bluuebunny/crossref_metadata_2025 huggingface dataset:
PCM-net: a refractive index database of chalcogenide phase change materials for tunable nanophotonic device modelling
Authors: Kim Hyun Jung , Sohn Jung-woo , Hong Nina , Williams Calum , Humphreys William
Published: March 2021

The growing demand for multifunctional nanophotonic devices has led to the exploration, and utilization, of a plethora of exotic electro-optical materials. Recently, chalcogenide glass based phase change materials (PCMs) have shown utility as a tuning material for a range of nanophotonic devices. Owing to their low loss, ultrafast switching speeds and wide waveband operation, PCMs are integrated in an increasing number of next-generation tunable components, including integrated photonic switches, metasurface optics and tunable spectral filters. Nonetheless, modelling of PCM-based devices is challenging—both in terms of accurate representation of experimentally derived material properties in different phase states, and standardization of results across the research community. Further, as each device requires optimization of specific performance metrics dependent on their respective application, any inaccuracies will lead to erroneous outcomes. In this work, we introduce PCM-net (http://nekocloud.com/pnet/): an online database of the complex refractive indices of a variety of chalcogenide glass PCMs (such as GeSbTe), as an accessible and indexed repository for data sharing across the PCM community. Refractive indices (n) and extinction coefficients (k) between amorphous and crystalline states are directly extracted from experimentally derived data in numerous academic research articles, and collated into the material resource database. Due to the inaccuracies associated with our data collection methods, this data is supplemented with additional computationally generated data, obtained through WVASE® —a commercial ellipsometry analysis software package. To demonstrate the utility of PCM-net, we provide a NASA application-driven device optimization example using the optical properties of PCMs collected with our database. We anticipate the database providing great use to the PCM community and coordinated research efforts enabled by PCM-net will promote the shared repository for the selection of appropriate PCMs for tunable nanophotonic device design for a range of applications.
A review of pumped hydro energy storage
Authors: Blakers Andrew , Stocks Matthew , Lu Bin , Cheng Cheng
Published: March 2021

The need for storage in electricity systems is increasing because large amounts of variable solar and wind generation capacity are being deployed. About two thirds of net global annual power capacity additions are solar and wind. Pumped hydro energy storage (PHES) comprises about 96% of global storage power capacity and 99% of global storage energy volume. Batteries occupy most of the balance of the electricity storage market including utility, home and electric vehicle batteries. Batteries are rapidly falling in price and can compete with pumped hydro for short-term storage (minutes to hours). However, pumped hydro continues to be much cheaper for large-scale energy storage (several hours to weeks). Most existing pumped hydro storage is river-based in conjunction with hydroelectric generation. Water can be pumped from a lower to an upper reservoir during times of low demand and the stored energy can be recovered at a later time. In the future, the vast storage opportunities available in closed loop off-river pumped hydro systems will be utilized. In such systems water is cycled repeatedly between two closely spaced small reservoirs located away from a river. This review covers the technology, cost, environmental impacts and opportunities for PHES. The key motivations for this review are firstly that large amounts of variable wind and solar generators are being deployed; and secondly that there are vast opportunities for low-cost pumped hydro storage that do not require interference with rivers (with the associated environmental cost).
Blow-up rates for a fractional heat equation
Authors: Ferreira R. , de Pablo A.
Published: March 2021

We study the speed at which nonglobal solutions to the fractional heat equation

u
t

+
(
−
Δ

)

α

/

2

u
=

u
p

,

\begin{equation*} u_t+(-\Delta )^{\alpha /2} u=u^p, \end{equation*}

with

0
>
α
>
2

0>\alpha >2

and

p
>
1

p>1

, tend to infinity. We prove that, assuming either

p
>

p
F

≡
1
+
α

/

N

p>p_F\equiv 1+\alpha /N

or

u
u

is strictly increasing in time, then for

t
t

close to the blow-up time

T
T

it holds that
<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" alttext="double-vertical-bar u left-parenthesis dot comma t right-parenthesis double-vertical-bar Subscript normal infinity Baseline tilde left-parenthesis upper T minus t right-parenthesis Superscript minus StartFraction 1 Over p minus 1 EndFraction">

‖
u
(
⋅
,
t
)

‖
∞

∼
(
T
−
t

)

−

1

p
−
1

\|u(\cdot ,t)\|_\infty \sim (T-t)^{-\frac 1{p-1}}

. The proofs use elementary tools, such as rescaling or comparison arguments.
Brake orbits of super-quadratic Hamiltonian systems
Authors: Xing Jiamin , Yang Xue , Li Yong
Published: March 2021

The brake orbits of Hamiltonian systems are studied. It is proved that if the Hamiltonian

H
H

is super-quadratic and satisfies

H
(
−
p
,
q
)
=
H
(
p
,
q
)

H(-p,q)=H(p,q)

for all

(
p
,
q
)
∈

R

2
n

(p,q)\in \mathbf {R}^{2n}

, the system has an unbounded sequence of brake orbits for any given period.
Risk Factors for Explantation of Breast Implants: A Cross-Sectional Study
Authors: Valente Denis Souto , Zanella Rafaela Koehler , Mulazzani Carolina Mattana , Valente Sibelie Souto
Published: March 2021

Background

Explantation of breast implant surgery (EBIS) is an emerging surgical field. Precise information about patients undergoing EBIS is important for preoperative planning of breast, augmentation, complications management, and to address any medicolegal issues.

