell thickness measurements the application of SEM-based techniques may be necessary. This is the first study where SEM-based techniques have been used to measure shell thickness in M. edulis.
Enhancing the interfacial binding strength between modular stretchable electronic components
Authors: Ji Shaobo , Chen Xiaodong
Published: August 2022

Stretchable electronics are emerging for personalized and decentralized clinics, wearable devices and human–machine interactions. Nowadays, separated stretchable functional parts have been well developed and are approaching practical usage. However, the production of whole stretchable devices with full functions still faces a huge challenge: the integration of different components, which was hindered by the mechanical mismatch and stress/strain concentration at the connection interfaces. To avoid connection failure in stretchable devices, a new research focus is to improve the interfacial binding strength between different components. In this review, recent developments to enhance interfacial strength in wearable/implantable electronics are introduced and catalogued into three major strategies: (i) covalent bonding between different device parts, (ii) molecular interpenetration or mechanical interlocking at the interfaces and (iii) covalent connection between the human body and devices. Besides reviewing current methods, we also discuss the existing challenges and possible improvements for stretchable devices from the aspect of interfacial connections.
Efficacy and Safety of Plazomicin in the Treatment of Enterobacterales Infections: A Meta-analysis of Randomized Controlled Trials
Authors: Yan Kaicheng , Liang Beibei , Zhang Guanxuanzi , Wang Jin , Zhu Man , Cai Yun
Published: August 2022

Background

In the present study, we aimed to compare the efficacy and safety of plazomicin with comparators for the treatment of Enterobacterales infections.

Methods

Randomized controlled trials (RCTs) assessing plazomicin for Enterobacterales infections were searched on the PubMed, Embase, and Cochrane Library databases. Meta-analyses were used to evaluate the efficacy and safety in RCTs.

Results

A total of 3 RCTs consisting of 761 patients were included in the present analysis. The study population included complex urinary tract infections (cUTIs), bloodstream infections (BSIs), and hospital-acquired pneumonia (HAP). Plazomicin had a clinical remission rate in the modified intention-to-treat (MITT) population that was similar to that of comparators (odds ratio [OR], 1.02; 95% CI, 0.60–1.73; I2 = 45%) in the pooled analysis of the 3 studies. The overall microbiologic eradication rate in the microbiological MITT (mMITT) population was similar to that of the comparators group (OR, 1.46; 95% CI, 0.72–2.95; I2 = 0%). However, the microbiologic recurrence rate of plazomicin for Enterobacterales was lower than that in the comparators group (OR, 0.38; 95% CI, 0.17–0.86; P = .02; I2 = 0%). No signiﬁcant differences were found between plazomicin and comparators for the risk of any adverse events (OR, 0.78; 95% CI, 0.55–1.11; I2 = 0%).

Conclusions

Plazomicin is as good as comparators in terms of efficacy and tolerance in the treatment of Enterobacterales infections. Therefore, plazomicin is a suitable choice for antibiotic treatment in adult patients with cUTIs, BSIs, or HAP.
SARS-CoV-2 Surface Swabs in Locations With Public Access—Potential for Improved Source Control
Authors: Nielsen Jacob P S , Madsen Johannes R , Fogh Kamille , Mikkelsen Emma H , Wolsk Emil , Kirkby Nikolai S , Bundgaard Henning , Iversen Kasper
Published: August 2022

The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on surfaces at public locations has been minimally described. By swab testing, we investigated the presence of SARS-CoV-2 on surfaces in public locations during the pandemic in February 2022. The viability of SARS-CoV-2 was not tested. Almost 25% of surfaces were positive for SARS-CoV-2; this was most pronounced in supermarkets.
Comprehensive Genomic Profiling of Cell-Free DNA in Men With Advanced Prostate Cancer: Differences in Genomic Landscape Based on Race
Authors: Zimmerman Raquel , Bilen Mehmet A , Heath Elisabeth I , Nandagopal Lakshminarayanan , Swami Umang , Kessel Adam , Jaeger Ellen , Wesolowski Sergiusz , Hernanadez Edgar J , Chipman Jonathan , Mack Alleda , Ravindranathan Deepak , Maughan Benjamin L , Nussenzveig Roberto , Yandell Mark , Kohli Manish , Lilly Michael B , Sartor A Oliver , Agarwal Neeraj , Barata Pedro C
Published: August 2022

