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INTRODUCTION: In order to successfully integrate telemedicine into the daily routine of rheumatology, both the patient's and the physician's perspective are important. For this purpose, a detailed study by means of a web-based survey was conducted by the Working Group Young Rheumatology (AGJR) of the German Society for Rheumatology (DGRh) and the German Rheumatism League National Association. By means of subgroup analysis of the data regarding video consultation, the aim was now to find out which requirements and wishes patients and physicians have for video consultations. METHODS: The prospective survey was distributed via social media, QR code and email. Descriptive statistics and regression analysis related to video consultation were performed and correlations were shown. RESULTS: The data indicated positive attitudes toward video consultation on the part of both patients (nâ¯= 299) and rheumatologists (nâ¯= 129). A correlation between age and positive opinion of the video consultation was found among the patients (râ¯= 0.161, pâ¯= 0.006), especially among female patients a positive approval of the video consultation was found with increasing age (râ¯= 0.244, pâ¯< 0.001 to male patients: râ¯= -0.190, pâ¯= 0.145). Regarding the travelling time to the treating rheumatologist, male patients found the video consultation more attractive with increasing travelling time (râ¯= 0.229, pâ¯= 0.078). With respect to the wishes of patients and physicians, video consultation should be used primarily for follow-up or emergency appointments. Video consultation for initial appointments, on the other hand, was very rarely mentioned. CONCLUSION: During the COVID 19 pandemic, video consultation was increasingly popular among rheumatology patients as well as among rheumatologists.
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COVID-19 , Doenças Reumáticas , Febre Reumática , Reumatologia , Telemedicina , Humanos , Masculino , Feminino , Estudos Prospectivos , Reumatologia/métodos , Doenças Reumáticas/diagnóstico , Doenças Reumáticas/terapia , ReumatologistasRESUMO
Vice epistemology studies the qualities of individuals and collectives that undermine the creation, sharing, and storing of knowledge. There is no settled understanding of which epistemic vices exist at the collective level. Yet understanding which collective epistemic vices exist is important, both to facilitate research on the antecedents and effects of collective epistemic vice, and to advance philosophical discussions such as whether some collective epistemic vices are genuinely collective. I propose an empirical approach to identifying epistemic vices in corporations, analyzing a large dataset of online employee reviews. The approach has parallels to the methodology for identifying the big-five personality traits. It surfaces epistemic vices that are attributed to corporations by its own members and reduces the number of vices to the minimum required to describe differences between corporations. This approach yields a new taxonomy of epistemic vices for corporations. While two vices identified have close correlates in the existing literature, four others have not been identified at all or only in aspects. Two of these vices are 'genuinely' collective in the sense that they can only be attributed to collectives. Supplementary Information: The online version contains supplementary material available at 10.1007/s11229-023-04133-2.
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A novel wireless eight-channel electroencephalography (EEG) headset specially developed for ICUs was tested in regard of comparability with standard 10/20 EEG systems. The continuous EEG (cEEG) derivations via CerebAir EEG headset (Nihon Kohden Europe, Rosbach, Germany) and internationally standardized 10/20 reference EEGs as the diagnostic standard were performed in a mixed collective on a neurointensive care unit (neuro-ICU). The derivations were verified for comparability in detection of EEG background activity, epileptiform discharges, and seizure patterns. Fifty-two patients with vigilance reduction following serious neurological or metabolic diseases were included, and both methods were applied and further analyzed in 47. EEG background activity matched in 24 of 45 patients (53%; p = 0.126), epileptiform discharges matched in 32 (68%) patients (p = 0.162), and seizure activity matched in 98%. Overall, in 89% of the patients, cEEG detected the same or additional ICU-relevant EEG patterns. The tested wireless cEEG headset is a useful monitoring tool in patients with consciousness disorders. The present study indicates that long-term measurements with the wireless eight-channel cEEG lead to a higher seizure and epileptiform discharge detection compared to intermittent 10/20 EEG derivations in the ICU setting.
