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Nurse leaders are dependent on establishing and maintaining highly functional productive council structures to guide and ensure that our patients', staff's, families', and organizational needs are met. When critical decisions need to be made that may involve multiple departments, nurses working in silos can be counterproductive and delay critical decisions. In academic health systems, the risks for working in isolation are even greater due to the systems' complex nature. The purpose of this paper is to demonstrate how one academic medical center in an academic health system developed a highly effective organized structured approach to an executive nursing council. [ABSTRACT FROM AUTHOR]

There is a growing incidence of heat-related illnesses due to rising global temperatures. Heat-related illnesses range from mild to severe, with heat stroke being the most critical. The wet bulb global temperature index considers humidity and solar intensity; its use is recommended to estimate heat stress on an individual and mitigate risk. Efficient cooling methods, such as cold water immersion, are essential in severe cases. Prevention is through hydration, appropriate clothing, recognition of high risk medications, and awareness of environmental conditions. Recognizing heat-related illnesses early in the clinical course and implementing rapid cooling strategies reduces morbidity and mortality.

Amorphous calcium carbonate (ACC) occurs as a precursor to geological and biogenic calcium carbonate (CaCO3), yet its transformation pathways and reaction mechanisms remain inconsistent and controversial. In this study, we investigated the transformation of ACC to calcite under both solution and dry conditions, in the presence and absence of impurity ions, utilizing operando time-resolved synchrotron X-ray diffraction (TRXRD) and reactive transport modeling. Results demonstrate that TRXRD techniques allow us to differentiate dissolution-reprecipitation versus solid-state transformation mechanisms for amorphous to crystalline phase transitions. Specifically, we observe that in environments with abundant water, ACC transforms to calcite through a dissolution-reprecipitation mechanism. This features an activation energy of 63 ± 2 kJ/mol and unit cell volume contraction during calcite crystal growth. Conversely, under water-limited conditions, ACC to calcite transformation proceeds via a solid-state transformation mechanism, with an activation energy of 210 ± 2 kJ/mol, three times greater than the dissolution-reprecipitation route, and a unit cell expansion during crystalline calcite growth. To illustrate the magnitude of these effects, the rates of calcite growth were similar during dissolution-reprecipitation at 3 °C [0.00207(35) s–1] and solid-state transformation at 280 °C [0.00134(11) s–1]. Moreover, the incorporation of an impurity, strontium, significantly retards the rate of calcite growth while expanding its unit cell but whose incorporation is history dependent. Reactive transport modeling of the dissolution–precipitation kinetics suggests that ACC must be dissolving as compact aggregates. These various transformation mechanisms drive diverse geological and biological carbonate formations, impacting their use as paleoenvironmental markers and functional materials synthesis.

The lecture discussed whether an European Union (‘EU’) Member State’s national court’s refusal to recognize and/or enforce a valid claim in the form of a final intra-EU arbitration award on the basis of the Court of Justice of the EU’s (CJEU’s) decision in Slowakische Republik v. Achmea BV and its progeny may infringe the right to the peaceful enjoyment of possessions, guaranteed by Article 1 of Protocol No. 1 of the European Convention Human Rights (ECHR). It sets out the legal analysis that the European Court of Human Rights might apply in assessing that issue, and the interaction between EU Member States’ obligations under the ECHR, EU law and the Convention on the Settlement of Investment Disputes between states and Nationals of Other States.

The lecture discussed whether an European Union (‘EU’) Member State’s national court’s refusal to recognize and/or enforce a valid claim in the form of a final intra-EU arbitration award on the basis of the Court of Justice of the EU’s (CJEU’s) decision in Slowakische Republik v. Achmea BV and its progeny may infringe the right to the peaceful enjoyment of possessions, guaranteed by Article 1 of Protocol No. 1 of the European Convention Human Rights (ECHR). It sets out the legal analysis that the European Court of Human Rights might apply in assessing that issue, and the interaction between EU Member States’ obligations under the ECHR, EU law and the Convention on the Settlement of Investment Disputes between states and Nationals of Other States.

