Parents and nurses balancing parent-infant closeness and separation: a qualitative study of NICU nurses' perceptions

Background: When a newborn requires neonatal intensive care unit (NICU) hospitalization, parent and infant experience an unusual often prolonged separation. This critical care environment poses challenges to parent-infant closeness. Parents desire physical contact and holding and touching are particularly important. Evidence shows that visitation, holding, talking, and skin to skin contact are associated with better outcomes for infants and parents during hospitalization and beyond. Thus, it would be important to understand closeness in this context. The purpose of this study was to explore from nurses' perspective, what do parents and nurses do to promote parent-infant closeness or provoke separation.Methods: Qualitative methods were utilized to attain an understanding of closeness and separation. Following ethics approval, purposive sampling was used to recruit nurses with varying experience working different shifts in NICUs in two countries. Nurses were loaned a smartphone over one work shift to record their thoughts and perceptions of events that occurred or experiences they had that they considered to be closeness or separation between parents and their hospitalized infant. Sample size was determined by saturation (18 Canada, 19 Finland). Audio recordings were subjected to inductive thematic analysis. Team meetings were held to discuss emerging codes, refine categories, and confirm these reflected data from both sites. One overarching theme was elaborated.Results: Balancing closeness and separation was the major theme. Both parents and nurses engaged in actions to optimize closeness. They sought closeness by acting autonomously in infant caregiving, assuming decision-making for their infant, seeking information or skills, and establishing a connection in the face of separation. Parents balanced their desire for closeness with other competing demands, such as their own needs. Nurses balanced infant care needs and ability to handle stimulation with the need for closeness with parents. Nurses undertook varied actions to facilitate closeness. Parent, infant and NICU-related factors influenced closeness. Consequences, both positive and negative, arose for parents, infants, and nurses.Conclusion: Findings point to actions that nurses undertake to promote closeness and help parents cope with separation including: promoting parent decision-making, organizing care to facilitate closeness, and supporting parent caregiving

Precision mass measurements on neutron-rich rare-earth isotopes at JYFLTRAP - reduced neutron pairing and implications for the rr-process calculations

The rare-earth peak in the $r$-process abundance pattern depends sensitively on both the astrophysical conditions and subtle changes in nuclear structure in the region. This work takes an important step elucidating the nuclear structure and reducing the uncertainties in $r$-process calculations via precise atomic mass measurements at the JYFLTRAP double Penning trap. $^{158}$Nd, $^{160}$Pm, $^{162}$Sm, and $^{164-166}$Gd have been measured for the first time and the precisions for $^{156}$Nd, $^{158}$Pm, $^{162,163}$Eu, $^{163}$Gd, and $^{164}$Tb have been improved considerably. Nuclear structure has been probed via two-neutron separation energies $S_{2n}$ and neutron pairing energy metrics $D_n$. The data do not support the existence of a subshell closure at $N=100$. Neutron pairing has been found to be weaker than predicted by theoretical mass models. The impact on the calculated $r$-process abundances has been studied. Substantial changes resulting in a smoother abundance distribution and a better agreement with the solar $r$-process abundances are observed.Comment: 8 pages, 4 figures, accepted for publication in Physical Review Letter

Major Histocompatibility Complex Class II-associated Invariant Chain Gene Expression Is Up-regulated by Cooperative Interactions of Sp1 and NF-Y

Expression of the major histocompatibility complex (MHC) class II-associated invariant chain (Ii) is required for efficient and complete presentation of antigens by MHC class II molecules and a normal immune response. The Ii gene is generally co-regulated with the MHC class II molecules at the level of transcription and a shared SXY promoter element has been described. This report defines the proximal promoter region of Ii which may regulate Ii transcription distinct from MHC class II. In vivo genomic footprinting identified an occupied, imperfect CCAAT box and an adjacent GC box in the proximal region. These sites are bound in Ii-ositive cell lines and upon interferon-gamma induction of Ii transcription. In contrast, both sites are unoccupied in Ii-egative cell lines and in inducible cell lines prior to interferon-gamma treatment. Together these two sites synergize to stimulate transcription. Independently, the transcription factor NF-Y binds poorly to the imperfect CCAAT box with a rapid off rate, while Sp1 binds to the GC box. Stabilization of NF-Y binding occurs upon Sp1 binding to DNA. In addition, the half-life of Sp1 binding also increased in the presence of NF-Y binding. These findings suggest a mechanism for the complete functional synergy of the GC and CCAAT elements observed in Ii transcription. Furthermore, this report defines a CCAAT box of imperfect sequence which binds NF-Y and activates transcription only when stabilized by an adjacent factor, Sp1

