bluuebunny/crossref_metadata_2025 huggingface dataset:
Ligand effects on phase separation of multivalent macromolecules
Authors: Ruff Kiersten M. , Dar Furqan , Pappu Rohit V.
Published: March 2021

Significance

Phase transitions of multivalent macromolecules known as scaffolds help drive the formation of functional biomolecular condensates in cells. The formation and dissolution of condensates is tightly regulated, as aberrant phase behavior is associated with disease. Here, we show that distinct types of ligands can exert control over the formation and dissolution of condensates by binding to distinct sites on scaffold molecules. We further show that the extent and direction of regulation can be inferred through direct measurements of how ligands impact scaffold phase boundaries. Our findings have broad implications for understanding and modeling ligand-mediated regulation of condensates in cells and for designing novel molecules that exert regulatory control over condensates.
Transcriptional heterogeneity and tightly regulated changes in gene expression duringPlasmodium bergheisporozoite development
Authors: Bogale Haikel N. , Pascini Tales V. , Kanatani Sachie , Sá Juliana M. , Wellems Thomas E. , Sinnis Photini , Vega-Rodríguez Joel , Serre David
Published: March 2021

Significance

A better understanding of the molecular mechanisms underlying the development ofPlasmodiumparasites inAnophelesmosquitoes would facilitate the development of malaria vaccines and of novel strategies to interrupt disease transmission. We characterized, at the single-cell level, the gene expression profiles of sporozoites from the rodent malaria parasitePlasmodium berghei, throughout their development in mosquitoes and upon salivation. Our analyses reveal heterogeneity in gene expression among parasites isolated from the same anatomical location, suggesting that parasite development is asynchronous in mosquitoes. In addition, our results highlight the role of gene expression changes in regulating the ability of sporozoites to remain quiescent in the salivary glands, and their rapid reactivation upon salivation.
In situ AP-XPS study on reduction of oxidized Rh catalysts under CO exposure and catalytic reaction conditions
Authors: Toyoshima Ryo , Ueda Kohei , Koda Yuki , Kodama Hiroshi , Sumida Hirosuke , Mase Kazuhiko , Kondoh Hiroshi
Published: March 2021

Reduction of oxidized Rh catalysts under carbon monoxide (CO) exposure and reaction conditions were studied by using ambient-pressure x-ray photoelectron spectroscopy. First, Rh powders pressed into a pellet were deeply oxidized and the reduction process under 100 mTorr CO environment was monitored in situ at different temperatures. The oxidized Rh surfaces are composed of Rh2O3 and RhO2, the latter of which is more segregated near the surface. Both oxide species are reduced simultaneously to the metallic state; kinetic analyses indicate that the activation energy of the reduction of the Rh oxides is 1.68 eV, which is a little larger than those for Pd oxides, probably due to a stronger Rh–O interaction. Reduction of oxidized Rh nano-particles deposited on SiO2 under two reaction conditions (CO + O2 and CO + NO + O2) was observed with increasing temperature. It was found that the reduction temperature shifts to the higher temperature in the presence of NO, even though the S-factors are almost the same. The NO molecule more strongly prevents the reduction of oxidized Rh catalyst compared to O2.
How to read between the lines of electronic spectra: the diagnostics of fluctuations in strongly correlated electron systems
Authors: Schäfer Thomas , Toschi Alessandro
Published: March 2021

While calculations and measurements of single-particle spectral properties often offer the most direct route to study correlated electron systems, the underlying physics may remain quite elusive, if information at higher particle levels is not explicitly included. Here, we present a comprehensive overview of the different approaches which have been recently developed and applied to identify the dominant two-particle scattering processes controlling the shape of the one-particle spectral functions and, in some cases, of the physical response of the system. In particular, we will discuss the underlying general idea, the common threads and the specific peculiarities of all the proposed approaches. While all of them rely on a selective analysis of the Schwinger–Dyson (or the Bethe–Salpeter) equation, the methodological differences originate from the specific two-particle vertex functions to be computed and decomposed. Finally, we illustrate the potential strength of these methodologies by means of their applications the two-dimensional Hubbard model, and we provide an outlook over the future perspective and developments of this route for understanding the physics of correlated electrons.
Is there a role for haematopoietic cell transplants after radiation and nuclear accidents?
Authors: Gale Robert Peter
Published: March 2021

My task is to consider whether haematopoietic cell transplants would be considered appropriate today in persons with features like victims of high-dose and dose-rate ionizing radiations after the Chernobyl nuclear power facility accident in 1986 given knowledge and experience gained over the past 35 years. First I consider the conceptual bases for considering an intervention appropriate and then the metric for deciding whether a transplant is appropriate in similar persons. Data needed to support this decision-making process include estimates of dose, dose-rate, dose uniformity, synchronous or metachronous injuries, donor availability and alternative interventions. Many of these co-variates have substantial uncertainties. Fundamental is a consideration of potential benefit-to-risk and risk-to-benefit ratios under conditions of substantial inaccuracy and imprecision. The bottom line is probably fewer transplants would be done and more victims would receive molecularly-cloned haematopoietic growth factors.
New two-dimensional arsenene polymorph predicted by first-principles calculation: robust direct bandgap and enhanced optical adsorption
Authors: Gao Yifan , Cheng Zixin , Wen Minru , Zhang Xin , Wu Fugen , Dong Huafeng , Zhang Gang
Published: March 2021

