Setting new priorities for nursing research: The updated Swiss Nursing Research Agenda—a systematic, participative approach

Aim To identify current key areas for nursing research in Switzerland, we revised the Swiss Research Agenda for Nursing (SRAN) initially published in 2008. Background By developing a research agenda, nursing researchers internationally prioritize and cluster relevant topics within the research community. The process should be collaborative and systematic to provide credible information for decisionmakers in health care research, policy, and practice. Sources of Evidence After a participative, systematic, and critical evaluation within and outside of the Swiss Association for Nursing Science, the updated SRAN 2019–2029 defines four research priorities (new models of care, nursing care interventions, work and care environment, and quality of care and patient safety) and four transversal themes (organization of research, research methodologies, research in health care policy and public health perspectives). Conclusion Adding to other national nursing research agendas, the categories are organized in a framework of key research priorities and transversal themes. They relate to the importance of global and local foci of research as well as challenges in health care services and policy systems. The agenda is an important prerequisite for enhancing the influence of nursing research in Switzerland and provides guidance for the next decade.Implications for Nursing PracticeThe revised agenda ensures that research projects target key knowledge gaps and the discipline's core questions in respective countries.Implications for Health PolicyNursing research should inform and influence health policy on all institutional and political levels. Therefore, the integration of public health perspectives in research is one of the most important new aspects of SRAN 2019–2029

A cell atlas of human thymic development defines T cell repertoire formation.

The thymus provides a nurturing environment for the differentiation and selection of T cells, a process orchestrated by their interaction with multiple thymic cell types. We used single-cell RNA sequencing to create a cell census of the human thymus across the life span and to reconstruct T cell differentiation trajectories and T cell receptor (TCR) recombination kinetics. Using this approach, we identified and located in situ CD8αα+ T cell populations, thymic fibroblast subtypes, and activated dendritic cell states. In addition, we reveal a bias in TCR recombination and selection, which is attributed to genomic position and the kinetics of lineage commitment. Taken together, our data provide a comprehensive atlas of the human thymus across the life span with new insights into human T cell development

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Properties of sugar-​based low-​melting mixtures

Physico-chem. properties of ternary sugar-based low-melting mixts. were detd. Choline chloride, urea and glucose or sorbitol, serving as sugars, were blended in various compns. The refractive index, d., viscosity, decompn. temps. and glass transition temps. were measured. Further, the influence of temp. and water content was investigated. The results show that the mixts. are liq. below room temp. and the viscosity and d. are dependent on the temp. and compn. Moreover, the viscosity decreases with increasing water content. These mixts. are biodegradable, low toxic, non-volatile, non-reactive with water and can be accomplished with low-cost materials. In consideration of these advantages and a m.p. below room temp., these low-melting mixts. can be a good alternative to ionic liqs. as well as environmentally unfriendly and toxic solvents

Low-​melting mixtures based on choline ionic liquids

A strategy is proposed for the design of low toxic, room temp. liq. low-melting mixts. (LMMs) which are entirely composed of natural materials. From literature it is well known that, in general, deep eutectic solvents based on choline chloride and dicarboxylic acids are LMMs, but not liqs. at room temp., with one exception: a 1:1 M mixt. of malonic acid and choline chloride. Therefore, the starting point of this study was the decrease of the m.p. of one of the components, namely the dicarboxylic acid, which is succinic, glutaric, or adipic acid. For this purpose, one of the two protons of the acidic group was exchanged by a bulky unsym. choline cation. The resulting ionic liqs. (ILs) were still solid at room temp., but have a reduced melting temp. compared with the corresponding acids. In the second step, mixts. of these ILs with choline chloride were prepd. It turned out that choline glutarate-choline chloride mixts. are liqs. at room temp. at compns. contg. 95-98 wt.% of choline glutarate. Finally, urea was added as another hydrogen bond donor. D., cond., and viscosity measurements were performed for all obtained mixts. Moreover, a Walden plot was drawn which indicates that all mixts. are liqs. with fully dissocd. ions moving independently. Therefore, they are considered as "good" ionic liqs. and, thus, for example they can be used to exchange more toxic or less biodegradable ILs in application processes. A brief outlook contg. application possibilities is given. It is demonstrated that choline dodecylsulfate is readily sol. in these mixts., forming aggregates in the LMM at temps. exceeding 55°C

Eco-friendly one pot synthesis of caffeic acid phenethyl ester (CAPE) via an in situ created deep eutectic solvent

