bluuebunny/crossref_metadata_2025 huggingface dataset:
Multilayered Electrospun/Electrosprayed Polyvinylidene Fluoride+Zinc Oxide Nanofiber Mats with Enhanced Piezoelectricity
Authors: Mirjalali Sheyda , Bagherzadeh Roohollah , Abrishami Shayan , Asadnia Mohsen , Huang Shujuan , Michael Aron , Peng Shuhua , Wang Chun‐Hui , Wu Shuying
Published: February 2023

Electrospun polyvinylidene fluoride (PVDF) nanofibers have been widely used in the fabrication of flexible piezoelectric sensors and nanogenerators, due to their excellent mechanical properties. However, their relatively low piezoelectricity is still a critical issue. Herein, a new and effective route to enhance the piezoelectricity of PVDF nanofiber mats by electrospraying zinc oxide (ZnO) nanoparticles between layers of PVDF nanofibers is demonstrated. As compared to the conventional way of dispersing ZnO nanoparticles into PVDF solution for electrospinning nanofiber mats, this approach results in multilayered PVDF+ZnO nanofiber mats with significantly increased piezoelectricity. For example, 6.2 times higher output is achieved when 100% of ZnO (relative to PVDF quantity) is electrosprayed between PVDF nanofibers. Moreover, this new method enables higher loading of ZnO without having processing challenges and the maximum peak voltage of ≈3 V is achieved, when ZnO content increases up to 150%. Additionally, it is shown that the samples with equal amount of material but consisting of different number of layers have no significant difference. This work demonstrates that the proposed multilayer design provides an alternative strategy to enhance the piezoelectricity of PVDF nanofibers, which can be readily scaled up for mass production.
Detection of ATXN2 Expansions in an Exome Dataset: An Underdiagnosed Cause of Parkinsonism
Authors: Casse Fanny , Courtin Thomas , Tesson Christelle , Ferrien Mélanie , Noël Sandrine , Fauret‐Amsellem Anne‐Laure , Gareau Thomas , Guegan Justine , Anheim Mathieu , Mariani Louise‐Laure , Le Forestier Nadine , Tranchant Christine , Corvol Jean‐Christophe , Lesage Suzanne , Brice Alexis ,   for the French Parkinson's disease genetics study group (PDG)
Published: February 2023

Background

CAG‐repeat expansions in Ataxin 2 (ATXN2) are known to cause spinocerebellar ataxia type 2 (SCA2), but CAA interrupted expansions may also result in autosomal dominant Parkinson's disease (AD PD). However, because of technical limitations, such expansions are not explored in whole exome sequencing (WES) data.

Objectives

To identify ATXN2 expansions using WES data from PD cases.

Methods

We explored WES data from a cohort of 477 index cases with PD using ExpansionHunter (Illumina DRAGEN Bio‐IT Platform, San Diego, CA). Putative expansions were confirmed by combining polymerase chain reaction and fragment length analysis followed by sub‐cloning and sequencing methods.

Results

Using ExpansionHunter, we identified three patients from two families with AD PD carrying either ATXN2 22/39 or 22/37 repeats, both interrupted by four CAA repeats.

Conclusion

These findings demonstrate the usefulness of WES to detect pathogenic CAG repeat expansions, which were found in 1.7% of AD PD in the ATXN2 gene in our exome dataset.
Enteral nutrition product formulations: A review of available products and indications for use
Authors: Church April , Zoeller Steph
Published: February 2023

When oral nutrition is not feasible, enteral nutrition (EN) therapy is often considered the preferred route of nutrition support to meet the nutrient needs of individuals with a functional gastrointestinal tract across multiple levels of care (critical care, acute care, and home care). Enteral formulations have progressively evolved over the last 50 years from the simple blending of hospital food thin enough to run through a feeding tube, to the development of commercial standard formulas, followed by specialized formulas with immune‐modulating and disease‐specific qualities, to the most recent shift to food‐based or blenderized EN composed of natural, whole foods with perceived health benefits. With the vast number of enteral formulations on the market, clinicians may be overwhelmed trying to determine proven vs theoretical benefits. This review is intended to explore differences in enteral formulations, identify implications for clinical practice, and review evidenced‐based clinical guidelines to assist clinicians in enteral formula selection.
Closed‐loop control of air supply to whole‐room indirect calorimeters to improve accuracy and standardize measurements during 24‐hour dynamic metabolic studies
Authors: Piaggi Paolo , Rodzevik Theresa L. , Wohlers Erica , Ruud Katherine , Moon Jon , Krakoff Jonathan , Chang Douglas C.
Published: February 2023

Objective

The aim of this study was to test proportional‐integral‐derivative (PID) control of air inflow rate in a whole‐room indirect calorimeter to improve accuracy in measuring oxygen (O2) consumption () and carbon dioxide (CO2) production ().

Methods

A precision gas blender infused nitrogen (N2) and CO2 into the calorimeter over 24 hours based on static and dynamic infusion profiles mimicking and patterns during resting and non‐resting conditions. Constant (60 L/min) versus time‐variant flow set by a PID controller based on the CO2 concentration was compared based on errors between measured versus expected values for respiratory exchange ratio, and metabolic rate.

