bluuebunny/crossref_metadata_2025 huggingface dataset:
Anomalous crystalline ordering of particles in a viscoelastic fluid under high shear
Authors: Sun Sijie , Xue Nan , Aime Stefano , Kim Hyoungsoo , Tang Jizhou , McKinley Gareth H. , Stone Howard A. , Weitz David A.
Published: September 2023

Addition of particles to a viscoelastic suspension dramatically alters the properties of the mixture, particularly when it is sheared or otherwise processed. Shear-induced stretching of the polymers results in elastic stress that causes a substantial increase in measured viscosity with increasing shear, and an attractive interaction between particles, leading to their chaining. At even higher shear rates, the flow becomes unstable, even in the absence of particles. This instability makes it very difficult to determine the properties of a particle suspension. Here, we use a fully immersed parallel plate geometry to measure the high-shear-rate behavior of a suspension of particles in a viscoelastic fluid. We find an unexpected separation of the particles within the suspension resulting in the formation of a layer of particles in the center of the cell. Remarkably, monodisperse particles form a crystalline layer which dramatically alters the shear instability. By combining measurements of the velocity field and torque fluctuations, we show that this solid layer disrupts the flow instability and introduces a single-frequency component to the torque fluctuations that reflects a dominant velocity pattern in the flow. These results highlight the interplay between particles and a suspending viscoelastic fluid at very high shear rates.
“There is new technology here that can perform miracles”
Authors: Nielsen Søren Beck
Published: September 2023

This paper puts the spotlight on the discursive practices by which politicians, interest group representatives,
and other influential public figures in effect promote climate inaction by conveying confidence in technological innovation. Data
consist of policy debates on prominent public service television in Denmark. The study uses Discursive Psychology to examine how
references to technological innovation are: (i) sequentially invoked as the solution to problematization of policies that allow
high levels of emissions; (ii) grammatically designed to highlight the force of technological innovation; and (iii) rhetorically
produced to support a subjective contrast between a pessimist and an optimist outlook. Overall, the study finds that invocation of
technological optimism constitutes a ‘ready answer’ to communicative challenges that emerge during the debates, which effectively
justifies inaction.
Writing process studies. Struggling with complexities
Authors: Rijlaarsdam Gert , Van Steendam Elke , van Weijen Daphne
Published: September 2023

This chapter discusses validity parameters for studies on
writing processes in a second or foreign language (L2). To that end, Cook
and Campbell’s validity framework, which discerns four types of validity,
i.e., statistical, internal, construct and external validity, has been used.
The chapter especially hones in on construct validity by combining a
case-based approach, based on a selection of frequently cited
L2-writing process studies, with a comprehensive causal model often used for
analyzing writing process studies (in terms of four components, Process –
Task – Learner – Output). We suggest seven functional and directional
parameters to discuss the construct of the writing process as intended
against the construct as studied, and propose a selective and non-exhaustive
list of guidelines for statistical and internal validity. Both parameters
and guidelines are provided to inform (the design of) future L2 writing
process studies.
Setting up a coding scheme for the analysis of the dynamics of children’s
engagement with written corrective feedback
Authors: Coyle Yvette
Published: September 2023

This chapter describes the development of a coding
scheme for the analysis of young English as a foreign language learners’
engagement with model texts. After outlining the theoretical rationale
underlying our analytical procedure, and the methodological problems we
experienced when attempting to apply constructs developed in research with
adults to a younger and less proficient group of learners, I go on to
explain the multiple steps involved in our process-product analysis. Careful
triangulation of different measures including the children’s written texts,
handwritten notes, and transcripts of their collaborative dialogue across
two multi-stage tasks, enabled us to identify a series of trajectories
involving diverse combinations of noticing, strategic problem-solving, and
degrees of uptake. The coding categories and methodological decisions are
illustrated with examples from the children’s data. Limitations in the
procedure are also highlighted.
Effect of sandwiched YbCl3 layer thickness on exciton dynamics of Yb3+ doped CsPbCl3 perovskite photodetectors
Authors: Mu Haichuan , Guo Qi , Wang Ruibin , Qian Min , Tang Jingjian
Published: September 2023

Yb3+ doped CsPbCl3 metal halide perovskite photodetectors (PDs) in the structure of CsPbCl3(50 nm)/YbCl3(x nm)/CsPbCl3(50 nm), in which x ranges from 10 to 40 nm corresponding to the molar ratio from 6.3% to 25.2%, are fabricated by thermal evaporation on Si/SiO2 substrate. Photoresponse from 350 to 980 nm have been achieved with the optimal responsivity (R) of 3959, 5425, 955 A W−1 for the case of 20 nm YbCl3 at the wavelength (λ) of 420, 680 and 980 nm, respectively. A series of photophysical and electrical characterization has been performed and it is found that the remarkably improved photoresponse originates from the combining effects of upconversion and defects passivation from Yb3+. Moreover, the optimal YbCl3 thickness of 20 nm can be ascribed to the balance between upconversion and concentration quenching of Yb3+. The influence of the YbCl3 doping on the CsPbCl3 electronic structure is investigated and downshifting and stabilization of valence band maximum (VBM) can be attributed to the p-type doping and counteracting effect of Yb3+ and Cl−, respectively.
Efficient plastic categorization for recycling and real-time annotated data collection with TensorFlow object detection model
Authors: Sundaralingam Sathiyapoobalan , Ramanathan Neela
Published: September 2023

