bluuebunny/crossref_metadata_2025 huggingface dataset:
Oxygen and sulfur mass-independent isotopic signatures in black crusts: the complementary negative Δ33S reservoir of sulfate aerosols?
Authors: Genot Isabelle , Au Yang David , Martin Erwan , Cartigny Pierre , Legendre Erwann , De Rafelis Marc
Published: April 2020

Abstract. To better understand the formation and the oxidation pathways
leading to gypsum-forming “black crusts” and investigate their bearing on
the whole atmospheric SO2 cycle, we measured the oxygen (δ17O, δ18O, and Δ17O) and sulfur (δ33S, δ34S, δ36S, Δ33S, and
Δ36S) isotopic compositions of black crust sulfates sampled on
carbonate building stones along a NW–SE cross section in the Parisian basin.
The δ18O and δ34S values, ranging between 7.5 ‰ and 16.7±0.5 ‰ (n=27, 2σ) and between −2.66 ‰
and 13.99±0.20 ‰, respectively, show
anthropogenic SO2 as the main sulfur source (from ∼2 % to
81 %, average ∼30 %) with host-rock sulfates making the
complement. This is supported by Δ17O values (up to 2.6 ‰, on average ∼0.86 ‰), requiring
> 60 % of atmospheric
sulfates in black crusts. Negative Δ33S and Δ36S values between −0.34 ‰ and 0.00±0.01 ‰
and between −0.76 ‰ and -0.22±0.20 ‰, respectively,
were measured in black crust sulfates, which is typical of a magnetic isotope
effect that would occur during the SO2 oxidation on the building stone,
leading to 33S depletion in black crust sulfates and subsequent
33S enrichment in residual SO2. Except for a few samples, sulfate
aerosols mostly have Δ33S values > 0 ‰,
and no processes can yet explain this enrichment, resulting in an
inconsistent S budget: black crust sulfates could well represent the
complementary negative Δ33S reservoir of the sulfate aerosols, thus
solving the atmospheric SO2 budget.
Liquid–liquid phase separation in organic particles consisting of α-pinene and β-caryophyllene ozonolysis products and mixtures with commercially-available organic compounds
Authors: Song Young-Chul , Bé Ariana G. , Martin Scot T. , Geiger Franz M. , Bertram Allan K. , Thomson Regan J. , Song Mijung
Published: April 2020

Abstract. Liquid–liquid phase separation (LLPS) in organic aerosol particles can impact several properties of atmospheric particulate matter, such as cloud condensation nuclei (CCN) properties, optical properties, and gas-to-particle partitioning. Yet, our understanding of LLPS in organic aerosols is far from complete. Here, we report on LLPS of one-component and two-component organic particles consisting of α-pinene- and β-caryophyllene-derived ozonolysis products and commercially-available organic compounds of relevance to atmospheric organic particles. In the experiments involving single-component organic particles, LLPS was observed in 8 out of 11 particle types studied. LLPS almost always occurred when the oxygen-to-carbon elemental ratio (O : C) was ≤ 0.44, but did not occur when O : C was > 0.44. The phase separation occurred by spinodal decomposition, and when LLPS occurred, two liquid phases co-existed up to ~ 100 % relative humidity (RH). In the experiments involving two-component organic particles, LLPS was observed in 23 out of 25 particles types studied. LLPS almost always occurred when the average was O : C ≤ 0.67, but never occurred when the average O : C was > 0.67. The phase separation occurred by spinodal decomposition or growth of a second phase at the surface of the particles. When LLPS occurred, two liquid phases co-existed up to ~ 100 %. These results provide further evidence that LLPS is likely a frequent occurrence in organic aerosol particles in the troposphere, even in the absence of inorganic salts.
Abutting faults: a case study of the evolution of strain at Courthouse branch point, Moab Fault, Utah
Authors: van Gent Heijn , Urai Janos L.
Published: April 2020

Abstract. Slip planes and slip directions of subsequent generations
of faults were measured and analysed in the interaction damage zone of two
abutting faults in porous sandstones in order to understand the
palaeostress/palaeostrain evolution. The Courthouse branch point of the Moab Fault in SE Utah (USA) is a
much-studied, spectacular outcrop of two abutting faults, located in the
footwall block of the main fault and in the hanging wall block of the
abutting fault. The abutting fault is synthetic to the main fault. The
outcrop shows a wide range of deformation structures and fault-related
diagenesis such as striated slip planes, deformation bands, veins, Liesegang bands
and copper-rich mineralization. By combining our own measurements with published data on the relative age of
these structures, we classified the data in four sets. Using a Numeric
Dynamic Analysis (NDA) to calculate the orientation of the kinematic axes we
found three different palaeo-extension directions in the four sets, recording
the evolution of stress/strain axes during the abutting process. The first phase of deformation is regional extension in the NE–SW direction.
As the second fault approached the main fault from its footwall side and the
two faults started to become kinematically linked, the extension direction
changed so that the overall extension became perpendicular to the
approaching fault (NW–SE). Finally, the extension direction changed back to
being perpendicular to the first segment (NE–SW) when the two faults became
geometrically linked and regional extension became dominant again.
Brief Communication: Heterogenous thinning and subglacial lake activity on Thwaites Glacier, West Antarctica
Authors: Hoffman Andrew O. , Christianson Knut , Shapero Daniel , Smith Benjamin E. , Joughin Ian
Published: April 2020

