Expressed Emotion in Families of Children with Neurodevelopmental Disorders: A Mixed-Method Approach.

Background: Family interaction plays a pivotal role in the overall well-being of each member of a family unit. It is foreseeable that a family caring for an individual with a mental or physical health condition could experience negative family interactions for various reasons. Expressed emotion refers to the family environment based on the relatives' interaction with the individual diagnosed with a specific illness. Expressed emotion in the families of a person with any form of mental condition could pose potential psychological distress and burden to family members, notably the primary caregivers. Purpose: The current study intends to explore the expressed emotion of the primary caregivers toward children with neurodevelopmental disorders (NDDs). The association between expressed emotion, stress experienced by the caregiver, and the self-sufficiency of the child diagnosed with neurodevelopmental disorders was examined. Methods: The Five-Minute Speech Sample (FMSS), Kingston Caregivers' Stress Scale (KCSS), and Waisman Activities of Daily Living (WADL) were used to assess expressed emotion, stress, and a child's self-sufficiency, respectively. The snowball sampling technique was adopted, and data were collected from 35 primary caregivers through telephonic interviews. A mixed-method research design was adopted, and the data were analyzed qualitatively and quantitatively. Results: The findings reveal that there is a significant association between expressed emotion and caregivers' stress, expressed emotion, and the child's self-sufficiency and a significant relationship between the caregivers' stress and the child's self-sufficiency. The qualitative analysis suggests the influence of factors such as future concerns, family factors, and relationship strains contribute to expressed emotion. Conclusion: It can be concluded that those primary caregivers who reported extreme caregivers' stress and low self-sufficiency in their child exhibited high negative expressed emotion and diverse individual and systemic factors influenced the display of high expressed emotion within the family.

Reactive Oxygen Species and Mitochondrial Calcium's Roles in the Development of Atherosclerosis.

In the last decade, there has been increasing evidence connecting mitochondrial dysfunction to the onset and advancement of atherosclerosis. Both reactive oxygen species (ROS) and the disruption of mitochondrial calcium (Ca2+) regulation have garnered significant attention due to their involvement in various stages of atherosclerosis. This abstract discusses the potential therapeutic applications of targeting mitochondrial calcium (Ca2+) and reactive oxygen species (ROS), while also providing an overview of their respective roles in atherosclerosis. The abstract underscores the importance of mitochondrial Ca2+ homeostasis in cellular physiology, including functions such as energy production, cell death signaling, and maintaining redox balance. Alterations in the mitochondria's Ca2+ handling disrupt all these procedures and speed up the development of atherosclerosis. Reactive oxygen species (ROS), generated during mitochondrial respiration, are widely recognized as significant contributors to the development of atherosclerosis. Through modulating the function of calcium ion (Ca2+) transport proteins, ROS can impact the regulation of mitochondrial Ca2+ handling. These oxidative modifications lead to vascular remodeling and plaque formation by impairing endothelial function, encouraging the recruitment of inflammatory cells, and promoting smooth muscle cell proliferation. Preclinical investigations indicate that interventions aimed at regulating the production and elimination of reactive oxygen species (ROS) hold promise for mitigating atherosclerosis. Targeting mitochondrial processes represents a prospective therapeutic strategy for addressing this condition. Further research is necessary to elucidate the intricate molecular mechanisms associated with mitochondrial dysfunction in atherosclerosis and develop effective therapeutic strategies to decelerate disease progression.

Study of biopolymer encapsulated Eu doped Fe3O4 nanoparticles for magnetic hyperthermia application.

