bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spectral properties and energy transfer at kinetic scales in collisionless plasma turbulence
Authors: Arró G. , Califano F. , Lapenta G. 
Published: October 2022

Context. Recent satellite observations in the solar wind and in the Earth’s magnetosheath have shown that the turbulent magnetic field spectrum, which is know to steepen around ion scales, has another break at electron scales where it becomes even steeper. The origin of this second spectral break is not yet fully understood, and the shape of the magnetic field spectrum below electron scales is still under debate.
Aims. By means of a fully kinetic simulation of freely decaying plasma turbulence, we study the spectral properties and the energy exchanges characterizing the turbulent cascade in the kinetic range.
Methods. We started by analyzing the magnetic field, electron velocity, and ion velocity spectra at fully developed turbulence. We then investigated the dynamics responsible for the development of the kinetic scale cascade by analyzing the ion and electron filtered energy conversion channels, represented by the electromagnetic work J ⋅ E, pressure–strain interaction −P : ∇ u, and the cross-scale fluxes of electromagnetic (e.m.) energy and fluid flow energy, accounting for the nonlinear scale-to-scale transfer of energy from large to small scales.
Results. We find that the magnetic field spectrum follows the k−α exp(−λ k) law at kinetic scales with α ≃ 2.73 and λ ≃ ρe (where ρe is the electron gyroradius). The same law with α ≃ 0.94 and λ ≃ 0.87ρe is observed in the electron velocity spectrum, but not in the ion velocity spectrum that drops as a steep power law ∼k−3.25 before reaching electron scales. By analyzing the filtered energy conversion channels, we find that electrons play a major role with respect to the ions in driving the magnetic field dynamics at kinetic scales. Our analysis reveals the presence of an indirect electron-driven mechanism that channels the e.m. energy from large to sub-ion scales more efficiently than the direct nonlinear scale-to-scale transfer of e.m. energy. This mechanism consists of three steps. In the first step the e.m. energy is converted into electron fluid flow energy at large scales; in the second step the electron fluid flow energy is nonlinearly transferred toward sub-ion scales; in the final step the electron fluid flow energy is converted back into e.m. energy at sub-ion scales. This electron-driven transfer drives the magnetic field cascade up to fully developed turbulence, after which dissipation becomes dominant and the electrons start to subtract energy from the magnetic field and dissipate it via the pressure–strain interaction at sub-ion scales.
Highly elastic halochromic fibers capable of reversible sensing of acidic/basic vapor for use in wearable textiles
Authors: Lim Taekyung , Lee Jeong Hui , Yang Keun-Hyeok , Ju Sanghyun , Jeong Sang-Mi 
Published: October 2022

Halochromic sensors, which allow users to visually recognize exposure to acid/base chemicals that are harmful to the human body, are routinely used in a wide range of industries, such as pharmaceuticals, biotechnology, cosmetics, and environmental/human monitoring systems. In this study, halochromic fibers that operate stably, even when exposed to rain or sweat and repeated stretching–releasing, were investigated. While the halochromic mesoporous silica was synthesized using tetraethylorthosilicate and cetyltrimethylammonium bromide, methyl yellow (MY) and bromothymol blue (BTB) as halochromic dyes were added so that MY and BTB were chemically or physically immobilized on the siloxane network structure of the halochromic mesoporous silica. Using the swelling and shrinking properties of the polymer, the halochromic mesoporous silica was embedded in a highly elastic spandex fiber composed of multiple strands. Because of the strong ionic and hydrogen bonding between the dye and the silica matrix, the dyes can be immobilized even in an aqueous solution without the leaching of the dyes. The stretchable halochromic fiber reversibly changed its color even after repeated exposure to acidic/basic conditions five times and could sense acid/base concentrations in the range of 0.5–10 wt %. In addition, because the halochromic mesoporous silica is tightly adhered between the stands of spandex fibers, stable color conversion properties were maintained even after stretching to 150% of the fibers and repeated 100 times. Because the halochromic fiber can be applied to lab coats, work clothes, and gloves, it is expected to be used as a wearable colorimetric sensor for daily life and industrial applications.
Post-fire resprouting ability in young plants of
Authors: Leite Marilaine Cristina Marques , Leal Alice Souza , Araujo Maycon Anderson , Martins Aline Redondo 
Published: October 2022

