Decreased prevalence of new-onset adhesive capsulitis in patients prescribed angiotensin receptor blockers.

BACKGROUND: Angiotensin receptor blockers (ARBs) are commonly prescribed antihypertensive agents that have well-known antifibrotic properties. The purpose of this study was to examine the association between ARB use and the rates of new-onset adhesive capsulitis as well as adhesive capsulitis requiring operative treatment. METHODS: Using a large national insurance database, a randomly generated cohort of patients with at least 3 continuous months of ARB use between January 2010 and December 2019 (n = 1,000,000) was compared to a separate randomly generated cohort without ARB use (n = 3,000,000). Rates of newly diagnosed adhesive capsulitis and associated manipulation under anesthesia (MUA) and/or arthroscopic capsulotomy were calculated over a 1- and 2-year period following the completion of at least 3 continuous months of ARB therapy. Rates were compared using multivariable logistic regression to control for demographics and comorbidities. Both unadjusted and adjusted odds ratios and 95% confidence intervals were calculated and reported for each comparison. Statistical significance was set at P <.05. RESULTS: The mean age in the ARB cohort was 61.8 years (standard deviation [SD] = 10.0), whereas in the control cohort, it was 54.8 years (SD = 12.3) (P < .001). The ARB cohort had significantly lower rates of newly diagnosed adhesive capsulitis compared with the control cohort at both 1 year (0.15% vs. 0.55%, P < .001) and 2 years (0.3% vs. 0.78%, P < .001). Similar findings were observed for the arthroscopic capsular release/MUA cohort associated with adhesive capsulitis. After adjusting for confounding factors, the lower rates of adhesive capsulitis and arthroscopic capsular release/MUA associated with adhesive capsulitis in the ARB cohort remained statistically significant (P < .001). CONCLUSION: Patients prescribed ARBs experienced a decreased rate of newly diagnosed adhesive capsulitis, as well as adhesive capsulitis requiring surgical intervention when compared to a control cohort. These findings suggest a potential protective effect of ARBs against the development of adhesive capsulitis. Further investigations are warranted to elucidate the underlying mechanisms and establish a causal relationship.

Development and Implementation of a Pediatric Nursing Emergency Behavioral Health Assessment Tool.

INTRODUCTION: The national pediatric mental and behavioral health crisis dramatically increased emergency department mental and behavioral health visits and changed emergency nursing practice. Acuity assessment determines patient severity level and supports appropriate resources and interventions. There are no established nursing tools that assess pediatric mental or behavioral health acuity in the emergency department setting. Our goal was to develop and implement the novel pediatric emergency nurse Emergency Behavioral Health Acuity Assessment Tool. METHODS: This quality-improvement project used the plan, do, study, act model to design/refine the Emergency Behavioral Health Acuity Assessment Tool and a non-experimental descriptive design to assess outcomes. The setting was a 47-bed urban level 1 pediatric trauma center with more than 60,000 annual visits. The team designed the tool using published evidence, emergency nurse feedback, and expert opinion. The tool objectively captured patient acuity and suggested acuity-specific nursing interventions. Project outcomes included acuity, length-of-stay, restraint use, and patient/staff injuries. Analyses included descriptive statistics and correlations. RESULTS: With over 3000 annual mental/behavioral-related visits, the emergency department had an average daily census of 23 mental and behavioral health patients. Implementation occurred in August 2021. The Emergency Behavioral Health Acuity Assessment Tool dashboard provided the number of patients, patient location, and acuity. Length-of-stay did not change; however, patient restraint use and patient/staff injuries declined. Number of restraints positively correlated with moderate acuity levels (r = 0.472, P = 0.036). DISCUSSION: For emergency nurses, the Emergency Behavioral Health Acuity Assessment Tool provided an objective measure of patient acuity. Targeted interventions can improve the care of this population.

Triplet-Triplet Energy Transfer in Bis-Cyclometalated Iridium Complexes with Pyrene-Substituted Isocyanides.