An exciting prospect in the field of magnetic fluid hyperthermia (MFH) has been the integration of noble rare earth elements (Eu) with biopolymers (chitosan/dextran) that have optimum structures to tune specific effects on magnetic nanoparticles (NPs). However, the heating efficiency of MNPs is primarily influenced by their magnetization, size distribution, magnetic anisotropy, dipolar interaction, amplitude, and frequency of the applied field, the MNPs with high heating efficiency are still challenging. In this study, a comprehensive experimental analysis has been conducted on single-domain magnetic nanoparticles (SDMNPs) for evaluating effective anisotropy, assessing the impact of particle-intrinsic factors and experimental conditions on self-heating efficiency in both noninteracting and interacting systems, with a particular focus on the dipolar interaction effect. The study successfully reconciles conflicting findings on the interaction effects in the agglomeration and less agglomerated arrangements for MFH applications. The results suggest that effective control of dipolar interactions can be achieved by encapsulating Chitosan/Dextran in the synthesized MNPs. The lower dipolar interactions successfully tune the self-heating efficiency and hold promise as potential candidates for MFH applications.

Analysis of decarbonization measures for the Indian Cement Sector.

Cement is one of the widely used materials in construction, and its production is both energy- and emission-intensive, contributing significantly to industrial emissions. This study investigates multiple methods for reducing emissions in the Indian cement sector based on the mass and energy balances of a representative cement plant. A novel methodology for calculating the overall emissions reduction per tonne of cement with multiple emission reduction measures and their interdependencies is proposed. The effect of captive power plants in the cement industry on emissions reduction is also considered. The results are depicted using an emission abatement curve, which gives the CO2 abatement cost against cumulative emission reduction per tonne of cement, and a cost premium curve, which shows the cumulative abatement cost against percentage abatement. The analysis shows that up to 30% emissions reduction is possible using existing emission reduction measures in all the cases considered with no additional cost, and near-zero emission reduction is only possible with the adoption of emerging technologies such as carbon capture and storage. The proposed methodology is the first to explore the impact of multiple measures for emission reduction on a given cement plant, allowing for a realistic estimate of emission reduction from the measures implemented.

Social media use and vision impairment in adults between the ages of 18 and 35 years in India.

SIGNIFICANCE: Social media is used by >4.48 billion people worldwide. Despite its popularity, vision-impaired individuals struggle to use social media given visual inaccessibility of content and lack of access to Internet/Wireless-Fidelity-enabled devices. Our study explores visually impaired adult's use of social media in comparison to a control group. PURPOSE: This study aimed to report the demographic profile and patterns of social media use among adults with vision impairment (VI) aged 18 to 35 years and compare it with an age-matched normally sighted group in India. In addition, we explored barriers to use of social media among adults with VI. METHODS: Vision-impaired and normally sighted adults (controls) aged 18 to 35 years at L V Prasad Eye Institute, Hyderabad, India, answered a questionnaire about social media use (e.g., platform used). RESULTS: Four hundred twenty-two individuals (201 VI, 221 controls) participated. Normally sighted adults (98%) used social media more than the VI group (81%; p<0.001). Vision-impaired users were predominantly male (85%) and unemployed (57%; p<0.00001 for both). There was no significant difference in educational level between groups (p=0.17). Smartphones were the most popular device used (VI, 161 [99%]; control, 206 [95%]), with tablet PC/iPad being the least popular (VI, 5 [3%]; control, 12 [6%]). Adults with VI and controls commonly used WhatsApp as communication platforms, and Facebook and Twitter as networking platforms. Approximately one-third of individuals across both social media user groups reported barriers to use (VI, 48 [30%]; control, 74 [34%]; p<0.001). Vision-impaired individuals cited accessibility issues of having to rely on audio over vision to navigate social media, whereas controls reported having to share a phone. CONCLUSIONS: The proportion of social media usage among VI adults is high (81%) and is substantially higher than the 33% reported in the general Indian population. Vision-impaired adults who used social media were male with moderate VI and were less likely to be employed compared with controls.

Enhancement in the induction heating efficacy of sol-gel derived SiO2-CaO-Na2O-P2O5 bioglass-ceramics by incorporating magnetite nanoparticles.

