bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating nursing satisfaction and utilization of the Clinical Institute Withdrawal Assessment for Alcohol, revised version (CIWA-Ar)
Authors: Bacon Opal , Robert Sophie , VandenBerg Amy 
Published: May 2016

Abstract

Introduction: The Clinical Institute Withdrawal Assessment for Alcohol, revised version (CIWA-Ar), developed and validated for research, is used in our inpatient academic medical center. We sought to assess nursing satisfaction with the scale itself, training for using the scale, and nursing staff use of the CIWA-Ar.

Methods: A retrospective chart review included all patients with an order for CIWA-Ar between August 1, 2014, and September 30, 2014. Data collected included demographics, admitting diagnosis, vital signs, admission blood alcohol level, lorazepam total daily dose, and CIWA-Ar scores. Nursing staff was sent an anonymous, 26-question survey in January 2015. The survey collected demographics, training history, and recommendations for modifications to the CIWA-Ar.

Results: During the 2-month period, 274 patients had orders for CIWA-Ar, with 113 receiving at least one dose of lorazepam. Lorazepam was not given to 21% of patients when they scored >8 on the CIWA-Ar, whereas 71% of patients received a dose of lorazepam when they had a CIWA score <8. The survey was sent to 2011 clinical nurses, with 284 responses received (14% response rate). Only 36% of responding nurses felt adequately trained to administer the CIWA-Ar. Most nurses preferred on-the-job and online training methods.

Discussion: Nursing use of the CIWA-Ar could be optimized at this institution. Fewer than half of respondents reported feeling adequately training to administer the CIWA-Ar. Results will be used to improve training for nursing staff regarding scoring of the CIWA-Ar and administering lorazepam to treat alcohol withdrawal syndrome.
Buprenorphine/naloxone addiction in a pharmacist as a result of migraine self-treatment
Authors: Norton Merrill , Cho Ah Young , Giebler Courtney , Smith Taylor , Walton Kathryn 
Published: May 2016

Abstract

Objective: A unique case report is presented to demonstrate addiction in a pharmacist through the use of buprenorphine/naloxone film for the self-prescribed treatment of migraine headaches.

Case Summary: A 35-year-old female hospital pharmacist was admitted to treatment for opioid use disorder for using buprenorphine/naloxone film to self-medicate her migraine headaches. After daily use of sublingual buprenorphine/naloxone, and several failed attempts to discontinue use, the pharmacist was admitted to a partial hospitalization treatment program. She was prescribed sumatriptan subcutaneous injection for her migraines, while maintaining buprenorphine/naloxone abstinence. Upon completion, the pharmacist transitioned to the aftercare program, where she maintains sobriety and uses her story to help aid in other patients' recoveries at the treatment center.

Discussion: Addiction and substance abuse affect a substantial number of health care professionals. Pharmacists are particularly vulnerable to prescription drug misuse and addiction as a result of their direct access and vast pharmacologic knowledge. In a 2004 self-report survey of a random sample of health care providers, 58.7% of pharmacists reported using nonprescribed prescription drugs at least once in their lifetime. This case is a story of rehabilitation and recovery of a pharmacist who has a desire to return to the practice of pharmacy through the use of effective pharmacologic and behavioral interventions.
Intolerance of sublingual buprenorphine-naloxone during induction in a patient with end-stage liver disease: A case report
Authors: Behan Jennifer , Geier Michelle 
Published: May 2016

Abstract

Introduction: Sublingual buprenorphine is indicated for opioid dependence. It comes in 2 formulations: a mono buprenorphine product (BUP) and a combination product containing naloxone (BUP-NAL), which functions as an abuse deterrent. Sublingual naloxone does not reach clinically significant levels except in cases of hepatic impairment, where its metabolism can be impaired. Substantial naloxone accumulation could block the therapeutic effects of buprenorphine. The risk of hepatic impairment is elevated in the opioid dependence population, and our case highlights the need for careful evaluation of hepatic function and consideration of BUP.

Case/Results: We report a patient with end-stage liver disease who began BUP-NAL induction with modest improvement on treatment day 1 followed by sustained withdrawal after receiving an observed dose on day 2. He returned to the clinic 2 days after his second successive day of BUP-NAL, vomiting and complaining of persistent withdrawal. To avoid potential accumulation of naloxone, the patient was eventually switched to and stabilized on BUP with good response.