Objectives

The aim of this study was to further extend current knowledge of EBIS risk factors.

Methods

An analytic cross-sectional study was conducted involving patients who had previously undergone cosmetic breast augmentation and were seeking EBIS.

Results

The study recruited 138 patients. The average time from implant placement and decision to explantation was 59.1 months. On average, each 1-year increase in age resulted in a 4% increase in the relative risk (RR) of explantation (confidence interval (CI), 1.07-1.21). Patients who were obese or overweight present a 1.5 times higher risk of EBIS (CI 95%, 1.03-2.29). On average, this RR was 40% lower (CI 95%, 0.33-0.91) in patients who never smoked compared with those with a history of tobacco use. Women with mastalgia had a 72% higher RR for EBIS (CI 95%, 1.11-2.65). The RR of EBIS was 5.6 times higher (CI 95%, 2.42-11.47) in patients presenting major Shoenfeld’s criteria for autoimmune/inflammatory syndrome induced by adjuvants (ASIA). The RR of EBIS was 4.3 times higher (CI 95%, 1.96-8.63) in patients presenting minor Shoenfeld’s criteria for ASIA.

Conclusions

EBIS poses a higher risk to patients who are overweight/obese, have a history of tobacco use, suffer from mastalgia, or present Shoenfeld’s criteria for ASIA. It is important to assess properly these individuals before performing implant surgery for breast augmentation.

Level of Evidence: 4
pgainsim: an R-package to assess the mode of inheritance for quantitative trait loci in GWAS
Authors: Scherer Nora , Sekula Peggy , Pfaffelhuber Peter , Schlosser Pascal
Published: March 2021

Motivation

When performing genome-wide association studies conventionally the additive genetic model is used to explore whether a single nucleotide polymorphism (SNP) is associated with a quantitative trait. But for variants, which do not follow an intermediate mode of inheritance (MOI), the recessive or the dominant genetic model can have more power to detect associations and furthermore the MOI is important for downstream analyses and clinical interpretation. When multiple MOIs are modelled the question arises, which describes the true underlying MOI best.

Results

We developed an R-package allowing for the first time to determine study specific critical values when one of the three models is more informative than the other ones for a quantitative trait locus. The package allows for user-friendly simulations to determine these critical values with predefined minor allele frequencies and study sizes. For application scenarios with extensive multiple testing we integrated an interpolation functionality to determine critical values already based on a moderate number of random draws.

Availability and implementation

The R-package pgainsim is freely available for download on Github at https://github.com/genepi-freiburg/pgainsim.

Supplementary information

Supplementary data are available at Bioinformatics online.
Fast Determination of Carbamates in Environmental Water Based on Magnetic Molecularly Imprinted Polymers as Adsorbent
Authors: Wang Shimiao , Zhao Qi , Li Jian
Published: March 2021

Magnetic molecularly imprinted polymers (MMIPs) were prepared with isoprocarb as template molecule and applied to extraction of carbamates pesticides in different water samples. This method based on magnetic solid-phase extraction (SPE) avoided the time-consuming column-passing process of loading large volume samples in conventional SPE. In the study, only 0.1 g MMIPs could be used to obtain satisfactory recoveries, due to the high-surface area and excellent adsorption capacity of these nano-magnetic adsorbents. Owing to the excellent selectivity of MMIPs, in high-performance liquid chromatography–mass spectrometry analysis, the matrix effects of this technique were obviously lower than the conventional SPE method. Under the optimal conditions, the detection limits of carbamates were in the range of 2.7–11.7 ng L−1. The relative standard deviations of intra-day and inter-day were 2.5–7.4% and 3.6–8.4%, respectively. At all the spiked level, the recoveries of four analyzed carbamates in environmental water samples were in the range of 74.2–94.2%. The significant positive results were achieved in the proposed method for the determination of four carbamates in water samples from different lakes and rivers. In the three samples we tested, the carbaryl was found in the lake water obtained from Yitong River, and the content was 2.4 ng L−1.
Pivoting during a Pandemic: School Social Work Practice with Families during COVID-19
Authors: Daftary Ashley-Marie H , Sugrue Erin P , Gustman Brian D , Lechuga-Peña Stephanie
Published: March 2021

