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Copyright of Rostrum of Asclepius / Vima tou Asklipiou is the property of Technological Educational Institute of Athens and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The prevention of Central Line-Associated Bloodstream Infections (CLABSIs) can be achieved through systematic surveillance and intervention through the implementation of care bundles. An integral component of the care bundles is the central line insertion and maintenance checklists. Aim: The aim of this literature review was to investigate the compliance rate of the nursing staff with the central line insertion and maintenance care checklists as well as the factors affecting it. Material and Methods: Search was performed on PubMed (April 05, 2021) with the keywords: "nurse*", "nursing staff", "compliance", "central line insertion checklist" and "central line maintenance checklist", without time limit for the publication of scientific papers. Keywords were searched in the title and abstract of the studies. Studies were excluded if they were not published in the English language, were conducted on animals, and were case studies, editorials, and letters to the editor. Results: Of the scientific papers retrieved, 5 were included in the systematic review. The compliance rate of nursing staff with central line insertion and maintenance checklists ranged from 8.4% to 74.3% and from 11.4% to 77.3%, respectively. Regarding the factors affecting the compliance of nursing staff with both types of checklists, these were the nurse-to-patient ratio and the number of beds of nursing wards. Conclusions: Compliance rates with the central line insertion and maintenance checklists are moderate and low. Interventions are required that will increase compliance rates leading to lower CLABSI rates. [ABSTRACT FROM AUTHOR]

Copyright of Rostrum of Asclepius / Vima tou Asklipiou is the property of Technological Educational Institute of Athens and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nursing Care & Research / Nosileia kai Ereuna is the property of Greek Nursing Studies Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

AIM: To investigate the impact of environmental crisis on hospital and outpatient health expenditures and more specifically to estimate the effect of climate change, air pollution, water pollution, soil pollution and noise pollution in hospital health expenditures and outpatient health expenditures. MATERIAL AND METHOD: A systematic literature review was conducted on PubMed, Scopus, Cinahl and Science Direct and included papers that have published until to June 2015 in English. We used the following key-words: climate change, air pollution, water pollution, ground pollution, noise pollution, health care expenditures, hospital health expenditures and outpatient health expenditures. RESULTS: Only 30 of the published scientific papers met the criteria for inclusion in this review. Twenty-one studies assessed the impact of the environmental crisis on hospital health expenditures and 9 assessed the impact on outpatient health expenditures. We found that components of the environmental crisis affect people's demand for primary and secondary health care services. CONCLUSIONS: The environmental crisis affects greatly in a direct way the health care expenditures globally, since it is responsible for a great number of hospital admissions, visits in hospitals' emergency departments and outpatient visits. [ABSTRACT FROM AUTHOR]

Copyright of Rostrum of Asclepius / Vima tou Asklipiou is the property of Technological Educational Institute of Athens and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rostrum of Asclepius / Vima tou Asklipiou is the property of Technological Educational Institute of Athens and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE: To investigate and present the effects of environmental crisis on health indicators and by extension to quality of life. More specifically, we searched the effects of climate change, air pollution, water pollution, soil pollution and noise pollution in health indicators, such as morbidity, mortality, infant mortality, life expectancy, years of life lost and years of life weighted for disability. MATERIAL AND METHOD: A systematic review of papers that were published until January 2015 was conducted. Search was performed on PubMed, Scopus, Cinahl and ScienceDirect with the following key-words: climate change, air pollution, water pollution, ground pollution, noise pollution, morbidity, mortality, infant mortality, life expectancy, years of life lost and years of life weighted for disability. The criteria for inclusion in this review was the existence of correlation between environmental crisis and morbidity, mortality, infant mortality, life expectancy, years of life lost and years of life weighted for disability. RESULTS: Only 24 of the published scientific papers met the criteria for inclusion in this review. Most of these studies assessed the impact of the environmental crisis on mortality, morbidity, life expectancy and infant mortality, while fewer were the studies investigating the environmental impact on years of life weighted for disability and lost years of life. We found that the environmental crisis affects negatively the configuration of health indicators on global reference frame. CONCLUSIONS: The environmental crisis affects greatly in a direct way morbidity, mortality, infant mortality, life expectancy, years of life lost and years of life weighted for disability. As a consequence of this fact there is loss of quality of human life. [ABSTRACT FROM AUTHOR]

