Pregnant Latinas' perspectives on pursuing expanded carrier screening: "It is better to know than not".

With the advance of genetic technologies, the use of expanded carrier screening (ECS) in the prenatal setting is growing. ECS tests for a wide range of inherited genetic disorders regardless of racial/ethnic background and family history. Latinxs are an important ECS stakeholder group as they are the largest minority group with the highest fertility rate in the United States. Yet, the Latinx population has, to date, been underrepresented and understudied in genetics/genomics research. We conducted a study to explore the knowledge and perspectives of pregnant Latinas regarding ECS in which descriptive statistics and content analysis were used to analyze the data. Thirty-two pregnant Latinas - mostly of low educational levels (no education beyond high school) and with less than $20,000 annual household income living in rural areas were surveyed, provided with education about ECS, and interviewed. Participants were found to possess limited knowledge about ECS prior to being interviewed. Most (68.8%), however, expressed interest in pursuing ECS following the educational component that explained ECS. Their interest was mainly driven by the desire to know their baby's chance of developing a genetic disorder, the low risk of ECS procedures for both pregnant Latinas and their fetus, and the opportunity to better prepare for raising a child with a genetic condition. Our findings contribute to the limited research in the genetics/genomics field by providing in-depth insights into the perspectives of pregnant Latinas regarding ECS. Obstetric providers and genetic counselors should provide culturally appropriate education and counseling to empower pregnant Latinas to make informed decisions about the use of ECS.

Pregnant Latinas' views of adopting exome sequencing into newborn screening: A qualitative study.

PURPOSE: There are, currently, conflicting opinions about the adoption of exome sequencing (ES) into the standard newborn screening program. This study aimed to explore the views of pregnant Latinas, a hard-to-reach, underserved, and understudied population, about pursuing ES for their newborns. METHODS: We conducted semistructured interviews with 32 pregnant Latinas who predominately lived in rural areas and had low levels of income and education. An emergent coding approach was used to analyze the qualitative data collected. RESULTS: Our entire sample believed that ES should be offered as a part of newborn screening, which could empower pregnant Latinas to better understand their children's health and take early treatment actions. Although some participants were concerned about potentially bad ES results and had questions about the accuracy of ES results, nearly all interviewees reported that they would be willing to have their newborns undergo ES. The main reasons given were to be informed of diseases that the baby may have, and the perception that ES is a procedure that involves minimal risk. CONCLUSION: Pregnant Latinas in this study had favorable attitudes toward newborn ES. Their perspectives should be considered when decisions are made about incorporating ES into newborn screening.

Second harmonic generation imaging of collagen scaffolds within the alveolar ducts of healthy and emphysematous mouse lungs.

The alveolar ducts are connected to peripheral septal fibers which extend from the visceral pleura into interlobular septa, and are anchored to axial fibers in the small airways. Together these axial and septal fibers constitute a fiber continuum that provides tension and integrity throughout the lung. Building on the observations that alveolar ducts associated with sub-pleural alveoli are orientated perpendicular to the visceral pleura, and in parallel to each other, the goal of the present study was to investigate the nature of the collagen fiber organization within sub-pleural alveolar ducts in healthy control and elastase-induced emphysema murine lungs. Employing three-dimensional second harmonic generation imaging, the structural arrangement of fibrilar collagen fibers could be visualized in cleared murine lungs. In healthy control lungs, fibrilar collagen fibers within alveolar mouths formed the coiled collagen structure within the alveolar duct. In the elastase-treated emphysema lungs, there was loss of fibrilar collagen fibers (p < 0.01) and disruption of collagens structural organization as measured by the fibrillar collagen length (p < 0.01) and entropy (p < 0.01). Compared to the alveolar ducts from healthy controls, there was a significant increase in the area of cells (nm2, p < 0.001), and area of cells with cytoplasmic granules (nm2, p < 0.001) compared to emphysematous lungs. These results are consistent with the idea that one of the major contributors to the progressive loss of alveolar surfaces and elastic recoil in the emphysematous lung is loss of the structural integrity of the collagen scaffold that maintains the spatial relationships important for cell survival and lung function.

Significant Effect of Pore Sizes on Energy Storage in Nanoporous Carbon Supercapacitors.