Abstract. A system of subglacial lakes drained on Thwaites Glacier from 2012–2014. To improve coverage for subsequent drainage events, we extended the elevation and ice velocity time series on Thwaites Glacier through austral winter 2019. These new observations document a second drainage cycle and identified two new lake systems located in the western tributaries of Thwaites and Haynes Glaciers. In situ and satellite velocity observations show temporary
Managing and Sustaining the Coupled Water-Land-Food Systems in the Context of Global Change: How Qualitative System Dynamic Modelling Can Assist in Understanding and Designing High-Leverage Interventions
Authors: H. Kotir Julius
Published: April 2020

The water-land-food system is essential for sustaining the basic human needs. While the demand for these resources is increasing rapidly, their sustainability has been hampered by a plethora of challenges, including rapid population growth, climate change, land-use change, and land degradation. To attain a sustainable supply and efficiently manage these resources, interactions between all resources and the factors constraining/sustaining them need to be understood. In this chapter, four systems archetypes based or grounded in the systems thinking framework and system dynamics approach were employed to explore and identify the key system drivers, factors, and processes that influence the behaviour and sustainability of water-land-food resources nexus in the Volta River Basin, West Africa. Development of the archetypes centered on a generic causal loop diagram constructed with stakeholders in previous studies capturing the linkages between the population, water system, environmental and socioeconomics. These system archetypes illustrate that the past and the current paradigm of water and land and agricultural production management is unsustainable. The results highlight key areas, which could be useful for the current and future sustainable management, even under uncertain system understanding or deficiencies in quantitative data.
GIS and Statistical Evaluation of Fluoride Content in Southern Part of Upper Rasyan Aquifer, Taiz, Yemen
Authors: Saeed Mahbob Naser Ramzy , El Bakkali Mohammed , Belghyti Driss
Published: April 2020

Fluorosis continues to be an endemic problem in Yemen. More areas are being affected by fluorosis in different parts of this country. The present study aims to identify the intensity and the spatial extent of fluoride concentration in groundwater of the southern part of the upper Wadi Rasyan, Taiz, Yemen. 93 sampling points were selected; the sampling included all types of sources of groundwater and all types of aquifers. The results show that 71% of samples exceed the WHO drinking water guidelines value of 1.5 mg/l, and there are wide variation for groundwater’s content of fluoride in the same aquifer (whether, volcanic and alluvial) and in the same of groundwater type, and these variations between the different water types or between the different depths of water (alluvial and volcanic aquifers) are not significantly different. The high concentration of fluoride in groundwater of the volcanic aquifer is likely because of the nature of geology formations by the water-rock interaction result of long-time residence of water in contact with the geology formation. The high concentration of fluoride in the alluvial aquifer likely resulting the waste of urban and industrial activates sources, the over exploration of groundwater, the arid climatic and the activities agriculture.
Fibril Formation by Glucagon in Solution and in Membrane Environments
Authors: Naito Akira
Published: April 2020

Glucagon is a 29-amino acid peptide hormone secreted by pancreatic α-cells and interacts with specific receptors located in various organs. Glucagon tends to form gel-like fibril aggregates that are cytotoxic because they activate apoptotic signaling pathways. First, fibril formation by glucagon in acidic solution is discussed in light of morphological and structural changes during elapsed time. Second, we provide kinetic analyses using a two-step autocatalytic reaction mechanism; the first step is a homogeneous nuclear formation process, and the second step is an autocatalytic heterogeneous fibril elongation process. Third, the processes of fibril formation by glucagon in a membrane environment are discussed based on the structural changes in the fibrils. In the presence of bicelles in acidic solution, glucagon interacts with the bicelles and forms fibril intermediates on the bicelle surface and grows into elongated fibrils. Glucagon-dimyristoylphosphatidylcholine (DMPC) bilayers in neutral solution mimic the environment for fibril formation by glucagon under near-physiological condition. Under these conditions, glucagon forms fibril intermediates that grow into elongated fibrils inside the lipid bilayer. Many days after preparing the glucagon-DMPC bilayer sample, the fibrils form networks inside and outside the bilayer. Furthermore, fibril intermediates strongly interact with lipid bilayers to form small particles.
Psychosomatic Approach to Fibromyalgia Syndrome: Medical, Psychological, and Social Aspects
Authors: Vicente Martínez-Quiñones José , Martínez Gamarra Mar , Jáuregui-Lobera Ignacio
Published: April 2020

Management of patients who describe chronic pain all over the body, associated with a range of symptoms as sleep disturbance, overwhelming fatigue, alteration in mood, or psychological distress that worsens the quality of life, is often complex and challenging. This syndrome has been named by terms such as “neurasthenia,” “fibrositis,” and “fibromyalgia”. At the present time, fibromyalgia is considered the most common central sensitivity syndrome, affecting over 5% of the population, being often observed in people with rheumatic conditions. While typically presenting in middle-aged women, fibromyalgia can affect both sexes at any age. The causes of fibromyalgia remain unknown. Significant research findings have focused on dysfunction of central pain processing, with defects in the ascending and descending pain pathways leading to increased pain perception. There are two methods used in the diagnosis of fibromyalgia: criteria-based diagnosis and clinical diagnosis. Although fibromyalgia defies definitively efficacious management, much evidence underlies the importance of treating the psychological factors that affect pain management process. The primary purpose of this paper is to provide a psychosomatic approach to fibromyalgia from three points of view of processing: the viewpoint of the medical profession, the position of the psychologist, and finally the way of thinking of people.
Head Nurses' Experiences in Clinical Practice Education of Nursing Students: A Qualitative Research
Authors: Park Young A , Kong Eun Hi , Park Yu Jin
Published: April 2020