The COVID-19 global pandemic led to the unprecedented shuttering of nearly all K–12 public education settings across the United States from March through June 2020. This article explores how school social workers’ roles, responsibilities, and work tasks shifted during spring 2020 distance learning to address the continuing and changing needs of families and the larger school community. Interviews were conducted with 20 school social workers in K–12 public schools, across three states, to understand the primary needs of children and families during the pandemic and to learn how school social workers can be most effective in responding to these needs. The data were analyzed using a grounded theory approach. Study findings revealed that during spring 2020, school social workers consistently had increased contact and interaction with students’ parents that centered around two major activities: (1) food assistance and referrals for families and (2) parent check-ins and coaching. The article discusses implications for the field of school social work during crises and beyond. Considerations include increased funding for schools that serve communities disproportionately affected by the pandemic and the reprioritization of school social workers’ roles and responsibilities to include increased contact with parents.
Race, Genetic Admixture, and Cognitive Performance in the Cuban Population
Authors: Llibre-Guerra Jorge J , Li Yan , Allen Isabel Elaine , Llibre-Guerra Juan C , Rodríguez Salgado Ana M , Peñalver Ana Ibis , Almirall Sanchez Arianna , Yokoyama Jennifer S , Grinberg Lea , Valcour Victor , Miller Bruce L , Llibre-Rodríguez Juan J
Published: March 2021

Background

Population aging will lead to a dramatic increase in dementia prevalence, which will disproportionally affect racial minorities. The presence of racial differences in dementia prevalence has been widely reported in United States, but there are no relevant studies on this topic in low- and middle-income countries.

Methods

In a cross-sectional survey, 2944 older Cubans were recruited at a community-based level aimed to identify the effects of self-identified race and genetic admixture on cognitive performance. Dementia diagnosis was established using 10/66 Dementia and DSM-IV criteria. APOE-ε4 genotype was determined in 2511 (85%) and genetic admixture was completed for all dementia cases and in a randomly selected sample of cognitive healthy participants (218 dementia cases and 367 participants without dementia).

Results

The overall prevalence of dementia was 8.7%, without large or statistically significant differences on dementia prevalence (p = .12) by self-identified race. Mean cognitive scores were similar across racial groups (p = .46). After controlling for age, sex, and education, greater proportion of African ancestry was not associated with cognitive performance (p = .17).

Conclusions

We found no evidence of an independent effect of self-identified race and/or population ancestry on dementia prevalence or cognitive performance. This suggests that observed differences in dementia prevalence among diverse populations may be driven primarily by social determinants of health.
Auto-assignment of providers in Medicaid Managed Care and factors influencing seasonal flu vaccine uptake: a retrospective analysis
Authors: Klein Colleen J , Dalstrom Matthew D , Foulger Roopa , Weinzimmer Laurence G
Published: March 2021

Objectives

Over 50 million people in the USA are enrolled in a Medicaid Managed Care plan. If they do not select a primary care provider, they are auto-assigned to one. The impact of auto-assignment has largely been understudied outside the context of patient satisfaction with the insurance plan. The purpose of the study was to explore the association between auto-assignment and flu vaccination use, which will contribute to our understanding of factors influencing the COVID-19 vaccine uptake.

Methods

Retrospective data from the Enterprise Data Warehouse of a health system were obtained for adult Medicaid enrolees assigned to a Midwestern health system in 2019. Descriptive statistics, independent t-tests and tetrachoric correlations were used to explore the relationship between auto-assignment and flu vaccine receipt among a large sample of Illinois residents (N = 7224). The sample was then divided into those who chose their provider (n = 6027) and those who were auto-assigned (n = 1197).

Key findings

Individuals who selected their provider were deemed to have flu vaccine coverage over those who were auto-assigned (33.2% vs. 6.6%). Furthermore, among those who were auto-assigned, age, number of office visits and having chronic morbidities, including chronic obstructive pulmonary disease (P < 0.01), diabetes (P < 0.01) and heart failure (P < 0.01), were positively associated with flu vaccine receipt.

Conclusions

Individuals who are auto-assigned to a primary care provider are less likely to be flu vaccine recipients than those who choose their provider. This suggests that auto-assignment is a risk factor that influences vaccine receipt. This research provides perspectives for outreach efforts that target individuals who are auto-assigned to a provider.
Juvenile-Onset Recurrent Respiratory Papillomatosis in the United States, Epidemiology and HPV Types—2015–2020
Authors: Amiling Raiza , Meites Elissa , Querec Troy D , Stone Laura , Singh Vidisha , Unger Elizabeth R , Derkay Craig S , Markowitz Lauri E
Published: March 2021

Background

Juvenile-onset recurrent respiratory papillomatosis (JORRP) is a rare disease characterized by the growth of papillomas in the respiratory tract. In the United States, JORRP is not a nationally notifiable condition and current data are limited.

Methods

Children with JORRP aged <18 years were enrolled from 26 pediatric otolaryngology centers in 23 US states from January 2015 through August 2020. Demographic, birth information, and maternal vaccination history were collected from a parent/guardian. Clinical history was abstracted from medical records. Papilloma biopsies were tested for 28 human papillomavirus (HPV) types. Mothers who delivered in 2006 or later were considered age-eligible for HPV vaccination if aged ≤26 years in 2006. We described characteristics of enrolled children and their birth mothers and analyzed disease severity by diagnosis age and HPV type using multiple logistic regression.