In this work, we predict a new polymorph of 2D monolayer arsenic. This structure, named δ-As, consists of a centrosymmetric monolayer, which is thermodynamically and kinetically stable. Distinctly different from the previously predicted monolayer arsenic with an indirect bandgap, the new allotrope exhibits a direct bandgap characteristic. Moreover, while keeping the direct bandgap unchanged, the bandgap of monolayer δ-As can be adjusted from 1.83 eV to 0 eV by applying zigzag-direction tensile strain, which is pronounced an advantage for solar cell and photodetector applications.
High electric field transport in GaAs0.51Sb0.49
Authors: Ferry David K
Published: March 2021

The semiconductor alloy GaAsSb is commonly found in many types of semiconductor devices, ranging from high electron mobility transistors to solar cells. Yet, surprisingly little is known about its transport properties. Here, we theoretically determine the high field transport properties of electrons and holes in the alloy GaAs0.51Sb0.49 that is lattice matched to InP and, in particular, is used in a great many of these types of semiconductor devices.
Internal energy activation stimulus on magneto-bioconvective Powell-Eyring nanofluid containing gyrotactic microorganisms under active/passive nanoparticles flux
Authors: Sreenivasulu P , Poornima T , Malleswari B , Reddy N Bhaskar , Souayeh Basma
Published: March 2021

Influence of Stephan blowing on a three-dimensional hydro magneto-bioconvective Eyring-Powell nanofluid containing Gyrotactic microorganisms under active and passive nanoparticle flux conditions is investigated in this paper. The presence of non-linear radiation along a bidirectional stretched surface is also deliberated throughout this analysis. A comparative study is made up for active and passive nanoparticle volume control. The study is relevant to novel microbial fuel cell technologies combining the nanofluid with bioconvection phenomena. The Prandtl’s boundary layer equations, approximated by Oberbeck-Boussinesq’s are studied under suitable boundary conditions. Similarity transformation is used to transform the governing boundary layer equations to dimensionless nonlinear ordinary differential equation model. The non-linear model is then resolved by combining the Runge–Kutta method and the MATHEMATICA software. The dimensionless velocity, temperature, nanoparticle concentration and density of motile microorganisms together with the wall shear stress, Nusselt, Sherwood and density of motile microorganism number are graphically presented to visualize the effects of particular parameters. A novel idea of Stefan blowing on three-dimensional space taking into consideration the non-linear radiation is implemented in the investigation of Eyring-Powell flow over a deformable sheet under the effects of slip and activation energy for the first time. Axial Newtonian slip decreases the momentum of the nanoflow while tangential slip augments the flow. Bio-convection parameter reduces the nanoparticle concentration of the rescaled density of motile microorganisms. Skin friction factor is dominant in passive nanoparticles flux rather than active nanoparticles flux. Passive nanoparticles help in smooth delivery of drugs which is seen here for zero mass flux. Energy transfer rate is high compared to active nanoparticle volume control. A zero mass flux acts as a cooling agent in this study by diffusing more heat from the system.
Entanglement based quantum key distribution: exact analytical solution in the case of detectors efficiency mismatch
Authors: Molotkov S N
Published: March 2021

The paper provides a complete analytical proof of the secrecy of the quantum key distribution for the single-photon quantum states in the case of different quantum efficiency of detectors. Taking into account the imperfect and different quantum efficiency of detectors is fundamentally important for ensuring the secrecy of keys in practical systems of quantum cryptography.
Evaluation of the characteristics of a hybrid power nuclear mini-reactor fueled by super-heavy elements
Authors: Okunev V S
Published: March 2021

The concept of a hybrid mini-reactor capable of operating in the mode of a nuclear fission reactor (on fast neurons), in the mode of a radionuclide source and simultaneously in both modes is considered. It is proposed to use the most long-lived isotopes of the 114th, 126th, and possibly 120th elements as fuel for such a mini-reactor. Such nuclides have not yet been obtained in laboratories around the world. The neutron effective cross sections and macroscopic cross sections for the nuclei of super-heavy elements are estimated. A simple and effective mathematical model of the neutron-physical calculation of a mini-reactor with fuel based on super-heavy nuclei is proposed. The model is based on the one-group diffusion approximation. The uncertainties of the cross sections are so great that the use of more accurate and high-precision calculation models can hardly be justified. The results of neutron-physical calculations of a mini-reactor with fuel based on the longest-lived isotopes of the 114th and 126th elements are presented. The critical mass of a ball (without a reflector) made from 114Fl will be 1.492 kg; the critical radius will be less than 2.48 cm. (For element 342126 1.474 kg and less than 2.33 cm respectively.)
Topological optimization of a part taking into account technological constraints
Authors: Lozhkin D V , Maksimov P V
Published: March 2021