Mesoporous carbon can be synthesized with good control of surface area, pore-size distribution, and porous architecture. Although the relationship between porosity and supercapacitor performance is well known, there are no thorough reports that compare the performance of numerous types of carbon samples side by side. In this manuscript, we describe the performance of 13 porous carbon samples in supercapacitor devices. We suggest that there is a "critical pore size" at which guest molecules can pass through the pores effectively. In this context, the specific surface area (SSA) and pore-size distribution (PSD) are used to show the point at which the pore size crosses the threshold of critical size. These measurements provide a guide for the development of new kinds of carbon materials for supercapacitor devices.

Ni-Co Binary Hydroxide Nanotubes with Three-Dimensionally Structured Nanoflakes: Synthesis and Application as Cathode Materials for Hybrid Supercapacitors.

Nickel-cobalt binary hydroxide nanotubes were fabricated by a facile synthetic approach by using Cu2 O nanowires as sacrificial templates. The surface morphology of the binary hydroxide nanotubes can be easily controlled by adjusting the molar ratio of Ni to Co. With increasing Co content, the surfaces of the nanotubes tend to form hierarchical nanoflakes. The obtained nanotubes with high specific surface area exhibit typical battery-like electrochemical behavior. Among them, Ni-Co hydroxide nanotubes with Ni:Co=48:52 showed outstanding electrochemical characteristics, with a specific capacity of 209.9 mAh g-1 at 1 Ag-1 and remarkable cycling stability with 84.4 % capacity retention after 10 000 cycles at 20 A g-1 . With the advantages of their unique nanostructure and the synergistic effect of the two elements, the Ni-Co binary hydroxide nanotubes are expected to be effective potential cathode materials for hybrid supercapacitors.

Correction: Zeolitic imidazolate framework (ZIF-8) derived nanoporous carbon: the effect of carbonization temperature on the supercapacitor performance in an aqueous electrolyte.

Correction for 'Zeolitic imidazolate framework (ZIF-8) derived nanoporous carbon: the effect of carbonization temperature on the supercapacitor performance in an aqueous electrolyte' by Christine Young et al., Phys. Chem. Chem. Phys., 2016, 18, 29308-29315.

Zeolitic imidazolate framework (ZIF-8) derived nanoporous carbon: the effect of carbonization temperature on the supercapacitor performance in an aqueous electrolyte.

Nanoporous carbon materials are a versatile source of carbons that would be useful in applications ranging from electronics to electrochemical energy storage. Here, we focus on nanoporous carbon materials prepared by direct carbonization of zeolitic imidazolate frameworks (ZIF-8) towards supercapacitor applications. Several types of nanoporous carbons have been prepared by varying the applied carbonization temperature. The symmetric devices assembled using nanoporous carbon electrodes were tested for their optimal performance in the electrolyte of sulfuric acid solution. We demonstrate the effects of various factors (e.g., surface area, nitrogen content, degree of graphitization, and relative percentage of micropores) on the performance.

Synergistic Charge Storage Enhancement in Supercapacitors via Ti3C2Tx MXene and CoMoO4 Nanoparticles.

MXene has emerged as a highly promising two-dimensional (2D) layered material with inherent advantages as an electrode material, such as a high electrical conductivity and spacious layer distances conducive to efficient ion transport. Despite these merits, the practical implementation faces challenges due to MXene's low theoretical capacitance and issues related to restacking. In order to overcome these limitations, we undertook a strategic approach by integrating Ti3C2Tx MXene with cobalt molybdate (CoMoO4) nanoparticles. The CoMoO4 nanoparticles bring to the table rich redox activity, high theoretical capacitance, and exceptional catalytic properties. Employing a facile hydrothermal method, we synthesized CoMoO4/Ti3C2Tx heterostructures, leveraging urea as a size-controlling agent for the CoMoO4 precursors. This innovative heterostructure design utilizes Ti3C2Tx MXene as a spacer, effectively mitigating excessive agglomeration, while CoMoO4 contributes its enhanced redox reaction capabilities. The resulting CoMoO4/Ti3C2Tx MXene hybrid material exhibited 698 F g-1 at a scan rate of 5 mV s-1, surpassing that of the individual pristine Ti3C2Tx MXene (1.7 F g-1) and CoMoO4 materials (501 F g-1). This integration presents a promising avenue for optimizing MXene-based electrode materials, addressing challenges and unlocking their full potential in various applications.

Effectiveness of standardized combination therapy for migraine treatment in the pediatric emergency department.

