bluuebunny/crossref_metadata_2025 huggingface dataset:
Metrological generation of SI-traceable gas-phase standards and reference materials for (semi-) volatile organic compounds
Authors: de Krom Iris , Heikens Dita , Horn Wolfgang , Wilke Olaf , Richter Matthias , Baldan Annarita
Published: November 2022

EN 16516 sets specifications for the determination of emissions into indoor air from construction products. Reliable, accurate and International System of Unit (SI)-traceable measurement results of the emissions are the key to consumer protection. Such measurement results can be obtained by using metrologically traceable reference materials. Gas-phase standards of volatile organic compounds (VOCs) in air can be prepared by a variety of dynamic methods according to the ISO 6145 series. However, these methods are not always applicable for semi-VOCs (SVOCs) due to their high boiling point and low vapour pressure. Therefore, a novel dynamic gas mixture generation system has been developed. With this system gas-phase standards with trace level VOCs and SVOCs in air can be prepared between 10 nmol mol−1 and 1000 nmol mol−1. The VOCs and SVOCs in this study have normal boiling points ranging from 146 °C to 343 °C. Metrologically traceable reference materials of the gas-phase standard were obtained by sampling of the VOC gas-phase standard into Tenax TA® sorbent material in SilcoNert® coated stainless steel tubes. Accurately known masses between 10 ng and 1000 ng per VOC were sampled. These reference materials were used to validate the dynamic system. Furthermore, the storage and stability periods of the VOCs in the reference materials were determined as these are crucial characteristics to obtain accurate and SI-traceable reference materials. In a round robin test (RRT), the reference materials were used with the aim of demonstrating the feasibility of providing SI-traceable standard reference values for SVOCs for interlaboratory comparison purposes. Based on the results from the validation, the storage and stability studies and the RRT, gas-phase standards and reference materials of VOCs and SVOCs with relative expanded uncertainties between 5% and 12% (k = 2) have been developed. These reference standards can be used as calibrants, reference materials or quality control materials for the analysis of VOC emissions.
Parallel network using intrinsic component filtering for rotating machinery fault diagnosis
Authors: Han Baokun , Liu Zongling , Zhang Zongzhen , Wang Jinrui , Bao Huaiqian , Yang Zujie , Xing Shuo , Jiang Xingwang , Li Bo
Published: November 2022

Machine learning is gradually applied to the fault diagnosis system of rotating machinery. However, the fault diagnosis system can only classify and identify the fault types previously trained by the model in the system. If the system is required to identify more types of faults, all the untrained new fault types and previously trained fault types need to be input into the model to retrain. Under the current background of big data, the upgrade time of fault types will be relatively long. To solve this problem, a parallel network model based on intrinsic component filtering (PICF) is proposed, in which each type of sample is trained separately, and then each type of training model is reduced in dimension, and finally the model we need is combined. The fault diagnosis framework based on the PICF is proposed. Firstly, the framework divides the input fault samples into training samples and test samples. Then the training samples are randomly segmented and input into the PICF training model, then the activation function is introduced to activate the training features and test features, and finally the softmax classifier is used for classification. The sparsity of order fault training in parallel network is discussed and the influence of sample segment number and nonlinear activation function on diagnosis is studied. Compared with other deep learning methods, the experiment results of the bearing and gearbox show that the proposed method can not only achieve higher fault classification accuracy under small sample training, but also update the model efficiently without reducing the diagnosis accuracy when increasing fault types.
Transitions in polycrystalline diamond probed by steady state, modulated and transient surface photovoltage spectroscopy
Authors: Dittrich Thomas , Fengler Steffen
Published: November 2022

Numerous electronic transitions in polycrystalline chemical vapor deposition diamond with characteristic nucleation and growth sides were obtained by highly sensitive surface photovoltage (SPV) spectroscopy in dc (Kelvin probe), ac (modulated) and ac (transient) regimes from near infrared to deep ultraviolet. In the dc regime, defect transitions D1 to D8 were detected at 0.8–0.9, 1, 1.37, 1.78, 2.27, 3.15, 4.2 and 5.42 eV, respectively. Hints for more transitions were found for measurements in the ac (modulated) regime in the range near D3. SPV measurements in the ac (transient) regime showed the importance of disorder for relaxation of SPV signals excited at different photon energies. Phonon assisted transitions were observed at E
g− E
x− hν
LA,LO, E
g− E
x + hν
LA,LO and E
g− E
x + hν
TO. The developed SPV techniques are suitable for applications in research and quality control not only for diamond but also for any other semiconductor with ultra-wide bandgap.
Demonstrating backflow in classical two beams’ interference
Authors: Daniel Anat , Ghosh Bohnishikha , Gorzkowski Bernard , Lapkiewicz Radek
Published: November 2022