Results

Compared with constant inflow, the PID controller allowed both a faster rise time and long‐term maintenance of a stable CO2 concentration inside the calorimeter, resulting in more accurate estimates (mean hourly error, PID: −0.9%, 60 L/min = −2.3%, p < 0.05) during static infusions. During dynamic infusions mimicking exercise sessions, the PID controller achieved smaller errors for (mean: −0.6% vs. −2.7%, p = 0.02) and respiratory exchange ratio (mean: 0.5% vs. −3.1%, p = 0.02) compared with constant inflow conditions, with similar (p = 0.97) and metabolic rate (p = 0.76) errors.

Conclusions

PID control in a whole‐room indirect calorimeter system leads to more accurate measurements of substrate oxidation during dynamic metabolic studies.
Effect of constrained annealing on the structural and dielectric properties of melt cast PVDF/PMMA films
Authors: Jain Mayank , Mutlu Zeynep , Mao Jiahao , Zhou Jierui , Wu Chao , Cao Yang , Cakmak Mukerrem
Published: February 2023

In this study, the relationship between structural hierarchy in PVDF/PMMA blends as altered by melt casting and annealing and electrical properties was investigated. PVDF was blended with PMMA in three crystallizable compositions: 50/50, 60/40 and 70/30 of PVDF/PMMA using twin screw extrusion followed by film casting. The films were characterized structurally through offline birefringence measurements as well as WAXS, SAXS, IR Dichroism and DSC to understand the processing induced structural changes and their effect on electrical properties. The addition of PMMA to PVDF suppressed crystalization during casting of films. This opened a low temperature film deformation window between Tg and cold crystallization temperatures allowing for development of high preferential chain orientation in the films. Crystallinity in cast films was shown to correlate directly with breakdown strength. Systemic annealing experiments were carried out to enhance crystallinity and the effect of annealing induced structural changes on the dielectric properties were studied. It was found that upon annealing, the amorphous PMMA tends to undergo relaxation that is detrimental to the breakdown properties. As annealing progresses, the mismatch in the kinetics between crystallization/recrystallization and the amorphous relaxation causes density gradients within the bulk of the films and dictate the overall orientation levels in the films, as well as have implications on the dielectric properties.
Advanced Thermoluminescence Spectroscopy as a Research Tool for Semiconductor and Photonic Materials: A Review and Perspective
Authors: Selim Farida A
Published: February 2023

Thermoluminescence (TL) or thermally stimulated luminescence (TSL) spectroscopy is based on liberating charge carriers from traps in the bandgap by providing enough thermal energy to overcome the potential barrier of the traps. It provides a powerful tool to measure the positions of the localized states/traps in the bandgap. Despite that, its applications in semiconductors are very limited. Herein, the basics of TL spectroscopy and the recent advances in the technique with focus on cryogenic thermally stimulated photoemission spectroscopy (C‐TSPS) which extends TL measurements to cryogenic regime and allows the detection of very low concentrations of shallow and deep localized states is discussed. One goal herein is to introduce the reader to the use of TL and C‐TSPS in the characterization of semiconductors, explaining how it can be applied and demonstrating its advantages as a powerful tool for measuring shallow donor/acceptor ionization energies in semiconductors and as a method for characterizing compensating defects. The article also discusses interesting potential applications of C‐TSPS in new research areas such as corrosion and formation of oxide layers on metal surfaces.
PPE needs in the United States during the COVID‐19 pandemic: An analysis using the GetUsPPE online platform
Authors: Rubashkin Matthew , Purzycki Taylor , Coolahan Kelsey , Lee Charlotte , Lurie Daniel J , Batorsky Benjamin , Chen Alexander , Calderón Joanna , He Shuhan
Published: February 2023

The United States is heavily impacted by the COVID‐19 pandemic starting in 2020. Demand for personal protective equipment (PPE) domestically, along with global surge in demand for PPE during the pandemic, overwhelmed supply chains, leading to acute PPE shortages. This article analyzes the PPE supply and demand in the United States by employing data collected by GetUsPPE, a data hub used throughout the pandemic to coordinate support efforts, including connecting facilities in need of PPE with donated supplies. In this article, PPE requests were examined by facility type (acute vs. non‐acute care), geographic location, and PPE type. The research team observed that PPE demand was dispersed across the United States. In the beginning of the pandemic when demand was highest, most requesting facilities self‐reported as acute care facilities, whereas non‐acute care facilities predominated after June 2020. Additionally, the demand for respirators, disinfecting wipes, gowns, face shields, and surgical masks peaked in response to the first, second, and third waves of COVID‐19. This analysis can be utilized in the future to optimize the tracking of PPE shortages and relief efforts.
Human brain organoids to explore SARS‐CoV‐2‐induced effects on the central nervous system
Authors: Ostermann Philipp Niklas , Schaal Heiner
Published: February 2023