Purpose: The aim of this study was to understand and describe difficulties and needs experienced by head nurses in the clinical practice education of nursing students. Methods: A qualitative descriptive method was employed. A convenience sampling method was used to recruit participants from four hospitals in South Korea. Twenty-one head nurses participated in the first interview and 17 of them participated in the second interview. Data were collected through two in-depth interviews and field notes were written. Qualitative content analysis method was utilized for data analysis using ATLAS.ti 6.2 software. Results: Thirty-one codes and twelve categories were identified. Four themes emerged from data analysis, which included 'too many tasks', 'limitations of student education', 'many differences', and 'lack of support and resources.' Conclusion: This qualitative study described head nurses' many difficulties and needs in the clinical practice education of nursing students. The results of this study provide valuable understanding and knowledge of head nurses' experiences in students' clinical education, which leads to improvement of the quality of clinical education for nursing students.
Clinical Practice Stress and Burnout in Nursing Students: The Mediating Effect of Empathy
Authors: Song Yeoungsuk
Published: April 2020

Purpose: The purpose of this paper was to examine the relationships between clinical practice stress and burnout, and the mediating role of empathy in nursing students. Methods: A cross-sectional research design was employed. One hundred seventeen nursing students completed questionnaires on clinical practice stress, empathy (perspective-taking, fantasy, empathic concern and personal distress) and burnout in December 2017. IBM SPSS Statistics 23 was used and descriptive statistics, frequency, Pearson correlation coefficient and multiple regression were conducted. Baron & Kenny method and Sobel test were adopted for analysis of the mediation effect (personal distress of empathy). Results: The mean scores of clinical practice stress and burnout were 3.45 and 43.09, and perspective-taking, fantasy, empathic concern and personal distress of empathy were 2.67, 2.42, 2.64 and 2.19, respectively. The highest relationship between clinical practice stress and empathy was personal distress of empathy (r=.32, p<.001). Burnout was positively associated with clinical practice stress and personal distress of empathy (r=.22, p=.015; r=.51, p<.001). Personal distress of empathy demonstrated a complete mediating effect on the relationship between clinical practice stress and burnout (Z=3.22, p=.001). Conclusion: These results showed that decreasing personal distress of empathy is important for nursing students, and may help in reducing clinical practice stress and burnout.
The Effects of a Communication Program on Incivility, Critical Thinking, and Clinical Practice Stress Experienced by Nursing Students
Authors: Kim Soon Ae , Lee So Young , Hong Eunhee
Published: April 2020

Purpose: To identify the effects of a communication program on nursing students' incivility, critical thinking, and clinical practice stress. Methods: A randomized control group pretest-posttest study was conducted. Fifty randomly selected nursing students were divided into experimental and control groups. A 160-minute communication program was applied to the experimental group and a second survey was conducted two weeks later, shortly after their clinical practice. Results: There was a statistically significant difference in the incivility experienced in the clinical practice after application of the communication program, and refusal in the sub-categories of incivility was statistically significant in this group. Conclusion: It is necessary to foster communication skills for nursing students. Communication programs reduce incivility. Therefore, nursing educators need to recognize the importance of communication during clinical practice and consider incorporating it into their regular curricula.
Husserlian Phenomenology in Korean Nursing Research: Analysis, Problems, and Suggestions
Authors: Kim Hye-Kyung , Jun Myunghee , Stephanie Rhee , Michael Wreen
Published: April 2020

Purpose: This paper is a critical review of descriptive phenomenological methodology in Korean nursing research. We propose constructive suggestions for the improvement of descriptive phenomenological methodology in light of Husserl's phenomenological approaches. Methods: Using the key words of 'phenomenology,' 'experience,' and 'nursing,' we identify and analyze 64 Korean empirical phenomenological studies (selected from 282 studies) published in 14 Korean nursing journals from 2005 to 2018. The PubMed and the Korea Citation Index were used to identify the studies. Results: Our analysis shows that all the reviewed articles used Giorgi's or Colaizzi's scientific phenomenological methodology, without critical attention to Husserl's philosophical phenomenological principles. Conclusions: The use of scientific phenomenology in nursing research, which originated in North America, has become a global phenomenon, and Korean phenomenological nursing research has faithfully followed this scholarly trend. This paper argues that greater integration of Husserlian phenomenological principles into scientific phenomenological methodology in nursing research, such as participant-centered bracketing and eidetic reduction, is needed to ensure that scientific phenomenology lives up to its promise as a research methodology.
Establishment and the concept of European State (culturological analysis)
Authors: Rozin Vadim Markovich
Published: April 2020