Advanced prostate cancer (aPC) in Black men was reported to present with aggressive features and to be associated with poor prognosis. Herein, we compared the cell-free DNA (cfDNA) genomic landscape of aPC in Black vs White men. Patients (pts) with aPC from 6 academic institutions and available cfDNA comprehensive genomic profiling (CGP) were included. Association between mutated genes and race was evaluated using Barnard’s test and a Probabilistic Graphical Model (PGM) machine learning approach. Analysis included 743 aPC pts (217 Black, 526 White) with available cfDNA CGP. The frequency of alterations in the androgen receptor gene was significantly higher in Black vs White men (55.3% vs 35% respectively, P < .001). Additionally, alterations in EGFR, MYC, FGFR1, and CTNNB1 were present at higher frequencies in Black men. PGM analysis and Barnard’s test were concordant. Findings from the largest cohort of Black men with aPC undergoing cfDNA CGP may guide further drug development in these men.
Articulating Grounded Theory Methodology for Public and Nonprofit Administration Scholars and Practitioners
Authors: Hafer Joseph A , Kitchens Jessica
Published: August 2022

Grounded theory as a term and as a methodology has received increasing attention from public administration scholars since the mid-2000s. Unfortunately, the application of grounded theory methodology across social science research—including public and nonprofit administration—is often shrouded in vagueness; however, rigorously conducted grounded theory research, particularly classic ground theory, holds great potential to develop theory that is relevant to practice. This article seeks to provide clarity on grounded theory methodology by detailing it through the lens of classic grounded theory methodology (i.e., the foundational methodology). Additionally, the authors examine the interpretation and application of grounded theory methodology through a conceptual content analysis of top public administration journals. The analysis reveals scholars either do not have a clear understanding of grounded theory methodology or needs to improve their reporting of such, as the theory development process is not clearly reported. Insight on directions forward to improve the rigor of grounded theory research in the field is offered, including adhering to established methodology.
Association of sleep abnormalities in older adults with risk of developing Parkinson’s disease
Authors: Otaiku Abidemi I
Published: August 2022

Study Objectives

Parkinson’s disease (PD) is associated with abnormalities of sleep macro- and microstructure as measured using polysomnography (PSG). Whether these abnormalities precede the development of PD is unknown. This study investigated the association between PSG measured sleep abnormalities in older adults and the risk of incident PD.

Methods

A total of 2,770 men from the ancillary sleep study of the Osteoporotic Fractures in Men Study (MrOS), a population-based cohort from the United States, who were free from PD baseline and underwent overnight PSG, were included in this longitudinal analysis. Incident PD was based on a clinical diagnosis from a medical professional. Multivariable logistic regression was used to estimate odds ratios (OR) for incident PD by quartiles of PSG measures, with adjustment for sociodemographic characteristics, medical comorbidities, and lifestyle factors.

Results

During a median follow-up of 9.8 years, 70 (2.5%) cases of incident PD were identified. Longer total sleep time, lower rapid eye movement sleep (REM) percentage, a lower α/θ ratio during non-REM sleep and higher minimum oxygen saturations during REM sleep, were each associated with an increased risk of developing PD. Conversely, a higher awakening index was associated with a decreased risk of developing PD. The OR for the highest risk quartiles compared to the lowest risk quartiles, ranged from 2.1 to 3.7 (p’s < .05). The associations remained significant when cases occurring within the first two years of follow-up were excluded from the analyses.

Conclusions

Macro- and micro-structural sleep abnormalities precede the development of PD by several years and can identify individuals at high risk of developing PD in the future.
Use of fixed calcium to phosphorus ratios in experimental diets may create bias in phytase efficacy responses in swine
Authors: Zhai Hengxiao , Bergstrom Jon R , Zhang Jingcheng , Dong Wei , Wang Zhenzhen , Stamatopoulos Kostas , Cowieson Aaron J
Published: August 2022