Annotation. In this work, the topological optimization of an aluminum alloy bracket with specified mass restrictions and maximum von Mises stress intensities arising under the influence of load is carried out. The part was redesigned for the additive manufacturing method without forming a support structure, for this, restrictions on the overhang angle between the surfaces of the part and the build platform were used, all surfaces are considered self-supporting. Comparison of strength and stiffness characteristics of parts for bracket options, including both the original one, created by the designer, and those obtained after optimization, taking into account and without taking into account restrictions on the method of technological manufacture of the product, is performed.
Training of engineers in demand in the engineering industry at PSEDA
Authors: Lizunkov V G , Politsinskaya E V , Valuev D V , Zhilin E O
Published: March 2021

The article identified the criteria and levels of formation of the supra-professional competencies (team competency) which are essential for future engineers of technical universities, according to the stakeholders’ feedback on the priority social and economic development areas. The authors defined the formation levels of team competency among students of technical areas of training at the Research Tomsk Polytechnic University. They described and investigated theoretical and empirical research methods that allowed formulating specific pedagogical recommendations to solve the problem identified in the article.
Simulation study on temperature field and microstructure of Ti-6Al-4V alloy round ingot during EBCHM
Authors: Peng Bing-Bing , Li Xiang-Ming , Wang Xian , Mo Jian , Luo Lei
Published: March 2021

The solidification structure of Ti-6Al-4V round ingot during the electron beam cold hearth melting (EBCHM) directly determines the quality of the ingot and the performance of the subsequent rolled coil. In this paper, the Cellular Automaton Finite Element (CAFE) method is used to numerically simulate the solidification structure of Ti-6Al-4V ingot. Firstly, the mathematical model is established with a numerical solution. Secondly, effects of process parameters including the pouring temperature and pulling speed on the solidification structure are revealed. The results show that the microstructures predicted by the numerical method match the experimental results. For the case of fixed pulling speed, a reduction in the pouring temperature leads to the grain refinement and the decreased volatilization of Al. With an increase of the pulling speed, the number of grains first increases and then decreases, but the average grain size first decreases and then increases. Furthermore, the maximum grain size monotonically increases with increasing the pulling speed. Thus, the fine solidified structure with fine grains can be obtained at the pouring temperature of 1700 °C and the pulling speed of 4 × 10−4 m s−1.
Rotation sensing at the ultimate limit
Authors: Z Goldberg Aaron , B Klimov Andrei , Leuchs Gerd , L Sánchez-Soto Luis
Published: March 2021

Conventional classical sensors are approaching their maximum sensitivity levels in many areas. Yet these levels are still far from the ultimate limits dictated by quantum mechanics. Quantum sensors promise a substantial step ahead by taking advantage of the salient sensitivity of quantum states to the environment. Here, we focus on sensing rotations, a topic of broad application. By resorting to the basic tools of estimation theory, we derive states that achieve the ultimate sensitivities in estimating both the orientation of an unknown rotation axis and the angle rotated about it. The critical enhancement obtained with these optimal states should make of them an indispensable ingredient in the next generation of rotation sensors that is now blossoming.
Parametric-Regression–Based Causal Mediation Analysis of Binary Outcomes and Binary Mediators: Moving Beyond the Rareness or Commonness of the Outcome
Authors: Samoilenko Mariia , Lefebvre Geneviève
Published: March 2021

In the causal mediation framework, several parametric-regression–based approaches have been introduced in the last decade for estimating natural direct and indirect effects. For a binary outcome, a number of proposed estimators use a logistic model and rely on specific assumptions or approximations that may be delicate or not easy to verify in practice. To circumvent the challenges prompted by the rare outcome assumption in this context, an exact closed-form natural-effects estimator on the odds ratio scale was recently introduced for a binary mediator. In this work, we further push this exact approach and extend it for the estimation of natural effects on the risk ratio and risk difference scales. Explicit formulas for the delta method standard errors are provided. The performance of our proposed exact estimators is demonstrated in simulation scenarios featuring various levels of outcome rareness/commonness. The total effect decomposition property on the multiplicative scales is also examined. Using a SAS macro (SAS Institute, Inc., Cary, North Carolina) we developed, our approach is illustrated to assess the separate effects of exposure to inhaled corticosteroids and placental abruption on low birth weight mediated by prematurity. Our exact natural-effects estimators are found to work properly in both simulations and the real data example.
Safety and Effectiveness of Silicone Gel–Filled Breast Implants in Primary Augmentation Patients
Authors: Maxwell Daniel , Estes Megan , Walcott Jennifer McMillen , Canady John W , Hunter Tina D , Gache Larry , Wang-Ashraf Bernadette , Alexander Diane
Published: March 2021

Background

Results from the MemoryGel Breast Implants Core Clinical Study suggest these devices are safe and effective at 10 years after implantation. Although clinical trials are essential for measuring the safety and effectiveness of a device, real-world evidence can supplement clinical trials by providing information on outcomes observed in diverse clinical settings for a more heterogeneous population, without fixed treatment patterns, and without continuous patient monitoring, such that follow-up is more representative of normal clinical practice.

