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Novel iron-based shape memory alloys could be candidates for large-scale structural applications if their grains grew large and long enough. Here, the authors add titanium to an Fe–Mn–Al–Ni shape-memory alloy to promote large grains via compositional tuning of abnormal grain growth.

Background: The Second Victim Phenomenon (SVP) significantly impacts the well-being of healthcare professionals and patient safety. While the SVP has been explored in various healthcare settings, there are limited data on its prevalence and associated factors among nurses in Austria. This study investigates the prevalence, symptomatology, and preferred support measures for SVP among Austrian nurses. Methods: A nationwide, cross-sectional, anonymous online survey was conducted September to December 2023 using the SeViD questionnaire (Second Victims in German-speaking Countries), which includes the Big Five Inventory-10 (BFI-10). Statistical analyses included binary logistic regression and multiple linear regression using the bias-corrected and accelerated (BCa) bootstrapping method based on 5000 bootstrap samples. Results: A total of 928 participants responded to the questionnaire with a response rate of 15.47%. The participants were on average 42.42 years old and were mainly women (79.63%). Among the respondents, 81.58% (744/912) identified as Second Victims (SVs). The primary cause of becoming an SV was aggressive behavior from patients or relatives. Females reported a higher symptom load than males, and higher agreeableness was linked to increased symptom severity. Notably, 92.47% of SVs who sought help preferred support from colleagues, and the most pronounced desire among participants was to process the event for better understanding. Conclusions: The prevalence of SVP among Austrian nurses is alarmingly high, with aggressive behavior identified as a significant trigger. The findings emphasize the necessity for tailored support strategies, including peer support and systematic organizational interventions to mitigate the impact of SVP on nurses and to improve overall patient care. Further research should focus on developing and implementing effective prevention and intervention programs for healthcare professionals in similar settings.

Background: In the field of research, psychological safety has been widely recognized as a contributing factor to improving the quality of care and patient safety. However, its consideration in the curricula and traineeship pathways of residents and health care students is scarce., Objective: This study aims to determine the extent to which health care trainees acquire psychological safety competencies during their internships in clinical settings and identify what measures can be taken to promote their learning., Methods: A mixed methods observational study based on a consensus conference and an open-ended survey among a sample of health care trainee mentors from health care institutions in a pan-European context was conducted. First, we administered an ad hoc questionnaire to assess the perceived degree of acquisition or implementation and significance of competencies (knowledge, attitudes, and skills) and institutional interventions in psychological safety. Second, we asked mentors to propose measures to foster among trainees those competencies that, in the first phase of the study, obtained an average acquisition score of <3.4 (scale of 1-5). A content analysis of the information collected was carried out, and the spontaneity of each category and theme was determined., Results: In total, 173 mentors from 11 pan-European countries completed the first questionnaire (response rate: 173/256, 67.6%), of which 63 (36.4%) participated in the second consultation. The competencies with the lowest acquisition level were related to warning a professional that their behavior posed a risk to the patient, managing their possible bad reaction, and offering support to a colleague who becomes a second victim. The mentors' proposals for improvement of this competency gap referred to training in communication skills and patient safety, safety culture, work climate, individual attitudes, a reference person for trainees, formal incorporation into the curricula of health care degrees and specialization pathways, specific systems and mechanisms to give trainees a voice, institutional risk management, regulations, guidelines and standards, supervision, and resources to support trainees. In terms of teaching methodology, the mentors recommended innovative strategies, many of them based on technological tools or solutions, including videos, seminars, lectures, workshops, simulation learning or role-playing with or without professional actors, case studies, videos with practical demonstrations or model situations, panel discussions, clinical sessions for joint analysis of patient safety incidents, and debriefings to set and discuss lessons learned., Conclusions: This study sought to promote psychological safety competencies as a formal part of the training of future health care professionals, facilitating the translation of international guidelines into practice and clinical settings in the pan-European context., (©Irene Carrillo, Ivana Skoumalová, Ireen Bruus, Victoria Klemm, Sofia Guerra-Paiva, Bojana Knežević, Augustina Jankauskiene, Dragana Jocic, Susanna Tella, Sandra C Buttigieg, Einav Srulovici, Andrea Madarasová Gecková, Kaja Põlluste, Reinhard Strametz, Paulo Sousa, Marina Odalovic, José Joaquín Mira. Originally published in JMIR Medical Education (https://mededu.jmir.org), 07.10.2024.)

