bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preparation of SiC-Coated Silicon Nanofiber/Graphite Composites as Anode Material for Li-Ion Batteries by the Chemical Vapor Deposition Method
Authors: Liu Mingqi , Liu Bei , Zhang Rui , Xie Zhiyong , Huang Peng , Zhang Jiali 
Published: August 2022

Abstract
Si material has huge lithium storage capacity, but its huge volume changes during charging and discharging making it difficult to use. However, by using nano-sizing Si material and building a coating structure can effectively reduce the capacity reduction caused by the expansion of the Si material. In our experiment, dichlorodimethylsilane was used as the silicon source and carbon source for the deposition of silicon nanofibers and SiC-coated on a spherical graphite substrate, and then the SiC cladding was deposited without changing the temperature and silicon source, and only the C to H ratio in the atmosphere was controlled to build the cladding layer. In our experiment, silicon nanofibers were deposited on graphite surfaces using dichlorodimethylsilane as the silicon source, followed by SiC cladding on the surface of the Si/G composites using dichlorodimethylsilane as the silicon source and carbon source. The end product was controlled by controlling only the C to H ratio in the atmosphere at the same temperature. The preparation of SiC@Si/G composites with silicon nanofibers and cladding structures by a single CVD process and single raw materials. The material has a silicon nanofiber structure and SiC coating structure. The presence of silicon is effective in providing very high capacity and the presence of the SiC layer is effective in improving the capacity retention of the composite material for increasing the Coulomb efficiency of the material. At a current density of 100 mA h g−1, the material has a reversible capacity of 647.3 mA h g−1 at the first cycle. After 100 cycles, it has a 76.2% retention rate. The electrodes can be extremely stable after cycling without significant swelling.
Paleoclimates inform on a weakening and amplitude-reduced East Asian winter monsoon in the warming future
Authors: Kang Shugang , Wang Xulong , Du Jinhua , Song Yougui 
Published: August 2022

AbstractThe East Asian winter monsoon (EAWM) has significant impacts on the weather and climate, and subsequently on the economy and society, in East Asia during boreal winters, and its projection into the future is scientifically and practically significant. However, projections relying on geological EAWM reconstructions, which can compensate for instrumental record limitations, are still lacking and urgently needed. It is more promising to conduct prediction under the background of not only instrumental but also geological changes in the EAWM. We used grain-size records from four high-resolution, chronologically well-defined loess sections on the Chinese Loess Plateau to represent past EAWM intensity and its amplitudes. Our results show that the EAWM is weaker and has lower amplitudes during warm periods than during cold stages at various time scales. Moreover, instrumental records reveal that the EAWM shows a weak level and reduced interannual amplitudes after the mid-1980s under the context of global warming. We propose that the EAWM will experience long-term weakening and reduced (e.g., interannual) amplitudes under 21st century global-warming scenarios.
Did transit through the galactic spiral arms seed crust production on the early Earth?
Authors: Kirkland C.L , Sutton P.J. , Erickson T. , Johnson T.E. , Hartnady M.I.H. , Smithies H. , Prause M. 
Published: August 2022

AbstractAlthough there is evidence for periodic geological perturbations driven by regular or semi-regular extra-terrestrial bombardment, the production of Earth's continental crust is generally regarded as a function of planetary differentiation driven by internal processes. We report time series analysis of the Hf isotopic composition of zircon grains from the North Atlantic and Pilbara cratons, the archetypes of Archean plate tectonic and non-plate tectonic settings, respectively. An ~170–200 m.y. frequency is recognized in both cratons that matches the transit of the solar system through the galactic spiral arms, where the density of stars is high. An increase in stellar density is consistent with an enhanced rate of Earth bombardment by comets, the larger of which would have initiated crustal nuclei production via impact-driven decompression melting of the mantle. Hence, the production and preservation of continental crust on the early Earth may have been fundamentally influenced by exogenous processes. A test of this model using oxygen isotopes in zircon from the Pilbara craton reveals correlations between crust with anomalously light isotopic signatures and exit from the Perseus spiral arm and entry into the Norma spiral arm, the latter of which matches the known age of terrestrial spherule beds. Our data support bolide impact, which promoted the growth of crustal nuclei, on solar system transit into and out of the galactic spiral arms.
Electron Paramagnetic Resonance: Study of the Regulatory Mechanisms of Light Phases of Photosynthesis in Plants
Authors: Ruuge E. K. , Tikhonov A. N. 
Published: August 2022