Plastic waste management is the major global issue, and recycling has become a necessary solution to mitigate the impact of plastic waste on the environment. Recycling plastic can significantly reduce pollution by diverting plastic waste from landfills, where it can take hundreds of years to decompose and release harmful chemicals and greenhouse gases. Several systems developed for segregating the municipal solid waste, only few focused on categorizing plastic waste. To address these issues, a plastic waste detection system using TensorFlow pre-trained object detection and MobileNet V2 has been proposed. This work is mainly focused on plastic waste such as PET, HDPE, PVC, LDPE, PP and PS. The proposed system can detect plastic waste category in real time and store the detection information as annotation files in various formats such as json, Pascal voc, and txt. The model saves the detection matrix only when the confidence of prediction is greater than threshold value. This data can be used for fine tuning the model as well as training the new model. To validate the dataset generated by the object detection model, a sample of 54 images annotated by the model is used to train the new model and to ensure that the model is learning from dataset. Furthermore, the proposed system promotes recycling, contributing to the reduction of environmental pollution.
Stable phase retrieval and perturbations of frames
Authors: Alharbi Wedad , Freeman Daniel , Ghoreishi Dorsa , Lois Claire , Sebastian Shanea
Published: September 2023

A frame

(

x
j

)

j
∈
J

(x_j)_{j\in J}

for a Hilbert space

H
H

is said to do phase retrieval if for all distinct vectors

x
,
y
∈
H

x,y\in H

the magnitudes of the frame coefficients

(

|

⟨
x
,

x
j

⟩

|

)

j
∈
J

(|\langle x, x_j\rangle |)_{j\in J}

and

(

|

⟨
y
,

x
j

⟩

|

)

j
∈
J

(|\langle y, x_j\rangle |)_{j\in J}

distinguish

x
x

from

y
y

(up to a unimodular scalar). A frame which does phase retrieval is said to do

C
C

-stable phase retrieval if the recovery of any vector

x
∈
H

x\in H

from the magnitude of the frame coefficients is

C
C

-Lipschitz. It is known that if a frame does stable phase retrieval then any sufficiently small perturbation of the frame vectors will do stable phase retrieval, though with a slightly worse stability constant. We provide new quantitative bounds on how the stability constant for phase retrieval is affected by a small perturbation of the frame vectors. These bounds are significant in that they are independent of the dimension of the Hilbert space and the number of vectors in the frame.
Potassium and Hypertension: A State-of-the-Art Review
Authors: Sriperumbuduri Sriram , Welling Paul , Ruzicka Marcel , Hundemer Gregory L , Hiremath Swapnil
Published: September 2023

Hypertension is the single most important and modifiable risk factor for cardiovascular morbidity and mortality worldwide. Non pharmacologic interventions, in particular dietary modifications have been established to decrease blood pressure (BP) and hypertension related adverse cardiovascular events. Among those dietary modifications, sodium intake restriction dominates guidelines from professional organizations and has garnered the greatest attention from the mainstream media. Despite guidelines and media exhortations, dietary sodium intake globally has not noticeably changed over recent decades. Meanwhile, increasing dietary potassium intake has remained on the sidelines, despite similar BP-lowering effects. New research reveals a potential mechanism of action, with the elucidation of its effect on natriuresis via the potassium switch effect. Additionally, potassium-substituted salt has been shown to not only reduce BP, but also reduce the risk for stroke and cardiovascular mortality. With these data, we argue that the focus on dietary modification should shift from a sodium-focused to a sodium- and potassium-focused approach with an emphasis on intervention strategies which can easily be implemented into clinical practice.
The Shifting Labour Process in Professional Care: Recreating Dominance and the Managerialised Mental Health Social Worker
Authors: Baines Donna , Brown Catrina , Cabahug Francis
Published: September 2023

Though the rationalisation of health care has been well documented, less is known about its impacts on mental health social workers. Drawing on qualitative data collected from 120 interviews and the qualitative comments on a Canadian four-province survey, the article explores the shifting labour process through profession-linked and organisational care strategies. The article argues that power is shifted from mental health social workers to management through stratagems including managerialism, biomedical hegemony and team-based care. These processes are complex and dynamic, travelling along professional divisions and logics, appearing neutral and scientific rather than as conduits reinforcing neoliberalised approaches to health care provision. Social workers’ resistance to these models of care is similarly complex and professionally based, though with strong elements of gendered altruism and social justice themes. Though this article draws on Canadian data, the analysis is likely highly applicable to other managerialised contexts including the UK. The article contributes to the intersection of Labour Process Theory and moral economy theory by highlighting the operation of a unique form of engagement referred to here as resistance-as-engagement. Overall, mental health social workers revealed strong oppositional narratives and identities pivoting on their marginalised position within team-based care, medical professional hierarchies and narrow, neoliberal approaches.
Sensitivity of shear wave splitting to fracture connectivity
Authors: He Yanbin , Rubino J Germán , Barbosa Nicolás D , Solazzi Santiago G , Favino Marco , Chen Tianning , Gao Jinghuai , Holliger Klaus
Published: September 2023