Nonlinear optical (NLO) materials are able to modulate responses of electromagnetic radiation, leading to phenomena critical to modern telecommunications technologies. The last two decades have seen significant advances in the area of molecular nonlinear chromophores, particularly with respect to reverse-saturable absorption (RSA). Here, we introduce a strategy for intense excited-state absorption (ESA) that involves bis-cyclometalated iridium complexes with isocyanide ancillary ligands decorated with pyrene triplet acceptors. Upon excitation, the complexes undergo rapid triplet-triplet energy transfer (TTET) to the acceptor excited states. This report describes five bis-cyclometalated iridium complexes using two different pyrene-substituted isocyanides with the general formula [Ir(C^N)2(CNAr)2]PF6 (C^N = cyclometalating ligand, CNAr = isocyanide ancillary ligand: CNArpyr = 2,6-dimethyl-4-(1-pyrenyl)phenyl isocyanide, CNpyr = 1-pyrenyl isocyanide). The synthesized complexes were thoroughly characterized via 1H and 13C{1H} NMR spectroscopy, Fourier-transform Infrared spectroscopy, and electrospray ionization mass spectrometry. The excited states were evaluated with UV-vis absorption, steady-state and time-resolved photoluminescence, and transient absorption spectroscopy. Phosphorescence is completely quenched at room temperature, but in the solvent glass matrix at 77 K, there is luminescence originating from a π → π* triplet state on the pyrene moiety, abbreviated herein as 3pyrene. All five complexes display intense and long-lived ESA originating from the 3pyrene state. The localization of the ground-state absorption on the cyclometalating ligands and the excited-state absorption on the pyrene moiety allows for independent tuning of ground-state absorption (GSA) and ESA to optimize RSA and other NLO attributes.

Surprise! Draw the scene: Visual recall reveals poor incidental working memory following visual search in natural scenes.

Searching within natural scenes can induce incidental encoding of information about the scene and the target, particularly when the scene is complex or repeated. However, recent evidence from attribute amnesia (AA) suggests that in some situations, searchers can find a target without building a robust incidental memory of it's task relevant features. Through drawing-based visual recall and an AA search task, we investigated whether search in natural scenes necessitates memory encoding. Participants repeatedly searched for and located an easily detected item in novel scenes for numerous trials before being unexpectedly prompted to draw either the entire scene (Experiment 1) or their search target (Experiment 2) directly after viewing the search image. Naïve raters assessed the similarity of the drawings to the original information. We found that surprise-trial drawings of the scene and search target were both poorly recognizable, but the same drawers produced highly recognizable drawings on the next trial when they had an expectation to draw the image. Experiment 3 further showed that the poor surprise trial memory could not merely be attributed to interference from the surprising event. Our findings suggest that even for searches done in natural scenes, it is possible to locate a target without creating a robust memory of either it or the scene it was in, even if attended to just a few seconds prior. This disconnection between attention and memory might reflect a fundamental property of cognitive computations designed to optimize task performance and minimize resource use.

Children and young people's experiences of living with rare diseases: An integrative review.

PROBLEM: Rare diseases are any disease affecting fewer than five people in 10,000. More than 8000 rare diseases and 50-75% of all rare diseases affect children. The purpose of this review was to critically appraise and synthesize existing literature relating to the impact of rare diseases on children's day-to-day lives. ELIGIBILITY CRITERIA: An integrative literature review was conducted using the CINAHL Plus, PsycINFO, and PubMed databases. Studies were included if they were a primary source was published between the years 2005 and 2019 and written in the English language. SAMPLE: Eight primary sources met the inclusion criteria. RESULTS: Seven main themes emerged from the review as follows: (i) the experience of stigmatisations, (ii) self-consciousness, (iii) restrictions in independent living, (iv) developing resilience/coping strategies, (v) psychological and emotional impact, (vi) social impact vs social connectedness and (vii) transition challenges. CONCLUSIONS: The experience of having a rare illness differed across different age groups. Children (typically aged 3-10) with rare diseases generally view themselves and their lives the same way like their healthy peers. They were more likely to report being adaptive and resilient than those aged 12 or older. Young people reported being different compared to young children, and they faced numerous challenges related to their illness. IMPLICATIONS FOR PRACTICE: To provide the best possible level of care for children and families with rare disorders, health services must be informed and equipped to provide the necessary supports specific to the unique needs of children and young people living with rare diseases.

