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Comparison of family centered care with family integrated care and mobile technology (mFICare) on preterm infant and family outcomes: a multi-site quasi-experimental clinical trial protocol.
BackgroundFamily Centered Care (FCC) has been widely adopted as the framework for caring for infants in the Neonatal Intensive Care Unit (NICU) but it is not uniformly defined or practiced, making it difficult to determine impact. Previous studies have shown that implementing the Family Integrated Care (FICare) intervention program for preterm infants in the NICU setting leads to significant improvements in infant and family outcomes. Further research is warranted to determine feasibility, acceptability and differential impact of FICare in the US context. The addition of a mobile application (app) may be effective in providing supplemental support for parent participation in the FICare program and provide detailed data on program component uptake and outcomes.MethodsThis exploratory multi-site quasi-experimental study will compare usual FCC with mobile enhanced FICare (mFICare) on growth and clinical outcomes of preterm infants born at or before 33 weeks gestational age, as well as the stress, competence and self-efficacy of their parents. The feasibility and acceptability of using mobile technology to gather data about parent involvement in the care of preterm infants receiving FCC or mFICare as well as of the mFICare intervention will be evaluated (Aim 1). The effect sizes for infant growth (primary outcome) and for secondary infant and parent outcomes at NICU discharge and three months after discharge will be estimated (Aim 2).DiscussionThis study will provide new data about the implementation of FICare in the US context within various hospital settings and identify important barriers, facilitators and key processes that may contribute to the effectiveness of FICare. It will also offer insights to clinicians on the feasibility of a new mobile application to support parent-focused research and promote integration of parents into the NICU care team in US hospital settings.Trial registrationClinicalTrials.gov, ID NCT03418870. Retrospectively registered on December 18, 2017
Negotiating the Personal and Professional: Ethnomusicologists and Uncomfortable Truths
The panel, “Negotiating the Personal and Professional: Ethnomusicologists and Uncomfortable Truths,” presented at the Forty-third ICTM World Conference in Astana, Kazakhstan, grew out of informal conversations common among ethnomusicologists. As practitioners in our discipline, we are involved in complex webs of experience, relationships, and representations focused around music, broadly defined. Our work is inherently social and, when in the field, we develop close relationships with our teachers and consultants as we become comfortable in our sites of research. We are grateful for priceless access to communities and individuals. The intensity and combination of certain relationships and circumstances, however, can lead to conflicting expectations, unanticipated misunderstanding, and situations of personal and professional conflict
The psychology of AMBER Alert: Unresolved issues and implications
The AMBER alert system is likely affected by a number of psychological processes, yet remains understudied. The system assumes people will remember Alert information accurately and notify police, but psychological research on related phenomena (e.g., memory, willingness to help) indicates that people may not be able or willing to act in ways the promote the success of the system. In addition, the system is intended to deter child abductions, however, the system could prompt copycat crimes from perpetrators seeking publicity. The system could also cause a precipitation effect in which a perpetrator who sees the Alert could decide to murder the child immediately to avoid capture. Policy recommendations are made based on psychological research and theory, although more research is needed to develop the most effective system possible
Thymoglobulin Induction Dosing Strategies in a Low-Risk Kidney Transplant Population: Three or Four Days?