Objectives

The aim of this study was to measure real-world outcomes, including safety and effectiveness, in patients who underwent primary breast augmentation with smooth MemoryGel implants.

Methods

This was a case series looking at patients, age 22 years and older, who underwent primary breast augmentation at a single site between December 2006 and December 2016 and who had a minimum of 2 years of follow-up. Descriptive statistics were used to summarize baseline characteristics and outcomes. Kaplan-Meier models were used to estimate safety outcomes for capsular contracture (Baker grade III/IV), infection, and rupture.

Results

A total of 50/777 (6.4%) patients reported a complication, with an average time to complication of 3.9 years (range, 19 days-11.8 years) postprocedure. Kaplan-Meier estimates of the 10-year cumulative incidence of capsular contracture (Baker grade III/IV), infection, and rupture were 4.7%, 0.1%, and 1.6%, respectively.

Conclusions

Analyses of a large population from a single site provide further support for the long-term safety and effectiveness of MemoryGel breast implants in a primary augmentation cohort.

Level of Evidence: 4
Mitochondria-targeted antioxidant MitoQ ameliorates ischaemia–reperfusion injury in kidney transplantation models
Authors: Hamed M , Logan A , Gruszczyk A V , Beach T E , James A M , Dare A J , Barlow A , Martin J , Georgakopoulos N , Gane A M , Crick K , Fouto D , Fear C , Thiru S , Dolezalova N , Ferdinand J R , Clatworthy M R , Hosgood S A , Nicholson M L , Murphy M P , Saeb-Parsy K
Published: March 2021

Background

Ischaemia-reperfusion (IR) injury makes a major contribution to graft damage during kidney transplantation. Oxidative damage to mitochondria is an early event in IR injury. Therefore, the uptake, safety, and efficacy of the mitochondria-targeted antioxidant MitoQ were investigated in models of transplant IR injury.

Methods

MitoQ uptake by warm and cooled pairs of pig and declined human kidneys was measured when preserved in cold static storage or by hypothermic machine perfusion. Pairs of pigs’ kidneys were exposed to defined periods of warm and cold ischaemia, flushed and stored at 4°C with or without MitoQ (50 nmol/l to 250 µmol/l), followed by reperfusion with oxygenated autologous blood in an ex vivo normothermic perfusion (EVNP). Pairs of declined human kidneys were flushed and stored with or without MitoQ (5–100 µmol/l) at 4°C for 6 h and underwent EVNP with ABO group-matched blood.

Results

Stable and concentration-dependent uptake of MitoQ was demonstrated for up to 24 h in pig and human kidneys. Total blood flow and urine output were significantly greater in pig kidneys treated with 50 µmol/l MitoQ compared with controls (P = 0.006 and P = 0.007 respectively). In proof-of-concept experiments, blood flow after 1 h of EVNP was significantly greater in human kidneys treated with 50 µmol/l MitoQ than in controls (P ≤ 0.001). Total urine output was numerically higher in the 50-µmol/l MitoQ group compared with the control, but the difference did not reach statistical significance (P = 0.054).

Conclusion

Mitochondria-targeted antioxidant MitoQ can be administered to ischaemic kidneys simply and effectively during cold storage, and may improve outcomes after transplantation.
The Association Between Injurious Falls and Older Adults’ Cognitive Function: The Role of Depressive Mood and Physical Performance
Authors: Trevisan Caterina , Ripamonti Enrico , Grande Giulia , Triolo Federico , Ek Stina , Maggi Stefania , Sergi Giuseppe , Fratiglioni Laura , Welmer Anna-Karin
Published: March 2021

Background

The impact of falls on cognitive function is unclear. We explored whether injurious falls are associated with cognitive decline in older adults, and evaluated the role of changes in psychological and physical health as mediators of such association.

Methods

This prospective study involved 2267 community-dwelling participants in the Swedish National study on Aging and Care in Kungsholmen (≥60 years). Data on injurious falls (ie, falls requiring medical attention) during each 3-year time interval of follow-up were obtained from national registers. Assessment of cognitive function (Mini-Mental State Examination), depressive mood (Montgomery-Åsberg Depression Rating Scale), and physical performance (walking speed) were carried out every 3 or 6 years over a 12-year follow-up. The association between falls and cognition was estimated through linear mixed-effects models, and the mediating role of changes in depressive mood and physical performance was tested using mediation analysis.