Optimization of ground and excited state wavefunctions and van der Waals clusters

A quantum Monte Carlo method is introduced to optimize excited state trial wavefunctions. The method is applied in a correlation function Monte Carlo calculation to compute ground and excited state energies of bosonic van der Waals clusters of upto seven particles. The calculations are performed using trial wavefunctions with general three-body correlations

Continuous 7-month Internet of Things -based monitoring of health parameters of pregnant and Postpartum Women: prospective observational feasibility study

Background: Monitoring during pregnancy is vital to ensure the mother's and infant's health. Remote continuous monitoring provides health care professionals with significant opportunities to observe health-related parameters in their patients and to detect any pathological signs at an early stage of pregnancy, and may thus partially replace traditional appointments.Objective: This study aimed to evaluate the feasibility of continuously monitoring the health parameters (physical activity, sleep, and heart rate) of nulliparous women throughout pregnancy and until 1 month postpartum, with a smart wristband and an Internet of Things (IoT)-based monitoring system.Methods: This prospective observational feasibility study used a convenience sample of 20 nulliparous women from the Hospital District of Southwest Finland. Continuous monitoring of physical activity/step counts, sleep, and heart rate was performed with a smart wristband for 24 hours a day, 7 days a week over 7 months (6 months during pregnancy and 1 month postpartum). The smart wristband was connected to a cloud server. The total number of possible monitoring days during pregnancy weeks 13 to 42 was 203 days and 28 days in the postpartum period.Results: Valid physical activity data were available for a median of 144 (range 13-188) days (75% of possible monitoring days), and valid sleep data were available for a median of 137 (range 0-184) days (72% of possible monitoring days) per participant during pregnancy. During the postpartum period, a median of 15 (range 0-25) days (54% of possible monitoring days) of valid physical activity data and 16 (range 0-27) days (57% of possible monitoring days) of valid sleep data were available. Physical activity decreased from the second trimester to the third trimester by a mean of 1793 (95% CI 1039-2548) steps per day (PConclusions: The smart wristband with IoT technology was a feasible system for collecting representative data on continuous variables of health parameters during pregnancy. Continuous monitoring provides real-time information between scheduled appointments and thus may help target and tailor pregnancy follow-up.</p

Early Preplasma Cells Define a Tolerance Checkpoint for Autoreactive B Cells

Ab-secreting plasma cells (PCs) are the effectors of humoral immunity. In this study, we describe regulation of autoreactive B cells specific for the ribonucleoprotein Smith (Sm) at an early pre-PC stage. These cells are defined by the expression of the PC marker CD138 and normal levels of CD19 and B220. They are present at a high frequency in normal mouse spleen and bone marrow, are Ag dependent, and are located predominantly along the T cell-B cell border and near bridging channels. Anti-Sm pre-PCs also occur at a high frequency in nonautoimmune mice and show additional phenotypic characteristics of PC differentiation. However, while some of these pre-PCs are Ab-secreting cells, those specific for Sm are not, indicating regulation. Consistent with this, anti-Sm pre-PCs have a higher turnover rate and higher frequency of cell death than those that do not bind Sm. Regulation of anti-Sm pre-PCs occurs upstream of the transcriptional repressor, B lymphocyte-induced maturation protein-1, expression. Regulation at this stage is overcome in autoimmune MRL/lpr mice and is accompanied by an altered B lymphocyte stimulator receptor profile. These data reveal a new B cell tolerance checkpoint that is overcome in autoimmunity

Non cell-Autonomous activity of the hemidesmosomal protein bp180/collagen xvii in granulopoiesis in humanized nc16a mice