This article analyzes the concept of state of the military historian Martin van Creveld. This analysis allowed the author to view prerequisites and establishment of the state and denote the concept of state. In the latter he differentiates the concepts of state and social practices that ensure their implementation, organization of management and accepted in culture explanations on the need for such organization, which in the author’s opinion comprises the meaning and content of power. Moreover, the article introduces the term of sociocultural pre-basis of the state that allows denoting the substantiation of the trajectory of development of the state and selection of a particular political form. Research methodology includes situational and comparative analysis, articulation of the problems, structuring of notions, reconstruction of historical evolution of the state, analysis and comprehension of the writings of M. Creveld. The author was able to analyze the proposed by Creveld concept of the state, as well as suggest an original version of establishment and development of the state, outline the characteristics of the concept of state (differentiation of stages of its establishment, concepts of states and social practices that ensure their realization, etc.), as well as raise a number of questions related to the discussed topic.
Hierarchical Defective Fe3‐xC@C Hollow Microsphere Enables Fast and Long‐Lasting Lithium–Sulfur Batteries
Authors: Zhang Yongguang , Li Gaoran , Wang Jiayi , Cui Guoliang , Wei Xiaoling , Shui Lingling , Kempa Krzysztof , Zhou Guofu , Wang Xin , Chen Zhongwei
Published: April 2020

Lithium–sulfur (Li–S) batteries present one of the most promising energy storage systems owing to their high energy density and low cost. However, the commercialization of Li–S batteries is still hindered by several technical issues; the notorious polysulfide shuttling and sluggish sulfur conversion kinetics. In this work, unique hierarchical Fe3‐xC@C hollow microspheres as an advanced sulfur immobilizer and promoter for enabling high‐efficiency Li–S batteries is developed. The porous hollow architecture not only accommodates the volume variation upon the lithiation–delithiation processes, but also exposes vast active interfaces for facilitated sulfur redox reactions. Meanwhile, the mesoporous carbon coating establishes a highly conductive network for fast electron transportation. More importantly, the defective Fe3‐xC nanosized subunits impose strong LiPS adsorption and catalyzation, enabling fast and durable sulfur electrochemistry. Attributed to these structural superiorities, the obtained sulfur electrodes exhibit excellent electrochemical performance, i.e., high areal capacity of 5.6 mAh cm−2, rate capability up to 5 C, and stable cycling over 1000 cycles with a low capacity fading rate of 0.04% per cycle at 1 C, demonstrating great promise in the development of practical Li–S batteries.
Strain‐Induced Modification of the Optical Characteristics of Quantum Emitters in Hexagonal Boron Nitride
Authors: Mendelson Noah , Doherty Marcus , Toth Milos , Aharonovich Igor , Tran Toan Trong
Published: April 2020

Quantum emitters in hexagonal boron nitride (hBN) are promising building blocks for the realization of integrated quantum photonic systems. However, their spectral inhomogeneity currently limits their potential applications. Here, tensile strain is applied to quantum emitters embedded in few‐layer hBN films and both red and blue spectral shifts are realized with tuning magnitudes up to 65 meV, a record for any 2D quantum source. Reversible tuning of the emission and related photophysical properties is demonstrated. Rotation of the optical dipole in response to strain is also observed, suggesting the presence of a second excited state. A theoretical model is derived to describe strain‐based tuning in hBN, and the rotation of the optical dipole. The study demonstrates the immense potential for strain tuning of quantum emitters in layered materials to enable their employment in scalable quantum photonic networks.
Synthesis and Immobilization of Metal Nanoparticles Using Photoactive Polymer‐Decorated Zeolite L Crystals and Their Application in Catalysis
Authors: Wissing Maren , Niehues Maximilian , Ravoo Bart Jan , Studer Armido
Published: April 2020

A facile route to generate Au and Pd nanoparticles (NPs) on zeolite L crystals decorated with photoactive polymer brushes is described. The polymers used in this approach serve a dual role: Upon irradiation with UV light, they release highly reducing ketyl radicals in a Norrish‐Type‐I reaction. These radicals serve as one electron donors to reduce metal salts to the corresponding metal NPs. At the same time the polymer shell stabilizes the in situ generated metal NPs. It is shown that the zeolite‐polymer‐NP composites can be used as recyclable catalysts for the oxidation of benzylic alcohols to aldehydes and the stereoselective semihydrogenation of alkynes to Z‐alkenes. The polymer shell in these hybrid catalysts protects the NPs from aggregation and also alters their catalytic properties.

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Nonsuicidal Self‐Injury and Attachment to God or a Higher Power
Authors: Buser Juleen K. , Buser Trevor J. , Pertuit Terry
Published: April 2020

The relationship between nonsuicidal self‐injury (NSSI) and spirituality is an emerging area of research deserving additional investigation. The authors examined the link between NSSI and attachment to God or a higher power among college students (N = 516). They found a statistically significant relationship between anxious attachment to God or a higher power and NSSI and avoidant attachment to God or a higher power and NSSI. Researchers and counselors can draw implications from these findings.
Investigating the concordance in molecular subtypes of primary colorectal tumors and their matched synchronous liver metastasis
Authors: Schlicker Andreas , Ellappalayam Architha , Beumer Ines J. , Snel Mireille H. J. , Mittempergher Lorenza , Diosdado Begona , Dreezen Christa , Tian Sun , Salazar Ramon , Loupakis Fotios , Pietrantonio Filippo , Santos Vivas Cristina , Martinez‐Villacampa Maria Mercedes , Villanueva Alberto , Sanjuán Xavier , Schirripa Marta , Fassan Matteo , Martinetti Antonia , Fucà Giovanni , Lonardi Sara , Keilholz Ulrich , Glas Annuska M. , Bernards René , Vecchione Loredana
Published: April 2020