Severe acute respiratory syndrome coronavirus type 2 (SARS‐CoV‐2) is the causative agent of coronavirus disease 2019 (COVID‐19). In less than three years, an estimated 600 million infections with SARS‐CoV‐2 occurred worldwide, resulting in a pandemic with tremendous impact especially on economic and health sectors. Initially considered a respiratory disease, COVID‐19, along with its long‐term sequelae (long‐COVID) rather is a systemic disease. Neurological symptoms like dementia or encephalopathy were reported early during the pandemic as concomitants of the acute phase and as characteristics of long‐COVID. An excessive inflammatory immune response is hypothesized to play a major role in this context. However, direct infection of neural cells may also contribute to the neurological aspects of (long)‐COVID‐19. To mainly explore such direct effects of SARS‐CoV‐2 on the central nervous system, human brain organoids provide a useful platform. Infecting these three‐dimensional tissue cultures allows the study of viral neurotropism as well as of virus‐induced effects on single cells or even the complex cellular network within the organoid. In this review, we summarize the experimental studies that used SARS‐CoV‐2‐infected human brain organoids to unravel the complex nature of (long)‐COVID‐19‐related neurological manifestations.
SARS‐CoV‐2 nucleocapsid: Biological functions and implication for disease diagnosis and vaccine design
Authors: Maghsood Faezeh , Ghorbani Ahmad , Yadegari Hamidreza , Golsaz‐Shirazi Forough , Amiri Mohammad Mehdi , Shokri Fazel
Published: February 2023

The coronavirus disease 2019 (COVID‐19) pandemic is transmitted by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and has affected millions of people all around the world, leading to more than 6.5 million deaths. The nucleocapsid (N) phosphoprotein plays important roles in modulating viral replication and transcription, virus‐infected cell cycle progression, apoptosis, and regulation of host innate immunity. As an immunodominant protein, N protein induces strong humoral and cellular immune responses in COVID‐19 patients, making it a key marker for studying N‐specific B cell and T cell responses and the development of diagnostic serological assays and efficient vaccines. In this review, we focus on the structural and functional features and the kinetic and epitope mapping of B cell and T cell responses against SARS‐CoV‐2 N protein to extend our understanding on the development of sensitive and specific diagnostic immunological tests and effective vaccines.
Insight on the dynamics of hydromagnetic stagnation‐point flow of magnetite‐water nanofluid due to a rotating stretchable disk: A two‐phase modified Buongiorno modeling and simulation
Authors: Sabu Alappat Sunny , Ali Farhan , Reddy Cherlacola Srinivas , Areekara Sujesh , Mathew Alphonsa
Published: February 2023

The hydromagnetic stagnation‐point flow of magnetite‐water nanofluid due to a rotating stretchable disk has been numerically accessed. The nanofluid flow has been modeled by employing the two‐phase modified Buongiorno model that incorporates the volume fraction dependent effective nanofluid properties, Brownian motion, and thermophoresis effects. Von Kármán's similarity transformations are utilized in transmuting the mathematically modeled equations into a system of first‐order ODEs which are then resolved numerically using the bvp4c numerical scheme. The consequence of influential parameters on the flow profiles and the physical quantities has been presented through graphs and tables. Engineering quantities like moment coefficient and pumping efficiency of the disk are also elucidated in this research work. Results show that an augmentation in the Hartmann number descends the velocity profiles and ascends the nanofluid temperature profile. Further, a drop in the drag coefficient and a rise in the heat transfer rate are noted with an increment in the velocity ratio parameter. The tidings of this numerical simulation have applications in spin coating, rotating heat exchangers, and rotating disk reactors.
Temporal changes of patient characteristics over 12 years in a single-center transcatheter aortic valve implantation cohort
Authors: Demal Till Joscha , Weimann Jessica , Ojeda Francisco Miguel , Bhadra Oliver D. , Linder Matthias , Ludwig Sebastian , Grundmann David , Voigtländer Lisa , Waldschmidt Lara , Schirmer Johannes , Schofer Niklas , Blankenberg Stefan , Reichenspurner Hermann , Conradi Lenard , Seiffert Moritz , Schaefer Andreas
Published: February 2023

Background

Beneficial results of transcatheter aortic valve implantation (TAVI) compared to surgical aortic valve replacement (SAVR) in patients at all risk strata have led to substantial changes in guideline recommendations for valvular heart disease.

Aim

To examine influence of these guideline changes on a real-world TAVI cohort, we evaluated how risk profiles and outcomes of TAVI patients developed in our single-center patient cohort over a period of 12 years.

Methods

Baseline, procedural and 30-day outcome parameters of TAVI patients were retrospectively compared between three time periods (period 1: 2008–2012, period 2: 2013–2017, period 3: 2018–2020).

Results

Between 03/2008 and 12/2020, a total of 3678 patients underwent TAVI at our center. The median age was 81.1 years (25th, 75th percentile: 76.7, 84.9) with no significant change over time. The EuroSCORE II showed a continuous and significant decline from 5.3% (3.3, 8.6) in period 1 to 2.8% (1.7, 5.0) in period 3 (p < 0.001). Furthermore, rates of permanent pacemaker implantation, acute kidney injury, and paravalvular leakage ≥ moderate continuously declined over time. Accordingly, the 30-day mortality fell from 9.3% in period 1 to 4.3% in period 3 (p < 0.001).

