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ObjectivesThis study hypothesized that bright spots in intravascular optical coherence tomography (IVOCT) images may originate by colocalization of plaque materials of differing indexes of refraction. To quantitatively identify bright spots, we developed an algorithm that accounts for factors including tissue depth, distance from light source, and signal-to-noise ratio. We used this algorithm to perform a bright spot analysis of IVOCT images and compared these results with histological examination of matching tissue sections.BackgroundBright spots are thought to represent macrophages in IVOCT images, and studies of alternative etiologies have not been reported.MethodsFresh human coronary arteries (n = 14 from 10 hearts) were imaged with IVOCT in a mock catheterization laboratory and then processed for histological analysis. The quantitative bright spot algorithm was applied to all images.ResultsResults are reported for 1,599 IVOCT images co-registered with histology. Macrophages alone were responsible for only 23% of the bright spot-positive regions, although they were present in 57% of bright spot-positive regions (as determined by histology). Additional etiologies for bright spots included cellular fibrous tissue (8%), interfaces between calcium and fibrous tissue (10%), calcium and lipids (5%), and fibrous cap and lipid pool (3%). Additionally, we showed that large pools of macrophages in CD68(+) histology sections corresponded to dark regions in comparative IVOCT images; this is due to the fact that a pool of lipid-rich macrophages will have the same index of refraction as a pool of lipid and thus will not cause bright spots.ConclusionsBright spots in IVOCT images were correlated with a variety of plaque components that cause sharp changes in the index of refraction. Algorithms that incorporate these correlations may be developed to improve the identification of some types of vulnerable plaque and allow standardization of IVOCT image interpretation.

We sought to elucidate the mechanisms underlying two common intravascular optical coherence tomography (IV-OCT) artifacts that occur when imaging metallic stents: “merry-go-rounding” (MGR), which is an increase in strut arc length (SAL), and “blooming,” which is an increase in the strut reflection thickness (blooming thickness). Due to uncontrollable variables that occur in vivo, we performed an in vitro assessment of MGR and blooming in stented vessel phantoms. Using Xience V and Driver stents, we examined the effects of catheter offset, intimal strut coverage, and residual blood on SAL and blooming thickness in IV-OCT images. Catheter offset and strut coverage both caused minor MGR, while the greatest MGR effect resulted from light scattering by residual blood in the vessel lumen, with 1% hematocrit (Hct) causing a more than fourfold increase in SAL compared with saline (p

We investigated a mixed outbreak of Legionnaires' disease (LD) and Pontiac fever (PF) at a military base to identify the outbreak's environmental source as well as known legionellosis risk factors. Base workers with possible legionellosis were interviewed and, if consenting, underwent testing for legionellosis. A retrospective cohort study collected information on occupants of the buildings closest to the outbreak source. We identified 29 confirmed and probable LD and 38 PF cases. All cases were exposed to airborne pathogens from a cooling tower. Occupants of the building closest to the cooling tower were 6·9 [95% confidence interval (CI) 2·2-22·0] and 5·5 (95% CI 2·1-14·5) times more likely to develop LD and PF, respectively, than occupants of the next closest building. Thorough preventive measures and aggressive responses to outbreaks, including searching for PF cases in mixed legionellosis outbreaks, are essential for legionellosis control.

F far-sided adj. (far said Id) (fr. the Far Side comics & far-sighted) able to view things from a warped, unusual or twisted perspective. faults prophets n. (fr, geological faults [...]

Bolanle Olapeju, Anwar E Ahmed, Kasi Chu, Jangho Yoon, James D Mancuso Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USACorrespondence: Bolanle Olapeju, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA, Tel +1 301-295-1585, Email bolanle.olapeju@usuhs.eduPurpose: This paper investigates the association between self-reported perceived health status and doctor-informed medical conditions among US active duty service members (ADSM).Methods: Data are from the 2018 Health-Related Behaviors Survey – a cross-sectional survey weighted to represent the US military (N = 17166). Perceived good health status was defined as having a response choice of “good”, “very good”, or “excellent” to the question: Would you say your overall physical health is ___? Medical conditions were based on self-reported presence of nine clinical conditions. Analysis included weighted prevalence and log-binomial regression models to explore relationships between ADSM characteristics with perceived good health status as well as concordance between perceived status and medical conditions.Results: ADSM rated their health to be excellent (14.6%), very good (37.7%), good (36.2%), fair (9.7%) and poor (1.7%). About 88.5% perceived a good (to excellent) health status. Perceived good health status was negatively associated with the number of medical conditions present (adjusted odds ratio (aOR): ranging from 0.78 to 0.92) as well as several health behaviors (aOR): ranging from 0.86 to 0.98) and other sociodemographic factors. Among all ADSMs, 51% perceived good health in the absence of medical conditions, while 8% perceived poor health status in the presence of medical conditions. Concordance between perceived health status and medical conditions was significantly lower among ADSM who were older (aOR: 0.61; 95% CI: 0.54– 0.69), with dependent children (aOR: 0.89; 95% CI: 0.84– 0.95), or had been deployed (aOR: 0.89, 95% CI: 0.84-0.95).Conclusion: The prevalence of perceived good health status among ADSMs was consistent with those documented in the general US population. The interrelationships between ADSM’s perceptions, medical conditions and sociodemographic characteristics may have implications for their health literacy and utilization of health services. Study findings suggest that interventions promoting healthy behaviors, health literacy and treatment-seeking may influence perceived health status and mitigate medical conditions among ADSM, thus improving the US Military readiness, resilience and mission success.Keywords: active duty service members, health status, medical conditions, risk behaviors, United States