Uranyl sulfates are important constituents of uranium ores and represent a significant fraction of U(VI) minerals discovered in recent years owing to their propensity to form in mine tailings and legacy sites related to uranium exploration. Recently, we surveyed all published Raman spectra for uranium minerals and found significantly less easily accessible data available for uranyl sulfates relative to other groups of uranium minerals (Spano et al. 2023). In that work, we described average spectra for groups of uranyl minerals to understand common vibrational spectroscopic features attributable to similarities in oxyanion chemistry among U(VI) minerals, but only data for three uranyl sulfate minerals were included in the study. The present work reports on Raman spectra collected for 18 additional uranyl sulfate minerals. To better understand underlying structural and chemical features that give rise to spectroscopic observables, we relate differences in structural topology, charge-balancing cations, and locality of origin to features observed in the Raman spectra of selected natural uranyl sulfates.

Le Collège national des enseignants de cancérologie (CNEC) a été créé en septembre 1986. Il a pour missions de développer l’enseignement de la cancérologie, de promouvoir les actions pédagogiques de la discipline, de participer à l’élaboration du contenu des enseignements et de la définition des cursus et du contrôle des connaissances pour la formation des étudiants en médecine et des spécialistes, d’élaborer et valider des documents pédagogiques relatifs aux enseignements ci-dessus, d’assurer la représentation de l’enseignement de l’oncologie auprès du Conseil National Universitaire (CNU) et des autorités administratives, d’assurer et coordonner les relations avec les autres disciplines universitaires, les sociétés savantes, les groupes professionnels nationaux, européens et internationaux, et de contribuer au développement de la recherche dans la discipline. Le bureau actuel a été élu en septembre 2022 pour trois ans.

The relationship between symmetry-breaking charge separation (SB-CS) and null aggregate (NA) formation in molecular dimer complexes is investigated theoretically, with applications mainly to dimers based on PDI chromophores. Both processes derive from null points, which are defined by degeneracies in either the upper or lower adiabatic exciton bands. The Hamiltonian contains intermolecular coupling derived from the interacting molecular transition dipole moments (Coulomb coupling), which gives rise to Frenkel excitons, as well as the coupling between the Frenkel excitons and charge-transfer (CT) excitons, driven by the electron (te) and hole (th) hopping integrals. A recipe for efficient SB-CS is presented, which, beyond the Weller condition─which holds that the solvent-stabilized CT state should appear below the optical gap -includes two additional conditions: the presence of a null point and, just as important, lopsided electron and hole transfer integrals, |te| ≫ |th| or |th| ≫ |te|. When such conditions are met, the developing charge asymmetry is optimized in response to small fluctuations in the polar solvent-induced electric field, which eventually leads to the solvent-stabilized charge-separated state. It is shown that SB-CS can also occur in H-dimers with significant cofacial overlap, consistent with the observations made by several groups.

The powder bed fusion of metals using a laser beam enables the additive manufacturing of topology-optimized parts involving structural transitions and rapid cross-sectional changes. Both geometry features can cause shrink lines, which reduce the dimensional accuracy and the fatigue resistance of the manufactured part. To provide reduction measures, their point of origin needs to be located in advance. This work presents an algorithm capable of automatically predicting the shrink line location for arbitrary discretized geometries. The results demonstrate the reliable detection and layer-wise characterization of the shrink-line-causing geometry features. Suitable discretization parameters were derived and the dependence of the computational time on the part complexity was quantified.

This study provides the first experimental polarized intermolecular and intramolecular optical absorption components of field-induced polarons in regioregular poly(3-hexylthiophene-2,5-diyl), rr-P3HT, a polymer semiconductor. Highly aligned rr-P3HT thin films were prepared by a high temperature shear-alignment process that orients polymer backbones along the shearing direction. rr-P3HT in-plane molecular orientation was measured by electron diffraction, and out-of-plane orientation was measured through series of synchrotron X-ray scattering techniques. Then, with molecular orientation quantified, polarized charge modulation spectroscopy was used to probe mid-IR polaron absorption in the ω= 0.075 − 0.75 eV range and unambiguously assign intermolecular and intramolecular optical absorption components of hole polarons in rr-P3HT. This data represents the first experimental quantification of these polarized components and allowed long-standing theoretical predictions to be compared to experimental results. The experimental data is discrepant with predictions of polaron absorption based on an adiabatic framework that works under the Born–Oppenheimer approximation, but the data is entirely consistent with a more recent nonadiabatic treatment of absorption based on a modified Holstein Hamiltonian. This nonadiabatic treatment was used to show that both intermolecular and intramolecular polaron coherence break down at length scales significantly smaller than estimated structural coherence in either direction. This strongly suggests that polaron delocalization is fundamentally limited by energetic disorder in rr-P3HT.

