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Purpose: This scoping review explores the critical yet often overlooked role of fathers in the neonatal intensive care unit (NICU) environment, particularly during the emotionally tumultuous period following the birth of a critically ill infant., Background: The birth of an infant significantly disrupts family dynamics and may impact the role of each parent. Fathers in the NICU are frequently overlooked, leading to feelings of isolation and stress. Fathers often face confusion, stress, and a sense of exclusion, which are compounded by the trauma of having a critically ill infant., Discussion: Using the Preferred Reporting Item for Systematic Reviews and Meta-analysis model, the authors identified 18 articles that provide guidance on potential solutions to supporting an inclusive NICU environment for families, including fathers. The articles also consider the need for staff and provider training for a sustainable and inclusive NICU environment. Outcomes from the scoping review highlight the need for inclusive support for fathers, emphasizing that their involvement is crucial for the well-being of the infant and the family., Implications for Practice: Creating a welcoming NICU environment, training staff to address fathers' needs, and providing flexible policies can improve paternal engagement. Effective communication and support systems, including peer-led groups, are vital., Precis Statement: Inclusive practices, better communication, and tailored support for fathers in the NICU can enhance paternal involvement and engagement., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Sleep difficulty in caregivers is associated with poor physical and psychological outcomes. The purpose of this study was to describe family caregivers' perception of sleep difficulty through the hospice trajectory after a cancer diagnosis as predicted by age, sex, self-report of anxiety or depression, and cohabitation., Methods: We conducted a secondary analysis of longitudinal data using multilevel modeling with nested model comparisons. Beginning with an unconditional growth model, predictors were added to nested models to test differential impact., Results: Caregivers (n = 164) were predominately white (n = 160; 97%) and female (n = 113, 69%). We hypothesized that age, sex, history of anxiety or depression, and cohabitation would predict sleep difficulty. The cohabitation predictor model was a statistically significant model for caregiver perception of sleep difficulty that worsened throughout hospice caregiving ( b = .184, χ 2 = 7.199, P = 0.027) but age, sex, and history of depression or anxiety did not improve model fit., Conclusion: Our findings indicate that family caregivers who cohabitate exhibit increased perception of sleep difficulty over the course of hospice. Future studies and interventions for hospice family caregivers' sleep should consider cohabitation between the patient and the caregiver as a significant predictor of sleep difficulty to observe and potentially mediate the negative outcomes associated with caregiver sleep difficulty. Further, determining the underlying reasons for sleep difficulty in cohabitation (e.g., patient symptoms or treatments) should be explored., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

For large classes of (finite and) infinite dimensional complex Banach spaces Z, B its open unit ball and f : B → B a compact holomorphic fixed-point free map, we introduce and define the Wolff hull, W(f), of f in ∂ B and prove that W(f) is proximal to the images of all subsequential limits of the sequences of iterates (f n) n of f. The Wolff hull generalises the concept of a Wolff point, where such a point can no longer be uniquely determined, and coincides with the Wolff point if Z is a Hilbert space. Recall that (f n) n does not generally converge even in finite dimensions, compactness of f (i.e. f(B) is relatively compact) is necessary for convergence in the infinite dimensional Hilbert ball and all accumulation points Γ (f) of (f n) n map B into ∂ B (for any topology finer than the topology of pointwise convergence on B). The target set of f is T (f) = ⋃ g ∈ Γ (f) g (B). To locate T(f), we use a concept of closed convex holomorphic hull, Ch (x) ⊂ ∂ B for each x ∈ ∂ B and define a distinguished Wolff hull W(f). We show that the Wolff hull intersects all hulls from T(f), namely W (f) ∩ Ch (x) ≠ ∅ for all x ∈ T (f). If B is the Hilbert ball, W(f) is the Wolff point, and this is the usual Denjoy–Wolff result. Our results are for all reflexive Banach spaces having a homogeneous ball (or equivalently, for all finite rank J B ∗ -triples). These include many well-known operator spaces, for example, L(H, K), where either H or K is finite dimensional. [ABSTRACT FROM AUTHOR]