The objective of this study was to investigate the effects of two dietary total Ca/P ratios on available P release by phytase, measured using growth performance and bone mineralization with 528 barrows and gilts according to a randomized complete block design. Three were 11 diets in a factorial of 2 by 4 plus 3, including 3 reference diets consisting of 0.25% (control), 0.70%, or 1.15% monocalcium phosphate (MCP) and 8 diets from combining 4 phytase doses (500, 1,000, 2,000, and 3,000 FYT/kg) with 0.25% MCP and 2 dietary Ca/P ratios (1.05 and 1.20). Each diet was fed to 6 pens of 8 pigs. All diets contained 3 g/kg TiO2, and fecal samples were collected from each pen on d 13–15 of trial. At the end of trial, one pig per pen was sacrificed to collect a tibia and urine in the bladder. The results showed that MCP improved growth performance linearly (P < 0.01), whereas both a linear and quadratic response was observed with the addition of phytase. The MCP increased the percent bone ash and weights of bone ash, Ca, and P linearly (P < 0.01). At both Ca/P ratios, increasing supplementation of phytase increased the percent bone ash and weights of bone ash, Ca, and P both linearly and quadratically (P < 0.05). Both MCP and phytase significantly increased digestibility of Ca and P as well as digestible Ca and P in diets and reduced the digestible Ca/P ratio. The dietary Ca/P ratio of 1.20 resulted in poorer feed utilization efficiency, more digestible Ca, greater percent bone ash, Ca, and P and heavier weights of bone Ca and P than the ratio of 1.05 (P < 0.05). The ratio of 1.20 elicited numerically higher available P release values from phytase, with percent bone ash and bone P weight as the response variables, but significantly lower values with gain:feed. The urinary concentration of Ca increased linearly (P < 0.01) with increasing digestible Ca/P ratios whilst urinary concentration of P decreased quadratically (P < 0.01). In conclusion, fixing the same total Ca/total P ratio in diets supplemented with increasing phytase dosing created an imbalance of digestible Ca and P, which could have an adverse effect on bone mineralization and thus compromise the phytase efficacy relative to mineral P.
Development of a Wellness Program for Nursing Students During the Pandemic
Authors: Franco Hollis , Veesart Amanda , Chapman Karla
Published: August 2022

Nursing students’ significant physical and emotional stress levels have been a recent topic in nursing education, amplifying wellness concerns among faculty and nursing schools. A solution is to implement a wellness program. Wellness programs can benefit the future of the nursing workforce by giving students the ability to cope with stressful situations. This article describes the implementation of a wellness program in a large nursing school during the worldwide pandemic.
Factors Associated With Rebound Pain After Patient-controlled Epidural Analgesia in Patients Undergoing Major Abdominal Surgery
Authors: Kwon Hyun-Jung , Kim Yeon Ju , Lee Dokyeong , Lee Dongreul , Kim Dongseok , Cho Hakmoo , Kim Doo-Hwan , Lee Jong-Hyuk , Jeong Sung-Moon
Published: August 2022

Objectives:

Although patient-controlled epidural analgesia (PCEA) is an effective form of regional analgesia for abdominal surgery, some patients experience significant rebound pain after the discontinuation of PCEA. However, risk factors for rebound pain associated with PCEA in major abdominal surgery remain unknown. This study evaluated the incidence of rebound pain related to PCEA and explored potential associated risk factors.

Materials and Methods:

We performed a retrospective review of 236 patients using PCEA following hepatobiliary and pancreas surgery between 2018 and 2020 in a tertiary hospital in South Korea. Rebound pain was defined as an increase from well-controlled pain (numeric rating scale <4) during epidural analgesia to severe pain (numeric rating scale ≥7) within 24 hours of discontinuation of PCEA. Logistic regression analysis was performed to determine the factors associated with rebound pain.

Results:

Patients were categorized into the nonrebound pain group (170 patients; 72%) and the rebound pain group (66 patients; 28%). Multivariable logistic regression analysis revealed that preoperative prognostic nutritional index below 45 (odds ratio=2.080, 95% confidential interval=1.061-4.079, P=0.033) and intraoperative transfusion (odds ratio=4.190, 95% confidential interval=1.436-12.226, P=0.009) were independently associated with rebound pain after PCEA discontinuation.

