bluuebunny/crossref_metadata_2025 huggingface dataset:
High aspect ratio TiO2–Mn3O4 heterostructure: proficient nanorods for pathogen inhibition and supercapacitor application
Authors: Hassan M. Shamshi , Amna Touseef , Alqarni Laila S. , Alqahtani Hussain S. , Alnaam Yaser A. , Almusabi Saleh , Alzharani Ahmed A.
Published: February 2023

Supercapacitors are in great demand owing to necessity of clean and sustainable energy. Alternately, waterborne microbial infections are prime cause of diseases. So, there is demand for synthesis of novel materials with multifunctional adaptability. Herein, heterostructured TiO2–Mn3O4 composite nanorods were synthesised by two-step methods. In first step, TiO2 nanorods were prepared using electrospinning and by hydrothermal method Mn3O4 nanoparticles were attached to TiO2 surface. The composite heterostructure was described using sophisticated procedures such as X-ray diffraction, Fourier transforms infrared spectroscopy, Scanning electron and Transmission electron microscopy. Antimicrobial studies were probed against Gram-negative Escherichia coli and Gram-positive Staphylococcus aureus pathogens. The results demonstrated that TiO2–Mn3O4 composite has more heightened antimicrobial activity than pristine TiO2. Additionally, the synthesised TiO2–Mn3O4 composite was implied as an electrode for supercapacitors. The definite capacitance of TiO2–Mn3O4 nanocomposite calculated at a potential scan rate of 5 mV/s was as amplified as 470 Fg−1.
The value of cardiopulmonary exercise testing and stress echocardiography in the prediction of all‐cause mortality in adults with end‐stage renal disease
Authors: O'Driscoll J.M. , Edwards J.J. , Greenhough E. , Smith E. , May M. , Gupta S. , Marciniak A. , Sharma R.
Published: February 2023

We aimed to assess the prognostic utility of different parameters routinely assessed from cardiopulmonary exercise testing (CPET) and exercise echocardiography in adults with end‐stage renal disease (ESRD). Forty‐two ESRD (37 male) individuals (age: 58 ± 13 years, height: 169.30 ± 8.30 cm, weight: 81 ± 15 kg, body surface area: 1.92 ± 0.20 m2) underwent a maximal/symptom limited CPET, with a full cross‐sectional echocardiogram performed at baseline and peak exercise. All participants were prospectively followed over a 10‐year period, with all‐cause mortality as the primary endpoint. After the follow‐up period, a total of 19 participants (45%) died. Left atrial size (4.70 ± 0.70 vs. 3.65 ± 0.50 cm, P < 0.001) and anteroseptal wall thickness (1.28 ± 0.40 vs. 1.06 ± 0.02 cm, P = 0.002) were significantly greater in those that died, while peak heart rate was significantly lower (108 ± 12 vs. 128 ± 14 bpm, P < 0.001). The prevalence of myocardial ischaemia (13 vs. 8 participants, P = 0.03) was significantly greater, while peak VO2 (9.80 ± 2.10 vs. 15.90 ± 4.30 ml·kg−1·min−1, P < 0.001) was significantly lower in those that died. Following multivariate cox regression, myocardial ischaemia (Hazard Ratio 3.08; 95% Confidence Interval 1.09–8.70; P = 0.03) and peak VO2 (HR 0.73; 95% CI 0.64–0.84; P < 0.001) were significant independent predictors of 10‐year all‐cause mortality. This is the first study to establish peak VO2 as powerful marker of all‐cause mortality when assessed with clinical, resting and stress echocardiography parameters in people with ESRD over a 10‐year follow up period. This observation indicates that, in clinical practice, CPET and exercise echocardiography may serve as valuable tools for the risk stratification of individuals with ESRD.
AP-1–independent NFAT signaling maintains follicular T cell function in infection and autoimmunity
Authors: Seth Abhinav , Yokokura Yoshiyuki , Choi Jin-Young , Shyer Justin A. , Vidyarthi Aurobind , Craft Joe
Published: February 2023

Coordinated gene expression programs enable development and function of T cell subsets. Follicular helper T (Tfh) cells coordinate humoral immune responses by providing selective and instructive cues to germinal center B cells. Here, we show that AP-1–independent NFAT gene expression, a program associated with hyporesponsive T cell states like anergy or exhaustion, is also a distinguishing feature of Tfh cells. NFAT signaling in Tfh cells, maintained by NFAT2 autoamplification, is required for their survival. ICOS signaling upregulates Bcl6 and induces an AP-1–independent NFAT program in primary T cells. Using lupus-prone mice, we demonstrate that genetic disruption or pharmacologic inhibition of NFAT signaling specifically impacts Tfh cell maintenance and leads to amelioration of autoantibody production and renal injury. Our data provide important conceptual and therapeutic insights into the signaling mechanisms that regulate Tfh cell development and function.
Genome-wide CRISPR/Cas9 screens reveal shared and cell-specific mechanisms of resistance to SHP2 inhibition
Authors: Wei Wei , Geer Mitchell J. , Guo Xinyi , Dolgalev Igor , Sanjana Neville E. , Neel Benjamin G.
Published: February 2023