Introduction: The phenomenon of mobbing in hospitals is an important inhibitor both for the psychospiritual balance of clinical nurses and for the proper functioning of hospitals as organizations. Aim: The investigation of the frequency of mobbing in clinical nurses and its impact on them. Methods: Search was performed on PubMed on March 13, 2020 with the key-words: "mobbing" and "nurse*", without time limit for the publication of scientific papers. Studies were excluded if they were not published in English language, were conducted on animals and were case studies, editorials and letters to the editor. Results: Of the scientific papers retrieved, 14 were included in the systematic review. The prevalence of mobbing in clinical nurses ranged from 4.6% to 86.5%. This large variation is due to the characteristics of the health system of each country. Finally, the results of the studies showed that mobbing reduces the productivity of clinical nurses and the climate of cooperation and solidarity between them, increases anxiety, depression and stress levels, reduces the feeling of satisfaction and safety of the working environment and increases the number of absences from work. Conclusions: Mobbing is a common form of work-related violence experienced by clinical nurses. Hospital administrations are invited to acquire the knowledge to identify this phenomenon in the workplace in order to develop policies to prevent and address it. Mobbing is a common form of work-related violence experienced by clinical nurses. Hospital administrations are called to acquire the knowledge to identify this phenomenon in the workplace in order to develop policies to prevent and address it. [ABSTRACT FROM AUTHOR]

Introduction: The Chronic Obstructive Pulmonary Disease (COPD) can affect patients' quality of life (QOL). Aim: The aim of this systematic review was to investigate the association between exercise and QOL of patients with COPD following a respiratory rehabilitation program in organized centers of respiratory rehabilitation of hospital units. Material and Methods: A systematic review of papers published up until June 2018 was conducted. Search was performed on PubMed with the key-words: "COPD", "Chronic Obstructive Pulmonary Disease", "physical activity", "exercise", "quality of life" and "QOL" as well as on IATROTEK-online with the key-words: "Chronic Obstructive Pulmonary Disease", "COPD", "quality of life" and "exercise". The criteria for inclusion in this review were: the QOL assessment has been done with the Saint George's Respiratory Questionnaire (SGRQ) and the content of the studies concerns the evaluation of the QOL of COPD patients following respiratory rehabilitation programs in organized centers of respiratory rehabilitation of hospital units. Results: Only 9 of the scientific papers retrieved met the criteria for inclusion in this review. The exercise was found to affect the QOL of COPD patients positively. Although, the degree of improvement in both the overall score and the scores of the three subscales of the SGRQ was not the same in all studies but varied significantly depending on the type of exercise and the limitations of each study. Conclusions: The QOL of patients with COPD was improved after the integration of rehabilitation programs that were performed in specialized respiratory centers of hospital units. [ABSTRACT FROM AUTHOR]

Copyright of Rostrum of Asclepius / Vima tou Asklipiou is the property of Technological Educational Institute of Athens and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rostrum of Asclepius / Vima tou Asklipiou is the property of Technological Educational Institute of Athens and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Coronavirus disease 2019 (COVID-19) is a global health and societal emergency respiratory disease that is caused by SARS-CoV-2. A poor understanding of the disease among Healthcare Workers (HCWs) can result in delayed identification and treatment leading to rapid spread of infections. Aim: The investigation of the knowledge, attitude and practices (KAP) of HCWs toward COVID-19. Material and Methods: Search was performed on PubMed for studies published from January 1, 2020 to June 30, 2020 with the key-words: "knowledge", "attitude», "practice", "COVID19", "healthcare workers" and "HCW", which were searched in the title and abstract of the studies. Studies were excluded if they were not published in English language, were conducted on animals and were case studies, editorials, and letters to the editor. Results: Of the scientific papers retrieved, 5 were included in the systematic review. Regarding the rate of knowledge of HCWs toward COVID-19, it ranged from 62.6 % to 89%. The rate of HCWs that had good practices and positive attitudes toward COVID-19 ranged from 74% to 89.7% and from 21% to 88.5%, respectively. The factors that positively affected (increase the rate) in statistically significant level the knowledge, attitudes and practices were the age of 40 years old and more, the higher level of education (possession of Master of Science Degree and/or Doctor of Philosophy), the medical profession and the more years of experience. Conclusions: Continuing professional education is advised among HCWs to improve knowledge of HCWs hence averting negative attitudes and promoting positive preventive and therapeutic practices. [ABSTRACT FROM AUTHOR]