Discussion:

Rebound pain after PCEA occurred in ~30% of patients who underwent major abdominal surgery, resulting in insufficient postoperative pain management. Preoperative low prognostic nutritional index and intraoperative transfusion may be associated with rebound pain after PCEA discontinuation.
Encourage, Assess, Transition (EAT)
Authors: Swanson Nellie Munn , Elgersma Kristin M. , McKechnie Anne Chevalier , McPherson Patricia L. , Bergeron Mark J. , Sommerness Samantha A. , Friedrich Cheri L. , Spatz Diane L.
Published: August 2022

Background:

The opportunity to establish a direct breastfeeding (DBF) relationship with a preterm infant, if desired by the mother or lactating parent, is a known driver of positive healthcare experiences. Preterm birth is an independent risk factor for early human milk (HM) cessation, and DBF at the first oral meal promotes continued DBF during hospitalization and HM duration beyond discharge. While the Spatz 10-step model for protecting and promoting HM and breastfeeding in vulnerable infants provides best practices, lack of standardized implementation results in missed opportunities to meet parents' DBF goals.

Purpose:

To standardize clinical practices to increase DBF at the first oral meal, total DBF meals during hospitalization, and use of test weighing to measure milk transfer for preterm infants.

Methods:

Quality improvement methods were used to develop and implement Encourage, Assess, Transition (EAT): a DBF protocol for infants less than 37 weeks gestation at birth, in a level II neonatal intensive care unit.

Results:

Thirty-eight (45%) infants from 27.7 to 36.7 weeks of gestation initiated the protocol. The proportion of infants' DBF at first oral meal increased from 22% to 54%; mean DBF meals during hospitalization increased from 13.3 to 20.3; and use of test weighing increased by 166%.

Implications for Practice and Research:

Standardizing DBF practices with the EAT protocol increased DBF during hospitalization—a known driver of patient experience—and HM duration beyond discharge, in hospitalized preterm infants. Researchers should validate the reported benefits of EAT (increased DBF during hospitalization, use of test weighing, and improved patient experience), methods to promote passive dissemination of evidence, and sustain change.

Video abstract available at:

https://journals.lww.com/advancesinneonatalcare/pages/video.aspx?v=61.
Psychological Attachment Orientation and Long-Term Posttraumatic Stress Symptoms Among Family Members of ICU Patients
Authors: Zhang Qiang , Knies Andrea K. , Pach Jolanta , Kimbrough Tara , Martinez Aida , Juthani Prerak , Tu Stephanie , Monin Joan K. , Vranceanu Ana-Maria , Hwang David Y.
Published: August 2022

OBJECTIVES:

To determine the degree to which an ICU patient’s family member having an “anxious” psychologic attachment orientation is a risk factor for developing long-term posttraumatic stress disorder (PTSD) symptoms following patient ICU discharge or death.

DESIGN:

Prospective cohort study.

SETTING:

Single academic neuroscience ICU from November 2017 to September 2020.

PARTICIPANTS:

Consecutively enrolled sample of family members, one for each ICU patient with a minimum length of stay of 24 hours.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Near time of ICU discharge or patient death, we determined each participant’s psychologic attachment orientation as anxious versus nonanxious via a brief standard survey tool, the Relationship Questionnaire, and measured other participant and patient characteristics as potential covariates. Six months after discharge or death, each participant completed the Impact of Events Scale-Revised (IES-R) to measure PTSD symptoms, with a score of greater than 24 indicative of clinically significant symptoms. Among 162 total participants, 10 of 27 participants (37.0%) with an anxious attachment orientation reported 6-month PTSD symptoms, compared with 24 of 135 nonanxious participants (17.8%) (relative risk, 2.08; 95% CI, 1.13–3.84; p = 0.02; risk difference 19.2%). In a subsequent univariate analysis of participant and patient covariates, anxious attachment orientation, participant Hispanic ethnicity, prior experience as a care partner of a patient with a disability, and participation in 3 or more formal ICU family meetings were all associated with 6-month PTSD symptoms. In a multiple logistic regression, anxious attachment remained an independent predictor of 6-month PTSD symptoms (odds ratio [OR], 3.64; 95% CI, 1.35–9.77; p = 0.01), as did Hispanic ethnicity (OR, 4.72; 95% CI, 1.34–16.6; p = 0.01) and participation in three or more ICU family meetings (odds ratio, 2.97; 95% CI, 1.14–7.68; p = 0.02).