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Cuidados Críticos , Eletroencefalografia , Humanos , Unidades de Terapia Intensiva , Monitorização Fisiológica , Convulsões/diagnósticoRESUMO
INTRODUCTION: Successful thrombectomy improves morbidity and mortality after stroke. The present prospective, observational cohort study investigated a potential correlation between the successful restoration of tissue perfusion by mechanical thrombectomy and intact cerebrovascular autoregulation (CA). OBJECTIVE: Status of CA in patients with large vessel occlusive stroke after thrombectomy. METHODS: After thrombectomy CA was measured using transcranial Doppler ultrasound. For this purpose a moving correlation index (Mxa) based on spontaneous arterial blood pressure fluctuations and corresponding cerebral blood flow velocity changes was calculated. CA impairment was defined by Mxa values more than .3. RESULTS: Twenty patients with an acute occlusion of the middle cerebral artery or distal internal carotid artery were included. A successful recanalization of the occluded vessel via interventional thrombectomy was achieved in 10 of these patients (successful recanalization group), while in 10 patients mechanical recanalization failed or could not be applied (no recanalization group). Mean Mxa at stroke side was .58 ± .21 Table 2a in patients with successful intervention. At the unaffected hemisphere Mxa was .50 ± .20 Table 2a in successful recanalization group and .45 ± .24 Table 2b in no recanalization group without statistically significant differences. Based on the previously defined Mxa cut off more than .3, CA impairment was observable in all successful recanalized patients and in 8 of 10 patients with unsuccessful interventional treatment. CONCLUSIONS: These results suggest that brain perfusion may be affected due to impaired CA even after successful mechanical thrombectomy. Therefore, a tight blood pressure management is of great importance in post-thrombectomy stroke treatment to avoid cerebral hypo- and hyperperfusion.
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Isquemia Encefálica/terapia , Circulação Cerebrovascular , Trombose Intracraniana/terapia , Acidente Vascular Cerebral/terapia , Trombectomia , Idoso , Idoso de 80 Anos ou mais , Pressão Arterial , Velocidade do Fluxo Sanguíneo , Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/fisiopatologia , Feminino , Homeostase , Humanos , Trombose Intracraniana/diagnóstico por imagem , Trombose Intracraniana/fisiopatologia , Masculino , Estudos Prospectivos , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/fisiopatologia , Trombectomia/efeitos adversos , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia Doppler TranscranianaRESUMO
The preparation, characterization and electrochemical and photophysical properties of a series of desymmetrized heteroleptic [Cu(P^P)(N^N)][PF6] compounds are reported. The complexes incorporate the chelating P^P ligands bis(2-(diphenylphosphanyl)phenyl)ether (POP) and (9,9-dimethyl-9H-xanthene-4,5-diyl)bis(diphenylphosphane) (xantphos), and 6-substituted 2,2'-bipyridine (bpy) derivatives with functional groups attached by -(CH2)n- spacers: 6-(2,2'-bipyridin-6-yl)hexanoic acid (1), 6-(5-phenylpentyl)-2,2'-bipyridine (2) and 6-[2-(4-phenyl-1H-1,2,3,triazol-1-yl)ethyl]-2,2'-bipyridine (3). [Cu(POP)(1)][PF6], [Cu(xantphos)(1)][PF6], [Cu(POP)(2)][PF6], [Cu(xantphos)(2)][PF6], and [Cu(xantphos)(3)][PF6] have been characterized in solution using multinuclear NMR spectroscopy, and the single crystal structure of [Cu(xantphos)(3)][PF6].0.5Et2O was determined. The conformation of the 6-[2-(4-phenyl-1H-1,2,3,triazol-1-yl)ethyl]-substituent in the [Cu(xantphos)(3)]+ cation is such that the α- and ß-CH2 units reside in the xanthene 'bowl' of the xantphos ligand. The 6-substituent desymmetrizes the structure of the [Cu(P^P)(N^N)]+ cation and this has consequences for the interpretation of the solution NMR spectra of the five complexes. The NOESY spectra and EXSY cross-peaks provide insight into the dynamic processes operating in the different compounds. For powdered samples, emission maxima are in the range 542-555 nm and photoluminescence quantum yields (PLQYs) lie in the range 13-28%, and a comparison of PLQYs and decay lifetimes with those of [Cu(xantphos)(6-Mebpy)][PF6] indicate that the introduction of the 6-substituent is not detrimental in terms of the photophysical properties.