Panchromatic Excited-State Absorption in Bis-Cyclometalated Iridium Isocyanide Complexes.

In this work, we introduce a series of cyclometalated iridium complexes and evaluate the suitability of this class of compounds in nonlinear optical (NLO) applications, with an emphasis on long-lived, panchromatic reverse-saturable absorption (RSA). The investigated complexes are represented by the general formula [Ir(C^N)2(CNArdmp)2]+, (C^N = cyclometalating ligand, CNArdmp = 2,6-dimethylphenyl isocyanide). Seven such complexes were synthesized and characterized, including in-depth analysis of their photophysical properties (UV-vis absorption, photoluminescence, and transient absorption). This series of compounds contains seven different cyclometalating ligands (2-phenylbenzothiazole (bt) (Ir1), 5-nitro-2-phenylpyridine (ppyNO2) (Ir2), 5-nitro-2-(9-phenanthryl)pyridine (phenNO2) (Ir3), 2-(benzo[b]thiophen-2-yl)quinoline (btq) (Ir4), 6-(benzo[b]thiophen-2'-yl)phenanthridine (btph) (Ir5), 2,4-diphenylquinoline (dpq) (Ir6), and 6-nitro-2,4-diphenylquinoline (NO2dpq) (Ir7)), which have profound effects on their ground-state and excited-state absorption spectra. To evaluate the effects of the isocyanide ancillary ligands, some heteroleptic bis-cyclometalated iridium(III) acetylacetonate (acac) analogue complexes are included as points of comparison. In the ground state, the bis-isocyanide complexes display UV-vis absorption with the characteristic 1LC (π → π*) band at λ < 350 nm and 1MLCT bands at 350-500 nm. Five of the complexes (Ir1, Ir2, Ir4, Ir5, and Ir6) display broad, intense triplet excited-state absorption with no ground-state bleach (GSB) over the spectral window of 400-900 nm, with excited-state lifetimes spanning three orders of magnitude from ∼32 ns to 12 µs. The photophysical data suggests that the isocyanide ancillary ligand blue-shifts the GSB transient into the UV, which is normally found in the middle of the visible region for cyclometalated iridium complexes. This study demonstrates the applicability of cationic cyclometalated iridium(III) bis-isocyanide complexes as candidate RSA materials.

Manipulating Excited State Properties of Iridium Phenylpyridine Complexes with "Push-Pull" Substituents.

We have prepared a series of complexes of the type [IrIII(ppy)2(L]n+ complexes (1-4), where ppy is a substituted 2-phenylpyridine and L is a chelating phosphine thioether ligand. The parent complex (1) comprises an unsubstituted phenylpyridine ligand, whereas complex 2 contains a nitro substituent on the pyridine ring, complex 3 features a diphenylamine group on the phenyl ring, and 4 has both nitro and diphenylamine groups. Crystallographic, 1H NMR, and elemental analysis data are consistent with each of the chemical formulae. DFT (density functional theory) computational results show a complicated electronic structure with contributions from Ir, ppy, and the PS ligand. Ultrafast pump-probe data show strong contributions from the phenylpyridine moieties as well as strong panchromatic excited state absorption transitions. The data show that nitro and/or diphenylamine substituents dominate the spectroscopy of this series of compounds.

Two-photon absorption characterization and comparison of Au(I) fluorenyl benzothiazole complexes in the visible wavelength regime.