Introduction: Second-victim phenomena may lead to severe reactions like depression or posttraumatic disorder, as well as dysfunction and absenteeism. Medical error as a cause for second victims is not limited to professionals, as family caregivers care for millions of patients at home. It remains unclear whether these are first, second, or double victims in case of error. This explorative study investigated whether second victim effects and signs of moral injury are detectable in family caregivers and whether existing instruments are applicable in lay persons., Methods: In an open convenience sampling online survey, we recruited 66 German family caregivers. Propensity score matching was conducted to obtain a balanced sample of family caregivers and qualified nurses who took part in the previous study by adjusting for age and sex. The groups were compared regarding the German Version of the Second Victim Experience and Support Tool-Revised and the German version of the Moral Injury Symptom and Support Scale for Health Professionals., Results: Sixty-six caregivers participated, of whom 31 completed the survey. Of all, 58% experienced a second victim-like effect, 35% experienced a prolonged effect, and 45% reported to still suffer from it. In a matched sample (22 family caregivers and 22 nurses), no significant differences were observed between the groups., Discussion: Regarding the limitations of this pilot study, demanding for resampling in larger populations, we could show that second victim effects and moral injury are detectable in family caregivers by validated instruments and are not inferior to professionals' experiences. Concerning the demand for further studies, we confirmed the applicability of the testing instruments but with need for item reduction to lower response burden., Competing Interests: The authors disclose no conflict of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Health care workers (HCWs) are often impacted by distressing situations during patient care and can experience the second victim phenomenon (SVP). Addressing an adequate response, training, and increasing awareness of the SVP can increase HCWs' well-being and ultimately improve the quality of care and patient safety., Objective: This study aims to describe and evaluate a multimodal training organized by the European Researchers' Network Working on Second Victims to increase knowledge and overall awareness of SVP and second victim programs., Methods: We implemented a multimodal training program, following an iterative approach based on a continuous quality improvement process, to enhance the methodology and materials of the training program over the duration of 2 years. We conducted web-based surveys and group interviews to evaluate the scope and design of the training, self-directed learning materials, and face-to-face activities., Results: Out of 42 accepted candidates, 38 (90%) participants attended the 2 editions of the Training School program. In the second edition, the level of participants' satisfaction increased, particularly when adjusting the allocated time for the case studies' discussion (P<.001). After the multimodal training, participants stated that they had a better awareness and understanding of the SVP, support interventions, and its impact on health care. The main strengths of this Training School were the interdisciplinary approach as well as the contact with multiple cultures, the diversity of learning materials, and the commitment of the trainers and organizing team., Conclusions: This multimodal training is suitable for different stakeholders of the health care community, including HCWs, clinical managers, patient safety and quality-of-care teams, academicians, researchers, and postgraduate students, regardless of their prior experience with SVP. Furthermore, this study represents a pioneering effort in elucidating the materials and methodology essential for extending this training approach to similar contexts., (©Sofia Guerra-Paiva, José Joaquín Mira, Reinhard Strametz, Joana Fernandes, Victoria Klemm, Andrea Madarasova Geckova, Bojana Knezevic, Eva Potura, Sandra Buttigieg, Irene Carrillo, Paulo Sousa. Originally published in JMIR Formative Research (https://formative.jmir.org), 30.08.2024.)

This study investigates the humoral and cellular immune responses and health-related quality of life measures in individuals with mild to moderate long COVID (LC) compared to age and gender matched recovered COVID-19 controls (MC) over 24 months. LC participants show elevated nucleocapsid IgG levels at 3 months, and higher neutralizing capacity up to 8 months post-infection. Increased spike-specific and nucleocapsid-specific CD4 + T cells, PD-1, and TIM-3 expression on CD4 + and CD8 + T cells were observed at 3 and 8 months, but these differences do not persist at 24 months. Some LC participants had detectable IFN-γ and IFN-β, that was attributed to reinfection and antigen re-exposure. Single-cell RNA sequencing at the 24 month timepoint shows similar immune cell proportions and reconstitution of naïve T and B cell subsets in LC and MC. No significant differences in exhaustion scores or antigen-specific T cell clones are observed. These findings suggest resolution of immune activation in LC and return to comparable immune responses between LC and MC over time. Improvement in self-reported health-related quality of life at 24 months was also evident in the majority of LC (62%). PTX3, CRP levels and platelet count are associated with improvements in health-related quality of life., (© 2024. The Author(s).)