OBJECTIVE: To compare outcomes of pediatric migraine patients treated in an emergency department (ED) before and after implementation of a standardized combination intravenous therapy regimen aimed toward improving and standardizing abortive migraine therapy. BACKGROUND: In a pediatric ED, migraines represent 8-18% of all headache visits. Despite this large number, no standard treatment for acute migraine therapy currently exists. METHODS: The study utilized a retrospective chart review of patients seeking acute migraine treatment at a tertiary care, pediatric ED from August 2006 to March 2010. Inclusion criteria were pediatric migraine patients as defined by International Headache Society guidelines. The comparison population received various migraine therapies based on attending practice preference. After October 2008, patients received standardized intravenous combination therapy involving a normal saline fluid bolus, ketorolac, prochlorperazine, and diphenhydramine. Occasionally, metoclopramide was substituted during prochlorperazine shortages. Reduction in headache pain score was the primary outcome. Secondary outcome measures included length of ED stay, hospital admission rate, and ED readmission rate within 48 hours. RESULTS: The study yielded 87 patients who received standardized combination therapy and 165 comparison patients. No significant difference in patient characteristics existed when evaluating patient demographics, outpatient medication use, and initial headache pain score. When compared with the non-standardized therapy population, the combination therapy patients revealed significant reductions in pain score (decrease of 5.3 vs. 6.9, difference -1.6, 95% confidence interval -2.2 to -0.8, P < .001), length of ED stay (5.3 vs. 4.4 hours, difference 0.9, 95% confidence interval 0.2-1.6, P = .008), and hospital admission rate (32% vs. 3%, P < .001) without changes in ED return rate (7% vs. 2%, P = .148). CONCLUSION: Standardized combination therapy is effective for acute pediatric migraine therapy in the ED by significantly reducing headache pain scores, length of ED stay, and hospital admission rates.

Benefits and concerns of expanded carrier screening: what do pregnant Latina women in Texas think?

The American College of Medical Genetics and Genomics (ACMG) recommends carrier screening for all pregnant women regardless of race or ethnicity. In recent years, the ACMG broadened the guidelines to include expanded carrier screening (ECS) which can screen for 112 conditions. This study seeks to explore the perceptions of pregnant Latina women about the benefits and concerns related to ECS use. Partnering with prenatal clinics in Texas, we conducted semi-structured qualitative interviews with 32 pregnant Latina women in their second or third trimester of pregnancy. NVivo 8 was used to conduct content analysis and emergent coding of the data. Participants reported the benefits of ECS as helping them prepare for the baby's arrival, informing them of the baby's risk for genetic conditions, ensuring the health of their baby, and preventing diseases before birth. The ECS-related concerns expressed by the participants included worries surrounding potential positive ECS results, insufficient knowledge about the genetic diseases screened for by ECS, the accuracy of the ECS, the potential harm ECS may cause the baby, and the affordability of ECS. After weighing both their perceived benefits and concerns, nearly all the participants believed that ECS should be offered to all pregnant women. This study contributes to an understudied research area in the genetic/genomic field. Our findings can help increase the awareness of obstetricians, genetic professionals, and other healthcare providers regarding pregnant Latina women's views on ECS and inform the design of culturally appropriate care as ECS is adopted into routine clinical practice.

Plasma lipid metabolites are associated with gestational age but not bronchopulmonary dysplasia.

AIM: To test the hypothesis that plasma lipid metabolite levels in premature infants are associated with the development of bronchopulmonary dysplasia (BPD). The studies also tested a secondary hypothesis that plasma lipid metabolite levels were correlated with gestational age. METHODS: Infants born <32 weeks' gestation were enrolled during the first 72 h of life. Plasma samples were obtained and lipid levels were measured by LC-MS/MS. Clinical data were collected to determine infant outcomes and BPD diagnosis. RESULTS: Following adjustment for confounders, lipid levels were not associated with BPD; however, levels of specific lipid metabolites were correlated with gestational age. CONCLUSION: Immature lipid metabolism pathways in premature infants may contribute to the pathogenesis of BPD and other diseases.

Highly Porous Holey Carbon for High Areal Energy Density Solid-State Supercapacitor Application.

Biomass materials are perceived as sustainable, carbon-rich precursors for the fabrication of carbon materials. In this study, we demonstrated the capacitance performance of biomass-derived carbon, produced by using golden shower tree seeds (GTs) as carbon precursors and potassium ferrate (K2FeO4) as the activation agent. The as-prepared porous carbon (GTPC) possessed an ultrahigh specific surface area (1915 m2 g-1) and abundant pores. They also exhibited superior electrochemical performance, owing to their well-constructed porous structure, high surface area, and optimized porous structure. Optimized activated carbon (GTPC-1) was used to assemble a symmetric solid-state supercapacitor device with poly(vinyl alcohol) (PVA)/H2SO4 as a solid-state gel electrolyte. The device exhibited a maximum areal energy density of 42.93 µWh cm-2 at a power density of 520 µW cm-2.