Structural characterization is crucial to understanding protein function. Compared with X-ray diffraction methods, electron crystallography can be performed on nanometer-sized crystals and can provide additional information from the resulting Coulomb potential map. Whereas electron crystallography has successfully resolved three-dimensional structures of vitrified protein crystals, its widespread use as a structural biology tool has been limited. One main reason is the fragility of such crystals. Protein crystals can be easily damaged by mechanical stress, change in temperature, or buffer conditions as well as by electron irradiation. This work demonstrates a methodology to preserve these nanocrystals in their natural environment at room temperature for electron diffraction experiments as an alternative to existing cryogenic techniques. Lysozyme crystals in their crystallization solution are hermetically sealed viagraphene-coated grids, and their radiation damage is minimized by employing a low-dose data collection strategy in combination with a hybrid-pixel direct electron detector. Diffraction patterns with reflections of up to 3 Å are obtained and successfully indexed using a template-matching algorithm. These results demonstrate the feasibility of in situprotein electron diffraction. The method described will also be applicable to structural studies of hydrated nanocrystals important in many research and technological developments.

Identification of radioactive materials is a critical goal of resource exploration, basic actinide science, and nuclear forensics, and we provide here new insights toward rapid, nondestructive analysis of uranium-containing minerals and technogenic phases. Raman and infrared spectroscopic data are powerful indicators of solid-phase U(VI) coordination chemistry. In addition, U(VI) minerals exhibit high chemical and structural diversity as artifacts of geochemical processes leading to ore formation. Spectral signals of axial UO22+U−Oyl$\mathrm{UO}_{2}^{2+}\left(\mathrm{U}-\mathrm{O}_{\mathrm{yl}}\right)$bond lengths and the influences of additional oxyanions on these values are well documented for uranium oxide and oxysalt minerals and technogenic phases. Additional insight regarding the underlying crystallographic structure and chemical composition of uranium materials can be extracted through a survey of all available Raman spectroscopic data for these phases. To this end, we have developed the Compendium of Uranium Raman and Infrared Experimental Spectra (CURIES). CURIES was compiled via a thorough review of literature and databases, and for mineral species that lack measured and recorded spectra, data were obtained either from museum and academic collections or by direct syntheses. Characteristic Raman spectroscopic features for subgroups of uranyl minerals within CURIES were elucidated using multivariate statistical analyses. In addition, average spectra for groups of uranyl minerals were determined, providing insight into common spectroscopic characteristics that are indicative of the structural origins from which they arise. As of publication, 275 mineral species and technogenic phases have been entered in CURIES, and of these, 83 phases have published spectra that have been included in the CURIES database. Data collection is ongoing, and we have triaged missing data sets to assess CURIES for completion and to identify mineral groups that lack representation and should therefore be prioritized for data acquisition and inclusion in the database.

Kingdon’s Multiple Streams Approach (MSA) and Jones and Baumgartner’s Punctuated Equilibrium Theory (PET) are public policy frameworks that have existed for many years. Given their long-term popularity, it is important for readers to have a strong working knowledge on how said frameworks function, and be able to compare and contrast them. It has also been put forth that PET only serves as an updated version of MSA, but this paper argues that said assertion is inaccurate, as PET is a useful framework in its own right. By inspecting this paper, readers will learn about MSA, PET, how they are similar and different, how they can be operationalized or used in real life circumstances, how they have been tested, and it is ultimately concluded that PET is not just a reworking of MSA.

