Effect of a Video-Supported Nurse-Led Advance Care Planning for Older Adults with Frailty: A Randomized Controlled Trial

This chapter reports the results of a parallel, double-blinded randomized controlled trial to examine the effect of video-supported nurse-led advance care planning (ACP) as compared with a health education program plus an ACP promotion leaflet on end-of-life decision-making outcomes in older adults with frailty. Outcomes were assessed at 1 month and 6 months after the intervention via telephone. Between December 2018 and January 2020, 449 older adults were screened for eligibility. The trial was terminated early after 105 subjects had been assigned (intervention: 51; control: 54) because of the COVID-19 pandemic and the end of the funding period. No significant between-group difference was found in the retention rate at 1 (41.2% vs. 38.9%) and 6 months (35.3% vs. 44.4%). In the intention-to-treat analysis, the ACP group reported a higher but non-significant advance directive completion rate (5.9% vs. 1.9%) and a significantly higher mean score in quality of communication about end-of-life care at 1 month [estimated difference: 8.73 (1.16–16.30). There was no evidence of a difference in favorable outcomes of subjects receiving the video-supported, nurse-led ACP compared with those receiving active control. Results might have been confounded by high attrition, poor intervention completion, and reduced sample size due to the early termination of the study

Ground state of a polydisperse electrorheological solid: Beyond the dipole approximation

The ground state of an electrorheological (ER) fluid has been studied based on our recently proposed dipole-induced dipole (DID) model. We obtained an analytic expression of the interaction between chains of particles which are of the same or different dielectric constants. The effects of dielectric constants on the structure formation in monodisperse and polydisperse electrorheological fluids are studied in a wide range of dielectric contrasts between the particles and the base fluid. Our results showed that the established body-centered tetragonal ground state in monodisperse ER fluids may become unstable due to a polydispersity in the particle dielectric constants. While our results agree with that of the fully multipole theory, the DID model is much simpler, which offers a basis for computer simulations in polydisperse ER fluids.Comment: Accepted for publications by Phys. Rev.

Study of the Linked Dipole Chain Model in heavy quark production at the Tevatron

We present calculations of charm and beauty production at Tevatron within the framework of kT-factorization, using the unintegrated gluon distributions as obtained from the Linked Dipole Chain model. The analysis covers transverse momentum and rapidity distributions and the azimuthal correlations between b and bbar quarks (or rather muons from their decay) which are powerful tests for the different unintegrated gluon distributions. We compare the theoretical results with recent experimental data taken by D0 and CDF collaborations at the Tevatron Run I and II.Comment: 16 page

Theory of Hysteresis Loop in Ferromagnets

We consider three mechanisms of hysteresis phenomena in alternating magnetic field: the domain wall motion in a random medium, the nucleation and the retardation of magnetization due to slow (critical) fluctuations. We construct quantitative theory for all these processes. The hysteresis is characterized by two dynamic threshold fields, by coercive field and by the so-called reversal field. Their ratios to the static threshold field is shown to be function of two dimensionless variables constituted from the frequency and amplitude of the ac field as well as from some characteristics of the magnet. The area and the shape of the hysteresis loop are found. We consider different limiting cases in which power dependencies are valid. Numerical simulations show the domain wall formation and propagation and confirm the main theoretical predictions. Theory is compared with available experimental data.Comment: RevTex, 13 pages, 8 figures (PostScript), acknowledgements adde

Absence of First-order Transition and Tri-critical Point in the Dynamic Phase Diagram of a Spatially Extended Bistable System in an Oscillating Field

It has been well established that spatially extended, bistable systems that are driven by an oscillating field exhibit a nonequilibrium dynamic phase transition (DPT). The DPT occurs when the field frequency is on the order of the inverse of an intrinsic lifetime associated with the transitions between the two stable states in a static field of the same magnitude as the amplitude of the oscillating field. The DPT is continuous and belongs to the same universality class as the equilibrium phase transition of the Ising model in zero field [G. Korniss et al., Phys. Rev. E 63, 016120 (2001); H. Fujisaka et al., Phys. Rev. E 63, 036109 (2001)]. However, it has previously been claimed that the DPT becomes discontinuous at temperatures below a tricritical point [M. Acharyya, Phys. Rev. E 59, 218 (1999)]. This claim was based on observations in dynamic Monte Carlo simulations of a multipeaked probability density for the dynamic order parameter and negative values of the fourth-order cumulant ratio. Both phenomena can be characteristic of discontinuous phase transitions. Here we use classical nucleation theory for the decay of metastable phases, together with data from large-scale dynamic Monte Carlo simulations of a two-dimensional kinetic Ising ferromagnet, to show that these observations in this case are merely finite-size effects. For sufficiently small systems and low temperatures, the continuous DPT is replaced, not by a discontinuous phase transition, but by a crossover to stochastic resonance. In the infinite-system limit the stochastic-resonance regime vanishes, and the continuous DPT should persist for all nonzero temperatures