Conclusion

Despite substantial guideline alterations, median patient age remained largely unchanged in our TAVI cohort over the past 12 years. Therefore, increased age still appears to be the main reason to choose TAVI over SAVR. However, risk profiles declined substantially. Significant improvements in early outcomes suggest favorable influence of less invasive access routes, improved device platforms and growing user experience.

Graphical abstract
Comparison of the LigaSure™ bipolar vessel sealer to monopolar electrocoagulation for thoracoscopic lobectomy and lymphadenectomy: a prospective randomized controlled trial
Authors: Gabryel Piotr , Kasprzyk Mariusz , Roszak Magdalena , Campisi Alessio , Smoliński Szymon , Zieliński Paweł , Piwkowski Cezary
Published: February 2023

Background

High-energy devices allow better vessel sealing compared with monopolar electrocautery and could improve the outcomes of surgical operations. The objective of the study was to compare tissue dissection by the LigaSure™ device with that by monopolar electrocoagulation for thoracoscopic lobectomy and lymphadenectomy.

Methods

This pragmatic, parallel group, prospective randomized controlled trial was funded by the Medtronic External Research Program (ISR-2016–10,756) and registered at www.clinicaltrials.gov (NCT03125798). The study included patients aged 18 years or older, who had undergone thoracoscopic lobectomy with lymphadenectomy at the Department of Thoracic Surgery of Poznan University of Medical Sciences between May 3, 2018, and November 4, 2021. Using simple randomization, the patients were assigned to undergo tissue dissection with either the LigaSure device (study group) or monopolar electrocautery (control group). Participants and care givers, except operating surgeons, were blinded to group assignment. The primary outcome was postoperative chest drainage volume. Secondary outcomes were change of the esophageal temperature during subcarinal lymphadenectomy and C-reactive protein level 72 h after surgery.

Results

Study outcomes were analyzed in 107 patients in each group. We found no differences between the study and control groups in terms of chest drainage volume (550 vs. 600 mL, respectively; p = 0.315), changes in esophageal temperature (− 0.1 °C vs. − 0.1 °C, respectively; p = 0.784), and C-reactive protein levels (72.8 vs. 70.8 mg/L, respectively; p = 0.503). The mean numbers of lymph nodes removed were 12.9 (SD: 3.1; 95% CI, 12.4 to 13.5) in the study group and 11.6 (SD: 3.2; 95% CI, 11.0 to 12.2) in the control group (p < 0.001).

Conclusions

The use of the LigaSure device did not allow to decrease the chest drainage volume, local thermal spread, and systemic inflammatory response. The number of lymph nodes removed was higher in patients operated with the LigaSure device, which indicated better quality of lymphadenectomy.
A harmonic framework for stepsize selection in gradient methods
Authors: Ferrandi Giulia , Hochstenbach Michiel E. , Krejić Nataša
Published: February 2023

We study the use of inverse harmonic Rayleigh quotients with target for the stepsize selection in gradient methods for nonlinear unconstrained optimization problems. This not only provides an elegant and flexible framework to parametrize and reinterpret existing stepsize schemes, but it also gives inspiration for new flexible and tunable families of steplengths. In particular, we analyze and extend the adaptive Barzilai–Borwein method to a new family of stepsizes. While this family exploits negative values for the target, we also consider positive targets. We present a convergence analysis for quadratic problems extending results by Dai and Liao (IMA J Numer Anal 22(1):1–10, 2002), and carry out experiments outlining the potential of the approaches.
The Relationship between Youth Police Stops and Depression among Fathers
Authors: Turney Kristin
Published: February 2023

Research shows youth police contact—a stressor experienced by more than one-quarter of urban-born youth by age 15—has deleterious mental health consequences for both youth and their mothers. Less is known about how youth’s fathers respond to this police contact, despite differences in how men and women respond to stress and relate to their children. I use data from the Fragile Families and Child Wellbeing Study to investigate the association between youth police stops and depression among youth’s fathers. Results show that fathers of youth stopped by the police, compared to fathers of youth not stopped by the police, are more likely to report depression, net of father and youth characteristics associated with selection into experiencing youth police stops. This association is concentrated among non-Black fathers and fathers of girls. The findings highlight how the repercussions of youth criminal legal contact extend to youth’s fathers and, more broadly, suggest that future research incorporate the responses of men connected to those enduring criminal legal contact.
Impact and Compression-After-Impact Performance of a Thin Z-Pinned Composite Laminate
Authors: Francesconi L. , Loi G. , Aymerich F.
Published: February 2023

Impact and compression-after-impact (CAI) tests were carried out on [02/ ± 45]s carbon/epoxy samples to characterize the effect of z-pinning on the delamination resistance and damage tolerance properties of the laminate. Unpinned and z-pinned samples were subjected to impacts between 2 and 36 J to produce damage conditions that extend from barely visible impact damage (BVID) to complete penetration. The damage induced by impact and the damage modes leading to ultimate CAI failure were examined by X-radiography and by direct observations of the sample faces during CAI loading. The analyses indicate that the role of z-pins on the impact and CAI response of the laminate is dependent on the size and features of the damage. Z-pins do not modify the structural response to impact of the laminate, but they are effective in reducing the extent of damage for impact energies above a threshold value. Z-pinning is also effective in improving the CAI strength of the laminate for impact energies above this threshold value, even though it degrades the residual compressive strength for lower impact energies. Reductions in impact delamination size of up to 50% and improvements in CAI strength of about 20% were achieved by z-pinning for high-energy impacts. The mechanisms by which the z-pins affect the CAI response of the samples are illustrated and examined in detail for different impact damage severities.
Mitigation of Imidacloprid Toxicity in Poultry Chicken by Selenium Nanoparticles: Growth Performance, Lipid Peroxidation, and Blood Traits
Authors: Eid Yahya Z. , Omara Yassin , Ragab Asmaa , Ismail Ahmed , Zommara Mohsen , Dawood Mahmoud A. O.
Published: February 2023

