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Photoemission electron microscopy and metastable electron emission microscopy were used to detect diffusion of chloraluminum phthalocyanine organic semiconductor molecule on MoS2.

Diffusion of a large organic semiconductor molecule, chloroaluminum phthalocyanine (ClAlPc), on a cleaved MoS[sub 2] surface was detected using photoemission electron microscopy (PEEM) and metastable electron emission microscopy (MEEM). The PEEM and MEEM images showed that a micropattern of ClAlPc ultrathin film prepared on the MoS[sub 2] surface by vacuum deposition shrinks with time and finally disappears even at room temperature at which the molecules do not evaporate. The results indicate that control of molecular diffusion is necessary for the preparation of stable micro or nanostructure of organic thin films. © 2001 American Institute of Physics. [ABSTRACT FROM AUTHOR]

Kamilah Thomas-Purcell,1 Tochukwu Adaobi Ibe,2 Donrie Purcell,3 Gwendolyn Quinn,4 Raymond Ownby3 1Department of Health Science, Dr. Pallavi Patel College of Health Care Sciences, Nova Southeastern University, Ft. Lauderdale, FL, USA; 2Mayo Clinic, College of Medicine and Science, Department of Internal Medicine, Jacksonville, FL, USA; 3Department of Psychiatry, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Ft. Lauderdale, FL, USA; 4Department of OB-GYN, Department of Population Health, New York University, Langone Medical Center, New York, NY, USACorrespondence: Kamilah Thomas-Purcell Tel +954-262-1222Email kthomaspurcell@nova.eduIntroduction: Having multiple chronic conditions (MCC) is the most common health condition in older US adults of which Blacks are disproportionally affected. The management of each condition presents many challenges. Blacks in the US frequently cite spirituality as facilitator to well-being. More information is needed to understand the many aspects of spirituality that older Black patients use to manage MCCs.Methods: In the current study, focus groups were conducted with 30 black men and women with MCCs to examine how spirituality can be incorporated into a mobile health intervention designed to increase chronic disease self-management (CDSM) skills by improving health literacy. Groups discussed spiritual practices used to facilitate CDSM and their perceptions about mobile technology use.Results: Inductive thematic analysis suggested that a chronic disease wellness plan that acknowledges the relationship between spirituality and health was preferred by most participants. Additionally, the desire for mobile health (mHealth) among this group points to an opportunity for intervention.Discussion: Creating culturally appropriate educational messages about CDSM that incorporate spiritual practices may be a useful method for building sustainable CDSM skills. Next steps include the development of a mHealth intervention prototype based on the results and pre-testing it prior to deployment.Keywords: spirituality, African American, qualitative, medication adherence, folk medicine

What is known and objective: Supraventricular tachycardia is a common complication after pulmonary resection. The objective of this study was to investigate the efficacy of landiolol hydrochloride, an ultra-short-acting β1-blocker, in patients with post-operative supraventricular tachycardia after pulmonary resection. Methods: The response to continuous intravenous infusion of landiolol was evaluated in 25 patients who developed post-operative atrial fibrillation or atrial flutter after major pulmonary resection. Four patients had preoperative rate-controlled chronic atrial fibrillation. The heart rate and blood pressure were compared before and after infusion of landiolol. Side effects and recurrence of supraventricular tachycardia after termination of landiolol infusion were also monitored. Results and discussion: The heart rate was reduced from 135 ± 24 bpm before landiolol infusion to a plateau rate of 85 ± 19 bpm during infusion ( P < 0·0001). Heart rate reduction occurred in all but two patients. Conversion to normal sinus rhythm from supraventricular tachycardia occurred in 14 patients (56%). Recurrence of supraventricular tachycardia after stopping landiolol infusion was observed in 17 patients (68%), but all patients without preoperative AF were cured of post-operative AF. There were no detectable side effects, including no adverse influence on the circulatory and respiratory systems. What is new and conclusion: Continuous intravenous infusion of landiolol was found to be effective and safe for supraventricular tachycardia after pulmonary resection. [ABSTRACT FROM AUTHOR]

