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OBJECTIVE: The Family Integrated Care (FICare) model improves outcomes for preterm infants and parents compared with family-centered care (FCC). FICare with mobile technology (mFICare) may improve uptake and impact. Research on FICare in the United States (US) is scarce and little is known about parents experience. METHODS: We conducted qualitative interviews with nine parents, exploring their NICU experiences, participation in and perceptions of the mFICare program. A directed content analysis approach was used, and common themes were derived from the data. RESULTS: Overall, parents had positive NICU experiences and found mFICare helpful in meeting three common parenting priorities: actively caring for their infant, learning how to care for their infant, and learning about the clinical status of their infant. They described alignment and misalignment with mFICare components relative to their personal parenting priorities and offered suggestions for improvement. Nurses were noted to play key roles in providing or facilitating parent support and encouragement to participate in mFICare and parenting activities. CONCLUSION: The mFICare program showed potential for parental acceptance and participation in US NICUs. INNOVATION: The mFICare model is an innovation in neonatal care that can advance the consistent delivery of NICU family-centered care planning and caregiving.Clinical Trial Registration:NCT03418870 01/02/2018.

Electrical signaling plays a crucial role in the cellular response to tissue injury in wound healing and an external electric field (EF) may expedite the healing process. Here, we have developed a standalone, wearable, and programmable electronic device to administer a well-controlled exogenous EF, aiming to accelerate wound healing in an in vivo mouse model to provide pre-clinical evidence. We monitored the healing process by assessing the re-epithelization rate and the ratio of M1/M2 macrophage phenotypes through histology staining. Following three days of treatment, the M1/M2 macrophage ratio decreased by 30.6% and the re-epithelization in the EF-treated wounds trended towards a non-statically significant 24.2% increase compared to the control. These findings provide point towards the effectiveness of the device in shortening the inflammatory phase by promoting reparative macrophages over inflammatory macrophages, and in speeding up re-epithelialization. Our wearable device supports the rationale for the application of programmed EFs for wound management in vivo and provides an exciting basis for further development of our technology based on the modulation of macrophages and inflammation to better wound healing.

Macrophages can exhibit pro-inflammatory or pro-reparatory functions, contingent upon their specific activation state. This dynamic behavior empowers macrophages to engage in immune reactions and contribute to tissue homeostasis. Understanding the intricate interplay between macrophage motility and activation status provides valuable insights into the complex mechanisms that govern their diverse functions. In a recent study, we developed a classification method based on morphology, which demonstrated that movement characteristics, including speed and displacement, can serve as distinguishing factors for macrophage subtypes. In this study, we develop a deep learning model to explore the potential of classifying macrophage subtypes based solely on raw trajectory patterns. The classification model relies on the time series of x-y coordinates, as well as the distance traveled and net displacement. We begin by investigating the migratory patterns of macrophages to gain a deeper understanding of their behavior. Although this analysis does not directly inform the deep learning model, it serves to highlight the intricate and distinct dynamics exhibited by different macrophage subtypes, which cannot be easily captured by a finite set of motility metrics. Our study uses cell trajectories to classify three macrophage subtypes: M0, M1, and M2. This advancement holds promising implications for the future, as it suggests the possibility of identifying macrophage subtypes without relying on shape analysis. Consequently, it could potentially eliminate the necessity for high-quality imaging techniques and provide more robust methods for analyzing inherently blurry images.

The composite material-like extracellular matrix (ECM) in the sinoatrial node (SAN) supports the native pacemaking cardiomyocytes (PCMs). To test the roles of SAN ECM in the PCM phenotype and function, we engineered reconstructed-SAN heart tissues (rSANHTs) by recellularizing porcine SAN ECMs with hiPSC-derived PCMs. The hiPSC-PCMs in rSANHTs self-organized into clusters resembling the native SAN and displayed higher expression of pacemaker-specific genes and a faster automaticity compared with PCMs in reconstructed-left ventricular heart tissues (rLVHTs). To test the protective nature of SAN ECMs under strain, rSANHTs and rLVHTs were transplanted onto the murine thoracic diaphragm to undergo constant cyclic strain. All strained-rSANHTs preserved automaticity, whereas 66% of strained-rLVHTs lost their automaticity. In contrast to the strained-rLVHTs, PCMs in strained-rSANHTs maintained high expression of key pacemaker genes (HCN4, TBX3, and TBX18). These findings highlight the promotive and protective roles of the composite SAN ECM and provide valuable insights for pacemaking tissue engineering.