SHP2 (PTPN11) acts upstream of SOS1/2 to enable RAS activation. Allosteric SHP2 inhibitors (SHP2i) in the clinic prevent SHP2 activation, block proliferation of RTK- or cycling RAS mutant-driven cancers, and overcome “adaptive resistance.” To identify SHP2i resistance mechanisms, we performed genome-wide CRISPR/Cas9 knockout screens on two SHP2i-sensitive cell lines, recovering genes expected to cause resistance (NF1, PTEN, CDKN1B, LZTR1, and RASA2) and novel targets (INPPL1, MAP4K5, epigenetic modifiers). We screened 14 additional lines with a focused CRISPR library targeting common “hits” from the genome-wide screens. LZTR1 deletion conferred resistance in 12/14 lines, followed by MAP4K5 (8/14), SPRED2/STK40 (6/14), and INPPL1 (5/14). INPPL1, MAP4K5, or LZTR1 deletion reactivated ERK signaling. INPPL1-mediated sensitization to SHP2i required its NPXY motif but not lipid phosphatase activity. MAP4K5 acted upstream of MEK through a kinase-dependent target(s); LZTR1 had cell-dependent effects on RIT and RAS stability. INPPL1, MAP4K5, or LZTR1 deletion also conferred SHP2i resistance in vivo. Defining the SHP2i resistance landscape could suggest effective combination approaches.
Probenecid affects muscle Ca2+ homeostasis and contraction independently from pannexin channel block
Authors: Jaque-Fernandez Francisco , Allard Bruno , Monteiro Laloé , Lafoux Aude , Huchet Corinne , Jaimovich Enrique , Berthier Christine , Jacquemond Vincent
Published: February 2023

Tight control of skeletal muscle contractile activation is secured by the excitation–contraction (EC) coupling protein complex, a molecular machinery allowing the plasma membrane voltage to control the activity of the ryanodine receptor Ca2+ release channel in the sarcoplasmic reticulum (SR) membrane. This machinery has been shown to be intimately linked to the plasma membrane protein pannexin-1 (Panx1). We investigated whether the prescription drug probenecid, a widely used Panx1 blocker, affects Ca2+ signaling, EC coupling, and muscle force. The effect of probenecid was tested on membrane current, resting Ca2+, and SR Ca2+ release in isolated mouse muscle fibers, using a combination of whole-cell voltage-clamp and Ca2+ imaging, and on electrically triggered contraction of isolated muscles. Probenecid (1 mM) induces SR Ca2+ leak at rest and reduces peak voltage-activated SR Ca2+ release and contractile force by 40%. Carbenoxolone, another Panx1 blocker, also reduces Ca2+ release, but neither a Panx1 channel inhibitory peptide nor a purinergic antagonist affected Ca2+ release, suggesting that probenecid and carbenoxolone do not act through inhibition of Panx1-mediated ATP release and consequently altered purinergic signaling. Probenecid may act by altering Panx1 interaction with the EC coupling machinery, yet the implication of another molecular target cannot be excluded. Since probenecid has been used both in the clinic and as a masking agent for doping in sports, these results should encourage evaluation of possible effects on muscle function in treated individuals. In addition, they also raise the question of whether probenecid-induced altered Ca2+ homeostasis may be shared by other tissues.
Cosmological fluids in the equivalence between Rastall and Einstein gravity
Authors: Chagoya Javier , López-Domínguez J C , Ortiz C
Published: February 2023

Rastall gravity is a modified gravity proposal that incorporates a non-conserved energy momentum tensor (EMT). We study the equivalence between Rastall gravity and general relativity, analyzing its consequences for an EMT of dark matter and dark energy. We find that the translation between Rastall and Einstein interpretations modifies the equation of state for each component. For instance, cold dark matter can translate into warm dark matter. If the EMT components are allowed to interact, the translation also changes the type of interaction between the components.
Early fault feature extraction for rolling bearings using adaptive variational mode decomposition with noise suppression and fast spectral correlation
Authors: Tian Shaoning , Zhen Dong , Liang Xiaoxia , Feng Guojin , Cui Lingli , Gu Fengshou
Published: February 2023

To accurately extract fault information from rolling bearing (RB) vibration signals with strong nonlinear and non-stationary characteristics, a novel method using adaptive variational mode decomposition with noise suppression and fast spectral correlation (AVMDNS-FSC) is proposed. The AVMDNS algorithm can adaptively select VMD parameters K and α, which reduces the error caused by the improper selection of VMD parameters based on experience or prior knowledge of the signal. Meanwhile, the AVMDNS also effectively suppresses noise in intrinsic mode function (IMFs) and avoids unexpected removal of the IMFs containing important fault information. In addition, the FSC can further suppress residual noise and interference harmonics to enhance the periodic fault pulses and hence accurately extract bearing fault features. Simulation analysis and experimental studies are carried out through comparison with other methods. Results show that the AVMDNS-FSC method has higher sensitivity and effectiveness in extracting early periodic fault pulses of RB vibration signals.
An accurate determination of the refractive indices of water and glass by smartphone photography
Authors: Chakrabarti Surajit , Pal Sanjoy Kumar , Sarkar Soumen
Published: February 2023