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Quelantes/química , Complexos de Coordenação/química , Cobre/química , Fosfinas/química , Xantenos/química , 2,2'-Dipiridil/química , Cristalografia por Raios X , Ligantes , Luminescência , Espectroscopia de Ressonância Magnética , Modelos MolecularesRESUMO
BACKGROUND: Diagnosing dysphagia in acute stroke patients is crucial, as this comorbidity determines morbidity and mortality; we therefore investigated the impact of flexible nasolaryngeal endoscopy (FEES) in acute stroke patients. METHODS: The FEES investigation as performed in acute stroke patients treated at a large university hospital, allocated as a standard procedure for all patients suspected of dysphagia. We correlated our findings with baseline data, disability status, pneumonia, duration of hospitalisation, necessity for mechanical ventilation and treatment on the intensive care unit. The study was designed as a cross-sectional hospital-based registry. RESULTS: We investigated 152 patients. The median age was 73; 94 were male. Ischemic stroke was diagnosed in 125 patients (82.2%); 27 (17.8%) suffered intracerebral haemorrhage. Oropharyngeal dysphagia was diagnosed in 72.4% of the patients, and was associated with higher stroke severity on admission (median NIHSS 11 [IQR 6-17] vs. 7 [4-12], p = .013; median mRS 5 [IQR 4-5] vs. 4 [IQR 3-5], p = .012). Short-term mortality was higher among patients diagnosed with dysphagia (7.2% vs. 0%, p = .107). FEES examinations revealed that only 30.9% of the patients had an oral diet appropriate for their swallowing abilities. A change of oral diet was associated with a better outcome at discharge (mRS; p = .006), less need of mechanical ventilation (p = .028), shorter period of hospitalisation (p = .044), and lower rates of pneumonia (p = .007) and mortality (p = .011). CONCLUSION: Due to the inability of clinical assessments to detect silent aspiration, FEES might be better suited to identify stroke patients at risk and may contribute to a better functional outcome and lower rates of pneumonia and mortality. Our findings also point to a low awareness of dysphagia, even in a specialised stroke centre. FEES in acute stroke patients helps to adjust the oral diet for the vast majority of stroke patients (69.1%) based on their swallowing abilities, potentially avoiding severe complications.
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Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/etiologia , Endoscopia do Sistema Digestório/métodos , Acidente Vascular Cerebral/complicações , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Dieta , Feminino , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de RegistrosRESUMO
BACKGROUND: Verbal and non-verbal aspects of communication as well as empathy are known to have an important impact on the medical encounter. The aim of the study was to analyze how well final year undergraduate medical students use skills of verbal and non-verbal communication during history-taking and whether these aspects of communication correlate with empathy and gender. METHODS: During a three steps performance assessment simulating the first day of a resident 30 medical final year students took histories of five simulated patients resulting in 150 videos of physician-patient encounters. These videos were analyzed by external rating with a newly developed observation scale for the verbal and non-verbal communication and with the validated CARE-questionnaire for empathy. One-way ANOVA, t-tests and bivariate correlations were used for statistical analyses. RESULTS: Female students showed signicantly higher scores for verbal communication in the case of a female patient with abdominal pain (p < 0.05), while male students started the conversations significantly more often with an open question (p < 0.05) and interrupted the patients significantly later in two cases than female students (p < 0.05). The number of W-questions asked by all students was significantly higher in the case of the female patient with abdominal pain (p < 0.05) and this patient was interrupted after the beginning of the interview significantly earlier than the patients in the other four cases (p < 0.001). Female students reached significantly higher scores for non-verbal communication in two cases (p < 0.05) and showed significantly more empathy than male students in the case of the female patient with abdominal pain (p < 0.05). In general, non-verbal communication correlated significantly with verbal communication and with empathy while verbal communication showed no significant correlation with empathy. CONCLUSIONS: Undergraduate medical students display differentiated communication behaviour with respect to verbal and non-verbal aspects of communication and empathy in a performance assessment and special differences could be detected between male and female students. These results suggest that explicit communication training and feedback might be necessary to raise students' awareness for the different aspects of communication and their interaction.