AbstractThe electron paramagnetic resonance (EPR) method is widely used in the biophysics of photosynthesis, because it serves as an effective tool for exploring the processes of electron and proton transport in various photosynthetic systems. This study on the regulation of electron transport in chloroplasts was performed with the direct participation of the authors using the EPR method. The possibilities of the EPR method to study the kinetics of electron transport in chloroplasts of higher plantsin situ(leaves of higher plants) at room temperature were shown, and the EPR spectra of chloroplasts at cryogenic temperatures were considered. The latter is of particular importance for substantiating the “kinetic” method of pH measurement inside thylakoids, which was used.
Examining the mental health adversity among healthcare providers during the two waves of the COVID-19 pandemic: results from a cross-sectional, survey-based study
Authors: Dezso Flóra , Birkás Béla , Vizin Gabriella , Váncsa Szilárd , Szőcs Henrietta , Erőss Attila , Lex Dániel , Gede Noémi , Molnar Zsolt , Hegyi Péter , Csathó Árpád 
Published: August 2022

ObjectivesThe current global health crisis of the COVID-19 pandemic has drastically affected the whole population, but healthcare workers are particularly exposed to high levels of physical and mental stress. This enormous burden requires both the continuous monitoring of their health conditions and research into various protective factors.DesignCross-sectional surveys.Setting and participantsSelf-administered questionnaires were constructed assessing COVID-19-related worries of health workers in Hungary. The surveys were conducted during two consecutive waves of the COVID-19 pandemic (N-first wave=376, N-second wave=406), between 17 July 2020 and 31 December 2020.Primary and secondary outcome measuresCOVID-19-related worry, well-being and distress levels of healthcare workers. We also tested whether psychological resilience mediates the association of worry with well-being and distress. Multiple linear regression analyses were performed.ResultsThe results indicated that healthcare workers had high levels of worry and distress in both pandemic waves. When comparing the two waves, enhanced levels of worry (Wald’s χ2=4.36, p=0.04) and distress (Wald’s χ2=25.18, p<0.001), as well as compromised well-being (Wald’s χ2=58.64, p<0.001), were found in the second wave. However, not all types of worries worsened to the same extent across the waves drawing attention to some specific COVID-19-sensitive concerns. Finally, the protective role of psychological resilience was shown by a mediator analysis suggesting the importance of increasing resilience as a key factor in maintaining the mental health of healthcare workers in the burden of the COVID-19 pandemic.ConclusionsOur results render the need for regular psychological surveillance in healthcare workers.RegistrationHungarian Scientific and Research Ethics Committee of the Medical Research Council (IV/5079-2/2020/EKU).
COVID-19 vaccination effectiveness rates by week and sources of bias: a retrospective cohort study
Authors: Ostropolets Anna , Hripcsak George 
Published: August 2022

