Some conceptualizations of attachment imply an instinctual behavior that occurs naturally. Mothers who endorse this view are at greater risk for psychological stress, depression, and harsh parenting ...styles if they do not feel an immediate bond with their infant postpartum. The purpose of this study is to explore actual experiences of attachment from the perspective of young mothers (N = 75, Mage = 19.45 years) and based on these findings the extent to which there is empirical support for a maternal instinct. Mothers were interviewed at home three times (2 weeks, four months, and seven months postpartum), and interviews were thematically analyzed using an open coding method. Three broad themes and six sub-themes emerged: 1) experiences with the immediacy of attachment at birth are diverse (traumatic birth experience, sense of a maternal identity), 2) contextual factors on the bonding experience (physical touch-based caretaking, parenting stress and depression), and 3) time spent parenting influences attachment (reciprocity, parental confidence/knowledge). In conclusion, we could not find empirical evidence to support an innate maternal instinct. Despite diverse experiences with felt attachment at birth, all mothers perceived that the mother-infant connection was influenced by contextual factors after birth and was strengthened over time with more care-taking experience. This suggests that mothers likely developed a “maternal instinct” through repetitive interaction with their infant as the primary caretaker rather than a genetic predisposition to be superior nurturing parents.
•We did not find empirical evidence to support an innate maternal instinct.•Young mothers' qualitative experiences with attachment at birth were diverse.•Physical touch-based parenting and parental stress impacted the bonding experience.•Reciprocity and parenting confidence/knowledge strengthened attachment over time.•Mothers developed an “instinct” through repetitive interactions with their infant.
Magnetic target tracking is a low-cost, portable, and passive method for tracking materials wherein magnets are physically attached or embedded without the need for line of sight. Traditional magnet ...tracking techniques use optimization algorithms to determine the positions and orientations of permanent magnets from magnetic field measurements. However, such techniques are constrained by high latencies, primarily due to the numerical calculation of the gradient. In this study, we derive the analytic gradient for multiple-magnet tracking and show a dramatic reduction in tracking latency. We design a physical system comprising an array of magnetometers and one or more spherical magnets. To validate the performance of our tracking algorithm, we compare the magnet tracking estimates with state-of-the-art motion capture measurements for each of four distinct magnet sizes. We find comparable position and orientation errors to state-of-the-art magnet tracking, but demonstrate increased maximum bandwidths of 336%, 525%, 635%, and 773% for the simultaneous tracking of 1, 2, 3, and 4 magnets, respectively. We further show that it is possible to extend the analytic gradient to account for disturbance fields, and we demonstrate the simultaneous tracking of 1 to 4 magnets with disturbance compensation. These findings extend the use of magnetic target tracking to high-speed, real-time applications requiring the tracking of one or more targets without the constraint of a fixed magnetometer array. This advancement enables applications such as low-latency augmented and virtual reality interaction, volitional or reflexive control of prostheses and exoskeletons, and simplified multi-degree-of-freedom magnetic levitation.
Occupational hazards pose varying threats to the joint replacement surgeon. Musculoskeletal pain due to the repetitive nature of performing joint arthroplasty is felt daily by most surgeons. The ...purpose of this paper is to offer a basic introduction and demonstrate the many ways technology utilized during total joint arthroplasty can help mitigate common occupational hazards for the arthroplasty surgeon. This paper guides readers through the evolution and drivers behind technology in joint arthroplasty, describes several technologies currently available, and discusses how certain aspects of this technology may work to improve surgeon and patient outcomes. We review how advanced technologies in arthroplasty may reduce physical and mental demand, improve reproducibility, and decrease complications. The decision to utilize advanced technology in joint arthroplasty is ultimately made on an individual level after careful consideration of available literature.
Genome engineering of bacteriophages provides opportunities for precise genetic dissection and for numerous phage applications including therapy. However, few methods are available for facile ...construction of unmarked precise deletions, insertions, gene replacements and point mutations in bacteriophages for most bacterial hosts. Here we describe CRISPY-BRED and CRISPY-BRIP, methods for efficient and precise engineering of phages in Mycobacterium species, with applicability to phages of a variety of other hosts. This recombineering approach uses phage-derived recombination proteins and Streptococcus thermophilus CRISPR-Cas9.
To characterize the prevalence of withdrawal of life-sustaining treatment, as well as the time to awakening, short-term neurologic outcomes, and cause of death in comatose survivors of ...out-of-hospital resuscitated cardiopulmonary arrests treated with therapeutic hypothermia.
Single center, prospective observational cohort study of consecutive patients with out-of-hospital cardiopulmonary arrests.
Academic tertiary care hospital and level one trauma center in Minneapolis, MN.
Adults with witnessed, nontraumatic, out-of-hospital cardiopulmonary arrests regardless of initial electrocardiographic rhythm with return of spontaneous circulation who were admitted to an ICU.
None.