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Comunicação , Educação de Graduação em Medicina , Empatia , Anamnese , Comunicação não Verbal , Relações Médico-Paciente , Estudantes de Medicina/psicologia , Gravação em Vídeo , Adulto , Idoso , Análise de Variância , Pré-Escolar , Competência Clínica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Simulação de Paciente , Fatores Sexuais , Comportamento VerbalAssuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Poliarterite Nodosa/tratamento farmacológico , Adulto , Assistência ao Convalescente , Idoso , Proteína C-Reativa/análise , Quimioterapia Combinada , Feminino , Glucocorticoides/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/etiologia , Doenças do Sistema Nervoso Periférico/etiologia , Poliarterite Nodosa/complicações , Poliarterite Nodosa/fisiopatologia , Prednisolona/uso terapêutico , Receptores de Interleucina-6/antagonistas & inibidores , Indução de Remissão , Resultado do TratamentoAssuntos
Anestésicos/uso terapêutico , Homeostase/efeitos dos fármacos , Estado Epiléptico/tratamento farmacológico , Adulto , Idoso , Anestésicos/administração & dosagem , Estudos de Coortes , Feminino , Homeostase/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Estudos ProspectivosRESUMO
BACKGROUND: Cardiovascular diseases and arrhythmias are medical conditions that increase with age and are associated with significant morbidities and mortality. The aim of the present study was to investigate the prevalence of arrhythmias and clinical associations in the collective of older adults receiving comprehensive geriatric care (CGC). METHODS: Holter ECG monitoring (HECG) of older patients hospitalized for CGC was analyzed. The prevalence of arrhythmias and the associations between the presence of arrhythmias, patients' characteristics and the functional status regarding basic activities of daily living (assessed by the Barthel index (BI)), walking ability (assessed by the timed up and go test (TUG)), and balance and gait (assessed by the Tinetti balance and gait test (TBGT)) were examined. RESULTS: In the presented study, 626 patients were included (mean age: 83.9 ± 6.6 years, 67.7% were female). The most common arrhythmias detected in HECG were premature ventricular contractions (87.2%), premature atrial contractions (71.7%), and atrial fibrillation (22.7%). Atrial flutter was found in 1.0%, paroxysmal supraventricular tachycardia in 5.8%, non-sustained ventricular tachycardia in 12.5%, first-degree AV block in 0.8%, second-degree AV block type Mobitz I in 0.8%, second-degree AV block type Mobitz II in 0.3%, pause > 2.5 s any cause in 3.5%, and pause > 3 s any cause in 1.6% of the cases. Premature atrial contractions were associated with the female sex (74.8% vs. 65.3%, p = 0.018), whereas in male patients, the following arrhythmias were more common: premature ventricular contractions (91.6% vs. 85.1%, p = 0.029), ventricular bigeminus (8.4% vs. 3.8%, p = 0.021), and non-sustained ventricular tachycardia (17.3% vs. 10.1%, p = 0.014). Atrial fibrillation detected in HECG was more frequent in patients at high risk of falls, indicated by their TBGT score ≤ 18 (24.7% vs. 12.0%, p = 0.006), and premature ventricular contractions were more common in patients unable to walk (TUG score 5) compared to those with largely independent mobility (TUG score 1 or 2) (88.0% vs. 75.0%, p = 0.023). In a logistic regression analysis, atrial fibrillation detected in HECG was identified as a risk factor for a high risk of falls (odds ratio (OR): 2.35, 95% confidence interval (CI): 1.23-4.46). CONCLUSION: In our study, investigation of HECG of older adults hospitalized for CGC revealed that premature atrial contractions, premature ventricular contractions, and atrial fibrillation were the most common arrhythmias. Premature atrial contractions were found to be more frequent in female patients, while male patients were more prone to premature ventricular contractions. In the investigated population, atrial fibrillation emerged as a risk factor associated with a high risk of falls.