Imidacloprid is an insecticide that protects against insects in the agriculture, animal, and poultry production sectors. Since the accumulation of imidacloprid induces adverse impacts on general health status and quality of the food chain, this study tested the impacts on broilers. Besides, selenium nanoparticles were fed to birds to relieve the negative impacts on growth performance and health status. Birds (1-day age, initial weight 46.05 ± 1.0 g) divided into four groups (triplicates) where 15 chicks of each replicate (45 for each group). The first group (control) was fed the basal diet without either selenium or imidacloprid toxicity. The second group was fed selenium nano form at 3 mg/kg. The third group was fed selenium and exposed to imidacloprid at 1/10 LT50 (3 mg/kg body weight). The fourth group was fed selenium nano form (3 mg/kg) and exposed to imidacloprid at 1/10 LT50 (3 mg/kg body weight). All groups were kept under the same conditions for 35 days. The final weight and weight gain of birds fed selenium nano form showed marked improvement compared to the imidacloprid-exposed group, while the feed intake and feed conversion ratio markedly reduced. The red blood cells showed higher values in birds fed selenium nano than the control and those exposed to imidacloprid. Interestingly, the hemoglobulin and hematocrit increased in birds fed selenium nano form with or without imidacloprid exposure. Furthermore, the white blood cells increased in birds fed selenium nano form with or without imidacloprid exposure. The total protein, albumin, and globulin were higher in birds fed selenium nanoparticles than those exposed to imidacloprid with or without selenium feeding. Birds in the control and imidacloprid groups had higher aspartate aminotransferase (AST), alanine aminotransferase (ALT), and malondialdehyde levels than the remaining groups. Accordingly, dietary selenium nanoparticles are suggested in broiler feed to cope with the adverse effects of imidacloprid toxicity.
Four Cases of Acute Kidney Injury Requiring Dialysis in Ultramarathoners
Authors: Pasternak Andrew V. , Newkirk-Thompson Cristin , Howard John H. , Onate John C. , Hew-Butler Tamara
Published: February 2023

Transient acute kidney injury (AKI) following ultraendurance footraces is a common biochemical diagnosis. However, severe AKI requiring renal replacement therapy is uncommon in ultramarathoners. We report 4 runners (3 men; mean age, 44 ± 3 y) who required prolonged (10–42 d) dialysis following the Western States 100 Mile Endurance Run over a 3-y span (0.38% of starters). The maximum ambient temperatures on the race day ranged from 36.6° to 38.3°C. The runners presented to local hospitals 17 to 32 h after running, with laboratories confirming rhabdomyolysis, hyponatremia (mean serum sodium concentration, 127±2 mmol⋅L-1), and AKI (mean serum creatinine concentration, 8.5±2 mg⋅dL-1). The case-cluster report highlights the potential synergistic effects of high ambient temperatures, muscle damage, and electrolyte imbalance on protracted renal dysfunction in ultramarathoners competing in a warming world.
Healthcare workers’ infection risk perceptions of aerosol-generating procedures and affective response
Authors: Benishek Lauren E. , Radonovich Lewis J. , Blackley Brie H. , Weissman David N.
Published: February 2023

Objective:

To understand healthcare worker (HCW) perceptions of infection risk associated with aerosol-generating procedures (AGPs) and their affective response to performing AGPs.

Design:

Systematic review.

Methods:

Systematic searches of PubMed, CINHAL Plus, and Scopus were conducted using combinations of selected keywords and synonyms. To reduce bias, titles and abstracts were screened for eligibility by 2 independent reviewers. Also, 2 independent reviewers extracted data from each eligible record. Discrepancies were discussed until consensus was reached.

Results:

In total, 16 reports from across the globe were included in this review. Findings suggest that AGPs are generally perceived to place HCWs at high risk of becoming infected with respiratory pathogens and that this perception stimulates a negative affective response and hesitancy to participate in the procedures.

Conclusions:

AGP risk perception are complex and context dependent but have important influences on HCW infection control practices, decision to participate in AGPs, emotional welfare, and workplace satisfaction. New and unfamiliar hazards paired with uncertainty lead to fear and anxiety about personal and others’ safety. These fears may create a psychological burden conducive to burnout. Empirical research is needed to thoroughly understand the interplay between HCW risk perceptions of distinct AGPs, their affective responses to conducting these procedures under various conditions, and their resulting decision to participate in these procedures. Results from such studies are essential for advancing clinical practice; they point to methods for mitigating provider distress and better recommendations for when and how to conduct AGPs.
Interdisciplinary Collaboration in International Crisis Medical Relief: A Look at the Nepal Earthquake and Ebola Relief Efforts
Authors: Penta Samantha
Published: February 2023

Objective:

This study explores interprofessional collaboration among medical and non-medical personnel planning and implementing international crisis health and medical relief efforts, and how disciplinary and professional background influences these activities.