We use the two-photon excited fluorescence method to determine the two-photon absorption (2PA) cross sections of three series of (fluorenyl benzothiazole) gold(I) complexes in the visible wavelength range from 570 to 700 nm. We compare the effect of ancillary ligand substitutions on the 2PA magnitudes and find that the ancillary ligand does not drastically affect either the magnitude or the shape of 2PA. Even so, moderate 2PA cross sections were measured that ranged from 10 to 1000 s of GM (Göppert-Mayer, =10-50cm4s/photon), making these types of complexes nonlinear optical materials for two-photon absorbing applications.

No explicit memory for individual trial display configurations in a visual search task.

Previous evidence demonstrated that individuals can recall a target's location in a search display even if location information is completely task-irrelevant. This finding raises the question: does this ability to automatically encode a single item's location into a reportable memory trace extend to other aspects of spatial information as well? We tested this question using a paradigm designed to elicit attribute amnesia (Chen & Wyble, Psychological Science, 26(2) 203-210, 2015a). Participants were initially asked to report the location of a target letter among digits with stimuli arranged to form one of two or four spatial configurations varying randomly across trials. After completing numerous trials that matched their expectations, participants were surprised with a series of unexpected questions probing their memory for various aspects of the display they had just viewed. Participants had a profound inability to report which spatial configuration they had just perceived when the target's location was not unique to a specific configuration (i.e., orthogonal). Despite being unable to report the most recent configuration, answer choices on the surprise trial were focused around previously seen configurations, rather than novel configurations. Thus, there were clear memories of the set of configurations that had been viewed during the experiment but not of the specific configuration from the most recent trial. This finding helps to set boundary conditions on previous findings regarding the automatic encoding of location information into memory.

Anterior Cruciate Ligament Tear Following Operative Treatment of Pediatric Tibial Eminence Fractures in a Multicenter Cohort.

BACKGROUND: Postoperative ipsilateral anterior cruciate ligament (ACL) tears after tibial eminence fracture fixation has been previously noted in the literature. This study aims to describe the prevalence of and risk factors for postoperative ACL tears in a cohort of patients operatively treated for tibial eminence fracture. METHODS: A retrospective review of children undergoing treatment of a tibial eminence fracture at 10 tertiary care children's hospitals was performed. The primary outcome of interest was subsequent ACL rupture. Incidence of ACL tear was recorded for the entire cohort. Patients who sustained a postoperative ACL tear were compared with those without ACL tear and analyzed for demographics and risk factors. A subgroup analysis was performed on patients with a minimum of 2-year follow-up data or those who had met the primary outcome (ACL tear) before 2 years. RESULTS: A total of 385 pediatric patients were reviewed. 2.6% of the cohort experienced a subsequent ACL tear. The median follow-up time was 6.5 months (SD=6.4 mo). Subsequent ACL tears occurred at a median of 10.2 months (SD=19.5 mo) postoperatively. There was a statistically significant association with higher grade tibial spine fractures (Myers and McKeever type III and IV) and subsequent ACL tear (P=0.01). Patients with a subsequent ACL tear were older on average (13.5 vs. 12.2 y old), however, this difference was not statistically significant (P=0.08). Subgroup analysis of 46 patients who had a 2-year follow-up or sustained an ACL tear before 2 years showed a 21.7% incidence of a subsequent ACL tear. There was a statistically significant association with higher grade tibial spine fractures (Myers and McKeever type III and IV) and subsequent ACL rupture (P=0.006) in this subgroup. Postoperative ACL tears occurred in patients who were older at the time that they sustained their original tibial eminence fracture (13.4 vs. 11.3 y old, P=0.035). CONCLUSIONS: Ipsilateral ACL tears following operatively treated pediatric tibial eminence fractures in a large multicenter cohort occurred at a rate of 2.6%. However, in those with at least 2 years of follow-up, the incidence was 21.7%. Subsequent ACL tear was more likely in those with completely displaced (type III or IV) tibial eminence fractures and older patients. LEVEL OF EVIDENCE: Level III-retrospective cohort study.