To date, no systematic analyses are available assessing concordance of molecular classifications between primary tumors (PT) and matched liver metastases (LM) of metastatic colorectal cancer (mCRC). We investigated concordance between PT and LM for four clinically relevant CRC gene signatures. Twenty‐seven fresh and 55 formalin‐fixed paraffin‐embedded pairs of PT and synchronous LM of untreated mCRC patients were retrospectively collected and classified according to the MSI‐like, BRAF‐like, TGFB activated‐like and the Consensus Molecular Subtypes (CMS) classification. We investigated classification concordance between PT and LM and association of TGFBa‐like and CMS classification with overall survival. Fifty‐one successfully profiled matched pairs were used for analyses. PT and matched LM were highly concordant in terms of BRAF‐like and MSI‐like signatures, (90.2% and 98% concordance, respectively). In contrast, 40% to 70% of PT that were classified as mesenchymal‐like, based on the CMS and the TGFBa‐like signature, respectively, lost this phenotype in their matched LM (60.8% and 76.5% concordance, respectively). This molecular switch was independent of the microenvironment composition. In addition, the significant change in subtypes was observed also by using methods developed to detect cancer cell‐intrinsic subtypes. More importantly, the molecular switch did not influence the survival. PT classified as mesenchymal had worse survival as compared to nonmesenchymal PT (CMS4 vs CMS2, hazard ratio [HR] = 5.2, 95% CI = 1.5‐18.5, P = .0048; TGFBa‐like vs TGFBi‐like, HR = 2.5, 95% CI = 1.1‐5.6, P = .028). The same was not true for LM. Our study highlights that the origin of the tissue may have major consequences for precision medicine in mCRC.
Selling rights: Changes and challenges for rights professionals
Authors: Hodder Clare
Published: April 2020

Key points

The new edition of Selling Rights by Lynette Owen is an opportunity to pause and take stock of the changes and challenges for rights people at the turn of the decade.

Revenues accruing to UK publishers from rights sales has increased by over 22% in the past 5 years.

The recent and controversial European Union Copyright Directive and Brexit will undoubtedly impact selling rights, but as yet, we do not know what that impact will be.

Technology plays a role both in changing the kinds of rights being licensed and in helping the management of rights sales to be carried out more efficiently.

It is vital that rights metadata is developed and implemented to ensure improved efficiency in rights management.

Rights Management Practice will need to evolve in response to the climate emergency.
Risk of thrombotic events after inpatient intravenous immunoglobulin or plasma exchange for neurologic disease: A case‐crossover study
Authors: Jin Peter H. , Shin Susan C. , Dhamoon Mandip S.
Published: April 2020

Introduction

Our aim in this study was to determine whether intravenous immunoglobulin (IVIg) or plasma exchange (PLEx) for treatment of neurologic disease is a trigger for thrombotic events.

Methods

Using administrative data from 2005 to 2014, we identified index admissions for thrombotic events. We performed case‐crossover analyses for these admissions with previous admissions for neurologic disease with IVIg or PLEx using exposure periods of between 7 and 120 days.

Results

We identified 1.9 million admissions for venous thrombosis embolism, myocardial infarction, or acute ischemic stroke. The odds ratio for venous thrombosis embolism within a 30‐day window after exposure to IVIg was 3.33 (1.34–8.30, P = .0097) and for PLEx was 4.29 (1.88–9.76, P = .0005). Myocardial infarction and acute ischemic stroke admissions were not associated with exposure to either therapy.

Discussion

Patients admitted for venous thrombosis embolism (but not acute ischemic stroke or myocardial infarction) were more likely exposed to either IVIg or PLEx during previous admission for neurologic disease.
SICs: Some Explanations
Authors: Bengtsson Ingemar
Published: April 2020

The problem of constructing maximal equiangular tight frames or SICs was raised by Zauner in 1998. Four years ago it was realized that the problem is closely connected to a major open problem in number theory. We discuss why such a connection was perhaps to be expected, and give a simplified sketch of some developments that have taken place in the past 4 years. The aim, so far unfulfilled, is to prove existence of SICs in an infinite sequence of dimensions.
Schutzkonzepte in der Pflegekinderhilfe
Authors: Husmann Laura , Rusack Tanja
Published: April 2020

Im Forschungsprojekt „FosterCare“ werden im Hinblick auf die Entwicklung und Implementierung von Schutzkonzepten in der Pflegekinderhilfe und die Verwirklichung von Rechten junger Menschen in Pflegefamilien Reformbedarfe in der Kinder- und Jugendhilfe aufgezeigt.
Educating the Public on Hemorrhage Control: Methods and Challenges of a Public Health Initiative
Authors: Humar P. , Goolsby C. A. , Forsythe R. M. , Reynolds B. , Murray K. M. , Bertoty D. , Peitzman A. B. , Neal M. D.
Published: April 2020

Purpose of Review

We aim to determine the various models of training and identify educational strategies that would be efficacious in teaching bleeding control to the public.

