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Objective: Shared decision-making (SDM) between parents facing extremely preterm delivery and the medical team is recommended to develop the best course of action for neonatal care. We aimed to describe the creation and testing of a literature-based checklist to assess SDM practices for consultation with parents facing extremely preterm delivery., Study Design: The checklist of SDM counseling behaviors was created after literature review and with expert consensus. Mock consultations with a standardized patient facing extremely preterm delivery were performed, video-recorded, and scored using the checklist. Intraclass correlation coefficients and Cronbach's alpha were calculated., Result: The checklist was moderately reliable for all scorers in aggregate. Differences existed between subcategories within classes of scorer, and between scorer classes. Agreement was moderate between expert scorers, but poor between novice scorers. Internal consistency of the checklist was excellent (Cronbach's alpha = 0.93)., Conclusion: This novel checklist for evaluating SDM shows promise for use in future research, training, and clinical settings., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Despite the advancement of medical therapies in the care of the preterm neonate, in the management of short bowel syndrome and the control of pediatric inflammatory bowel disease, the need to create fecal ostomies remains a common, advantageous treatment option for many medically complex children., (© American Academy of Pediatrics, 2024. All rights reserved.)

In response to the COVID pandemic, Uniformed Services University (USU) suspended clerkships. As the nation's military medical school, USU had to keep students safe while still preparing them to be military physicians. In this commentary, we, a group of USU students, explore what this experience taught us about military medicine., (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2021. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

Introduction: Cognitive complaints in older adults may be indicative of progressive cognitive decline including Alzheimer's disease (AD), but also occur in other age-related chronic conditions, complicating identification of early AD symptoms. To better understand cognitive complaints in aging, we systematically reviewed the evidence to determine their prevalence and characterization among older adults with the most common age-related chronic conditions., Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the review protocol was prospectively registered with PROSPERO (ID: CRD42020153147). Searches were conducted in PubMed, CINAHL, PsycINFO, Web of Science, and ProQuest Dissertations & Theses A&I in June 2020. Two members of the review team independently determined article eligibility for inclusion and conducted quality appraisal. A narrative synthesis of results was used to integrate findings across studies and draw conclusions regarding the strength of the evidence in each chronic condition category., Results: Thirty-seven articles met eligibility criteria and were included in the review. Conditions represented were diabetes (n = 20), heart disease (n = 13), hypertension (n = 10), chronic lung disease (n = 5), arthritis (n = 4), heart failure (n = 2), and hyperlipidemia (n = 2). In addition, 16 studies included a measure of multimorbidity. Overall, there was a higher prevalence of cognitive complaints in individuals with higher multimorbidity, including a potential dose-dependent relationship. Findings for specific conditions were inconsistent, but there is evidence to suggest that cross-sectionally, older adults with diabetes, heart disease, chronic lung disease, and arthritis have more cognitive complaints than those without these conditions., Conclusion: There is strong evidence demonstrating that cognitive complaints are more common in older adults with higher multimorbidity, but little research examining these associations over time. Improving our understanding of the longitudinal trajectory of cognitive complaints, multimorbidity, and objective cognition in older age is an important area for future research., Competing Interests: The authors have declared that no competing interests exist.

Specialized hardware for neural networks requires materials with tunable symmetry, retention, and speed at low power consumption. The study proposes lithium titanates, originally developed as Li-ion battery anode materials, as promising candidates for memristive-based neuromorphic computing hardware. By using ex- and in operando spectroscopy to monitor the lithium filling and emptying of structural positions during electrochemical measurements, the study also investigates the controlled formation of a metallic phase (Li 7 Ti 5 O 12 ) percolating through an insulating medium (Li 4 Ti 5 O 12 ) with no volume changes under voltage bias, thereby controlling the spatially averaged conductivity of the film device. A theoretical model to explain the observed hysteretic switching behavior based on electrochemical nonequilibrium thermodynamics is presented, in which the metal-insulator transition results from electrically driven phase separation of Li 4 Ti 5 O 12 and Li 7 Ti 5 O 12 . Ability of highly lithiated phase of Li 7 Ti 5 O 12 for Deep Neural Network applications is reported, given the large retentions and symmetry, and opportunity for the low lithiated phase of Li 4 Ti 5 O 12 toward Spiking Neural Network applications, due to the shorter retention and large resistance changes. The findings pave the way for lithium oxides to enable thin-film memristive devices with adjustable symmetry and retention., (© 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Blockage of pipelines due to accretion of salt particles is detrimental in desalination and water-harvesting industries as they compromise productivity, while increasing maintenance costs. We present a micro-/nanoscale approach to study fundamentals of scale formation, deposition, and adhesion to engineered surfaces with a wide range of surface energies fabricated using the initiated chemical vapor deposition method. Silicon wafers and steel substrates are coated with poly(1 H,1 H,2 H,2 H-perfluorodecylacrylate) or pPFDA, poly(tetravinyl-tetramethylcyclotetrasilohexane) or pV4D4, poly(divinylbenzene) or pDVB, poly(1,3,5,7-tetravinyl-1,3,5,7-tetramethylcyclotetrasilohexane) or pV3D3, and cross-linked copolymers of poly(2-hydroxyethylmethacrylate) and poly(ethylene glycol) diacrylate or p(PHEMA- co-EGDA). Particles of salt (CaSO 4 ·2H 2 O) are formed and shaped with a focused ion beam and adhered to a tipless cantilever beam using a micromanipulator setup to study their adhesion strength with a molecular force probe (MFP). Adhesion forces were measured on the substrates in wet and dry conditions to evaluate the effects of interfacial fluid layers and capillary bridges on net adhesion strength. The adhesion between salt particles and the pPFDA coatings decreased by 5.1 ± 1.15 nN in wet states, indicating the influence of capillary bridging between the particle and the liquid layer. In addition, scale nucleation and growth on various surfaces is examined using a quartz crystal microbalance (QCM), where supersaturated solution of CaSO 4 ·2H 2 O is passed over bare and polymer-coated quartz substrates while mass gain is measured in real time. The salt accretion decreased by 2 folds on pPFDA-coated substrates when compared to that on p(HEMA- co-EGDA) coatings. Both MFP and QCM studies are essential in studying the impact of surface energy and roughness on the extent of scale formation and adhesion strength. This study can pave way for the design of scale-resistant surfaces with potential applications in water treatment, energy harvesting, and purification industries.