Harmonising nursing terminologies using a conceptual framework

The International Classification for Nursing Practice (ICNP®) and the Clinical Care Classification (CCC) System are standardised nursing terminologies that identify discrete elements of nursing practice, including nursing diagnoses, interventions, and outcomes. While CCC uses a conceptual framework or model with 21 Care Components to classify these elements, ICNP, built on a formal Web Ontology Language (OWL) description logic foundation, uses a logical hierarchical framework that is useful for computing and maintenance of ICNP. Since the logical framework of ICNP may not always align with the needs of nursing practice, an informal framework may be a more useful organisational tool to represent nursing content. The purpose of this study was to classify ICNP nursing diagnoses using the 21 Care Components of the CCC as a conceptual framework to facilitate usability and inter-operability of nursing diagnoses in electronic health records. Findings resulted in all 521 ICNP diagnoses being assigned to one of the 21 CCC Care Components. Further research is needed to validate the resulting product of this study with practitioners and develop recommendations for improvement of both terminologie

Low-Dose T-3 Replacement Restores Depressed Cardiac T-3 Levels, Preserves Coronary Microvasculature and Attenuates Cardiac Dysfunction in Experimental Diabetes Mellitus

Thyroid dysfunction is common in individuals with diabetes mellitus (DM) and may contribute to the associated cardiac dysfunction. However, little is known about the extent and pathophysiological consequences of low thyroid conditions on the heart in DM. DM was induced in adult female Sprague Dawley (SD) rats by injection of nicotinamide (N; 200 mg/kg) followed by streptozotocin (STZ; 65 mg/kg). One month after STZ/N, rats were randomized to the following groups (N = 10/group): STZ/N or STZ/N + 0.03 g/mL T-3; age-matched vehicle-treated rats served as nondiabetic controls (C). After 2 months of T-3 treatment (3 months post-DM induction), left ventricular (LV) function was assessed by echocardiography and LV pressure measurements. Despite normal serum thyroid hormone (TH) levels, STZ/N treatment resulted in reductions in myocardial tissue content of THs (T-3 and T-4 : 39% and 17% reduction versus C, respectively). Tissue hypothyroidism in the DM hearts was associated with increased DIO3 deiodinase (which converts THs to inactive metabolites) altered TH transporter expression, reexpression of the fetal gene phenotype, reduced arteriolar resistance vessel density, and diminished cardiac function. Low-dose T-3 replacement largely restored cardiac tissue TH levels (T-3 and T-4 : 43% and 10% increase versus STZ/N, respectively), improved cardiac function, reversed fetal gene expression and preserved the arteriolar resistance vessel network without causing overt symptoms of hyperthyroidism. We conclude that cardiac dysfunction in chronic DM may be associated with tissue hypothyroidism despite normal serum TH levels. Low-dose T-3 replacement appears to be a safe and effective adjunct therapy to attenuate and/or reverse cardiac remodeling and dysfunction induced by experimental DM

Polariton condensation and lasing in optical microcavities - the decoherence driven crossover

We explore the behaviour of a system which consists of a photon mode dipole coupled to a medium of two-level oscillators in a microcavity in the presence of decoherence. We consider two types of decoherence processes which are analogous to magnetic and non-magnetic impurities in superconductors. We study different phases of this system as the decoherence strength and the excitation density is changed. For a low decoherence we obtain a polariton condensate with comparable excitonic and photonic parts at low densities and a BCS-like state with bigger photon component due to the fermionic phase space filling effect at high densities. In both cases there is a large gap in the density of states. As the decoherence is increased the gap is broadened and suppressed, resulting in a gapless condensate and finally a suppression of the coherence in a low density regime and a laser at high density limit. A crossover between these regimes is studied in a self-consistent way analogous to the Abrikosov and Gor'kov theory of gapless superconductivity.Comment: 17 pages, 8 figures, submitted to PR

Covid-19 disease, women’s predominant non-heparin vaccine-induced thrombotic thrombocytopenia and kounis syndrome: A passepartout cytokine storm interplay

Coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) constitute one of the deadliest pandemics in modern history demonstrating cardiovascular, gastrointestinal, hematologic, mucocutaneous, respiratory, neurological, renal and testicular manifestations and further complications. COVID-19-induced excessive immune response accompanied with uncontrolled release of cytokines culminating in cytokine storm seem to be the common pathogenetic mechanism of these complications. The aim of this narrative review is to elucidate the relation between anaphylaxis associated with profound hypotension or hypoxemia with pro-inflammatory cytokine release. COVID-19 relation with Kounis syndrome and post-COVID-19 vaccination correlation with heparin-induced thrombocytopenia with thrombosis (HITT), especially serious cerebral venous sinus thrombosis, were also reviewed. Methods: A current literature search in PubMed, Embase and Google databases was performed to reveal the pathophysiology, prevalence, clinical manifestation, correlation and treatment of COVID-19, anaphylaxis with profuse hypotension, Kounis acute coronary syndrome and thrombotic events post vaccination. Results: The same key immunological pathophysiology mechanisms and cells seem to underlie COVID-19 cardiovascular complications and the anaphylaxis-associated Kounis syndrome. The myocardial injury in patients with COVID-19 has been attributed to coronary spasm, plaque rupture and microthrombi formation, hypoxic injury or cytokine storm disposing the same pathophysiology with the three clinical variants of Kounis syndrome. COVID-19-interrelated vaccine excipients as polysorbate, polyethelene glycol (PEG) and trometamol constitute potential allergenic substances. Conclusion: Better acknowledgement of the pathophysiological mechanisms, clinical similarities, multiorgan complications of COVID-19 or other viral infections as dengue and human immunodeficiency viruses along with the action of inflammatory cells inducing the Kounis syndrome could identify better immunological approaches for prevention, treatment of the COVID-19 pandemic as well as post-COVID-19 vaccine adverse reactions

Identification of Radiopure Titanium for the LZ Dark Matter Experiment and Future Rare Event Searches

The LUX-ZEPLIN (LZ) experiment will search for dark matter particle interactions with a detector containing a total of 10 tonnes of liquid xenon within a double-vessel cryostat. The large mass and proximity of the cryostat to the active detector volume demand the use of material with extremely low intrinsic radioactivity. We report on the radioassay campaign conducted to identify suitable metals, the determination of factors limiting radiopure production, and the selection of titanium for construction of the LZ cryostat and other detector components. This titanium has been measured with activities of $^{238}$U$_{e}$~$<$1.6~mBq/kg, $^{238}$U$_{l}$~$<$0.09~mBq/kg, $^{232}$Th$_{e}$~$=0.28\pm 0.03$~mBq/kg, $^{232}$Th$_{l}$~$=0.25\pm 0.02$~mBq/kg, $^{40}$K~$<$0.54~mBq/kg, and $^{60}$Co~$<$0.02~mBq/kg (68\% CL). Such low intrinsic activities, which are some of the lowest ever reported for titanium, enable its use for future dark matter and other rare event searches. Monte Carlo simulations have been performed to assess the expected background contribution from the LZ cryostat with this radioactivity. In 1,000 days of WIMP search exposure of a 5.6-tonne fiducial mass, the cryostat will contribute only a mean background of $0.160\pm0.001$(stat)$\pm0.030$(sys) counts.Comment: 13 pages, 3 figures, accepted for publication in Astroparticle Physic

Functional diversity among cardiolipin binding sites on the mitochondrial ADP/ATP carrier

Lipid-protein interactions play a multitude of essential roles in membrane homeostasis. Mitochondrial membranes have a unique lipid-protein environment that ensures bioenergetic efficiency. Cardiolipin (CL), the signature mitochondrial lipid, plays multiple roles in promoting oxidative phosphorylation (OXPHOS). In the inner mitochondrial membrane, the ADP/ATP carrier (AAC in yeast; adenine nucleotide translocator, ANT in mammals) exchanges ADP and ATP, enabling OXPHOS. AAC/ANT contains three tightly bound CLs, and these interactions are evolutionarily conserved. Here, we investigated the role of these buried CLs in AAC/ANT using a combination of biochemical approaches, native mass spectrometry, and molecular dynamics simulations. We introduced negatively charged mutations into each CL-binding site of yeast Aac2 and established experimentally that the mutations disrupted the CL interactions. While all mutations destabilized Aac2 tertiary structure, transport activity was impaired in a binding site-specific manner. Additionally, we determined that a disease-associated missense mutation in one CL-binding site in human ANT1 compromised its structure and transport activity, resulting in OXPHOS defects. Our findings highlight the conserved significance of CL in AAC/ANT structure and function, directly tied to specific lipid-protein interactions

Properties of Microelectromagnet Mirrors as Reflectors of Cold Rb Atoms

Cryogenically cooled microelectromagnet mirrors were used to reflect a cloud of free-falling laser-cooled 85Rb atoms at normal incidence. The mirrors consisted of microfabricated current-carrying Au wires in a periodic serpentine pattern on a sapphire substrate. The fluorescence from the atomic cloud was imaged after it had bounced off a mirror. The transverse width of the cloud reached a local minimum at an optimal current corresponding to minimum mirror roughness. A distinct increase in roughness was found for mirror configurations with even versus odd number of lines. These observations confirm theoretical predictions.Comment: Physical Review A, in print; 11 pages, 4 figure

