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This essay uses an example of a library instruction exercise in which otherwise competent online searching goes wrong as a springboard for reconceptualizing digital literacy as an environmental ethics of information. This reconceptualization is presented as a corrective measure for teachers and students grappling with the uses and misuses of AI tools and search technologies. [ABSTRACT FROM AUTHOR]

Climate change, an urgent public health problem, will increase the morbidity and mortality of older adults. The 2020 report of The Lancet Countdown highlighted that older adults are susceptible to the effects of extreme weather events, including heatwaves. Through the lens of the socio-ecological model, we identified influences on persons at risk for heat-related illnesses. We applied the Heat-related Intolerance Screening Tool (HIST) to a case that demonstrates the impact of physical, social, environmental, and societal factors on older people. The hypothetical case provides a context for ambulatory care nurses to explore innovative ways to screen for heat intolerance to mitigate the risk of heat-related illnesses, such as heat stroke. Our innovation supports the broad utility of the simple HIST by ambulatory care nurses to identify and prevent heat-related illnesses, thereby reducing emergency room visits and hospital admissions. [ABSTRACT FROM AUTHOR]

The reaction of free di-manganese oxide clusters Mn2Ox+ (x = 2-7) with hydrogen in a flow tube reactor results in a strongly cluster size dependent complex formation: Mn2O3+ and Mn2O4+ are most reactive and adsorb up to two H2 molecules, the reactivity is reduced for Mn2O2+/Mn2O5+, and Mn2O6+/Mn2O7+ appear to be non-reactive. Infrared multiple-photon dissociation (IR-MPD) spectra of the complexes Mn2O4H2+ and Mn2O5H2+ reveal one band that shifts upon isotopic labelling of hydrogen, whereas the spectra of Mn2O2H2+ and Mn2O3H2+ do not show any clear spectral shifts upon H2/D2 exchange. Detailed analysis of the IR-MPD spectra in conjunction with density functional theory (DFT) calculations strongly indicate the molecular η2-binding of H2 to one of the Mn atoms. H2 dissociation via hydroxylation of the cluster oxo bridges yielding H-Mn(MH)O(OH)O2+ or Mn2(OH)2O2+ appears to be thermodynamically favourable but kinetically hampered. [ABSTRACT FROM AUTHOR]

The American Academy of Ambulatory Care Nursing (AAACN) recognizes a paradigm shift represented by the volume of health care delivery flowing from episodic acute care encounters to long-term relationships. This shift presents opportunities to further recognize and prepare nurse graduates for the complex and expanded role of the ambulatory care registered nurse (RN). This position paper discusses the current state of the RN role in ambulatory care and provides a vision for the future. The paper further identifies challenges, poses possible solutions, and highlights the AAACN position on the role of the ambulatory care RN. [ABSTRACT FROM AUTHOR]

Globalization in Asia and consequent strengthening of healthcare economic factors in tandem with an increasing heart failure (HF) population have enhanced potential for development and progress in the fields of HF medicine and mechanical circulatory support (MCS). In Japan, there are unique opportunities to investigate the outcome of acute and chronic MCS and a national registry for percutaneous and implantable left ventricular assist device (LVAD) including Impella pumps has been established. A Peripheral extracorporeal membrane oxygenation (ECMO) for acute MCS has been used in more than 7000 patients annually and Impella usage in more than 4000 patients over the past 4 years was noted. Recently, a novel centrifugal pump with hydrodynamically levitated impeller was developed and approved for mid‐term extracorporeal circulatory support. In terms of chronic MCS more than 1200 continuous flow LVADs have been implanted during the past decade, and 2‐year survival rate after primary LVAD implantation is 91%. Because of donor organ shortage, more than 70% of heart transplant recipients required LVAD support for more than 3 years and prevention and treatment of complications during long‐term LVAD support have become important. Five important topics including hemocompatibility‐related complications, LVAD infections, aortic valve insufficiency, right ventricular failure and cardiac recovery during LVAD support are discussed in this review for improving clinical outcomes. Findings from Japan will continue to provide useful information regarding MCS for the Asia‐Pacific region and beyond. [ABSTRACT FROM AUTHOR]

Extreme heat contributes to heat-related illnesses resulting from heat intolerance, which is the inability to maintain a thermal balance to tolerate heat stress. In the United States, heat-related mortality for older persons has almost doubled in the past 20 years. Other populations at risk for heat-related illness (HRI) include children, pregnant people, those who work outside, young people participating in outdoor sports, and at-risk populations such as Black, indigenous, and populations of color. The classic heat tolerance test used for decades monitoring physiological responses to repetitive motions is impractical across large and potentially health challenged populations and does not identify environmental or social factors or specific vulnerable populations. To address this issue, we developed a heat-related illness screening tool (HIST) to identify individuals at risk for HRI morbidity and mortality based on their physical, environmental, and social vulnerabilities with an emphasis on populations of concern. The HIST has the potential to be used as routine clinical screening in the same way as other commonly used screening tools. Heat intolerance affects patient outcomes and quality of life; therefore, early screening with a simple, easy-to-administer screening tool such as the HIST can identify people at risk and refer them to services that address heat exposure and/or create safety nets to prevent heat-related illnesses. [ABSTRACT FROM AUTHOR]