In this paper, a new strategy towards the synthesis of caffeic acid phenethyl ester (CAPE) is introduced. The reaction is carried out in a deep eutectic solvent made of caffeic acid and choline chloride. Caffeic acid is used as part of the solvent and as reactant. Phenethyl alcohol is soluble in this mixture in every molar ratio, and as a consequence no additional solvent is necessary. Reaction conditions were optimised with respect to the molar ratio of phenethyl alcohol and caffeic acid, and by varying the amount and nature of the acid catalyst as well as the reaction time. The obtained CAPE ester could easily be separated from the reaction mixture by simply adding water to destroy the deep eutectic by solubilisation of choline chloride in the aqueous phase. (C) 2016 Elsevier B.V. All rights reserved

Demographic outlook in the European Union 2017

This paper presents the demographic outlook in the European Union (EU) in 2017. It shows that the EU population, having grown substantially, is now beginning to stagnate, before its expected decline from around the middle of the century. With the world population having risen still more substantially and growth continuing, the EU represents a shrinking proportion of the world population. The EU population is also ageing dramatically, as life expectancy increases and fertility rates are lower than in the past. This has serious implications across a range of areas including the economy, healthcare and pensions. Free movement within the EU and migration from third countries also plays an important role in shaping demography in individual Member States and regions. The 'in-focus' section of this analysis looks at health and notes that the data, whilst inconsistent, suggests that people are not necessarily experiencing the extra life years without limitations to their usual activity

Toward surfactant-free and water-free microemulsions

International audienc

Practicability of Hygienic Wrapping of Touchscreen Operated Mobile Devices in a Clinical Setting

Background: To prove effectiveness of wrapping tablet computers in order to reduce microbiological contamination and to evaluate whether a plastic bag-covered tablet leads to impaired user satisfaction or touchscreen functionality. Materials and Methods: Within a period of 11 days 115 patients were provided with a tablet computer while waiting for their magnetic resonance imaging examination. Every day the contamination of the surface of the tablet was determined before the first and after the final use. Before the device was handed over to a patient, it was enclosed in a customized single-use plastic bag, which was analyzed for bacterial contamination after each use. A questionnaire was applied to determine whether the plastic bag impairs the user satisfaction and the functionality of the touchscreen. Results: Following the use by patients the outside of the plastic bags was found to be contaminated with various bacteria (657.5 6 368.5 colony forming units/day); some of them were potentially pathogenic. In contrast, the plastic bag covered surface of the tablet was significantly less contaminated (1.7 6 1.9 colony forming units/day). Likewise, unused plastic bags did not show any contamination. 11% of the patients reported problems with the functionality of the touchscreen. These patients admitted that they had never used a tablet or a smartphone before. Conclusions: Tablets get severely contaminated during usage in a clinical setting. Wrapping with a customized single-use plastic bag significantly reduces microbiological contamination of the device, protects patients from the acquisition of potentially pathogenic bacteria and hardly impairs the user satisfaction and the functionality of the touchscreen

Practicability of hygienic wrapping of touchscreen operated mobile devices in a clinical setting.

BACKGROUND: To prove effectiveness of wrapping tablet computers in order to reduce microbiological contamination and to evaluate whether a plastic bag-covered tablet leads to impaired user satisfaction or touchscreen functionality. MATERIALS AND METHODS: Within a period of 11 days 115 patients were provided with a tablet computer while waiting for their magnetic resonance imaging examination. Every day the contamination of the surface of the tablet was determined before the first and after the final use. Before the device was handed over to a patient, it was enclosed in a customized single-use plastic bag, which was analyzed for bacterial contamination after each use. A questionnaire was applied to determine whether the plastic bag impairs the user satisfaction and the functionality of the touchscreen. RESULTS: Following the use by patients the outside of the plastic bags was found to be contaminated with various bacteria (657.5 ± 368.5 colony forming units/day); some of them were potentially pathogenic. In contrast, the plastic bag covered surface of the tablet was significantly less contaminated (1.7 ± 1.9 colony forming units/day). Likewise, unused plastic bags did not show any contamination. 11% of the patients reported problems with the functionality of the touchscreen. These patients admitted that they had never used a tablet or a smartphone before. CONCLUSIONS: Tablets get severely contaminated during usage in a clinical setting. Wrapping with a customized single-use plastic bag significantly reduces microbiological contamination of the device, protects patients from the acquisition of potentially pathogenic bacteria and hardly impairs the user satisfaction and the functionality of the touchscreen