Discussion/Conclusion: The clinical course this patient experienced during induction makes a case that naloxone can accumulate and interfere with the effectiveness of buprenorphine in the presence of liver dysfunction. Our case highlights the need for consideration of BUP in circumstances where patient safety and effective treatment outweigh the risks of prescribing a product with abuse deterrent properties.
Hospitalizations and emergency room visits after initiation of long-acting injectable antipsychotics
Authors: Heesch Chelsie B. , Moore Troy A. , Gutierrez Cynthia A. , Lee Shuko 
Published: May 2016

Abstract

Introduction: Long-acting injectable antipsychotics (LAIs) serve as a means to ensure medication adherence with the intention of improving outcomes for psychiatric patients. Evidence remains inconclusive regarding the impact of LAIs on relapses and psychiatric hospitalizations rates.

Methods: The primary objective of this retrospective pre/post study was to determine whether initiating an LAI in a veteran population with schizophrenia, schizoaffective disorder, or bipolar disorder is associated with a decrease in the 1-year rate of psychiatric hospitalizations and emergency room (ER) visits.

Results: For the combined primary endpoint, the 1-year rate of psychiatric hospitalizations and ER visits for patients with schizophrenia, schizoaffective disorder, or bipolar disorder was not significantly reduced after initiation of LAIs (n = 50, median [interquartile range]: 1.5 [1, 3] to 1 [0, 3], P = .055). However, the secondary endpoint of the 1-year rate of psychiatric hospitalizations was reduced (1 [0, 3] to 0 [0, 2], P = .026). Additionally, for those who received injections on a regular basis, the 1-year rate of hospitalizations and ER visits was significantly reduced (2 [1, 3] to 0 [0, 1.5], P = .009).

Discussion: This retrospective study suggests that the initiation of LAIs is associated with a reduced rate of psychiatric hospitalizations as well as a reduced rate of psychiatric hospitalizations and ER visits for those patients who receive injections on a regular basis.
Using Photovoice to explore patients' experiences with mental health medication: A pilot study
Authors: Werremeyer Amy B. , Aalgaard-Kelly Gina , Skoy Elizabeth 
Published: May 2016

Abstract

Introduction: The objective of this research is to explore and share the medication experience of those with a mental illness in order to gain understanding of the patient's medication perceptions as well as the impact of medication upon patients' lives.

Methods: Patients with a mental disorder were given cameras and asked to capture the experience of “living with my medication.” Using Photovoice methodology, participants reflected on their photos individually and in focus groups. Conceptual themes were drawn from the data.

Results: Five participants captured an average of 14 photos each. Self-efficacy with mental illness, mental and physical health connections, and education were the 3 most prominent themes. Aspects of medications were interwoven within these themes but were not the primary focus of the participants.

Discussion: Medication experiences of patients with mental illness may encompass much more than the medications themselves.
Implementation and evaluation of a pharmacist-run mental health treatment clinic via clinical video telehealth
Authors: Leach Molly , Garcia Guadalupe , Ganzer Nicole 
Published: May 2016

Abstract

Introduction: The Veterans Health Administration is extending its mental health services to reach those in rural areas who find it difficult to travel to a Veterans Affairs Medical Center (VAMC). This project aimed to outline implementation of a Pharmacy Mental Health Clinical Video Telehealth (MHCVT) clinic for veterans. Secondary endpoints were to assess patient satisfaction with MHCVT, describe the potential benefits of this clinic regarding travel saved, and summarize no-show rates.

Methods: Veterans received mental health disease state medication management from a mental health clinical pharmacy specialist via clinical video telehealth (CVT) in place of an in-clinic appointment and were asked to complete a satisfaction survey after the initial CVT appointment. Data collected from all veterans enrolled in the CVT clinic from September 8, 2014, through March 23, 2015 included: patient demographics, service connection percentage, number of CVT visits, travel miles saved, travel reimbursement, no-show rate, and documentation of medication management therapy.