Simple Summary: Breast cancer—ductal carcinoma of the breast and invasive ductal carcinoma (IDC)—arises within the confines of the mammary ductal epithelium. Progression to IDC can occur through a pre-invasive, ductal carcinoma in situ stage (DCIS), or in the absence of DCIS. The immune system has recently been identified as a factor in disease progression, highlighting the need for immune-competent mouse models of pre-invasive disease. To model early-stage disease, we tested six distinct murine mammary tumor cell lines injected directly into the mammary ducts of immune-competent mice. We find that all six mouse cell lines bypassed a stable DCIS stage, rapidly progressing to IDC. Similarly, in immune-compromised mice, we observed IDC in the absence of DCIS, suggesting an intact immune system may not play a primary role in early disease progression in these mouse models. These models may be useful for the study of IDC that occur in the absence of DCIS, and in the development of immune therapies. In breast cancer, progression to invasive ductal carcinoma (IDC) involves interactions between immune, myoepithelial, and tumor cells. Development of IDC can proceed through ductal carcinoma in situ (DCIS), a non-obligate, non-invasive stage, or IDC can develop without evidence of DCIS and these cases associate with poorer prognosis. Tractable, immune-competent mouse models are needed to help delineate distinct mechanisms of local tumor cell invasion and prognostic implications. To address these gaps, we delivered murine mammary carcinoma cell lines directly into the main mammary lactiferous duct of immune-competent mice. Using two strains of immune-competent mice (BALB/c, C57BL/6), one immune-compromised (severe combined immunodeficiency; SCID) C57BL/6 strain, and six different murine mammary cancer cell lines (D2.OR, D2A1, 4T1, EMT6, EO771, Py230), we found early loss of ductal myoepithelial cell differentiation markers p63, α-smooth muscle actin, and calponin, and rapid formation of IDC in the absence of DCIS. Rapid IDC formation also occurred in the absence of adaptive immunity. Combined, these studies demonstrate that loss of myoepithelial barrier function does not require an intact immune system, and suggest that these isogenic murine models may prove a useful tool to study IDC in the absence of a non-obligatory DCIS stage—an under-investigated subset of poor prognostic human breast cancer. [ABSTRACT FROM AUTHOR]

CCL2 is an inflammatory cytokine that regulates macrophage activity and is implicated in increased mammographic density and early breast tumorigenesis. The role of CCL2 in mediating stromal interactions that contribute to breast tumorigenesis has yet to be fully elucidated. THP-1-derived macrophages and mammary fibroblasts were co-cultured for 72 h. Fibroblasts and macrophages were analysed for phenotype, expression of inflammatory and ECM-regulatory genes and collagen production. Mice overexpressing CCL2 in the mammary glands were analysed for global gene expression by RNAseq at 12 weeks of age. These mice were cross-bred with PyMT mammary tumour mice to examine the role of CCL2 in tumorigenesis. The co-culture of macrophages with fibroblasts resulted in macrophage polarization towards an M2 phenotype, and upregulated expression of CCL2 and other genes associated with inflammation and ECM remodelling. CCL2 increased the production of insoluble collagen by fibroblasts. A global gene expression analysis of CCL2 overexpressing mice revealed that CCL2 upregulates cancer-associated gene pathways and downregulates fatty acid metabolism gene pathways. In the PyMT mammary tumour model, CCL2 overexpressing mice exhibited increased macrophage infiltration and early tumorigenesis. Interactions between macrophages and fibroblasts regulated by CCL2 can promote an environment that may increase breast cancer risk, leading to enhanced early tumorigenesis. [ABSTRACT FROM AUTHOR]

Review of Cullen, M. A., & Dill, E. (Eds.). (2022). Intersections of open educational resources and information literacy. Association of College and Research Libraries. [ABSTRACT FROM AUTHOR]

Interprofessional teams are useful in providing complex care to patients with substance use disorder. Predictors of treatment outcomes, such as age, socioeconomic status, and social supports, have been studied in addiction treatment. Individual contributions of the office-based addiction treatment nurse in the care of patients with opioid use disorder are not well understood. Through the lens of the Nursing Role Effectiveness Model, nursing interventions related to care coordination and transition management in patients on medication-assisted treatment were examined. Documentation from interprofessional team members was reviewed and collected in REDCap. Linear regression was conducted to identify significant factors in predicting time to stabilization, defined as achieving a third opiate-free toxicology screen. Logistic regression was used to identify significant associations between patient demographics, care team members, and documented interventions. Overall, patients' time to stability on buprenorphine was decreased by approximately five months when a recovery coach was on the nurses' team (p = 0.03) and by seven months when the patient was referred for and received counseling services (p = 0.001). Our results support the role of the nurse in care coordination involves bringing together clinicians, particularly those who can provide counseling, to support recovery efforts. [ABSTRACT FROM AUTHOR]

The bound unoccupied electronic state structure of an Ir(111)/graphene surface covered by differently sized and spaced Ir clusters was investigated by means of two-photon photoemission spectroscopy. The cluster lattice was found to affect the image potential states of the substrate to a surprisingly large extent. This effect can be related to the influence of the cluster lattice on the screening of the image state electron trapped in front of the surface. The symmetric arrangement of Ir clusters considerably reduces the lateral extension of graphene areas with a homogeneous local work function, and from a certain minimum area size, the excitation of an electron to a stable state in a Coulomb-like potential is not possible anymore. Furthermore, lateral confinement effects could be observed due to the decreasing extension of bare graphene areas. [ABSTRACT FROM AUTHOR]

Climate change represents a looming health challenge and a critical area for nursing leadership at all levels of organizations and settings. With a lens on The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity , addressing climate change–related health consequences should be a major focus and spotlight for nurses and nurse leaders with a lens on individuals, communities, populations, and from a national and global perspective. [ABSTRACT FROM AUTHOR]