Fire is an important ecological factor that influences the composition of the Cerrado vegetation in Brazil. In environments where fire is recurrent, tree species with seedlings/saplings that accumulate underground reserves and/or present distinctive underground structures (tuberous roots and root crowns) are more likely to reach maturity. Astronium fraxinifolium Schott is a tree species native to the Cerrado. The tree has xeromorphic characteristics, which perhaps is an adaptation to dry and rocky environments. To evaluate whether these morphological characteristics allow the species to recover from fire, an experiment was conducted where we compared burnt and unburnt saplings of A. fraxinifolium. We verified the emergence of buds closer to the root crown and compared the storage dynamics of lipids, starch, phenolic compounds, and mucilage between the burnt and unburnt saplings. Buds were observed in some of the individuals within 7 days of burning. The burnt saplings showed a high survival rate of 77.8%. Two cotyledonary buds per plant originated from the base of the stem. The rapid recovery of the species could be attributed to the starch reserves in the stems and roots, which helped nourish the buds and the resprouted seedlings. The results of our study showed the resprouting ability of A. fraxinifolium as a survival mechanism in response to fire events.
4 HIGH-PROTEIN, HIGH-CALORIE ICE-CREAM PRESCRIPTION IN AN ORTHOGERIATRIC INPATIENT POPULATION
Authors: Cloney T , Crowley P , Lynch K , Gannon E , McGurk C , Coakley K , Ahern E 
Published: October 2022

Abstract

Background
At a major trauma centre in the South of Ireland, all older adults admitted with hip and other fragility fractures are co-managed by the Orthopaedic & Orthogeriatric services with an average of over 500 hip fractures a year. A recent publication by described improving calcium and protein intake by using dairy foods as a readily accessible intervention that reduces the risk of falls and fractures in aged care residents. Foods used included cheese, yoghurt and milk being described as “low cost” and “palatable”. Other dairy alternatives such as ice-cream are not used as not protein or calcium rich. In Ireland high calorie-high protein ice-cream is widely available (10g protein, 220 kcal/100g serving).

Methods
A point prevalence survey relating to the preference of calcium and/or protein rich food ‘snacks’ was completed on 20 inpatients in hospital with a hip or other fragility fracture.
Survey Questions: (1) Would an additional calcium and/or protein rich food snack be acceptable to you?; (2) Which food snack would you prefer: a serving of milk, cheese, yogurt, or ice-cream?; (3) What time would you prefer to eat an additional snack? Morning, afternoon, or evening?

Results
The majority of participants (95%; 19/20) replied an additional snack would be acceptable. With reference to snack preference: 35% (7/20) would prefer a serving of yoghurt, 30% (6/20) ice-cream, 25% (5/20) cheese and only 10% (2/20) would prefer milk. The majority said they would prefer to be offered a snack in the afternoon (55%; 11/20).

Conclusion
Our inpatient population would benefit from the addition of such snacks to optimise recovery and bone health. Patient preference needs to inform any dietary or menu modifications. Following our survey, in addition to calcium and vitamin D supplementation, high-protein high-calorie ice-cream is offered and prescribed to patients if eating less than 50% of their energy dense meals.
5 THE WEALTH SHIELD: A MICROSIMULATION OF INEQUALITIES, INHERITANCE AND THE IRISH FAIR DEAL
Authors: Köppe S , Szelewa D 
Published: October 2022

Abstract

Background
The article analyses the inequalities resulting from the long-term funding scheme in Ireland with a unique focus on intergenerational obligations. With the Fair Deal scheme of 2009, officially the Nursing Homes Support Scheme (NHSS), Ireland introduced a unique inheritance clawback clause. The state covers long term care costs for those in need up-front and claims the costs back from the estate after the older person deceases. The article focusses on the emerging income and wealth inequalities and intergenerational redistributive effects.