BACKGROUND: Involvement in caregiving and tailored support services may reduce the risk of mental health symptoms for mothers after their preterm infants neonatal intensive care unit (NICU) discharge. We aimed to compare Family-Centered Care (FCC) with mobile-enhanced Family-Integrated Care (mFICare) on post-discharge maternal mental health symptoms. METHOD: This quasi-experimental study enrolled preterm infant (≤ 33 weeks)/parent dyads from three NICUs into sequential cohorts: FCC or mFICare. We analyzed post-discharge symptoms of perinatal post-traumatic stress disorder (PTSD) and depression using intention-to-treat and per protocol approaches. RESULTS: 178 mothers (89 FCC; 89 mFICare) completed measures. We found no main effect of group assignment. We found an interaction between group and stress, indicating fewer PTSD and depression symptoms among mothers who had higher NICU-related stress and received mFICare, compared with mothers who had high stress and received FCC (PTSD: interaction β=-1.18, 95% CI: -2.10, -0.26; depression: interaction β=-0.76, 95% CI: -1.53, 0.006). Per protocol analyses of mFICare components suggested fewer PTSD and depression symptoms among mothers who had higher NICU stress scores and participated in clinical team rounds and/or group classes, compared with mothers who had high stress and did not participate in rounds or classes. CONCLUSION: Overall, post-discharge maternal mental health symptoms did not differ between the mFICare and FCC groups. However, for mothers with high levels of stress during the NICU stay, mFICare was associated with fewer post-discharge PTSD and depression symptoms.

Temporomandibular joint osteoarthritis (TMJOA) is characterized by progressive cartilage degeneration, subchondral bone remodeling, chronic inflammation in the synovial tissue and osteophyte formation. Chondrocyte apoptosis is one of the main factors of cartilage degeneration. Prevention and treatment of TMJOA can be achieved by inhibiting premature or excessive chondrocyte apoptosis. Primary cilia protruding from the surface of chondrocytes can sense mechanical stimulation and induce chondrocyte differentiation. Studying the role of primary cilia in TMJOA will help us understand the pathogenesis of TMJOA and construct a reasonable and effective treatment strategy.

BackgroundSocial support is associated with decreased symptoms of postpartum mood and anxiety disorders (PMAD) in mothers of healthy infants, but less is known about social support and PMADs in mothers with preterm infants. The purpose of this study was to examine the relationship between social support and symptoms of PMADs reported by mothers in the months following hospital discharge of their preterm infant.MethodsMothers of infants less than 33 weeks gestational age were enrolled from neonatal intensive care units (NICU) at 6 sites. Mothers completed PMAD measures of depression, anxiety and post-traumatic stress approximately 3 months following their infant's discharge. Multivariable regression was used to evaluate relationships between social support and PMAD measures.ResultsOf 129 mothers, 1 in 5 reported clinically significant PMAD symptoms of: depression (24%), anxiety (19%), and post-traumatic stress (20%). Social support was strongly inversely associated with all 3 PMADs. Social support explained between 21% and 26% of the variance in depression, anxiety and post-traumatic stress symptoms.ConclusionIncreased social support may buffer PMAD symptoms in mothers of preterm infants after discharge. Research is needed to determine effective screening and interventions aimed at promoting social support for all parents during and following their infant's hospitalisation.