Results

After adjusting for potential confounders, individuals who experienced injurious falls had a greater annual decline in Mini-Mental State Examination in the subsequent time interval (β = −1.49, 95% CI: −1.84; −1.13), than those who did not. The association increased with the occurrence of ≥2 falls (β = −2.13, 95% CI: −2.70; −1.56). Worsening of walking speed and depressive mood explained around 26% and 8%, respectively, of the association between falls and cognitive decline.

Conclusions

Injurious falls are associated with greater cognitive decline, and this association is partly mediated by worsening of physical performance and, in a lesser extent, of depressive mood. These findings suggest that physical deficits and low mood are potential therapeutic targets for mitigating the association between falls and cognitive decline.
Gait Speed and Instrumental Activities of Daily Living in Older Adults After Hospitalization: A Longitudinal Population-Based Study
Authors: Sprung Juraj , Laporta Mariana , Knopman David S , Petersen Ronald C , Mielke Michelle M , Weingarten Toby N , Vassilaki Maria , Martin David P , Schulte Phillip J , Hanson Andrew C , Schroeder Darrell R , Vemuri Prashanthi , Warner David O
Published: March 2021

Background

Hospitalization can impair physical and functional status of older adults, but it is unclear whether these deficits are transient or chronic. This study determined the association between hospitalization of older adults and changes in long-term longitudinal trajectories of 2 measures of physical and functional status: gait speed (GS) and instrumental activities of daily living measured with Functional Activities Questionnaire (FAQ).

Method

Linear mixed-effects models assessed the association between hospitalization (nonelective vs elective, and surgical vs medical) and outcomes of GS and FAQ score in participants (older than 60 years) enrolled in the Mayo Clinic Study of Aging who had longitudinal assessments.

Results

Of 4902 participants, 1879 had ≥1 hospital admission. Median GS at enrollment was 1.1 m/s. The slope of the annual decline in GS before hospitalization was −0.015 m/s. The parameter estimate (95% CI) for additional annual change in GS trajectory after hospitalization was −0.009 (−0.011 to −0.006) m/s, p < .001. The accelerated GS decline was greater for medical versus surgical hospitalizations (−0.010 vs −0.003 m/s, p = .005), and nonelective versus elective hospitalizations (−0.011 vs −0.006 m/s, p = .067). The odds of a worsening FAQ score increased on average by 4% per year. Following hospitalization, odds of FAQ score worsening further increased (multiplicative annual increase in odds ratio per year [95% CI] following hospitalization was 1.05 [1.03, 1.07], p < .001).

Conclusions

Hospitalization of older adults is associated with accelerated long-term decline in GS and functional limitations, especially after nonelective admissions and those for medical indications. However, for most well-functioning participants, these changes have little clinical significance.
The Uneven Later Work Course: Intersectional Gender, Age, Race, and Class Disparities
Authors: Moen Phyllis , Flood Sarah M , Wang Janet
Published: March 2021

Objectives

Later adult work attachments and exits are in flux, suggesting the need for understanding both the range of contemporary population-level pathways of work and nonwork and variations by overlapping social locations. We document patterned continuity and change in monthly work attachments and analyze the intersecting effects of age, gender, education, and race/ethnicity.

Methods

We capitalize on massive microlevel 16-month panel data from the Current Population Survey from 2008 through 2016 to empirically identify patterned pathways of monthly states: working full-time, long hours, part-time; being self-employed or unemployed; not working because of a disability, due to family care or other reasons, or because one defines oneself as retired.

Results

Analyses of 346,488 American women and men aged 50–75 years reveal patterned elasticity in the timing and nature of work attachments in the form of six distinctive pathways. Our intersectional analyses illustrate divergences and disparities: advantages for educated White men, disadvantages for low-educated Black men and women through their early 60s, and intersecting effects of gender, education, and race/ethnicity during the later work course across age groups. We find convergence across social markers by the 70s.

Discussion

This research highlights the importance of intersectional analysis, recasting the gendered work course in later adulthood into a framework of even greater complexities within mutually shaping categories of race/ethnicity, class, and age. Older Americans experience patterned, uneven pathways around work and nonwork. We recommend additional scholarship on the dynamics of constrained and disparate choices unfolding across multiple intersecting social locations.
RTEX: A novel framework for ranking, tagging, and explanatory diagnostic captioning of radiography exams
Authors: Kougia Vasiliki , Pavlopoulos John , Papapetrou Panagiotis , Gordon Max
Published: March 2021

Objective

The study sought to assist practitioners in identifying and prioritizing radiography exams that are more likely to contain abnormalities, and provide them with a diagnosis in order to manage heavy workload more efficiently (eg, during a pandemic) or avoid mistakes due to tiredness.

Materials and Methods

This article introduces RTEx, a novel framework for (1) ranking radiography exams based on their probability to be abnormal, (2) generating abnormality tags for abnormal exams, and (3) providing a diagnostic explanation in natural language for each abnormal exam. Our framework consists of deep learning and retrieval methods and is assessed on 2 publicly available datasets.

