Interactions between inorganic pigments and rabbit skin glue in reference paint reconstructions

The thermal degradation of rabbit skin glue, a collagen-based proteinaceous material used as a paint binder in paintings, was investigated in this paper. Paint reconstructions of the glue on its own or mixed with azurite (Cu3(CO3)2(OH)2), calcium carbonate (CaCO3), hematite (Fe2O3nH2O) and red lead (Pb3O4) were analysed using a thermoanalytical approach. This method enabled us to investigate the interactions between the glue and pigments before and after artificial indoor light ageing. The study was carried out using differential scanning calorimetry, thermogravimetry and thermogravimetry/FTIR analysis already successfully employed to characterize the paint binders. The results highlighted that all the inorganic pigments interact with rabbit skin glue, thus decreasing the thermal stability of the binder. Light ageing further decreased the thermal stability of pigmented paint replicas, suggesting a moderate increase in the rate of the degradation

Fourier transform infrared spectroscopic study of rabbit glue/inorganic pigments mixtures in fresh and aged reference paint reconstructions

We studied the interactions of rabbit glue, a collagen-based proteinaceous binder, with azurite (Cu3(CO3)2(OH)2), calcium carbonate (CaCO3), hematite (Fe2O3·nH2O), red lead (Pb3O4) and cinnabar (HgS) by Fourier transform infrared spectroscopy (FT-IR). The research was carried out on a set of paint reconstructions, which were analysed before and after artificial light ageing. A deconvolution of the amide I FT-IR absorption peak was performed with a written-in-house LabVIEW program to study the secondary structure of the glue.The changes in the glue conformation highlighted that all the inorganic pigments interact with the proteinaceous binder. The conformational changes were correlated with a loss of stability of the collagen structure, especially after ageing, likely due to the interlayer coordination of metals salts and oxide with protein functional groups. These results were correlated with the lower thermal stability of the glue/pigment mixtures with respect to the pure glue, evidenced by thermogravimetry (TG) and differential scanning calorimetry (DSC) analyses performed in a previous step of this work

Development and initial validation of a mathematics-specific spatial vocabulary scale

This study describes the development and initial validation of a mathematics-specific spatial vocabulary measure for upper elementary school students. Reviews of spatial vocabulary items, mathematics textbooks, and Mathematics Common Core State Standards identified 720 mathematical terms, 148 of which had spatial content (e.g., edge). In total, 29 of these items were appropriate for elementary students, and a pilot study (59 fourth graders) indicated that nine of them were too difficult (< 50% correct) or too easy (> 95% correct). The remaining 20 items were retained as a spatial vocabulary measure and administered to 181 (75 girls, mean age = 119.73 months, SD =4.01) fourth graders, along with measures of geometry, arithmetic, spatial abilities, verbal memory span, and mathematics attitudes and anxiety. A Rasch model indicated that all 20 items assessed an underlying spatial vocabulary latent construct. The convergent and discriminant validity of the vocabulary measure was supported by stronger correlations with theoretically related (i.e., geometry) than with more distantly related (i.e., arithmetic) mathematics content and stronger relations with spatial abilities than with verbal memory span or mathematics attitudes and anxiety. Simultaneous regression analyses and structural equation models, including all measures, confirmed this pattern, whereby spatial vocabulary was predicted by geometry knowledge and spatial abilities but not by verbal memory span, mathematics attitudes and anxiety. Thus, the measure developed in this study helps in assessing upper elementary students' mathematics-specific spatial vocabulary

IRC/The Hague:

Contract HRN-I-00-99-00011-0

Understanding care coordination for Veterans with complex care needs: protocol of a multiple-methods study to build evidence for an effectiveness and implementation study

Background For patients with complex health and social needs, care coordination is crucial for improving their access to care, clinical outcomes, care experiences, and controlling their healthcare costs. However, evidence is inconsistent regarding the core elements of care coordination interventions, and lack of standardized processes for assessing patients’ needs has made it challenging for providers to optimize care coordination based on patient needs and preferences. Further, ensuring providers have reliable and timely means of communicating about care plans, patients’ full spectrum of needs, and transitions in care is important for overcoming potential care fragmentation. In the Veterans Health Administration (VA), several initiatives are underway to implement care coordination processes and services. In this paper, we describe our study underway in the VA aimed at building evidence for designing and implementing care coordination practices that enhance care integration and improve health and care outcomes for Veterans with complex care needs. Methods In a prospective observational multiple methods study, for Aim 1 we will use existing data to identify Veterans with complex care needs who have and have not received care coordination services. We will examine the relationship between receipt of care coordination services and their health outcomes. In Aim 2, we will adapt the Patient Perceptions of Integrated Veteran Care questionnaire to survey a sample of Veterans about their experiences regarding coordination, integration, and the extent to which their care needs are being met. For Aim 3, we will interview providers and care teams about their perceptions of the innovation attributes of current care coordination needs assessment tools and processes, including their improvement over other approaches (relative advantage), fit with current practices (compatibility and innovation fit), complexity, and ability to visualize how the steps proceed to impact the right care at the right time (observability). The provider interviews will inform design and deployment of a widescale provider survey. Discussion Taken together, our study will inform development of an enhanced care coordination intervention that seeks to improve care and outcomes for Veterans with complex care needs

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Evaluation of an Emergency Department-based Palliative Care Extender Program on Hospital and Patient Outcomes

Background: Boston Medical Center (BMC), a safety-net hospital, treated a substantial portion of the Boston cohort that was sick with COVID-19. Unfortunately, these patients experienced high rates of morbidity and mortality given the significant health disparities that many of BMC’s patients face. Boston Medical Center launched a palliative care extender program to help address the needs of critically ill ED patients under crisis conditions. In this program evaluation our goal was to assess outcomes between those who received palliative care in the emergency department (ED) vs those who received palliative care as an inpatient or were admitted to an intensive care unit (ICU).Methods: We used a matched retrospective cohort study design to assess the difference in outcomes between the two groups.Results: A total of 82 patients received palliative care services in the ED, and 317 patients received palliative care services as an inpatient. After controlling for demographics, patients who received palliative care services in the ED were less likely to have a change in level of care (P<0.001) or be admitted to an ICU (P<0.001). Cases had an average length of stay of 5.2 days compared to controls who stayed 9.9 days (P<0.001).Conclusion: Within a busy ED environment, initiating palliative care discussions by ED staff can be challenging. This study demonstrates that consulting palliative care specialists early in the course of the patient’s ED stay can benefit patients and families and improve resource utilization