Aim: To investigate the predictors of pressure ulcer and physical restraint prevalence in Japanese acute care units and their relationship to the nursing hours, skill mix, and Nursing Need Scores (NNS). Methods: In this descriptive study, quantitative methods were employed to determine if pressure ulcers and physical restraint prevalence, as outcomes of nursing care, were related to the nursing hours, skill mix, and intensity of nursing-care needs. The sample included 87 acute care units in 42 hospitals in Tokyo and its surrounding prefectures in Japan. The NNS was used as the instrument to measure the intensity of nursing-care needs. The data were analyzed with descriptive statistics, correlations, and multiple regression analyses. Results: Pressure ulcer prevalence was positively correlated with the NNS-A and NNS-B. Physical restraint use was positively correlated with the NNS-B and negatively correlated with the NNS-A. However, the total nursing hours per patient day was positively related with both pressure ulcer and physical restraint prevalence. Conclusions: The nursing hours and NNS are predictors of pressure ulcer development and physical restraint use. The results also suggest that we should revise our process of nursing care. Many functions that might be shared with other personnel are performed by nurses, which results in longer total nursing hours but shorter direct nursing hours, used in order to observe and care for patients. Japan's aging population will result in higher NNS, requiring more direct nursing hours and other personnel to participate in our process of nursing care. [ABSTRACT FROM AUTHOR]

Background: Inflammation plays a fundamental role in the pathogenesis of heart failure with preserved ejection fraction (HFpEF). In most patients, inflammation develops secondary to cardiometabolic comorbidities, but in some, HFpEF develops in the setting of an underlying systemic inflammatory disease such as rheumatoid arthritis or systemic lupus erythematosus., Objectives: This study aimed to investigate the prevalence, pathophysiology, and outcome of patients with HFpEF and autoimmune or primary inflammatory disorders., Methods: Of 982 consecutively evaluated patients with HFpEF diagnosed, 79 (8.0%) had autoimmune disorders. HFpEF was defined by invasive cardiopulmonary hemodynamic exercise testing., Results: Female sex, higher heart rate, lower hemoglobin, absence of atrial fibrillation, and absence of coronary artery disease were independently associated with autoimmune disorders. Hemodynamics at rest and exercise did not differ between the groups, but peripheral oxygen extraction was lower in those with autoimmune disorders, reflected by lower arterial-venous oxygen content difference at rest (4.2 ± 0.7 mL/dL vs 4.6 ± 1.0 mL/dL; P < 0.001) and during exercise (9.3 ± 2.2 mL/dL vs 10.4 ± 2.2 mL/dL; P < 0.001), suggesting a greater peripheral deficit, and ventilatory efficiency (VE/VCo 2 slope, regression slope relating minute ventilation to carbon dioxide output) was also more impaired (38.0 ± 7.9 vs 36.2 ± 7.3; P = 0.043). Patients with autoimmune disorders had a higher risk of death or heart failure (HF) hospitalization compared with those without in adjusted analyses (HR: 1.95 [95% CI: 1.17-3.27]; P = 0.011) over a median follow-up of 3.0 years, which was primarily attributable to higher risk of HF hospitalization (HR: 2.87 [95% CI: 1.09-7.57]; P = 0.033)., Conclusions: Patients with HFpEF and autoimmune disorders have similar hemodynamic derangements but greater peripheral deficits in oxygen transport and higher risk for adverse outcome compared with those without., Competing Interests: Funding Support and Author Disclosures Dr Borlaug is supported by National Institutes of Health grants R01 HL128526 and U01 HL160226, and U.S. Department of Defense grant W81XWH2210245. Dr Tada is supported by a research fellowship from the Uehara Memorial Foundation, Japan. Dr Borlaug has received research grant funding from AstraZeneca, Axon, GlaxoSmithKline, Medtronic, Mesoblast, Novo Nordisk, Rivus, and Tenax Therapeutics; has served as a consultant for Actelion, Amgen, Aria, Axon Therapies, BD, Boehringer Ingelheim, Cytokinetics, Edwards Lifesciences, Eli Lilly, Imbria, Janssen, Merck, Novo Nordisk, NGM, NXT, and VADovations; and is named inventor (US Patent number 10,307,179) for the tools and approach for a minimally invasive pericardial modification procedure to treat heart failure. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Aims: This study aimed to evaluate the clinical significance of secondary mitral regurgitation (MR) in patients with heart failure with preserved ejection fraction (HFpEF)., Methods and Results: We conducted a prospective study enrolling consecutively evaluated patients with HFpEF undergoing invasive haemodynamic exercise testing with simultaneous echocardiography. Compared to HFpEF without MR (n = 145, 79.7%), those with mild or moderate MR (n = 37, 20.3%) were older, more likely to be women, had more left ventricular (LV) systolic dysfunction, and more likely to have left atrial (LA) myopathy reflected by greater burden of atrial fibrillation, more LA dilatation, and poorer LA function. Pulmonary artery (PA) wedge pressure was higher at rest in HFpEF with MR (17 ± 5 mmHg vs. 20 ± 5 mmHg, p = 0.005), but there was no difference with exercise. At rest, only 2 (1.1%) patients had moderate MR, and none developed severe MR. Pulmonary vascular resistance was higher, and right ventricular (RV)-PA coupling was more impaired in patients with HFpEF and MR at rest and exercise. LV and LA myocardial dysfunction remained more severe in patients with MR during stress compared to those without MR, characterized by greater LA dilatation during all stages of exertion, lower LA emptying fraction and compliance, steeper and rightward-shifted LA pressure-volume relationships, and reduced LV longitudinal contractile function., Conclusions: Patients with HFpEF and mild or moderate MR have more severe LV systolic dysfunction, LA myopathy, RV-PA uncoupling, and more severe pulmonary vascular disease. Mitral valve incompetence in this setting is a phenotypic marker of more advanced disease but is not a causal factor in development of HFpEF., (© 2024 European Society of Cardiology.)