Introduction: Central line-associated bloodstream infections (CLABSIs) are one of the most common nosocomial infections and are associated with increased mortality, prolonged hospitalization and increased healthcare costs. Aim: The aim of the present review was to investigate the impact of central line insertion and maintenance care checklists on CLABSIs in Neonatal Intensive Care Units (NICUs), Pediatric Intensive Care Units (PICUs) and Hematology/Oncology Units. Material and Methods: Search was performed on PubMed with the key-words: "children", "hematology/oncology", "NICU", "PICU", "pediatric intensive care unit", "neonatal intensive care unit", "central line-associated bloodstream infections", "CLABSI","checklists", without time limit for the publication of scientific papers. Studies were excluded if they were not published in English language, were conducted on animals and were case studies, editorials and letters to the editor. Of the 11 studies that were included, 7 referred to NICUs, 2 to PICUs and the remaining 2 to hematology/oncology units. Results: CLABSI rate was reduced in all 11 studies. In NICUs, the highest reduction of CLABSI rate was 92%, in PICUs more than 50% and in hematology/oncology units the reduction was 28% and 64% respectively. Conclusions: Central line insertion and maintenance care checklists reduce CLABSIs, either as an independent intervention or as element of CLABSI bundle. [ABSTRACT FROM AUTHOR]

Copyright of Rostrum of Asclepius / Vima tou Asklipiou is the property of Technological Educational Institute of Athens and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nursing Care & Research / Nosileia kai Ereuna is the property of Greek Nursing Studies Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The Psychiatric Reform aims to provide psychiatric patients' treatment within the community. In that way, patients will succeed in living with a functional ordinary everyday activity. Harsh socio-economic conditions in the era of crisis though pose serious obstacles towards the implementation of this reform. Aim: The current review aims to investigate the literature created in the recent years in order to depict causes and circumstances which downgraded the level of Mental Health services provided in the era of financial crisis. Method: There was conducted literature review through multifaceted search within research studies, review papers and reports published in print and digital form in both Greek and English languages. There were also investigated information sources in Pubmed and there was also analyzed the legal and institutional framework on which the mental health services were based upon. Results: Certain parts of population with low income have lost of 24,2% of their income in years between 2009-2012. A 10% of the most destitute part of population lost a 56,5% of their income. The use of antidepressant medication was increased by 34,8% in years between 2006--2011 and suicidal ideas amongst individuals under treatment were increased from 4,5% in 2009 up to 22,7% in 2011. A 40-50% of inpatients in public institutions derives from public prosecutor's order for involuntary hospitalization which in turn results in asphyxiating conditions within those institutions. Conclusions: The increasing shortage of institutional hospices, the increasing number of involuntary hospitalization, the understaffness along with forced restriction of patients as an immediate and safe solution for treatment, accompanied with inadequate coordination of health and general justice services tend to the restrict altogether the judicial and civil rights of inpatients. The inefficient coverage of basic needs in certain parts of population, (youth unemployed, children and their families) requires a more adequate cooperation between health and social welfare professionals and ministry of justice officers in order to wear off the general feeling that "since we serve in an era of low expectations, then we will have low demands as well". [ABSTRACT FROM AUTHOR]

Copyright of Nosileftiki is the property of Hellenic Nurses' Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nosileftiki is the property of Hellenic Nurses' Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nosileftiki is the property of Hellenic Nurses' Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