The study cohort included 154 comatose survivors of witnessed out-of-hospital cardiopulmonary arrests who were admitted to an ICU during the 54-month study period. One hundred eighteen patients (77%) were treated with therapeutic hypothermia. The mean age was 59 years, 104 (68%) were men, and 83 (54%) had an initial rhythm of ventricular tachycardia or fibrillation. Only eight of all 78 patients (10%) who died qualified as brain dead; and 81% of all patients (63 of 78) who died did so after withdrawal of life-sustaining treatment. Twenty of 56 comatose survivors (32%) treated with hypothermia who awoke (as defined by Glasgow Motor Score of 6) and had good neurologic outcomes (defined as Cerebral Performance Category 1-2) did so after 72 hours.
Our study supports delaying prognostication and withdrawal of life-sustaining treatment to beyond 72 hours in cases treated with therapeutic hypothermia. Larger multicenter prospective studies are needed to better define the most appropriate time frame for prognostication in comatose cardiac arrest survivors treated with therapeutic hypothermia. These data are also consistent with the notion that a majority of out-of-hospital cardiopulmonary arrest survivors die after a decision to withdrawal of life-sustaining treatment and that very few of these survivors progress to brain death.
Mycobacterium abscessus infections are relatively common in patients with cystic fibrosis and are clinically challenging, with frequent intrinsic resistance to antibiotics. Therapeutic treatment with ...bacteriophages offers some promise but faces many challenges including substantial variation in phage susceptibilities among clinical isolates, and the need to personalize therapies for individual patients. Many strains are not susceptible to any phages or are not efficiently killed by lytic phages, including all smooth colony morphotype strains tested to-date. Here, we analyze a set of new M. abscessus isolates for the genomic relationships, prophage content, spontaneous phage release, and phage susceptibilities. We find that prophages are common in these M. abscessus genomes, but some have unusual arrangements, including tandemly integrated prophages, internal duplications, and they participate in active exchange of polymorphic toxin-immunity cassettes secreted by ESX systems. Relatively few strains are efficiently infected by any mycobacteriophages, and the infection patterns do not reflect the overall phylogenetic relationships of the strains. Characterization of these strains and their phage susceptibility profiles will help to advance the broader application of phage therapies for NTM infections.
is an opportunistic pathogen whose treatment is confounded by widespread multidrug resistance. The therapeutic use of bacteriophages against
infections offers a potential alternative approach, ...although the spectrum of phage susceptibilities among
isolates is not known. We determined the phage infection profiles of 82
recent clinical isolates and find that colony morphotype-rough or smooth-is a key indicator of phage susceptibility. None of the smooth strains are efficiently killed by any phages, whereas 80% of rough strains are infected and efficiently killed by at least one phage. The repertoire of phages available for potential therapy of rough morphotype infections includes those with relatively broad host ranges, host range mutants of
phages, and lytically propagated viruses derived from integrated prophages. The rough colony morphotype results from indels in the glycopeptidolipid synthesis genes
and
, negating reversion to smooth as a common route to phage resistance. Resistance is thus rare, and although mutations in polyketide synthesis,
, and
can confer resistance, these likely also impair survival
The expanded therapeutic repertoire and the resistance profiles show that small cocktails or single phages could be suitable for controlling infections with rough strains.
infections in cystic fibrosis patients are challenging to treat due to widespread antibiotic resistance. The therapeutic use of lytic bacteriophages presents a new potential strategy, but the great variation among clinical
isolates demands determination of phage susceptibility prior to therapy. Elucidation of the variation in phage infection and factors determining it, expansion of the suite of therapeutic phage candidates, and a greater understanding of phage resistance mechanisms substantially advances the potential for broad implementation of new therapeutic options for
infections.
is an emerging pathogen that is often refractory to antibiotic control. Treatment is further complicated by considerable variation among clinical isolates in both their genetic constitution and their ...clinical manifestations. Here, we show that the prophage and plasmid mobilome is a likely contributor to this variation. Prophages and plasmids are common, abundant, and highly diverse, and code for large repertoires of genes influencing virulence, antibiotic susceptibility, and defense against viral infection. At least 85% of the strains we describe carry one or more prophages, representing at least 17 distinct and diverse sequence "clusters," integrated at 18 different
locations. The prophages code for 19 distinct configurations of polymorphic toxin and toxin-immunity systems, each with WXG-100 motifs for export through type VII secretion systems. These are located adjacent to attachment junctions, are lysogenically expressed, and are implicated in promoting growth in infected host cells. Although the plethora of prophages and plasmids confounds the understanding of
pathogenicity, they also provide an abundance of tools for
engineering.
is an important emerging pathogen that is challenging to treat with current antibiotic regimens. There is substantial genomic variation in
clinical isolates, but little is known about how this influences pathogenicity and
growth. Much of the genomic variation is likely due to the large and varied mobilome, especially a large and diverse array of prophages and plasmids. The prophages are unrelated to previously characterized phages of mycobacteria and code for a diverse array of genes implicated in both viral defense and
growth. Prophage-encoded polymorphic toxin proteins secreted via the type VII secretion system are common and highly varied and likely contribute to strain-specific pathogenesis.
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