CONCLUSIONS:

An anxious psychologic attachment orientation is associated with double the risk of long-term PTSD symptoms among family members of ICU patients. Future interventions designed to decrease risk of adverse psychologic outcomes among ICU families could be initially tested for efficacy amongst those who fall into this high-risk category.
Wound Healing After Fractional Skin Harvesting
Authors: Champlain Amanda H. , DiGiorgio Catherine M. , Zurakowski David , Sakamoto Fernanda H. , Anderson R. Rox
Published: August 2022

BACKGROUND

Autologous fractional full-thickness skin grafting is a method of harvesting full-thickness skin with reduced donor site morbidity compared with conventional skin grafting.

OBJECTIVE

To demonstrate that full-thickness skin microbiopsies can be harvested with minimal scarring or complications.

MATERIALS AND METHODS

In a nonrandomized, self-controlled, pilot trial, subjects (n = 8) underwent tissue harvesting of full-thickness skin columns of 200, 400, 500, 600, 800 μm, 1, and 2 mm diameters. The extent of scarring was measured by using the Patient and Observer Scar Assessment Scale and blinded evaluation of photographs at 6 weeks postprocedure. Pain visual analog scale (VAS) and side effects were recorded.

RESULTS

When present, scars were first observed after 2 to 4 weeks, much more often for wounds >400 μm (p < .001). Blinded dermatologists increasingly identified clinical scarring on photographs with larger harvested microcolumn diameters (p < .001). Median VAS pain score was 0 (range 0–4). All subjects rated the procedure safe and tolerable.

CONCLUSION

Harvesting full-thickness skin microcolumns is well-tolerated over a wide range of column diameters. At diameters of less than 500 μm, side effects including scarring are minimal.
The Efficacy and Safety of a 755-nm Picosecond Laser in the Treatment of Physiologic Lip Hyperpigmentation in Thai Patients
Authors: Ng Janice Natasha C. , Manuskiatti Woraphong , Apinuntham Chalermkwan , Yan Chadakan
Published: August 2022

BACKGROUND

Physiologic lip hyperpigmentation is a common aesthetic concern, especially in Southeast Asia. There is limited data on the application of the picosecond laser for this condition.

OBJECTIVE

To evaluate the efficacy and safety of using a 755-nm picosecond laser in the treatment of physiologic lip hyperpigmentation.

METHODS

Twenty healthy patients with physiologic lip hyperpigmentation received 5 bi-weekly treatments with a 755-nm picosecond laser using a 6-mm spot size, fluence of 0.71 J/cm2 at 5 Hz. Subjective and objective evaluation on the improvement of lip hyperpigmentation were obtained at baseline, 2 weeks after each treatment and at 1, 3, and 6 months after the final treatment. Patient self-assessment, pain score, and adverse reactions were also recorded.

RESULTS

All patients completed the study and attended all follow-ups. Most (52.6%) patients presented with moderate clinical improvement at 6-month follow-up. The average melanin index decreased significantly after the fourth treatment (p = .048) and at 1-month follow-up (p = .026). More than half the patients (70%) reported moderate-to-marked improvement at 6-month follow-up. Only 1 patient presented with a transient adverse reaction of lip edema.

CONCLUSION

The 755-nm picosecond laser is safe and effective for the treatment of physiologic lip hyperpigmentation in Thai patients.
Antiamoebic Susceptibility in Acanthamoeba Keratitis: Comparison of Isolates From South India and Northern California
Authors: Richardson Quintin R. , Prajna Lalitha , Elakkiya Shanmugam , Kamal Fathima Sulthana , Talbott Maya , Prajna Namperumalsamy Venkatesh , Rajaraman Revathi , Cevallos Vicky , Seitzman Gerami D. , Lietman Thomas M. , Keenan Jeremy D.
Published: August 2022

Purpose:

Outcomes of Acanthamoeba keratitis are often worse in India than in the United States. The goal of this study was to determine whether antiamoebic susceptibility patterns were different when comparing Acanthamoeba isolates from India with those of the United States.

Methods:

Acanthamoeba isolates were obtained from corneal scrapings of 43 patients with infectious keratitis seen at the Francis I. Proctor Foundation (N = 23) and Aravind Eye Hospital (N = 20) from 2008 through 2012 and plated on growth media. A previously described minimum cysticidal concentration (MCC) assay was performed by a single laboratory technician to assess susceptibility to 5 antiamoebic agents for all isolates. Testing was conducted in triplicate, with the median MCC chosen for analyses.