Anwar E Ahmed,1 Michael H Yim,1 Jimmy Dawood,2 Cara H Olsen,1 Andrew J Waters,3 Darrell E Singer,1 James D Mancuso1 1Department of Preventive Medicine & Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA; 2School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA; 3Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USACorrespondence: Anwar E Ahmed, Department of Preventive Medicine & Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA, Email anwar.ahmed@usuhs.eduBackground: This study aimed to 1) determine the prevalence of past-year suicidal ideation (SI) and attempts (SA) among active-duty SMs; 2) determine whether differences exist by age, sex, and race; and 3) assess whether prevalence estimates vary by risk profiles of mental health conditions and substance use.Methods: Data were from the 2018 Health-Related Behavior Survey (HRBS), a cross-sectional survey of active-duty SMs (n = 17,166). We used the logistic model to identify the factors of SI and SA and latent class analysis (LCA) to identify the risk profiles.Results: Among active duty SMs, 8.26% had SI and 1.25% had SA in the past year. Gender and age have been shown to influence how race might contribute to suicidal behaviors. Mental health conditions were associated with higher odds of SI and SA, as were younger ages; LGB identity; being separated, divorced, or widowed; use of e-cigarettes, dual use of e-cigarettes and cigarettes, or drugs; and history of deployment of less than 12 months. Frequencies of cigarette and e-cigarette use were also associated with SI and SA, indicating the odds were increasing by 0.3% for every additional cigarette or e-cigarette used. Five risk profiles were identified: class 1 (illegal drug use), class 2 (mental health needs with tobacco and alcohol use), class 3 (mental health conditions only), class 4 (“low risk” SMs with low levels of illegal drug use, mental health visits, tobacco use, and alcohol use), and class 5 (alcohol use). Compared to class 4 (“low risk”), all other risk profiles were associated with increased odds of suicidal behaviors.Conclusion: Despite the resources and increased access provided for mental health support, the prevalence of SI among active-duty SMs is greater than in the general population of the same age, likely due to additional military exposures and stressors.Keywords: suicide, ideation, attempts, mental health, e-cigarette, active-duty service member

This article is designed to help librarians, especially solo librarians, recognize how the professionals around them can assist with the development of their library collection and to provide practical instruction and tools to encourage their collaborative process. But I was an English major as an undergrad. What do I know about biblical theology resources? If this type of thought has crossed your mind, you are not alone! No one can know everything about every academic discipline. There are people who know, however, who can help us develop a more complete library collection. But guess what? They do not know everything either! It takes the collective effort of many to truly provide a well-rounded collection that supports your degree programs. Collaboration is key, especially for solo librarians with limited time and resources, but this applies to all librarians. The information in this article is the collaborative result of five of the Association of Christian Librarian's (ACL's) solo librarians and was presented to the Solo Librarian Interest Group at the 2021 ACL Conference. Some of the comments from other solos during the presentation discussion are also included. By using resources already at your disposal and by building a rapport with experts in their field, you can share the collection development responsibility and maintain a robust and relevant library. [ABSTRACT FROM AUTHOR]

Over the last several years, the number of deaths from drug overdose has increased. Heart transplantation (HT) utilizing donor hearts from patients dying from drug overdose has expanded the donor pool. The current standard method of organ procurement includes the use of an ice cooler (ICE), which adds the risk of tissue freezing injury. The SherpaPak Cardiac Transport System (CTS) is a controlled hypothermic organ preservation technology that maintains donor heart temperatures between 4°C - 8°C, potentially mitigating this risk. The GUARDIAN Heart registry (October 2015-August 2022) includes 761 HT patients from 9 US centers in which donor hearts were procured using either CTS or ICE. Subgroup analysis of HTs using donors who died due to drug overdose, and whose total ischemic time was > 4 hours was performed. The outcomes were compared between HTs performed using CTS vs ICE. Summary statistics were used for comparison. Our cohort included 26 HTs in CTS and 12 in ICE group. The cohorts were well-matched aside from a few areas. Significantly fewer recipients in the CTS cohort had durable VAD at baseline. Additionally, while the ICE cohort had zero gender mismatches, the CTS cohort included 8 (30.8%) mismatches, with 5 (19.2%) female-to-male mismatches. The ICE cohort showed a trend of requiring new post-transplant mechanical circulatory support (MCS) at a rate more than double that of the CTS cohort (50.0% v 23.1%, p=0.10). The primary graft dysfunction (PGD) and survival between the cohorts were similar (details in Table 1). The 30-day survival was similar between the two groups. The use of CTS trends towards a lower need of post-transplant MCS in donors who died of drug overdose and had ischemic times > 4 hours. Utilizing donor hearts from drug overdose individuals and prolonged ischemic time appears to have trended toward favorable outcomes when utilizing CTS over ICE. [ABSTRACT FROM AUTHOR]

A selection of neologisms starting with the letters A & B A APR financing n. (tax refunds come in APRIL) using a tax refund for necessary household purchases ad ridiculum [...]