A smartphone can be used for many physics experiments by using the sensors built into the phone. The complementary metal oxide semiconductor (CMOS) (charge-coupled device, CCD) sensor of the camera records the images of objects photographed in pixels. The width of the image can be read off with micron level accuracy with the help of software available freely from the internet. If the dimensions of the object in the direction transverse to the viewing direction of the camera are known, the magnification of the object photographed can be determined accurately. A smartphone camera is a compound lens comprising a number of very thin lenses. A single thin lens is equivalent, as far as the transverse magnification is concerned, to a compound lens of the smartphone, when the thin lens has the same focal length as the effective focal length of the compound lens and is placed at its first principal plane. This property allows us to find experimentally the effective focal length of the compound lens of the camera accurately, using the thin lens equation. Once the focal length of the camera is known, the distance of an object can be determined by finding its magnification from the photograph. We have determined the refractive index of water accurately by photographing the apparent position of an object immersed in it. By determining the magnifications, we have found the real and apparent depths of the object. The ratio of these depths gives the refractive index. We have determined the refractive index of glass also using some thin glass slides.
Vertical control of DIII-D discharges with strong negative triangularity
Authors: Nelson A O , Hyatt A , Wehner W , Welander A , Paz-Soldan C , Osborne T , Anand H , Thome K E
Published: February 2023

Through predictive modeling validated by a series of experiments on DIII-D, the vertical stability of low β diverted plasmas with strong negative triangularity (NT) (

δ
∼
−
0.6

) is assessed. As a result of their unique magnetic geometry, NT plasmas feature larger Shafranov shifts and more elongated inner flux surfaces than positive triangularity counterparts, typically leading to enhanced vertical instability growth rates. However, coupling with the non-conformal vessel DIII-D wall reduces these growth rates to controllable values, providing a path forward for stabilizing strongly NT plasma with a diverted geometry. These discharges are used to validate GSdesign (part of the TokSys code suite) stability calculations in strong NT plasmas on DIII-D, with errors of no more than ∼20% observed between modeled and experimentally measured growth rates. Additions of diagnostic noise and power supply tuning to the TokSys model are needed to accurately capture the time dependence of DIII-D NT discharges, assisting with the design of control schemes specific to the DIII-D poloidal field coils. Finally, implications of these results on a future NT reactor are briefly described.
Constitutive behaviour study of Ba
x
K1−

x
Fe2As2 iron-based superconducting powder
Authors: Xia Xi , Zhu Yanchang , Zhu Chundong , Han Meng , Liu Cong , Wang Dongliang , Zhang Xianping , Ma Yanwei
Published: February 2023

In order to simulate the preparation process of Ba
x
K1−x
Fe2As2 (BaK-122) iron-based superconducting (IBS) wires and tapes and formulate appropriate forming process for practical production, it is very important to study the constitutive behaviour of BaK-122 IBS powder. However, there is little research on this aspect at present. In this paper, the constitutive behaviour of BaK-122 powder was investigated. The modified Drucker–Prager cap (DPC) model was introduced to describe the constitutive behaviour of BaK-122 powder. Uniaxial compression test, radial compression test and mould pressing test were carried out to determine the material parameters. Furthermore, the numerical simulation of pressing forming of BaK-122 powder and drawing process of BaK-122 IBS wires were carried out through the finite element simulation method. These results demonstrated that the simulations were in good agreement with the experimental results, which verified the accuracy of the model. The first proposal of this mode lays a foundation for further simulating the preparation process of BaK-122 IBS wires and tapes to guide the actual production.
Enhancement of vortex liquid phase and reentrant behavior in NiBi3 single crystals
Authors: Rollano V , de Ory M C , Gomez A , Gonzalez E M , Pribulová Z , Marcin M , Samuely P , Sanchez-Santolino G , Torres-Pardo A , Mompean F , García-Hernández M , Guillamón I , Suderow H , Menghini M , Vicent J L
Published: February 2023

We investigate the vortex phase diagram of needle shaped high quality NiBi3 single crystals by transport measurements. The current is applied along the crystalline b-axis of this intermetallic quasi-1D BCS superconductor. The single crystals show a Ginzburg-Levanyuk (G
i) parameter of about 10−7, larger by two orders of magnitude than G
i in elemental low T
c BCS superconductors. Vortex phase diagram, critical currents and pinning forces have been extracted from the experimental data. We observe (i) an enhancement of the vortex liquid phase, (ii) a reentrance of the liquid phase at low fields and (iii) an unusual magnetic field dependence of the pinning force. We suggest that these phenomena result from the interplay between pinning due to quenched disorder and the quasi-1D character of the material which could lead, for instance, to more complex pinning mechanisms at play.
New angular momentum state via the bosonic operator realization and its nonclassical property
Authors: Gao Qiang , Xia Yun-Jie
Published: February 2023

We theoretically introduce a new angular momentum state via the bosonic operator realization of angular momentum operators on a number state, and study its nonclassicality based on the sub-Poissonian distribution, photon number distribution, entanglement entropy and Wigner distribution. The results show that the nonclassicality of the new state for odd q is more stronger than that for even q, and the nonclassicality for any q always enhances first and then weakens with increasing g. Besides, the entanglement always increases with the increase of q for all of g, and finally reaches a maximum when g and h are in certain value ranges and q is large enough.
Microscopic study of neutron-induced fission process of 239Pu via zero- and finite-temperature density functional theory*
Authors: Chen Yong-Jing , Su Yang , Liu Li-Le , Dong Guoxiang , Ge Zhigang , Shu Nengchuan , Wang Xiaobao
Published: February 2023