The well-known interference pattern of bright and dark fringes was first observed for light beams back in 1801 by Thomas Young. The maximum visibility fringes occur when the irradiance of the two beams is equal, and as the ratio of the beam intensities deviates from unity, fringe visibility decreases. An interesting outcome that might not be entirely intuitive, however, is that the wavefront of such unequal amplitude beams’ superposition will exhibit a wavy behavior. In this work, we experimentally observe the backflow phenomenon within this wavy wavefront. Backflow appears in both optics (retro- propagating light) and in quantum mechanics (QM), where a local phase gradient is not present within the spectrum of the system. It has become an interesting subject for applications as it is closely related to superoscillations whose features are used in super resolution imaging and in a particle’s path manipulations. The first successful attempt to observe backflow was made only recently in an assembly of optical fields, by synthesizing their wavefront in a complex manner. Yet, backflow is perceived as hard to detect. Here, by utilizing interference in its most basic form, we reveal that backflow in optical fields is robust and surprisingly common, more than it was previously thought to be.
Klein–Gordon particles in Gödel-type Som-Raychaudhuri cosmic string spacetime and the phenomenon of spacetime associated degeneracies
Authors: Mustafa Omar
Published: November 2022

We argue that only exact, comprehensive, and explicit solutions for the fundamental quantum mechanical models (i.e., the Klein–Gordon (KG) oscillators and the KG-Coulomb) would help to understand and describe the effects of gravitational fields on the dynamics of such systems. In the current methodical proposal, the effects of the gravitational fields generated by a Gödel-type Som-Raychaudhuri (SR) cosmic string spacetime on KG-oscillators (KG-particles in general) are studied and reported. In so doing, we revisit the KG-oscillators in a topologically trivial Gödel-type spacetime background and use textbook procedures to report its exact solution that covers even and odd parities. Next, we discuss the drawbacks associated with the power series expansion approach that implies the biconfluent Heun functions/polynomials solution. We, therefore, recollect the so called pseudo perturbative shifted ℓ expansion technique (PSLET) as an alternative and more sophisticated method/technique. Illustrative examples are used: (i) a KG-oscillator in a topologically trivial Gödel-type spacetime, (ii) a quasi-free KG-oscillator in Gödel SR-type cosmic string spacetime, (iii) a KG-Coulombic particle in Gödel SR-type cosmic string spacetime at zero vorticity, and (iv) a massless KG-particle in Gödel SR-type cosmic string spacetime in a Cornell-type Lorentz scalar potential. The corresponding exact energies are obtained from the zeroth (leading) order correction of PSLET, where all higher order correction identically vanish. The comprehensive exactness of the reported solutions manifestly suggest degeneracies associated with spacetime (STAD) phenomenon.
Modulation effect of mouse hippocampal neural oscillations by closed-loop transcranial ultrasound stimulation
Authors: Dong Shuxun , Yan Jiaqing , Xie Zhenyu , Yuan Yi , Ji Hui
Published: November 2022

Objective. Closed-loop transcranial ultrasound stimulation (TUS) can be applied at a specific time according to the state of neural activity to achieve timely and precise neuromodulation and improve the modulation effect. In a previous study, we found that closed-loop TUS at the peaks and troughs of the theta rhythm in the mouse hippocampus was able to increase the absolute power and decrease the relative power of the theta rhythm of local field potentials (LFPs) independent of the peaks and troughs of the stimulus. However, it remained unclear whether the modulation effect of this closed-loop TUS-induced mouse hippocampal neural oscillation depended on the peaks and troughs of the theta rhythm. Approach. In this study, we used ultrasound with different stimulation modes and durations to stimulate the peaks (peak stimulation) and troughs (trough stimulation) of the hippocampal theta rhythm. The LFPs in the area of ultrasound stimulation were recorded and the amplitudes and power spectra of the theta rhythm before and after ultrasound stimulation were analyzed. Main results. The results showed that (a) the relative change in amplitude of theta rhythm decreases as the number of stimulation trials under peak stimulation increases; (b) the relative change in the absolute power of the theta rhythm decreases as the number of stimulation trials under peak stimulation increases; (c) the relative change in amplitude of the theta rhythm increases nonlinearly with the stimulation duration (SD) under peak stimulation, and; (d) the relative change in absolute power exhibits a nonlinear increase with SD under peak stimulation. Significance. These results suggest that the modulation effect of closed-loop TUS on theta rhythm is dependent on the stimulation mode and duration under peak stimulation. TUS has the potential to precisely modulate theta rhythm-related neural activity.
More people too poor to move: divergent effects of climate change on global migration patterns
Authors: Rikani Albano , Otto Christian , Levermann Anders , Schewe Jacob
Published: November 2022

The observed temperature increase due to anthropogenic carbon emissions has impacted economies worldwide. National income levels in origin and destination countries influence international migration. Emigration is relatively low not only from high income countries but also from very poor regions, which is explained in current migration theory by credit constraints and lower average education levels, among other reasons. These relationships suggest a potential non-linear, indirect effect of climate change on migration through this indirect channel. Here we explore this effect through a counterfactual analysis using observational data and a simple model of migration. We show that a world without climate change would have seen less migration during the past 30 years, but that this effect is strongly reduced due to inhibited mobility. Our framework suggests that migration within the Global South has been strongly reduced because these countries have seen less economic growth than they would have experienced without climate change. Importantly, climate change has impacted international migration in the richer and poorer parts of the world very differently. In the future, climate change may keep increasing global migration as it slows down countries’ transition across the middle-income range associated with the highest emigration rates.
How global change impacted the rise and fall of the Guge Kingdom
Authors: Han Likun , Wang Xunming , Hao Zhixin , Zheng Jingyun , Li Danfeng , Geng Xin
Published: November 2022