Aims: We evaluated two species of human oral commensal streptococci in protection against dental caries induced by Streptococcus mutans., Methods and Results: Candidate probiotics, Streptococcus sp. A12, Streptococcus sanguinis BCC23 and an arginine deiminase mutant of BCC23 (∆arcADS) were tested for their ability to reduce S. mutans-induced caries in an established mouse model. Mice were colonized with a probiotic, challenged with S. mutans, then intermittently reinoculated with a probiotic strain. Oral colonization of each strain and autochthonous bacteria was assessed by quantitative polymerase chain reaction. Both BCC23 strains, but not A12, were associated with markedly reduced sulcal caries, persistently colonized mucosal and dental biofilms, and significantly lowered S. mutans counts. All three strains enhanced mucosal colonization of autochthonous bacteria. In a follow-up experiment, when S. mutans was established first, dental and mucosal colonization of S. mutans was unaltered by a subsequent challenge with either BCC23 strain. Results between BCC23 and BCC23 ∆arcADS were equivalent., Conclusions: BCC23 is a potential probiotic to treat patients at high caries risk. Its effectiveness is independent of ADS activity, but initial dental cleaning to enhance establishment in dental biofilms may be required., Significance and Impact of the Study: In vivo testing of candidate probiotics is highly informative, as effectiveness is not always reflected by genotype or in vitro behaviours., (© 2022 Society for Applied Microbiology.)

Background: Increased noxious noise leads to adverse short-term and long-term effects on the growing neonate. The American Academy of Pediatrics recommends maintaining a noise level of less than 45 decibels (dBA). The average baseline noise level in an open-pod neonatal intensive care unit (NICU) was 62.6 dBA., Purpose: The purpose of this pilot project was to reduce the average noise levels by 39% at the end of an 11-week period., Methods: The location of the project was in a large, high-acuity level IV open-pod layout NICU that consisted of 4 pods, one of which was cardiac-focused. The average baseline noise level in the cardiac pod was 62.6 dBA in a 24-hour period. Noise levels were not monitored before this pilot project. This project was implemented over an 11-week period. Several modes of education were used for parents and staff. Post-education, Quiet Times were implemented at set times twice daily. Noise levels were monitored for 4 weeks during Quiet Times, with weekly noise level updates for staff. General noise levels were collected a final time to evaluate the overall change in the average noise levels., Results: At the end of the project, noise levels decreased from 62.6 dBA to 54 dBA, a 13.7% reduction., Implications for Practice and Research: At the end of this pilot project it was noted that: Online modules were the best way to educate staff. Parents should be included in the implementation of quality improvement. Healthcare providers need to know and understand that they can make preventative changes to improve the outcomes of the population., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 by The National Association of Neonatal Nurses.)

Sporadic Alzheimer's disease (sAD) represents a serious and growing worldwide economic and healthcare burden. Almost 95% of current AD patients are associated with sAD as opposed to patients presenting with well-characterized genetic mutations that lead to AD predisposition, i.e., familial AD (fAD). Presently, the use of transgenic ( Tg ) animals overexpressing human versions of these causative fAD genes represents the dominant research model for AD therapeutic development. As significant differences in etiology exist between sAD and fAD, it is perhaps more appropriate to develop novel, more sAD-reminiscent experimental models that would expedite the discovery of effective therapies for the majority of AD patients. Here we present the oDGal mouse model, a novel model of sAD that displays a range of AD-like pathologies as well as multiple cognitive deficits reminiscent of AD symptomology. Hippocampal cognitive impairment and pathology were delayed with N-acetyl-cysteine (NaC) treatment, which strongly suggests that reactive oxygen species (ROS) are the drivers of downstream pathologies such as elevated amyloid beta and hyperphosphorylated tau. These features demonstrate a desired pathophenotype that distinguishes our model from current transgenic rodent AD models. A preclinical model that presents a phenotype of non-genetic AD-like pathologies and cognitive deficits would benefit the sAD field, particularly when translating therapeutics from the preclinical to the clinical phase.

Background: Nephrology is a subject which is challenged by a lack of applicants for trainee places. This study addresses the attitudes of medical students towards the subject and explores the causes of this lack of interest amongst potential specialty trainees., Methods: Students were asked to complete a survey ranking their attitudes towards nephrology and other specialties. This data was collated and analysed to show trends and allow comparison of the attitudes towards each specialty., Results: Students felt that along with geriatrics, their least favourite subject was nephrology. Students felt unconfident in diagnosing, managing and understanding chronic conditions more so than acute conditions. Nephrology was consistently amongst the least popular subject for all areas of diagnosis, management and pathophysiology. Renal anatomy was the only area of nephrology that students felt confident in. The less popular specialties of nephrology and geriatrics had the greatest room for improvement when directly instructed in specialty medical training., Conclusions: Nephrology remains a problematic and unpopular specialty for medical students, driving their unwillingness to consider it as a future career route. This study identifies areas of misconception amongst medical students toward the specialty and highlights areas for improvement in renal training for students., (© 2022. The Author(s).)

Suggestions are given for innovation in planning international exchange and study abroad programs that maximize an institution's flexibility and reduce cost. These include flexible program length and intensity, flexible planning and contracting options with the corresponding schools, direct negotiations, reciprocity arrangements, and using international students already on campus. (MSE)