Background: The second victim phenomenon and moral injury are acknowledged entities of psychological harm for healthcare providers. Both pose risks to patients, healthcare workers, and medical institutions, leading to further adverse events, economic burden, and dysfunctionality. Preceding studies in Germany and Austria showed a prevalence of second victim phenomena exceeding 53 percent among physicians, nurses, emergency physicians, and pediatricians. Using two German instruments for assessing moral injury and second victim phenomena, this study aimed to evaluate their feasibility for general practitioners and healthcare assistants., Methods: We conducted a nationwide anonymous online survey in Germany among general practitioners and healthcare assistants utilizing the SeViD (Second Victims in Deutschland) questionnaire, the German version of the Second Victim Experience and Support Tool Revised Version (G-SVESTR), and the German version of the Moral Injury Symptom and Support Scale for Health Professionals (G-MISS-HP)., Results: Out of 108 participants, 67 completed the survey. In G-SVESTR, the collegial support items exhibited lower internal consistency than in prior studies, while all other scales showed good-quality properties. Personality traits, especially neuroticism, negatively correlated to age, seem to play a significant role in symptom count and warrant further evaluation. Multiple linear regression indicated that neuroticism, agreeableness, G-SVESTR, and G-MISS-HP were significant predictors of symptom count. Furthermore, moral injury partially mediated the relationship between second victim experience and symptom count., Discussion: The results demonstrate the feasible use of the questionnaires, except for collegial support. With respect to selection bias and the cross-sectional design of the study, moral injury may be subsequent to the second victim phenomenon, strongly influencing symptom count in retrospect. This aspect should be thoroughly evaluated in future studies.

Adverse events can occur at any time during medical treatment of patients. These adverse events not only negatively impact patients but also the medical personnel involved. The impairment of medical personnel after an adverse event is known as the second victim phenomenon (SVP). Although the concept of second victims is relatively unknown, the chances to become a second victim during the course of one's professional carrier are high. Effective measures to support second victims are peer support programs within medical institutions, which also benefit economically from the implementation of these programs. Supporting second victims is also beneficial to future patients and finally healthcare systems as a whole., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

(1) Background: The second victim phenomenon (SVP) plays a critical role in workplace and patient safety. So far, there are limited epidemiological data on the SVP in German-speaking countries. Some studies have been carried out in Germany, but so far, no quantitative studies have been carried out in Austria examining the prevalence, symptom load and preferred support measures for second victims (SVs). This study therefore examines the SVP among Austrian pediatricians. (2) Methods: A nationwide, cross-sectional and anonymous online study was conducted using the SeViD questionnaire (Second Victims in Deutschland) including the Big Five Inventory-10 (BFI-10). Statistical analysis included binary-logistic and multiple linear regression with the bootstrapping, bias-corrected and accelerated (BCa) method based on 1000 bootstrap samples. (3) Results: Of 414 Austrian pediatricians, 89% self-identified as SVs. The main cause of becoming an SV was the unexpected death or suicide of a patient. High neuroticism and extraversion values as well as working in outpatient care positively correlated with having experienced the SVP. A preferred support strategy was access to legal counseling. (4) Conclusions: Austrian pediatricians have the highest SVP prevalence measured with the SeViD questionnaire. Further research should focus on prevention strategies and intervention programs.

For over two decades, nanomaterials have been employed to facilitate intracellular delivery of small interfering RNA (siRNA), both in vitro and in vivo, to induce post-transcriptional gene silencing (PTGS) via RNA interference. Besides PTGS, siRNAs are also capable of transcriptional gene silencing (TGS) or epigenetic silencing, which targets the gene promoter in the nucleus and prevents transcription via repressive epigenetic modifications. However, silencing efficiency is hampered by poor intracellular and nuclear delivery. Here, polyarginine-terminated multilayered particles are reported as a versatile system for the delivery of TGS-inducing siRNA to potently suppress virus transcription in HIV-infected cells. siRNA is complexed with multilayered particles formed by layer-by-layer assembly of poly(styrenesulfonate) and poly(arginine) and incubated with HIV-infected cell types, including primary cells. Using deconvolution microscopy, uptake of fluorescently labeled siRNA is observed in the nuclei of HIV-1 infected cells. Viral RNA and protein are measured to confirm functional virus silencing from siRNA delivered using particles 16 days post-treatment. This work extends conventional particle-enabled PTGS siRNA delivery to the TGS pathway and paves the way for future studies on particle-delivered siRNA for efficient TGS of various diseases and infections, including HIV.