To study the neutron-induced fission of

Pu, potential energy surface (PES) calculations were performed using zero and finite-temperature density functional theory (FT-DFT) with the Skyrme force. The energy of the incident neutron was simulated by the temperature of the FT-DFT. The variations of the least-energy fission path, fission barrier, total kinetic energy, scission line, and mass distribution of fission fragments with the incident neutron energy were analyzed. It was learned that an increase in the temperature lowers the barrier height, the isomeric-state energy, and the ridge between symmetric and asymmetric fission valleys. Additionally, the gaps of the single particle levels become smaller with an increase in the temperature. As the temperature increases, the pre-fission region shrinks, and the scission occurs at smaller deformation around the symmetric fission channel. At low temperatures, the pairing correlations in the collective space are similar to those in zero-temperature DFT, and when the temperature is

0.3 MeV, the pairing gaps decrease rapidly. Two different methods were used to calculate the fission yields of the neutron-induced fission

Pu (n, f) with different incident neutron energies, in the framework of time-dependent generator coordinate method (TDGCM). One way to calculate the fission yield of

Pu (n, f) is to solve the collective equation of the TDGCM by using the PES from the FT-DFT with the corresponding temperature. The other involves using the PES from the zero-temperature DFT and adjusting the initial collective energy of the wave packet in the TDGCM according to the incident neutron energy. For the cases of the lower incident neutron energies, these two methods gave similar results and reproduced the experimental peak and width of fission fragment distribution. However, for the highest incident neutron energy considered in this study, the results from the TDGCM using the PES from zero-temperature DFT deviated explicitly from the experimental data, whereas those obtained by using the PES from FT-DFT remained close to the experimental data. This indicated that, with the increase in the incident neutron energy, the shell structure of the compound nuclei changed explicitly; thus, it may not be effective to use the PES from zero-temperature to perform the fission dynamic calculation.
Validation and optimization of the epithermal neutron flux detector using the 71Ga(n,γ)72Ga reaction
Authors: Byambatseren E. , Burdakov A. , Bykov T. , Kasatov D. , Kolesnikov Ia. , Savinov S. , Sycheva T. , Taskaev S.
Published: February 2023

An intense epithermal neutron flux is necessary for boron
neutron capture therapy (BNCT), a promising technique for the
treatment of malignant tumors. The epithermal neutron flux is an
essential characteristic of the BNCT neutron beam and its
measurement is directly related to the reliability of the treatment
planning system. Such a tool could be a cylindrical activation
detector using 71Ga(n,γ)72Ga reaction. This paper
describes a detector made in the likeness of the previously proposed
one and presents the results of numerical simulation of the detector
sensitivity and its experimental use. The paper notes the difference
between the simulated sensitivity of the detector and the
sensitivity of the previously proposed one and makes assumptions
about the reason for this difference. The work also proposes an
improvement of the detector, which allows not only to reduce the
contribution of fast neutrons to the detector sensitivity, but also
to provide a new opportunity to refine the spectrum of neutrons that
are most effective for the treatment of deep-seated tumors.
Real energies and Berry phases in all PT-regimes in time-dependent non-Hermitian theories
Authors: Fring Andreas , Taira Takano , Tenney Rebecca
Published: February 2023

We demonstrate that the existence of a Hermitian time-dependent intertwining operator that maps the non-Hermitian time-dependent energy operator to its Hermitian conjugate and its right to its left eigenstates guarantees the reality of the instantaneous energies. This property holds throughout all three

P
T

-regimes, in the time-independent scenario referred to as the

P
T

-symmetric regime, the exceptional point and the spontaneously broken

P
T

-regime. We also propose a modified adiabatic approximation consisting of an expansion of the wavefunctions in terms the instantaneous eigenstates of the energy operator, instead of the usually used eigenfunctions of the Hamiltonian. We show that this proposal always leads to real Berry phases. We illustrate the working of our general proposals with two explicit examples for a time-dependent non-Hermitian spin model.
Influence of solvent on accelerating deposition time of α-Fe2O3 photoanode via AACVD
Authors: Aadenan Amin , Arzaee Nurul Affiqah , Noh Mohamad Firdaus Mohamad , Daud Mohd Norizam Md , Mumthas Inzamam Nawas Nawas , Hisham Danial Hakim Badrul , Anuar Muhammad Athir Mohamed , Mohamed Nurul Aida , Ibrahim Mohd Adib , Ludin Norasikin Ahmad , Teridi Mohd Asri Mat
Published: February 2023

The optical and photoelectrochemical (PEC) properties of semiconductors can be manipulated by varying the deposition time and the solvent used. In this work, the study investigates the influence of organic solvent (methanol and ethanol) on accelerating deposition time for the efficient optical and photoelectrochemical performance of the fabricated α-Fe2O3 thin film photoanode below 10 minutes. The α-Fe2O3 film was fabricated via aerosol-assisted chemical vapor deposition (AACVD). The study discovered that the solvent with high polarity enhanced the crystal growth direction of α-Fe2O3 on the (110) orientation. The UV-vis showed that all deposited α-Fe2O3 films exhibit the absorption band in the visible-light region with the estimated energy bandgap of 2.10 eV. Furthermore, the PEC performance exhibited good photoanodic responses with excellent charge transfer behavior and photostability. These findings show that the choice of solvent could influence the rapid deposition time, thus, would be reliable to accelerate the fabrication process of photoelectrochemical water-splitting photoanode.
Single-walled carbon nanotube (SWCNT) thin film for optoelectronics device prepared by spray coating technique.
Authors: Kunaraj Arulampalam , Yahya Iskandar , Bakar Ahmad AA , Chelvanathan Puvaneswaran
Published: February 2023

