Work engagement, emotional exhaustion, and OCB-civic virtue among nurses: a multilevel analysis of emotional supervisor support

Introduction: This study investigates the moderating role of supervisor emotional support at the group level on the relationship between emotional exhaustion and work engagement with organizational citizenship behavior-civic virtue (OCB-civic virtue) at the individual level among nurses. Method: A cross-sectional study was carried out on 558 nurses nested in 36 working units from two hospitals in Algiers. A multilevel analysis using Hierarchical Linear Modeling was performed. Results: Results show that the positive effect of work engagement on OCB-civic virtue was moderated by supervisor emotional support at group level. The nurses emotional exhaustion and OCB-civic virtue negative relationship at the individual level is buffered by supervisor emotional support at group level. Discussion: In consequence, supervisor emotional support experienced by the team has an influence on the emotional exhaustion and work engagement OCB-civic virtue relationship

Numerical simulations of kink instability in line-tied coronal loops

The results from numerical simulations carried out using a new shock-capturing, Lagrangian-remap, 3D MHD code, Lare3d are presented. We study the evolution of the m=1 kink mode instability in a photospherically line-tied coronal loop that has no net axial current. During the non-linear evolution of the kink instability, large current concentrations develop in the neighbourhood of the infinite length mode rational surface. We investigate whether this strong current saturates at a finite value or whether scaling indicates current sheet formation. In particular, we consider the effect of the shear, defined by where is the fieldline twist of the loop, on the current concentration. We also include a non-uniform resistivity in the simulations and observe the amount of free magnetic energy released by magnetic reconnection

Inverted and Programmable Poynting Effects in Metamaterials

The Poynting effect generically manifests itself as the extension of the material in the direction perpendicular to an applied shear deformation (torsion) and is a material parameter hard to design. Unlike isotropic solids, in designed structures, peculiar couplings between shear and normal deformations can be achieved and exploited for practical applications. Here, we engineer a metamaterial that can be programmed to contract or extend under torsion and undergo nonlinear twist under compression. First, we show that our system exhibits a novel type of inverted Poynting effect, where axial compression induces a nonlinear torsion. Then the Poynting modulus of the structure is programmed from initial negative values to zero and positive values via a pre-compression applied prior to torsion. Our work opens avenues for programming nonlinear elastic moduli of materials and tuning the couplings between shear and normal responses by rational design. Obtaining inverted and programmable Poynting effects in metamaterials inspires diverse applications from designing machine materials, soft robots and actuators to engineering biological tissues, implants and prosthetic devices functioning under compression and torsion.Comment: 9 pages, 6 figure

Symptom complexes in patients with seropositive arthralgia and in patients newly diagnosed with rheumatoid arthritis: a qualitative exploration of symptom development

Objective: The aim of this study was to explore symptoms and symptom development during the earliest phases of rheumatoid arthritis (RA) in patients with seropositive arthralgia and patients newly diagnosed with RA

An Easy-to-Use Prognostic Model for Survival Estimation for Patients with Symptomatic Long Bone Metastases

BACKGROUND: A survival estimation for patients with symptomatic long bone metastases (LBM) is crucial to prevent overtreatment and undertreatment. This study analyzed prognostic factors for overall survival and developed a simple, easy-to-use prognostic model. METHODS: A multicenter retrospective study of 1,520 patients treated for symptomatic LBM between 2000 and 2013 at the radiation therapy and/or orthopaedic departments was performed. Primary tumors were categorized into 3 clinical profiles (favorable, moderate, or unfavorable) according to an existing classification system. Associations between prognostic variables and overall survival were investigated using the Kaplan-Meier method and multivariate Cox regression models. The discriminatory ability of the developed model was assessed with the Harrell C-statistic. The observed and expected survival for each survival category were compared on the basis of an external cohort. RESULTS: Median overall survival was 7.4 months (95% confidence interval [CI], 6.7 to 8.1 months). On the basis of the independent prognostic factors, namely the clinical profile, Karnofsky Performance Score, and presence of visceral and/or brain metastases, 12 prognostic categories were created. The Harrell C-statistic was 0.70. A flowchart was developed to easily stratify patients. Using cutoff points for clinical decision-making, the 12 categories were narrowed down to 4 categories with clinical consequences. Median survival was 21.9 months (95% CI, 18.7 to 25.1 months), 10.5 months (95% CI, 7.9 to 13.1 months), 4.6 months (95% CI, 3.9 to 5.3 months), and 2.2 months (95% CI, 1.8 to 2.6 months) for the 4 categories. CONCLUSIONS: This study presents a model to easily stratify patients with symptomatic LBM according to their expected survival. The simplicity and clarity of the model facilitate and encourage its use in the routine care of patients with LBM, to provide the most appropriate treatment for each individual patient. LEVEL OF EVIDENCE: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence

Large Epidemiologic Studies of Gout: Challenges in Diagnosis and Diagnostic Criteria

Large epidemiologic studies of gout can improve insight into the etiology, pathology, impact, and management of the disease. Identification of monosodium urate monohydrate crystals is considered the gold standard for diagnosis, but its application is often not possible in large studies. Therefore, under such circumstances, several proxy approaches are used to classify patients as having gout, including ICD coding in several types of databases or questionnaires that are usually based on the existing classification criteria. However, agreement among these methods is disappointing. Moreover, studies use the terms acute, recurrent, and chronic gout in different ways and without clear definitions. Better definitions of the different manifestations and stages of gout may provide better insight into the natural course and burden of disease and can be the basis for valid approaches to correctly classifying patients within large epidemiologic studies

Does implicit memory during anaesthesia persist in children?

Background Recent studies suggest that implicit memory (especially perceptual implicit memory) persists during adequate general anaesthesia in adults. Studies in children, however, have failed to demonstrate implicit memory during general anaesthesia, possibly because of differences in methodological design. We therefore designed a prospective study with the aim of evaluating implicit memory in children undergoing general anaesthesia, using a perceptual memory test based on the mere exposure effect, previously tested in a control group. Methods Twelve infrequent neutral words were played 12 times in a random sequence via headphones to 36 children aged 8-12 yr during elective or emergency surgery. The children were not premedicated, and general anaesthesia was maintained with isoflurane. The word presentation started immediately after the surgical incision. Within 36 h after the stimulus presentation, the memory was assessed by using a forced-choice preference judgement task. Time constraint and word deterioration with a low-pass filter were used to prevent the subjects from utilizing intentional retrieval. The implicit memory score was obtained by calculating the proportion of target words preferred, which was compared with the chance level (0.5). Results The percentage of correct responses given by the children was comparable with the chance level. The memory score was mean (sd) 0.48 (0.16) (95% CI 0.43-0.53). Conclusions The use of a perceptual implicit memory test based on the mere exposure procedure in children failed to reveal any evidence of implicit memory under general anaesthesi

Regional variation in the interpretation of contact precautions for multi-drug-resistant Gram-negative bacteria:a cross-sectional survey

Background: Contact precautions are recommended when caring for patients with carbapenemase-producing Enterobacterales (CPE), carbapenemase-producing Pseudomonas aeruginosa (CPPA), and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E). Aim: Our aim was to determine the interpretation of contact precautions and associated infection prevention and control (IPC) measures in the non-ICU hospital setting for patients with CPE, CPPA or ESBL-E in 11 hospitals in the Southwest of the Netherlands. Methods: A cross-sectional survey was developed to collect information on all implemented IPC measures, including use of personal protective equipment, IPC measures for visitors, cleaning and disinfection, precautions during outpatient care and follow-up strategies. All 11 hospitals were invited to participate between November 2020 and April 2021. Findings: The survey was filled together with each hospital. All hospitals installed isolation precautions for patients with CPE and CPPA during inpatient care and day admissions, whereas 10 hospitals (90.9%) applied isolation precautions for patients with ESBL-E. Gloves and gowns were always used during physical contact with the patient in isolation. Large variations were identified in IPC measures for visitors, cleaning and disinfection products used, and precautions during outpatient care. Four hospitals (36.4%) actively followed up on CPE or CPPA patients with the aim of declaring them CPE- or CPPA-negative as timely as possible, and two hospitals (20.0%) actively followed up on ESBL-E patients. Conclusion: Contact precautions are interpreted differently between hospitals, leading to regional differences in IPC measures applied in clinical settings. Harmonizing infection-control policies between the hospitals could facilitate patient transfers and benefit collective efforts of preventing transmission of multi-drug-resistant Gram-negative bacteria.</p

The effect of angular momentum conservation in the phase transitions of collapsing systems

The effect of angular momentum conservation in microcanonical thermodynamics is considered. This is relevant in gravitating systems, where angular momentum is conserved and the collapsing nature of the forces makes the microcanonical ensemble the proper statistical description of the physical processes. The microcanonical distribution function with non-vanishing angular momentum is obtained as a function of the coordinates of the particles. As an example, a simple model of gravitating particles, introduced by Thirring long ago, is worked out. The phase diagram contains three phases: for low values of the angular momentum $L$ the system behaves as the original model, showing a complete collapse at low energies and an entropy with a convex intruder. For intermediate values of $L$ the collapse at low energies is not complete and the entropy still has a convex intruder. For large $L$ there is neither collapse nor anomalies in the thermodynamical quantities. A short discussion of the extension of these results to more realistic situations is exposed.Comment: Latex, 21 pages, 5 figures. Corrected misprints in some equations and a few clarifying remarks adde