Methods:

This study analyzes semi-structured interviews with individuals involved in organizations medical or health services to the Ebola epidemic in West Africa (2014-2016) or the 2015 Nepal earthquake.

Results:

Disciplinary background, sometimes coupled with organization role, shaped how relief workers engaged in the process of planning and implementing crisis medical relief. There were 3 thematic areas where these differences emerged: issue focus, problem -solving approaches, and decision-making approaches. Solutions from the field emerged as a fourth theme.

Conclusions:

The study demonstrates medical relief required collaboration across medical and non-medical professions and highlights the importance of relief workers’ disciplinary background in shaping the planning and implementation of crisis medical relief. Successful collaboration requires that people involved in crisis relief communicate the relevance of their own expertise, identify limits of their own and others’ disciplinary perspective(s), seek out strengths in others’ expertise, and can identify/ respond appropriately to others who do not see their own disciplinary limits, as well as learn these skills before engaging in relief.
Healthcare and Social Organizations’ Disaster Preparedness, Response, and Recovery Experience: Lessons Learned From Hurricanes Irma and Maria
Authors: Noboa-Ramos Carlamarie , Almodóvar-Díaz Yadira , Fernández-Repollet Emma , Joshipura Kaumudi
Published: February 2023

Background:

Healthcare and social organizations (HSOs) are first respondents after natural disasters. Hence, their preparedness and resilience are critical components for addressing future disasters. However, little is known about HSOs’ experiences prior to, during, and after hurricanes.

Objective:

To describe preparedness, response, and recovery experiences from hurricanes Irma/ Maria among HSOs in Puerto Rico and the US Virgin Islands.

Methods:

Using a convenience sample, semi-structured interviews were conducted with 52 key-informants. Content analysis for common and recurring themes and patterns was performed by HSO type.

Results:

Most HSOs (80.8%) had a preparedness plan and 55.8% responded providing emergency supplies. HSOs’ human resources (61.2%) was the main recovery facilitator/ enabler, while 36.5% identified the lack of economic resources and the lack of an integrated emergency plan as the top barriers. The main lesson learned include understanding the need to make improvements to their emergency preparedness plans (56.3%), and to establish an integrated/ centralized plan between relevant parties.

Conclusion:

Lessons learned after hurricanes allowed HSOs to identify gaps and opportunities to become more resilient. Infrastructure capacity, human resources, communication systems, and economic support, as well as training, partnerships, and new policies should be defined, revised, and/ or integrated into the HSOs’ preparedness plans to mitigate the impact of future disasters.
Viscous flow beneath a viscous or plastic skin
Authors: Ball Thomasina V. , Balmforth Neil J.
Published: February 2023

When a viscous fluid spreads underneath a deformable surface skin or crust, the peeling dynamics at the fluid front can control the rate of advance rather than bulk self-similar flow. For an elastic skin, this control results in a quasi-static interior blister held at constant pressure that is matched to a narrow peeling region behind the fluid front. In this paper, the analogous problem is considered for a skin that deforms either viscously or plastically, or both. In particular, the deformable surface is assumed to be a thin plate of material governed by the Herschel–Bulkley constitutive law. We examine how such a skin controls viscous flow underneath, fed at constant flux and spreading as either a planar or axisymmetric current. As for an elastic skin, the peeling dynamics at the viscous fluid front again controls the rate of spreading. However, contrary to that situation, the mathematical matching problem for viscoplastic peeling is simplified considerably as a result of an integral constraint. Despite this, the structure of the peeling region is complicated significantly by any plasticity in the skin, which can create a convoluted peeling wave ahead of the main blister that features interwoven yielded and plugged sections of the plate.
Legal dispositionism and artificially-intelligent attributions
Authors: Soh Jerrold
Published: February 2023

It is conventionally argued that because an artificially-intelligent (AI) system acts autonomously, its makers cannot easily be held liable should the system's actions harm. Since the system cannot be liable on its own account either, existing laws expose victims to accountability gaps and need to be reformed. Recent legal instruments have nonetheless established obligations against AI developers and providers. Drawing on attribution theory, this paper examines how these seemingly opposing positions are shaped by the ways in which AI systems are conceptualised. Specifically, folk dispositionism underpins conventional legal discourse on AI liability, personality, publications, and inventions and leads us towards problematic legal outcomes. Examining the technology and terminology driving contemporary AI systems, the paper contends that AI systems are better conceptualised instead as situational characters whose actions remain constrained by their programming. Properly viewing AI systems as such illuminates how existing legal doctrines could be sensibly applied to AI and reinforces emerging calls for placing greater scrutiny on the broader AI ecosystem.
Abandoning individual enforcement? Interrogating the enforcement of age discrimination law
Authors: Blackham Alysia
Published: February 2023