Recent Findings

Recent studies have examined various educational strategies of bleeding control education including lectures, web-based classes, and hands-on training. The effectiveness of these trainings can not only be measured in increases in knowledge, but also in feelings of confidence, preparedness, and willingness to assist in a bleeding emergency. When looking at retention or skills and knowledge, we found that multiple studies showed decreases in ability to stop life-threatening bleeding when retested weeks or months after training. These issues of retention and a lack of education in general lead to a discussion about the possible benefits of having just-in-time (JiT) information during a bleeding emergency.

Based on the recent findings, bleeding control trainings have proven to be a very effective method of providing the general public with necessary skills. Therefore, moving forward, it is crucial to look at retention and the use of JiT information in longitudinal studies.
Is the Religious Left Resurgent?
Authors: Baker Joseph O , Martí Gerardo
Published: April 2020

Journalistic sources seem to suggest that there has been a resurgence of the American Religious Left (i.e., politically liberal Christians who support progressive agendas) in the wake of the strong support from the conservative Christian right in the 2016 presidential election of Donald J. Trump. Using quantitative analysis, we draw on survey data from the General Social Survey, the Public Religion Research Institute, and the National Congregations Study to assess the possibility of a resurgence among the Religious Left. In comparison with a speculated rise, our analysis indicates a notable decline in both the prevalence and engagement of Americans who self-identify as both religious and politically liberal. Not only is the constituency of the Religious Left shrinking, they have also been steadily disengaging from political activity in the last decade. Especially when looking at more recent elections, it has been those among the Secular Left who have been the most politically engaged. We summarize these empirical patterns in relation to the Religious Right and consider the potential for influence among the Religious Left aside from electoral politics. We also briefly consider other possibilities for their political impact and reflect on the inadequacy of the label “Religious Left” for capturing important dynamics. In the end, we urge greater attention to politics among sociologists of religion, providing a set of research questions to consider in light of the upcoming American 2020 national election.
Fast, Easy, and Good: Assessing Entrustable Professional Activities in Psychiatry Residents With a Mobile App
Authors: Young John Q. , McClure Matthew
Published: April 2020

Problem

Entrustable professional activities (EPAs) can be used to operationalize competency-based medical education. Mobile apps can efficiently capture feedback based on direct observation. To leverage the benefits of both, the authors developed an assessment tool that combines EPAs with mobile technology.

Approach

The authors designed an app to collect EPA data based on direct observation using human–technology interface guidelines. Data collected in the app included: name of resident, the 13 end-of-training EPAs for psychiatry, entrustment ratings, and corrective narrative feedback. The app was implemented in an outpatient continuity clinic for second-year psychiatry residents over a 10-month period between September 2017 and June 2018. Ten faculty–resident dyads piloted the app. To assess the feasibility, utility, and validity of this intervention, the authors examined 3 outcomes: (1) utilization (mean time to complete each assessment; percentage of dyads who completed 10 assessments), (2) quality of the comments (proportion of comments that were behaviorally specific and actionable), and (3) correlation between entrustment level and resident experience (defined as days elapsed since the beginning of the experience).

Outcomes

A total of 99 assessments were completed during the pilot. Mean time to complete an assessment was 76 seconds (standard deviation = 50 seconds, median = 67 seconds). Only 6 of the 10 dyads completed at least 10 assessments. Of all comments, 95% (94) were behaviorally specific and actionable and 91% (90) were corrective. Entrustment scores correlated moderately with resident experience (r = 0.43, P < .001).

Next Steps

The authors’ EPA mobile app was efficient, generated high-quality feedback, and produced entrustment scores that improved as the residents gained experience. Challenges included uneven adoption. Looking forward, the authors plan to examine the enablers and barriers to adoption from an implementation science perspective.
Evaluation of the Minimum Clinically Important Differences of the Zurich Claudication Questionnaire in Patients With Lumbar Spinal Stenosis
Authors: Fukushima Masayoshi , Oka Hiroyuki , Oshima Yasushi , Yuzawa Yohei , Matsudaira Ko , Tanaka Sakae , Inanami Hirohiko
Published: April 2020

Study Design:

A case-control study.

Object:

This study aimed to evaluate the minimally clinically important differences (MCIDs) of the Zurich Claudication Questionnaire (ZCQ) after microendoscopic laminectomy in patients with lumbar spinal stenosis (LSS).

Summary of Background Data:

The ZCQ is a self-administered tool used to evaluate symptom severity and physical function in patients with LSS. It has been used in many studies worldwide. However, the MCIDs of the ZCQ have not yet been determined.

Materials and Methods:

The study sample consisted of 514 patients who underwent microendoscopic laminectomy for LSS at our hospital between March 2012 and May 2014. The ZCQ, which includes 7 items for symptom severity (scored from 1 to 5) and 5 items for functional disability (scored from 1 to 4), was administered preoperatively and 1-year postoperatively. The MCID was calculated by 4 approaches, including average change, minimum detectable change, change difference, and receiver operating characteristic curve. The authors calculated the area under the curve (AUC) to evaluate the accuracy of the receiver operating characteristic curve. The responsiveness of each measurement was then analyzed.