Climate changes and its influences on human society are of increasing concern in science communities. Based on the reconstructed climate data and CENTURY model, we simulated net primary productivity of grassland and the grain yield of highland barley during the pre-industrial millennium in Ali Prefecture, Tibet Autonomous Region. It showed that the variation of precipitation and temperature together affected the fluctuation of land productivity. Wavelet analysis results showed that the land productivity in Ali fluctuated within main periodic bands of 180 yr. We found that the rise and falls of the Guge Kingdom in Ali was synchronic with the fluctuation of land productivity, and the collapse of the Guge Kingdom was obviously related to the sudden change of climate in the 17th century, which turned dry and cold. By combining with historical studies, this study further proposes the mechanism of land productivity fluctuation under climate change on Guge Kingdom. Our findings are helpful to understand the relationship between climate change and social vulnerability, especially providing a typical case study of ancient plateau countries.
Why Pacific quasi-decadal oscillation has emerged since the mid-20th century
Authors: Jin Chunhan , Wang Bin , Liu Jian
Published: November 2022

Pacific quasi-decadal oscillation (PQDO) is one component of the multi-time-scale tropical Pacific decadal variability, with a variability center in the equatorial central Pacific (ECP). PQDO has emerged since the 1950s and has a significant impact on decadal climate variability over Asia and North America and Pacific storms. However, why it has intensified since the 1950s remains unknown. Here we test two competing hypotheses, (1) 11-year solar cycle forcing and (2) internal variability arising from El Niño–Southern Oscillation (ENSO) asymmetry, by analyzing simulation results, including one fixed-forcing control (CTRL) experiment and four sensitive experiments with millennial spectral solar irradiance (SSI), obtained from the Community Earth System Model–Last Millennium Ensemble modeling project. The four-member ensemble-averaged SSI experiments suggest that 11-year solar irradiance forcing cannot excite PQDO without stratospheric amplification of solar forcing. By analyzing 144 years of observations and the CTRL experiment, we find that the PQDO is nonstationary, and consecutive La Niña-induced decadal variability can boost PQDO in the ECP. El Niño could induce decadal ENSO signals in the NINO3.4 region but not in PQDO regions. The negative phase of PQDO tends to follow the occurrence of multi-year La Niña. We suggest that the emergence of PQDO since the 1950s is mainly due to the increase in multi-year La Niña events.
Gauge theoretic approach to (ordinary) gravity and its fuzzy extensions in three and four dimensions
Authors: Manolakos G , Manousselis P , Roumelioti D , Stefas S , Zoupanos G
Published: November 2022

In the prospect to discuss the construction of fuzzy gravity theories based on the gauge-theoretic approach of ordinary gravity, in the present article we review first the latter in three and four dimensions and then, after recalling the formulation of gauge theories on noncommutative spaces, we present in detail the construction of fuzzy gravity theories in three and four dimensions, as matrix models.
LSOS: Line-search second-order stochastic optimization methods for nonconvex finite sums
Authors: di Serafino Daniela , Krejić Nataša , Krklec Jerinkić Nataša , Viola Marco
Published: November 2022

We develop a line-search second-order algorithmic framework for minimizing finite sums. We do not make any convexity assumptions, but require the terms of the sum to be continuously differentiable and have Lipschitz-continuous gradients. The methods fitting into this framework combine line searches and suitably decaying step lengths. A key issue is a two-step sampling at each iteration, which allows us to control the error present in the line-search procedure. Stationarity of limit points is proved in the almost-sure sense, while almost-sure convergence of the sequence of approximations to the solution holds with the additional hypothesis that the functions are strongly convex. Numerical experiments, including comparisons with state-of-the art stochastic optimization methods, show the efficiency of our approach.
The Dunkl-Laplace transform and Macdonald’s hypergeometric series
Authors: Brennecken Dominik , Rösler Margit
Published: November 2022

We continue a program generalizing classical results from the analysis on symmetric cones to the Dunkl setting for root systems of typeAA. In particular, we prove a Dunkl-Laplace transform identity for Heckman-Opdam hypergeometric functions of typeAAand more generally, for the associated Opdam-Cherednik kernel. This is achieved by analytic continuation from a Laplace transform identity for non-symmetric Jack polynomials which was stated, for the symmetric case, as a key conjecture by I.G. Macdonald [arXiv:1309.4568v1]. Our proof for the Jack polynomials is based on Dunkl operator techniques and the raising operator of Knop and Sahi. Moreover, we use these results to establish Laplace transform identities between hypergeometric series in terms of Jack polynomials. Finally, we conclude with a Post-Widder inversion formula for the Dunkl-Laplace transform.
The impact of clinical pharmacist integration in a community rheumatology clinic
Authors: Sandhu Vaneet Kaur , Tuico Alexa , Hum Jennifer , Zachary Bishoy
Published: November 2022

Purpose

To describe the benefits of pharmacist integration into a community rheumatology clinic in terms of clinical outcomes, patient and provider satisfaction, and clinic time efficiency.