Discrimination law primarily relies on individual enforcement for addressing discrimination at work; yet those who are most impacted by discrimination are likely the least able to enforce their rights. The question then becomes: what role should individual enforcement play in discrimination law? Can we effectively abandon individual enforcement as part of the legislative model? Drawing on a mixed method, multi-year comparative study of the enforcement of age discrimination law in the UK, Australia and Sweden, this paper considers the gaps, limits and risks of the individual enforcement model in discrimination law. Integrating doctrinal analysis; statistical analysis of claims and cases, and data from the EU and OECD; qualitative expert interviews; and a survey of legal practitioners, this paper argues that while individual enforcement is inherently limited as a tool for achieving systemic change, it must remain part of any legislative model. Reflecting on the experience in Sweden, where individual enforcement of discrimination law is significantly curtailed, the paper posits that individual rights and individual enforcement remain important complements to other regulatory tools, particularly in jurisdictions with strong enduring age norms. Abandoning or severely restricting individual enforcement is unlikely to support either the macro or micro effectiveness of age discrimination law.
Microbiota signatures and mucosal healing in the use of enteral nutrition therapy v. corticosteroids for the treatment of children with Crohn’s disease: a systematic review and meta-analysis
Authors: Ding Zhaolu , Ninan Kiran , Johnston Bradley C. , Moayyedi Paul , Sherlock Mary , Zachos Mary
Published: February 2023

Corticosteroids (CS) and exclusive and partial enteral nutrition (EEN and PEN) are effective therapies in paediatric Crohn’s disease (CD). This systematic review of randomised controlled trials (RCT) and cohort studies analyses the impact of EEN/PEN v. CS on intestinal microbiota, mucosal healing as well as other clinically important outcomes, including clinical remission, relapse, adherence, adverse events and health-related quality of life (HRQL) in paediatric CD. Three RCT (n 76) and sixteen cohort studies (n 1104) compared EEN v. CS. With limited available data (one RCT), the effect on intestinal microbiome indicated a trend towards EEN regarding Shannon diversity. Based on two RCT, EEN achieved higher mucosal healing than CS (risk ratio (RR) 2·36, 95 % CI (1·22, 4·57), low certainty). Compared with CS, patients on EEN were less likely to experience adverse events based on two RCT (RR 0·32, 95 % CI (0·13, 0·80), low certainty). For HRQL, there was a trend in favour of CS based on data from two published abstracts of cohort studies. Based on thirteen cohort studies, EEN achieved higher clinical remission than CS (RR 1·18, 95 % CI (1·02, 1·38), very low certainty). Studies also reported no important differences in relapse and adherence. Compared with CS, EEN may improve mucosal healing with fewer adverse events based on RCT data. While limited data indicate the need for further trials, this is the first systematic review to comprehensively summarise the data on intestinal microbiome, mucosal healing and HRQOL when comparing enteral nutrition and CS in paediatric CD.
Mass Pilgrimage and the Usable Empire in a Napoleonic Borderland
Authors: Harrer Kilian
Published: February 2023

This article analyses the biggest pilgrimage event of the Napoleonic era, showing how Catholics used imperial opportunities and imperial loopholes to progress on their path toward religious revival. In September 1810, more than 200,000 pilgrims rushed to the small provincial city of Trier to venerate one of Christianity's most important relics, the Holy Coat of Jesus. This pilgrimage could take place and grow to such gigantic dimensions because both clerical elites and laypeople deftly navigated territorial frameworks created by the Napoleonic state. In the Rhenish borderlands to which Trier belonged, French hegemony enabled the return of the relic to the city in the first place, but pilgrims subsequently exploited the malleability of public order that also characterized imperial governance. The great pilgrimage of 1810 represented neither a form of exclusively top-down mobilization orchestrated by the church and controlled by the state, nor an act of overt, politicized opposition – even as state officials, in turn, proved undeniably hostile to pilgrim mobility and ‘superstition’. The article therefore argues that, in the more peaceful parts of Napoleon's empire, pilgrims and pilgrimage organizers accelerated post-revolutionary Catholic renewal by using that empire rather than either resisting or collaborating with it.
Simulation campaign of the turbulent diffusion at the edge of fusion devices
Authors: Scarivaglione L. , Valentini F. , Servidio S.
Published: February 2023

The understanding of cross-field transport is crucial for optimizing the properties of magnetic confinement in fusion devices. In this work, a two-dimensional, simplified model is used to study the turbulent dynamics in the region of the scrape-off layer. The numerical model, based on the reduced Braginskii equations, is able to describe the formation and the evolution of blob-like structures. The dynamics has been investigated by using both classical Eulerian analysis and the Lagrangian approach, by varying the ambient conditions of the plasma. The major goals are (i) a detailed and systematic study of turbulence by varying the plasma jump conditions in the edge tokamaks plasmas and (ii) a Lagrangian diffusion study of the edge turbulence by using an appropriate Braginskii model. It has been found that both the magnetic shear and the plasma mean profiles of density and temperature are crucial for setting the properties of the transport. By following fluid tracers, diffusive transients for the radial transport are observed, at length scales larger than the typical blob size. This work is relevant for the comprehension of the turbulent transport at tokamaks edges.
Analysis of deprescription strategies of proton pump inhibitors in primary care: a narrative review
Authors: Del-Pino Miguel , Sanz Emilio J.
Published: February 2023

Background:

Since the introduction of omeprazole in 1989, proton pump inhibitors (PPIs) have become the mainstream of treatment for acid-related pathologies, but nowadays, it is estimated that between 20% and 80% of people worldwide who are using PPIs are doing so without an approved indication. Overusing PPIs is known to involve a tremendous cost in financial terms, and many western countries have reported high spending on these medicines.