Learning how to exploit sources of information.

How is our strategy for forming memories shaped by experience with a task? Previous work using surprise questions (i.e., unexpected by the participant) has shown a remarkable inability to report attributes of an attended target in a search display. This representational poverty presumably reflects a form of information exploitation, in which control processes specialize the conversion of available information into memory representations. We hypothesize that such control is refined by repeated experience with a task, and as a result, memory representations will specialize as task experience accrues, such that report accuracy for an unexpected question will progressively worsen as the number of preceding trials increases. To test this, subjects were asked to report the location of a letter among three digits. The ability to respond correctly to a surprise question about the identity of that letter became worse as the experiment progressed. A follow-up study evaluated whether this incremental worsening of report accuracy could be explained as a buildup of proactive interference by varying the set of letters for the surprise test. The results were unchanged relative to the original experiment, which argues against a primary contribution of proactive interference in the worsening performance. The effect was replicated in a similar paradigm using color disks. These findings illustrate that repeated performance of a prescriptive task engages an adaptive modification of control processes that focus information processing on specific attributes of a stimulus that are expected to be necessary in the future, regardless of their immediate task relevance.

Manipulating triplet states: tuning energies, absorption, lifetimes, and annihilation rates in anthanthrene derivatives.

The photophysical properties of anthanthrene, four anthanthrene derivatives containing varying phenyl and p-tBu-phenyl substituents, and two anthanthrones with phenyl and p-tBu-phenyl substituents are examined. In general, as the anthanthrenes and anthanthrones become more substituted, red-shifts are observed in the peak maxima of the ground- and excited-state absorption and fluorescence spectra. The anthanthrones have large (>0.8) intersystem crossing (ISC) quantum yields (ΦT) likely caused by nπ* character in the ground or excited states. A bromo-substituted anthanthrene has a unity ISC yield due to an ISC rate constant of 2.5 × 1010 s-1 caused by heavy-atom induced, spin-orbit coupling. This leads to low fluorescence quantum yields (ΦF) in these three derivatives. The parent anthanthrene and remaining derivatives behave much differently. All have ΦF values from 0.58-0.84 with lower ΦT values as radiative decay outcompetes ISC. The anthanthrones have remarkable excited-state absorption with strong, broad transitions across the visible region with weaker transitions extending to nearly two µm. The anthanthrenes have very similar-shaped, broad transitions in the visible which can be shifted ∼60 nm by controlling the substituents. The triplet lifetimes range from 31-1200 µs and increase as the ISC yields decrease; the bromo-substituted anthanthrene is the shortest, followed by the anthanthrones then the other anthanthrenes. The rate of triplet-triplet annihilation is also affected by the presence of substituents; as the amount of steric bulk is increased, the rate of annihilation decreases.

Photodriven Oxygen Removal via Chromophore-Mediated Singlet Oxygen Sensitization and Chemical Capture.

We report a general, photochemical method for the rapid deoxygenation of organic solvents and aqueous solutions via visible light excitation of transition metal chromophores (TMCs) in the presence of singlet oxygen scavenging substrates. Either 2,5-dimethylfuran or an amino acid (histidine or tryptophan methyl ester) was used as the substrate in conjunction with an iridium or ruthenium TMC in toluene, acetonitrile, or water. This behavior is described for solutions with chromophore concentrations that are pertinent for both luminescence and transient absorption spectroscopies. These results consistently produce TMC lifetimes comparable to those measured using traditional inert gas sparging and freeze-pump-thaw techniques. This method has the added benefits of providing long-term stability (days to months); economical preparation due to use of inexpensive, commercially available oxygen scrubbing substrates; and negligible size and weight footprints compared to traditional methods. Furthermore, attainment of dissolved [O2] < 50 µM makes this method relevant to any solution application requiring low dissolved oxygen concentration in solution, provided that the oxygenated substrate does not interfere with the intended chemical process.