Denileukin diftitox (ONTAK) is a diphtheria/IL-2R fusion protein able to deplete regulatory T cells in peripheral blood. Regulatory T cells in the local immune microenvironment have been shown to be associated with poor prognosis in ovarian cancer. This study examined whether denileukin diftitox (ONTAK) could be safely administered intraperitoneal in patients with advanced refractory ovarian cancer and assessed its effects on regulatory T cells and tumor associated cytokines in ascites and peripheral blood. A phase I dose escalation study of intraperitoneal denileukin diftitox (ONTAK) enrolled 10 patients with advanced, refractory ovarian carcinoma at 3 doses (5 μg/kg, 15 μg/kg, and 25 μg/kg). Serial CA-125 measurements assessed clinical response. Regulatory T cells were quantified using RT-PCR and cytokine levels measured by Luminex. The maximum tolerated dose was 15 μg/kg with a dose limiting toxicity observed in 1 out of 6 patients in the expansion group. The majority of adverse events were transient grades 1–2. One patient treated at the 25 μg/kg dose experienced cytokine storm with prolonged hospitalization. 3 patients had decreases in CA-125 after treatment but none met criteria for partial response. Treatment with denileukin diftitox (ONTAK) decreased regulatory T cells in peripheral blood and ascites. Treated patients did not show any significant changes in IL-8, TGF-β, sIL2Ra in ascites or peripheral blood. Denileukin diftitox (ONTAK) can be safely administered intraperitoneally to recurrent refractory ovarian cancer patients. Regulatory T cells were reduced in ascites and peripheral blood, but there were no significant changes in cytokine levels. Clinical Trial Registration: ClinicalTrials.gov # NCT00357448 • Ovarian cancer has an immunosuppressive tumor microenvironment that has proven resistant to many immunotherapies. • Denileukin diftitox can be safely given intraperitoneally to treatment refractory ovarian cancer patients. • Intraperitoneal denileukin diftitox reduces regulatory T cells both locally, in ascites, and in the peripheral circulation. • Intraperitoneal immunotherapy is feasible and may decrease immunosuppression in the tumor microenvironment. • The effects of local administration should be considered as novel immunotherapies are developed for ovarian cancer. [ABSTRACT FROM AUTHOR]

The Abiomed Impella 5.5 (Danvers, MA) is a newly developed axial flow transaortic cardiac support device mounted on a 9 Fr steering catheter with a 21 Fr pump cannula. Impella 5.5 is intended for longer use and was approved for 30 days in 2018. This study evaluated the first-in-man series at six high-volume mechanical circulatory support centers in Germany after CE approval. The first 46 consecutive patients worldwide underwent implantation in six German centers between March 2018 and September 2019 for post-CE approval evaluation. The primary end-point was 30 days and 90 days all-cause mortality. The mean age of patients was 59.0 ± 11.5 years , and 43 (93.4%) were men. Half of the patients had acute on chronic heart failure. The main indication for Impella 5.5 implantation was ischemic cardiomyopathy and acute myocardial infarction (47.8%). The mean support time was 15.5 ± 24.2 days (range 0-164, median 10 days (IQR = 7-19)) with a total of 712 patient-days on support. The 30 days and 90 days survival rates were 73.9% (95% CI: 63.3–88.9%) and 71.7% (95% CI: 60.7-87.1%), respectively. Additionally, 16 patients (34.8%) were weaned from the device for native heart recovery, and 19 (41.3%) were bridged to a durable device. Fifteen patients (32.6%) were mobilized to a chair, and 15 (32.6%) were ambulatory. We only noted one stroke and found no other thromboembolic complications. No aortic valve damage was observed in the study cohort. Finally, seven patients (15.2 %) had pump thrombosis, and nine (19.6 %) underwent device exchange. Sixteen patients (34.8 %) suffered from bleeding requiring transfusions during the whole treatment course. In ten patients (21.7%), the inflow cannula dislocated into the aortic root. The first version of the Impella 5.5 presents promising early outcomes for patients with acute heart failure and expands the spectrum of available devices. The adverse event profile is favorable for short-term devices. Dislocations have been addressed by design changes. With increasing experience with this device, our study suggests that the indications for use will expand to other cardiac shock etiologies and may improve myocardial recovery and survival in patients with cardiogenic shock. [ABSTRACT FROM AUTHOR]

The article presents a mixed-methods study which assessed the perceptions of interprofessional staff members at respiratory illness clinics (RIC) of the Massachusetts General Hospital on the daily management and operational effectiveness of clinical leads (CL) during the COVID-19 pandemic. Topics include the use of RICs to screen, test and treat COVID-related illnesses and provide general medical care, and the credentials for Clinical Nurse Leader.

The article discusses the experience of the Massachusetts General Hospital in establishing respiratory illness clinics (RIC) and creating clinical nurse leaders (CNL) to effectively manage mild-to-moderate suspected coronavirus disease of 2019 (COVID-19) patients. Topics include the appointment of a nurse director to oversee and deploy CNL team at the RICs and the duties of the CNLs like ensuring adherence to infection control measures.

An intriguing relationship between menstrual cycle phase at the time of breast cancer surgery and clinical outcomes was first proposed in the late 1980s. Despite a number of clinical studies conducted to address this, as well as meta-analyses and systematic reviews, there remains significant controversy surrounding the effect of menstrual cycle phase at time of surgery on the prognosis of premenopausal breast cancer. While some studies have suggested that surgery performed during the luteal phase results in the most favourable outcome, other studies report the follicular phase is more favourable, and others show no association. Given the conflicting results, there remains insufficient evidence to determine whether there is an optimal time of the month to perform surgery. This issue has dogged breast cancer surgery for decades; knowledge of an optimal time of the month to conduct surgery would be a simple approach to improving patient outcomes. This review explores the potential biological mechanisms through which the hormonal milieu might contribute to differences in prognosis, and why clinical findings are so variable. It is concluded that a significant problem with current clinical research is the lack of insight from mechanistic studies. While there are a number of plausible biological mechanisms that could lead to altered survival, supporting evidence is limited. There are also variable approaches to defining the menstrual cycle phase and hormone receptor status of the tumour and few studies controlled for prognostic factors such as tumour size and stage, or addressed the impact of adjuvant treatments. Elucidation of the specific confounding factors, as well as biological mechanistic pathways that could explain the potential relationship between timing of surgery and survival, will greatly assist in designing robust well-controlled prospective clinical studies to evaluate this paradigm. [ABSTRACT FROM AUTHOR]

This study used the regulatory focus/fit framework to compare the impact of text message wording on college students' drinking behaviors. In this 2 × 3 × 2 pre-test/post-test experiment, participants (N = 279) were randomly assigned to one of the three groups: messages matching regulatory focus (congruent group), messages mismatching regulatory focus (incongruent group), and general health messages (control group). Messages were tailored by regulatory fit (prevention-oriented or promotion-oriented). Mixed factorial analyses of covariance revealed that prevention-oriented individuals who received text messages incongruent with their regulatory focus reported drinking alcohol for more hours and were more likely to consume a higher quantity of drinks than participants in the congruent or control group. These findings suggest that health messages mismatched to a receiver's regulatory focus might exacerbate unhealthy behavior. [ABSTRACT FROM AUTHOR]