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A series of ten N^N chelating ligands based on a 2,2'-bipyridine (bpy) metal-binding domain and featuring sterically hindering substituents in the 6- and 6,6'-positions has been synthesized and characterized. The ligands have been incorporated into a family of 15 heteroleptic complexes of type [Cu(P^P)(N^N)][PF6] where P^P is the wide bite-angle bisphosphane ligand bis(2(diphenylphosphanyl)phenyl)ether (POP) or (9,9-dimethyl-9H-xanthene-4,5-diyl)bis(diphenylphosphane) (xantphos). Substituents in several of the N^N ligands ligands possess phenyl rings remotely tethered to enable intra- and intermolecular π-π-interactions in the [Cu(P^P)(N^N)]+ cations. Single crystal X-ray structures of 12 complexes are reported. The effects of the functional groups in the bpy ligand on the photophysical properties of the complexes have been studied; solid-state emission maxima range from 518 to 567 nm. Values of the solid-state photoluminescence quantum yields (PLQYs) of the [Cu(P^P)(N^N)][PF6] compounds respond to the nature of the N^N ligand. In general, we observed that the [Cu(P^P)(N^N)]+ complexes containing 6,6'-disubstituted complexes with phenyl moieties connected via a CH2CH2 or CH2CH2CH2 spacer to the bpy domain have the highest values of PLQY. The most significant compounds are [Cu(POP)((2-PhEt)2bpy)][PF6] (PLQY = 67%) and [Cu(POP)((3-PhPr)2bpy)][PF6] (PLQY = 72%) where (2-PhEt)2bpy = 6,6'-bis(2-phenylethyl)-2,2'-bipyridine and (3-PhPr)2bpy = 6,6'-bis(3-phenylpropyl)-2,2'-bipyridine. These PLQY values are among the best performing previously reported families of [Cu(P^P)(N^N)][PF6] compounds.
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Research on organizational epistemic vice alleges that some organizations are epistemically malevolent, i.e. they habitually harm others by deceiving them. Yet, there is a lack of empirical research on epistemic malevolence. We connect the discussion of epistemic malevolence to the empirical literature on organizational deception. The existing empirical literature does not pay sufficient attention to the impact of an organization's ability to control compromising information on its deception strategy. We address this gap by studying eighty high-penalty corporate misconduct cases between 2000 and 2020 in the United States. We find that organizations use two different strategies to deceive: Organizations 'sow doubt' when they contest information about them or their impacts that others have access to. By contrast, organizations 'exploit trust' when they deceive others by obfuscating, concealing, or falsifying information that they themselves control. While previous research has focused on cases of 'sowing doubt', we find that organizations 'exploit trust' in the majority of cases that we studied. This has important policy implications because the strategy of 'exploiting trust' calls for a different response from regulators and organizations than the strategy of 'sowing doubt'.
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BACKGROUND: Comprehensive geriatric care (CGC) is a multiprofessional treatment for older people which considers medical conditions and functional status. The aim of the presented study is to investigate the impact of hypertensive blood pressure (BP) on functional outcomes among older adults receiving CGC. METHODS: Functional status was documented by the Barthel index (BI), Tinetti test (TBGT), and timed up and go test (TUG) prior to and after CGC. The results were analyzed in relation to hypertensive BP, indicated by mean BP ≥ 130/80 mmHg determined by 24 h blood pressure monitoring (BPM) while hospitalized. RESULTS: In the presented monocentric, retrospective, observational study, 490 patients were included (mean age (SD): 83.86 ± 6.17 years, 72.2% females). Hypertension in BPM was found in 302 (61.6%) individuals. Hypertensive BP was associated with the female sex (p < 0.001) and current fracture (p = 0.001), and inversely associated with heart failure (p < 0.001), coronary heart disease (p < 0.001), atrial fibrillation (p < 0.001), urinary tract infection (p = 0.022), and hypocalcemia (p = 0.014). After CGC, improvements in BI (p < 0.001), TBGT (p < 0.001), and TUG (p < 0.001) were observed in patients with both normotensive and hypertensive BP profiles. The proportion of patients with outcome improvements did not differ between the two groups (BI: 84.4% vs. 88.3%, p = 0.285; TBGT: 81.1% vs. 77.7%, p = 0.357; TUG: 50.3% vs. 48.4%, p = 0.711). CONCLUSION: Patients both with and without hypertensive BP profiles benefited from comprehensive geriatric care with comparable outcome improvements. Particularly, normotensive BP was associated with chronic cardiovascular comorbidities, indicating increased awareness of the importance of BP management in patients diagnosed with cardiac diseases.