Results

Among 215 children with JORRP, 88.8% were delivered vaginally; 64.2% were firstborn. Among 190 mothers, the median delivery age was 22 years. Among 114 (60.0%) age-eligible for HPV vaccination, 16 (14.0%) were vaccinated, 1 (0.9%) before delivery. Among 162 specimens tested, 157 (96.9%) had detectable HPV; all 157 had a vaccine-preventable type. Disease severity was associated with younger diagnosis age and HPV 11; adjusted analyses found only younger diagnosis age significant (adjusted odds ratio: 6.1; 95% confidence interval: 2.9, 12.8).

Conclusions

Children with JORRP were commonly firstborn and delivered vaginally to young mothers; most of the mothers reported no HPV vaccination before delivery. Vaccine-preventable HPV was identified in all specimens with detectable HPV. Increasing preexposure HPV vaccination could substantially reduce or eliminate JORRP in the United States.
Follow-Up and Sticking with Treatment
Authors: Broussard Beth , Compton Michael T.
Published: March 2021

Sticking with treatment is important to continue to feel better, continue to experience a decrease in symptoms, and learn how to manage instances when symptoms may return. Good mental health treatment places the young person and the family at the center of the treatment team and encourages active participation when making treatment decisions. Shared decision-making can be used to plan treatment and identify goals in all settings, including the hospital or clinic. It can also be used to adjust the treatment plan as needed. One way that family and friends can support the young person in moving toward recovery is to understand the treatment plan so that they can help the individual stick with treatment. Psychosocial treatments teach individuals various strategies and skills to practice, while medicine makes pursuing life goals easier given that symptoms will be under better control.
Understanding Mental Health First Aid for Psychosis
Authors: Broussard Beth , Compton Michael T.
Published: March 2021

This last chapter includes advice on how to provide mental health first aid to someone who may be experiencing an episode of psychosis. These guidelines were developed by and reprinted here with permission from Mental Health First Aid Australia. These guidelines are designed to help members of the public to provide first aid to someone who may be experiencing psychosis. The role of the first aider is to assist the person until appropriate professional help is received or the crisis resolves. These guidelines are a general set of recommendations. Each individual is unique, and it is important to tailor your support to that person’s needs. So, these recommendations may not be appropriate for every person.
MRI-Targeted or Standard Biopsy for Prostate Cancer Diagnosis
Authors: Dahm Philipp
Published: March 2021

This chapter provides a summary of the landmark PRECISION trial, which investigated how magnetic resonance imaging (MRI) with or without targeted biopsy compared to standard transrectal ultrasonography-guided biopsy in detecting clinically significant prostate cancer. The study provided high-quality evidence to support the use of multiparametric MRI in men with an elevated prostate-specific antigen level as a triage test to help determine the need for a biopsy.
Radical Prostatectomy Versus Observation in Early Prostate Cancer
Authors: Dahm Philipp
Published: March 2021

This chapter provides a summary of the landmark Scandinavian Prostate Cancer Group Study Number 4 trial of men with clinically localized prostate cancer from the pre–prostate-specific antigen (PSA) era who were randomized to radical prostatectomy versus watchful waiting and were followed long term. With follow-up of more than 20 years, the results favored surgery with regard to prostate cancer mortality.
Docetaxel Plus Prednisone or Mitoxantrone Plus Prednisone for Advanced Prostate Cancer
Authors: Zabell Joseph
Published: March 2021

This chapter summarizes the findings of landmark TAX 327 trial in men with castrate-refractory prostate cancer who received either docetaxel (weekly or every 3 weeks) or mitoxantrone (every 3 weeks). The study found improved overall survival, better quality of life, and similar side effects in men treated with docetaxel.
A Randomized Comparison of Cisplatin Alone or in Combination With Methotrexate, Vinblastine, and Doxorubicin in Patients With Metastatic Urothelial Carcinoma
Authors: Dahm Philipp , Narayan Vikram M.
Published: March 2021

This chapter reviews the landmark trial in patients with advanced urothelial carcinoma of the bladder assessing how the addition of methotrexate, vinblastine, and doxorubicin to cisplatin (M-VAC) compared to cisplatin alone. The study found improved overall survival and progression-free survival in the M-VAC group, but at the expense of increased toxicity and more drug-related deaths.
Burch Colposuspension Versus Fascial Sling to Reduce Urinary Stress Incontinence
Authors: Dixon Colby A. , Lane Giulia I. , Fok Cynthia S. , Louis Moy M.
Published: March 2021

This chapter summarizes the results of the Stress Incontinence Surgical Treatment Efficacy (SISTEr) trial, which randomized women with stress urinary incontinence to an autologous sling procedure versus a Burch colposuspension. Overall treatment success favored the fascial sling over the Burch procedure group, as did the stress incontinence–specific success rate at 24 months. Postoperative voiding dysfunction and urge incontinence were more common in the sling group than the Burch group. These findings supported the historical shift toward slings (autologous and synthetic) versus Burch colposuspension procedures in clinical practice.
Antimicrobial Prophylaxis for Children With Vesicoureteral Reflux
Authors: Dahm Philipp , Lewis Jane M.
Published: March 2021