Shear wave splitting (SWS) is currently considered to be the most robust seismic attribute to characterize fractures in geological formations. Despite its importance, the influence of fluid pressure communication between connected fractures on SWS remains largely unexplored. Using a 3-D numerical upscaling procedure based on the theory of poroelasticity, we show that fracture connectivity has a significant impact on SWS magnitude and can produce a 90° rotation in the polarization of the fast quasi-shear wave. The simulations also indicate that SWS can become insensitive to the type of fluid located within connected fractures. These effects are due to changes of fracture compliance in response to wave-induced fluid pressure diffusion. Our results improve the understanding of SWS in fractured formations and have important implications for the detection and monitoring of fracture connectivity in hydrocarbon and geothermal reservoirs as well as for the use of SWS as a forecasting tool for earthquakes and volcanic eruptions.
Interseismic slip rate and fault geometry along the northwest Himalaya
Authors: Sharma Yogendra , Pasari Sumanta , Ching Kuo-En , Verma Himanshu , Kato Teruyuki , Dikshit Onkar
Published: September 2023

Geodetic networks enable us to investigate interseismic crustal deformation along the northwest Himalaya. Using 144 GNSS surface velocities and a Bayesian inversion model, we estimate the slip rate and fault geometry of the Main Himalayan Thrust (MHT) along six arc-normal transects in the northwest Himalaya. We consider that the fault plane consists of three sections along the décollement, namely the locking zone (0−12 km), the transition zone (10−22 km) and the creeping zone (≥22 km). The MHT is found to be completely locked from the surface down to an average depth of 6 ± 2 km. The locking-to-creeping transition zone along the décollement extends from the edge of the fully locked area to a deeper depth (14 ± 3 km) to the tip of the creeping zone of the MHT (17 ± 2 km) with a slip rate of 1.6 ± 0.9 to 3.7 ± 1.1 mm yr−1. Considering the range of uncertainties between 1−2 mm yr−1 for the GNSS velocities, the inverted slip rate along the transition zone of MHT turns out to be insignificant. Thus, the locking zone along the northwest Himalaya extends from the MFT to ∼111 ± 6 km in the north with a locking depth of ∼17 ± 2 km. The deeper part of the MHT is inferred to be creeping with an average slip rate of ∼19.1 ± 1.9 mm yr−1 along the northwest Himalaya. In addition, we have also illustrated a splay-fault model to account for the fault kinematics along the splay faults and the main décollement. The splay-fault model indicates a distributed slip rate at the locking-to-creeping transition zone and about ∼15 per cent smaller slip rate of the MHT than that of the single-fault model. Further, the checkerboard test and the uniform slip model exhibit the reliability of the current GNSS network and the inversion model (single- and splay-fault models). Overall, the updated fault kinematics inevitably contribute to the improvement of seismic hazard evaluation along the northwest Himalaya.
ELP3 stabilizes c-Myc to promote tumorigenesis
Authors: Zhao Wentao , Ouyang Cong , Huang Chen , Zhang Jiaojiao , Xiao Qiao , Zhang Fengqiong , Wang Huihui , Lin Furong , Wang Jinyang , Wang Zhanxiang , Jiang Bin , Li Qinxi
Published: September 2023

ELP3, the catalytic subunit of the Elongator complex, is an acetyltransferase and associated with tumor progression. However, the detail of ELP3 oncogenic function remains largely unclear. Here, we found that ELP3 stabilizes c-Myc to promote tumorigenesis in an acetyltransferase-independent manner. Mechanistically, ELP3 competes with the E3-ligase FBXW7β for c-Myc binding, resulting in the inhibition of FBXW7β-mediated ubiquitination and proteasomal degradation of c-Myc. ELP3 knockdown diminishes glycolysis and glutaminolysis and dramatically retards cell proliferation and xenograft growth by downregulating c-Myc, and such effects are rescued by the reconstitution of c-Myc expression. Moreover, ELP3 and c-Myc were found overexpressed with a positive correlation in colorectal cancer and hepatocellular carcinoma. Taken together, we elucidate a new function of ELP3 in promoting tumorigenesis by stabilizing c-Myc, suggesting that inhibition of ELP3 is a potential strategy for treating c-Myc-driven carcinomas.
Moral Distress, Conscientious Practice, and the Endurance of Ethics in Health Care through Times of Crisis and Calm
Authors: Kaldjian Lauris Christopher
Published: September 2023