INTRODUCTION: Major crises and disasters have a wide range of effects on the physical and mental health of the general population and of rescuers who are exposed to them. However, post traumatic stress disorder (PTSD) is the mental health condition that is most frequently explored by researchers after a disaster. PURPOSE: Purpose of the current systematic review is to investigate whether professional rescuers (firefighters, police officers, emergency medical service workers), consist a high risk group for PTSD after being exposed to catastrophic events. METHODS: A literature systematic review was conducted the period October-December 2015 regarding the exposure of professional responders to crises and disasters. The search was performed on PubMed and Scopus with the use of keywords: first responders, police, firefighters, stress, PTSD, disasters. RESULTS: Only 37 scientific papers explored the prevalence of PTSD in professional rescuers, and met the inclusion criteria in the present review. The prevalence of PTSD among professional rescuers worldwide is estimated to approximate 10% for studies conducted one month to ten years after the catastrophic event. The highest risk is documented among firefighters, followed by ambulance personnel, and police officers, particularly women police officers. PTSD often coexists with other mental health disorders such as depression, anxiety disorders, and drug or alcohol dependency or abuse. The factors which are related to an increased risk for PTSD include gender, direct exposure to major disasters causing multiple losses, the death of a co-worker and personal injury. CONCLUSIONS: Further qualitative and longitudinal studies are warranted, with samples comprising professional rescuers who, by profession, are trained to cope with the effects of disasters, and are repeatedly exposed to traumatic events which affect their mental health being. [ABSTRACT FROM AUTHOR]

Over half a century after the discovery of chlorpromazine and haloperidol, antipsychotic drugs showed a true evolutionary revolution. The knowledge of their adverse effects is of outmost importance as it may contribute to the prevention of unwanted sequelae, to the decrease of the duration and cost of hospitalization, it may improve the quality of life of patients, minimize the problems and maximize the therapeutic gain. Aim: The aim of this review was the presentation of the hematologic side-effects of antipsychotic drugs, and most particularly their frequency and association with the different classes of these drugs, their clinical picture and their pathophysiologic mechanisms. Material-method: This paper is a review of the literature (mainly articles from journals, PubMed, as well as books and monographs) of the period 1978-2012. Key-words used included antipsychotics, hematologic adverse effects, drug-induced adverse effects. Results: Antipsychotic-drug induced hematologic side-effects are not particularly highly prevalent, while many of them are found in case reports. For this reason they have not drawn much of attention. These hematologic dyscrasias may concern all the blood cell series as well as the coagulation mechanism. Excluded from this rule is the case of clozapine-induced agranulocytosis, which demands increased clinical vigilance. In fact, agranulocytosis was the reason why the drug was drawn away from circulation approximately 35 years ago. Conclusions: In any case the appearance of a hematologic disorder in a patient receiving antipsychotic medications should prompt careful evaluation. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Delphi method aims to facilitate the discussion and achieve the judgment in a concrete theme, in order to express experts' team perspectives. AIM: This article aims to discuss basic methodological issues regarding the appropriate application of the Delphi method, for future users. Added objectives include a. The description of the Delphi method and its basic characteristics, b. The reference to the benefits of Delphi and its application to the nursing science. METHODS: A literature review was conducted through the data bases of PubMed, CINAHL, Cochrane and Google scholar with the keywords- delphi, consensus, experts, nursing rounds, data analysis, validity, reliability, guidelines and a combination of these. Papers (general, critical review, research) in Greek and English language in which the Delphi method was applied and methodological issues were discussed. Articles that did not refer to the basic methodological issues that emerge through the application of Delphi, were excluded. RESULTS: According to the literature review, there are no guidelines regarding the way of the selection and the number of the experts that participate. The decision regarding the number of experts is made empirically; and it varies according to the aim of the study, the available time and resources. Before distribution, the questionnaires must be reviewed thoroughly, so that any unclarity would be avoided. A reliable Delphi method consist of at least three rounds, but this is also doubtful. The methods of analysis seem to vary, according to the purpose of the chosen method, the structure of the rounds, the types of the questions and the number of participants. Also, no rules seem to exist regarding when there is consensus between the participants. Delphi method has been criticized by many researchers for the absence of evidence, validity and reliability. CONCLUSIONS: Delphi method is still in a developing stage. Many queries regarding the Delphi methodology remain unresolved. In order to use the method successfully and homogenously, at least in the field of nursing or health in general, the study of method's criteria and characteristics, should be chosen taking into consideration available guidelines. [ABSTRACT FROM AUTHOR]