This chapter summarizes the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial, a landmark trial that randomized children with vesicoureteral reflux diagnosed after a first or second febrile or symptomatic urinary tract infection to receive trimethoprim–sulfamethoxazole (TMP-SMX) prophylaxis versus placebo. It found that antibiotic prophylaxis reduced the incidence of recurrent febrile or symptomatic urinary tract infection but had little effect on renal scarring. Recurrent febrile or symptomatic urinary tract infections resistant pathogens were increased. This study provides the underpinning for guidelines that advocate for low-dose antibiotic prophylaxis for the first year of life; however, this remains an area of considerable controversy.
The Surgical Learning Curve for Prostate Cancer Control After Radical Prostatectomy
Authors: Dahm Philipp
Published: March 2021

This chapter summarizes an important study exploring the learning curve of surgeons performing open radical prostatectomy with clinically localized prostate cancer. The study retrospectively analyzed a large cohort of patients from several major medical centers who underwent surgery by several dozen surgeons with varying experience with regards to the outcome of freedom from biochemical recurrence. The study found a dramatic improvement in cancer control with increasing surgeon experience up to 250 prior operations but no large change with further surgeon experience. This study stands out as the first large, high-quality study in the urological literature to provide a detailed analysis of the association of surgical experience with an important clinical outcome measure. It provided compelling evidence that surgical experience with prostatectomy results in improved oncological outcomes.
Anatomy and physiology
Authors: Robinson Terry , Scullion Jane
Published: March 2021

This chapter covers some fundamental aspects of the respiratory tract, and describes the structure and function of both the upper and lower airways, processes by which air is moved from the external environment to the gas exchange area of the lungs, and some of the aspects of the normal respiratory tract which are affected by the more common respiratory diseases. Its functions in terms of respiration are to facilitate the uptake of oxygen; eliminate carbon dioxide; and maintain the pH of the blood. Conventionally the tract is divided into upper and lower parts. The upper tract is composed of the mouth, nasal passages, and behind these a wide tube termed the pharynx. This receives inhaled air from the nose and mouth and accordingly is termed the naso- and oropharynx, respectively.
Respiratory investigations
Authors: Robinson Terry , Scullion Jane
Published: March 2021

There are many investigations in respiratory medicine, ranging from basic tests to more invasive procedures. Respiratory investigations are the final pieces in the jigsaw to help respiratory nurses and nurse practitioners reach a diagnosis. Many nurses do not work in specialized respiratory units and will not have access to the most sophisticated investigations. However, all respiratory nurses should understand what tests are available, be aware of how the tests are performed, and of any preparation required before and after the test, so they can explain these procedures to their patients. This chapter offers an insight into the application of respiratory investigations and their role in specialized respiratory units.
Asthma and allergies
Authors: Robinson Terry , Scullion Jane
Published: March 2021

Asthma is a significant problem in the UK reported to affect approximately 5.2 million people; and occurring in 21% of children and 15% of adults. Allergy is an important component of asthma, and most people with asthma are sensitive to one or more common aeroallergens. Approximately 80% of people with asthma also have rhinitis (essentially a runny, blocked nose), which is associated with a significant impact on quality of life. This chapter covers asthma and its assessment and management, patient education, and an introduction to allergy. This also includes the allergic response, diagnosis, anaphylaxis, immunology, and care algorithms as other important aspects.
Chronic obstructive pulmonary disease (COPD)
Authors: Robinson Terry , Scullion Jane
Published: March 2021

Chronic obstructive pulmonary disease (COPD) is a common respiratory disorder that causes considerable morbidity and mortality throughout the world. COPD is predominantly caused by smoking. COPD is characterized by fixed airflow obstruction. Significant airflow obstruction may be present before the individual is aware of it. Airflow obstruction is slowly progressive, with minimal or no reversibility to bronchodilators. This chapter covers the causes and risk factors, epidemiology, investigations, differential diagnosis, and assessment. It then goes on to describe management strategies (pharmacotherapy, drug delivery systems, other therapies), the management and treatment of acute exacerbations of COPD, oxygen, and assisted ventilation, the role of the nurse and the nurse specialist, complications, and palliative care.
Non-invasive ventilation (NIV)
Authors: Robinson Terry , Scullion Jane
Published: March 2021

Non-invasive positive pressure ventilation (NiPPV) is an effective form of ventilatory assistance. It was first used at the beginning of the twentieth century; since then, there has been growing interest in its role in treating type 2 (hypercapnic) respiratory failure. In the last 20 years NiPPV has had an important role in the management of acute exacerbations of chronic obstructive pulmonary disease (COPD), but its use is not limited to those with COPD. Initially, NiPPV was used mainly to support patients with neuromuscular disease, poliomyelitis, and pulmonary oedema. Since then many different groups of patients have been found to benefit from NiPPV, including patients requiring bridging pre-transplant, post-surgical respiratory support, and weaning from mechanical ventilation. NiPPV is also increasingly used to support patients with spinal injury. This chapter describes types 1 and 2 of chronic respiratory failure, types of ventilators and interfaces, and the British Thoracic Society indications for use and contraindications are all covered. Nursing care considerations and service provision are both included.
The undeniable reality of the ‘War on Terror’, radicalization, and sanity
Authors: Ahmed Shamila
Published: March 2021

