Hidden magnetic transitions in thermoelectric layered cobaltite, [Ca2_2CoO3_3]0.62_{0.62}[CoO2_2]

A positive muon spin rotation and relaxation ($\mu^+$SR) experiment on [Ca$_2$CoO$_3$]$_{0.62}$[CoO$_2$], ({\sl i.e.}, Ca$_3$Co$_4$O$_9$, a layered thermoelectric cobaltite) indicates the existence of two magnetic transitions at $\sim$ 100 K and 400 - 600 K; the former is a transition from a paramagnetic state to an incommensurate ({\sf IC}) spin density wave ({\sf SDW}) state. The anisotropic behavior of zero-field $\mu^+$SR spectra at 5 K suggests that the {\sf IC-SDW} propagates in the $a$-$b$ plane, with oscillating moments directed along the c-axis; also the {\sf IC-SDW} is found to exist not in the [Ca$_2$CoO$_3$] subsystem but in the [CoO$_2$] subsystem. In addition, it is found that the long-range {\sf IC-SDW} order completes below $\sim$ 30 K, whereas the short-range order appears below 100 K. The latter transition is interpreted as a gradual change in the spin state of Co ions %% at temperatures above 400 K. These two magnetic transitions detected by $\mu^+$SR are found to correlate closely with the transport properties of [Ca$_2$CoO$_3$]$_{0.62}$[CoO$_2$].Comment: 7 pages, 8 figures. to be appeared in Phys. Rev.

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The involvement of intensive care nurses in end-of-life decisions: a nationwide survey

Objective: To investigate the prevalence and predictors of intensive care nurses’ active involvement in end-of-life (EOL) decisions. Design and setting: A survey of intensive care nurses from 36 intensive care units (ICUs) in New Zealand. Measurements and results: A total of 611 ICU nurses from 35 ICUs responded to this survey. The response rate was estimated to be between 43% and 81%. Seventy-eight percent of respondents reported active involvement in EOL decisions, especially the senior nurses (level IV vs. I nurses, OR 7.9; nurse educators vs. level I nurses, OR 4.3). Asian (OR 0.2) and Pacific Islander nurses (OR 0.2) were less often involved than European nurses. Sixty-eight percent of respondents preferred more involvement in EOL decisions, and this preference was associated with the perception that EOL decisions are often made too late (OR 2.2). Sixty-five percent believed their active involvement in EOL decisions would improve nursing job satisfaction. Conclusions: Most ICU nurses in New Zealand reported that they are often involved in EOL decisions, especially senior and European nurses

A multiscale Cauchy–Born meshfree model for deformability of red blood cells parasitized by Plasmodium falciparum

In normal physiological and healthy conditions, red blood cells (RBCs) deform readily as they pass through the microcapillaries and the spleen, however, upon invasion by the malaria parasite, the host RBC membrane begins to lose their deformability. In spite of the progress in understanding malaria pathogenesis, the primary mechanism responsible for the loss of deformability remains unclear. In this paper, we examine the effects of Plasmodium falciparum infection and maturation on the deformability of parasitized or infected red blood cells (iRBCs) by means of a three-dimensional (3D) multiscale red blood cell (RBC) framework. This multiscale framework is developed based on the Cauchy–Born rule and the meshfree IMLS-Ritz method. The atomistic scale strain energy density function of the RBC membrane was computed using a selected representative cell based on the membrane spectrin network. The results obtained from our numerical simulations affirm that the presence of malaria infection significantly increases the rigidity of RBC membrane. It was observed that in the trophozoite and schizont infection stages, biconcave cell geometry leads to better prediction than nearly spherical geometry in comparison with experimental studies. Furthermore, we confirm that increase in temperature also results to increased stiffening of the cell membrane. Lastly, the observed decrease in the deformability of iRBC membrane may be primarily due to the structural remodeling and changes in the microstructure of the membrane rather than the change in cell shape