Methods
We estimate micro simulations to show the distributional effects based on income and housing wealth. The simulations are based on aggregate data from the Central Statistics Office, Nursing Homes Ireland, Eurostat and the European Central Bank. Each simulation estimates the individual contributions based on 50, 100, 150 and 200 percent of average income and wealth, while keeping either income or wealth constant at the average. Based on average nursing home fees, the simulations show the relative contributions from the state, income and wealth. These simulations are contrasted to the funding gaps of the old subvention scheme in place until 2009.

Results
The Fair Deal has expanded eligibility to the middle class and shields property wealth after three years. Nursing home residents with above average pension income and housing wealth benefit disproportionately from the reform and can pass on more relative wealth to their kin. Overall, the wealth distribution of the Fair Deal scheme is regressive, despite the inclusion of the middle class.

Conclusion
The increased eligibility of the fair deal has the benefit of increased legitimacy for the welfare state. However, considerable inequalities of risks exposure remain as less than 50 percent of older people will need nursing home care. Estimations for a long-term care insurance scheme at 3 percent social contributions would reduce the lifetime wealth contribution of nursing home residents by about 35 percent.
7 LEARNING FROM THE FALLS ANALYSIS OF OLDER PEOPLE ADMITTED TO AN IRISH POST-ACUTE REHABILITATION SERVICE
Authors: Reynolds A , Landers R 
Published: October 2022

Abstract

Background
Thirty percent of community-dwelling older adults fall each year with 10% suffering a severe injury often resulting in hospital admission. To deliver effective falls prevention a thorough falls history is required. The objective of this study was to complete a SPLATT (symptoms before fall, previous falls, location of fall, activity at time of fall, time of day and trauma sustained) analysis of falls that resulted in an acute hospital admission reported by older people on admission to the post-acute rehabilitation unit.

Methods
Older people admitted to rehabilitation post fall that resulted in acute admission were included in this study. The SPLATT analysis was completed on OT initial assessment. Data was anonymized and recorded using Microsoft excel.

Results
A total of 61 falls were included in the analysis. Participants were all older people admitted to post-acute rehabilitation (female= 48, male= 13). 93% reported no symptoms before their fall. Almost half (43%) had experienced previous falls. Most falls (51%) happened at home with most of these (29%) occurring in the bedroom. A significant proportion (30%) happened in the community. The most common cause of fall was a loss of balance (32%) while completing a reaching or functional task. Most falls (87%) happened during the day but of those who fell at night, 62.5% occurred while trying to use the toilet. The majority (82%) of the falls lead to a significant trauma – hip fracture.

Conclusion
The results of this study supports that falls prevention interventions for rehabilitation service users should incorporate functional training both at home and in the community. The individual SPLATT analysis could support the design of a falls prevention intervention tailored to the person’s needs and history.
9 EFFECTIVENESS OF INTERVENTIONS TO SUPPORT THE TRANSITION HOME AFTER ACUTE STROKE: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: O'Callaghan G , Fahy M , Murphy P , Langhorne P , Galvin R , Horgan F 
Published: October 2022

Abstract

Background
There are considerable gaps in knowledge about effective support interventions to manage the transition to home after stroke. This systematic review looked at the effectiveness of support interventions at transition from structured stroke services to independent living at home.

Methods
We searched, up to June 2021, the Cochrane Central Register of Controlled Trials, and six databases including MEDLINE and Embase; and extended to trial registries, grey literature, and Google Scholar.
We included randomised controlled trials recruiting stroke patients to receive either usual care or any support intervention from structured stroke services to home. The primary outcome was functional status.
Two authors determined eligibility, extracted data, assessed risk of bias (ROB2) and certainty of evidence (GRADE). Where possible we performed meta-analyses using Risk Ratios (RR) or Mean Differences(MD).

Results
We included 17 studies. Support interventions led to important improvements in functional status, measured by Barthel Index up to 3-months (MD 7.87 points, 95%CI:6.84 to 19.16; 620 participants; five studies; I2=77%). Results in the medium to long-term demonstrated small but significant functional gains (6-12 month follow-up; MD 2.91 points, 95%CI:0.03 to 5.81; 1207 participants; six studies; I2=84%). Certainty of evidence was low.
Support interventions may improve quality of life up to 3-months (MD 1.3,95% CI:0.84 to 1.76), and reduce depression (SMD –0.1,95% CI:-0.29 to –0.05) and anxiety (MD –1.18,95% CI:-1.84 to –0.52) at 6 –12 months. Effects on other secondary outcomes remain inconclusive.