Introduction: The impact of cancer in the mental realm is an issue of huge interest, which has been studied for decades by health care scientists and psychologists. The review of medical literature reveals that approximately one in two patients with cancer manifest psychiatric disorders due to the illness. In the case of breast cancer, patients often experience anxiety and depression problems involving also their families, either as a side effect of therapeutic approaches that are followed, or as an effect of the disease itself. So, an in-depth analysis and understanding of these problems is extremely important, aiming to tackle them. Aim: The purpose of this article is to analyze the impact of breast cancer in the psychological world of the patient and her family, regarding the generation of feelings of anxiety and depression. Method: A comprehensive search in the bibliographic databases “Medline” and “ScienceDirect” has been conducted, along with a search over HEAL-Link. The keywords used included “breast cancer”, “family” and “psychological implications”. The search referred to articles from 1995 to 2012, whereas purely medical articles on breast cancer were excluded. Results: The paper identified extensive international research on the subject of stress and depression that breast cancer incurs to patients. The psychological morbidity causes are summarized in the cancer itself, as well as in the therapeutic approaches followed by the patient. Its implications lie in the patient and the quality of her mental life, in her family, in the social environment and in the disease itself, exacerbating its effects. Conclusions: There are consequences to both the quality of life of the patient and the disease itself. For this reason, a careful behavior towards the patient is needed, as well as patience on behalf of the patient herself. In addition, there are several internationally proposed ways of therapeutic approach to depression and anxiety that causes the disease. [ABSTRACT FROM AUTHOR]

Scientific evidences are about the results of studies that are conducted in health sciences and are used in everyday clinical practice in combination with clinical experience and patients' values. For this reason, health scientists must rely on the results that come from reliable and valid studies. Today, articles are searched and found relatively easily and immediately via the internet, using the various databases with regards to health sciences. Finding of appropriate evidence in databases requires common sense, knowledge, experience and patience. During the time, adaptation to the databases is increased continuously and literature search becomes easier and leads to more valid results. Successful search and recovery of the appropriate articles in databases are determined to a large extent from key-words or, differently, from search terms that are used by the investigators. Substantially, the key-words are those that determine the validity of recovery of appropriate articles. Moreover, it is very important to determine with clarity the research question that is to be investigated. The most important databases via the internet with regards to health sciences are the following: PubMed, Embase, Cochrane Collaboration, CINAHL, ISI Web of Knowledge, PsycINFO, Scopus, ProQuest Dissertations and Theses, COS Conference Papers Index, Scirus, ClinicalTrials.gov and IATROTEK. [ABSTRACT FROM AUTHOR]

Behavioral data provide information for the understanding of the epidemic locally. The main course of the spread of HIV differentiates from country to country. The basic characteristics of established HIV surveillance system are the identification/exploration of the subpopulation as well as of the behavior that contribute to the outspread of HIV. The aim of this paper is the presentation of a) prevalence data of HIV infection for the men who have sex with men, sex workers, intravenous drug users, prisoners b) behavioral data relevant with the rate of HIV infection to referential sub populations. Electronic databases, including MEDLINE, PsycINFO, CINAHL, EMBASE, COCHRANE library and AIDSLINE as well as website of the international organizations were searched to identify relevant published articles. We crossed multiple keywords reflecting 2 categories: (1) HIV prevalence among high risk groups (men who have sex with men, sex workers, intravenous drug users, prisoners) and (2) sexual behavior of these groups. The drug and alcohol abuse, the unprotected anal and vaginal intercourse, the multiple sexual partners, the imprisonment, the syringe sharing, the coinfections with others STDs are the main behaviors of the high risk groups. The above in conjunction with some sociodemographic data contribute to the vulnerability in HIV infection of the referential subpopulations. [ABSTRACT FROM AUTHOR]

Copyright of Rostrum of Asclepius / Vima tou Asklipiou is the property of Technological Educational Institute of Athens and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nursing Care & Research / Nosileia kai Ereuna is the property of Greek Nursing Studies Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rostrum of Asclepius / Vima tou Asklipiou is the property of Technological Educational Institute of Athens and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Rostrum of Asclepius / Vima tou Asklipiou is the property of Technological Educational Institute of Athens and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)