Background: Right heart failure (RHF) after left ventricular assist device (LVAD) implantation is common and associated with worse outcome. Prediction of RHF remains challenging. Our study aims to assess predictors of RHF focusing on clinical manifestations.Methods: We retrospectively analyzed clinical, echocardiographic and hemodynamic parameters of 112 patients undergoing LVAD implantation. Pre-operative, early (ERHF, day 7 and 14) and late postoperative RHF (LRHF, after 1, 3, 6 and 12 months) were assessed.Results: In the total study population (87.5% men, mean age 55 years), early RHF was frequent (47% on day 7 and 30% on day 14). Prevalence of late RHF and death from RHF was high after 3, 6 and 12 months (23, 24 and 17%). Pre-existing RHF was only associated with early RHF and persistent, but not for new onset late RHF. Early RHF was associated with lower INTERMACS level (p < 0.001), higher pulmonary vascular resistance (p = 0.046) and CVP/PAWP quotient (p = 0.011), higher bilirubin (p = 0.038) and creatinine (p = 0.013). LRHF was associated with creatinine (p = 0.006), urea (p = 0.012) and load adaption index (p = 0.007). Binary logistic regression models identified no single risk factors. Comparing the predictive value of regression models with a model of three clinical findings (INTERMACS level, age and pre-operative RHF) did not reveal differences in RHF.Conclusions: RHF before LVAD implantation enhances the risk of early RHF and persistent late RHF, but not for new onset late RHF, supporting the hypothesis of differences in the etiology. Echocardiographic or hemodynamic parameters did not show a predictive value for new onset late RHF. Similar predictive value of clinical findings and statistic models of risk factors suggest that a clinical evaluation is equally matched to predict RHF. [ABSTRACT FROM AUTHOR]

The reactions of the small gas-phase gold cluster cations Au3+ and Au5+ with N2, H2, and O2 as well as mixtures thereof were investigated in an octopole ion trap under multicollision conditions. While gold cations are inert toward molecular oxygen, a distinct reaction time and temperature dependent reaction behavior was observed toward H2 and N2. Introducing mixtures of the reactive gases to the ion trap revealed both, competitive and cooperative coadsorption effects: (i) A competitive displacement reaction was detected for the coadsorption of H2 and N2 indicating the molecular adsorption of these molecules onto the gold clusters. The enthalpy of the displacement reaction determined from equilibrium mass spectra was found to be small (<10 kJ/mol). (ii) Preadsorption of N2 enabled the cooperative coadsorption of O2 under special experimental conditions (low temperature and very small amounts of N2). In this surprising cooperative reaction even AuxO2y+ were formed via elimination of the initially activating nitrogen molecules, whereas such complexes were never detected in reactions of gold cluster cations with pure molecular oxygen. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide Open in new tab Download slide OBJECTIVES Peripheral venoarterial extracorporeal life support (ECLS) for the treatment of cardiogenic shock has shown to improve survival but is associated with complications. However, if the patient cannot be weaned from ECLS, their therapy options are limited. Although durable left ventricular assist device implantation might be an option in such cases, an unclear neurological outcome is often a contraindication. We hypothesize that Impella 5.0 therapy provides sufficient circulatory support while avoiding ECLS-related complications, thereby allowing for an adequate evaluation of a patient's neurological state and facilitating further treatment options. METHODS We retrospectively reviewed data from 22 ECLS patients (mean age 56.5 ± 10.7 years) with an unclear neurological status who underwent Impella 5.0 implantation between January 2016 and July 2018 in our institution. Neurological status was evaluated on a daily basis using the cerebral performance category score and the modified Rankin scale. RESULTS Sixteen patients (72.7%) were resuscitated before ECLS implantation and 13 patients (59.1%) had acute myocardial infarction. The mean duration on ECLS before Impella 5.0 implantation was 9.3 ± 1.7 days. All patients were successfully weaned from ECLS by Impella 5.0 implantation via the axillary artery. The mean duration on Impella 5.0 was 16.3 ± 4.7 days. In surviving patients, both quantitative measurements of cerebral performance improved after 30 days compared to the baseline (P  < 0.01). Six patients (27.3%) were bridged to a durable left ventricular assist device. In 9 patients (40.9%), myocardial function recovered during Impella 5.0 support and the device was successfully explanted. The 30-day survival rate was 68.2%. CONCLUSIONS Impella 5.0 support provides a bridge-to-decision option for patients following ECLS implantation and leads to left ventricular unloading. It allows further evaluation of a patient's neurological situation and facilitates further therapy. About two-thirds of patients survived with acceptable neurological outcomes. [ABSTRACT FROM AUTHOR]

Infrared multiple photon dissociation (IR-MPD) spectroscopy in conjunction with density functional theory (DFT) calculations has been employed to study the activation of molecular oxygen and ethylene co-adsorbed on a free gold dimer cation Au2+. Both studied complexes, Au2O2(C2H4)+ and Au2O2(C2H4)2+, show distinct features of both intact O2 and ethylene co-adsorbed on the cluster. However, the ethylene C=C double bond is activated, increasing in length by up to 0.07 Å compared with the free molecule, and the red shift of the O–O vibration frequency increases with the number of adsorbed ethylene molecules, indicating a small but increasing activation of the O–O bond. The small O2 activation and the rather weak interaction between O2 and C2H4 are also reflected in the calculated electronic structure of the co-adsorption complexes which shows only a small occupation of the empty anti-bonding O2 2π*2p orbital as well as the localization of most of the Kohn–Sham orbitals on O2 and C2H4, respectively, with only limited mixing between O2 and C2H4 orbitals. The results are compared with theoretical studies on neutral AuxO2(C2H4) (x = 3, 5, 7, 9) complexes. [ABSTRACT FROM AUTHOR]

Investigates the formation of positively charged antimony oxide clusters as a function of oxygen partial pressure using time of flight mass spectroscopy. Results of ab initio geometry optimizations; Cluster structures by ab initio quantum chemistry calculations; Neutral clusters; Cations.