Magnetite (Fe3O4) nanoparticle (MNP)-substituted glass-ceramic (MSGC) powders with compositions of (45 - x)SiO2-24.5CaO-24.5Na2O-6P2O5-xFe3O4 (x = 5, 8, and 10 wt%) have been prepared by a sol-gel route by introducing Fe3O4 nanoparticles during the synthesis. The X-ray diffraction patterns of the as-prepared MSGC nanopowders revealed the presence of combeite (Na2Ca2Si3O9), magnetite, and sodium nitrate (NaNO3) crystalline phases. Heat-treatment up to 700 °C for 1 h resulted in the complete dissolution of NaNO3 along with partial conversion of magnetite into hematite (α-Fe2O3). Optimal heat-treatment of the MSGC powders at 550 °C for 1 h yielded the highest relative percentage of magnetite (without hematite) with some residual NaNO3. The saturation magnetization and heat generation capacity of the MSGC fluids increased with an increase in the MNP content. The in vitro bioactivity of the MSGC pellets was evaluated by monitoring the pH and the formation of a hydroxyapatite surface layer upon immersion in modified simulated body fluid. Proliferation of MG-63 osteoblast cells indicated that all of the MSGC compositions were non-toxic and MSGC with 10 wt% MNPs exhibited extraordinarily high cell viability. The MSGC with 10 wt% MNPs demonstrated optimal characteristics in terms of cell viability, magnetic properties, and induction heating capacity, which surpass those of the commercial magnetic fluid FluidMag-CT employed in hyperthermia treatment.

Influence of Controlled Dipolar Interaction for Polymer-Coated Gd-Doped Magnetite Nanoparticles toward Magnetic Hyperthermia Application.

To maximize heat release from immobilized nanoparticles (NPs), a detailed understanding of the controlled dipolar interaction is essential for challenging magnetic hyperthermia (MH) therapies. To design optimal MH experiments, it is necessary to precisely determine magnetic states impacted by the inevitable concurrence of magnetic interactions under a common experimental form. In this work, we describe how the presence of dipolar interaction significantly alters the heating mechanism of host materials when NPs are embedded in them for MH applications. The concentration of the NPs and the intensity of their interaction can profoundly impact the amplitude and shape of the heating curves of the host material. The heating capability of interacting NPs might be enhanced or diminished, depending on their concentration within the host material. We propose chitosan- and dextran-coated Gd-doped Fe3O4 NPs directing dipole interactions effective for the linear regime to enlighten the pragmatic trends. The outcomes of our study may have substantial implications for cancer therapy and could inspire novel approaches for maximizing the effectiveness of MH.

A comprehensive scrutiny to controlled dipolar interactions to intensify the self-heating efficiency of biopolymer encapsulated Tb doped magnetite nanoparticles.

An exciting prospect in the field of magnetic fluid hyperthermia (MFH) has been the integration of noble rare earth elements with biopolymers (chitosan/dextran) that have optimum structures to tune specific effects on magnetic nanoparticles (MNPs). Remarkably, it has been demonstrated that dipole-dipole interactions have a significant influence on nanoparticle dynamics. In this article, we present an exhaustive scrutiny of dipolar interactions and how this affects the efficiency of MFH applications. In particular, we prepare chitosan and dextran-coated Tb-doped MNPs and study whether it is possible to increase the heat released by controlling the dipole-dipole interactions. It has been indicated that even moderate control of agglomeration may substantially impact the structure and magnetization dynamics of the system. Besides estimating the specific loss power value, our findings provide a deep insight into the relaxation mechanisms and bring to light how to tune the self-heating efficacy towards magnetic hyperthermia.

Clinical and Anatomical Variation During Assessment of Maximum Glottic Angle.