When health professionals experience moral distress during routine clinical practice, they are challenged to maintain integrity through conscientious practice guided by ethical principles and virtues that promote the dignity of all human beings who need care. Their integrity also needs preservation during a crisis like the COVID-19 pandemic, especially when faced with triage protocols that allocate scarce resources. Although a crisis may change our ability to provide life-saving treatment to all who need it, a crisis should not change the ethical values that should always be guiding clinical care. Enduring ethical commitments should encourage clinicians to base treatment decisions on the medical needs of individual patients. This approach contrasts with utilitarian attempts to maximize selected aggregate outcomes by using scoring systems that use short-term and possibly long-term prognostic estimates to discriminate between patients and thereby treat them unequally in terms of their eligibility for life-sustaining treatment. During times of crisis and calm, moral communication allows clinicians to exercise moral agency and advocate for their individual patients, thereby demonstrating conscientious practice and resisting influences that may contribute to compartmentalization, moral injury, and burnout.
Antinomies of Agency: Liberalism and Asia
Authors: Fujitani Takashi
Published: September 2023

This essay builds on Walter Johnson’s “On Agency” to reflect on how the concept of the liberal subject as agent has been understood in Euro-American and Japanese intellectual discourses on Asia and especially Japan. It begins with a discussion of “the subject” in Orientalism and Liberalism and its entanglements with historicist and imperialist understandings of a progressive “West” and laggard “East,” as well as the travels of Orientalist discourse from Europe to Asia. It then considers how postcolonial interventions as well as Foucault’s critique of the liberal subject have stimulated a rethinking of the self-constituting agent of choice and ends with thoughts on how a multiply spirited notion of the subject may offer suggestions for conceptualizing an alternative agent of action and social responsibility who refuses the self-importance of a singular subject.
Cardiac Tamponade
Authors: Andoniadis Matthew M.
Published: September 2023

Cardiac tamponade should be considered in any patient who suddenly complains of dyspnea and orthopnea accompanied by physical examination findings of hypotension, jugular venous distension (JVD), and muffled heart sounds, which is also known as Beck’s Triad. Tachycardia, altered mental status, and pulsus paradoxus frequently are associated signs of cardiac tamponade. Transthoracic echocardiography (TTE) will confirm the diagnosis by visualizing pericardial fluid and abnormal right ventricular diastolic wall motion. Emergent drainage in these patients is via a surgical pericardial window or echocardiographic catheter pericardiocentesis. The anesthetic management of a patient with cardiac tamponade physiology varies from being prepared for a hemodynamically unstable orthopneic patient who can only tolerate local anesthetic and vocal support to administering a full general anesthetic (GA) with the placement of a double-lumen endotracheal tube, one-lung ventilation, and transesophageal echocardiography (TEE) guidance to a loculated pericardial fluid collection. Determining which anesthetic plan will be required is accomplished by performing a timely and thorough preoperative evaluation and discussing the surgical and anesthetic management with the cardiovascular surgical attending.
Vascular Access
Authors: Le-Wendling Linda , Looper Jayme N. , Gu Lisa
Published: September 2023

Access to the venous system can be used for both drug delivery and volume resuscitation. Peripheral intravenous (PIV) access is the main route of drug delivery. Central venous line (CVL) access is indicated for delivery of vasoactive or caustic medications, large and rapid volume infusions, total parenteral nutrition, invasive monitoring (central venous pressures, pulmonary artery pressures), and certain procedures (extracorporeal membrane oxygenation, transvenous pacing, dialysis). Intraosseous access can be used when PIV access is difficult, especially in emergency situations such as cardiac arrest due to more rapid and successful access, though it is usually a temporary (usually <24 hour) modality. For PIV and CVL access, ultrasound can be used to visualize the target vein in real time as well as neighboring neurovascular structures to determine the optimal entry point and needle trajectory. Maintaining sterility is important. Visualizing the vessel in cross-section and advancing the needle in an out-of-plane approach is the simplest technique when using ultrasound. Local lidocaine infiltration can be used to increase patient comfort. Confirming venous, and not arterial or extravascular, placement is key in minimizing complications. Other complications include fluid extravasation, compartment syndrome, air embolism, hemo-/pneumothorax (with CVL), and infection.
Intraoperative Management of the Bleeding Patient
Authors: George Renuka M. , Francis Loren R.
Published: September 2023

A bleeding patient in the intraoperative setting can be complex to diagnose and manage. It is important for anesthesiologists to recognize signs and symptoms of bleeding, rule out differential diagnoses, and treat appropriately to optimize resuscitation. Ideal management starts in the preoperative setting with the goal of preparing the patient for surgery, followed by thorough evaluation and close monitoring on the day of surgery. Utilization of both invasive and noninvasive monitors provides information about the patient’s clinical picture in the intraoperative setting. In addition to traditional laboratory tests, newer point-of-care testing is available to efficiently diagnose complex coagulopathies. Perioperative management requires knowledge of commonly utilized blood products including packed red blood cells, fresh frozen plasma, platelets, and cryoprecipitate. The anesthesiologist must keep in mind the type of surgery, overall clinical picture, and laboratory results and understand that transfusion is not always the best answer.
Transfusion Reactions
Authors: Panjeton Geoffrey D. , Coons Alex , Looper Jayme N. , White Jeffrey D. F.
Published: September 2023