Results:

The MCC (μg/mL) of polyhexamethylene biguanide was 6.25 [IQR 5.47–12.5] for Aravind isolates and 6.25 [IQR 6.25–9.375] for Proctor isolates (P = 0.75), corresponding values were 6.25 [IQR 3.125–6.25] and 3.125 [IQR 3.125–9.375] for chlorhexidine (P = 0.81), 2500 [IQR 2500–5000] and 5000 [IQR 1250–20,000] for voriconazole (P = 0.25), 15.6 [IQR 15.6–39.0625] and 15.6 [IQR 15.6–31.25] for hexamidine (P = 0.92), and 15.6 [IQR 7.81–15.6] and 15.6 [IQR 7.81–31.25] for propamidine (P = 0.42).

Conclusions:

This study found no statistically significant differences in antiamoebic susceptibility of Indian versus US samples from Acanthamoeba keratitis clinical isolates. These findings suggest that differences in antiamoebic susceptibility are likely not responsible for differential outcomes in Acanthamoeba keratitis between the 2 locations.
Comparison of Graft Outcomes Reusing Original Intermediate-Term Cold Storage Solution for Entire Corneal Donor Storage Period With Exchanged Fresh Storage Solution After Donor Preparation in the Cornea Preservation Time Study
Authors: Lass Jonathan H. , Bailey Ryan J. , Szczotka-Flynn Loretta B. , Benetz Beth Ann , Soper Mark , Titus Michael S. , Kollman Craig , Beck Roy W.
Published: August 2022

Purpose:

The purpose of this study was to evaluate outcomes of Descemet stripping automated endothelial keratoplasty comparing exchange with fresh intermediate-term cold storage solution after lenticule preparation versus reuse of the original solution in the Cornea Preservation Time Study.

Methods:

In the Cornea Preservation Time Study, 508 donor corneas had lenticules prepared by the eye bank with fresh solution exchange (Fresh group) and 283 with reuse of the original solution (Original group). Storage time for all donors was ≤11 days. Graft success rates, central endothelial cell loss at 3 years, and frequency of positive donor rim cultures were compared between the 2 groups.

Results:

The 3-year graft success rate (95% confidence interval) was 93.4% (90.7%–95.3%) in the Fresh group and 95.2% (91.8%–97.2%) in the Original group (adjusted hazard ratio for graft failure = 0.64, 95% confidence interval, 0.33–1.24, P = 0.19). The mean percentage endothelial cell loss was significantly greater in the Fresh group versus Original group (45% ± 22% vs. 38% ± 20%, respectively, P = 0.004). Cultures were positive in 4 (1.5%) of 267 donor rims (3 fungal and 1 bacterial) in the Fresh group and in 4 (2.5%) of 158 in the Original group (P = 0.57). There were 2 postoperative infections in the Original group and none in the Fresh group.

Conclusions:

The use of the original intermediate-term cold storage solution did not reduce the 3-year graft success rate compared with exchanging with fresh solution after lenticule preparation for Descemet stripping automated endothelial keratoplasty, while the frequency of positive donor rim cultures did not significantly differ between groups.
Intrastromal Corneal Ring Segments Implantation After Deep Anterior Lamellar Keratoplasty for Astigmatism Correction: Mid-term and Long-term Follow-up
Authors: Alfonso-Bartolozzi Belén , Fernández-Vega-Cueto Luis , Poo-López Aranzazu , Lisa Carlos , Madrid-Costa David , Alfonso José F.
Published: August 2022

Purpose:

The aim of this study was to assess the long-term outcomes of implanting intrastromal corneal ring segments (ICRSs) using a femtosecond laser for correcting astigmatism in patients who had previous deep anterior lamellar keratoplasty (DALK) throughout a 5-year follow-up period.

Methods:

This retrospective study included 40 eyes of 40 patients with previous DALK and astigmatism ≥3.00 D who underwent Ferrara-type ICRS implantation. The manifest refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuity (logMAR), and corneal topography were recorded preoperatively and at 6, 12, 36, and 60 months postoperatively.