INTRODUCTION: Quantitative measurement and analysis of glottic abduction is used to assess laryngeal function and success of interventions; however, the consistency of measurement over time has not been established. This study assesses the consistency of glottic abduction measurements across visits in healthy patients and anatomic factors impacting these measurements. METHODS: Review of patients with two sequential flexible stroboscopic exams over seven months from 2019-2022. Images of maximal glottic abduction were captured and uploaded into and measured with ImageJ. Cadaver heads were used to assess the impact of visualization angles on glottic measurements with a monofilament inserted into the supraglottis of each cadaver as a point of reference. Comparisons were done with a paired T-test, T-test, or Mann-Whitney U test as appropriate. RESULTS: Fifty-nine patients and twenty-six cadaveric exams were included. Absolute change in maximum glottic abduction angle (MGAA) was 6.90° (95% CI [5.36°, 8.42°]; p < 0.05). There were no significant differences in change in MGAA by gender or age. Twenty percent of patients had a change of at least 25% in their MGAA between visits. Absolute differences in glottic angle between nasal side for cadaveric measurements was 4.77 ± 4.59° (p < 0.005)-2.22° less than the change in MGAA seen over time (p = 0.185). CONCLUSION: Maximal glottic abduction angles varied significantly between visits. Factors considered to be contributing to the differences include different viewing windows between examinations due to the position and angulation of the laryngoscope and changes in patient positioning, intra- and inter-rater variations in measurement, and patient effort. LEVEL OF EVIDENCE: N/a Laryngoscope, 134:2793-2798, 2024.

More Than 1 Way to Put in A T-Tube: A Review of Different Techniques Used in Insertion of Montgomery T-Tubes.

OBJECTIVE: The Montgomery T-tube is a commonly used device initially designed as a temporary airway stent, but also used as a long-term airway solution for stenosis. For patients undergoing either endoscopic or open airway procedures, proper techniques for inserting these tubes are well documented. This review compiles the techniques used for insertion of the Montgomery T-tube stent. METHODS: The NCBI Pubmed database was queried using the keywords: "stent," "Montgomery," "T-tube," "stenosis," "technique." A total of 33 papers were reviewed with 12 papers selected for the study. Papers were selected based on inclusion criteria of English language and whether the paper described a technique for insertion of a Montgomery T-tube into the airway. Papers were excluded if they did not describe the technique of insertion of Montgomery T-tubes or dealt with another aspect of T-tube management. RESULTS: The 12 selected papers each described a different technique for insertion of a Montgomery T-tube stent. Though nearly all the selected studies described using a modified Seldinger technique for insertion of the T-tube, there were discrepancies and a wide array of different instruments used. The instrument and/or technique that was selected was often determined by the individual need of the patient. Several studies addressed the challenge of interrupting ventilation while inserting or exchanging a T-tube in the operating room. These studies described attaching the T-tube to the endotracheal tube to pass the T-tube into the airway while allowing for continuous ventilation. Yet other studies used optical forceps or rigid bronchoscopes to allow placement of the T-tube with direct visualization. CONCLUSION: There are many techniques used for the insertion of a Montgomery T-tube. Nearly all studies described using a modified Seldinger technique and all the studies agreed on the necessity of a team approach for placement of the Montgomery T-tube.

Female Surgical Ergonomics in Otolaryngology: A National Survey Study.