Objective: This study aimed to compare the contribution of 18 F-fluorodepxyglucose (FDG) positron (PET)/ computed tomography (CT) acquisition of early and delayed scans in patients with cardiac sarcoidosis (CS)., Methods: Twenty-three patients with CS (median age: 69 years; 11 women) were retrospectively evaluated using dual-phase FDG PET/CT. All patients were instructed to consume a low-carbohydrate diet followed by fasting for 18 h before FDG injection to reduce physiological myocardial uptake. PET/CT was acquired at 60 min (early) and 100 min (delayed) after FDG administration. Focal and focal on diffuse uptake on visual analysis was considered positive for CS. A semi-quantitative analysis was performed using the maximum standardized uptake value (SUVmax) of the cardiac lesion and the mean SUV (SUVmean) of the blood pool., Results: Significant myocardial FDG uptake was observed in 21 patients (91.3%) in the early acquisition group and in 23 patients in the delayed scan group (100%). Compared to the early scan, the delayed scan showed a significantly higher SUVmax of the cardiac lesion [median, 4.0; IQR (interquartile range, 2.9 to 7.0) vs. 5.8 (IQR 3.7 to 10.1); P = 0.0030] and a significantly lower SUVmean of blood pool [median, 1.3 (IQR, 1.2 to 1.4) vs. 1.1 (IQR, 0.9 to 1.2); P < 0.0001]., Conclusion: Delayed FDG PET/CT acquisition improves detection accuracy in patients with CS compared to early scans with washout of the blood pool activity. Therefore, it can contribute to a more accurate assessment of CS., (© 2023. The Author(s) under exclusive licence to The Japanese Society of Nuclear Medicine.)

Previous research has shown that simulated child sexual abuse (CSA) interview training using avatars paired with feedback and modeling improves interview quality. However, to make this approach scalable, the classification of interviewer questions needs to be automated. We tested an automated question classification system for these avatar interviews while also providing automated interventions (feedback and modeling) to improve interview quality. Forty-two professionals conducted two simulated CSA interviews online and were randomly provided with no intervention, feedback, or modeling after the first interview. Feedback consisted of the outcome of the alleged case and comments on the quality of the interviewer's questions. Modeling consisted of learning points and videos illustrating good and bad questioning methods. The total percentage of agreement in question coding between human operators and the automated classification was 72% for the main categories (recommended vs. not recommended) and 52% when 11 subcategories were considered. The intervention groups improved from first to second interview while this was not the case in the no intervention group (intervention x time: p  = 0.007, η p 2  = 0.28). Automated question classification worked well for classifying the interviewers' questions allowing interventions to improve interview quality., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Haginoya, Ibe, Yamamoto, Yoshimoto, Mizushi and Santtila.)