Transforming Confocal Microscopy Imaging Data of Retinal Vasculature into 3D Animation.

This research study presents a methodology for creation of 3D models from confocal microscopy, specifically the retinal trilaminar capillary network, that can be used in 3D biomedical animation. Biomedical visualization professionals regularly use CT and MRI imaging data to create 3D models and other visuals. Adding confocal microscopy to this toolkit using ImageJ FIJI1 and Materialise Mimics® allows for a wider range of options to create data-driven 3D models of microscopic structures. Understanding the interactions of the neurovascular unit through visualization may be a key to advancing understanding of normal function of the retina and diabetic retinopathy pathology. This Vesalius Trust research poster was presented at the Association of Medical Illustrators' 2021 virtual annual meeting.

Pure White Cell Aplasia and Immune Thrombocytopenia after Thymoma Resection: A Case Report and Review of the Literature.

We report a case of pure white cell aplasia (PWCA) postthymoma resection in a 74-year-old male presenting with a 2-week history of fevers, night sweats, and severe febrile neutropenia. His pure white cell aplasia was treated with intravenous immunoglobulin (IVIg), granulocyte colony-stimulating factor (G-CSF), prednisone, and cyclosporine with a mixed response. He also developed immune thrombocytopenia, which responded well to a short course of eltrombopag. With continued cyclosporine treatment, his platelet counts were stable after stopping eltrombopag. The patient's cyclosporine treatment was complicated by renal failure, resulting in cessation of cyclosporine. His PWCA and immune thrombocytopenia significantly worsened after stopping cyclosporine, and unfortunately, he died from multiorgan failure and sepsis.

Intrinsic function of the peptidylarginine deiminase PADI4 is dispensable for normal haematopoiesis.

Peptidylarginine deiminases (PADIs) are strongly associated with the development of autoimmunity, neurodegeneration and cancer but their physiological roles are ill-defined. The nuclear deiminase PADI4 regulates pluripotency in the mammalian pre-implantation embryo but its function in tissue development is unknown. PADI4 is primarily expressed in the bone marrow, as part of a self-renewal-associated gene signature. It has been shown to regulate the proliferation of multipotent haematopoietic progenitors and proposed to impact on the differentiation of haematopoietic stem cells (HSCs), suggesting that it controls haematopoietic development or regeneration. Using conditional in vivo models of steady state and acute Padi4 ablation, we examined the role of PADI4 in the development and function of the haematopoietic system. We found that PADI4 loss does not significantly affect HSC self-renewal or differentiation potential upon injury or serial transplantation, nor does it lead to HSC exhaustion or premature ageing. Thus PADI4 is dispensable for cell-autonomous HSC maintenance, differentiation and haematopoietic regeneration. This work represents the first study of PADI4 in tissue development and indicates that pharmacological PADI4 inhibition may be tolerated without adverse effects.

A Randomized Clinical Trial of Perfusion Modalities in Pediatric Congenital Heart Surgery Patients.

BACKGROUND: The objective of this randomized clinical trial was to investigate the effects of perfusion modalities on cerebral hemodynamics, vital organ injury, quantified by the Pediatric Logistic Organ Dysfunction-2 (PELOD-2) Score, and clinical outcomes in risk-stratified congenital cardiac surgery patients. METHODS: This randomized clinical trial included 159 consecutive congenital cardiac surgery patients in whom pulsatile (n = 83) or nonpulsatile (n = 76) perfusion was used. Cerebral hemodynamics were assessed using transcranial Doppler ultrasound. Multiple organ injury was quantified using the PELOD-2 score at 24, 48, and 72 hours. Clinical outcomes, including intubation time, intensive care unit length of stay (LOS), hospital LOS, and mortality, were also evaluated. RESULTS: The Pulsatility Index at the middle cerebral artery and in the arterial line during aortic cross-clamping was consistently better maintained in the pulsatile group. Demographics and cardiopulmonary bypass characteristics were similar between the 2 groups. While risk stratification with The Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STAT) Mortality Categories was similar between the groups, Mortality Categories 1 to 3 demonstrated more patients than Mortality Categories 4 and 5. There were no differences in clinical outcomes between the groups. The PELOD-2 scores showed a progressive improvement from 24 hours to 72 hours, but the results were not statistically different between the groups. CONCLUSIONS: The Pulsatillity Index for the pulsatile group demonstrated a more physiologic pattern compared with the nonpulsatile group. While pulsatile perfusion did not increase plasma-free hemoglobin levels or microemboli delivery, it also did not demonstrate any improvements in clinical outcomes or PELOD-2 scores, suggesting that while pulsatile perfusion is a safe method, it not a "magic bullet" for congenital cardiac operations.

