Sleep Quality as a Critical Pathway Between Adverse Childhood Experiences and Multimorbidity and the Impact of Lifestyle.

OBJECTIVES: This study aims to establish the effects of ACEs on multimorbidity through sleep quality and investigate whether lifestyle factors (e.g., eating habits and exercise) may influence this relationship among middle-aged and older adults. METHODS: Participants were drawn from a cross-sectional sample of community dwelling older adults (N = 276, 55+) and three waves of data from the Midlife in the United States study (MIDUS, N = 843). We examined the direct and indirect effects of ACEs, sleep quality, and health conditions, as well as the conditional effects of physical activity and eating habits. RESULTS: Across both samples, sleep quality mediated the relationship between ACEs and chronic health conditions. Moderating effects of unhealthy eating and physical activity differed between samples. DISCUSSION: Sleep quality is an important pathway connecting ACEs and adult multimorbidity, and health behaviors may provide targets for intervention particularly in older adults.

Determination of Flap Survival Isolated From Wound Bed Vasculature Using a Murine Axial Flap Model.

Background: Axial pattern flaps are a common reconstructive option following resection of soft tissue malignancies. We determine the early dependence of an axial flap on wound bed vasculature by isolating the underlying wound bed and depriving contact with the overlying flap. Materials and Methods: Mice were divided into 5 groups: No silicone (n = 7), silicone in the proximal 50% of the wound bed (n = 8), silicone in the distal 50% of the wound bed (n = 5), silicone over the full length of the wound bed with pedicle preservation (n = 5), and silicone over the full length of the wound bed with pedicle sacrifice (n = 5). The pedicle was the lateral thoracic artery. Daily photographs were taken, and the percent of viable flap was determined using ImageJ© software (public domain JAVA image processing program, National Institute of Health, Bethesda, MA). Percent flap viability for each group was compared to the no silicone group, which acted as the reference. Results: Mean differences in percent flap necrotic area (with 95% confidence interval) compared to the no silicone group were -0.15% (-15.09 to 14.09), 2.07% (-5.26 to 9.39), 2.98% (-10.98 to 16.94), and 14.21% (0.48 to 27.94) for the full-length silicone with preserved pedicle, proximal silicone, distal silicone, and full-length silicone with sacrificed pedicle groups, respectively. The full-length silicone with sacrificed pedicle group had a significant difference in flap viability (P = .045) compared to the no silicone group. Conclusion: We investigate the role of the wound bed vasculature in a murine axial flap model and demonstrate that the wound bed vasculature is not essential for early distal flap survival.

Stability of vitamin C, color, and garlic aroma of garlic mashed potatoes in polymer packages processed with microwave-assisted thermal sterilization technology.

The U.S. Army and NASA need ready-to-eat meals with extended shelf-life for military operations and future manned space missions. For traditional heat sterilization methods, aluminum foil laminated pouches are used to achieve a shelf-life of 3 to 5 years at room temperature. However, those packages are not suited for advanced thermal processing technologies based on microwave energy. This research investigated the effect of polymeric packaging materials on storage stability of garlic flavor, vitamin C, and color of garlic mashed potatoes processed with microwave-assisted thermal sterilization (MATS) technology. Three types of high-barrier metal oxide-coated polymer pouches were used for MATS process, designed to achieve lethality approximately F0 = 6 min. Aluminum foil-based pouches were used for retort process as control. Results demonstrated that both oxygen and water vapor barrier properties (oxygen transmission rate [OTR] and water vapor transmission rate [WVTR]) of the polymer pouches were affected by MATS processing. OTR increased by three to nine times, while WVTR increased by 5 to 20 times after processing. The MATS process resulted in 13% to 16% vitamin C loss, while retort process resulted in 18% loss in garlic mashed potato. The kinetics of vitamin C indicated that metal oxide-coated high-barrier packages (after processing OTR <0.1 cc/m2 .day; WVTR <1.0 g/m2 .day) could replace aluminum foil-based pouches for MATS processed shelf-stable ready-to-eat garlic mashed potatoes. PRACTICAL APPLICATION: Garlic mashed potatoes in polymer packages processed in a microwave-assisted thermal sterilization (MATS) system had better retention of vitamin C compared to samples packaged in aluminum laminated pouches and processed in retort. Polymer packages combined with MATS processing could potentially provide safe, better quality, and nutritious shelf-stable food products for military and space missions.

Convolutional neural networks to automate the screening of malaria in low-resource countries.

Malaria is an infectious disease caused by Plasmodium parasites, transmitted through mosquito bites. Symptoms include fever, headache, and vomiting, and in severe cases, seizures and coma. The World Health Organization reports that there were 228 million cases and 405,000 deaths in 2018, with Africa representing 93% of total cases and 94% of total deaths. Rapid diagnosis and subsequent treatment are the most effective means to mitigate the progression into serious symptoms. However, many fatal cases have been attributed to poor access to healthcare resources for malaria screenings. In these low-resource settings, the use of light microscopy on a thin blood smear with Giemsa stain is used to examine the severity of infection, requiring tedious and manual counting by a trained technician. To address the malaria endemic in Africa and its coexisting socioeconomic constraints, we propose an automated, mobile phone-based screening process that takes advantage of already existing resources. Through the use of convolutional neural networks (CNNs), we utilize a SSD multibox object detection architecture that rapidly processes thin blood smears acquired via light microscopy to isolate images of individual red blood cells with 90.4% average precision. Then we implement a FSRCNN model that upscales 32 × 32 low-resolution images to 128 × 128 high-resolution images with a PSNR of 30.2, compared to a baseline PSNR of 24.2 through traditional bicubic interpolation. Lastly, we utilize a modified VGG16 CNN that classifies red blood cells as either infected or uninfected with an accuracy of 96.5% in a balanced class dataset. These sequential models create a streamlined screening platform, giving the healthcare provider the number of malaria-infected red blood cells in a given sample. Our deep learning platform is efficient enough to operate exclusively on low-tier smartphone hardware, eliminating the need for high-speed internet connection.

Isolated Complete Jejunal Transection After Blunt Abdominal Trauma: CT Imaging.

Abdominal injury following road traffic accident is less common, compared to the extremities, head and chest. Bowel may get injured following blunt abdominal trauma, but perforation and complete transection is rare. Initial clinical examination may be unreliable, as signs of bowel injury may take some time to develop. Imaging plays a crucial role in the early and accurate diagnosis of bowel injuries. We report a case of 21-year-old male, who presented with severe abdominal pain, following a road traffic accident. Chest X-Ray was normal and abdominal ultrasound revealed intra-peritoneal free fluid with internal echoes. Contrast enhanced CT scan showed pneumoperitoneum and intraperitoneal free fluid with disruption in continuity of proximal jejunum along with signs of shock bowel and bowel ischemia. This report highlights the role of CT imaging in the prompt diagnosis of bowel transection following blunt abdominal trauma.