E-cigarette Risk Factors and Effects on Adolescent Health in the United States

Despite their adverse health effects, e-cigarette use has increased considerably among adolescents (people aged 10-19 years) in the United States. This is due to a number of factors including peer pressure, the availability of a variety of e-liquid flavors, the targeted marketing of these products to adolescents, and the belief by adolescents that e-cigarettes are less harmful to health than tobacco products. Just as traditional tobacco products, e-cigarettes have been found to be harmful to health and responsible for multiple adverse health conditions in adolescents, including inhibited growth and development, poor mental health, certain cancers, lung damage, nicotine dependency, future drug use, and social stigmatization. While the United States government realizes the harmful effects of e-cigarettes on adolescents, and although it has put in place certain policies to regulate the issue, e-cigarette use continues to be a public health problem among adolescents. This article discusses e-cigarettes, their use, risk factors, and health effects on adolescents in the US. It also proposes strategies for safeguarding adolescent health

In Situ Self-Cross-Linkable, Long-Term Stable Hyaluronic Acid Filler by Gallol Autoxidation for Tissue Augmentation and Wrinkle Correction

Copyright © 2019 American Chemical Society.Injectable fillers mainly aim to augment tissue volume and correct wrinkles in cosmetic and plastic reconstructions. However, the development of long-lasting, injectable fillers with minimal complications of pain, toxicity, and displacement has been challenging because of the absence of reliable cross-linking chemistry. Here, we report a novel cross-linker-free injectable hydrogel formulated by autoxidation as a highly biocompatible, easily injectable, and long-term volumetrically stable filler agent. Self-cross-linkable hyaluronic acid (SC-HA) with gallol moieties could form a hydrogel via autoxidation of gallols in vivo without additional cross-linking agents. The gelation of SC-HA in situ after injection is accelerated by the self-production of oxygen species and endogenous peroxidase in vivo. The SC-HA filler does not require a high injection force, thus minimizing pain, bleeding, and tissue damage-associated complications. In addition, improved tissue adhesiveness of the SC-HA hydrogel by oxidized gallols (shear strength; 2 kPa) prevented displacement of the filler constructs from the injection site. The SC-HA filler retained its mechanical properties in vivo (600-700 Pa) for wrinkle correction and volumetric augmentation up to 1 year after injection. Overall, the performance of the SC-HA hydrogel as an injectable dermal filler was superior to that of commercially available, chemically cross-linked biphasic HA filler composites in terms of injectability, tissue adhesiveness, and long-term volumetric augmentation. Our injectable HA hydrogel with no need of cross-linkers provides a long-lasting filler that has clinical utility for cosmetic applications11sciescopu

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Contactless Manipulation of Soft Robots

In recent years, jointless soft robots have demonstrated various curvilinear motions unlike conventional robotic systems requiring complex mechanical joints and electrical design principles. The materials employed to construct soft robots are mainly programmable anisotropic polymeric materials to achieve contactless manipulation of miniaturized and lightweight soft robots through their anisotropic strain responsivity to external stimuli. Although reviews on soft actuators are extensive, those on untethered soft robots are scant. In this study, we focus on the recent progress in the manipulation of untethered soft robots upon receiving external stimuli such as magnetic fields, light, humidity, and organic solvents. For each external stimulus, we provide an overview of the working principles along with the characteristics of programmable anisotropic materials and polymeric composites used in soft robotic systems. In addition, potential applications for untethered soft robots are discussed based on the physicochemical properties of programmable anisotropic materials for the given external stimuli

Magnetomechanical Transport of Liquid Metal Droplets via Asymmetric Microwall Arrays

Abstract Eutectic gallium indium liquid metal (LM) is a promising conductive liquid for various electronic applications. In particular, the directional transport of LM droplets has potential applications in soft electronics to control electrical conductivity. Existing methods transport LM droplets by applying an electric field to generate an interfacial tension difference within the LM droplet due to nonuniform ionic distribution of the electrical double layer. However, these methods require confined channels and tethered systems to apply the electric field. In this study, channel‐free wireless transport of LM droplets is demonstrated via on‐demand magnetomechanical actuation of asymmetric microwall arrays comprising vertically aligned ferromagnetic iron particles embedded in polydimethylsiloxane. Asymmetric microwall of two different widths is designed to generate an asymmetric bending stiffness at a given magnetic field. The asymmetric microwall bends gradually in response to a linear external magnetic field perpendicular to the alignment axis of the iron particles. Therefore, nonuniform magnetomechanical bending induces a local height gradient along the microwall, causing gravitational‐force‐driven roll‐off motion of the LM droplet. Transport direction of LM droplet is modulated by varying the geometric parameters. Finally, the opposite‐directional transport of two LM droplets is demonstrated under a linear magnetic field by pre‐programming the asymmetric bending direction of each microwall array