Results:

The authors were able to administer the ZCQ at 1-year postoperatively in 349 patients. The ZCQ score was statistically significantly improved 1-year postoperatively. The MCID of ZCQ for symptom severity varied from 0.75 to 0.84, whereas the MCID of the ZCQ score for functional disability varied from 0.60 to 0.76. The AUC of the ZCQ for symptom severity was 0.81 and that for functional disability was 0.80.

Conclusions:

This study showed that the MCID of the ZCQ for symptom severity varied from 0.75 to 0.84 and the MCID for functional disability varied from 0.60 to 0.76. In addition, each AUC was over 0.80, indicating that MCIDs of the ZCQ were found to have a high diagnostic performance.
Photoaging Reversibility in Asian Patients With Melasma Treated Using Picosecond Lasers With a Diffractive Lens Array: A 1-Year Prospective Observational Cohort Study
Authors: Lin Erh-Ti , Chiang Hsiu-Mei , Lin Bor-Shyh , Huang Yung-Hsueh , Chang Chang-Cheng
Published: April 2020

BACKGROUND

Picosecond lasers appear to be effective and safe in treating pigmentation and photoaging disorders through laser-induced optical breakdown.

OBJECTIVE

To analyze the feasibility of photorejuvenation using picosecond lasers with diffractive lens array (DLA) in patients with melasma.

METHODS

Ten Asian (N = 10) women with melasma and Fitzpatrick skin Type IV were enrolled and treated using 755-nm picosecond alexandrite lasers with DLA. All individuals were assessed before treatment, and at 12, 20 weeks, and 1 year by post-hoc test on melasma area and severity index (MASI) and with VISIA Complexion Analysis System using percentile rank for measurement.

RESULTS

The median participant age was 46.5 years. The average MASI continually and significantly (p < .05) decreased until the 1-year follow-up, with the photoaging characteristics, such as wrinkles and red areas improving simultaneously (p < .05). Spots, texture, pores, ultraviolet (UV) spots, brown spots, and porphyrins exhibited alleviation, but this improvement relapsed by the 1-year follow-up. No postinflammatory hyperpigmentation or hypopigmentation occurred.

CONCLUSION

In patients with melasma, picosecond laser treatment with DLA may alleviate pigmentation disorder and the related photoaging characteristics (e.g., wrinkled skin and increased vascularity), and the effects may be maintained for a long time. Nevertheless, post-treatment clinical visits every 3 to 6 months are recommended.
Cholesterol efflux capacity in coronary artery disease: a meta-analysis
Authors: Ye Huiming , Xu Guiyu , Ren Lihui , Peng Jianjun
Published: April 2020

Objective

To quantitatively analyze the association between cholesterol efflux capacity (CEC) and the risk and prognosis of coronary artery disease (CAD).

Methods

A systematic search of electronic databases for studies published until September 2019 was performed. Cohorts, case-control studies, and randomized controlled trials that examined the effect of CEC on the risk and prognosis of CAD were included.

Results

Eighteen studies with 12 685 subjects met our inclusion criteria. Among them, 14 studies reported the CEC in non-CAD and CAD groups, and eight studies reported the association between CEC and risk of CAD. Four studies reported the prognosis of stable CAD or acute coronary syndrome (ACS). In the pooled analyses, significantly decreased CEC was found in patients with stable CAD as compared with those without CAD. Decreased CEC was also present in subgroup in patients with ACS. High CEC was significantly associated with decreased risk of CAD [odds ratio (OR) = 0.65, 95% confidence interval (CI): 0.55–0.75, P < 0.001]. High CEC predicted lower all-cause mortality (OR = 0.39, 95% CI: 0.20–0.77, P = 0.007) and cardiovascular mortality (OR = 0.34, 95% CI: 0.13–0.90, P = 0.03) in patients with CAD. However, CEC failed to predict the occurrence of stroke and myocardial infraction in patients with CAD.

Conclusions

Decreased CEC is an independent risk factor for CAD, and it predicts all-cause and cardiovascular mortality in patients with CAD.
Proof of concept of a novelex vivo, in situmethod for MRI and histological brain assessment
Authors: Maranzano Josefina , Dadar Mahsa , Bertrand-Grenier Antony , Frigon Eve-Marie , Pellerin Johanne , Plante Sophie , Duchesne Simon , Tardif Christine L. , Boire Denis , Bronchti Gilles
Published: April 2020

MRI-histology correlation studies of theex vivobrain mostly employ fresh, extracted (ex situ) specimens, aldehyde fixed by immersion. This method entails manipulation of the fresh brain during extraction, introducing several disadvantages: deformation of the specimen prior to MRI acquisition; introduction of air bubbles in the sulci, creating artifacts; and uneven or poor fixation of the deeper regions of the brain.

We propose a new paradigm to scan theex vivobrain, exploiting a technique used by anatomists: fixation by whole body perfusion, which implies fixation of the brainin situ. This allows scanning the brain surrounded by fluids, meninges, and skull, thus preserving the structural relationships of the brainin vivoand avoiding the disadvantages ofex situscanning. Our aims were: 1) to assess whether months ofin situfixation resulted in a loss of fluid around the brain; 2) to evaluate whetherin situfixation modified antigenicity for myelin and neuron specific marker; 3) to assess whetherin situfixation improved the register ofex vivobrain images to standard neuroanatomical templates in pseudo-Talairach space for morphometry studies.