Introduction: The reliable and accurate detection of rare circulating tumor cells (CTCs) from cancer patient blood samples promises advantages in both research and clinical applications. Numerous CTC detection methods have been explored that rely on either the physical properties of CTCs such as density, size, charge, and/or their antigen expression profiles. Multiple factors can influence CTC recovery including blood processing method and time to processing. This study aimed to examine the accuracy and sensitivity of an enrichment-free method of isolating leukocytes (AccuCyte ® system) followed by immunofluorescence staining and high-resolution imaging (CyteFinder ® instrument) to detect CTCs., Method: Healthy human blood samples, spiked with cancer cells from cancer cell lines, as well as blood samples obtained from 4 subjects diagnosed with cancer (2 pancreatic, 1 thyroid, and 1 small cell lung) were processed using the AccuCyte-CyteFinder system to assess recovery rate, accuracy, and reliability over a range of processing times., Results: The AccuCyte-CyteFinder system was highly accurate (95.0%) at identifying cancer cells in spiked-in samples (in 7.5 mL of blood), even at low spiked-in numbers of 5 cells with high sensitivity (90%). The AccuCyte-CyteFinder recovery rate (90.9%) was significantly higher compared to recovery rates obtained by density gradient centrifugation (20.0%) and red blood cell lysis (52.0%). Reliable and comparable recovery was observed in spiked-in samples and in clinical blood samples processed up to 72 hours post-collection. Reviewer analysis of images from spiked-in and clinical samples resulted in high concordance (R-squared value of 0.998 and 0.984 respectively)., Discussion: The AccuCyte-CyteFinder system is as an accurate, sensitive, and clinically practical method to detect and enumerate cancer cells. This system addresses some of the practical logistical challenges in incorporating CTCs as part of routine clinical care. This could facilitate the clinical use of CTCs in guiding precision, personalized medicine., Competing Interests: Authors AR, LC, RH, BG are employees of RareCyte, Inc. Author JR reports advisory roles in The Gene Technology Technical Advisory Committee, Office of the Gene Technology Regulator, Australian Government. Author JR also reports honoraria, speaker fees or advisory roles for GSK, Takeda, Gilead, Cynata, Pfizer, Spark, Novartis, Celgene, bluebird bio, Shire, Avrobio; stocks in Genea; consultant role for Rarecyte stocks in lieu. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Yeo, Kao, Gupta, Wahlroos, Bastian, Strauss, Klemm, Shrestha, Ramirez, Costandy, Huston, Gardner, Grimison, Clark and Rasko.)

Background: Patient care in the prehospital emergency setting is error-prone. Wu's publications on the second victim syndrome made very clear that medical errors may lead to severe emotional injury on the caregiver's part. So far, little is known about the extent of the problem within the field of prehospital emergency care. Our study aimed at identifying the prevalence of the Second Victim Phenomenon among Emergency Medical Services (EMS) physicians in Germany., Methods: Web-based distribution of the SeViD questionnaire among n = 12.000 members of the German Prehospital Emergency Physician Association (BAND) to assess general experience, symptoms and support strategies associated with the Second Victim Phenomenon., Results: In total, 401 participants fully completed the survey, 69.1% were male and the majority (91.2%) were board-certified in prehospital emergency medicine. The median length of experience in this field of medicine was 11 years. Out of 401 participants, 213 (53.1%) had experienced at least one second victim incident. Self-perceived time to full recovery was up to one month according to 57.7% (123) and more than one month to 31.0% (66) of the participants. A total of 11.3% (24) had not fully recovered by the time of the survey. Overall, 12-month prevalence was 13.7% (55/401). The COVID-19 pandemic had little effect on SVP prevalence within this specific sample., Conclusions: Our data indicate that the Second Victim Phenomenon is very frequent among prehospital emergency physicians in Germany. However, four out of ten caregivers affected did not seek or receive any assistance in coping with this stressful situation. One out of nine respondents had not yet fully recovered by the time of the survey. Effective support networks, e.g., easy access to psychological and legal counseling as well as the opportunity to discuss ethical issues, are urgently required in order to prevent employees from further harm, to keep healthcare professionals from leaving this field of medical care and to maintain a high level of system safety and well-being of subsequent patients.

