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

Magnetic field dependence of the internal quality factor and noise performance of lumped-element kinetic inductance detectors

We present a technique for increasing the internal quality factor of kinetic inductance detectors (KIDs) by nulling ambient magnetic fields with a properly applied magnetic field. The KIDs used in this study are made from thin-film aluminum, they are mounted inside a light-tight package made from bulk aluminum, and they are operated near $150 \, \mathrm{mK}$. Since the thin-film aluminum has a slightly elevated critical temperature ($T_\mathrm{c} = 1.4 \, \mathrm{K}$), it therefore transitions before the package ($T_\mathrm{c} = 1.2 \, \mathrm{K}$), which also serves as a magnetic shield. On cooldown, ambient magnetic fields as small as approximately $30 \, \mathrm{\mu T}$ can produce vortices in the thin-film aluminum as it transitions because the bulk aluminum package has not yet transitioned and therefore is not yet shielding. These vortices become trapped inside the aluminum package below $1.2 \, \mathrm{K}$ and ultimately produce low internal quality factors in the thin-film superconducting resonators. We show that by controlling the strength of the magnetic field present when the thin film transitions, we can control the internal quality factor of the resonators. We also compare the noise performance with and without vortices present, and find no evidence for excess noise beyond the increase in amplifier noise, which is expected with increasing loss.Comment: 5 pages, 4 figure

Epithelial Overexpression of BDNF or NT4 Disrupts Targeting of Taste Neurons That Innervate the Anterior Tongue

AbstractBrain-derived neurotrophic factor (BDNF) and neurotrophin-4 (NT4) are essential for the survival of geniculate ganglion neurons, which provide the sensory afferents for taste buds of the anterior tongue and palate. To determine how these target-derived growth factors regulate gustatory development, the taste system was examined in transgenic mice that overexpress BDNF (BDNF-OE) or NT4 (NT4-OE) in basal epithelial cells of the tongue. Overexpression of BDNF or NT4 caused a 93 and 140% increase, respectively, in the number of geniculate ganglion neurons. Surprisingly, both transgenic lines had severe reduction in fungiform papillae and taste bud number, primarily in the dorsal midregion and ventral tip of the tongue. No alterations were observed in taste buds of circumvallate or incisal papillae. Fungiform papillae were initially present on tongues of newborn BDNF-OE animals, but many were small, poorly innervated, and lost postnatally. To explain the loss of nerve innervation to fungiform papillae, the facial nerve of developing animals was labeled with the lipophilic tracer DiI. In contrast to control mice, in which taste neurons innervated only fungiform papillae, taste neurons in BDNF-OE and NT4-OE mice innervated few fungiform papillae. Instead, some fibers approached but did not penetrate the epithelium and aberrant innervation to filiform papillae was observed. In addition, some papillae that formed in transgenic mice had two taste buds (instead of one) and were frequently arranged in clusters of two or three papillae. These results indicate that target-derived BDNF and NT4 are not only survival factors for geniculate ganglion neurons, but also have important roles in regulating the development and spatial patterning of fungiform papilla and targeting of taste neurons to these sensory structures

Decoherence from a Chaotic Environment: An Upside Down "Oscillator" as a Model

Chaotic evolutions exhibit exponential sensitivity to initial conditions. This suggests that even very small perturbations resulting from weak coupling of a quantum chaotic environment to the position of a system whose state is a non-local superposition will lead to rapid decoherence. However, it is also known that quantum counterparts of classically chaotic systems lose exponential sensitivity to initial conditions, so this expectation of enhanced decoherence is by no means obvious. We analyze decoherence due to a "toy" quantum environment that is analytically solvable, yet displays the crucial phenomenon of exponential sensitivity to perturbations. We show that such an environment, with a single degree of freedom, can be far more effective at destroying quantum coherence than a heat bath with infinitely many degrees of freedom. This also means that the standard "quantum Brownian motion" model for a decohering environment may not be as universally applicable as it once was conjectured to be.Comment: RevTeX, 29 pages, 5 EPS figures. Substantially rewritten analysis, improved figures, additional references, and errors fixed. Final version (to appear in PRA