Blood product transfusions may be required during a variety of surgical procedures. Anesthesia providers must be vigilant and prepared to administer transfusion(s) of the correct blood components. Providers must be knowledgeable about the possible transfusion reactions that might subsequently occur, especially their various manifestations in the patient under general anesthesia. Providers must further be able to implement the necessary and appropriate treatment. The American Association of Blood Banks reported that in 2013 the rate of adverse reactions following blood product transfusion was 0.25%, or 2.5 per 1000 units transfused. Therefore, the likelihood that an anesthesia provider will encounter a perioperative blood transfusion reaction during their career is very high. This chapter provides the key concepts to formulate the correct diagnosis and treatment plan via an algorithmic approach to the various blood transfusion reactions.
Management of the Unstable Cervical Spine
Authors: White Peggy , Maxwell Christopher W.
Published: September 2023

Spinal cord injury can occur due to trauma or secondarily by maneuvering the pathologic spine. Damage can be exacerbated when manipulating the airway with intubating devices, as well as with bag-mask ventilation. Remain cautious, even when a cervical collar is in place, as the spinal cord integrity is still at risk. Despite decades of research on cervical column stability with the use of airway devices, there remains no clear evidence that supports the use of one device over the other. However, use of manual in-line stabilization has stood the test of time in rapidly providing safe intubating conditions. If time allows, a properly performed awake fiberoptic intubation is the preferred method if the patient is calm and cooperative. Myriad other injuries can be associated with traumatic cervical spine injuries. One must have comprehensive knowledge of these to predict complications and treat accordingly. If the integrity of the spinal cord is disrupted, neurogenic and spinal shock can be an acute threat to life.
Anesthetic Management of Morbidly Adherent Placenta (Accreta/Increta/Percreta)
Authors: Lopez Brandon M. , Cometa M. Anthony
Published: September 2023

Morbidly adherent placenta is a condition where the placenta attaches or invades into or through the uterus and does not normally detach from the uterus during childbirth. Morbidly adherent placenta is on the rise due to increased cesarean delivery rates and uterine instrumentation in the population. Abnormally adherent placentation rates as high as 1 in 500 pregnancies are now being quoted. Placenta accreta can lead to an obstetric emergency, including massive hemorrhage and emergent hysterectomy, especially if it is undiagnosed prior to delivery. Preparation and planning with a multidisciplinary team is key to success for these challenging deliveries.
Operating Room Fires
Authors: Matos Jennifer R. , Gutman David
Published: September 2023

Operating room (OR) fires that occur in the OR theater can be divided into those that occur within the airway versus on or around the patient or drapes. The Emergency Care Research Institute (ECRI) estimates that 90–100 surgical fires occur every year. As such, an OR fire is a very rare but potentially devastating event that can lead to significant morbidity or mortality. For a fire to occur, there must be three elements present: an oxidizer, an ignition source, and a fuel. This is known as the “fire triad,” and if any one of these is not present, a fire cannot happen. An analysis of malpractice claims in the American Society of Anesthesiologists Closed Claims Database from the years 1985–2009 was conducted showing 103 OR fire claims were made. Ninety percent of fires involved electrocautery as the primary ignition source, with 95% having supplemental oxygen as the oxidizer source. Of the electrocautery-induced OR fires, 85% of these events occurred during head, neck, and upper chest surgery. The analysis also revealed that 83% of the fires occurred during monitored anesthesia care and sedation cases where oxygen was delivered via an open delivery system (nasal cannula or facemask).
Motivational Interviewing in Practice
Authors: Rosen Miriam , Kmiec Julie
Published: September 2023

This chapter incorporates the core behaviors discussed in previous chapters and expounds on what is expected of Motivational Interview (MI)–experienced trainees: a patient-centered approach, the clear expression of clinical empathy, use of collaborative language, and evocation of goal-directed communication. Clinical empathy is discussed as the effort of a skilled observer to genuinely understand the world from the perspective of a person who is struggling, which in turn, leads to a sensitive, attuned response from that observer. Collaborative language involves providing new knowledge and expertise while tapping into the knowledge, awareness, and resourcefulness that patients already possess. Building upon these elements is crucial to maintaining long-term behavior change. Goal-directed communication is accomplished by engaging patients in a dialogue intended to guide patient awareness of problematic behavior and identify the discrepancy between that behavior and the goal(s) patients wish to achieve. The chapter concludes with a discussion of common challenges faced when beginning to use MI, and it presents methods to address these obstacles.
Brief Interventions
Authors: Pringle Janice , Rice-Stubbs Mara
Published: September 2023