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BACKGROUND/OBJECTIVES: Comprehensive Geriatric Care (CGC) is a specific multimodal treatment for older patients. In the current study, we aimed to investigate walking performance after CGC in medically ill patients versus those with fractures. METHODS: The timed up and go test (TuG), a 5-grade scale assessment (1 = no walking impairment to 5 = no walking ability at all) for evaluating individual walking ability was performed in all patients who underwent CGC prior to and after treatment. Factors associated with improvement in walking ability were analyzed in the subgroup of patients with fractures. RESULTS: Out of 1263 hospitalized patients, 1099 underwent CGC (median age: 83.1 years (IQR 79.0-87.8 years); 64.1% were female). Patients with fractures (n = 300) were older than those without (n = 799), (median 85.6 versus 82.4 years, p = 0.001). Improvement in TuG after CGC was found in 54.2% of the fracture patients compared to just 45.9% of those without fractures. In fracture group patients, TuG improved from median 5 on admission to median 3 on discharge (p = 0.001). In fracture patients, improvement in walking ability was associated with higher Barthel index values on admission (median 45 (IQR: 35-55) versus 35 (IQR: 20-50): p = 0.001) and Tinetti assessment scores (median 9 (IQR: 4-14.25) versus 5 (IQR: 0-13); p = 0.001) and was negatively associated with the diagnosis of dementia (21.4% versus 31.5%; p = 0.058). CONCLUSION: CGC improved walking ability in more than half of all patients examined. Older patients in particular might benefit from undergoing the procedure after an acute fracture. A better initial functional status favors a positive result following the treatment.
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Fraturas do Quadril , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Masculino , Equilíbrio Postural , Estudos de Tempo e Movimento , Atividades Cotidianas , Assistência Integral à SaúdeRESUMO
Since nanofibers have a high surface-to-volume ratio, van der Waals forces render them attracted to virtually any surface. The high ratio provides significant advantages for applications in drug delivery, wound healing, tissue regeneration, and filtration. Cribellate spiders integrate thousands of nanofibers into their capture threads as an adhesive to immobilize their prey. These spiders have antiadhesive nanoripples on the calamistrum, a comb-like structure on their hindmost legs, and are thus an ideal model for investigating how nanofiber adhesion can be reduced. We found that these nanoripples had similar spacing in the cribellate species Uloborus plumipes, Amaurobius similis, and Menneus superciliosus, independent of phylogenetic relation and size. Ripple spacing on other body parts (i.e., cuticle, claws, and spinnerets), however, was less homogeneous. To investigate whether a specific distance between the ripples determines antiadhesion, we fabricated nanorippled foils by nanosecond UV laser processing. We varied the spatial periods of the nanoripples in the range ~203-613 nm. Using two different pulse numbers resulted in ripples of different heights. The antiadhesion was measured for all surfaces, showing that the effect is robust against alterations across the whole range of spatial periods tested. Motivated by these results, we fabricated irregular surface nanoripples with spacing in the range ~130-480 nm, which showed the same antiadhesive behavior. The tested surfaces may be useful in tools for handling nanofibers such as spoolers for single nanofibers, conveyor belts for producing endless nanofiber nonwoven, and cylindrical tools for fabricating tubular nanofiber nonwoven. Engineered fibers such as carbon nanotubes represent a further candidate application area.
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BACKGROUND/OBJECTIVES: Depressive symptoms (DS) may interfere with comprehensive geriatric care (CGC), the specific multimodal treatment for older patients. In view of this, the aim of the current study was to investigate the extent to which DS occur in older hospitalized patients scheduled for CGC and to analyze the associated factors. Furthermore, we aimed to investigate whether DS are relevant with respect to outcomes after CGC. METHODS: For this retrospective study, all patients fulfilling the inclusion criteria were selected by reviewing case files. The main inclusion criterion was the completion of CGC within the defined period (May 2018 and May 2019) in the geriatrics department of the Diakonie Hospital Jung-Stilling Siegen (Germany). The Geriatric Depression Scale was used to asses DS in older adults scheduled for CGC (0-5, no evidence of DS; 6-15 points, DS). Scores for functional assessments (Timed Up and Go test (TuG), Barthel Index, and Tinetti Gait and Balance test) were compared prior to versus after CGC. Factors associated with the presence of DS were studied. RESULTS: Out of the 1263 patients available for inclusion in this study, 1092 were selected for the analysis (median age: 83.1 years (IQR 79.1-87.7 years); 64.1% were female). DS (GDS > 5) were found in 302 patients (27.7%). The proportion of female patients was higher in the subgroup of patients with DS (85.5% versus 76.3%, p = 0.024). Lower rates of patients diagnosed with chronic pulmonary obstructive disease were detected in the subgroup of patients without DS (8.0% versus 14.9%, p = 0.001). Higher rates of dizziness were observed in patients with DS than in those without (9.9% versus 6.2%, p = 0.037). After CGC, TuG scores improved from a median of 4 to 3 (p < 0.001) and Barthel Index scores improved from a median of 45 to 55 (p < 0.001) after CGC in both patients with and without DS. In patients with DS, the Tinetti score improved from a median of 10 (IQR: 4.75-14.25) prior to CGC to 14 (IQR 8-19) after CGC (p < 0.001). In patients without DS, the Tinetti score improved from a median of 12 (IQR: 6-7) prior to CGC to 15 (IQR 2-20) after CGC (p < 0.001). CONCLUSIONS: DS were detected in 27.7% of the patients selected for CGC. Although patients with DS had a poorer baseline status, we detected no difference in the degree of improvement in both groups, indicating that the performance of CGC is unaffected by the presence of DS prior to the procedure.