This chapter explores the relationship between structure, mental health (agency–emotions–trauma) and radicalization. It uses Cohen’s States of Denial as a Freudian meta narrative to explore how denial operates to protect individual’s sanity against the atrocities and suffering in the world. It demonstrates how the denials of injustice, suffering, and erosion of human rights in the ‘War on Terror’ are exposed by Islamists and form part of their counter-narrative to the ‘War on Terror’. The chapter contends that this exposure of harmful realities leads to overwhelming emotions that individuals struggle to regulate, and it is the need for support, understanding, and compassion in dealing with such emotions that leads individuals to seek out extremist groups. It is argued that public services must support emotional resilience, and the absence of these services represents a continuing academic and policy neglect of how societal structures and institutions impact individuals’ beliefs and emotions, and form part of their experience of victimization.
What attracts people to the English Defence League and who is most vulnerable to recruitment?
Authors: Sibley Alice
Published: March 2021

The English Defence League (EDL) is a British far-right/counter-jihad group, which mostly operates online through social media. In 2012, 3% of the British public (n = 298) reported that they agreed with the EDL’s methods and values. A study in 2011 found the three main reasons for supporting the EDL were: a perceived threat from Islam and immigration; to protect their cultural identity; and disillusionment with their lives and the political ruling class. In addition to this, variables that make individuals vulnerable to EDL recruitment may include a lack of differentiation between Muslims and terrorists, a belief in conspiracy theories, sudden localized cultural change, a lack of belonging, a perceived threat to British values, a lack of identification with political parties, economic hardship, age, and gender.
Clinical intervention to address violent radicalization: The Quebec model
Authors: Rousseau Cécile , Savard Christian , Bonnel Anna , Horne Richard , Machouf Anousheh , Rivest Marie-Hélène
Published: March 2021

Radicalization to violence is a world social phenomenon that is related to mental health in multiple ways, not only because psychological factors and psychopathology are determinants of violent radicalization, but also because psychological distress, grief, and trauma are significant public health consequences of this form of violence. The complexity of violent radicalization manifestations and its increasing association with severe psychopathology in lone actors suggests that there is an important role for clinicians to play in supporting and complementing the work of frontline psychosocial services, as well as contributing to the transdisciplinary network needed to develop effective intervention models. However, given the risks of medicalizing forms of social suffering and of being co-opted by ideologically driven political interests, this professional involvement cannot take place without continuous ethical reflection and systemic evaluation. This chapter will describe the clinical model of intervention developed in Quebec (Canada), and discuss some of the organizational, clinical, and ethical challenges encountered.
The heart team
Authors: Leonardi Sergio , Modine Thomas , Windecker Stephan
Published: March 2021

Modern cardiovascular medicine is complex, dynamic and interactive. Therefore multidisciplinary dialogue between different cardiovascular specialists is required to deliver optimal patient care. This requirement has led to the concept of teams of different specialists caring for patients with complex cardiovascular diseases – hence the concept of “heart teams”. These teams are particularly valuable when complex and/or rapid decision-making is essential. This chapter is intended to provide conceptual and practical considerations for the composition, structure and function of multidisciplinary teams involved in the treatment of complex cardiovascular diseases; discuss strategies for clear and transparent patient communication and promotion of a patient-centric approach; and provide guidance on optimal implementation of the heart team concept in patients requiring myocardial revascularization of a broad spectrum of complex coronary artery disease, from stable angina to acute coronary syndrome patients with mechanical complications and hemodynamic instability.
Quality of care assessment in acute cardiac care
Authors: Ecarnot Fiona , Schiele François
Published: March 2021

This chapter will describe the use of performance measures and quality measures in the assessment of the quality of care delivered to patients with acute cardiovascular disease. It gives a brief recap of the major landmarks in the development of the use of performance measures, and goes on to explain the different approaches to measuring processes of care and to measuring outcomes. The utility and construction of composite measures is also described.
Pathophysiology and clinical assessment of the cardiovascular system (including pulmonary artery catheterization)
Authors: Sionis Alessandro , Gayat Etienne , Mebazaa Alexandre
Published: March 2021

The underlying pathophysiological derangements of the cardiovascular system in many medical conditions are often complex. Acute circulatory dysfunction can be related broadly to a cardiogenic cause leading to acute heart failure or be secondary to hypovolaemia or vascular dysfunction (e.g. sepsis). Different mechanisms may be involved, including left ventricular diastolic and/or systolic dysfunction and/or right ventricular dysfunction. Many aspects of left ventricular function are explained by considering ventricular pressure–volume characteristics. Epidemiological studies show that clinical signs at admission, morbidity, and mortality differ between the main scenarios of acute heart failure: left ventricular diastolic dysfunction, left ventricular systolic dysfunction, right ventricular dysfunction, and cardiogenic shock. Although echocardiography is usually the first investigation used to assess the mechanism of cardiac dysfunction, in selected cases (in particular, in cases of refractory shock secondary to both vascular and heart dysfunction or in cases of refractory haemodynamic instability associated with severe hypoxaemia), the pulmonary artery catheter can help to assess and monitor the cardiovascular status and evaluate response to treatments.
The respiratory system
Authors: Vieillard-Baron Antoine
Published: March 2021