Motivational Interviewing (MI) is an evidence-based therapeutic approach that is compatible with a wide range of brief interventions (BIs). In this chapter, we review and describe several widely used frameworks or organizing structures designed to screen for health-related problems and deliver BIs using the MI interactional style and spirit. BIs may vary considerably in their communication style and underlying modality, or theoretical framework used to facilitate change. We review four of these frameworks, including: FRAMES (feedback, responsibility, advice, menu of alternatives, empathic style, and Self-efficacy), POLAR*S (asking permission, open-ended questions, listening reflectively, affirmations, and summary), BNI (brief negotiated interview), and SBIRT (screening, BI, and referral to treatment). This chapter also presents a vignette of a BI in a medical setting showing the common pitfalls of delivering BIs. One of the most common is moving too quickly to provide answers (“righting reflex”) rather than listening to patient concerns and establishing a therapeutic alliance.
Integration of Motivational Interviewing with Mindfulness and Other Integrative Health Modalities
Authors: Stephens Jessica J. , Gold Melanie A.
Published: September 2023

In this chapter, we explore how Motivational Interviewing (MI) can enrich the care we provide to our patients through exploration of some less conventional approaches to treatment. We focus on mindfulness and other integrative health modalities as a means to further enhance motivation for change. Doing so provides patients with a plethora of treatment options for symptom management and improvement of chronic diseases, and it offers beneficial resources aimed at engaging patients in self-care practices. Additionally, we describe how synergism between MI and these modalities can strengthen the practitioner and patient relationship to enhance motivation for change. This chapter functions as a guide and a starting point for medical trainees to facilitate the use of MI with patients across various settings and explore complementary resources that empower change toward positive self-care practices.
C3PO: towards a complete census of co-moving pairs of stars – I. High precision stellar parameters for 250 stars
Authors: Yong David , Liu Fan , Ting Yuan-Sen , Joyce Meridith , Bitsch Bertram , Dai Fei , Dotter Aaron , Karakas Amanda I , Murphy Michael T
Published: September 2023

We conduct a line-by-line differential analysis of a sample of 125 co-moving pairs of stars (dwarfs and subgiants near solar metallicity). We obtain high-precision stellar parameters with average uncertainties in effective temperature, surface gravity, and metallicity of 16.5 K, 0.033 and 0.014 dex, respectively. We classify the co-moving pairs of stars into two groups, chemically homogeneous (conatal; |Δ[Fe/H]| ≤ 0.04 dex) and inhomogeneous (non-conatal), and examine the fraction of chemically homogeneous pairs as a function of separation and effective temperature. The four main conclusions from this study are (1) A spatial separation of Δs = 106 au is an approximate boundary between homogeneous and inhomogeneous pairs of stars, and we restrict our conclusions to only consider the 91 pairs with Δs ≤ 106 au; (2) There is no trend between velocity separation and the fraction of chemically homogeneous pairs in the range Δv ≤ 4 km s−1; (3) We confirm that the fraction of chemically inhomogeneous pairs increases with increasing Teff and the trend matches a toy model of that expected from planet ingestion; (4) Atomic diffusion is not the main cause of the chemical inhomogeneity. A major outcome from this study is a sample of 56 bright co-moving pairs of stars with chemical abundance differences ≤ 0.02 dex (5 per cent) which is a level of chemical homogeneity comparable to that of the Hyades open cluster. These important objects can be used, in conjunction with star clusters and the Gaia ‘benchmark’ stars, to calibrate stellar abundances from large-scale spectroscopic surveys.
A disc wind model for blueshifts in quasar broad emission lines
Authors: Matthews James H , Strong-Wright Jago , Knigge Christian , Hewett Paul , Temple Matthew J , Long Knox S , Rankine Amy L , Stepney Matthew , Banerji Manda , Richards Gordon T
Published: September 2023

Blueshifts – or, more accurately, blue asymmetries – in broad emission lines such as C iv λ1550 are common in luminous quasars and correlate with fundamental properties such as Eddington ratio and broad absorption line (BAL) characteristics. However, the formation of these blueshifts is still not understood, and neither is their physical connection to the BAL phenomenon or accretion disc. In this work, we present Monte Carlo radiative transfer and photoionization simulations using parametrized biconical disc-wind models. We take advantage of the azimuthal symmetry of a quasar and show that we can reproduce C iv blueshifts provided that (i) the disc-mid-plane is optically thick out to radii beyond the line formation region, so that the receding wind bicone is obscured; and (ii) the system is viewed from relatively low (that is, more face-on) inclinations (≲40°). We show that C iv emission-line blueshifts and BALs can form in the same wind structure. The velocity profile of the wind has a significant impact on the location of the line formation region and the resulting line profile, suggesting that the shape of the emission lines can be used as a probe of wind-driving physics. While we are successful at producing blueshifts/blue asymmetries in outflows, we struggle to match the detailed shape or skew of the observed emission-line profiles. In addition, our models produce redshifted emission-line asymmetries for certain viewing angles. We discuss our work in the context of the C iv λ1550 emission blueshift versus equivalent-width space and explore the implications for quasar disc wind physics.
The Existence of Contributory Negligence
Authors: Goudkamp James , Nolan Donal
Published: September 2023

Chapter 3 addresses the circumstances in which a court will make a finding of contributory negligence, as well as looking at whose claims will be affected by such a finding. Two requirements must be met before a claimant will be found to have been contributorily negligent. The first is that the claimant failed to take reasonable care in respect of their own safety or interests. The second is that this failure caused some or all of the claimant’s damage. After looking at these two requirements in turn, the rules regarding the circumstances in which the contributory negligence of a third party will be imputed to the claimant are considered.
The Cost of Ruling above Everything Else
Authors: Grossman Emiliano , Guinaudeau Isabelle
Published: September 2023