Results

For ranking, RTEx outperforms its competitors in terms of nDCG@k. The tagging component outperforms 2 strong competitor methods in terms of F1. Moreover, the diagnostic captioning component, which exploits the predicted tags to constrain the captioning process, outperforms 4 captioning competitors with respect to clinical precision and recall.

Discussion

RTEx prioritizes abnormal exams toward the improvement of the healthcare workflow by introducing a ranking method. Also, for each abnormal radiography exam RTEx generates a set of abnormality tags alongside a diagnostic text to explain the tags and guide the medical expert. Human evaluation of the produced text shows that employing the generated tags offers consistency to the clinical correctness and that the sentences of each text have high clinical accuracy.

Conclusions

This is the first framework that successfully combines 3 tasks: ranking, tagging, and diagnostic captioning with focus on radiography exams that contain abnormalities.
Why do people oppose mask wearing? A comprehensive analysis of U.S. tweets during the COVID-19 pandemic
Authors: He Lu , He Changyang , Reynolds Tera L , Bai Qiushi , Huang Yicong , Li Chen , Zheng Kai , Chen Yunan
Published: March 2021

Objective

Facial masks are an essential personal protective measure to fight the COVID-19 (coronavirus disease) pandemic. However, the mask adoption rate in the United States is still less than optimal. This study aims to understand the beliefs held by individuals who oppose the use of facial masks, and the evidence that they use to support these beliefs, to inform the development of targeted public health communication strategies.

Materials and Methods

We analyzed a total of 771 268 U.S.-based tweets between January to October 2020. We developed machine learning classifiers to identify and categorize relevant tweets, followed by a qualitative content analysis of a subset of the tweets to understand the rationale of those opposed mask wearing.

Results

We identified 267 152 tweets that contained personal opinions about wearing facial masks to prevent the spread of COVID-19. While the majority of the tweets supported mask wearing, the proportion of anti-mask tweets stayed constant at about a 10% level throughout the study period. Common reasons for opposition included physical discomfort and negative effects, lack of effectiveness, and being unnecessary or inappropriate for certain people or under certain circumstances. The opposing tweets were significantly less likely to cite external sources of information such as public health agencies’ websites to support the arguments.

Conclusions

Combining machine learning and qualitative content analysis is an effective strategy for identifying public attitudes toward mask wearing and the reasons for opposition. The results may inform better communication strategies to improve the public perception of wearing masks and, in particular, to specifically address common anti-mask beliefs.
Oxford Handbook of Respiratory Nursing
Authors: Robinson Terry , Scullion Jane
Published: March 2021

Respiratory disease is one of the leading causes of both mortality and morbidity, causing a significant burden on healthcare resources, the economy, and on individual patients and their carers. Respiratory conditions are managed in many different settings, from home and residential care through the full range of primary to tertiary care. The multifaceted nature of both diseases affecting respiration and the care options is comprehensively covered in this second edition of the Oxford Handbook of Respiratory Nursing. Offering a systematic description of the main respiratory diseases found in adults, the Handbook covers the assessment, diagnosis, and nursing management of each condition. With a special focus on the role of the multidisciplinary team in meeting the multiple care needs of respiratory patients, the Handbook covers both physical and psychosocial concerns, and both pharmacological and non-pharmacological therapies.
Pleural effusion
Authors: Robinson Terry , Scullion Jane
Published: March 2021

If fluid collects in between the pleural layers the patient is deemed to have a pleural effusion. A pleural effusion can occur unilaterally (affecting the pleural space of one lung) or bilaterally (affecting both lungs). Pleural effusion is a very common presentation for a variety of different pathologies. This chapter provides the definition, aetiology, and clinical features of pleural effusion. Investigations (chest X-ray, ultrasound, thorax CT, pleural aspiration, LDH, and cytology among others) and management are included. Specific aspects of nursing care, including symptom control, care of drains and wound sites, and the provision of information and patient support are outlined.
Useful contacts
Authors: Robinson Terry , Scullion Jane
Published: March 2021

This chapter provides links to the major societies and organizations involved in respiratory nursing, which are also mentioned throughout the text of this second edition of the Oxford Handbook of Respiratory Nursing. In the individual chapters in this book, references are made to useful contacts for specific disease areas, evidence-based guidelines, charities, and support groups—the contact details for these organizations have all been consolidated here in one easy-to-find location. The list in this chapter includes website addresses of organizations that may apply to the majority of readers, and which may prove useful when meeting the needs of respiratory patients.
The psychological impact of involvement in the Irish Republican Army during the ‘Troubles’: Preliminary evidence of moral injury
Authors: Bont Eke
Published: March 2021