CNT is a novel material with exceptional properties. SWCNT thin films have been used in many different applications. To fabricate the SWCNT film, various methodologies have been introduced, however, the problem of fabricating uniform SWCNT thin film remains unsolved. Spray coating technique (SCT) is the most effective method for producing a uniform SWCNT thin film. The CNT thin films were deposited on glass substrates via SCT with different nozzle distances (from 2.5 cm to 12.5 cm). The morphological, topological, electrical and optical properties of CNT thin films were characterized using appropriate techniques. The electrical analysis depicted that the sheet resistance of thin films reduced from 40220 Ω/sq. to 1330 Ω/sq. as the spray nozzle distance was increased from 2.5 cm to 10 cm sheet resistance reached 2133 Ω/sq. for 12.5 cm which confirmed the concentration of CNT was highest at 10 cm nozzle distance. The optical analysis of the CNT thin films gave transmittance values in percentage of 64%, 60%, 52%, 43%, and 46%, respectively for the nozzle distance of 2.5 cm, 5 cm, 7.5 cm, 10 cm, and 12.5 cm. Transmittance percentage decreased from 2.5 cm to 10 cm nozzle distance, indicative of an uniform film coverage of CNT layer. The findings of this study could be a platform for producing an optimized CNT thin film using a SCT for optoelectronic devices.
Before Montgomery
Authors: Holt Thomas C.
Published: February 2023

Although the Montgomery Bus Boycott in 1955 is generally agreed to be the starting point of the “classic” Civil Rights Movement, it built on a century-long history of African American protests of segregated transportation. Beginning with challenges to racially discriminatory treatment on horse-drawn streetcars in the decade before the Civil War and continuing with boycotts in the 1890s and street protests of racial violence and employment discrimination over the first five decades of the 20th century, African Americans in the North and South never relented in their demands for equal justice. The founding of the NAACP in 1909 provided the organizational means for sustained legal challenges as well as occasional street protests against racial segregation and discrimination. By the 1940s, other, more militant organizations joined the struggle and pursued more direct challenges to the Jim Crow laws.
Communities organizing for change: The new “Old South”
Authors: Holt Thomas C.
Published: February 2023

During the early 1960s, Movement tactics shifted from lunch-counter sit-ins to mass marches designed to pressure city administrations to respond to a broader racial reform agenda, including ending discrimination in public service and private employment as well as the desegregation of public accommodations like buses and lunch-counters. The most prominent targets during this second phase of the Movement were cities and towns steeped in “Old South” traditions but also experiencing social and economic changes much like the New South cities. In these cities whites reacted with harsh legal penalties and both official as well as vigilante violence. Thus did civil rights activism in cities like Birmingham, Alabama and Danville, Virginia bring international as well as national attention to the brutalities as well as the absurdities of the South’s discriminatory laws governing public accommodations.
Race, slavery, and ideology in colonial North America
Authors: Holloway Jonathan Scott
Published: February 2023

This chapter places the arrival of the enslaved Africans in Jamestown Colony in 1619 into the larger context of the emergence of the slave trade in Africa and the presence of early African explorers in North America. It describes the horrors of the Middle Passage. The chapter also explores the contradictions in the founding ideologies of the English colonies and then the United States of America, both of which relied upon narratives of freedom while creating systems of racialized slavery. Thomas Jefferson embodies many of these contradictions—simultaneously an eloquent author of democratic governance and a slaveholder.
The nature of addiction
Authors: Humphreys Keith
Published: February 2023

This chapter explores different ways of describing the nature of addiction. According to Alcoholics Anonymous, addiction is a disease rooted in a person’s character that has physical, psychological, and spiritual components. The 12-step disease model infers that recovery needs cessation of substance use alongside the reconstruction of moral character. The chapter also looks into the idea of addiction as a brain disease as well as viewing it not as a disease but as poor health behavior. The chapter explains how each model of addiction triggers implications for holding people accountable for their conduct. Moreover, legal alcohol and other public safety harms correlate to the significant interaction between the criminal justice system and addicted people.
Causes of addiction
Authors: Humphreys Keith
Published: February 2023

This chapter considers the possible causes of addictions. According to science, addiction has genetic components wherein people with addicted relatives can have higher risks of addiction. Other possible contributors to addiction range between human evolution and modern technology, biochemistry, and global commerce. The chapter also covers the risk and protective factors for addiction existing in individuals, environments, and transactions between the two. Moreover, the availability of the drugs and norms and values affect how common drug consumption will be. The most prevalent factor shaping human values and norms is religion, and religion tends to denounce substance use and intoxication. The chapter also studies the correlation between addiction and mental health.
Cultural and public policy approaches to addiction
Authors: Humphreys Keith
Published: February 2023

This chapter explores the cultural and public policy approaches to addiction. It recognizes the varying prevalence of drug addiction and its correlated experience in societies. Countries typically impose public policy involving formal laws, regulations, and programs to curb addiction. Meanwhile, cultural approaches refer to widespread practices and beliefs around drugs and addiction. The chapter examines the difference in cultural attitudes about drugs between more restrictive and more libertarian cultures. It also details the different public policies toward addiction, including prohibitions, regulation of addiction producing industries, providing services for people with addiction, preventing addiction in individuals, and reducing the incidence of addiction in the population.
133 THE RELATIONSHIP BETWEEN DELAYED HEALTHCARE UTILISATION AND CHRONIC CONDITIONS AMONG OLDER ADULTS DURING THE COVID-19 PANDEMIC IN IRELAND
Authors: Hennelly N , Lalor G , Gibney S , Kenny R A , Ward M
Published: February 2023

Background

The coronavirus 2019 (COVID-19) pandemic impacted significantly on the lives of older adults in Ireland, including the cancellation or postponement of healthcare services. This study examined the relationship between healthcare delay and older adults (50 years and over) with chronic conditions in Ireland.