(1) Background: The Second Victim Phenomenon (SVP) is widespread throughout health care institutions worldwide. Second Victims not only suffer emotional stress themselves; the SVP can also have a great financial and reputational impact on health care institutions. Therefore, we conducted a study (Kollegiale Hilfe I/KoHi I) in the Hietzing Clinic (KHI), located in Vienna, Austria, to find out how widespread the SVP was there. (2) Methods: The SeViD (Second Victims in Deutschland) questionnaire was used and given to 2800 employees of KHI, of which 966 filled it in anonymously. (3) Results: The SVP is prevalent at KHI (43% of the participants stated they at least once suffered from SVP), although less prevalent and pronounced than expected when compared to other studies conducted in German-speaking countries. There is still a need for action, however, to ensure a psychologically safer workspace and to further prevent health care workers at KHI from becoming psychologically traumatized.

Patients with indolent lymphoma undertaking recurrent or continuous B cell suppression are at risk of severe COVID-19. Patients and healthy controls (HC; N = 13) received two doses of BNT162b2: follicular lymphoma (FL; N = 35) who were treatment naïve (TN; N = 11) or received immunochemotherapy (ICT; N = 23) and Waldenström's macroglobulinemia (WM; N = 37) including TN (N = 9), ICT (N = 14), or treated with Bruton's tyrosine kinase inhibitors (BTKi; N = 12). Anti-spike immunoglobulin G (IgG) was determined by a high-sensitivity flow-cytometric assay, in addition to live-virus neutralization. Antigen-specific T cells were identified by coexpression of CD69/CD137 and CD25/CD134 on T cells. A subgroup (N = 29) were assessed for third mRNA vaccine response, including omicron neutralization. One month after second BNT162b2, median anti-spike IgG mean fluorescence intensity (MFI) in FL ICT patients (9977) was 25-fold lower than TN (245 898) and HC (228 255, p = .0002 for both). Anti-spike IgG correlated with lymphocyte count (r = .63; p = .002), and time from treatment (r = .56; p = .007), on univariate analysis, but only with lymphocyte count on multivariate analysis (p = .03). In the WM cohort, median anti-spike IgG MFI in BTKi patients (39 039) was reduced compared to TN (220 645, p = .0008) and HC (p < .0001). Anti-spike IgG correlated with neutralization of the delta variant (r = .62, p < .0001). Median neutralization titer for WM BTKi (0) was lower than HC (40, p < .0001) for early-clade and delta. All cohorts had functional T cell responses. Median anti-spike IgG decreased 4-fold from second to third dose (p = .004). Only 5 of 29 poor initial responders assessed after third vaccination demonstrated seroconversion and improvement in neutralization activity, including to the omicron variant., (© 2022 The Authors. American Journal of Hematology published by Wiley Periodicals LLC.)

Background: Long-term immunity to SARS-CoV-2 infection, including neutralizing antibodies and T cell-mediated immunity, is required in a very large majority of the population in order to reduce ongoing disease burden., Methods: We have investigated the association between memory CD4 and CD8 T cells and levels of neutralizing antibodies in convalescent COVID-19 subjects., Findings: Higher titres of convalescent neutralizing antibodies were associated with significantly higher levels of RBD-specific CD4 T cells, including specific memory cells that proliferated vigorously in vitro . Conversely, up to half of convalescent individuals had low neutralizing antibody titres together with a lack of receptor binding domain (RBD)-specific memory CD4 T cells. These low antibody subjects had other, non-RBD, spike-specific CD4 T cells, but with more of an inhibitory Foxp3+ and CTLA-4+ cell phenotype, in contrast to the effector T-bet+, cytotoxic granzymes+ and perforin+ cells seen in RBD-specific memory CD4 T cells from high antibody subjects. Single cell transcriptomics of antigen-specific CD4+ T cells from high antibody subjects similarly revealed heterogenous RBD-specific CD4+ T cells that comprised central memory, transitional memory and Tregs, as well as cytotoxic clusters containing diverse TCR repertoires, in individuals with high antibody levels. However, vaccination of low antibody convalescent individuals led to a slight but significant improvement in RBD-specific memory CD4 T cells and increased neutralizing antibody titres., Interpretation: Our results suggest that targeting CD4 T cell epitopes proximal to and within the RBD-region should be prioritized in booster vaccines., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Phetsouphanh, Khoo, Jackson, Klemm, Howe, Aggarwal, Akerman, Milogiannakis, Stella, Rouet, Schofield, Faulks, Law, Danwilai, Starr, Munier, Christ, Singh, Croucher, Brilot-Turville, Turville, Phan, Dore, Darley, Cunningham, Matthews, Kelleher and Zaunders.)