Avec plus de 60 000 nouveaux cas de cancer du sein en France métropolitaine en 2023 et 8 % de l'ensemble des décès par cancer tous sexes confondus, le cancer du sein se situe au 1errang des cancers chez la femme par l'incidence et la mortalité. Si le nombre de nouveaux cas a presque doublé en 30 ans, le pourcentage de patientes, tout stade confondu, en vie à cinq ans (87 %) et dix ans (76 %), témoigne des progrès majeurs réalisés en termes de dépistage, caractérisation et traitements. Toutefois, ces progrès aussi rapides soient-ils, nécessitent d’être évalués et intégrés dans une stratégie globale, tenant compte les caractéristiques de la maladie (stade et biologie), mais également de celles des patients pris en charge. Tels sont les objectifs des recommandations pour la pratique clinique (RPC) de St Paul de Vence. Nous rapportons ici le résumé des votes, des discussions et des conclusions des RPC de Saint-Paul-de-Vence 2022-2023.

ABSTRACTEuropean systems have long had rules in place to secure pluralism in media ownership and to ensure that audiences are exposed to diverse content. The role of those regulations has come under increased scrutiny in recent years, as a result of political polarisation and access to international media sources. In NIT Srl v Republic of Moldova (2022), the Grand Chamber of the European Court of Human Rights considered the compatibility of rules requiring political impartiality and neutrality in broadcast media coverage with Article 10. In its decision, the Court considered the balance to be struck between two important components of media freedom: pluralism in media content and editorial freedom. Drawing on the decision in NIT, and making a comparison with the decision of the EU General Court in RT v Council of the European Union, this article examines the evolving Article 10 jurisprudence and the role of the ECHR in promoting media pluralism.

The compositions of sweat and blood are related. Therefore, sweat is an ideal noninvasive test body fluid that could replace blood for linear detection of many biomarkers, especially blood glucose. However, access to sweat samples remains limited to physical exercise, thermal stimulation, or electrical stimulation. Despite intensive research, a continuous, innocuous, and stable method for sweat stimulation and detection has not yet been developed. In this study, a nanomaterial for a sweat-stimulating gel based on the transdermal drug delivery system is presented, which transports acetylcholine chloride into the receptors of sweat glands to achieve the function of biological stimulation of skin sweating. The nanomaterial was applied to a suitable integrated sweat glucose detection device for noninvasive blood glucose monitoring. The total amount of evaporated sweat enabled by the nanomaterial is up to 35 μL·cm–2for 24 h, and the device detects up to 17.65 μM glucose under optimal conditions, showing stable performance regardless of the user’s activity level. In addition, the in vivo test was performed and compared with several studies and products, which showed excellent detection performance and osmotic relationship. The nanomaterial and associated integrated device represent a significant advance in continuous passive sweat stimulation and noninvasive sweat glucose measurement for point-of-care applications.

Institutional and Chaos Theory are frameworks in organizational behavior that have existed for many years. Given their long-term popularity in said field, it is important to have a strong working knowledge of each theory and be able to compare and contrast them. Both theories are wholly applicable to current world happenings, such as the COVID-19 pandemic and the Black Lives Matter movement. By inspecting this paper, readers will learn about Institutional and Chaos Theory, be able to identify how they relate to timely world occurrences, discover their implications in regard to public policy and public administrations, and reflect upon how they can be useful in respect to other organizational and global matters.

Multipolaron complexes in p-doped poly(3-hexylthiophene) films are investigated theoretically for polaron-anion configurations in which stationary dopant anions are positioned on both sides of the polymer chain, within the lamellar region. Complexes as large as tetrapolarons, consisting of four anions and an equal number of mobile holes, are considered. It is found that the mid-IR absorption band (P1) red-shifts and the hole ionization potential decreases as the complex grows in size, from a single polaron to a tetrapolaron. Such behavior is shown to arise mainly from enhanced hole delocalization due to hole–hole repulsion and has important implications for charge transport in organic materials.

Reducing treatment burden is a priority for people with cystic fibrosis, whose health has benefited from using new modulators that substantially increase CFTR protein function. The SIMPLIFY study aimed to assess the effects of discontinuing nebulised hypertonic saline or dornase alfa in individuals using the CFTR modulator elexacaftor plus tezacaftor plus ivacaftor (ETI).