Objective:

We conducted a narrative review to evaluate PPI deprescription strategies carried out entirely or in collaboration with primary care and to identify factors that could influence the success of these strategies.

Method:

This review was conducted in November 2022, following PRISMA guidelines. Four databases were searched: PubMed, Web of Science, Scopus and CINAHL Complete, using the MeSH terms ‘proton pump inhibitors’ AND ‘deprescriptions’.

Results:

The search with the established criteria found eight studies. The different success rates obtained by the various studies analysed in this review may be due to the different methodologies used when establishing the protocols, sample selection and monitoring of the results.

Conclusion:

We can conclude that the two factors related to the most successful strategies were a) the clarity and simplicity of the de-escalation protocols, in which patients were instructed on the measures to follow in the event of the reappearance of symptoms, and b) the training of the physicians responsible for deprescribing. Long-term conclusions cannot be drawn about the effectiveness of these protocols, given that the studies are limited in time. Other barriers to generalizing the results are the small sample size and the absence of control groups.
“Mãos de Conforto” (Hands of Comfort): A novel non-pharmacological intervention to ease agitation in elderly persons with dementia
Authors: Julião Miguel , Bruera Eduardo , Silva Carina , Calado José , Cruz Mário , Vaz Marília , Paiva Bianca Sakamoto Ribeiro
Published: February 2023

Behavioral symptoms associated with dementia, such as agitation, are frequent and associated with well-known negative consequences for patients, their carers, and their environment. Pharmacological treatments for agitation using sedatives and antipsychotics are known to have several undesirable side effects and modest efficacy. Non-pharmacological alternatives are recommended as first-line options for agitation in persons with dementia with few side effects, but there is limited evidence of efficacy. We developed a novel and simple non-pharmacological alternative for agitation in dementia residents based on a Brazilian intervention using warm water surgical gloves used in patients with COVID-19 in intensive care units during the pandemic. We coined it “Mãos de Conforto” – Hands of Comfort. We report a series of 7 cases in 3 residents with dementia who whore Hands of Comfort.
Which political outsiders do Europeans prefer as ministers?
Authors: Rojon Sebastien , Pilet Jean-Benoit , Vittori Davide , Panel Sophie , Paulis Emilien
Published: February 2023

Previous research suggests that Europeans want more experts in government, but which experts do they want and why? Using survey data collected in 15 European countries, this study compared citizens’ preferences for high-ranking civil servants, university professors, and business executives over traditional political actors (MPs and former ministers) as ministers in government. Overall, university professors were rated more positively than MPs or former ministers in almost all countries, whereas civil servants and business executives were only rated more positively than politicians in Poland, Italy, Spain, Greece, Ireland, and Belgium. While political distrust is a key predictor of preferring political outsiders, we also found that civil servants are not as appealing to politically distrusting individuals, depending on the country. Furthermore, while the demand for more expertise in government mainly influences preferences for university professors, the demand for more government by the people is connected to preferences for business executives and (to a lesser extent) civil servants. The latter finding challenges the common distinction between citizen and expert-oriented visions of democracy and the alleged ‘elitist’ underpinnings of empowering non-elected outsiders.
Differential Trends in Iron Concentrations of Boreal Streams Linked to Catchment Characteristics
Authors: Škerlep M. , Nehzati S. , Sponseller R. A. , Persson P. , Laudon H. , Kritzberg E. S.
Published: February 2023

Increasing iron (Fe) concentrations have been reported for freshwaters across northern Europe over the last decades. This increase, together with elevated concentrations of dissolved organic carbon (DOC), leads to browning of freshwaters, which affects aquatic organisms, ecosystem functioning, biogeochemical cycles, and brings challenges to drinking water production. However, how such increasing trends in stream Fe concentrations reflect the contribution of different catchment sources remains poorly resolved. Here, we explored how catchment characteristics, that is, mires and coniferous soils, regulate spatial and temporal patterns of Fe in a boreal stream network. For this, we determined Fe speciation in riparian and mire soils, and studied temporal Fe dynamics in soil‐water and stream‐water over a span of 18 years. Positive Fe trends were found in the solution of the riparian soil, while no long‐term trend was observed in the mire. These differences were reflected in stream‐water, where three headwater streams dominated by coniferous cover also displayed positive Fe trends, whereas the mire dominated stream showed no trend. Surprisingly, the majority of higher order streams showed declining Fe trends, despite long‐term increases in DOC. In addition, we found that an extreme drought event led to a prolonged release of Fe and DOC from the riparian soils, that could have long‐term effects on stream Fe concentrations. Our results show that riparian forest soils can be major contributors to ongoing increases in freshwater Fe concentrations and that drought can further promote the release of Fe from organic soils.