Introduction: The experience of a second victim phenomenon after an event plays a significant role in health care providers' well-being. Untreated; it may lead to severe harm to victims and their families; other patients; hospitals; and society due to impairment or even loss of highly specialised employees. In order to manage the phenomenon, lifelong learning is inevitable but depends on learning motivation to attend training. This motivation may be impaired by overconfidence effects (e.g., over-placement and overestimation) that may suggest no demand for education. The aim of this study was to examine the interdependency of learning motivation and overconfidence concerning second victim effects., Methods: We assessed 176 physicians about overconfidence and learning motivation combined with a knowledge test. The nationwide online study took place in early 2022 and addressed about 3000 German physicians of internal medicine. Statistics included analytical and qualitative methods., Results: Of 176 participants, 83 completed the assessment. Analysis showed the presence of two overconfidence effects and in-group biases (clinical tribalism). None of the effects correlated directly with learning motivation, but cluster analysis revealed three different learning types: highly motivated, competent, and confident "experts", motivated and overconfident "recruitables", and unmotivated and overconfident "unawares". Qualitative analysis revealed four main themes: "environmental factors", "emotionality", "violence and death", and "missing qualifications" contributing to the phenomenon., Discussion: We confirmed the presence of overconfidence in second victim management competencies in about 3% of all persons addressed. Further, we could detect the same three learning motivation patterns compared to preceding studies on learning motivation in other medical competencies like life support and infection control. These findings considering overconfidence effects may be helpful for safety managers, medical teachers, curriculum developers and supervisors to create preventive educational curricula on second victim recognition and management.

This quantitative study examines whether employees in the fields of intensive care or acute and emergency medicine experience psychological distress because of their daily work. In addition, it was examined if self-stigmatization tendencies can significantly influence the willingness to seek help, and therefore psychological problems are not being treated adequately. These problems lead to various difficulties in professional and private contexts and ultimately endanger patient safety. From May to June 2021, an online questionnaire survey was conducted. This questionnaire combined two validated measuring instruments (PHQ-D and SSDS). To ensure high participation, the departments of anesthesia and/or intensive care medicine in 68 German hospitals were contacted, of which 5 responded positively. A total of 244 people participated in the questionnaire survey. On average, depressive symptoms were of mild severity. At the same time, self-stigmatization regarding depressive symptoms was high. These results highlight the practical need to prepare staff who work in the field of intensive care or acute and emergency medicine at the early onset for potentially traumatic and emotionally demanding events during their university education or studies. Adequate, evaluated, and continuously available support services from the psychosocial field should become an integral part of every staff care structure.

Background: The second victim phenomenon is common among nurses in intensive care units. Apart from quantitative studies, little is known about individual cases among those high-risk groups. This study evaluates the natural history and cause of second victim traumatization in Western Austria for the first time to tailor specific intervention., Methods: A total of 20 guided interviews were conducted with intensive care nurses in Western Austria. All interviews were transcribed and analyzed with MAXQDA software. Evaluation followed the structuring qualitative content analysis scheme according to Kuckartz., Results: The most frequent symptoms of the second victim phenomenon reported were feelings of guilt and problems with falling asleep. Coping with the second victim phenomenon was accomplished by conversations in private as well as among work colleagues., Conclusions: Intensive care nurses are exposed to many exceptional situations which have a high likelihood of resulting in second victim traumatization. As proximal psychosocial support is considered to be a main source of coping, wide-spread implementation of effective psychosocial peer support programs ought to be applied by medical organizations. Patient safety measures such as proactive and reactive clinical risk management (e.g., CIRS) should be linked to second victim support.