Results: As of March 23, 2015, there were 22 veterans enrolled in the MHCVT clinic, of whom, 19 completed their appointments. Of the 48 potential encounters, 7 were considered a no-show (17%). On average veterans saved 34 travel miles per visit with cumulative savings of 1432.6 miles. Of those who were eligible to receive travel reimbursement (n = 13), the medical center potentially saved $674.50 in a 7-month period. Overall clinic satisfaction per survey (n = 14) was 100% (strongly agreed or agreed). A majority (93%) would recommend the clinic to other veterans.

Conclusions: This project successfully implemented a MHCVT pilot clinic. The veterans were satisfied with the services. The 41 clinic visits resulted in a potential cost savings. Expansion of this clinic in the future will expand more mental health resources to veterans.
Transport and entry of plasma clouds/jets across transverse magnetic discontinuities: Three‐dimensional electromagnetic particle‐in‐cell simulations
Authors: Voitcu Gabriel , Echim Marius 
Published: May 2016

AbstractIn this paper we use three‐dimensional electromagnetic particle‐in‐cell simulations to investigate the interaction of a small Larmor radius plasma cloud/jet with a transverse nonuniform magnetic field typical to a tangential discontinuity in a parallel geometry. The simulation setup corresponds to an idealized, yet relevant, magnetospheric configuration likely to be observed at the magnetopause during northward orientation of the interplanetary magnetic field. The numerical simulations are adapted to study the kinetic effects and their role on the transport and entry of localized plasma jets similar to those identified inside the Earth's magnetosheath propagating toward the magnetopause. The simulations reveal the formation of a perpendicular polarization electric field inside the main bulk of the plasma cloud that enables its forward transport and entry across the transverse magnetic field. The jet is able to penetrate the transition region when the height of the magnetic barrier does not exceed a certain critical threshold. Otherwise, the forward transport along the injection direction is stopped before full penetration of the magnetopause. Moreover, the jet is pushed back and simultaneously deflected in the perpendicular plane to the magnetic field. Our simulations evidence physical processes advocated previously by the theoretical model of impulsive penetration and revealed in laboratory experiments.
MLT dependence in the relationship between plasmapause, solar wind, and geomagnetic activity based on CRRES: 1990–1991
Authors: Bandić Mario , Verbanac Giuli , Moldwin Mark B. , Pierrard Viviane , Piredda Giovanni 
Published: May 2016

AbstractUsing the database of CRRES in situ observations of the plasmapause crossings, we develop linear and more complex plasmapause models parametrized by (a) solar wind parameters V (solar wind velocity), BV (where B is the magnitude of the interplanetary magnetic field (IMF)), and dΦmp/dt (which combines different physical mechanisms which run magnetospheric activity), and (b) geomagnetic indices Dst, Ap, and AE. The complex models are built by including a first harmonic in magnetic local time (MLT). Our method based on the cross‐correlation analyses provides not only the plasmapause shape for different levels of geomagnetic activity but additionally yields the information of the delays in the MLT response of the plasmapause. All models based on both solar wind parameters and geomagnetic indices indicate the maximal plasmapause extension in the postdusk side at high geomagnetic activity. The decrease in the convection electric field places the bulge toward midnight. These results are compared and discussed in regard to past works. Our study shows that the time delays in the plasmapause response are a function of MLT and suggests that the plasmapause is formed by the mechanism of interchange instability motion. We observed that any change quickly propagates across dawn to noon, and then at lower rate toward midnight. The results further indicate that the instability may propagate much faster during solar maximum than around solar minimum. This study contributes to the determination of the MLT dependence of the plasmapause and to constrain physical mechanism by which the plasmapause is formed.
Lagrangian flow measurements and observations of the 2015 Chilean tsunami in Ventura, CA
Authors: Kalligeris Nikos , Skanavis Vassilios , Tavakkol Sasan , Ayca Aykut , Safty Hoda El , Lynett Patrick , Synolakis Costas 
Published: May 2016