OBJECTIVE: To assess the nature and impact surgical ergonomic challenges experienced by female otolaryngologists. STUDY DESIGN: National survey study. SETTING: Female otolaryngology residents, fellows and attendings recruited via social media posting and email distribution. METHODS: We distributed a survey study to female otolaryngologists throughout the United States. The height and glove size of participants reporting difficulties with equipment and instruments were compared to those not reporting difficulties. RESULTS: Ninety-six female otolaryngologists participated in our study, comprised of 43% residents, 10% fellows, and 47% attendings. Ninety percent of participants reported difficulties using equipment and 77% of participants reported difficulty with instruments, the most common being nasal endoscopic instruments (28%). The vast majority of participants reported pain during and (or) after the operation (92%). Head and neck (53%) and rhinology (44%) were identified as particularly challenging specialities, but only 25% of participants reported that ergonomics affected their career plans. Participants felt that adjustable equipment (60%), a variety of sizes of instruments (43%), and more discussion around ergonomics (47%) would help. Respondents reported adjusting the operating room to accommodate their size took extra time (44%) and was a mental burden (39%). Participants reporting difficulties with operating room equipment were significantly shorter than those without difficulties (64 inches vs 67 inches, P = .037), and those reporting difficulties with instruments had a smaller median glove size (6 vs 6.5, P = .018). CONCLUSION: Surgical ergonomics represent a challenge for female otolaryngologists, particularly those with smaller hands and shorter height. Partnering with industry, we must address the needs of an increasingly diverse workforce to ensure that all surgeons can operate effectively and comfortably.

Proinflammatory signaling mechanism of endocan in macrophages: Involvement of TLR2 mediated MAPK-NFkB pathways.

Endocan is an endothelial cell-specific proteoglycan that contributes to vascular dysfunction by impairing endothelial function and inducing vascular smooth muscle cell migration. However, its role in regulating macrophage inflammation, a key pathological feature of vascular dysfunction, is not well understood. In this study, we investigated the effect of endocan on macrophage inflammation to better understand its contribution to vascular dysfunction. We found that endocan upregulated pro-inflammatory cytokines including IL-1ß, IL-6 and TNF-α in RAW 264.7 cells and activated MAPK/NFkB signaling pathways. Inhibiting these pathways reduced endocan-induced cytokine levels, while inhibiting TLR2 compromised the MAPK/NFkB regulation. Additionally, LPS-induced HUVEC conditioned medium stimulated cytokine levels in RAW 264.7 cells, which were reduced by endocan siRNA treatment in HUVEC. These results suggest that endocan positively regulates pro-inflammation in macrophages through the TLR2-MAPK-NFkB axis, highlighting the potential of targeting endocan to reduce inflammation in vascular dysfunction.

Chronic Refractory Cough: Long-Term Outcomes Following Cough Suppression Therapy.

OBJECTIVE: This study aimed to determine the long-term outcomes of patients with chronic refractory cough (CRC) following treatment for cough suppression therapy (CST). Currently, there is a lack of objective data regarding the long-term outcome of behavioral treatment for CRC. METHODS: From the charts of 106 adult patients diagnosed with CRC, 24 patients were identified as having long-term data at least 3 months post-CST in the form of otolaryngologic examination, Voice Handicap Index-10 (VHI-10), and Cough Severity Index (CSI) scores. Patients underwent otolaryngologic evaluation and completed the VHI-10 and CSI assessments during pretreatment, posttreatment, and long-term follow-up visits. Patients were also divided into two groups based on their number of comorbidities. RESULTS: Twenty of the 24 patients had significant reduction in cough severity after completing CST (P < 0.001). A significant difference was also found in CSI scores from pretherapy to the long-term follow-up visits (P = 0.001). No significant difference was found in CSI scores from posttherapy to long-term follow-up visits (P = 0.93). No significant difference was found in VHI-10 scores over time (P = 0.83). No correlation was found between changes in cough and voice severity and number of comorbidities at the tested level. CONCLUSIONS: Findings of no significant change in CRC over the long term compared to posttherapy measures suggest that patients were able to maintain improvement in cough over the long term despite various comorbidities. The current results suggest that CST represents a satisfactory approach to treating CRC and provides patients with an ongoing tool to maintain reduced cough severity. No significant correlations between number of comorbidities and mean CSI or VHI-10 scores were found over the long term.

Physico-chemical and extraction properties on alkali-treated Acacia pennata fiber.