This chapter examines the drivers of presidential popularity in the context of the French Fifth Republic. French presidents over time have strikingly similar experiences in terms of popularity: a peak after the election soon followed by a process of erosion. This ‘cost-of-ruling’ pattern is particularly strong in the Fifth Republic, facilitated by the concentration of power in the hands of presidents, making them the person to blame. Cost of ruling tends to dominate other possible drivers of popularity and hinders the president’s capacity to benefit from good economic conditions. This changes only during cohabitations, when presidents and prime ministers are of different parties or coalitions: power-sharing makes the president more popular and better able to gain from good economic performance. The authors’ analyses also reveal that this cost of ruling has increased over time: in the early years of the Fifth Republic presidents enjoyed consistently higher levels of popularity, but this is no longer the case.
Moving beyond the Economy
Authors: Romero-Vidal Xavier , Orriols Lluís , Riera Pedro
Published: September 2023

This chapter revisits the effects of economic performance on executive approval in Spain and identifies new non-economic factors that provide a more comprehensive account of approval dynamics. As regards the role of the economy, the chapter shows that it still is a crucial predictor of approval ratings in Spain, but also provides evidence that its influence has fluctuated over time. As regards non-economic factors, it finds that the salience of terrorism is strongly associated with positive approval ratings in Spain. Similarly, congruence between mass preferences and government ideology results in higher approval ratings. By contrast, when mass preferences deviate from the incumbent’s ideology, the popularity of the latter deteriorates, which might ultimately result in electoral turnover. The authors’ study suggests that the economy continues to be a crucial factor behind government popularity in Spain, but also uncovers the role of other contextual factors like issue salience and mass preferences, which have received much less attention so far.
The Economy and Chancellor Approval in Germany
Authors: Kayser Mark A. , Leininger Arndt
Published: September 2023

Economic performance is widely considered a key determinant of government popularity. In Germany and internationally, individual-level evidence using perceived measures of the economy provides robust support for this relationship. Aggregate-level evidence using macroeconomic indicators, in contrast, is mixed. While many scholars have advanced substantive explanations, like clarity of responsibility or benchmarking, to account for heterogeneous results, this chapter investigates the role of different economic data vintages and measurement periods. Real-time data may capture the role of the media in forming economic perceptions while quarterly data that capture growth since the previous quarter makes different assumptions about time-discounting in economic assessments than do quarterly data that capture growth since the same quarter in the previous year. The authors find that the initially stronger effect of real-time data on support for the executive when growth is measured since the previous quarter converges to that of revised economic growth vintages when growth is measured over a longer period. All economic estimates show a weakening relationship between the economy and chancellor approval over time, a trend that can only partly be explained by Germany-specific developments such as changes in clarity of responsibility and reunification.
Absence of Practitioner
Authors: Hamer Kenneth
Published: September 2023

This chapter discusses the issue of the absence of the practitioner. The Court of Appeal’s checklist, outlined in Hayward, Jones and Purvis [2001] QB 862, remains a useful starting point for any decision by a tribunal or committee whether to proceed in the absence of the practitioner. However, as emphasized by the Court of Appeal in GMC v. Adeogba and Visivardis [2016] EWCA Civ 162, there are important differences between continuing a criminal trial in the absence of the defendant and continuing a disciplinary hearing in the absence of the registrant. The discretion to proceed remains to be exercised with caution; whether to proceed in the absence of the practitioner is a question of procedural fairness. The cases are grouped into pre-Adeogba and post-Adeogba cases for convenience, but some of the earlier cases may still be relevant depending on the particular circumstances. In the case of disciplinary proceedings, the fairness to the practitioner is a prime consideration, along with the public interest and the overall objectives of the regulator as enshrined in its statute or governing charter. Cases involving the practitioner attending for part of the hearing and becoming ill or absconding may present particular difficulties.
Bias
Authors: Hamer Kenneth
Published: September 2023

This chapter addresses the issue of bias, which can arise in many different guises. The cases clearly demonstrate that the Porter v. Magill [2002] test of bias applies in this field as it does in other areas of the law. Ultimately, each case turns on its own facts, as Carr J said in Rasool v. General Pharmaceutical Council [2015]. As Carnwath LJ observed in R (Mahfouz) v. Professional Conduct Committee of the General Medical Council [2004], the underlying question is whether the proceedings are fair and seen to be fair, or, as Sir Stephen Silber put it in Gosalakkal v. General Medical Council [2015], there was a serious procedural irregularity. In Higgs v. Farmor’s School [2022] EAT 101, an application for recusal was made on the basis that a lay member of the Employment Appeal Tribunal panel had made a number of public statements on Twitter that expressed firmly held views on issues relevant to the appeal, giving rise to the appearance of bias.
Case Management
Authors: Hamer Kenneth
Published: September 2023