AbstractTsunami‐induced coastal currents are spectacular examples of nonlinear and chaotic phenomena. Due to their long periods, tsunamis transport substantial energy into coastal waters, and as this energy interacts with the ubiquitous irregularity of bathymetry, shear and turbulent features appear. The oscillatory character of a tsunami wave train leads to flow reversals, which in principle can spawn persistent turbulent coherent structures (e.g., large vortices or “whirlpools”) that can dominate damage and transport potential. However, no quantitative measurements exist to provide physical insight into this kind of turbulent variability, and no motion recordings are available to help elucidate how these vortical structures evolve and terminate. We report our measurements of currents in Ventura Harbor, California, generated by the 2015 Chilean M8.3 earthquake. We measured surface velocities using GPS drifters and image sequences of surface tracers deployed at a channel bifurcation, as the event unfolded. From the maps of the flow field, we find that a tsunami with a near‐shore amplitude of 30 cm at 6 m depth produced unexpectedly large currents up to 1.5 m/s, which is a fourfold increase over what simple linear scaling would suggest. Coherent turbulent structures appear throughout the event, across a wide range of scales, often generating the greatest local currents.
Optimal interpolation analysis of high‐latitude ionospheric Hall and Pedersen conductivities: Application to assimilative ionospheric electrodynamics reconstruction
Authors: McGranaghan Ryan , Knipp Delores J. , Matsuo Tomoko , Cousins Ellen 
Published: May 2016

AbstractWe have developed a new optimal interpolation (OI) technique to estimate complete high‐latitude ionospheric conductance distributions from Defense Meteorological Satellite Program particle data. The technique combines particle precipitation‐based calculations of ionospheric conductances and their errors with a background model and its error covariance (modeled with empirical orthogonal functions) to infer complete distributions of the high‐latitude ionospheric conductances. We demonstrate this technique for the 26 November through 2 December 2011 period and analyze a moderate geomagnetic storm event on 30 November 2011. Quantitatively and qualitatively, this new technique provides better ionospheric conductance specification than past statistical models, especially during heightened geomagnetic activity. We provide initial evidence that auroral images from the Defense Meteorological Satellite Program Special Sensor Ultraviolet Spectrographic Imager instrument can be used to further improve the OI conductance maps. Our OI conductance patterns allow assimilative mapping of ionospheric electrodynamics reconstructions driven separately by radar and satellite magnetometer observations to be in closer agreement than when other, commonly used, conductance models are applied. This work (1) supports better use of the diverse observations available for high‐latitude ionospheric electrodynamics specification and (2) supports the Cousins et al. (2015b) assertion that more accurate models of the ionospheric conductance are needed to robustly assimilate ground‐ and space‐based observations of ionospheric electrodynamics. We find that the OI conductance distributions better capture the dynamics and locations of discrete electron precipitation that modulate the coupling of the magnetosphere‐ionosphere‐thermosphere system.
Access to Air‐Stable 1,3‐Diphosphacyclobutane‐2,4‐diyls by an Arylation Reaction with Arynes
Authors: Ueta Yasuhiro , Mikami Koichi , Ito Shigekazu 
Published: May 2016

AbstractTuning of the physicochemical properties of the 1,3‐diphosphacyclobutane‐2,4‐diyl unit is attractive in view of materials applications. The use of arynes is shown to be effective for installing relatively electron rich aryl substituents into the open‐shell singlet P‐heterocyclic system. Treatment of the sterically encumbered 1,3‐diphosphacyclobuten‐4‐yl anion with ortho‐silylated aryl triflates in the presence of fluoride under appropriate conditions afforded the corresponding 1‐aryl 1,3‐diphosphacyclobutane‐2,4‐diyls. The air‐stable open‐shell singlet P‐heterocycles exhibit considerable electron‐donating character, and the aromatic substituent influences the open‐shell character, which is thought to be related to the property of p‐type semiconductivity. The P‐arylated 1,3‐diphosphacyclobutane‐2,4‐diyl systems can be further utilized as detectors of hydrogen fluoride (HF), which causes a remarkable change in their photoabsorption properties.
Triple‐Mode Emission of Carbon Dots: Applications for Advanced Anti‐Counterfeiting
Authors: Jiang Kai , Zhang Ling , Lu Junfeng , Xu Chunxiang , Cai Congzhong , Lin Hengwei 
Published: May 2016