Methods

A 6-month study was conducted at a community rheumatology clinic to compare clinical and patient and provider satisfaction outcomes before and after a clinical pharmacist (CP) was integrated into the clinic staff to assist with providing medication counseling, ordering and monitoring laboratory tests, monitoring adverse effects and medication adherence, and titrating medication doses. The primary outcome was the change in Routine Assessment of Patient Index Data 3 (RAPID-3) scores from baseline to 3 and 6 months after CP integration. Secondary outcomes included the change in monthly pain scores from baseline to 6 months, the change in patient satisfaction scores from baseline to 6 months, and time saved for the rheumatology providers after pharmacist integration into the clinic.

Results

The mean difference in RAPID-3 scores from baseline to 3 months (N = 55) was an improvement of 5.58 points (P < 0.001), while the mean change in weighted RAPID-3 scores was an improvement of 1.87 (P < 0.001). The mean change in RAPID-3 scores from baseline to 6 months (n = 25) was an improvement of 5.13 (P = 0.003), and the mean change in weighted RAPID-3 scores was 1.78 (P = 0.003).

Conclusion

The results of this quality improvement project suggest that the integration of a CP in the rheumatology clinic improved patient-reported outcomes, as quantified by patients’ pain scores and RAPID-3 scores. The integration of the CP also appeared to enhance patient and provider satisfaction.
Description of a Novel Web-Based Liposuction System to Estimate Fat Volume and Distribution
Authors: Harutyunyan Robert , Gilardino Mirko S , Wu Yichen , Jeffries Sean D , Hemmerling Thomas M
Published: November 2022

Background

Preoperative planning for liposuction is vital to ensure safe practice and patient satisfaction. However, current standards of fat assessment before surgery are guided by subjective methods such as visual inspection, skin-pinch tests, and waist circumference measurements.

Objectives

This study aimed to develop an inexpensive software-based tool that utilizes ultrasound (US) imaging and an online platform to accurately simulate regional subcutaneous adipose tissue (SAT) distribution and safe volume estimation for liposuction procedures.

Methods

The authors present a web-based platform with integrated 2-dimensional (2D) and 3-dimensional (3D) simulations of SAT to support liposuction planning and execution. SAT-Map was constructed using multiple sub-applications linked with the python framework programming language (Wilmington, DE).

Results

The SAT-Map interface provides an intuitive and fluid means of generating patient-specific models and volumetric data. To further accommodate this, an operational manual was prepared to achieve consistent visualization and examination of estimated SAT content. The system currently supports static 2D heatmap simulation and 3D interactive virtual modelling of the SAT distribution. Supplementary clinical studies are needed to evaluate SAT-Map's clinical performance and practicality.

Conclusions

SAT-Map revolutionizes the concept of preoperative planning for liposuction by developing the first combined web-based software that objectively simulates fat distribution and measures safe liposuction volume. Our software approach presents a cost-efficient, accessible, and user-friendly system offering multiple advantages over current SAT assessment modalities. The immediacy of clinically accurate 3D virtual simulation provides objective support to surgeons towards improving patient conversation, outcomes, and satisfaction in liposuction procedures.
Species delimitation in Psalidodon fasciatus (Cuvier, 1819) complex (Teleostei: Characidae) from three hydrographic basins
Authors: Gavazzoni Mariane , Pavanelli Carla S , Graça Weferson J , De Oliveira Ezequiel A , Moreira-Filho Orlando , Margarido Vladimir P
Published: November 2022

Psalidodon fasciatus is a complex of several fish species widely distributed in Brazilian hydrographic systems that share morphological characteristics and show a high taxonomic complexity and genetic variability. Cytogenetic and molecular analyses were carried out in populations from three Brazilian hydrographic basins, aiming to contribute to systematic and biogeographical knowledge of the group. The chromosomal markers verified the occurrence of species-specific characters and indicated the existence of six distinct operational taxonomic units (OTUs): P. fasciatus (São Francisco River basin), Psalidodon sp. 1, Psalidodon sp. 2 and Psalidodon eigenmanniorum (Uruguay River basin); and Psalidodon sp. 3 and Psalidodon sp. 4 (Paraná River basin). The chromosomal markers showed more similarities among species from the Uruguay River and São Francisco River basins. DNA barcoding analyses (assemble species by automatic partitioning, neighbour-joining, maximum likelihood and maximum parsimony) indicated the existence of at least three distinct OTUs. The chromosomal evolution rates were demonstrated to be higher than the molecular evolution rates, reinforcing the importance of using chromosomal markers to delimit OTUs in integrative taxonomy studies. These results suggest that the São Francisco River Basin population (the type locality) should be considered as true P. fasciatus, and the others, until now treated as Psalidodon aff. fasciatus, are cryptic species.
Understanding Local Adaptation to Prepare Populations for Climate Change
Authors: Meek Mariah H , Beever Erik A , Barbosa Soraia , Fitzpatrick Sarah W , Fletcher Nicholas K , Mittan-Moreau Cinnamon S , Reid Brendan N , Campbell-Staton Shane C , Green Nancy F , Hellmann Jessica J
Published: November 2022