BP180 (also termed type XVII collagen) is a hemidesmosomal protein and plays a critical role in cell cell matrix adhesion in the skin; however, its other biological functions are largely unclear. In this study, we generated a BP180 functional deficient mouse strain by deleting its extracellular domain of humanized NC16A (termed DNC16A mice). We found that BP180 is expressed by bone marrow mesenchymal stem cells (BM-MSC), and its functional deficiency leads to myeloid hyperplasia. Altered granulopoiesis in DNC16A mice is through bone marrow stromal cells evidenced by bone marrow transplantation. Furthermore, the level of G-CSF in bone marrow and circulation were significantly increased in DNC16A mice as compared with wild-Type mice. The increased G-CSF was accompanied by an increased activation of the NF-kB signaling pathway in bone marrow and BM-MSC of DNC16A mice. Blockade of G-CSF restored normal granulopoiesis in DNC16A mice. Inhibition of NF-kB signaling pathway significantly reduces the release of G-CSF from DNC16A BM-MSC in vitro and the level of serum G-CSF in DNC16A mice. To our knowledge, these findings provide the first direct evidence that BP180 plays an important role in granulopoiesis through regulating NF-kB signaling pathway in BM-MSC

High-precision mass measurements and production of neutron-deficient isotopes using heavy-ion beams at IGISOL

An upgraded ion-guide system for the production of neutron-deficient isotopes with heavy-ion beams has been commissioned at the IGISOL facility with an Ar-36 beam on a Ni-nat target. It was used together with the JYFLTRAP double Penning trap to measure the masses of Zr-82, Nb-84, Mo-86, Tc-88, and Ru-89 ground states and the isomeric state Tc-88(m). Of these, Ru-89 and Tc-88(m) weremeasured for the first time. The precision of measurements of Zr-82, Nb-84, and Tc-88 was significantly improved. The literature value for Mo-86 was verified. The measured states in Tc-88 were compared to shell-model calculations and additional constraints on the spins and level scheme were obtained. The masses of Mo-82 and Ru-86 have been predicted using the measured masses of their mirror partners and theoretical mirror displacement energies, resulting in more tightly bound nuclei with smaller atomic mass uncertainties than reported in the literature.Peer reviewe

Mass measurements towards doubly magic Ni-78 : Hydrodynamics versus nuclear mass contribution in core-collapse supernovae

We report the first high-precision mass measurements of the neutron-rich nuclei Ni-74,Ni-75 and the clearly identified ground state of Cu-76, along with a more precise mass-excess value of Cu-78, performed with the double Penning trap JYFLTRAP at the Ion Guide Isotope Separator On-Line (IGISOL) facility. These new results lead to a quantitative estimation of the quenching for the N = 50 neutron shell gap. The impact of this shell quenching on core-collapse supernova dynamics is specifically tested using a dedicated statistical equilibrium approach that allows a variation of the mass model independent of the other microphysical inputs. We conclude that the impact of nuclear masses is strong when implemented using a fixed trajectory as in the previous studies, but the effect is substantially reduced when implemented self-consistently in the simulation. (C) 2022 The Authors. Published by Elsevier B.V.Peer reviewe

Apoptotic Debris Accumulates on Hematopoietic Cells and Promotes Disease in Murine and Human Systemic Lupus Erythematosus

Apoptotic debris, autoantibody, and IgG-immune complexes (ICs) have long been implicated in the inflammation associated with systemic lupus erythematosus (SLE); however, it remains unclear whether they initiate immune-mediated events that promote disease. In this study, we show that peripheral blood mononuclear cells from SLE patients experiencing active disease, and hematopoietic cells from lupus-prone MRL/lpr and NZM2410 mice accumulate markedly elevated levels of surface-bound nuclear self-antigens. On dendritic cells (DCs) and macrophages (MFs), the self-antigens are part of IgG-ICs that promote FcγRI-mediated signal transduction. Accumulation of IgG-ICs is evident on ex vivo myeloid cells from MRL/lpr mice by 10 weeks of age, and steadily increases prior to lupus nephritis. IgG and FcγRI play a critical role in disease pathology. Passive transfer of pathogenic IgG into IgG-deficient MRL/lpr mice promotes the accumulation of IgG-ICs prior to significant B cell expansion, BAFF secretion, and lupus nephritis. In contrast, diminishing the burden IgG-ICs in MRL/lpr mice through deficiency in FcγRI markedly improves these lupus pathologies. Together, our findings reveal a previously unappreciated role for the cell surface accumulation of IgG-ICs in human and murine lupus