The production of reinforced composite materials can generally benefit greatly from the use of natural cellulosic woody fibers as good sustainable resources. Natural plants like hemp, cotton, and bamboo are great options for knitters and crocheters looking to make eco-friendly goods. The current study examines the properties of natural fiber obtained from the stem of the Acacia pennata (AP) plant, as well as its basic physico-chemical, structural, thermal, and mechanical characteristics. The key goal of this work was to investigate how alkali treatment affected the AP fibers' morphology, chemical composition, tensile capabilities, morphological changes, structural changes, and thermal degradation (APFs). The SEM image and pXRD analyses support the improved surface roughness of the fiber, and that was seen after the alkaline treatment. From XRD analysis, the fiber crystallinity index (54.65%) was improved and it was connected to their SEM pictograms in comparison to untreated APF. Alkali-treated AP fibers include a higher percentage of chemical components including cellulose (51.38%) and ash (5.13%). Alkali-treated AP fibers have a lower amount of hemi-cellulose (30.30%), lignin (20.96%), pectin (8.77%), wax (0.12%), and moisture (13.44%) than untreated APF. Their low density and high cellulosic content will improve their ability to fiber matrices. The thermal behavior of AP fiber at various temperatures was demonstrated by TG-DTA analysis, and tensile strength was also investigated.

Role of site selective substitution, magnetic parameter tuning, and self heating in magnetic hyperthermia application: Eu-doped magnetite nanoparticles.

Various researchers have provided considerable insight into the fundamental mechanisms behind the power absorption of single-domain magnetic nanoparticles (MNPs) in magnetic hyperthermia applications. However, the role of all parameters pertinent to magnetic relaxation continues to be debated. Herein, to explore the role of magnetic anisotropy with the site selective substitution related to magnetic relaxation has generally been missing, which is critically essential in respective of hyperthermia treatment. Our study unravels contradictory results of rare earth (RE) interaction effects in ferrite to that of recently reported literature. Despite this, rare earth atoms have unique f-block properties, which significantly impact the magnetic anisotropy as well as the relaxation mechanism. Here, we use appropriate Eu doping concentration in magnetite and analyze its effect on the matrix. Furthermore, a positive SAR can effectively reduce the relative dose assigned to a patient to a minimal level. This study indicates that the introduction of Eu ion positively influenced the heating efficiency of the examined magnetite systems.

Identification of two ISG15 homologues involved in host immune response against RGNNV in Asian seabass (Lates calcarifer).

Interferon Stimulated Gene (ISG)15 is a ubiquitin-like protein that is induced upon viral infections. Our study reports the identification of two homologues of ISG15 in the Asian seabass designated LcISG15A and LcISG15B. The cloned LcISG15A cDNA fragment contained a 474 bp ORF encoding a 157 amino acid protein whereas LcISG15B featured a 498 bp ORF encoding a slightly longer protein of 165 amino acids. Both proteins featured the two tandem ubiquitin-like domains and the C-terminal LRGG motif characteristic of ISG15. The LcISG15B protein has a 10-amino acid C-terminal extension after the LRGG motif. Molecular docking studies revealed that LcISG15A showed more conformational variability of the ubiquitin domains and catalytic function than LcISG15B. The Lates ISG15A and ISG15B genes, reside close in the genome, share the same basic structure with two exons and an intron, but only the second exon encoding the protein. These genes also featured the IFN-stimulatory response elements (ISRE) in the promoter region and ATTTA instability motif in the 3' UTR region. Leukocyte-rich organs such as the head kidney, heart, spleen, and gill showed higher levels of ISG15A and ISG15B basal expression. Poly (I:C) injection rapidly upregulated the transcription of both the ISG15 genes in these tissues in Lates. In-vivo viral infection by red-spotted grouper nervous necrosis virus also induced upregulation of ISG15 genes in the head kidney, spleen, heart and gill. These findings indicate that the two ISG15 homologues may play a crucial role in innate antiviral immunity and could be used to improve prophylactic strategies and develop species-specific immunological tools for Lates calcarifer.