Methods

This study used data from the Irish Longitudinal Study on Ageing (TILDA) COVID-19 study and previous waves of TILDA. The COVID-19 study data was collected between July 2020 and November 2020. Taking existing healthcare demand into account, logistic regression analysis was used to examine the relationship between healthcare delay and older adults with chronic conditions. Additional analysis, using multinomial logit regression, explored the reasons for healthcare delay, whether the delays were on the participants behalf or the health service provider.

Results

In total, 31.6% of participants reported healthcare delay. Older adults with two or more chronic conditions were more likely to experience healthcare delay than those with no chronic conditions. In the second analysis, older adults with two or more chronic conditions were more likely to have healthcare delayed by the provider and were also more likely to delay their own healthcare than those with no chronic conditions. Additionally, some other groups were more likely to experience healthcare delay such as: people aged 70 years and over, females, those with problematic alcohol consumption, those with third-level education, those who had visited the GP and those who reported polypharmacy. While older adults living with others and those living outside Dublin were less likely to experience healthcare delay.

Conclusion

The findings suggest that some groups of older adults may have been impacted more than others by healthcare delay during the pandemic. Policy and practice should focus on effective strategies to support the healthcare needs of these older adults going forward. Additionally, future research should examine the implications of healthcare delay on health outcomes.
199 EMBEDDING PHYSICAL ACTIVITY WITHIN HOME CARE SERVICES FOR OLDER ADULTS IN IRELAND—A QUALITATIVE STUDY OF BARRIERS AND FACILITATORS
Authors: Swan L , Horgan F , Cummins V , Doyle F , Galvin R , Burton E , Sorensen J , Jabakhanji S B , Skelton D , Townley B , Rooney D , Jackson G , Murphy L , Warters A , O'Sullivan M
Published: February 2023

Background

In Ireland, over 53,000 older adults are supported in their community by formal home support, amounting to an estimated 19 million care hours annually. There is a growing need to move beyond care, to more proactive approaches to maintain physical function. In a feasibility study, we delivered the ‘Care to Move’ (CTM) programme through existing home support services. The aim of the present qualitative study was to explore the experience and perceptions of Health Care Assistants (HCAs), who were trained in, and delivered the CTM programme.

Methods

We conducted semi-structured telephone interviews with 22 HCAs involved in the delivery of the programme among older adults [n = 35, mean age 82.8 (7.8) years]. Interview transcripts were coded and analysed thematically to capture barriers and facilitators to programme delivery.

Results

Barriers and facilitators were identified under three main themes i) the programme ii) the care setting, iii) the clients. Overall, there was a positive perception of the programme’s focus on ‘movement prompts and motivators’, the ‘fit’ within home support services, and the training provided. Practical challenges of limited time and the task-orientation nature of home support were reported as recurring barriers for CTM. Many HCAs commented on the value and perceived positive benefits of the programme for their clients. Though negative perceptions of older adult’s motivation or ability to engage with physical activity also emerged. Risk, such as injury or pain, was identified but was not a dominant theme.

Conclusion

Our preliminary findings suggest that embedding physical activity initiatives within home support services could be feasible. Restructuring of services, engaging HCAs, and moving beyond traditional ‘task-oriented' care models to more personalised proactive approaches may facilitate this initiative and support ageing in place.
201 THE BI-DIRECTIONAL ASSOCIATION BETWEEN LONELINESS AND DEPRESSION, BEFORE AND DURING THE COVID-19 PANDEMIC
Authors: Ward M , Kenny R A
Published: February 2023

Background

During the early months of the COVID-19 pandemic, older adults in Ireland experienced a threefold increase in the prevalence of loneliness while the percentage experiencing clinically significant depressive more than doubled. While loneliness and depression are related, the nature and directionality of this association is still unclear. This study describes changes in both depression and loneliness from before to during the COVID-19 pandemic and adds to the limited literature on the potential bi-directional nature of the association between loneliness and depression.

Methods

Data are from The Irish Longitudinal Study on Ageing (TILDA), a prospective nationally representative study of community-dwelling adults recruited from community-dwelling adults aged 50+. Data from three waves of TILDA, including a COVID-19 specific sub-study (n = 3,964), were included in the analyses. An auto-regressive cross-lagged panel modelling approach was used to estimate the effect of depression on loneliness and vice versa.

Results

Neither loneliness nor depression increased between the two time points prior to the COVID-19 pandemic and increased significantly during the pandemic. There was a bi-directional association between loneliness and depression across time while the strength of the correlation between the two was stronger during the pandemic than had previously been the case.