Conclusion
Incorporating support interventions at hospital-to-home discharge can improve functional status and other outcomes when transitioning home after a stroke. Due to study heterogeneity, the key elements of a successful transition of care interventions remain unclear. Adoption of core outcome sets in stroke research would allow for greater comparison across studies; while applying a development and evaluation framework, and engaging stakeholders, would increase understanding of stroke survivor priorities and key elements of a transition intervention.
11 A QUALITY IMPROVEMENT INITIATIVE TO MAXIMISE UTILISATION OF EARLY SUPPORTED DISCHARGE SERVICE IN A LEVEL 3 HOSPITAL SETTING
Authors: McCarthy K , O'Flynn D , Moynihan B 
Published: October 2022

Abstract

Background
Early Supported Discharge (ESD) originated in stroke care however also applies to general medical patients. This ESD service was funded by the local Integrated Care Programme for Older Persons (ICPOP) and saw over 100 patients in its first year. A review of current ESD criteria and limitations was undertaken

Methods
Data was collected, by chart review, over a 2-week period on medical wards. A general townland was used as the patient's address. All patients aged over 70 were included. ESD criteria include all of: living within 30km of the hospital, not living alone, assistance of 1 with mobility or Activities of Daily Living, medically discharged.

Results
91 patients aged over 70 years included 54 patients were medically discharged 27% of medically suitable patients lived outside the ESD radius 2 of 12 patients that met all ESD criteria but had been referred

Conclusion
From our data 54 patients met some ESD criteria but awaited assessment by the multidisciplinary team (MDT). Only 2 of 12 patients who met all criteria were referred to ESD. Education campaigns are ongoing within the hospital to increase awareness of the service. This includes a daily discharge huddle to identify potential candidates. Distance from the hospital was identified as a limiting factor. A business case is under development to support increasing this radius to allow an increased number of patients to avail of the service. ESD has been utilised successfully in urban settings. The continued success of this new service in a rural setting requires ongoing education to increase awareness of the service and development of existing criteria. Limited access to therapists in hospital reduces the effectiveness of ESD.
18 EDUCATION AND TRAINING TO SUPPORT PHYSIOTHERAPISTS WORKING IN DEMENTIA CARE: A SCOPING REVIEW
Authors: O'Sullivan T , McVeigh JG , Timmons S , Foley T 
Published: October 2022

Abstract

Background
Physical impairments associated with dementia include loss of mobility, diminished postural control and reduced muscle strength, which in turn can lead to an increase in falls, hip fractures and frailty. Physiotherapy can play a key role in many aspects of dementia care. Physiotherapists have reported carrying a high caseload of people with dementia. However, there is a paucity of evidence as to what constitutes effective dementia education and training for physiotherapists. The aim of this scoping review was to explore and map the evidence relating to education and training for physiotherapists, with a view to using these findings to inform the design and delivery of an educational program for physiotherapists.

Methods
This scoping review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews. The protocol for this review was published in March 2021. This review included studies that examined dementia education and training for the wider healthcare team if physiotherapy was an included profession. All studies with a focus on any aspect of physiotherapy dementia education and training were included. Studies conducted in any setting, including acute, community care and residential or any educational setting were included. A chronological narrative synthesis of the data outlined how the results relate to the objectives of this study.

Results
A total of eleven papers were included. The principal learning outcomes evaluated were knowledge, confidence and attitudes. Immediate post intervention scores showed an improvement in all three outcomes. Most educational interventions reached Kirkpatrick level 2, which evaluates learning. A multi-modal approach, with active participation and direct patient involvement seems to enhance learning.