Nonlinear optical characterization of multinuclear iridium compounds containing tricycloquinazoline.

Nonlinear optical properties were characterized for a series of multinuclear iridium compounds of the form TCQ[IrIII(ppz)2]n, where n=1, 2, or 3, TCQ is tricycloquinazoline, and ppz is 1-phenylpyrazole. Transient absorption (TA) spectroscopy indicated that the triplet metal-to-ligand charge transfer excited state was formed on a subpicosecond time scale and decayed back to the ground state on a microsecond time scale, consistent with precedents in the literature. TA bands were observed for all three compounds from 475 to 900 nm, implying the potential for reverse-saturable absorption (RSA) at those wavelengths. Z-scan measurements using picosecond and nanosecond pulses were obtained at 532 nm and confirmed the presence of RSA behavior for all three compounds. The triplet excited state cross sections and the RSA figure of merit were found to decrease with increasing n:1>2∼3.

Photoacidic and Photobasic Behavior of Transition Metal Compounds with Carboxylic Acid Group(s).

Excited state proton transfer studies of six Ru polypyridyl compounds with carboxylic acid/carboxylate group(s) revealed that some were photoacids and some were photobases. The compounds [Ru(II)(btfmb)2(LL)](2+), [Ru(II)(dtb)2(LL)](2+), and [Ru(II)(bpy)2(LL)](2+), where bpy is 2,2'-bipyridine, btfmb is 4,4'-(CF3)2-bpy, and dtb is 4,4'-((CH3)3C)2-bpy, and LL is either dcb = 4,4'-(CO2H)2-bpy or mcb = 4-(CO2H),4'-(CO2Et)-2,2'-bpy, were synthesized and characterized. The compounds exhibited intense metal-to-ligand charge-transfer (MLCT) absorption bands in the visible region and room temperature photoluminescence (PL) with long τ > 100 ns excited state lifetimes. The mcb compounds had very similar ground state pKa's of 2.31 ± 0.07, and their characterization enabled accurate determination of the two pKa values for the commonly utilized dcb ligand, pKa1 = 2.1 ± 0.1 and pKa2 = 3.0 ± 0.2. Compounds with the btfmb ligand were photoacidic, and the other compounds were photobasic. Transient absorption spectra indicated that btfmb compounds displayed a [Ru(III)(btfmb(-))L2](2+)* localized excited state and a [Ru(III)(dcb(-))L2](2+)* formulation for all the other excited states. Time dependent PL spectral shifts provided the first kinetic data for excited state proton transfer in a transition metal compound. PL titrations, thermochemical cycles, and kinetic analysis (for the mcb compounds) provided self-consistent pKa* values. The ability to make a single ionizable group photobasic or photoacidic through ligand design was unprecedented and was understood based on the orientation of the lowest-lying MLCT excited state dipole relative to the ligand that contained the carboxylic acid group(s).

Monocyte Traffic, Dorsal Root Ganglion Histopathology, and Loss of Intraepidermal Nerve Fiber Density in SIV Peripheral Neuropathy.

HIV-associated sensory neuropathy remains the most common neurological complication of HIV infection and is characterized by dorsal root ganglion (DRG) inflammation and intraepidermal nerve fiber density (IENFD) loss. Chronic peripheral immune cell activation and accumulation may cause damage to the DRG, but has not been fully investigated yet. By using an SIV-infected, CD8-lymphocyte-depleted rhesus macaque model, we defined immune cells surrounding DRG neurons and their role in DRG pathology, measured cell traffic from the bone marrow to the DRGs using 5-bromo-2-deoxyuridine (BrdU) pulse, and serially measured IENFD. We found an increase in CD68(+) and CD163(+) macrophages in DRGs of SIV-infected animals. MAC387(+) recently recruited monocytes/macrophages were increased, along with BrdU(+) cells, in the DRGs of SIV-infected macaques. We demonstrated that 78.1% of all BrdU(+) cells in DRGs were also MAC387(+). The number of BrdU(+) monocytes correlated with severe DRG histopathology, which included neuronophagia, neuronal loss, and Nageotte nodules. These data demonstrate that newly recruited MAC387(+)BrdU(+) macrophages may play a significant role in DRG pathogenesis. IENFD decreased early (day 21), consistent with the development of sensory neuropathy in SIV-infected macaques. Decreased IENFD was associated with elevated BrdU(+) cells in the DRG. These data suggest that increased recruitment of macrophages to DRG is associated with severe DRG histopathology and IENFD loss.