Understanding the long-term maintenance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunity is critical for predicting protection against reinfection. In an age- and gender-matched cohort of 24 participants, the association of disease severity and early immune responses on the maintenance of humoral immunity 12 months post-infection is examined. All severely affected participants maintain a stable subset of SARS-CoV-2 receptor-binding domain (RBD)-specific memory B cells (MBCs) and good neutralizing antibody breadth against the majority of the variants of concern, including the Delta variant. Modeling these immune responses against vaccine efficacy data indicate a 45%-76% protection against symptomatic infection (variant dependent). Overall, these findings indicate durable humoral responses in most participants after infection, reasonable protection against reinfection, and implicate baseline antigen-specific CD4+ T cell responses as a predictor of maintenance of antibody neutralization breadth and RBD-specific MBC levels at 12 months post-infection., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

In electrochemistry, the electrode/electrolyte interface (EEI) governs the charge/mass-transfer processes and controls the nucleation/growth phenomena. The EEI in ionic liquids (ILs) can be controlled by changing the cation/anion of the IL, salt concentration, electrode potential, and temperature. Here, we show that adding a dopant salt leads to the deposition of nanowires. To illustrate, zinc nanowires were electrodeposited from ZnCl 2 /1-butyl-1-methylpyrrolidinium trifluoromethylsulfonate in the presence of GaCl 3 as a dopant salt. The choice of Zn salt and its ratio to GaCl 3 were found to be crucial for Zn nanowires formation. AFM studies revealed that the solvation structure of Au(111)/IL changes significantly in the presence of GaCl 3 and ZnCl 2 . Chronoamperometry showed changes in the nucleation/growth process, consequently leading to the formation of nanowires. A similar approach was adopted to synthesize Sn nanowires. Thus, modification of the EEI by adding a dopant to ILs can be a viable method to obtain nanowires.

HIV-1 infection has been transformed by combined anti-retroviral therapy (ART), changing a universally fatal infection into a controllable infection. However, major obstacles for an HIV-1 cure exist. The HIV latent reservoir, which exists in resting CD4+ T cells, is not impacted by ART, and can reactivate when ART is interrupted or ceased. Additionally, multi-drug resistance can arise. One alternate approach to conventional HIV-1 drug treatment that is being explored involves gene therapies utilizing RNA-directed gene regulation. Commonly known as RNA interference (RNAi), short interfering RNA (siRNA) induce gene silencing in conserved biological pathways, which require a high degree of sequence specificity. This review will provide an overview of the silencing pathways, the current RNAi technologies being developed for HIV-1 gene therapy, current clinical trials, and the challenges faced in progressing these treatments into clinical trials., Competing Interests: The authors declare there is no conflict of interest regarding the publication of this article. C.A., A.D.K., K.S. and G.S. hold a patent for si/shRNA sequences targeting HIV-1. G.S. works for Calimmune Inc.

Different physical vapor deposition methods have been used to fabricate strontium titanate thin films. Within the binary phase diagram of SrO and TiO 2 the stoichiometry ranges from Ti rich to Sr rich, respectively. The crystallization of these amorphous SrTiO 3 layers is investigated by in situ grazing-incidence X-ray diffraction using synchrotron radiation. The crystallization dynamics and evolution of the lattice constants as well as crystallite sizes of the SrTiO 3 layers were determined for temperatures up to 1223 K under atmospheric conditions applying different heating rates. At approximately 473 K, crystallization of perovskite-type SrTiO 3 is initiated for Sr-rich electron beam evaporated layers, whereas Sr-depleted sputter-deposited thin films crystallize at 739 K. During annealing, a significant diffusion of Si from the substrate into the SrTiO 3 layers occurs in the case of Sr-rich composition. This leads to the formation of secondary silicate phases which are observed by X-ray diffraction, transmission electron microscopy and X-ray photoelectron spectroscopy.

