Utilizing ChatGPT to assist CAD design for microfluidic devices.

ChatGPT is a generative AI model that has garnered tremendous public interest due to its ability to solve diverse problems through high-level reasoning and analysis. Among its features is an ability to create and debug code. While this capability has been explored with conventional programming languages such as Python, it has yet to be applied to computer-aided design (CAD). In this work, we utilized GPT-4 to create functional microfluidic components using OpenSCAD, an open-source CAD software package. Through an iterative dialogue, GPT-4 created functional designs for a helix/spiral, a valve, a t-junction, and a serpentine channel. This concept could facilitate CAD in the future for both technical and non-technical users and can be reasonably extended to other fields.

Strategies to Address COVID-19 Vaccine Hesitancy Among Ohio Nursing Home Staff.

BACKGROUND AND OBJECTIVES: Despite federal legislation requiring nursing home (NH) staff members to be vaccinated against coronavirus disease 2019 (COVID-19), unvaccinated staff pose an ongoing public health risk. The research question guiding this study is as follows: What is the relationship between strategies to address vaccine hesitancy and vaccination rates among staff? We used the diffusion of innovation (DOI) theory as a theoretical framework. RESEARCH DESIGN AND METHODS: The sample (N = 627) included Ohio-based NHs. Using national and state NH data, multivariable linear regression techniques demonstrated the relationship between strategies to address vaccine hesitancy and vaccination rates among NH staff. RESULTS: Peer counseling and providing sick time or time off for vaccine symptoms were both statistically significant strategies. Compared to facilities that did not engage in peer counseling, those that did saw an average increase of 3.2% of their staff vaccinated. Those that provided sick time or time off saw an average increase of 3.9% of their staff vaccinated. There was no statistically significant relationship between hiring full- or part-time facility infection preventionists and vaccination rates. DISCUSSION AND IMPLICATIONS: In order to foster vaccine confidence among long-term services staff, peer counseling, and providing sick time or time off are examples of strategies that can affect vaccination rates among staff. According to DOI, these strategies target the communication channels and social systems of an organization. While this study focuses on NHs, results remain critically important to the remainder of the long-term services system, which does not have vaccine requirements similar to the NH industry.

Exploring the Criterion Validity of Pragmatic Person-Centered Care/Culture Change Measures.

BACKGROUND: Nursing homes (NHs) are required to provide person-centered care, efforts often folded into broader culture change initiatives. Despite the known benefits of culture change, it is difficult to measure. This study aims to assess the criterion validity of the Preferences for Everyday Living Inventory (PELI) Implementation Indicator with other culture change measures. METHODS: Using data from Ohio-based NHs (n = 771), logistic regression techniques demonstrated the relationship between the PELI Implementation Indicator and two validated culture change measures, the Resident Preferences for Care (RPC) and Certified Nursing Assistant (CNA) Empowerment scales. RESULTS: There was a significant relationship between the two scales and complete PELI implementation holding all other variables constant. The RPC and CNA Empowerment scales were significantly associated with complete PELI implementation. DISCUSSION: Findings suggest that the PELI Implementation Indicator can be used as a pragmatic indicator of a community's adoption of person-centered care and culture change.

The Influence of Kin Proximity on the Reproductive Success of American Couples, 1900-1910.

Children require a large amount of time, effort, and resources to raise. Physical help, financial contributions, medical care, and other types of assistance from kin and social network members allow couples to space births closer together while maintaining or increasing child survival. We examine the impact of kin availability on couples' reproductive success in the early twentieth-century United States with a panel data set of over 3.1 million couples linked between the 1900 and 1910 U.S. censuses. Our results indicate that kin proximity outside the household was positively associated with fertility, child survival, and net reproduction, and suggest that declining kin availability was an important contributing factor to the fertility transition in the United States. We also find important differences between maternal and paternal kin inside the household-including higher fertility among women residing with their mother-in-law than among those residing with their mother-that support hypotheses related to the contrasting motivations and concerns of parents and parents-in-law.

The Decline of Patrilineal Kin Propinquity in the United States, 1790-1940.

BACKGROUND: Historical change in the availability of kin beyond the household has long interested scholars, but there has been little comparable evidence on long-run change. While generally accepted that individuals lived near kin historically, no systematic measures have been available to assess historical kin propinquity at the national level. METHODS: With the release of historical complete count United States census data from the Integrated Public Use Microdata Series (IPUMS), a robust estimate of patrilineal kin propinquity for the United States nationally from 1790 to 1940 is calculated. Defined as the probability of non-random isonymy within an enumeration district, the estimate of patrilineal kin propinquity relies on the sequential ordering of households in the census. RESULTS: The United States experienced a long-run decline in patrilineal kin propinquity from nearly 50% of households in 1790 to 17% of households in 1940. The age patterns of kin propinquity show substantial variation across the life course, and regional differences demonstrate the impact of economic and demographic conditions. The decline in kin propinquity reflected urbanization and the decline of agriculture, declining kin availability, growing distance between potential kin links, and a change in preferences of living near kin. CONTRIBUTION: This is the first study to produce a systematic estimate of patrilineal kin propinquity at the national level for the United States between 1790 and 1940. Researchers can use this meaningful measure of patrilineal kin propinquity to better explain its relationships with other demographic behaviors and outcomes such as fertility, mortality, and migration choices.