Conclusion

The COVID-19 pandemic has resulted in significant increases in both loneliness and depression among older adults. Furthermore, the bi-directional nature of the association between the two suggests that loneliness can both be considered a symptom of depression and that depression may foment a negative evaluation of an individual's social interactions resulting in greater loneliness.
34 PATHFINDER; AN ALTERNATIVE TO THE EMERGENCY DEPARTMENT FOR OLDER PATIENTS WHO DIAL 999/112
Authors: Bernard P , Corcoran G , Kenna L , O'Brien C , Ward P , Howard W , Hogan L , Mooney R
Published: February 2023

Background

Traditionally in Ireland, people who dial 999/112 are transported to the Emergency Department (ED) unless they decline to travel. Many have non-urgent needs that could be treated elsewhere. Older people are particularly vulnerable to adverse events while in hospital. Alternative care pathway models can reduce ED crowding and improve patient outcomes.

Methods

This service is a collaboration between the National Ambulance Service and Occupational Therapy (OT) and Physiotherapy Departments at a Dublin teaching hospital; funded by the Sláintecare Integration fund. It responds to low acuity 999/112 calls for people 65 years and older within the hospital catchment.

The team operates Monday–Friday, a ‘Rapid Response Team’ (Advanced Paramedic and Physiotherapy/OT) (8:00–20:00) and a ‘Follow-Up Team’ (Physiotherapy and OT) (8:00–16:00).

Once activated, the ‘Rapid Response Team’ conduct a comprehensive assessment in the home to establish whether a suitable alternative to the ED is available, commonly through the activation of one or more alternative care pathways (e.g. GP, Integrated Care Team, Primary Care Team, Community Intervention Team, Geriatric Day Hospital).

Results

In the first year, 485 patients were responded to. Average age was 80 years, average Rockwood Clinical Frailty Scale score was 6 (moderately frail). The majority (68%) remained at home following initial review. Less than 1% re-presented within 24 hours, 9% re-presented within 7 days. The three most common reasons for dialling 999/112 were falls, generally unwell and non-traumatic back pain. Patient and care-giver feedback demonstrated a very high level of satisfaction with the service.

Conclusion

This model is a safe alternative to the ED for older people following a low-acuity 999/112 call. Access to a network of alternative care pathways and immediate follow-up are two key enablers. The overwhelmingly positive feedback confirms that older people want this service. It is the first model of this kind to be evaluated in Ireland, and could expand, with local adaptation, nationally.
62 GAITKEEPER- A NOVEL ARTIFICIAL INTELLIGENCE BASED VIDEO GAIT ANALYSIS SYSTEM TO OBJECTIVELY MEASURE HEALTH STATUS
Authors: Kennelly S , Harte G , Boran A
Published: February 2023

Background

Frailty is associated with increased risk of falls, dependency, disability and higher health and social care utilisation. While characterised by a slowly progressive functional deterioration, frailty can be delayed or reversed through timely intervention. Identification of those at risk of new or worsening frailty remains a challenge. How fast we walk (gait-speed) is a reliable correlate of one’s physical, psychological, and cognitive performance. Slow gait speed can discriminate those at high risk of adverse outcomes due to declining health, however current gait-speed assessment instruments are often not feasible in clinical or community settings due to cost, specialist training, and space requirements. Here we introduce GaitKeeper, a system that uses artificial intelligence (AI) to measure gait and step events from video recorded on a mobile phone, thus facilitating identification of those at risk of new or worsening frailty.

Methods

A technical evaluation, in a research setting (n = 30), compared GaitKeeper’s performance capturing accurate positional data in healthy young individuals, versus the Vicon camera motion-capture system as the verification standard.

A subsequent clinical evaluation in people with mild cognitive impairment (n = 30), within an acute hospital, compared GaitKeeper gait speed data with specialist-physiotherapist clinical observational studies, and GaitRite systems during five-meter walking under single and dual-task conditions. Comprehensive measures of frailty (SHARE-FI), cognition (RBANS, MoCA), and physical performance (MiniBEST) were recorded in this clinical evaluation.

Results

The technical evaluation provides evidence of the ability of GaitKeeper to capture accurate gait data from video (n = 30, p < 0.001, error < 3%) versus the Vicon system. The clinical evaluation provides evidence of the accuracy in comparison with the GaitRite gold standard (n = 30, P < 0.001, error < 6%) in clinical setting.

Conclusion

GaitKeeper performance was well validated in comparison to existing gait analysis practices. This innovative AI based solution provides an opportunity to longitudinally monitor and quantify ‘wellness’ in older persons with accessible, accurate gait performance measurements anytime, anywhere, by anyone.
63 USING CO-DESIGN TO DEVELOP A CORE COMPETENCY FRAMEWORK FOR INTERPROFESSIONAL COLLABORATION WITHIN INTEGRATED CARE TEAMS FOR OLDER PEOPLE IN IRELAND
Authors: O'Donoghue G , Shé É N , O'Shea M , Donnelly S , O'Donnell D
Published: February 2023

Background

Fundamental to the successful delivery of integrated care for older people in Ireland and internationally, is sustainable interprofessional collaboration (IPC). Current evidence, however, offers little guidance in terms of how IPC can be fostered and sustained within the context of integrated care and older people. This research aimed to design a framework that describes core competencies for IPC within integrated care teams (ICTs) for older people, and outline mechanisms by which ICTs could start to develop the necessary knowledge, skills and behaviours to demonstrate proficiency.