ObjectiveTo examine COVID-19 vaccine effectiveness over six 7-day intervals after the first dose and assess underlying bias in observational data.Design and settingRetrospective cohort study using Columbia University Irving Medical Center data linked to state and city immunisation registries.Outcomes and measuresWe used large-scale propensity score matching with up to 54 987 covariates, fitted Cox proportional hazards models and constructed Kaplan-Meier plots for two main outcomes (COVID-19 infection and COVID-19-associated hospitalisation). We conducted manual chart review of cases in week 1 in both groups along with a set of secondary analyses for other index date, outcome and population choices.ResultsThe study included 179 666 patients. We observed increasing effectiveness after the first dose of mRNA vaccines with week 6 effectiveness approximating 84% (95% CI 72% to 91%) for COVID-19 infection and 86% (95% CI 69% to 95%) for COVID-19-associated hospitalisation. When analysing unexpectedly high effectiveness in week 1, chart review revealed that vaccinated patients are less likely to seek care after vaccination and are more likely to be diagnosed with COVID-19 during the encounters for other conditions. Secondary analyses highlighted potential outcome misclassification for International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis, the influence of excluding patients with prior COVID-19 infection and anchoring in the unexposed group. Long-term vaccine effectiveness in fully vaccinated patients matched the results of the randomised trials.ConclusionsFor vaccine effectiveness studies, observational data need to be scrutinised to ensure compared groups exhibit similar health-seeking behaviour and are equally likely to be captured in the data. While we found that studies may be capable of accurately estimating long-term effectiveness despite bias in early weeks, the early week results should be reported in every study so that we may gain a better understanding of the biases. Given the difference in temporal trends of vaccine exposure and patients’ baseline characteristics, indirect comparison of vaccines may produce biased results.
Safety of surgical Treatment In severe primary Pontine haemorrhage Evacuation (STIPE): study protocol for a multi-centre, randomised, controlled, open-label trial
Authors: He Qiang , Wang Jiajing , Ma Lu , Li Hao , Tao Chuanyuan , You Chao 
Published: August 2022

IntroductionPrimary pontine haemorrhage (PPH) is the most devastating subtype of intracerebral haemorrhage and is associated with poor prognosis, especially for the severe patients. Although medical treatment (MT) is widely accepted, a large number of studies have shown surgical haematoma evacuation (HE) might dramatically reduce mortality and improve prognosis outcome in severe PPH (sPPH). However, evidence to clarify the safety of HE remains insufficient.Methods and analysisThe Safety of surgical Treatment In severe primary Pontine haemorrhage Evacuation study is a multi-centre, randomised, controlled, open-label trial, conducted from January 2022 to November 2024 in 20 tertiary hospitals in China. A total of 64 patients with sPPH will be randomly assigned to MT or HE group. Eligible patients will receive the corresponding treatment according to the result of randomisation. The primary outcomes are related to the safety of surgery including rate of symptomatic rebleeding at 3 days and rate of mortality and intracranial infection at 30 days. The secondary outcomes are the neurological function indexes following up at 30 days, 90 days, 180 days and 365 days.Ethics and disseminationThe clinical trial has been approved by the Biomedical Research Ethics Committee of West China Hospital of Sichuan University (unique identifiers: No. 2020-894). All results of the trial will be published in international peer-reviewed scientific journals and will be disseminated through scientific conferences. Academic dissertation will be published in a peer-reviewed journal.Trial registration numbersNCT04647162, ChiCTR2000039679.
Approaches to improving symptom appraisal: a systematic literature review
Authors: Xiang Ling , Yoon Sungwon , Low Andrea H L , Leung Ying Ying , Fong Warren , Lau Tang Ching , Koh Dow Rhoon , Thumboo Julian 
Published: August 2022

ObjectivesPoor symptom appraisal (detection, interpretation and response to symptoms) plays a major role in prolonged prediagnosis interval in various health conditions. Theories and models have been proposed to study the symptom appraisal process but how they could be employed to improve symptom appraisal remains unclear. We therefore aimed to review approaches to improving symptom appraisal in the literature and to develop a theoretical framework that could guide the development of approaches to improving symptom appraisal among individuals in the general population.DesignSystematic review.Data sourcesMedline, Web of Science, PsycINFO, Embase, CINAHL and Scopus were searched from inception to 30 March 2021.Eligibility criteriaWe included original articles in English in which approaches to improve the detection, interpretation or response to symptoms for symptomatic individuals were described. We excluded articles in which approaches were developed to improve symptom appraisal among healthcare professionals.Data extraction and synthesisA predefined data extraction form was used to extract the development, characteristics and evaluation of approaches to improving symptom appraisal. This formed the basis for the narrative synthesis.ResultsOf 19 046 publications identified from the literature search, 112 were selected for full-text review and 29 approaches comprising provision of knowledge of symptoms/signs and additional components (eg, symptom self-examination and comparison) for symptom appraisal were included in the synthesis. Less than half (41.4%) of these approaches were developed based on theories/models. Interestingly, despite the variety of theories/models adopted in developing these approaches, the components of these approaches were similar.ConclusionSymptom appraisal is an essential process in a patient’s journey that can be targeted to facilitate early diagnosis but is largely unstudied. Building on the literature, we proposed a theoretical framework and approaches to improving symptom appraisal. This could facilitate early identification of a variety of health conditions in the general population.Trial registration numberCRD42021279500.
EP12 Emergency services provision of take home naloxone to people at risk of opiate overdose: perspectives of potential recipients – a qualitative study
Authors: Hughes Jane , Sampson Fiona C , Long Jaqui , Buykx Penny , Snooks Helen 
Published: August 2022