The oxidation of carbon monoxide with nitrous oxide on mass-selected Au3+ and Ag3+ clusters has been investigated under multicollision conditions in an octopole ion trap experiment. The comparative study reveals that for both gold and silver cations carbon dioxide is formed on the clusters. However, whereas in the case of Au3+ the cluster itself acts as reactive species that facilitates the formation of CO2 from N2O and CO, for silver the oxidized clusters Ag3Ox+ (n = 1-3) are identified as active in the CO oxidation reaction. Thus, in the case of the silver cluster cations N2O is dissociated and one oxygen atom is suggested to directly react with CO, whereas a second kind of oxygen strongly bound to silver is acting as a substrate for the reaction. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • Free gold clusters Au x + (x = 2–4) mediate the activation of ethane C–H bonds and reduce the activation barrier for C–H bond dissociation. • The C–H bond activation is caused by the mixing of the ethane CH 3 bond-forming orbitals π−(CH 3) with gold d-orbitals. • Au 2 + mediates the selective dissociation of one C–H bond resulting in aethyl group and a bridge-bonded H atom. • The reaction is exothermic and kinetically feasible at room temperature. Abstract The activation and potential dissociation of ethane mediated by small cationic gold clusters Au x + (x = 2–4) has been explored by infrared multiple photon dissociation (IR-MPD) spectroscopy and density functional theory (DFT) calculations. The calculations show that the interaction between the gold clusters and ethane is mainly governed by the mixing of the ethane CH 3 bond-forming orbitals π−(CH 3) with gold d-orbitals. While the C C single bond appears to be unaffected, this mixing leads to the selective activation of up to two ethane C–H bonds and a reduction of the activation barrier for C–H bond dissociation to up to 0.82 eV, making the reaction kinetically feasible at room temperature. In agreement with this, experimental IR-MPD spectra of the complexes Au 2 (C 2 H 6) 2 + and Au 2 (C 2 D 6) 2 + show strong indications for the co-existence of two isomeric structures, one representing the encounter complex and one where a single ethane C–H bond is dissociated resulting in a complex which contains an ethyl group and a bridge-bonded H atom along with a second, adsorbed C 2 H 6 molecule. A similar C–H bond dissociation mechanism is theoretically predicted for the Au 3 (C 2 H 6) y + (y = 2,3) and Au 4 (C 2 H 6) y + (y = 2,3) complexes, albeit thermodynamically less favorable. IR-MPD spectra of Au 3 (C 2 H 6) y + (y = 2,3) and Au 4 (C 2 H 6) y + (y = 2,3) confirm the encounter product to be the dominant one, although the co-existence of isomers containing ethyl groups cannot be excluded. Various pathways for C–H bond activation are theoretically explored and the ethane activation mechanism is compared to the gold mediated activation of methane and ethylene. [ABSTRACT FROM AUTHOR]

We tested whether cheap and quick chlorophyll (Chl) fluorescence can be used in ecophysiological field studies as proxies for gas-exchange measurements. We measured net photosynthetic rate at saturating irradiance and ambient atmospheric CO2 concentrations (PNsat), maximum carboxylation rate (Vcmax), maximum quantum yield of PSII (Fv/Fm), the performance index (PIabs), leaf nitrogen (Narea), and carbon isotope discrimination (Δ13C) within four herbaceous species along two elevational gradients. We analysed the relationship between Chl fluorescence and gas-exchange parameters and their link to indirect assessment of plant performance via ecophysiological traits. Fv/Fm showed no relationship to PNsat and only weak relationships to Vcmax. PIabs was positively related to PNsat and Vcmax. PIabs, PNsat, and Vcmax were positively associated with Narea and negatively to Δ13C, whereas Fv/Fm showed no relationship to Narea and a positive to Δ13C. Thus, PIabs might be suitable to characterize the photosynthetic activity when aiming on large numbers of samples. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • Free Mn x O x + (x = 3, 4) clusters mediate the decomposition of acetic acid molecules. • Decarboxylation of acetic acid to CO 2 in competition with the dehydration to ketene (in the case of Mn 3 O 3 +) are observed. • Major reaction channel, however, consisted in the deprotonation of the acetic acid. • Implications and perspectives for the selective catalytic ketene synthesis are discussed. Abstract The decomposition of acetic acid upon reaction with the free mass-selected manganese oxide clusters Mn 3 O 3 + and Mn 4 O 4 + was studied in an octopole ion trap under well-defined reaction conditions. Three distinct reaction channels have been identified: (1) the decarboxylation of acetic acid to CO 2 , (2) in the case of Mn 3 O 3 + the dehydration of acetic acid to ketene in competition with the decarboxylation, and (3) the deprotonation of the acid. The latter was found to represent the major reaction channel for both investigated cluster ions. The observation of the manganese oxide cluster mediated decomposition of acetic acid represents an important first step for future investigations aiming at the development of new materials for the selective catalytic ketene production. [ABSTRACT FROM AUTHOR]

Background Despite the increasing use of ventricular assist devices (VADs), gender differences in indications, hemodynamics, and outcome are not well understood. We examined gender differences and gender-specific predictors for perioperative outcome in patients on ventricular support. Methods Multicenter data of 966 patients (median age 55 years, 151 women) from the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) were analyzed. Median follow-up was 1.26 years. Results At the time of VAD implantation, women were more often in an unstable condition (Interagency Registry for Mechanically Assisted Circulatory Support [INTERMACS] profile 1 and 2) (51.7% vs 41.6% in men), experiencing significantly more often major bleeding ( p = 0.0012), arrhythmias ( p = 0.022), and right ventricular (RV) failure ( p < 0.001) with need for additional RV support. The survival of women on isolated LVAD support was significantly worse (1-year survival 75.5% vs 83.2% in men). Age-adjusted Cox regression analyses showed significant associations with mortality for preoperative inotropic therapy, percutaneous mechanical support, INTERMACS profile 1 and 2, RV dysfunction, major bleeding, cerebral bleeding, ischemic stroke, and RV failure. In women, pump thrombosis was more strongly related with mortality compared to men, while the direction of the association of renal dysfunction with mortality was different for women and men ( p -value interaction 0.028 and 0.023, respectively). Conclusions Women and men differ in perioperative hemodynamics, adverse events, and mortality after VAD implantation. A gender-dependent association of pump thrombosis with mortality was seen. The impact on treatment practice needs to be shown. [ABSTRACT FROM AUTHOR]