Select and resequence reveals relative fitness of bacteria in symbiotic and free-living environments.

Assays to accurately estimate relative fitness of bacteria growing in multistrain communities can advance our understanding of how selection shapes diversity within a lineage. Here, we present a variant of the "evolve and resequence" approach both to estimate relative fitness and to identify genetic variants responsible for fitness variation of symbiotic bacteria in free-living and host environments. We demonstrate the utility of this approach by characterizing selection by two plant hosts and in two free-living environments (sterilized soil and liquid media) acting on synthetic communities of the facultatively symbiotic bacterium Ensifer meliloti We find (i) selection that hosts exert on rhizobial communities depends on competition among strains, (ii) selection is stronger inside hosts than in either free-living environment, and (iii) a positive host-dependent relationship between relative strain fitness in multistrain communities and host benefits provided by strains in single-strain experiments. The greatest changes in allele frequencies in response to plant hosts are in genes associated with motility, regulation of nitrogen fixation, and host/rhizobia signaling. The approach we present provides a powerful complement to experimental evolution and forward genetic screens for characterizing selection in bacterial populations, identifying gene function, and surveying the functional importance of naturally occurring genomic variation.

Multiyear surveillance for avian influenza virus in waterfowl from wintering grounds, Texas coast, USA.

We studied the prevalence of influenza A virus in wintering waterfowl from the Central Flyway on the Gulf Coast of Texas. Of 5,363 hunter-harvested migratory and resident waterfowl and wetland-associated game birds sampled during 3 consecutive hunting seasons (September-January 2006-07, 2007-08, and 2008-09), real-time reverse transcription-PCR detected influenza A matrix sequences in 8.5% of samples, H5 in 0.7%, and H7 in 0.6%. Virus isolation yielded 134 influenza A viruses, including N1-N9, H1-H7, H10, and H11 subtypes. Low-pathogenicity H7 subtype was isolated during January, September, and November 2007 and January 2008; low-pathogenicity H5 subtype was isolated during November and December 2007.

Comparison of real-time reverse transcription-PCR and virus isolation for estimating prevalence of avian influenza virus in hunter-harvested wild birds at waterfowl wintering grounds along the Texas mid-Gulf Coast (2005-2006 through 2008-2009).

Historically, virus isolation has been the method of choice for conducting surveillance for avian influenza virus (AIV) in avian species. More recently, the primary screening method has become real-time reverse transcription-polymerase chain reaction (RRT-PCR). We wanted to determine how these two testing methods (virus isolation and RRT-PCR) affected AIV prevalence estimation, particularly in an understudied, low-prevalence region-the waterfowl wintering grounds along the Texas mid-Gulf Coast. Cloacal swabs were collected from hunter-harvested waterfowl and other wetland-associated game birds during four consecutive hunting seasons (2005-2006 through 2008-2009). Overall prevalence by RRT-PCR (5.9%, 6.5%, 11.2%, and 5.5%) was approximately an order of magnitude higher than prevalence by virus isolation (0.5%, 1.3%, 3.9%, and 0.7%) for the four hunting seasons, respectively. Apparent AIV prevalence by virus isolation conducted only on RRT-PCR-positive samples resulted in estimates nearly identical in magnitude to those derived from parallel testing (0.5% vs. 0.6%, 1.3% vs. 1.7%, and 3.9% vs. 4.0% for 2005-2006, 2006-2007, and 2007-2008, respectively). Unlike most reports of seasonal variation in AIV prevalence, we documented differences in prevalence estimates among months by RRT-PCR only during 2008-2009 and by virus isolation only during 2006-2007 and 2007-2008. Our data indicate that screening samples by RRT-PCR followed by virus isolation only on RRT-PCR-positive samples provides a reasonable means to generate prevalence estimates close to the true prevalence as determined by virus isolation. We also confirmed the low prevalence of AIV in waterfowl wintering grounds along the Texas mid-Gulf Coast and demonstrated little variation in prevalence among months during the four hunting seasons sampled.

A case of traumatic tricuspid valve regurgitation caused by blunt chest trauma.

A case of severe tricuspid valve regurgitation caused by ruptured chordae tendineae secondary to blunt chest trauma from a motor vehicle accident is described. A transthoracic echocardiogram did not demonstrate these findings, which were clearly visualized on a transesophageal echocardiogram. We propose that patients with blunt chest trauma be considered for transesophageal echocardiography (unless surface images are of high quality) to evaluate not only the tricuspid valve apparatus but to examine other cardiac structures as early (ie, presymptomatic) treatment is preferable.