Methods

Using a co-design approach, academic health systems researchers, members of the National Integrated Care Programme for Older People in Ireland (IPC subcommittee), and public and patient representatives (nominated by Age Friendly Ireland) collaborated across three studies to devise a core competency framework. Study 1 used co-design workshops to develop and gain consensus on core competencies; study 2 employed semi-structured interviews to explore current working practice within two existing interprofessional ICTs and study 3, combined findings from study 1 and 2, validated the agreed upon competencies and finalised the IPC competency framework.

Results

Six competencies, within three domains, were agreed. Domain one, knowledge of the team, includes the competencies, understanding roles and making referrals. Domain two, communication, includes sharing information and communicating effectively and domain three, shared decision-making, includes the final two competencies, supporting decision making with older people and collective clinical decision-making.

Conclusion

This co-designed framework provides the scaffold for curriculum development for the training of health and social care professionals around interdisciplinary team working for the care of older people. The core competencies prioritise mutual respect and active elicitation of input from all disciplines, thereby empowering disciplinary-specific expertise. Finally, and perhaps most critically, the will and preferences of the older person are deemed central to effective integrated interprofessional working within the developed IPC framework.
80 THE EXPERIENCE OF ACCESSING PARKINSON’S DISEASE CARE: A QUALITATIVE INTERVIEW STUDY
Authors: O'Shea E , Rukundo A , Timmons S
Published: February 2023

Background

Little is known about the experience of health service access amongst people living with PD in Ireland.

Methods

Semi-structured telephone interviews were conducted from April 2020–January 2021. Purposive maximum variation sampling was employed, to ensure diversity. Recruitment was multipronged; through voluntary support groups, social media outlets, local newspaper, magazine and radio advertising, and posters in nursing homes and GP offices. Interviews ranged from 30–90 minutes and were audio-recorded. The data were managed using NVivo12. A thematic analysis was applied.

Results

Twenty-two participants were interviewed. Four themes were identified relating to service access: 1) ‘The Two Waitlists’; 2) ‘Geographic Factors’; 3) ‘The Private-Public Switch’; and 4) ‘Discriminatory Practices’. Regarding theme 1, the lengthy public waiting list was a deterrent, leading many to pay out-of-pocket to obtain their PD diagnosis privately. However, many cannot afford to pay out-of-pocket, creating a distinct inequity in terms of timely access for those with fewer resources. Additionally, post-diagnosis, the wait times between outpatient follow-up visits is significantly greater for public patients. The second theme refers to the distribution of PD services across the country; the concept of the ‘postcode lottery’ was recurring. Substantial variation in service provision is evident, with rural areas being particularly under-served. The ‘Private-Public Switch’ refers to a pattern of transfer from the private to the public system, post-diagnosis, to access to the range of HSCPs necessary for optimal PD management. Finally, ‘Discriminatory Practices’ refers to perceived discrimination by referring healthcare professionals, at two levels, on the basis of 1) age, and/or 2) perceived severity of disability. Such practices can affect timely access to diagnosis, and ongoing integrated PD management.

Conclusion

The two-tier health system structure, along with under-provision of integrated, outpatient PD services in certain areas, and biases/lack of knowledge amongst referring healthcare professionals, have contributed differentially to inequities in access for public and private PD patients across Ireland.
102 PROMOTING BRAIN HEALTH IN AN INTEGRATED CARE OUTREACH PROGRAMME
Authors: Mc Carthy C E , O'Malley K , Mannion E , Geoghegan J , Costello M , Conry M , Flanagan L , Corry M , Reddin C , Murphy R , Waters R , O'Donnell M , Robinson S , Canavan M
Published: February 2023

Background

Lifestyle modifications, in older at risk populations, may prevent or slow the rate of cognitive decline. Promotion of brain health has been recommended by the WHO and other governing bodies. Supporting patients in making these lifestyle changes, however, can be complex. Generic guidance may not apply to all in a heterogenous and frail patient cohort, when physical mobility may be limited and weight loss/nutrition a concern. We sought to review current practices and barriers to brain health guidance in a regional integrated care outreach programme (ICOP).

Methods

From March–June’21 the comprehensive geriatric assessment (CGA) of consecutive patients were reviewed. Those presenting with cognitive complaints, for their first assessment, were included. Demographic data and data on screening for hearing impairment and sleep disturbance were collected, in addition to information on physical activity and nutritional risk. Whether information and guidance on aspects of brain health was given was also assessed.

Results

30 patients met the inclusion criteria. The mean age was 80.3 and the mean clinical frailty scale (CFS) was 4.4. Hearing impairment was present in 20% (n = 6), with no information available in 10% (n = 3). All patients were screened for sleep disturbance, with 13% (n = 4) not fully satisfied with their sleep. Mobility aids, assistance or supervision were required in 40% (n = 12), and 23% (n = 7) were at medium or high malnutrition risk. Only 30% (n = 9) cooked their own meals. Generic brain health advice, or advice about sleep was documented in 30 (n = 9), without hearing impairment advice documented in any patient.

Conclusion

There are several barriers to brain health advice in the ICOP setting, with only 30% of patients having brain health advice documented. We are currently developing patient information leaflets on brain health, that will take potential barriers into account. Dedicated and specific information on local hearing services is also in development, as part of an ongoing quality improvement project.