The femtosecond-laser induced photodissociation of CH 3 Br adsorbed at sub-monolayer coverage on a solid surface was investigated by time-resolved pump-probe mass spectrometry. To tune the interaction of the CH 3 Br molecules with the substrate, an Mo(1 0 0) surface was covered with ultrathin insulating MgO layers of variable thickness. By gradually decreasing the magnesia layer thickness to the 2D limit the photodissociation dynamics observed by detection of the methyl fragment indicates an energetic lowering of the relevant methyl bromide excited states due to the increasing spatial proximity of the metallic support. Potential orientational effects of the methyl bromide adsorption geometry are also considered. [ABSTRACT FROM AUTHOR]

Methane represents the major constituent of natural gas. It is primarily used only as a source of energy by means of combustion, but could also serve as an abundant hydrocarbon feedstock for high quality chemicals. One of the major challenges in catalysis research nowadays is therefore the development of materials that selectively cleave one of the four C−H bonds of methane and thus make it amenable for further chemical conversion into valuable compounds. By employing infrared spectroscopy and first-principles calculations it is uncovered herein that the interaction of methane with small gold cluster cations leads to selective C−H bond dissociation and the formation of hydrido methyl complexes, H-Au x+-CH3. The distinctive selectivity offered by these gold clusters originates from a fine interplay between the closed-shell nature of the d states and relativistic effects in gold. Such fine balance in fundamental interactions could prove to be a tunable feature in the rational design of a catalyst. [ABSTRACT FROM AUTHOR]

Methane represents the major constituent of natural gas. It is primarily used only as a source of energy by means of combustion, but could also serve as an abundant hydrocarbon feedstock for high quality chemicals. One of the major challenges in catalysis research nowadays is therefore the development of materials that selectively cleave one of the four C−H bonds of methane and thus make it amenable for further chemical conversion into valuable compounds. By employing infrared spectroscopy and first-principles calculations it is uncovered herein that the interaction of methane with small gold cluster cations leads to selective C−H bond dissociation and the formation of hydrido methyl complexes, H-Au x+-CH3. The distinctive selectivity offered by these gold clusters originates from a fine interplay between the closed-shell nature of the d states and relativistic effects in gold. Such fine balance in fundamental interactions could prove to be a tunable feature in the rational design of a catalyst. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purpose of this study was to examine relationships between leaders_ perceived influence over professional practice environments (PPEs) and clinical nurses_ reported engagement in essential professional nursing practice. BACKGROUND: There is little empirical evidence identifying impact of nurse leader influence or why nursing leaders are not perceived, nor do they perceive themselves, as influential in healthcare decision making. METHODS: A nonexperimental method of prediction was used to examine relationships between engagement in professional practice, measured by Essentials of Magnetism II (EOMII) tool, and nurse leaders" perceived influence, measured by Leadership Influence over Professional Practice Environment Scale (LIPPES). A convenience sample of 30 nurse leaders and 169 clinical nurses, employed in a 247-bed acute care MagnetA hospital, participated. RESULTS: Findings indicated that leaders perceived their influence presence from Boften[ to Balways,[ with mean scores of 3.02 to 3.70 on a 4-point Likert scale, with the lowest subscale as Baccess to resources[ for which a significant relationship was found with clinical nurses_ reported presence of adequate staffing (P G.004). Clinical nurses reported more positive perceptions in adequacy of staffing on the EOMII when nurse leaders perceived themselves to be more influential, as measured by the LIPPES, in collegial administrative approach (P = .014), authority (P = .001), access to resources (P = .004), and leadership expectations of staff (P = .039). Relationships were seen in the outcome measure of the EOMII scale, nurse-assessed quality of patient care (NAQC), where nurse leaders_ perception of their authority (P = .003) and access to resources (P = .022) positively impacted and was predictive of NAQC. CONCLUSIONS: Findings support assertion that nurse leaders are integral in enhancing PPEs and their influence links structures necessary for an environment that supports outcomes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Infections are major complications in patients with ventricular assist devices (VAD). Positron emission tomography with deoxyglucose marked by fluorine-18 (18F-FDG PET/CT) is a diagnostic tool to scan for tissue with high metabolism as present in infections. The specificity of 18F-FDG PET/CT to discriminate between infection and an aseptic reaction of the implanted device is not defined and its evaluation is the aim of this retrospective analysis. METHODS: Until September 2015 a total of 100 patients underwent VAD implantations in our institution. Twenty-one patients (mean age 53.7 ± 14.3 years) had 29 PET-CT examinations for a suspected infection. All radiology reports were compared to clinical and intraoperative parameters. Infections were reported according to the guidelines of the International Society of Heart and Lung Transplantation. Followup was 222 days (range 107-484 days) after PET-CT scans and was complete in all patients. RESULTS: In 7 patients PET-CT scan ruled out any VAD associated infection. Sixteen patients had a VAD specific infection. Two patients had false negative PET-CT scan results. The sensitivity of VAD-specific infections was 87.5%, the specificity 100%, the positive predictive value was 100% and the negative predictive value 86.7%. Seven patients had more than one PET-CT scans at different time points. CONCLUSIONS: PET-CT scan findings showed a high specificity and positive predictive value for VAD-specific infections. Therefore, it may have the potential to guide the clinician in handling patients with infectious complications after VAD implantation. [ABSTRACT FROM AUTHOR]