Results:

The mean UDVA (logMAR scale) improved from 1.39 ± 0.55 preoperatively to 0.71 ± 0.37 at 6 months postoperatively (P < 0.0001). The mean CDVA (logMAR) significantly improved from 0.36 ± 0.17 to 0.22 ± 0.12 at 6 months after surgery (P < 0.0001). Both UDVA and CDVA remained unchanged throughout the follow-up (P = 0.09). Postoperatively, no eyes lost lines of CDVA compared to preoperatively, and around 80% of the eyes gained lines of CDVA. The safety index remained stable at a value of 1.4 throughout the follow-up. The refractive cylinder decreased from −6.86 ± 2.62 D preoperatively to −2.33 ± 1.09D at 6 months postoperatively (P < 0.0001), and subsequently, it was stable over the postoperative period (P = 0.2). The maximum and minimum keratometry measurements significantly decreased after surgery and remained stable over the postoperative follow-up period (P > 0.07).

Conclusions:

This study shows the long-term viability of Ferrara-type ICRS implantation using a femtosecond laser as a surgical alternative for astigmatism correction in post-DALK eyes.
Impact of Fuchs Endothelial Corneal Dystrophy Severity on Scheimpflug-Derived Parameters After Descemet Membrane Endothelial Keratoplasty
Authors: Voncken Santana Stefanie , Vasiliauskaitė Indrė , van Dijk Korine , van Tilborg Mirjam , Melles Gerrit R. J. , Kocaba Viridiana , Oellerich Silke
Published: August 2022

Purpose:

The aim of this study was to evaluate how Scheimpflug-derived parameters of eyes with Fuchs endothelial corneal dystrophy (FECD) are influenced by Descemet membrane endothelial keratoplasty (DMEK) depending on FECD severity and the presence of subclinical edema.

Methods:

A retrospective cohort study including 115 eyes (115 patients) that underwent DMEK for FECD and a control group of 27 eyes with nonpathological corneas was conducted. Preoperative and 6 months postoperative Scheimpflug imaging was used to analyze pachymetry, presence of tomographic features (loss of isopachs/displacement of the thinnest point/focal posterior depression), and corneal backscatter. FECD severity was based on the modified Krachmer scale and the absence/presence of subclinical edema.

Results:

Scheimpflug-derived pachymetry, tomographic, and corneal backscatter parameters were correlated with FECD severity, and all changed from preoperatively to postoperatively (all P < 0.05). Postoperative central corneal thickness, anterior and posterior corneal backscatter, and presence of focal posterior depression remained different from the control group (all P < 0.05). Of eyes without preoperative clinical edema (n = 75), 18.7% showed 0 or 1 tomographic feature (no edema group) and 82.4% had 2 or 3 features (subclinical edema group). Compared with the control group, postoperative best-corrected visual acuity for the “no edema” group did not differ (0.03 ± 0.12 vs. −0.02 ± 0.08 logarithm of the minimum angle of resolution, P = 0.150) but was worse for the subclinical edema group (0.06 ± 0.08 vs. −0.02 ± 0.08 logarithm of the minimum angle of resolution, P = 0.001).

Conclusions:

For eyes without preoperative edema, more parameters reversed back to ‘normal’ levels than for eyes with (sub)clinical edema. Although most analyzed parameters correlated with FECD severity, corneal tomography might be best suited for objective grading of disease severity to aid in surgical decision-making.
Measuring Return on Investment for Professional Development Activities
Authors: Opperman Cathleen , Liebig Debra , Bowling Judith , Johnson Carol Susan , Stiesmeyer Johanna , Miller Susi
Published: August 2022

How do you articulate the value of professional development (PD) activities? In addition to reporting the number of learners, frequency of offerings, and unique courses offered, are you correlating education to outcomes (patient or employee)? Are you capturing the cost of implementing learning activities or initiatives to demonstrate the need for resources dedicated to PD? If you answered “no,” then you are missing measurement of the economic impact of PD essential for resource decision-making.
Assessment of the Costs of Implementing COVID-19 Vaccination Clinics in 34 Sites, United States, March 2021
Authors: Yarnoff Benjamin O. , Pike Jamison J. , Athar Heba M. , Bates Laurel G. , Tayebali Zohra A. , Harris LaTreace Q. , Jones-Jack Nkenge H. , Washington Michael L. , Cho Bo-Hyun
Published: August 2022

Objectives:

To estimate the costs to implement public health department (PHD)–run COVID-19 vaccination clinics.

Design:

Retrospectively reported data on COVID-19 vaccination clinic characteristics and resources used during a high-demand day in March 2021. These resources were combined with national average wages, supply costs, and facility costs to estimate the operational cost and start-up cost of clinics.