Loss of a gimap/ian gene leads to activation of NF-kappaB through a MAPK-dependent pathway.

The diabetes-prone biobreeding (BB-DP) rat contains the lyp mutation which results in lymphopenia and promotes the progression of a T cell-mediated autoimmune attack of the pancreas in certain rat strains. This mutation has been mapped to a gene which bears homology to human Gimap5/Ian5 and results in the truncation and loss of activity of this protein. The lymphopenic state induced by the loss of this protein has led to the proposal that Gimap5 has an anti-apoptotic function. Previously we described an additional phenotype of incomplete activation mediated by the loss of Gimap5 function. Here we further characterize this incomplete activation phenotype and map a potential signal transduction pathway leading to activation. We show that CD5 expression on peripheral T cells is elevated in Gimap5 animals, while thymocyte expression remains similar between the two strains. Additionally, we show that NF-kappaB but not NFAT is activated in unstimulated Gimap5 mutant T cells as compared to unstimulated wild type T cells. Mapping this activation to its upstream source we show that activation of NF-kappaB is correlated with an activation of IKK. Using a variety of kinase inhibitors we further map this increase in IKK to an increase in MEK activation. Finally, to counter the possibility that activation is an indirect consequence of the lymphopenic environment, we created bone marrow chimeras in which Gimap5 mutant T cells developed in a normal environment and show that these cells retain their activated phenotype. Together, we interpret these data as demonstrating that the activation caused by loss of Gimap5 is a cell intrinsic phenomenon caused, in part, by a MEK-dependent activation of IKK. This, in turn, would suggest that Gimap5 functions to promote both T cell survival and quiescence and that these pathways are biochemically linked.

Estrogen restores cognition and cholinergic phenotype in an animal model of Down syndrome.

Estrogen maintains normal function of basal forebrain (BF) cholinergic neurons and estrogen replacement therapy (ERT) has therefore been proposed as a therapy for Alzheimer's disease (AD). We provide evidence to support this hypothesis in an animal model of Down syndrome (DS), a chromosome 16 segmental trisomy (Ts65Dn) mouse. These mice develop cholinergic degeneration similar to young adults with DS and AD patients. ERT has not been tested in women with DS, even though they are more likely than normosomic women to develop early menopause and AD. Female Ts65Dn and normosomic mice (11-15 months) received a subcutaneous estrogen pellet or a sham operation. After 60 days, estrogen treatment improved learning of a T-maze task and normalized behavior in the Ts65Dn mice in reversal learning of the task, a measure of cognitive flexibility. Stereological evaluation of choline acetyltransferase (ChAT) immunopositive BF neurons showed that estrogen increased cell size and total number of cholinergic neurons in the medial septum of Ts65Dn mice. In addition, estrogen increased NGF protein levels in the BF of trisomic mice. These findings support the emerging hypothesis that estrogen may play a protective role during neurodegeneration and cognitive decline, particularly in cholinergic BF neuronal systems underlying cognition. The findings also indicate that estrogen may act, at least partially, via endogenous growth factors. Collectively, the data suggest that ERT may be a viable therapeutic approach for women with DS coupled with dementia.

Strategic planning: looking beyond the next move.

Effective strategic planning can help healthcare organizations better plan for the future and understand when change is needed. Strategic planning is a dynamic process. Unified communication throughout the organization is necessary. Progress should be tracked with quantifiable goals.

Expression of the stress proteins, ubiquitin, heat shock protein 72, and myofibrillar protein content after 12 weeks of leg cycling in persons with spinal cord injury.

OBJECTIVE: To determine the effects of leg cycling exercise on ubiquitin (UBI), heat shock protein 72 (HSP-72) mRNA, protein expression, and myofibrillar protein content in individuals with spinal cord injury (SCI). DESIGN: Case series. SETTING: Motor behavior laboratory. PARTICIPANTS: Seven subjects with motor-complete SCI (4 men, 3 women). INTERVENTION: A 12-week exercise program involving an electromagnetically braked recumbent bicycle ergometer, which allowed for passive exercise of the legs. Training occurred 2 days a week at approximately 75% of each subject's maximum heart rate. MAIN OUTCOME MEASURES: Total body mass (TBM) and muscle biopsies were obtained pre- and posttraining. The mRNA and protein expression of UBI, HSP-72, and myofibrillar protein content were determined. RESULTS: Nonsignificant increases (P > .05) of 2.45% were observed for TBM. There were significant increases (P < .05) in the expression of both HSP-72 mRNA (33.71%) and protein (30.23%). For UBI, there were also significant decreases (P < .05) in the expression of both mRNA (26.86%) and protein (69.43%). Myofibrillar protein content increased significantly (P < .05, 41.86%). CONCLUSION: Leg cycling exercise in SCI increases myofibrillar protein content, possibly because of up-regulation in the expression of HSP-72 with concomitant down-regulation in the expression of UBI.