Glioma Mimics: Magnetic Resonance Imaging Characteristics of Granulomas in Dogs

Granulomas can “mimic” gliomas on magnetic resonance imaging (MRI) in human patients. The goal of this retrospective study was to report canine brain granulomas that were consistent with glioma based upon MRI, report their histologic diagnosis, and identify MRI criteria that might be useful to distinguish granuloma from glioma. Ten granulomas, initially suspected to be glioma based on MRI, were ultimately diagnosed as granulomatous meningoencephalomyelitis (n = 5), infectious granulomas (n = 3) or other meningoencephalitis (n = 2). Age was 1.6–15.0 years and two dogs were brachycephalic breeds. MRI characteristics overlapping with glioma included intra-axial, heterogeneous, T2-weighted hyperintense, T1-weighted hypointense to isointense mass lesions with contrast-enhancement. Signals on fluid attenuation inversion recovery, gradient echo and diffusion weighted imaging also matched glioma. Peri-lesional edema and mass effect were toward the high end of findings reported for glioma. MRI characteristics that would be considered unusual for glioma included dural contact (n = 4), T2-hypointensity (n = 2), concomitant meningeal-enhancement (n = 9), and minor changes in the contralateral brain (n = 2). Cerebrospinal fluid analysis revealed albuminocytological dissociation or mild pleocytosis. These cases show that granulomas can “mimic” glioma on canine brain MRI. In individual cases, certain MRI findings may help increase the index of suspicion for granuloma. Lack of pronounced cerebrospinal fluid pleocytosis does not exclude granuloma. Signalment is very useful in the suspicion of glioma, and many of these dogs with granuloma were of ages and breeds in which glioma is less commonly seen

Evaluation of Management Routes for the Paldiski Sarcophagi

The necessity to develop the submarine fleet in Russia required constructing a special training base for the training of submarine crews. To this purpose two prototypes of nuclear power units, close analogous to those fitting out nuclear submarines were constructed and commissioned in the sixties on the Navy training centre's base located in Paldiski (Pakri peninsula, Estonia). In 1994, nuclear fuel was discharged from the reactors and transported to Russia while the reactors themselves were prepared for prolonged storage, prior to transfer of the Paldiski facilities to the ownership of the Estonian Republic. The Paldiski facilities are currently being dismantled with the exception of two sarcophagi made of concrete that are housing the two reactor compartments. The question of the future management of both sarcophagi is a key-issue in the cleaning up of the whole Paldiski site. Actually, three basic questions should answered: when should dismantling operations occur, how this should be done, and what could be the corresponding cost. Within the context of enlargement of the European Union, the Commission services (first Directorate-General for Environment and then Directorate-General for Enlargement) decided to support Estonia to respond to these three questions through a study contract that was awarded in 1999 to a TECHNICATOME/BNFL consortium. The work scope was made up of three distinct tasks: data collection regarding the nuclear reactors and enclosing compartments design, and the works carried in order to prepare the reactor compartments for long-term storage; drawing up dismantling strategies in order to reach the third decommissioning level defined by IAEA; and evaluation of these decommissioning options on the basis cost estimation and radiological impact evaluation, in view to recommend the best management route. This article gives the key stages and the conclusions of this study

Semantic Approach in Image Change Detection

International audienceChange detection is a main issue in various domains, and especially for remote sensing purposes. Indeed, plethora of geospatial images are available and can be used to update geographical databases. In this paper, we propose a classification-based method to detect changes between a database and a more recent image. It is based both on an efficient training point selection and a hierarchical decision process. This allows to take into account the intrinsic heterogeneity of the objects and themes composing a database while limiting false detection rates. The reliability of the designed framework method is first assessed on simulated data, and then successfully applied on very high resolution satellite images and two land-cover databases