Adaptation within species to local environments is widespread in nature. Better understanding this local adaptation is critical to conserving biodiversity. However, conservation practices can rely on species’ trait averages or can broadly assume homogeneity across the range to inform management. Recent methodological advances for studying local adaptation provide the opportunity to fine-tune efforts for managing and conserving species. The implementation of these advances will allow us to better identify populations at greatest risk of decline because of climate change, as well as highlighting possible strategies for improving the likelihood of population persistence amid climate change. In the present article, we review recent advances in the study of local adaptation and highlight ways these tools can be applied in conservation efforts. Cutting-edge tools are available to help better identify and characterize local adaptation. Indeed, increased incorporation of local adaptation in management decisions may help meet the imminent demands of managing species amid a rapidly changing world.
A metapopulation model reveals connectivity-driven hotspots in treatment resistance evolution in a marine parasite
Authors: Coates Andrew , Robinson Nick , Dempster Tim , Samsing Francisca , Johnsen Ingrid , Phillips Ben L
Published: November 2022

In salmon aquaculture, the sustainable management of salmon lice (Lepeophtheirus salmonis) is limited by the adaptive capacity of the parasite. This is evident in the repeated evolution of pesticide resistance in the salmon louse population. To better prepare for resistance, we constructed a numerical metapopulation model that predicts the evolutionary dynamics of lice across an interconnected farm network. This model integrates within-farm population dynamics and between-farm louse dispersal, the latter using outputs from a state-of-the-art particle-tracking model. Distinct from previous metapopulation models, it also simulates spatial and temporal genetic variation arising from selection. The model was parameterized to simulate the evolution of resistance to the pesticide azamethiphos on farms in southern Norway. It successfully reproduced the rapid (within 10 years) evolution of azamethiphos resistance following extensive delousing treatments. It also identified strong spatial patterns in resistance, with regions of high farm connectivity being potential hotspots of louse adaptation. Rates of infestation and evolution were significantly reduced when highly connected farms were excluded from the simulation, compared to when low-connectivity or random sites were excluded. This model can be a valuable tool for coordinating pest management at a regional scale, in a way that slows or prevents the spread of resistance.
A survey exploring the barriers and drivers to leader and leadership development of the pharmacy workforce: a focus on advanced practice
Authors: Gondongwe X D , Jani Y
Published: November 2022

Introduction

Developing professional leadership skills is one of the workforce development goals of the International Pharmaceutical Federation1. Leadership is identified as an essential domain in advanced practice curricula for pharmacists in the United Kingdom2. The National Health Service People Plan recognises that leadership training and development can maximise productivity and shape a positive culture, which is essential for provision of 21st century healthcare3. However, leader and leadership development remain under-researched within the pharmacy profession.

Aim

To describe pharmacist leadership training experience and perceptions of barriers and drivers to leader and leadership development.

Methods

An online survey was developed, piloted, and distributed to 105 pharmacists at a single, tertiary care, acute hospital organisation in the UK between August and October 2020. The survey consisted of Likert scale questions relating to importance of leadership competencies, personal leadership qualities, barrier, and drivers to pharmacist leadership development. Quantitative data were analysed using Microsoft Excel®. The study formed part of a local pharmacy service education and training service evaluation and review. Therefore, in accordance with the Health Research Authority toolkit NHS ethical approval was not required.

Results

The survey was completed by 39 pharmacists, providing a 37.1% response rate. Almost three quarters of pharmacists did not have leadership training. Over half the pharmacists surveyed identified leadership development as essential for career progression (n=26, 66.6%) and to improve performance in their current role (n=23, 59.0%). A key driver was support from line managers or work colleagues (n=28, 71.8%). Pharmacists reported workload (n = 19, 48.7%), not being valued (n=16, 41.0%) and lack of access or opportunity to work at strategic level (n= 14, 35.9%) as barriers to pharmacy leadership development.

Discussion/Conclusion

This is the first survey of pharmacist leadership development among pharmacists working in the hospital setting in the UK. Improving performance in current role and career development were identified as key drivers for pharmacist leadership development while workload and lack of access or opportunity of working at strategic levels were identified as key barriers.

References

1. Leadership Development [Internet]. FIP Development Goals. [cited 2022 Apr 14]. Available from: https://developmentgoals.fip.org/dg6/

2. RPS Advanced Pharmacy Framework.pdf [Internet]. [cited 2021 Dec 10]. Available from: https://www.rpharms.com/Portals/0/RPS%20document%20library/Open%20access/Frameworks/RPS%20Advanced%20Pharmacy%20Framework.pdf

3. NHS England » NHS People Plan [Internet]. [cited 2022 Apr 14]. Available from: https://www.england.nhs.uk/ournhspeople/
A service evaluation of patient care relating toClostridioides difficile infection (CDI) in Oxford University Hospital NHS Foundation
Authors: Katsiroumpas E , Dunsmure L , Lim R
Published: November 2022

Introduction

The bacterium Clostridioides difficile (C. difficile) frequently colonises the human intestine. In an adult who is healthy, this organism is relatively harmless. However, disruption of the normal gut flora, which is frequently brought on by the use of antibiotics, can result in Clostridioides difficile (C. difficile) infection (CDI). As a result, C. difficile can grow and produce a toxin that causes diarrhoea. Due to the ease with which C. difficile can be spread in healthcare environments, it is essential to recognise and treat CDI patients as soon as possible and in accordance with best practises.