As the biological activation and oxidation of water takes place at an inorganic cluster of the stoichiometry CaMn4O5, manganese oxide is one of the materials of choice in the quest for versatile, earth-abundant water splitting catalysts. To probe basic concepts and aid the design of artificial water-splitting molecular catalysts, a hierarchical modeling strategy was employed that explores clusters of increasing complexity, starting from the tetramanganese oxide cluster Mn4O4+ as a molecular model system for catalyzed water activation. First-principles calculations in conjunction with IR spectroscopy provide fundamental insight into the interaction of water with Mn4O4+, one water molecule at a time. All of the investigated complexes Mn4O4(H2O)n+ (n = 1-7) contain deprotonated water with a maximum of four dissociatively bound water molecules, and they exhibit structural fluxionality upon water adsorption, inducing dimensional and structural transformations of the cluster core. [ABSTRACT FROM AUTHOR]

As the biological activation and oxidation of water takes place at an inorganic cluster of the stoichiometry CaMn4O5, manganese oxide is one of the materials of choice in the quest for versatile, earth-abundant water splitting catalysts. To probe basic concepts and aid the design of artificial water-splitting molecular catalysts, a hierarchical modeling strategy was employed that explores clusters of increasing complexity, starting from the tetramanganese oxide cluster Mn4O4+ as a molecular model system for catalyzed water activation. First-principles calculations in conjunction with IR spectroscopy provide fundamental insight into the interaction of water with Mn4O4+, one water molecule at a time. All of the investigated complexes Mn4O4(H2O)n+ (n=1-7) contain deprotonated water with a maximum of four dissociatively bound water molecules, and they exhibit structural fluxionality upon water adsorption, inducing dimensional and structural transformations of the cluster core. [ABSTRACT FROM AUTHOR]

Free iron-sulfur cluster cations are generated by the sputtering of targets which are composed of a mixture of iron and sulfur powder and the produced cluster distributions are analyzed with a quadrupole mass spectrometer. As the iron powder is prone to the facile oxidation by air, a significant amount of oxygen in the targets is observed. Consequently, the determination of the exact cluster composition is impeded by the almost identical mass of S and O 2 . Therefore, a series of targets with different material compositions have been investigated to assist the stoichiometric assignment of the produced cluster cations and to gain insight into the influence of oxygen on the production of iron-sulfur clusters. The generation of iron-chalcogenide clusters Fe x O y S z + ( x = 2–4) is studied as a function of target composition and compared with the cluster generation by sputtering the mineral pyrite. [ABSTRACT FROM AUTHOR]

We know little about older adults' use of online and offline health information sources for medical decision making despite increasing numbers of older adults who report using the Internet for health information to aid in patient–provider communication and medical decision making. Therefore we investigated older adult users and nonusers of online and offline sources of health information and factors related to medical decision making. Survey research was conducted using random digit dialing of Florida residents' landline telephones. The Decision Self-Efficacy Scale and the Reliance Scale were used to measure relationships between users and nonusers of online health information. Study respondents were 225 older adults (age range = 50−92 years,M = 68.9,SD = 10.4), which included users (n = 105) and nonusers (n = 119) of online health information. Users and nonusers differed in frequency and types of health sources sought. Users of online health information preferred a self-reliant approach and nonusers of online health information preferred a physician-reliant approach to involvement in medical decisions on the Reliance Scale. This study found significant differences between older adult users and nonusers of online and offline sources of health information and examined factors related to online health information engagement for medical decision making. [ABSTRACT FROM PUBLISHER]

We know little about older adults' use of online and offline health information sources for medical decision making despite increasing numbers of older adults who report using the Internet for health information to aid in patient-provider communication and medical decision making. Therefore we investigated older adult users and nonusers of online and offline sources of health information and factors related to medical decision making. Survey research was conducted using random digit dialing of Florida residents' landline telephones. The Decision Self-Efficacy Scale and the Reliance Scale were used to measure relationships between users and nonusers of online health information. Study respondents were 225 older adults (age range = 50-92 years, M = 68.9, SD = 10.4), which included users (n = 105) and nonusers (n = 119) of online health information. Users and nonusers differed in frequency and types of health sources sought. Users of online health information preferred a self-reliant approach and nonusers of online health information preferred a physician-reliant approach to involvement in medical decisions on the Reliance Scale. This study found significant differences between older adult users and nonusers of online and offline sources of health information and examined factors related to online health information engagement for medical decision making. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Isolated right ventricular (RV) dysfunction with preserved left ventricular function is difficult to treat and associated with high mortality. Temporary devices for right ventricular support [right ventricular assist device (RVAD)] are available and have been used for short-term right heart assistance. In some patients, RV function does not recover and long-term devices are needed. Recently, isolated RVAD implantation with a permanent HeartWare HeartWare ventricular assist device (HVAD) device has been reported in patients with acute RV infarction and chronic graft failure. However, isolated implantation on the right side remains rare and is still an off-label use for this pump. To gather European data, we queried the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) database, in which procedures and outcome data for patients receiving mechanical circulatory support are registered. METHODS: Until May 2014, data of 8 patients (mean age 55.0 ± 17.3 years, 100% males) with an isolated HVAD for RV support were submitted to the EUROMACS registry. All patients were in INTERMACS classes 1-3. Device strategy was rescue therapy in 6 patients (75.0%) and destination therapy in 2 patients (25.0%). Indications for RVAD placement were acute myocardial infarction in 4 (50.0%), failure to wean from cardiopulmonary bypass in 2 (25.0%) and post-cardiotomy RV failure in another 2 patients (25.0%). Intra- and postoperative results of the EUROMACS registry were analysed. RESULTS: Inflow cannulas were implanted into the right atrium (RA) in 6 patients (75.0%) and into the RV in 2 patients (25.0%). CPB was used in 6 patients (75.0%). Four patients (50.0%) survived the first 30 days. During follow-up, 1 patient died after 44 days due to multiorgan failure. In the surviving three patients, 2 patients were transplanted after 29 and 419 days, respectively, and, in 1 patient, the device was explanted for pump thrombosis and recovered RV function. CONCLUSION: In this very specific and sick patient cohort within the EUROMACS registry, isolated permanent RVAD implantation is a novel and promising strategy for patients with isolated right heart failure. However, more experience is needed to identify patients who benefit from this technology. [ABSTRACT FROM AUTHOR]