IntroductionUK clinical guidelines recommend that provision of Take Home Naloxone (THN) to heroin and other opiate users can reduce mortality and morbidity in this population. Emergency departments (ED) and ambulance staff could provide ideal opportunities for THN distribution, due to regular encounters with patients experiencing opioid overdose. As part of a wider feasibility study for emergency service provision of THN, we explored user perspectives on feasibility and acceptability of THN, based on previous knowledge and experience of overdose.MethodsWe conducted qualitative, semi-structured interviews with a sample (n=26) of people who use opiates attending drug treatment outpatient clinic or third sector drug organisation in three UK cities. We analysed data using thematic analysis.ResultsRespondents had significant experience of overdose (experienced personally or witnessed) and high awareness and understanding of overdose management, including personal experience of THN use. Respondents identified some barriers to THN provision at the time of overdose, e.g. reluctance to engage with health professionals at the time of opioid withdrawal but overall were highly supportive of increased access to THN. Service users perceived THN as an acceptable and easy to use intervention, valuing provision of THN via ambulance or ED staff in addition to community provision. THN training and provision gave respondents a sense of self-agency and empowerment and an opportunity to potentially save the lives of others. Respondents wanted more opportunities for friends and family to also undergo training and receive the THN kits.ConclusionPeople who access services for their opioid use support increased provision of THN from a wider variety of providers including ED and ambulance staff but also extending to other community support services. Extending THN provision to peers and family of people at risk of overdose could also offer additional opportunities to improve outcomes from opioid overdose events.
PP20 Self-identification of psychological wellbeing: a mental health continuum for EMS employees
Authors: Johnston Sasha , Mildenhall Jo , Wylam Jaimee 
Published: August 2022

BackgroundAcross Emergency Medical Service (EMS) organisations the high prevalence of poor employee mental health, elevated risk of employee suicide and cultural stigma, bring to the fore the need for tools that enable EMS staff to self-identify, articulate, and disclose their mental wellbeing status.MethodsThe aim of this project was to develop a visual aid, tailored to the EMS sector, to enable ambulance employees to self-identify their own mental wellbeing status. A literature review of available English-language, adult population articles relating to mental health continua in the ambulance context was conducted in July 2021. Electronic databases Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, Epistemenikos, Medline, Prospero, PsycINFO, Scopus and Google Scholar were searched from 2002. Existing mental health continua utilised by EMS organisations were examined and alongside the identified database articles, an expert working group created through stakeholder mapping, debated findings and developed an ambulance specific continuum.ResultsA descriptive narrative of the included studies was produced. Several factors for supporting wellbeing, such as regular eating and sleeping patterns, are not achievable for irregular EMS shift work and would likely create a barrier to participation. Factors such as concise, inclusive, de-stigmatising and appropriate language and taking a holistic view towards employee mental wellbeing were identified as important. A visual four-point continuum of wellbeing consisting of Thriving, surviving, struggling and ‘in crisis’, anchored by five holistic elements of emotional, psychosocial, social, physical wellbeing and addiction was developed. Elements such sleep hygiene moderated by shift work were included. Four suggested supportive techniques are provided to align with the four continuum self-identification points.ConclusionsEvidence suggests that a visual continuum can promote a shared understanding of fluctuating mental health and reduces stigma. Although it is recommended that this tool is disseminated and adopted by EMS, given the lack of validation and evaluation for visual mental health continua identified in the literature, evaluation of adoption, acceptability and effectiveness should be prioritised.
PP24 Emergent themes of interviews with NHS staff involved in creating and implementing a Wales-wide framework for improving EDs
Authors: Jones Katie , Rance Jaynie 
Published: August 2022