The optimal dose and duration of rabbit antithymocyte globulin (rATG) induction has not been defined. Methods. We compared the safety and efficacy of 2 dosing strategies, rATG 1.5 mg/kg for 4 days (n = 59) versus 2 mg/kg for 3 days (n = 59), in a retrospective, cohort study. Results. Two-year rejection-free survival was 95% in each group (P = .983). Renal function and infection rates were similar. The incidence of leucopenia was similar, although the 2 mg/kg group was more likely to be thrombocytopenic on day 2 (4% versus 28%, P = .04). Length of stay tended to be longer for the 1.5 mg/kg group (6.0 ± 3.7 versus 5.1 ± 1.9 days P = .104). A cost savings of $920 per patient for rATG were seen in the 2 mg/kg group (P = .122). Conclusions. Shorter, more intense dosing of rATG is safe and effective. The 3-day dose strategy resulted in a clinically shorter length of stay and may result in cost savings
MicroRNA profiling reveals marker of motor neuron disease in ALS models
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder marked by the loss of motor neurons (MNs) in the brain and spinal cord, leading to fatally debilitating weakness. Because this disease predominantly affects MNs, we aimed to characterize the distinct expression profile of that cell type to elucidate underlying disease mechanisms and to identify novel targets that inform on MN health during ALS disease time course. microRNAs (miRNAs) are short, noncoding RNAs that can shape the expression profile of a cell and thus often exhibit cell-type-enriched expression. To determine MN-enriched miRNA expression, we used Cre recombinase-dependent miRNA tagging and affinity purification in mice. By defining thein vivomiRNA expression of MNs, all neurons, astrocytes, and microglia, we then focused on MN-enriched miRNAs via a comparative analysis and found that they may functionally distinguish MNs postnatally from other spinal neurons. Characterizing the levels of the MN-enriched miRNAs in CSF harvested from ALS models of MN disease demonstrated that one miRNA (miR-218) tracked with MN loss and was responsive to an ALS therapy in rodent models. Therefore, we have used cellular expression profiling tools to define the distinct miRNA expression of MNs, which is likely to enrich future studies of MN disease. This approach enabled the development of a novel, drug-responsive marker of MN disease in ALS rodents.SIGNIFICANCE STATEMENTAmyotrophic lateral sclerosis (ALS) is a neurodegenerative disease in which motor neurons (MNs) in the brain and spinal cord are selectively lost. To develop tools to aid in our understanding of the distinct expression profiles of MNs and, ultimately, to monitor MN disease progression, we identified small regulatory microRNAs (miRNAs) that were highly enriched or exclusive in MNs. The signal for one of these MN-enriched miRNAs is detectable in spinal tap biofluid from an ALS rat model, where its levels change as disease progresses, suggesting that it may be a clinically useful marker of disease status. Furthermore, rats treated with ALS therapy have restored expression of this MN RNA marker, making it an MN-specific and drug-responsive marker for ALS rodents.</jats:p
Non-amidated and amidated members of the C-type allatostatin (AST-C) family are differentially distributed in the stomatogastric nervous system of the American lobster, Homarus americanus
The crustacean stomatogastric nervous system (STNS) is a well-known model for investigating neuropeptidergic control of rhythmic behavior. Among the peptides known to modulate the STNS are the C-type allatostatins (AST-Cs). In the lobster, Homarus americanus, three AST-Cs are known. Two of these, pQIRYHQCYFNPISCF (AST-C I) and GNGDGRLYWRCYFNAVSCF (AST-C III), have non-amidated C-termini, while the third, SYWKQCAFNAVSCFamide (AST-C II), is C-terminally amidated. Here, antibodies were generated against one of the non-amidated peptides (AST-C I) and against the amidated isoform (AST-C II). Specificity tests show that the AST-C I antibody cross-reacts with both AST-C I and AST-C III, but not AST-C II; the AST-C II antibody does not cross-react with either non-amidated peptide. Wholemount immunohistochemistry shows that both subclasses (non-amidated and amidated) of AST-C are distributed throughout the lobster STNS. Specifically, the antibody that cross-reacts with the two non-amidated peptides labels neuropil in the CoGs and the stomatogastric ganglion (STG), axons in the superior esophageal (son) and stomatogastric (stn) nerves, and ~ 14 somata in each commissural ganglion (CoG). The AST-C II-specific antibody labels neuropil in the CoGs, STG and at the junction of the sons and stn, axons in the sons and stn, ~ 42 somata in each CoG, and two somata in the STG. Double immunolabeling shows that, except for one soma in each CoG, the non-amidated and amidated peptides are present in distinct sets of neuronal profiles. The differential distributions of the two AST-C subclasses suggest that the two peptide groups are likely to serve different modulatory roles in the lobster STNS
Does an Interactive Health Promotion Website Facilitate Workplace Peer-to-Peer Substance Abuse Prevention?