Disseminated intravascular coagulation (DIC) poses a high mortality risk, yet its exact impact remains contentious. This study investigates DIC's association with mortality in individuals with sepsis, emphasizing multiple organ function. Using data from the Peking University People's Hospital Investigation on Sepsis-Induced Coagulopathy database, we categorized patients into DIC and non-DIC groups based on DIC scores within 24 h of ICU admission (< 5 cutoff). ICU mortality was the main outcome. Initial data comparison preceded logistic regression analysis of mortality factors post-propensity score matching (PSM). Employing mediation analysis estimated direct and indirect associations. Of 549 participants, 131 were in the DIC group, with the remaining 418 in the non-DIC group. Following baseline characteristic presentation, PSM was conducted, revealing significantly higher nonplatelet sequential organ failure assessment (nonplt-SOFA) scores (6.3 ± 2.7 vs 5.0 ± 2.5, P

[Objective] To improve the detection accuracy of early apple spoilage zone. [Methods] An apple spoilage detection method was proposed based on generative adversarial network and convolutional neural network. The Pix2PixHD model was used to generate near-infrared imaging data of stored apples in the early postharvest metamorphic area. The Mask R-CNN model was used to segment the generated near Infrared image to detect the deterioration zone in the apple. Based on generative adversarial network and convolutional neural network technology, the early deterioration region segmentation and prediction of postharvest apples were implemented by using the generated near-infrared imaging data on a low-cost embedded system with artificial intelligence function. [Results] The average accuracy of this method was 1.825%～10.435% higher than that of the other nine methods. The Pix2PixHD generated a visible NIR image from an RGB image at 17 frames per second, and the Mask R-CNN was able to segment spoilage areas in an apple image at 4.2 frames per second. [Conclusion] The proposed method is expected to facilitate the development of low-cost food quality controllers.

The wear resistance of the part surface has become an important factor affecting its own service life. Laser cladding (LC), as a surface modification technology, can prepare a coating with good metallurgical bonding with the substrate, which can significantly improve the wear resistance of the material surface. High entropy alloys (HEAs) are an emerging coating material with excellent wear resistance. Therefore, this paper reviews the latest development status in wear resistance of laser cladding-high-entropy alloy coatings (LC-HEACs) in terms of the HEAs material system, LC process parameters, strengthening phase, amorphous phase strengthening, assisted cladding, and post-treatment. At the same time, this paper also expounds on the mechanism of LC-HEACs enhancing the surface wear resistance of materials, and the current research status of LC-HEACs in different engineering materials and application environments. Finally, the current research deficiencies, challenges, and future development trends of LC-HEACs in the field of wear resistance are also elaborated, and it is expected to provide some references for their future development and applications.

Utilizing waste materials to produce sustainable concrete has substantial environmental implications. Furthermore, understanding the exceptional durability performance of ultra-high-performance concrete can minimize environmental impacts and retrofitting costs associated with structures. This study presents a systematic experimental investigation of eco-friendly ultra-high-performance self-compacting basalt fiber (BF)-reinforced concrete by incorporating waste nanomaterials, namely nano-wheat straw ash (NWSA), nano-sesame stalk ash (NSSA), and nano-cotton stalk ash (NCSA), as partial substitutes for Portland cement. The research evaluates the effects of varying dosages of nanomaterials (ranging from 5 to 15% as cement replacements) in the presence of BFs. Rheological properties were analyzed, including flow diameter, L-box, and V-funnel tests. Additionally, the study investigated compressive, splitting tensile, and flexural strengths, load-displacement behavior, ultrasonic pulse velocity, and durability performance of the ultra-high-performance self-compacting basalt fiber (BF)-reinforced concrete (UHPSCFRC) samples subjected to sulfate attack, freeze-thaw cycles, autogenous shrinkage, and exposure to temperatures of 150, 300, 450, and 600°C. Microstructural characteristics of the mixtures were examined using X-ray diffraction (XRD) analysis. The findings reveal that self-compacting properties can be achieved in the UHPSCFRC by incorporating NWSA, NSSA, and NCSA. The presence of 10% NWSA significantly improved the mechanical properties of the UHPSCFRC, exhibiting more than 27.55% increase in compressive strength, 17.36% increase in splitting tensile strength, and 21.5% increase in flexural strength compared to the control sample. The UHPSCFRC sample with 10% NWSA demonstrated superior performance across all extreme durability tests, surpassing both the control and other modified samples. XRD analysis revealed the development of microcracking at temperatures of 450 and 600°C due to the evaporation of absorbed and capillary water and the decomposition of ettringites.