BackgroundIn 2018 a Wales-wide improvement project was launched to design an emergency department quality and delivery framework (EDQDF). The project aimed to combine top-down and bottom-up working to describe and implementwhat good looks like for emergency departments. The collaborative design of the EDQDF took place between 2018 and 2020; the project’s currently in its implementation phase. This evaluation asks about the barriers and enablers pertaining to implementation of the EDQDF, which was designed using the CAREMORE methodology, found to be a promising tool for collaborative improvement projects for health services (Nelson et al 2018).MethodsWe interviewed 8 participants involved with the EDQDF (nurses n3; consultant paramedic n1; policy-maker n1; project managers n2; senior level manager n1). We thematized the data according to preconceived concepts and to identify emerging themes.ResultsStrong emergent themes include: challenges of combining top-down/bottom-up working; interdependencies on other parts of the system as a barrier to implementation; staff pressures; the positive perception of a developing network for ED-staff.Covid-19 significantly shifted the focus of the project to reconsider ‘access’ for patients, especially remote access to advice, ED appointments, or teletriage and streaming to alternative services. Some participants perceived this positively, others negatively.When considering ‘patient access’, participants often referred to technological advancement as an answer to problems such as overcrowding, and regularly invoked the language of consumerism. Participants demonstrated a conflict between a desire for the slick operational models used by fast-food chains (participants often mentioned chains like Starbucks and domino’s pizza, for instance), and a recognition of the differences between the delivery of care and a consumer product.ConclusionThe primary barrier to implementation is considered to be the interdependent nature of the health system; ED pressures were perceived as symptomatic of failures elsewhere in the health and social care system.
PP38 Impact of working through COVID-19 on ambulance staff resilience and intention to leave the NHS: a mixed methods study
Authors: Coster Joanne , O’Hara Rachel , Glendinning Richard , Nolan Peter , Roy Deborah , Weyman Andrew 
Published: August 2022

BackgroundThe Covid-19 pandemic has imposed unprecedented demands on NHS staff and resources, during which time ambulance staff have been working at consistently high levels of operational pressure. This study explores the impact of prevailing conditions on NHS staff experiences, future employment intentions and key factors in decisions to remain in the NHS or leave.MethodsThe study was undertaken in two ambulance trusts using an online survey (n=500) and qualitative interviews (n=20) between April 2021 – December 2021. Two rounds of survey data collection captured information at different time points in the pandemic. Interview participants were sampled purposively to include frontline staff, line managers and senior managers. Survey analysis was undertaken in SPSS and interviews were analysed thematically.ResultsThe majority of survey respondents were frontline staff: Paramedics (44%); Emergency Medical Technicians (25%) and call-handlers (10%). Mean length of service was 13 years. Compared with prior to the pandemic, staff perceived things were worse in terms of staffing levels (80%), stress (77%), workloads (76%), morale (73%) and their mental health (66%). Key concerns related to abnormally high levels of staff absence, the impact of work on mental and physical health, inadequate time to do the job and making mistakes because of workloads. Almost one-in-five respondents had applied for a non-NHS job in the last six months, including 25% paramedics, and 27% wished to be working elsewhere in 5 years time. The interviews provided complementary detail on experiences and employment intentions, with key issues relating to staffing pressures, work demands and conditions, and burnout.ConclusionThe Covid-19 pandemic has had and continues to have a detrimental effect on workload, morale and both mental and physical health, with implications for staff retention and NHS care delivery. Insights provided by this study are intended to inform approaches to staff retention.