Excited-state relaxation of ruthenium polypyridyl compounds relevant to dye-sensitized solar cells.

Remarkably little is known about metal-to-ligand charge transfer (MLCT) excited-state relaxation pathways for the ruthenium polypyridyl compounds commonly utilized in dye-sensitized solar cells. Herein, we report variable-temperature photoluminescence studies of compounds of the general type cis-Ru(LL)2(X)2, where LL is a bipyridyl ligand and X is CN(-) or NCS(-), and contrast them with the well-known Ru(bpy)3(2+) and Os(bpy)3(2+), where bpy is 2,2'-bipyridine, to identify relaxation pathways. In fluid acetonitrile and propylene carbonate solutions, excited-state relaxation was found to obey a first-order kinetic model. An Arrhenius analysis revealed internal conversion to two different states, assigned to an upper MLCT excited state and a ligand field excited state. Relaxation through the upper MLCT excited state typically displayed pre-exponential factors of 10(7)-10(8) s(-1) with activation energies of 400-900 cm(-1), while relaxation rates through ligand field states occurred with 10(14)-10(15) s(-1) and activation energies of 4000-5000 cm(-1). Nonradiative decay through LF states was sensitive to the ligand identity, but in a manner that was not fully consistent with the spectrochemical series. Excited-state relaxation of cis-Ru(dcbH2)2(NCS)2, where dcbH2 is 4,4'-(CO2H)2-2,2'-bipyridine, sometimes termed N3, anchored to mesoporous TiO2 or ZrO2 thin films immersed in CH3CN occurred through the upper MLCT excited state with activational parameters in surprisingly good agreement with those abstracted from data measured in fluid solution. An important finding from these studies is that the population of dissociative ligand field excited states is unlikely to lead to unwanted photochemistry of dye-sensitized solar cells based on cis-Ru(LL)2(NCS)2-type compounds at room temperature.

The influence of category representativeness on the low prevalence effect in visual search.

Visual search is greatly affected by the appearance rate of given target types, such that low-prevalence items are harder to detect, which has consequences for real-world search tasks where target frequency cannot be balanced. However, targets that are highly representative of a categorically defined task set are also easier to find. We hypothesized that targets that are highly representative are less vulnerable to low-prevalence effects because an observer's attentional set prioritizes guidance toward them even when they are rare. We assessed this hypothesis by first determining the categorical structure of "prohibited carry-ons" via an exemplar-naming task, and used this structure to assess how category representativeness interacted with prevalence. Specifically, from the exemplar-naming task we selected a commonly named (knives) and rarely named (gas cans) target for a search task in which one of the targets was shown infrequently. As predicted, highly representative targets were found more easily than their less representative counterparts, but they also were less affected by prevalence manipulations. Experiment 1b replicated the results with targets matched for emotional valence (water bottles and fireworks). These findings demonstrate the powerful explanatory power of theories of attentional guidance that incorporate the dynamic influence of recent experience with the knowledge that comes from life experience to better predict behavioral outcomes associated with high-stakes search environments.

Slipping through the cracks: The peril of unexpected interruption on the contents of working memory.