Setting:

Thirty-four PHD-run COVID-19 vaccination clinics across 8 states and 1 metropolitan statistical area.

Participants:

Clinic managers at 34 PHD-run COVID-19 vaccination clinics.

Intervention:

Large-scale COVID-19 vaccination clinics were implemented by public health agencies as part of the pandemic response.

Main Outcomes Measured:

Operational cost per day, operational cost per vaccination, start-up cost per clinic.

Results:

Median operational cost per day for a clinic was $10 314 (range, $637-$95 163) and median cost per vaccination was $38 (range, $9-$206). There was a large range of operational costs across clinics. Clinics used an average of 99 total staff hours per 100 patients vaccinated. Median start-up cost per clinic was $15 348 (range, $1 409-$165 190).

Conclusions:

Results show that clinics require a large range of resources to meet the high throughput needs of the COVID-19 pandemic response. Estimating the costs of PHD-run vaccination clinics for the pandemic response is essential for ensuring that resources are available for clinic success. If clinics are not adequately supported, they may stop functioning, which would slow the pandemic response if no other setting or approach is possible.
Biomechanical determinants of top running speeds in para-athletes with unilateral transfemoral amputation
Authors: Hobara Hiroaki , Murata Hiroto , Hisano Genki , Hashizume Satoru , Ichimura Daisuke , Cutti Andrea Giovanni , Petrone Nicola
Published: August 2022

Background:

An increased understanding of biomechanical determinants that influence the sprint performance of para-athletes with a unilateral transfemoral amputation will provide us with a basis for better evaluating athletes' sprint performance and would be expected to aid in the development of more effective training methods and running-specific prosthesis selection guidelines.

Objectives:

The aim of this study was to investigate the relative contributions of mechanical determinants to the top running speeds of para-athletes with unilateral transfemoral amputation wearing a running-specific prosthesis.

Study design:

Observational study within the subject.

Methods:

Nine para-athletes with unilateral transfemoral amputation wearing a running-specific prosthesis were recruited in this study. They were asked to run at their respective constant top speeds on an instrumented treadmill. From the ground reaction force and spatiotemporal parameters, three mechanical variables—step frequency, mass-specific averaged vertical ground-reaction force, and contact length—were determined for both the affected and unaffected limbs.

Results:

Stepwise regression analysis showed that the contact length of the affected limb was significant and an independent factor of top running speed (β = 0.760, P < 0.05), with a coefficient of determination (R
2) of 0.577 (P < 0.05), whereas the other variables were not associated.

Conclusion:

These results suggest that prosthetic components and alignment are crucial to determining the maximal sprinting performance in uTFA.
A generalized Ogden model for the compressibility of rubber-like solids
Authors: Yao Yin , Chen Shaohua , Huang Zhuping
Published: August 2022

The aim of this paper is to further demonstrate the advantages and effectiveness of the constitutive formulation proposed by Huang (Huang 2014
J. Appl. Mech.
59
, 902–908 (
doi:10.1115/1.2894059
)). In this formulation, any strain-energy function for an incompressible material can be easily generalized to include the effect of material compressibility, in which only a few material parameters and material functions to be fitted with the experimental data are required. To this end, the Ogden model for incompressible rubber-like solids is chosen as the starting point. By means of this formulation, the generalized Ogden strain-energy function, which takes into account material compressibility, can conveniently be constructed so long as its incompressible counterpart is given. The obvious advantage shown in this paper is that only a few material parameters and material functions are needed, i.e. in addition to the material parameters used in the original Ogden model for incompressible solids, only one material function depending on the volume ratio is involved to characterize the effect of compressibility. Both the material parameters in the original Ogden model and the material function suggested in this paper can be determined by fitting the experimental data for uniaxially tensile test and hydrostatic deformation test of rubbers, respectively. The present model considering compressibility is general since it can be applied to predict the stress–strain responses of rubber-like materials and porous rubbers in various loading conditions. With the present formulation, the applicable range of the celebrated Ogden model can be further broadened, which should be of practical importance for accurately describing the mechanical behaviour of rubber-like solids.

This article is part of the theme issue 'The Ogden model of rubber mechanics: Fifty years of impact on nonlinear elasticity'.