Three procedures (P) were applied to prepare silver nanoparticles on natural Ca-montmorillonite (MT). The intercalation of the montmorillonite with silver nitrate in aqueous solution (P1), the intercalation of the montmorillonite with silver nitrate in glycerol (P2) and the successive combination of both P1 and P2 methods resulted to P3 method. X-ray powder diffraction (XRD), high-resolution transmission electron microscopy (HRTEM) and Fourier Transform Infrared (FTIR) spectroscopy and the molecular modeling were employed to characterize silver nanoparticles and montmorillonite nanocomposite. The P1 produced MT-1 composite with 2.3 wt% Ag and the partially collapsed layered structure. Nanoparticles of silver larger than 20 nm with a lot of planar defects were randomly distributed on the MT-1 surface; nanoparticles smaller than 20 nm were oriented to the montmorillonite substrate. The MT-2 composite from P2 contained only 1 wt% of Ag. The molecular simulation model of MT-2 showed the interlayer space with the exchangeable cations and metallic silver atoms arrangement within the glycerol bilayer. The P3 produced composite MT-3 that contained 2.4 wt% Ag. The nanoparticles > 20 nm size had a well-defined geometry, very small nanoparticles were amorphous. The modeled structure showed the exchangeable cations, Ag+ and Ag0 located close to the silicate layers and monolayer of glycerol molecules in the interlayer space.

An excess of 60Fe in 2.4-3.2 x 10(6) year old ferromanganese crust (237 KD) from the deep Pacific Ocean has been considered as evidence for the delivery of debris from a nearby supernova explosion to Earth. Extremely high ;{3}He/;{4}He (up to 6.12 x 10(-3)) and 3He concentrations (up to 8 x 10(9) atoms/g) measured in 237 KD cannot be supernova-derived. The helium is produced by galactic cosmic rays (GCR) and delivered in micrometeorites that have survived atmospheric entry to be trapped by the crust. 60Fe is produced by GCR reactions on Ni in extraterrestrial material. The maximum (3)He/(60)Fe of 237 KD (80-850) is comparable to the GCR (3)He/(60)Fe production ratio (400-500) predicted for Ni-bearing minerals in iron meteorites. The excess 60Fe can be plausibly explained by the presence of micrometeorites trapped by the crust, rather than injection from a supernova source.

Unidirectionally reinforced metal-matrix composites with a fibre volume content between 63 and 68% were processed by squeeze casting using T800 H carbon fibres and the magnesium alloy AZ91. The surface of the fibres was prepared by thermal desizing of the fibres or by deposition of a pyrolytic carbon (pyC) coating. Different interfacial conditions could be identified by transmission electron microscopy (TEM) and the single-fibre push-in test. TEM confirmed the formation of needle-like phases at the fibre surface or, for coated fibres, within the pyrolytic carbon coating. During loading by the Vickers type indenter an intense response was observed for composites of coated fibres and the magnesium alloy. This could by caused by stick-slip effects within the pyrolytic carbon coating.

Hydroxyapatite (HA) and alumina short fibre reinforced hydroxyapatite (Al2O3/HA) were processed by uniaxial pressing of green bodies with 200 MPa and sintering in air for 4 hours at 1150 degrees C, 1175 degrees C and 1200 degrees C. The phase composition of the materials were investigated by transmission electron microscopy and Raman spectroscopy. Results were supported by X-ray diffraction. Amorphous calcium phosphate could be found either as islands in unreinforced HA or at the grain boundaries in the Al2O3/HA composite. The reinforced calcium phosphate contains an enhanced amount of decomposition products like tetracalcium phosphate.

Undoped and Ca-O-modified diamond-like carbon coatings were deposited by a direct current discharge. Hardness and Young's modulus of Ca-O-modified DLCs were reduced in comparison with the undoped DLC, but the adherence of the Ca-O-modified films is improved. Ca-O-modified DLCs have a higher fraction of nano-crystalline regions with carbon in sp2 hybridisation. In addition, an increased oxygen content and CaCO3 was identified in Ca-O-modified DLCs. While mouse fibroblasts of the type L929 attach and grow on unmodified diamond-like carbon coatings synthesized by the decomposition of hydrocarbon, the addition of CaO-H2O into the precursor gas improves the coatings biological acceptance by the cells.

Bonnecor metabolism in the rat urine was studied. The main metabolites of bonnecor were identified by means of chromatography-mass-spectrometry.

The pharmacokinetics of 14C-bonnecor after intravenous and oral administration was studied. The bioavailability was 70%. It was shown that administration of doses in the range of from 3 to 43 mg/kg as well as the repeated use of bonnecor failed to influence the pharmacokinetic parameters.