The respiratory system is key to the management of patients with respiratory, as well as haemodynamic, compromise and should be monitored. The ventilator is more than just a machine that delivers gas; it is a true respiratory system monitoring device, allowing the measurement of airway pressures and intrinsic positive end-expiratory pressure and the plotting of pressure/volume curves. For effective and reliable monitoring, it is necessary to keep in mind the physiology such as the alveolar gas equation, heart–lung interactions, the equation of movement, etc. Monitoring the respiratory system enables adaptation of not only respiratory management, but also haemodynamic management.
Interpretation and clinical use of chest radiographs
Authors: Parkhomenko Alexander , Gurjeva Olga S , Yalynska Tetyana
Published: March 2021

Although chest X-ray (CXR) is a well-studied classic diagnostic tool, this easy-to-obtain, readily accessible imaging modality is still capable of giving physicians new information on patient conditions in an efficient manner. This chapter provides intensivists, cardiologists, cardiology fellows, and medical students with concise information on recent data on CXR imaging and interpretation and briefly reviews the most common medical conditions in which CXR is useful. It includes a brief review of a multistep approach to the evaluation of the quality of chest radiographs and the systematic description of imaged structures. This chapter covers water retention, air collection, and lung-related problems, gives information on monitoring of line and device placements (central venous catheters, tubes, pacemaker lead positions, etc.), and also focuses on the pitfalls of image interpretation in intensive care unit settings. In addition, the chapter reviews recent data on accuracy of other imaging modalities, in terms of describing certain abnormalities, as compared with regular chest radiographs.
Echocardiography and thoracic ultrasound
Authors: Flachskampf Frank A , Myrianthefs Pavlos , Beyer Ruxandra
Published: March 2021

Thoracic ultrasound is a rapidly evolving method in assessing diseases of the chest and particularly in emergency conditions for the evaluation of dyspnoeic and hypoxic patients. An increased number of B-lines are an unspecific sign for an increased quantity of fluid in the lungs, resembling interstitial syndromes such as cardiogenic pulmonary oedema. The presence of a B-line pattern allows the differentiation between a cardiogenic and a respiratory origin of acute respiratory failure. Also, ultrasound can be used for the diagnosis and monitoring of pulmonary consolidation, for the diagnosis and quantification of pleural fluid, and for the diagnosis of pneumothorax using the ‘lung point’. Finally, thoracic ultrasound can be used for guided pleural fluid aspiration, closed intercostal tube drainage, and central vessel catheterization.
Non-invasive ventilation
Authors: Masip Josep , Planas Kenneth , Mas Arantxa
Published: March 2021

During the last 25 years, the use of non-invasive ventilation has grown substantially. Non-invasive ventilation refers to the delivery of positive pressure to the lungs without endotracheal intubation and plays a significant role in the treatment of patients with acute respiratory failure and in the domiciliary management of some chronic respiratory and sleep disorders. In the intensive and acute care setting, the primary aim of non-invasive ventilation is to avoid intubation, and it is mainly used in patients with chronic obstructive pulmonary disease exacerbations, acute cardiogenic pulmonary oedema, immunocompromised or in the context of weaning, situations in which a reduction in mortality has been demonstrated. The principal techniques are continuous positive airway pressure, bilevel pressure support ventilation and more recently, high flow nasal cannula. Whereas non-invasive pressure support ventilation requires a ventilator, the other two techniques are simpler and can be easily used in non-equipped areas by less experienced teams, including the pre-hospital setting. The success of non-invasive ventilation is related to an adequate timing, proper selection of patients and interfaces, close monitoring as well as the achievement of a good adaptation to patients’ demand.
Mechanical ventilation
Authors: Camporota Luigi , Vasques Francesco
Published: March 2021