An evaluation of ocean color model estimates of marine primary productivity in coastal and pelagic regions across the globe

Abstract. Nearly half of the earth’s photosynthetically fixed carbon derives from the oceans. To determine global and region specific rates, we rely on models that estimate marine net primary productivity (NPP) thus it is essential that these models are evaluated to determine their accuracy. Here we assessed the skill of 21 ocean color models by comparing their estimates of depth-integrated NPP to 1156 in situ 14C measurements encompassing ten marine regions including the Sargasso Sea, pelagic North Atlantic, coastal Northeast Atlantic, Black Sea, Mediterranean Sea, Arabian Sea, subtropical North Pacific, Ross Sea, West Antarctic Peninsula, and the Antarctic Polar Frontal Zone. Average model skill, as determined by root-mean square difference calculations, was lowest in the Black and Mediterranean Seas, highest in the pelagic North Atlantic and the Antarctic Polar Frontal Zone, and intermediate in the other six regions. The maximum fraction of model skill that may be attributable to uncertainties in both the input variables and in situ NPP measurements was nearly 72%. On average, the simplest depth/wavelength integrated models performed no worse than the more complex depth/wavelength resolved models. Ocean color models were not highly challenged in extreme conditions of surface chlorophyll-a and sea surface temperature, nor in high-nitrate low-chlorophyll waters. Water column depth was the primary influence on ocean color model performance such that average skill was significantly higher at depths greater than 250 m, suggesting that ocean color models are more challenged in Case-2 waters (coastal) than in Case-1 (pelagic) waters. Given that in situ chlorophyll-a data was used as input data, algorithm improvement is required to eliminate the poor performance of ocean color NPP models in Case-2 waters that are close to coastlines. Finally, ocean color chlorophyll-a algorithms are challenged by optically complex Case-2 waters, thus using satellite-derived chlorophyll-a to estimate NPP in coastal areas would likely further reduce the skill of ocean color models

Cardiovascular/stroke risk predictive calculators: a comparison between statistical and machine learning models

Background: Statistically derived cardiovascular risk calculators (CVRC) that use conventional risk factors, generally underestimate or overestimate the risk of cardiovascular disease (CVD) or stroke events primarily due to lack of integration of plaque burden. This study investigates the role of machine learning (ML)-based CVD/stroke risk calculators (CVRCML) and compares against statistically derived CVRC (CVRCStat) based on (I) conventional factors or (II) combined conventional with plaque burden (integrated factors). Methods: The proposed study is divided into 3 parts: (I) statistical calculator: initially, the 10-year CVD/stroke risk was computed using 13 types of CVRCStat (without and with plaque burden) and binary risk stratification of the patients was performed using the predefined thresholds and risk classes; (II) ML calculator: using the same risk factors (without and with plaque burden), as adopted in 13 different CVRCStat, the patients were again risk-stratified using CVRCML based on support vector machine (SVM) and finally; (III) both types of calculators were evaluated using AUC based on ROC analysis, which was computed using combination of predicted class and endpoint equivalent to CVD/stroke events. Results: An Institutional Review Board approved 202 patients (156 males and 46 females) of Japanese ethnicity were recruited for this study with a mean age of 69±11 years. The AUC for 13 different types of CVRCStat calculators were: AECRS2.0 (AUC 0.83, P&lt;0.001), QRISK3 (AUC 0.72, P&lt;0.001), WHO (AUC 0.70, P&lt;0.001), ASCVD (AUC 0.67, P&lt;0.001), FRScardio (AUC 0.67, P&lt;0.01), FRSstroke (AUC 0.64, P&lt;0.001), MSRC (AUC 0.63, P=0.03), UKPDS56 (AUC 0.63, P&lt;0.001), NIPPON (AUC 0.63, P&lt;0.001), PROCAM (AUC 0.59, P&lt;0.001), RRS (AUC 0.57, P&lt;0.001), UKPDS60 (AUC 0.53, P&lt;0.001), and SCORE (AUC 0.45, P&lt;0.001), while the AUC for the CVRCML with integrated risk factors (AUC 0.88, P&lt;0.001), a 42% increase in performance. The overall risk-stratification accuracy for the CVRCML with integrated risk factors was 92.52% which was higher compared all the other CVRCStat. Conclusions: ML-based CVD/stroke risk calculator provided a higher predictive ability of 10-year CVD/ stroke compared to the 13 different types of statistically derived risk calculators including integrated model AECRS 2.0