Working memory allows us to hold specific pieces of information in an active and easily retrieved state, but what happens to that information during an unexpected interruption between study and test? To answer this question, we used a surprise trial paradigm in which an unexpected event precedes a probe of the observer's memory for a search target. In the first set of experiments, participants were tasked to report the identity of the target letter before unexpectedly being asked to read a task-irrelevant passage. We observed that the introduction of this passage interfered with the observer's memory of the target letter, but this interference only occurred after participants had experience completing the task without interruption. However, a remember cue placed just prior to the reading prompt reduced this cost, suggesting that participants can rapidly reinforce information about the target in working memory to resist the interference. We then used this same cuing manipulation to test whether information in an attribute amnesia paradigm, which unexpectedly probes an attribute relevant to target selection but irrelevant to participant's response expectations, could also be protected against unexpected interference. Using this paradigm, we observed that a remember cue did not improve performance following the surprising event, which supports theories that attribute amnesia is not caused solely by interference. These results reveal both the vulnerability and flexibility of working memory and demonstrate the importance of understanding how task experience establishes expectations that impact the underlying cognitive representations formed by the observer. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Patient presentations to an after-hours general practice, an urgent care clinic and an emergency department on Sundays: a comparative, observational study.

PURPOSE: The purpose of this paper is to determine which factors are associated with 6,065 patient presentations with non-life-threatening urgent conditions (NLTUCs) to an after-hours general practice, an urgent care clinic (UCC) and an emergency department (ED) on Sundays in Southeast Queensland (Qld). DESIGN/METHODOLOGY/APPROACH: A retrospective, comparative and observational study was conducted involving the auditing of medical records of patients with NLTUCs consulting three medical services between 0,800 and 1,700 h, on Sundays, over a one-year period. The study was limited to 6,065 patients. FINDINGS: There were statistically significant differences in choice of location according to age, number of postcodes from the patient's residence, time of the day, season, patient presentations for infection and injury, non-infectious, non-injurious conditions of the circulatory, gastrointestinal and genitourinary systems, and need for imaging, pathology, plastering/back-slab application, splinting and wound closure. Older adults were more likely to be admitted to the hospital and Ed Short Stay Unit, compared with other age groups. RESEARCH LIMITATIONS/IMPLICATIONS: Based on international models of UCC healthcare systems in United Kingdom (UK), USA and New Zealand (NZ) and the results of this study, it is recommended that UCCs in Australia have extended hours, walk-in availability, access to on-site radiology, ability to treat fractures and wounds and staffing by medical practitioners able to manage these conditions. Recommendations also include setting a national standard for UCC operation (National Urgent Care Centre Accreditation, 2018; NHS, 2020; RNZCUC, 2015) and requirements for vocational registration for medical practitioners (National Urgent Care Centre Accreditation, 2018; RNZCUC, 2015; The Royal College of Surgeons of Edinburgh, 2021a, b). PRACTICAL IMPLICATIONS: This study has highlighted three key areas for future research: first, research involving general practitioners (GPs), emergency physicians, urgent care physicians, nurse practitioners, urgent care pharmacists and paramedics could help to predict the type of patients more accurately, patient presentations and associated comorbidities that might be encouraged to attend or be diverted to Urgent Care Clinics. Second, larger studies of more facilities and more patients could improve the accuracy and generalisability of the findings. Lastly, studies of public health messaging need to be undertaken to determine how best to encourage patients with NLTUCs (especially infections and injuries) to present to UCCs. SOCIAL IMPLICATIONS: The Urgent Care Clinic model has existed in developed countries since 1973. The adoption of this model in Australia close to a patient's home, open extended hours and with onsite radiology could provide a community option, to ED, for NLTUCs (especially patient presentations with infections and injuries). ORIGINALITY/VALUE: This study reviewed three types of medical facilities for the management of NLTUCs. They were an after-hours general practice, an urgent care clinic and an emergency department. This study found that the patient choice of destination depends on the ability of the service to manage their NLTUCs, patient age, type of condition, postcodes lived away from the facility, availability of testing and provision of consumables. This study also provides recommendations for the development of an urgent care healthcare system in Australia based on international models and includes requirements for extended hours, walk-in availability, radiology on-site, national standard and national requirements for vocational registration for medical professionals.