This chapter explores issues relating to case management. All regulators have rules for case management with a view to ensuring the efficient and fair disposal of proceedings. Active, hands-on, case management, both pre-trial and throughout the trial itself, is now regarded as an essential part of the judge’s duty. In Council for the Regulation of Health Care Professionals v. General Medical Council and Ruscillo; Council for the Regulation of Health Care Professionals v. Nursing and Midwifery Council and Truscott [2005], the Court of Appeal emphasized that a disciplinary tribunal should play a more proactive role than a judge presiding over a criminal trial in making sure that cases are properly presented and that the relevant evidence is placed before them. There remains, however, judicial concern at the lack of proper case management and the duration of some hearings, particularly when conducted with substantial gaps owing largely to the difficulties in bringing panel members together.
Deficient Professional Performance
Authors: Hamer Kenneth
Published: September 2023

This chapter assesses cases of deficient professional performance, lack of competence, or inadequate professional services. Lack of competence or deficient professional performance is conceptually different from misconduct, as made clear in the judgments of Jackson J in Calhaem v. General Medical Council [2007] and Ouseley J in R (Vali) v. General Optical Council [2011]. Negligence is also different in character from misconduct and deficient professional performance. A practitioner should be judged by the standards applicable to the post to which they are appointed and the work they are carrying out, rather than a general allegation that they lack competency. The Department of Health’s framework document for handling concerns by Trusts about doctors and dentists employed in the National Health Service (NHS), Maintaining High Professional Standards in the Modern NHS, Part 1V Procedures for dealing with issues of capability, says that concerns about the capability of a doctor or dentist may arise from a single incident or a series of events, reports, or poor clinical outcomes.
Evidence
Authors: Hamer Kenneth
Published: September 2023

This chapter looks at a known fact that a practitioner cannot go behind a criminal conviction and endeavour to show that they were innocent of the charge and should have been acquitted. It discusses how a finding in civil proceedings provides a strong prima facie case, which throws a heavy burden on the practitioner who seeks to deny the findings of the civil court. It also mentions Dame Janet Smith, who recommended that hearsay evidence should be more readily admissible in disciplinary proceedings than in proceedings before a court of law. The chapter examines witness statements that may pose a particular problem if there is no opportunity for the other party to cross-examine the witness. Anonymous letters and the like should be treated with the greatest of caution before being admitted.
Good Character
Authors: Hamer Kenneth
Published: September 2023

This chapter covers the evidence of good character, which is relevant and admissible at the fact-finding stage if the alleged behaviour requires proof of a guilty state of mind. Good character evidence of the practitioner will be relevant when considering the credibility of the practitioner. It explains how the evidence of good character may be relevant to show that the alleged conduct is inherently unlikely to have occurred. The chapter explores the degree to which evidence of good character or reputation may be significant will vary according to the facts and circumstances of a particular case. While evidence of good character may be relevant to whether a breast examination by a consultant obstetrician and urogynaecologist was sexually motivated, it would not be relevant as to whether the examination was clinically indicated.
Independent and Impartial Tribunal
Authors: Hamer Kenneth
Published: September 2023

This chapter cites Article 6(1) of the European Convention on Human Rights (ECHR), which provides that everyone is entitled to a hearing before an independent and impartial tribunal. It explains how the common law and the ECHR ensure that every tribunal or committee determining a practitioner’s rights and obligations are independent and impartial. The challenge to the independence and impartiality of a tribunal may take the form of a challenge to the constitution of the tribunal as a whole or to one or more individual members of the tribunal. The chapter explores the challenge to the constitution of the tribunal that raise questions of bias. Any announcement of the tribunal’s decision must be given in public.
Misconduct (Specific Misconduct)
Authors: Hamer Kenneth
Published: September 2023

This chapter discusses specific cases of misconduct. It tackles cases of financial misconduct, abuse of professional relationships, breach of statutory provisions, NHS contracts, and social media. Single incident cases committed by a practitioner with a hitherto long-standing unblemished professional career will often cause anxiety to the parties and the tribunal. In line with Campbell, the Court of Appeal indicated how matters of personal mitigation and testimonial evidence would be relevant only to penalty mitigation, but the evidence might be relevant to culpability. The chapter explains how Campbell was decided before the introduction of the current impairment of fitness of practise, and testimonial evidence is invariably offered along with evidence of remediation and insight.
Non-Compliance
Authors: Hamer Kenneth
Published: September 2023

This chapter tackles the General Medical Council’s rules revolving around the non-compliance of a party concerning rules or case management orders. It explains that the tribunal may draw adverse inferences, refuse to admit evidence where the failure relates to the admissibility of that evidence, or make an award of costs when a party failed to comply. Moreover, legislation requires a doctor to submit to an assessment of their professional performance, health, or knowledge of English and failure to comply with a direction is likely to lead to disciplinary sanction. The GMC also holds the power to refer a doctor to the Medical Practitioners Tribunal Service (MPTS) when a doctor has failed to comply with a request to provide information. The chapter discusses disciplinary cases that featured non-compliance.