AbstractPhotoluminescence (PL), up‐conversion PL (UCPL), and phosphorescence are three kinds of phenomena common to light‐emitting materials, but it is very difficult to observe all of them simultaneously when they are derived from a single material at room temperature. For the first time, triple‐mode emission (that is, PL, UCPL, and room temperature phosphorescence (RTP)) is reported, which relies on a composite of the luminescent carbon dots (CDs) prepared from m‐phenylenediamine and poly(vinyl alcohol) (PVA). Moreover, the CDs‐PVA aqueous dispersion is nearly colorless and demonstrates promise as a triple‐mode emission ink in the field of advanced anti‐counterfeiting.
Semi‐Crystalline Polar Polyethylene: Ester‐Functionalized Linear Polyolefins Enabled by a Functional‐Group‐Tolerant, Cationic Nickel Catalyst
Authors: Long Brian K. , Eagan James M. , Mulzer Michael , Coates Geoffrey W. 
Published: May 2016

AbstractA dibenzobarrelene‐bridged, α‐diimine NiII catalyst (rac‐3) was synthesized and shown to have exceptional behavior for the polymerization of ethylene. The catalyst afforded high molecular weight polyethylenes with narrow dispersities and degrees of branching much lower than those made by related α‐diimine nickel catalysts. Catalyst rac‐3 demonstrated living behavior at room temperature, produced linear polyethylene (Tm=135 °C) at −20 °C, and, most importantly, was able to copolymerize ethylene with the biorenewable polar monomer methyl 10‐undecenoate to yield highly linear ester‐functionalized polyethylene.
Perovskite materials in energy storage and conversion
Authors: Zhu Liang , Ran Ran , Tadé Moses , Wang Wei , Shao Zongping 
Published: May 2016

AbstractIn this review, the recent progress in the application of an important category of materials, i.e. ABO3 perovskite‐type compounds in the fields of energy storage and conversion, is reviewed. Four main areas, as materials for oxygen transporting membrane toward the application in oxy‐fuel combustion, as key material for solid oxide fuel cells for efficient power generation from fuels, as room‐temperature electrocatalysts for oxygen reduction reaction and oxygen evolution reaction, and as material for solar cells for solar energy harvest, are referred. Our past efforts in these research areas are emphasized. Some prospects about the future development in the application of perovskite materials in energy storage and conversion is proposed. Copyright © 2016 Curtin University of Technology and John Wiley & Sons, Ltd.
Ultraluminous X‐ray sources: Three exciting years
Authors: Bachetti M. 
Published: May 2016

AbstractThe extreme extragalactic sources known as Ultraluminous X‐ray Sources (ULX) represent a unique testing environment for compact objects population studies and the accretion process. Their nature has long been disputed. Their luminosity, well above the Eddington luminosity for a stellar‐mass black hole, can imply the presence of an intermediate‐mass black hole or a stellar black hole accreting above the Eddington limit. Both these interpretations are important to understand better the accretion process and the evolution of massive black holes. The last few years have seen a dramatic improvement of our knowledge of these sources. In particular, the super‐Eddington interpretation for the bulk of the ULX population has gained a strong consensus. Nonetheless, exceptions to this general trend do exist, and in particular one ULX was shown to be a neutron star, and another was shown to be a very likely IMBH candidate. In this paper, I will review the most relevant results in this field of research in the last few years. (© 2016 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Accretion disc atmospheres and winds in low‐mass X‐ray binaries
Authors: Díaz Trigo M. , Boirin L. 
Published: May 2016

AbstractIn the last decade, X‐ray spectroscopy has enabled a wealth of discoveries of photoionised absorbers in X‐ray binaries. Studies of such accretion disc atmospheres and winds are of fundamental importance to understand accretion processes and possible feedback mechanisms to the environment. In this work, we review the current observational state and theoretical understanding of accretion disc atmospheres and winds in low‐mass X‐ray binaries, focusing on the wind launching mechanisms and on the dependence on accretion state. We conclude with issues that deserve particular attention. (© 2016 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
The innermost extremes of black hole accretion
Authors: Fabian A.C. 
Published: May 2016

AbstractThe inner 20 gravitational radii around the black hole at the centre of luminous active galactic nuclei and stellar mass black hole binaries are now being routinely mapped by X‐ray spectral‐timing techniques. Spectral blurring and reverberation of the reflection spectrum are key tools in this work. In the most extreme AGN cases with high black hole spin, when the source appears in a low state, observations probe the region within 1 gravitational radius of the event horizon. The location, size, and operation of the corona which generates the power‐law X‐ray continuum is also being revealed. (© 2016 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)