The purpose of the present study was to evaluate the feasibility of applying the advanced lung cancer inflammation index (ALI) in patients with coronavirus disease 2019 (COVID-19) and to establish a combined ALI and radiologic risk prediction model for disease exacerbation. The present study included patients diagnosed with COVID-19 infection in our single institution from March to October 2020. Patients without clinical information and/or chest computed tomography (CT) upon admission were excluded. A radiologist assessed the CT severity score and abnormality on chest radiograph. The combined ALI and radiologic risk prediction model was developed via random forest classification. Among 79 patients (age, 43±19 years; male/female, 45:34), 72 experienced improvement and seven patients experienced exacerbation after admission. Significant differences were observed between the improved and exacerbated groups in the ALI (median, 47.6 vs. 13.2; P=0.011), frequency of chest radiograph abnormality (24.7 vs. 83.3%; P<0.001), and chest CT score (CCTS; median, 1 vs. 9; P<0.001). For the accuracy of predicting exacerbation, the receiver-operating characteristic curve analysis demonstrated an area under the curve of 0.79 and 0.92 for the ALI and CCTS, respectively. The combined ALI and radiologic risk prediction model had a sensitivity of 1.00 and a specificity of 0.81. Overall, ALI alone and CCTS alone modestly predicted the exacerbation of COVID-19, and the combined ALI and radiologic risk prediction model exhibited decent sensitivity and specificity., Competing Interests: The authors declare that they have no competing interests., (Copyright: © Inoue et al.)

Objectives: To compare the clinical usefulness among three different semiquantitative computed tomography (CT) severity scoring systems for coronavirus disease 2019 (COVID-19) pneumonia., Methods: Two radiologists independently reviewed chest CT images in 108 patients to rate three CT scoring systems (total CT score [TSS], chest CT score [CCTS], and CT severity score [CTSS]). We made a minor modification to CTSS. Quantitative dense area ratio (QDAR: the ratio of lung involvement to lung parenchyma) was calculated using the U-net model. Clinical severity at admission was classified as severe (n = 14) or mild (n = 94). Interobserver agreement, interpretation time, and degree of correlation with clinical severity as well as QDAR were evaluated., Results: Interobserver agreement was excellent (intraclass correlation coefficient: 0.952-0.970, p < 0.001). Mean interpretation time was significantly longer in CTSS (48.9-80.0 s) than in TSS (25.7-41.7 s, p < 0.001) and CCTS (27.7-39.5 s, p < 0.001). Area under the curve for differentiating clinical severity at admission was 0.855-0.842 in TSS, 0.853-0.850 in CCTS, and 0.853-0.836 in CTSS. All scoring systems correlated with QDAR in the order of CCTS (ρ = 0.443-0.448), TSS (ρ = 0.435-0.437), and CTSS (ρ = 0.415-0.426)., Conclusions: All semiquantitative scoring systems demonstrated substantial diagnostic performance for clinical severity at admission with excellent interobserver agreement. Interpretation time was significantly shorter in TSS and CCTS than in CTSS. The correlation between the scoring system and QDAR was highest in CCTS, followed by TSS and CTSS. CCTS appeared to be the most appropriate CT scoring system for clinical practice., Key Points: • Three semiquantitative scoring systems demonstrate substantial accuracy (area under the curve: 0.836-0.855) for diagnosing clinical severity at admission and (area under the curve: 0.786-0.802) for risk of developing critical illness. • Total CT score (TSS) and chest CT score (CCTS) were considered to be more appropriate in terms of clinical usefulness as compared with CT severity score (CTSS), given the shorter interpretation time in TSS and CCTS, and the lowest correlation with quantitative dense area ratio in CTSS. • CCTS is assumed to distinguish subtle from mild lung involvement better than TSS by adopting a 5% threshold in scoring the degree of severity., (© 2022. The Author(s), under exclusive licence to European Society of Radiology.)