Aim

This service evaluation aimed to explore and understand how adult inpatients presenting with diarrhoea where (CDI is suspected are managed according to Trust Clostridioides difficile guidelines.

Methods

Purposive sampling of up to 100 adult inpatients presenting with diarrhoea where C. difficile is suspected and the patient has been an in-patient for least 48 hours post sample request. A data collection tool was developed, pilot tested and used to collect patient data from the Oxford University Hospital's Electronic Prescribing Record. Data was analysed using descriptive statistics and the Functional Resonance Analysis Method (FRAM) that involved 1) Identifying and describing key functions relating to the management of patients 2) Identifying variability in performing key functions and 3) Determine the possibility of function resonance. Ethical approval was obtained from University of Reading.

Results

Fifty patient records were accessed. The results showed that many patients had a stool sample sent for review as soon as possible, a clinical review of their condition and where there was the absence of a strong suspicion or strong evidence of C. Difficile a delay in the initiation of empirical therapy. Documentation was an area with poor compliance to guidelines. 50 % had a Bristol stool chart completed before sample sent and after CDI suspected, 60 % had isolation of the patient documented, 47 % had placement of contact precautions documented, and 20 % had documentation of discontinuation of empirical therapy. A FRAM model was developed and a total of 14 functions were identified with three functions “Record Bristol stool charts”, “clinical review of the patient”, and “placement of contact precautions” being most connected to the other functions, demonstrating the significance of these functions in the management of patients who are suspected of having CDI.

Discussion/Conclusion

The three key tasks outlined by FRAM are important to ensure that provide patients with the best care. Understanding variability in how the functions identified in FRAM are performed is important to understand how work is performed in order to then design ways of working that benefits both patients and HCPs. Further work is required to explore this area.
The Role of Judges
Authors: Klein Natalie , Parlett Kate
Published: November 2022

This chapter explores who are the judges involved in resolving disputes in the UN Convention on the Law of the Sea (UNCLOS) and examines their educational and professional backgrounds across the International Tribunal for the Law of the Sea and Annex VII arbitral tribunals. The chapter also analyses the different roles performed by international judges. These tasks include settling the procedure, treaty interpretation, fact finding, and settling the dispute presented. The discussion also acknowledges the role of international judges in relation to the broader contexts of disputes. Beyond contentious proceedings, judges also contribute to the law of the sea through the issuance of advisory opinions. The final part of the chapter contemplates what the role of the international judge should be in UNCLOS dispute settlement, and suggests the possible relevance of stakeholder identification theory as one explanatory paradigm.
Navigation
Authors: Klein Natalie , Parlett Kate
Published: November 2022

This chapter discusses different aspects of navigation that have been subjected to judicial scrutiny during dispute settlement proceedings under the UN Convention on the Law of the Sea (UNCLOS). The chapter considers the status of vessels, especially matters relating to nationality and immunity that have featured in UNCLOS cases. The scope of the freedom of navigation has been a source of dispute under UNCLOS and cases have examined the application of the freedom of navigation to vessels in port as well as examining what activities fall within the freedom of navigation, focusing on bunkering and protest in this regard. The chapter also analyses cases that have addressed interference with navigation and navigational safety matters. The final part of the chapter examines different aspects of law enforcement by coastal States, as well as limits on the use of force and the right of hot pursuit.
A Qualitative Analysis of the Experiences of People Who Resumed Smoking Following Exclusive Electronic Nicotine Delivery Systems Use
Authors: Robertson Lindsay , Sanford Kealey-Rei , Waa Anaru , Hoek Janet
Published: November 2022

Introduction

For electronic nicotine delivery systems (ENDS) to reduce harms caused by smoking, people who smoke must be able to switch to exclusive ENDS use without subsequently returning to smoking. Identifying factors prompting a return to smoking among former exclusive ENDS users is crucial, yet few qualitative studies have probed experiences of this process.

Aims and Methods

We conducted in-depth, semi-structured interviews with 20 people (seven indigenous Māori and 13 non-Māori) who smoked tobacco at least weekly, had smoked at least 100 cigarettes in their lifetime, and reported using ENDS to stop smoking cigarettes for at least 30 days (ideally, within the preceding 6 months). We explored their experiences of ENDS use, probed critical return-to-smoking settings and triggers, and analyzed strategies that could promote sustained smoking abstinence. We managed data using NVivo12 and used a reflexive thematic analysis approach to interpret the transcripts.