Conclusion
Allowing for the heterogeneity of intervention design and evaluation, some common components of educational interventions were identified that led to positive outcomes. This review highlights the need for more robust studies in this area. Further research is needed to develop bespoke dementia curricula specific to physiotherapy.
28 DRUG-DRUG INTERACTIONS IN OLDER HOSPITALISED PATIENTS: A PROSPECTIVE PREVALENCE STUDY
Authors: Monahan J , O'Mahony D , Curtin D 
Published: October 2022

Abstract

Background
Drug-Drug Interactions (DDIs) are common in older adults and are associated with increased risk of adverse drug events and hospitalisation. Older adults are particularly susceptible to DDIs due to multimorbidity, polypharmacy and age-related changes in pharmacokinetics. A recently published standardised list of 66 potentially significant DDIs specifically relevant to adults aged ≥ 65 years has been validated by an expert consensus group. The aim of the present study was to prospectively assess the prevalence of DDIs in multimorbid older patients with polypharmacy at the point of unscheduled acute hospital admission, using this 66-item DDI list.

Methods
77 unselected consecutive patients aged ≥65 years with ≥3 comorbidities and prescribed ≥5 daily regular medications were included. Medication reconciliations were conducted within 48 hours of admission. Medications were confirmed with two or more sources: the patient, their carer, the general practitioner, or the community pharmacist. Drug prescriptions reflecting pre-admission medication lists were manually screened for DDIs according to the 66-item DDI list.

Results
47 participants (61.04%) had ≥1 listed DDI. The most commonly identified DDI was concomitant use of ≥3 centrally-acting neuropsychiatric drugs (n=18, 23.28%), which increases the risk of falls and impaired cognition. A highly significant correlation was found between the number of daily medications and the number of DDIs experienced (Spearman’s ρ=0.512, P&lt;0.001). No statistically significant relationship was found between the number of comorbidities and the number of DDIs (Spearman’s ρ=0.194, P=0.107). No significant differences were detected in the number of DDIs, medications or comorbidities between men and women (P=0.818, P=0.428, P=0.281, respectively).

Conclusion
The majority (61%) of participants had at least one clinically significant DDI. Given the high prevalence of DDIs in this rapidly growing patient population, frequent review and rationalisation of medications using the 66-item DDI list is indicated to minimize DDIs and enhance medication safety.
33 PREVALENCE OF FALLS RISK-INCREASING DRUGS (FRIDS) DEFINED BY STOPPFALL CRITERIA AMONG MULTI-MORBID OLDER PATIENTS PRESENTING TO HOSPITAL WITH FALLS
Authors: Chawla N , O'Mahony D 
Published: October 2022

Abstract

Background
Several drug classes e.g. antidepressants, hypnotics significantly the risk of falls in older people. As an intervention in several studies, withdrawal of Falls Risk-Increasing Drugs (FRIDs) has led to a significantly decreased incidence of falls and injuries in older people. Recently, an explicit deprescribing tool focusing on FRIDs known as STOPPFall (Screening Tool of Older Persons Prescriptions with high Fall risk) has been validated. STOPPFall consists of 14 drug classes, most of which are psychotropics, known to increase falls risk in older people. There are no prospective studies of STOPPFall-defined prevalence of FRIDs in the literature.

Methods
We undertook a prospective study of 200 consecutively enrolled patients aged ≥65 years (mean age ± SD: 80.9±7.4 years) presenting with falls to the emergency department and Geriatric Medicine OPD clinics between August 2021 to February 2022. We screened for STOPPFall criteria FRIDs in this cohort with additional data collected to define age, sex and comorbidity status.

Results
STOPPFall FRIDs were detected in 59.5% of this cohort which was predominantly female (68%). Comparison of falls incidence between the youngest subgroup (65-74 years) and the oldest subgroup (&gt;85 years) showed that patients aged &gt;85 years fell repeatedly (i.e. ≥ 2 falls in the previous year) more than younger fallers (35.5% vs 21%). Of the 14 drug classes in STOPPFall criteria, antidepressants were the most prevalent FRID category (24%), followed by diuretics (17%). There was a significant positive correlation between the number of reported falls and the number of STOPPFall FRIDs prescribed (R=0.17; p=.016). Almost two-thirds of fallers were prescribed two or more STOPPFall drugs.

Conclusion
STOPPFall medications are highly prevalent among older people presenting to hospital with falls. STOPPFall represents an important tool for attending doctors to identify and deprescribe medications contributing to falls in older people.