Background and Aim: In the United States, the fast food companies McDonald’s and Burger King participate in marketing self-regulation programs that aim to limit emphasis on premiums and promote emphasis of healthy food choices. We determine what children recall from fast food television advertisements aired by these companies. Methods: One hundred children aged 3–7 years were shown McDonald’s and Burger King children’s (MDC & BKC) and adult (MDA & BKA) meal ads, randomly drawn from ads that aired on national US television from 2010–11. Immediately after seeing the ad, children were asked to recall what they had seen and transcripts evaluated for descriptors of food, healthy food (apples or milk), and premiums/tie-ins. Results: Premiums/tie-ins were common in children’s but rarely appeared in adult ads, and all children’s ads contained images of healthy foods (apples and milk). Participants were significantly less likely to recall any food after viewing the children’s vs. the adult ad (MDC 32% [95% confidence interval 23, 41] vs. MDA 68% [59, 77]) p <0.001; BKC 46% [39, 56] vs. BKA 67% [58, 76] respectively, p = 0.002). For children’s ads alone and for both restaurants, recall frequency for all food was not significantly different from premium/tie-ins, and participants were significantly more likely to recall other food items than apples or milk. Moreover, premiums/tie-ins were recalled much more frequently than healthy food (MDC 45% [35, 55] vs. 9% [3, 15] p<0.001; BKC 54% [44, 64] vs. 2% [0, 5] respectively, p<0.001). Conclusions: Children’s net impressions of television fast food advertising indicate that industry self-regulation failed to achieve a de-emphasis on toy premiums and tie-ins and did not adequately communicate healthy menu choices. The methods devised for this study could be used to monitor and better regulate advertising patterns of practice. [ABSTRACT FROM AUTHOR]

Individualised medical strategy (IMS) seeks therapeutic success in the following three dimensions: (1) biology, (2) sociology, and (3) psychology. IMS addresses these dimensions of success (1) as efficiency by achieving biological goals such as medication that normalizes blood pressure or surgery that completely eradicates cancer; (2) as effectiveness by achieving social goals such as satisfying guidelines, patients' purposes, and ethical demands; and (3) as motivation by achieving psychological goals such emotional support and identification of patients with therapy. IMS designs patients as principals of care, with utility-driven action style, physicians as agents of medical rationality with duty-driven action style, and strategy as primer for cooperation between patients and physicians. Dialog is central to maximize success through (1) informing patients about their pathologic conditions, options, and risks of treatment, (2) negotiating patients' needs, and (3) motivating patients to support therapy. IMS understands therapy as open-ended process where one-sided views of what is to be considered as "best medicine" is not appropriate, and where physicians integrate normative and emotional dimensions of patients into therapy. In conclusion, we suggest IMS as a highly useful concept of medical action, where physicians integrate patients' individual utilities, ethical principles, and emotions to maximize therapeutic success. [ABSTRACT FROM AUTHOR]

Rutheniumcluster Run+ (n=2 – 6) in der Gasphase werden als Modellsysteme verwendet, um den Ursprung der außergewöhnlichen Eigenschaften trägerfixierter subnanometergroßer Rutheniumpartikel bei der katalytischen CO ‐ Methanisierung mit Bezug zur Wasserstoff ‐ Prozessgasreinigung für hochentwickelte Brennstoffzellenanwendungen aufzudecken. Mithilfe von Ionenfallen ‐ Massenspektrometrie und Ab ‐ initio ‐ Dichtfunktionalrechnungen werden folgende Eigenschaften dieser Cluster ausgemacht, die die Selektivität und katalytische Aktivität bestimmen: hohe Reaktivität gegenüber CO bei gleichzeitiger Inertheit gegenüber CO2; Förderung der kooperativ verstärkten H2 ‐ Koadsorption und ‐ Dissozation auf den zuvor gebildeten Rutheniumcarbonylclustern (d. h., es findet keine CO ‐ Vergiftung statt); die Gegenwart von Ru ‐ Atomplätzen mit einer niedrigen Zahl von Metall ‐ Metall ‐ Bindungen, die besonders aktiv für die H2 ‐ Koadsorption und ‐ Aktivierung sind. Weiterhin liefern Rechnungen mechanistische Einblicke in die CO ‐ Methanisierung und decken einen Reaktionsweg auf, der die Bildung einer Formyl ‐ artigen Zwischenstufe umfasst. Sei selektiv! Effiziente CO ‐ Methanisierungskatalysatoren für die Brennstoffzellen ‐ Prozessgasreinigung müssen selektiv CO umsetzen und dabei CO2 unangetastet lassen. Unter Verwendung freier Cluster als Modelle werden mechanistische Einblicke erhalten, die helfen, die Wirkungsweise trägerfixierter Ru ‐ Katalysatoren bei dieser Reaktion zu verstehen und zu verbessern (siehe Bild; grün Ru, grau C, weiß H, rot O). [ABSTRACT FROM AUTHOR]

Gas-phase ruthenium clusters Ru n+ ( n=2-6) are employed as model systems to discover the origin of the outstanding performance of supported sub-nanometer ruthenium particles in the catalytic CO methanation reaction with relevance to the hydrogen feed-gas purification for advanced fuel-cell applications. Using ion-trap mass spectrometry in conjunction with first-principles density functional theory calculations three fundamental properties of these clusters are identified which determine the selectivity and catalytic activity: high reactivity toward CO in contrast to inertness in the reaction with CO2; promotion of cooperatively enhanced H2 coadsorption and dissociation on pre-formed ruthenium carbonyl clusters, that is, no CO poisoning occurs; and the presence of Ru-atom sites with a low number of metal-metal bonds, which are particularly active for H2 coadsorption and activation. Furthermore, comprehensive theoretical investigations provide mechanistic insight into the CO methanation reaction and discover a reaction route involving the formation of a formyl-type intermediate. [ABSTRACT FROM AUTHOR]