To elucidate some of the psychological implications of involvement in terrorism, this study investigated whether former members of the Irish Republican Army (IRA) experienced moral injury. Ten autobiographical sources from former IRA members who were active during the ‘Troubles’ in Northern Ireland were qualitatively analysed through interpretative phenomenological analysis. The analysis yielded preliminary evidence of morally injurious experiences and symptoms. These symptoms were commonly coped with through reparative actions. Three types of morally injurious experiences were found in this population: experiences associated with the IRA’s strategy of violence; experiences of informing; and experiences during the hunger strike campaigns. Additionally, there was evidence of moral disillusionment with the IRA. The analysis also identified factors that decreased susceptibility to moral injury. How moral injury and moral disillusionment might have played a role in disengagement from the IRA is discussed.
Counter-radicalization, public health, and racism: A case analysis of Prevent
Authors: Younis Tarek
Published: March 2021

The threat of terrorism is well documented to be associated with Muslims and Islam in British public consciousness. This chapter will emphasize the sociopolitical context underlying public health strategies seeking to address radicalization and extremism, especially given the UK government’s recent pivoting of its ‘Prevent’ policy within mental health services. Drawing upon two years of empirical fieldwork exploring the impact of the Prevent duty in the National Health Service, this chapter will outline several key issues with counter-radicalization policies enacted within health settings. Firstly, I found that mental health professionals—especially Muslims—self-censored their critical thoughts of Prevent, largely as a result of the political and moral subscript underlying counterterrorism: the ‘good’ position was to accept their counterterrorism duty, and the ‘bad’ position was to reject it. Secondly, Prevent significantly emphasizes reliance on ‘trusting one’s gut’ given the elusive framework of psychological risk factors it outlines during training. In turn, the government engages in what I call performative colour blindness: the active recognition and erasure of a common sense that associates racialized Muslims with the threat of terrorism. Colour blindness, however, is known to be integral for the maintenance of institutionally racist practices in contemporary times. This chapter ends by highlighting two understated issues of racism in contemporary public health approaches to counter-radicalization: the reinvigorated impulse to ‘tackle’ the far-right and the question of coercion and accountability.
Leadership, conflict, and cooperation
Authors: Alderdice Lord John
Published: March 2021

The author reviews what he has learnt from 40 years of analysing and engaging in the resolution of campaigns of terrorism and politically motivated violence, initially in Ireland, and then in other parts of the world. He uses his experience as a psychoanalytic psychiatrist and the leader of a political party to address not just theory but practice and some key lessons learnt about leadership in the context of increasing polarization and violence. This includes the personality and qualities of the leader, the counter-intuitive tactics required and the challenges and opportunities in moving from violent conflict to democratic cooperation. He describes aspects of large group psychology and the practice of negotiation and peace-building as well as important requirements for political and community leadership in the changing context of violent conflict.
Extremism, violence, and mind: Apprehending the super-complex
Authors: Bhui Kamaldeep , Bhugra Dinesh
Published: March 2021

In this concluding chapter we review the key concepts and emergent research and practice domains for future investigation. We consider the shift from simple to complicated, complex, and super-complexity sciences as the foundation for future interdisciplinary research and practice, and synthesize the contributions in this chapter towards a future agenda.
Intensive and acute cardiovascular care: an introduction
Authors: Bonnefoy-Cudraz Eric , Price Susanna , Tubaro Marco , Vranckx Pascal , Vrints Christiaan
Published: March 2021

Cardiovascular diseases (CVDs) are a major cause of premature death worldwide and an important cause of loss of disability-adjusted life years. For most types of CVD early diagnosis (within minutes) and intervention are independent drivers of patient outcome. Clinicians must be properly trained and centres appropriately equipped in order to deal with these critically ill cardiac patients.
Patient safety and clinical governance
Authors: Parkin Matthew , Quinn Tom
Published: March 2021

This chapter builds on the original work done by Elizabeth Haxby and Susanna Walker in the 2nd edition of the ESC Textbook of Critical and Acute Cardiac Care. Clinical governance appeared as a concept in the UK in the late 1990s following scandals in which patients were harmed as a consequence of health care failures. Further international research estimates that one in ten inpatients suffer harm as a result of their health care, leading to death in some cases. Clinical governance is a framework centred around domains of patient safety, clinical effectiveness, and patient experience, underpinned by effective teamwork, leadership, and communication. Its aim is to ensure consistent, reliable, high-quality care delivered by competent individuals in a safe environment. Understanding why things go wrong in health care is key to finding solutions to ensure patient safety. Health care is an increasingly high-risk activity at organizational, departmental, and individual levels, and hazard identification and management are important. Recent recognition of human factors as contributing to many adverse events has facilitated the exploration of how health care professionals function within the context of a high-pressure, unpredictable environment.
Chest pain in the emergency department and the chest pain unit
Authors: Vrints Christiaan , Stepinska Janina , Claeys Marc J
Published: March 2021