In the last fifteen years, scholars have challenged the neoclassical definition of the market. The debate is not closed. The plurality of definitions suggests a need for an understanding of the different approaches that are emerging, and their degrees of development. The research method is based on a series of bibliometric analyses; mainly, the co-occurrence network of keywords and the development of a thematic map. The paper provides three conceptual contributions. First, it provides evidence of an intensification in the conversation on the understanding of the market. Second, it elicits five clusters: performance, marketing systems, market shaping, institutions and market practices. Finally, adopting Sawyer’s (Social emergence: societies as complex systems, Cambridge University Press, 2005) social emergence model, it suggests a positioning of the clusters within the five ontological levels of emergence.

Finchite (IMA2017-052), Sr(UO2)2(V2O8)·5H2O, is the first uranium mineral known to contain essential Sr. The new mineral occurs as yellow-green blades up to ~10 μm in length in surface outcrops of the calcrete-type uranium deposit at Sulfur Springs Draw, Martin County, Texas, U.S.A. Crystals of finchite were subsequently discovered underground in the Pandora mine, La Sal, San Juan County, Utah, U.S.A., as diamond-shaped golden-yellow crystals reaching up to 1 mm. The crystal structure of finchite from both localities was determined using single-crystal X‑ray diffraction and is orthorhombic, Pcan,with a= 10.363(6) Å, b= 8.498(5) Å, c= 16.250(9) Å, V= 1431.0(13) Å3, Z= 4 (R1= 0.0555) from Sulfur Springs Draw; and a= 10.3898(16), b= 8.5326(14), c= 16.3765(3) Å, V= 1451.8(4) Å3, Z= 4 (R1= 0.0600) from the Pandora mine. Electron-probe microanalysis provided the empirical formula (Sr0.88K0.17Ca0.10Mg0.07Al0.03Fe0.02)Σ1.20(UO2)2(V2.08O8)·5H2O for crystals from Sulfur Springs Draw, and (Sr0.50Ca0.28Ba0.22K0.05)Σ0.94(U0.99O2)2(V2.01O8)·5H2O for crystals from the Pandora mine, based on 17 O atoms per formula unit. The structure of finchite contains uranyl vanadate sheets based upon the francevillite topology. Finchite is a possible immobilization species for both uranium and the dangerous radionuclide 90Sr because of the relative insolubility of uranyl vanadate minerals in water.

La thrombose associée au cancer est une complication fréquente résultant de divers mécanismes vasculaires liés au cancer, au traitement antitumoral et au patient, et qui est associée à un mauvais pronostic. L’anticoagulation recommandée, en prévention ou en traitement curatif, repose essentiellement sur les héparines de bas poids moléculaire (HBPM) ou les anticoagulants oraux directs. L’enjeu de la thromboprophylaxie, pour laquelle les HBPM sont privilégiées en raison d’un moindre risque hémorragique notamment en cas de tumeur digestive endoluminale ou urothéliale en place, demeure l’identification des patients à risque. La question majeure concernant la prise en charge des thromboses avérées est le choix de l’anticoagulant. Du fait de la simplicité de leur administration, les anticoagulants oraux directs apparaissent comme attractifs, et les études randomisées les ayant évalués ont montré leur efficacité. Cependant, ces études sont limitées par le profil des patients inclus qui ne sont pas toujours représentatifs des situations en vraie vie, notamment concernant les cancers à risque hémorragique et certains traitements antitumoraux, inhibiteurs de tyrosine kinase notamment, qui peuvent interagir avec les anticoagulants oraux directs et en modifier potentiellement la biodisponibilité. Les recommandations disponibles soulignent ces précautions et renvoient in fineà des décisions au cas par cas. Cet article a pour but de guider l’oncologue dans son choix d’anticoagulation à travers une série de réponses documentées et pragmatiques aux questions qui se posent face à un patient pris en charge pour une tumeur solide et potentiellement à risque de thrombose ou avec une thrombose établie.