Use of plasma DNA to predict mortality and need for intensive care in patients with abdominal pain

Background We investigated the value of plasma deoxyribonucleic acid concentrations in patients presenting with acute abdominal pain to predict need for intensive care or mortality. Methods Plasma deoxyribonucleic acid taken from patients with acute abdominal pain was analyzed for the β-globin gene using the quantitative polymerase chain reaction. The primary outcome measure was the combined 28-day mortality or admission to the intensive care unit. Results Of 287 consecutive patients with acute abdominal pain recruited, 12 patients were admitted to the intensive care unit and/or died. Median plasma DNA concentrations were higher in patients with cancer and major organ inflammation. Mean plasma DNA concentrations were three-fold higher in patients with systemic inflammatory response syndrome, five-fold higher in patients who died within 28 days, and eight-fold higher in patients admitted to the intensive care unit. The area under the receiver operator curve for plasma DNA concentrations and intensive care unit admission/mortality was 0.804. At a cut-off of 1100 GE/ml, the sensitivity was 67% (95%CI 35–90) and specificity was 89% (95%CI 84–92). At a cut-off of 175 GE/ml, the sensitivity was 100% (95%CI 73–100) and specificity was 30% (95%CI 25–36). Plasma DNA concentration predicted need for intensive care unit admission or death (adjusted odds ratio 1.4; P < 0.0001). Conclusions Plasma DNA may have a role in patients with acute abdominal pain as a marker for inflammation and cancer, and a predictor of intensive care unit admission/mortality

Transformation of β-Ni(OH)2to NiO nano-sheets via surface nanocrystalline zirconia coating: Shape and size retention

Shape and size of the synthesized NiO nano-sheets were retained during transformation of sheet-like β-Ni(OH)2to NiO at elevated temperatures via nano-sized zirconia coating on the surface of β-Ni(OH)2. The average grain size was 6.42 nm after 600 °C treatment and slightly increased to 10 nm after 1000 °C treatment, showing effective sintering retardation between NiO nano-sheets. The excellent thermal stability revealed potential application at elevated temperatures, especially for high temperature catalysts and solid-state electrochemical devices

Vancomycin Pharmacokinetics Throughout Life: Results from a Pooled Population Analysis and Evaluation of Current Dosing Recommendations

Abstract Background and Objectives Uncertainty exists regarding the optimal dosing regimen for vancomycin in diferent patient populations, leading to a plethora of subgroup-specifc pharmacokinetic models and derived dosing regimens. We aimed to investigate whether a single model for vancomycin could be developed based on a broad dataset covering the extremes of patient characteristics. Furthermore, as a benchmark for current dosing recommendations, we evaluated and optimised the expected vancomycin exposure throughout life and for specifc patient subgroups. Methods A pooled population-pharmacokinetic model was built in NONMEM based on data from 14 diferent studies in diferent patient populations. Steady-state exposure was simulated and compared across patient subgr

Effects of polyethylene glycols on intestinal efflux pump expression and activity in Caco-2 cells

The present study was planned to investigate the influence of polyethylene glycols (PEGs) on the activity and expression of P-glycoprotein (P-gp). Sub-toxic concentrations of PEGs in Caco-2 cells were determined using the MTT test assay. Then the measurement of Rhodamine-123 (Rho-123) uptake, a P-gp fluorescence substrate, in Caco-2 cells confronting PEG 400 (1% and 2% w/v), PEG 4000 (2% and 4% w/v), PEG 6000 (2% and 4% w/v), PEG 10000 (2% and 4% w/v), PEG 15000 (1% and 2% w/v), and PEG 35000 (2% and 4% w/v) overnight was taken to elucidate whether non-toxic concentrations of PEGs are able to impact P-gp activity. Furthermore, western blotting was carried out to investigate P-gp protein expression. The results showed that PEG 400 at concentrations of 1% (w/v) and 2% (w/v) and PEG 6000 at the concentration of 4% (w/v) are notably capable of blocking P-gp. Based on the obtained results it is concluded that the mentioned excipients could be used to obstruct P-gp efflux transporter in order to increase the bioavailability of co-administered substrate drug

Measurement of the cross section for isolated-photon plus jet production in pp collisions at √s=13 TeV using the ATLAS detector

The dynamics of isolated-photon production in association with a jet in proton–proton collisions at a centre-of-mass energy of 13 TeV are studied with the ATLAS detector at the LHC using a dataset with an integrated luminosity of 3.2 fb−1. Photons are required to have transverse energies above 125 GeV. Jets are identified using the anti- algorithm with radius parameter and required to have transverse momenta above 100 GeV. Measurements of isolated-photon plus jet cross sections are presented as functions of the leading-photon transverse energy, the leading-jet transverse momentum, the azimuthal angular separation between the photon and the jet, the photon–jet invariant mass and the scattering angle in the photon–jet centre-of-mass system. Tree-level plus parton-shower predictions from Sherpa and Pythia as well as next-to-leading-order QCD predictions from Jetphox and Sherpa are compared to the measurements