Operation RedBlock, a substance abuse prevention and early intervention program at Amtrak, implemented an interactive health promotion website (On The Right Track, OTRT) for its volunteers, other employees and their families. OTRT was customized from the Substance Abuse and Mental Health Services Administration (SAMHSA) -sponsored [email protected] website and implemented with the purpose of facilitating the peer-to-peer substance abuse prevention efforts of Operation RedBlock volunteers. SAMHSA’s GetFit website combines broad health and wellness messages with current substance abuse prevention resources. The OTRT customization adds Amtrak relevant and specific content concerning substance abuse prevention resources and treatment options, drug and alcohol use policies, health care coverage, support group meeting locations and dates, and local Operation RedBlock and Employee Assistance Program contact information. Using a retrospective pretest-posttest design this study evaluates whether and how OTRT facilitated peer-to-peer efforts in substance abuse prevention and early intervention. The evaluation revealed that the website significantly improved access to information and resources that helped Operation RedBlock volunteers’ in their peer-to-peer efforts. Volunteers valued the ready availability of reliable information, the confidential nature, and the ease of use of OTRT. Facilitated access to information and resources may help reduce substance abuse among employees at high risk
Infrared Cloud Monitoring with UCIRC2
The second generation of the Extreme Universe Space Observatory on a Super
Pressure Balloon (EUSO-SPB2) is a balloon instrument that searched for ultra
high energy cosmic rays (UHECRs) with energies above 1 EeV and very high energy
neutrinos with energies above 1 PeV. EUSO-SPB2 consists of two telescopes: a
fluorescence telescope pointed downward for the detection of UHECRs and a
Cherenkov telescope toward the limb for the detection of PeV-scale showers
produced by neutrino-sourced tau decay (just below the limb) and by cosmic rays
(just above the limb). Clouds inside the fields of view of these
telescopes--particularly that of the fluorescence telescope--reduce EUSO-SPB2's
geometric aperture. As such, cloud coverage and cloud-top altitude within the
field of view of the fluorescence telescope must be monitored throughout
data-taking. The University of Chicago Infrared Camera (UCIRC2) monitored these
clouds using two infrared cameras centered at 10 and 12 m. By capturing
images at wavelengths spanning the cloud thermal emission peak, UCIRC2 measured
cloud color-temperatures and thus cloud-top altitudes. In this contribution, we
provide an overview of UCIRC2, including an update on its construction and
performance. We also show first results from the flight.Comment: 10 pages, 7 figures, proceedings of the 38th International Cosmic Ray
Conference (ICRC 2023). arXiv admin note: substantial text overlap with
arXiv:2112.09618, arXiv:1909.0266
Black Phosphorus Degradation during Intercalation and Alloying in Batteries
Numerous layered materials are being recognized as promising candidates for high-performance alkali-ion battery anodes, but black phosphorus (BP) has received particular attention. This is due to its high specific capacity, due to a mixed alkali-ion storage mechanism (intercalation-alloying), and fast alkali-ion transport within its layers. Unfortunately, BP based batteries are also commonly associated with serious irreversible losses and poor cycling stability. This is known to be linked to alloying, but there is little experimental evidence of the morphological, mechanical, or chemical changes that BP undergoes in operational cells and thus little understanding of the factors that must be mitigated to optimize performance. Here the degradation mechanisms of BP alkali-ion battery anodes are revealed through operando electrochemical atomic force microscopy (EC-AFM) and ex situ spectroscopy. Among other phenomena, BP is observed to wrinkle and deform during intercalation but suffers from complete structural breakdown upon alloying. The solid electrolyte interphase (SEI) is also found to be unstable, nucleating at defects before spreading across the basal planes but then disintegrating upon desodiation, even above alloying potentials. By directly linking these localized phenomena with the whole-cell performance, we can now engineer stabilizing protocols for next-generation high-capacity alkali-ion batteries
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