The diagnosis and assessment of acute chest pain remain challenging. Inappropriate discharge of patients with unrecognised life-threatening acute cardiovascular disease such as acute myocardial infarction or acute aortic syndromes from the hospital can result in potentially avoidable death. By contrast, routine hospital admission of patients with non-significant chest pain can lead to unnecessary investigations and interventions, with associated potential harm and increased healthcare costs. As only a small minority of the patients presenting with acute chest pain will ultimately be diagnosed with an acute coronary syndrome or another life-threatening acute cardiovascular syndrome it is essential to use rapid and straightforward diagnostic methods that allow accurate identification of high-risk chest pain patients and safe and early discharge of low risk patients in order to avoid congestion in the emergency department. Triage and diagnosis of patients presenting with acute chest pain should rely on careful history taking, judicious interpretation of the 12 lead ECG on presentation and the use of rapid rule-in/rule out diagnostic algorithms of acute myocardial infarction using high sensitivity cardiac troponin assays for the detection of myocardial cell necrosis. Chest pain units (CPU) are organizational short-stay units with specific management protocols designed to facilitate and optimize the diagnosis of patients presenting with chest pain. Implementation of CPU has results in increased adherence to guidelines and an improved clinical outcome.
Blood gas analysis: acid–base, fluid, and electrolyte disorders
Authors: Shariff Farah , Paul Richard
Published: March 2021

Acid-base homeostasis is vital for the maintenance of normal tissue and organ function, as both acidosis and alkalosis can have harmful and potentially life-threatening effects on the human body. Arterial blood gas analysis, combined with routine clinical history and examination, can provide useful information for the management of the critically ill cardiac patient. Most acid–base derangements are reversed by treatment of the underlying disease process, rather than by simple correction of the abnormal pH, and prognosis is determined by the nature of the underlying disease, rather than by the extent of pH value deviation. In this chapter, an approach is presented for prompt and accurate acid–base interpretation. Water and electrolyte disorders are common in the intensive cardiac care unit, particularly in patients with cardiac failure. Prompt recognition and treatment are required to prevent cardiovascular and neurological compromise. Therapeutic strategies range from simple electrolyte substitution and fluid management to extracorporeal filtration of excess fluid and electrolytes. These are discussed in this chapter.
Computerized tomography: coronary angiography and cardiac imaging
Authors: Smit Jeff M , Mahdiui Mohammed El , Graaf Michiel A de , Scholte Arthur JHA , Kroft Lucia , Bax Jeroen J
Published: March 2021

Patients presenting with chronic and acute chest pain constitute a common and important diagnostic challenge. This has increased interest in using computerized tomography for non-invasive visualization of coronary artery disease in patients presenting with acute chest pain to the emergency department, particularly the subset of patients who are suspected of having an acute coronary syndrome, but without typical electrocardiographic changes and with normal troponin levels at presentation. As a result of rapid developments in coronary computerized tomography angiography technology, high diagnostic accuracies for excluding coronary artery disease can be obtained. It has been shown that these patients can be discharged safely. The accuracy for detecting a significant coronary artery stenosis is also high, but the presence of coronary artery atherosclerosis or stenosis does not imply necessarily that the cause of the chest pain is related to coronary artery disease. Moreover, non-invasive detection of coronary artery disease by computerized tomography has been shown to be related with an increased use of subsequent invasive coronary angiography and revascularization, and further studies are needed to define which patients benefit from invasive evaluation following coronary computerized tomography angiography. Conversely, implementation of coronary computerized tomography angiography can significantly reduce the length of hospital stay, with a significant cost reduction. Additionally, computerized tomography is an excellent modality in patients whose symptoms suggest other causes of acute chest pain such as aortic aneurysm, aortic dissection, or pulmonary embolism. Furthermore, acquisition of the coronary arteries, thoracic aorta, and pulmonary arteries in a single computerized tomography examination is feasible, allowing ‘triple rule-out’ (exclusion of aortic dissection, pulmonary embolism, and coronary artery disease). Finally, other applications, such as evaluation of coronary artery plaque composition, myocardial function and perfusion, and non-invasive assessment of fractional flow reserve from coronary computerized tomography angiography, are currently being developed and may also become valuable in the setting of chronic and acute chest pain in the future.
Physiotherapy in critically ill patients
Authors: Gosselink Rik , Roeseler Jean
Published: March 2021

Physiotherapists are involved in the management of patients with critical illness. Physiotherapy assessment of critically ill patients is less driven by medical diagnosis; instead, there is a strong focus on deficiencies at a pathophysiological and functional level. An accurate and valid assessment of respiratory conditions (retained airway secretions, atelectasis, and respiratory muscle weakness), physical deconditioning, and related problems (muscle weakness, joint stiffness, impaired functional exercise capacity, physical inactivity, and emotional function) allows the identifying of targets for physiotherapy. Evidence-based targets for physiotherapy are deconditioning, impaired airway clearance, atelectasis, (re-)intubation avoidance, and weaning failure. Early physical activity and mobility are key in the prevention, attenuation, or reversion of physical deconditioning related to critical illness. A variety of modalities for exercise training and early mobility are evidence-based and are implemented, depending on the stage of critical illness, comorbid conditions, and cooperation of the patient. The physiotherapist should be responsible for implementing mobilization plans and exercise prescription and make recommendations for their progression, jointly with medical and nursing staff.