Clean pump oil is critical to the performance and longevity of oil-sealed vacuum pumps. Cold traps charged with cryogens can protect pump oil from solvent contamination but are subject to operator error. Notably, cold traps with evaporated or warmed cryogens do not protect the vacuum pump. Here, we report an open source device to automatically protect oil-sealed vacuum pumps from cold trap warming and facilitate the daily maintenance of cold traps.

In this brief, we propose a FPGA implementation of a novel Variable Fractional Delay (VFD) filter architecture for digital wideband (hundred of MHz or more) beamforming applications. The proposed architecture is based on a multirate structure that allows reaching high performance in terms of amplitude and group delay with a significant reduction in design complexity. Usually, the antenna’s beams are modified by introducing precise delays that can be multiples or fractions of the sampling period. The most used structures for realizing this operation are Farrow filters but, for wideband applications, the classical Farrow structure may require a huge amount of resources. A common solution to simplify the Farrow filter architecture is interpolation. However, this solution requires an increase of the clock frequency which is not always possible. In this context, our multirate approach mitigates the limitations in terms of computational complexity avoiding the requirement to increase of the clock frequency, while still exhibiting great performance. A comparison between a reference design based on the proposed approach and the literature is also provided. The experimental results confirm that the proposed architecture, characterized by a computational complexity similar to other works, exhibits better performance without the need to increase the clock frequency.

Alzheimer disease (AD) is the most common cause of dementia, accounting for 50% to 60% of cases and affecting nearly 6 million people in the United States. Definitive diagnosis requires either antemortem brain biopsy or postmortem autopsy. However, clinical neuroimaging has been playing a greater role in the diagnosis and management of AD, and several PET tracers approach the sensitivity of tissue diagnosis in identifying AD pathologic condition. This review will focus on the utility of PET imaging in the setting of cognitive impairment, with an emphasis on its role in the diagnosis of AD.

Monitoring-based preventive medicine relies heavily on minimal or noninvasive, portable, and cost-effective measurement solutions. In this study, we present a handheld multiwavelength fluorescence measurement system for detection of dermally injected fluorescent tracers. The circular detection area of the device is positioned on the sample containing the fluorescent marker. The marker is excited at regular intervals by a pulse of light. The optical output power is controlled by a laser diode driver, which receives direct feedback on the emitted light intensity from the monitor photodiode integrated into the laser diode package. An optical diffuser is located in front of each laser diode to ensure uniform illumination of the measurement area. Pulsed excitation of the fluorescent tracer allows alternate measurement of foreground and background light intensity. By subtracting the background from the foreground and using a switched-input photocurrent measurement technique, the measured photocurrent represents the actual light emission from the marker. The instrument has interchangeable modules that contain the excitation electronics and emission filter. These modules allow the instrument to be configured for a variety of different fluorescent markers. In vitro measurements show that the device is capable of performing fluorescence measurements for its intended use as a point-of-care device in preventive medicine.

Synthetic efforts have delivered a library of organic mixed ionic–electronic conductors (OMIECs) with high performance in electrochemical transistors. The most promising materials are redox-active conjugated polymers with hydrophilic side chains that reach high transconductances in aqueous electrolytes due to volumetric electrochemical charging. Current approaches to improve transconductance and device stability focus mostly on materials chemistry including backbone and side chain design. However, other parameters such as the initial microstructure and microstructural rearrangements during electrochemical charging are equally important and are influenced by backbone and side chain chemistry. In this study, we employ a polymer system to investigate the fundamental electrochemical charging mechanisms of OMIECs. We couple in situelectronic charge transport measurements and spectroelectrochemistry with ex situX-ray scattering electrochemical charging experiments and find that polymer chains planarize during electrochemical charging. Our work shows that the most effective conductivity modulation is related to electrochemical accessibility of well-ordered, interconnected aggregates that host high mobility electronic charge carriers. Electrochemical stress cycling induces microstructural changes, but we find that these aggregates can largely maintain order, providing insights on the structural stability and reversibility of electrochemical charging in these systems. This work shows the importance of material design for creating OMIECs that undergo structural rearrangements to accommodate ions and electronic charge carriers during which percolating networks are formed for efficient electronic charge transport.