Acute respiratory failure is the most common cause of admission to critical care. Many patients presenting to ICU have pre-existing heart disease and 13.1% will be diagnosed with chronic, NYHA IV heart failure. In addition, global left ventricular hypokinesia frequently occurs in adults with septic shock and around 20% of patients with acute respiratory distress syndrome (ARDS) have acute pulmonary hypertension and right heart failure. The presence of heart failure adds significant challenges for the management of mechanically ventilated patients and increases their morbidity and mortality. Furthermore, positive pressure ventilation can exert profound cardiovascular effects through heart-lung interactions. It is thus essential for the cardiologist to have an appreciation of the assessment and management of patients with respiratory failure, particularly if mechanically ventilated. Mechanical ventilation is used to assist or replace spontaneous respiration. Gas flow can be generated by negative pressure techniques, but it is positive pressure ventilation that is the most efficacious and most commonly used in intensive care. There are numerous pulmonary and extrapulmonary indications for mechanical ventilation, and it is the underlying pathology that will determine the duration of ventilation required. Ventilation modes can broadly be classified as volume- or pressure-controlled, but modern ventilators combine the characteristics of both in order to complement the diverse requirements of individual patients. To avoid confusion, it is important to appreciate that there is no international consensus on the classification of ventilation modes. Ventilator manufacturers can use terms that are similar to those used by others that describe very different modes or have completely different names for similar modes. This chapter provides an introduction on mechanisms of respiratory failure, principles of physiological assessment, modes and strategies of invasive mechanical ventilation. Whenever possible we discuss the heart-lung interactions of relevance to the cardiologist.
Percutaneous (short-term) mechanical circulatory support
Authors: Thiele Holger , Vranckx Pascal
Published: March 2021

Coronary artery disease (CAD) has emerged as the dominant aetiologic factor in acute heart failure syndromes (AHFS) and cardiogenic shock (CS). The invasive management of the complex cardiac patient with advanced (decompensated) heart failure, CS, and/or potential haemodynamic compromise during and/after percutaneous coronary intervention (PCI) has become the remit of specialty myocardial intervention centres. Such centres provide state-of the art facilities for PCI, including experienced senior operators and critical care physicians who are available 24 hours per day, 7 days per week, with immediate access to cardiac surgery and mechanical circulatory support (MCS) systems.
Percutaneous coronary interventions in acute coronary syndromes
Authors: Mitsis Andreas , Valgimigli Marco
Published: March 2021

Acute coronary syndromes (ACS) remain the most common disease in acute cardiovascular care. Historically, two groups of patients should be differentiated based on initial ECG features: patients with ongoing chest pain and persistent ST-segment elevation and patients with acute chest pain but no persistent ST-segment elevation. The first condition is defined as STEMI and requires immediate reperfusion by primary angioplasty or fibrinolytic therapy. The second condition is defined as NSTE-ACS and consists a big spectrum of cases range from patients free of symptoms at presentation to individuals with ongoing ischaemia, electrical or haemodynamic instability or cardiac arrest. The different types of ACS must be differentiated as their prognosis and therapeutic strategy varies. However, over the last years, the early and broad use of percutaneous coronary intervention (PCI) as well as innovations in the adjunctive antithrombotic medication, including more effective P2Y12-Inhibitors and new generation DES resulted to a dramatic improvement of the prognosis across the whole spectrum of ACS patients.
Acute heart failure: early pharmacological therapy
Authors: Docherty Kieran F , Dalzell Jonathan R , Petrie Mark C , McMurray John JV
Published: March 2021

Acute heart failure syndromes consist of a spectrum of clinical presentations due to impairment of some aspect of cardiac function. They represent a final common pathway for a vast array of pathologies, and may be either a de novo presentation or, more commonly, a decompensation of pre-existing chronic heart failure. Despite being one of the most common medical presentations, there are no definitively proven prognosis-modifying treatments. The mainstay of current therapy is oxygen and intra-venous diuretics. However, within this spectrum of presentations there is a crucial dichotomy which governs ultimate treatment approach, i.e. the presence, or absence, of cardiogenic shock. Patients without cardiogenic shock may receive vasodilators whilst shocked patients should be considered for treatment with inotropic therapy and/or mechanical circulatory support when appropriate and where available
Donor organ management
Authors: Neyrinck Arne P , Ferdinande Patrick , Raemdonck Dirk Van , Velde Marc Van de
Published: March 2021

Organ transplantation is the standard treatment modality for end-stage organ disease in selected cases. Two types of potential organ donors can be identified: the brain-dead 'heart-beating donors', referred to as DBD (donation after brain death), and the warm ischaemic 'non-heart-beating donors', referred to as DCD (donation after circulatory death). Brain death induces several physiological changes in the DBD donor. An autonomic storm is characterized by massive catecholamine release, followed by autonomic depletion during a vasoplegic phase. This is associated with several hormonal changes (suppression of vasopressin, the hypothalamic-pituitary-adrenal axis, and the hypothalamic-pituitary-thyroid axis) and an inflammatory response. These physiological changes form the basis of organ donor management, including cardiovascular stabilization and hormonal therapy (including vasopressin and analogues, thyroid hormone, and cortisol). Donor management is the continuation of critical care, with a shift towards individual organ stabilization. An aggressive approach to maximize organ yield is recommended; however, many treatment strategies need further investigation in large randomized trials. DCD donors have now evolved as a valid alternative to increase the potential donor pool and challenge the clinician with new questions. Optimal donor comfort therapy and end-of-life care are important to minimize the agonal phase. A strict approach towards the determination of death, based on cardiorespiratory criteria, is prerequisite. Novel strategies have been developed, using ex situ organ perfusion as a tool, to evaluate and recondition donor organs. They might become more important in the future to further optimize organ quality.