MOF-derived nanoporous carbons with diverse tunable nanoarchitectures.

Metal-organic frameworks (MOFs), or porous coordination polymers, are crystalline porous materials formed by coordination bonding between inorganic and organic species on the basis of the self-assembly of the reacting units. The typical characteristics of MOFs, including their large specific surface areas, ultrahigh porosities and excellent thermal and chemical stabilities, as well as their great potential for chemical and structural modifications, make them excellent candidates for versatile applications. Their poor electrical conductivity, however, has meant that they have not been useful for electrochemical applications. Fortuitously, the direct carbonization of MOFs results in a rearrangement of the carbon atoms of the organic units into a network of carbon atoms, which means that the products have useful levels of conductivity. The direct carbonization of zeolitic imidazolate framework (ZIF)-type MOFs, particularly ZIF-8, has successfully widened the scope of possible applications of MOFs to include electrochemical reactions that could be used in, for example, energy storage, energy conversion, electrochemical biosensors and capacitive deionization of saline water. Here, we present the first detailed protocols for synthesizing high-quality ZIF-8 and its modified forms of hollow ZIF-8, core-shell ZIF-8@ZIF-67 and ZIF-8@mesostuctured polydopamine. Typically, ZIF-8 synthesis takes 27 h to complete, and subsequent nanoarchitecturing procedures leading to hollow ZIF-8, ZIF-8@ZIF-67 and ZIF-8@mPDA take 6, 14 and 30 h, respectively. The direct-carbonization procedure takes 12 h. The resulting nanoporous carbons are suitable for electrochemical applications, in particular as materials for supercapacitors.

MYC sensitises cells to apoptosis by driving energetic demand.

The MYC oncogene is a potent driver of growth and proliferation but also sensitises cells to apoptosis, which limits its oncogenic potential. MYC induces several biosynthetic programmes and primary cells overexpressing MYC are highly sensitive to glutamine withdrawal suggesting that MYC-induced sensitisation to apoptosis may be due to imbalance of metabolic/energetic supply and demand. Here we show that MYC elevates global transcription and translation, even in the absence of glutamine, revealing metabolic demand without corresponding supply. Glutamine withdrawal from MRC-5 fibroblasts depletes key tricarboxylic acid (TCA) cycle metabolites and, in combination with MYC activation, leads to AMP accumulation and nucleotide catabolism indicative of energetic stress. Further analyses reveal that glutamine supports viability through TCA cycle energetics rather than asparagine biosynthesis and that TCA cycle inhibition confers tumour suppression on MYC-driven lymphoma in vivo. In summary, glutamine supports the viability of MYC-overexpressing cells through an energetic rather than a biosynthetic mechanism.

Modeling the Way: Strategies to Enhance Nurse Certification.

Specialty certification demonstrates RNs' commitment to high levels of clinical achievement and continuous learning. This column provides a chief nursing officer's perspective on how an organization can support nursing professional development while focusing on the value of specialty certification. [J Contin Educ Nurs. 2021;52(7):304-306.].

Nursing Students' Perceptions of Staff Nurse Instructors' Characteristics in a Dedicated Education Unit.

BACKGROUND: The dedicated education unit is a model that has been used for clinical experiences in recent years. The importance of effective staff nurse instructors (SNIs) is paramount in nursing students' development of nursing skills and critical thinking. PURPOSE: This study examined nursing students' perceptions of positive and negative characteristics of SNIs. METHOD: During a 3-year period, an estimated 265 nursing students evaluated SNIs using an optional two question survey. Qualitative data were retrieved and reviewed by researchers to analyze common themes delineated by students. RESULTS: Various themes were noted in which students identified exemplary SNI characteristics as well as barriers to learning. CONCLUSION: Data revealed positive and negative attributes that promoted student learning by the SNIs. Areas for improvement in training of the SNIs became evident through analyzing data, which can be used by clinical faculty to improve the experiences for both students and SNIs. [J Nurs Educ. 2021;60(8):459-461.].