Results

We identified three themes that explained participants’ experiences. ENDS performed a functional role by mimicking some aspects of smoking. Yet participants experienced ENDS as inauthentic and unsatisfying across physical, social, and affectual domains, including in the most common return-to-smoking situations. Furthermore, fewer constraints on ENDS usage led participants to feel they could perpetuate addiction and risk of harm.

Conclusions

Return to smoking reflected two factors: ENDS’ failure to replicate core smoking attributes that remained appealing, and the burden of self-regulation required when using ENDS. Understanding and informing people about the challenges involved in transitioning to ENDS, beyond obtaining sufficient nicotine, could help support informed ENDS use and may potentially prevent people returning to smoking.

Implications

Our study extends our understanding of the satisfaction people seek when attempting to transition from smoking to exclusive ENDS use, and how ENDS’ failure to replicate that satisfaction, in addition to uncertainty about ENDS-related risks, contributes to smoking resumption. Satisfaction went beyond nicotine delivery, and included affective experiences, maintenance of rituals, rewards, and social connections. Conceptualizing satisfaction more broadly could support a richer understanding of factors that prompt return to smoking. People might manage challenges more effectively if they understood these before attempting to switch from smoking to ENDS, and if they are advised to monitor and regulate their ENDS use. Educational resources and behavioral support could provide more guidance on these points.
Deregulating Innovation Capital: The Effects of the JOBS Act on Biotech Startups
Authors: Lewis Craig M , White Joshua T
Published: November 2022

We examine real outcomes for biotech startups going public around the Jumpstart Our Business Startups (JOBS) Act. Reduced compliance costs associate with greater innovation capital formation as biotech IPO volume and proceeds increase after the JOBS Act. Biotechs, which conduct over 30% of IPOs since 2012, go public with products earlier in the FDA approval process and more frequently target rare diseases and cancer. Consistent with our survey evidence that managers use compliance savings to invest in R&D, we link the JOBS Act to post-IPO increases in project-level development, such as new patents, clinical trials, and staffing of laboratories. Post-JOBS Act product candidates are more likely to reach key milestones in the FDA approval process and these startups fail at lower rates. Benefits accrue to shareholders without sacrificing financial reporting quality. Our results demonstrate how tailoring regulations for startups can provide economic and societal benefits.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Coevolution between institutions and scientific organizations: The case of IMPA
Authors: Petrin Renata , Gonzalez Duarte Roberto , Kazumi Miura Irene
Published: November 2022

In this study, the properties of coevolution were analysed and presented as a promising avenue to investigate the interaction between institutions and scientific organizations, which has implications for the development of scientific fields and public scientific policies. These properties were used to analyse the interaction between the Institute for Pure and Applied Mathematics (IMPA) and national and international institutions from 1951 to 2019. The findings reveal that if an area of knowledge is weak in a country, it can develop through different institutional actions by interested parties such as researchers. The institutional agency of IMPA researchers has functioned as an element that feeds coevolutionary dynamics. This dynamic has caused changes in the IMPA (micro-level), scientific community (meso-level), and governmental institutions and civil society (macro-level). This study’s main contribution is the cross-fertilization of coevolution with the agency approach of institutional theory.
Dementia detection from brain activity during sleep
Authors: Ye Elissa M , Sun Haoqi , Krishnamurthy Parimala V , Adra Noor , Ganglberger Wolfgang , Thomas Robert J , Lam Alice D , Westover M Brandon
Published: November 2022

Study Objectives

Dementia is a growing cause of disability and loss of independence in the elderly, yet remains largely underdiagnosed. Early detection and classification of dementia can help close this diagnostic gap and improve management of disease progression. Altered oscillations in brain activity during sleep are an early feature of neurodegenerative diseases and be used to identify those on the verge of cognitive decline.

Methods

Our observational cross-sectional study used a clinical dataset of 10 784 polysomnography from 8044 participants. Sleep macro- and micro-structural features were extracted from the electroencephalogram (EEG). Microstructural features were engineered from spectral band powers, EEG coherence, spindle, and slow oscillations. Participants were classified as dementia (DEM), mild cognitive impairment (MCI), or cognitively normal (CN) based on clinical diagnosis, Montreal Cognitive Assessment, Mini-Mental State Exam scores, clinical dementia rating, and prescribed medications. We trained logistic regression, support vector machine, and random forest models to classify patients into DEM, MCI, and CN groups.

Results

For discriminating DEM versus CN, the best model achieved an area under receiver operating characteristic curve (AUROC) of 0.78 and area under precision-recall curve (AUPRC) of 0.22. For discriminating MCI versus CN, the best model achieved an AUROC of 0.73 and AUPRC of 0.18. For discriminating DEM or MCI versus CN, the best model achieved an AUROC of 0.76 and AUPRC of 0.32.