Five head specimens fixed with a saturated sodium chloride solution (a non-standard fixative used in our anatomy laboratory for neurosurgical simulation) were employed. We acquired 3D T1-weighted (MPRAGE), 2D fluid-attenuated inversion recovery T2-weighted turbo spin echo (T2w-FLAIR), and 3D gradient-echo (3D-GRE) pulse sequences of all brains on a 1.5T MRI. After brain extraction, sections were processed for binding with myelin basic protein (MBP) and neuronal nuclei (NeuN) primary antibodies by immunofluorescence.

This study showed that all but one specimen retained fluids in the subarachnoid and ventricular spaces. The specimen that lost fluid was the oldest one, with the longest interval between the time of death and the MRI scanning day being 403 days. All T1-weighted images were successfully processed through a validated pipeline used within vivoMRIs. The pipeline did not require any modification to run on theex vivo-in situscans. All scans were successfully registered to the brain template, more accurately than anex vivo-ex situscan and exhibited positive antigenicity for MBP and NeuN.

MRI and histology study of theex vivo-in situbrain fixed by perfusion is feasible and allows forin situMRI imaging for of at least 10 months post-mortem prior to histology analyses. Fluids around and inside the brain specimens and antigenicity for myelin and neurons were all well preserved.
Intercontinental test of constraint‐breaking adaptations: Testing behavioural plasticity in the face of a predator with novel hunting strategies
Authors: Bleicher Sonny S. , Kotler Burt P. , Downs Cynthia J. , Brown Joel S.
Published: April 2020

Constraint‐breaking adaptations are evolutionary tools that provide a mechanism for incumbent‐replacement between species filling similar ecological roles.

In common‐garden experiments, we exposed populations of two desert rodents to two different viper species, testing their ability to adjust to novel predators that use different hunting strategies. We aimed to understand whether both predators and prey with constraint‐breaking adaptations actually manifest comparative advantage over their counterparts.

We used convergent species from desert dunes in the Mojave Desert in North America, Merriam's kangaroo rat Dipodomys merriami and the sidewinder rattlesnake Crotalus cerastes, and from the Negev Desert in the Middle East, the greater Egyptian gerbil Gerbillus pyramidum and the Saharan horned viper Cerastes cerastes. Both Mojave species hold constraint‐breaking adaptations in relation to their counterparts from the Negev. The rattlesnakes have heat sensing organs (pits) and the kangaroo rats have fur‐lined cheek pouches that allow for greater foraging efficiency and food preservation. Using patch‐use theory, we evaluated the rodents' risk‐assessment from each snake—separately, together and in combination with barn owls.

Initially each rodent species foraged less in the presence of its familiar snake, but within a month both foraged less in the presence of the pit‐viper (sidewinder).

Our findings indicate a level of learning, and behavioural plasticity, in both rodents and ability to assess the risk from novel predators. The kangaroo rats were capable of harvesting far greater amounts of resources under the same conditions of elevated risk. However, the reason for their advantage may lie in bi‐pedal agility and not only their ability collect food more efficiently.
What Is an Observation Stay? Evaluating the Use of Hospital Observation Stays in Medicare
Authors: Powell W. Ryan , Kaiksow Farah A. , Kind Amy J. H. , Sheehy Ann M.
Published: April 2020

BACKGROUND/OBJECTIVES

Observation stays are increasingly common for older adults, yet little is known about the extent to which they are being used as the Centers for Medicare and Medicaid Services (CMS) originally intended for unscheduled or acute problems and whether different types of services are reflected in current billing practices.

DESIGN

Observational cohort study.

SETTING/PARTICIPANTS

A total of 867,165 qualifying observation stays identified from 451,408 patients using Medicare fee‐for‐service claims data from a nationally representative 20% beneficiary sample between January 1, 2014, and November 30, 2014.

MEASUREMENTS

Using descriptive and multivariable logistic model analytic approaches, we evaluated the patient, stay, and hospital characteristics associated with the most common billing practice for observation stays (charge revenue center 0761 exclusively) vs all other practices.

RESULTS

Sixty‐three percent of observation stays were billed exclusively under the 0761 revenue center and were more likely to be for preplanned chronic conditions consisting of short‐term treatments (eg, chemotherapy, radiation therapy, wound care, paracentesis, epidural spinal injection). These stays appeared to be used for recurrent single‐day visits, given their strong association with prior visits and a high rate of reobservation (41.4%), with frequent return stays appearing in a 7‐day pattern.

CONCLUSION

Nearly two‐thirds of observation stays are billed using only the 0761 revenue code and appear to be for prescheduled, repeated treatments—differing substantially from CMSʼ explicitly stated purpose as a form of care used while a healthcare provider determines whether a patient presenting for unscheduled or acute conditions requires inpatient hospital admission or can be safely discharged. Guidance is needed from CMS to clarify the appropriate role of observation stays, with discussion as to whether episodic single‐day, planned treatment for chronic conditions not originating in the emergency department should be billed as observation stays or placed under another mechanism. Subsequent research is needed to understand how the current use of observation stays impact patient out‐of‐pocket costs. J Am Geriatr Soc 68:1568‐1572, 2020.