Conclusions

Our dementia classification algorithms show promise for incorporating dementia screening techniques using routine sleep EEG. The findings strengthen the concept of sleep as a window into neurodegenerative diseases.
Microscopic and Transcriptomic Analyses of Early Events Triggered by ‘Candidatus Liberibacter asiaticus’ in Young Flushes of Huanglongbing-Positive Citrus Trees
Authors: Pandey Sheo Shankar , Xu Jin , Achor Diann S. , Li Jinyun , Wang Nian
Published: November 2022

‘ Candidatus Liberibacter asiaticus’ (CLas) is associated with the devastating citrus disease Huanglongbing (HLB). Young flushes are the center of the HLB pathosystem due to their roles in the psyllid life cycle and in the acquisition and transmission of CLas. However, the early events of CLas infection and how CLas modulates young flush physiology remain poorly understood. Here, transmission electron microscopy analysis showed that the mean diameter of the sieve pores decreased in young leaves of HLB-positive trees after CLas infection, consistent with CLas-triggered callose deposition. RNA-seq-based global expression analysis of young leaves of HLB-positive sweet orange with (CLas-Pos) and without (CLas-Neg) detectable CLas demonstrated a significant impact on gene expression in young leaves, including on the expression of genes involved in host immunity, stress response, and plant hormone biosynthesis and signaling. CLas-Pos and CLas-Neg expression data displayed distinct patterns. The number of upregulated genes was higher than that of the downregulated genes in CLas-Pos for plant−pathogen interactions, glutathione metabolism, peroxisome, and calcium signaling, which are commonly associated with pathogen infections, compared with the healthy control. On the contrary, the number of upregulated genes was lower than that of the downregulated genes in CLas-Neg for genes involved in plant−pathogen interactions and peroxisome biogenesis/metabolism. Additionally, a time-course quantitative reverse transcription-PCR-based expression analysis visualized the induced expression of companion cell-specific genes, phloem protein 2 genes, and sucrose transport genes in young flushes triggered by CLas. This study advances our understanding of early events during CLas infection of citrus young flushes.
Bridging the gaps of healthcare inequity and nurse well-being
Authors: Moore Kevin T. , Sepe Paulette , Dans Maricon
Published: November 2022

A crosswalk of the Pathway to Excellence framework and The Future of Nursing report
Breast Autologous Fat Transfer Entirely Under Tumescent Anesthesia: Safety and Efficacy
Authors: Salmon Paul J. M.
Published: November 2022

BACKGROUND/OBJECTIVES

The prior use of external expansion has been described in the literature as a tool to allow reliable grafting of more than 200 mLs of autologous fat under general anesthesia. The purpose of this study was to determine whether breast autologous fat transfer entirely under tumescent anesthesia (BAFTEUTA) is a safe and effective technique.

METHODS

After institutional board approval, 22 consecutive patients were enrolled in this single-cohort, prospective study. All patients underwent preoperative expansion using manually evacuated domes. All procedures were performed under tumescent anesthesia with oral sedation.

RESULTS

There was a median successful graft of 200 mLs. Complications were minimal and limited to occlusive folliculitis.

CONCLUSION

Although the author has not reported as large graft volumes as some other authors, BAFTEUTA is a safe procedure and can have good outcomes with high levels of patient satisfaction.
Invasive Pneumococcal Disease in High-risk Children: A 10-Year Retrospective Study
Authors: van Warmerdam Jacqui , Campigotto Aaron , Bitnun Ari , MacDougall Georgina , Kirby-Allen Melanie , Papsin Blake , McGeer Allison , Allen Upton , Morris Shaun K.
Published: November 2022

Background:

Despite the availability of conjugate pneumococcal vaccines, children with high-risk conditions remain vulnerable to invasive pneumococcal disease (IPD). This study sought to describe IPD prevalence, vaccination and outcomes among high-risk children.

Methods:

We used International Classification of Disease10 discharge and microbiology codes to identify patients hospitalized for IPD at a large pediatric hospital from January 1, 2009, to December 31, 2018. Patients were considered high-risk if they had: primary immunodeficiency, asplenia, transplant, active malignancy, sickle cell disease, cochlear implant, nephrotic syndrome, chronic lung disease, cerebrospinal fluid leak, HIV or used immunosuppressive therapy.

Results:

In total 94 high-risk patients were hospitalized for IPD. The most common high-risk conditions included malignancy (n = 33, 35%), solid-organ or bone marrow transplant (n = 17, 18%) and sickle cell disease (n = 14, 15%). Bacteremia was the most common presentation (n = 81, 86%) followed by pneumonia (n = 23, 25%) and meningitis (n = 9, 10%). No deaths occurred. Of 66 patients with known pneumococcal vaccination status, 15 (23%) were unvaccinated, and 51 (77%) received at least one dose of a pneumococcal vaccine; 20 received all four recommended pneumococcal conjugate vaccine (PCV) doses. Only three children received PPSV23. Of 20 children with no or partial (<3 doses) immunization, 70% (14) of IPD episodes were due to vaccine-preventable serotypes. Of 66 known IPD serotypes, 17% (n = 11) were covered by PCV13, 39% (n = 26) were covered by PPSV23 and 39% (n = 26) were nonvaccine serotype.

Conclusions:

Despite the availability of effective pneumococcal vaccines, IPD persists among children with high-risk conditions. Improving PCV13 and PPSV23 vaccination could significantly reduce IPD; most episodes were due to vaccine-preventable serotypes in incompletely immunized patients.