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The N^N chelating ligands 6,6'-bis(but-3-en-1-yl)-2,2'-bipyridine (1), 6-(but-3-en-1-yl)-6'-methyl-2,2'-bipyridine (2), 6,6'-bis(pent-4-en-1-yl)-2,2'-bipyridine (3) and 6-(pent-4-en-1-yl)-6'-methyl-2,2'-bipyridine (4) have been prepared, characterized, and incorporated into the heteroleptic [Cu(N^N)(P^P)][PF6] complexes in which P^P is either POP (bis(2-(diphenylphosphanyl)phenyl)ether) or xantphos (9,9-dimethyl-9H-xanthene-4,5-diyl)bis(diphenylphosphane). The eight coordination compounds have been fully characterized, including the single crystal structures of [Cu(1)(xantphos)][PF6], [Cu(1)(POP)][PF6]·CH2Cl2, [Cu(2)(xantphos)][PF6], [Cu(2)(POP)][PF6] and [Cu(3)(POP)][PF6]·0.5Et2O. The [Cu(N^N)(P^P)]+ cations exhibit a partially reversible or irreversible Cu+/Cu2+ oxidation at more positive potentials than the benchmark [Cu(bpy)(P^P)]+ and [Cu(Me2bpy)(P^P)]+ complexes consistent with the increase in steric hindrance of the terminal alkenyl substituents. When excited in the region of the metal-to-ligand charge transfer (MLCT) absorption, solutions of the [Cu(N^N)(P^P)][PF6] complexes are weak emitters with λmaxem in the range 565-578 nm. However, powdered samples achieve photoluminescence quantum yields in the range of 28.5 to 62.3%, with the highest PLQY found for [Cu(3)(POP)][PF6] with an excited-state lifetime, τ, of 16.1 µs. For [Cu(3)(POP)][PF6], the excited state lifetime was measured in MeTHF at 293 and 77 K, and the increase in τ from 1.77 to 59.4 µs upon cooling supports thermally activated delayed fluorescence (TADF) at ambient temperatures.
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Background: Comprehensive geriatric care (CGC) is a multidisciplinary approach developed to meet the needs of older patients. Electroencephalography (EEG) provides valuable information for monitoring the cerebral function. As a surrogate, EEG findings may help to estimate the course of diseases as well as the treatment outcomes. Objectives: Therefore, the aim of the present study is to investigate EEG findings in older patients receiving CGC. Methods: Patients with an initial EEG in a geriatric unit between May 2019 and April 2020 and treated using the CGC approach were analyzed. EEG abnormalities were defined as generalized (diffuse) background slowing and/or intermittent/persistent focal slowing and/or epileptiform discharges. Assessment results for the Barthel index (BI), Tinetti Balance and Gait test (TBGT), and Timed Up and Go test (TUG) were analyzed in relation to the presence of EEG abnormalities. Results: The study included 398 patients (mean age: 83.0 ± 6.57 years, 69.3% were female). Abnormal EEG patterns were found in 94 (23.6%) patients. Patients with EEG abnormalities had a mean age of 83.4 years versus a mean of 82.8 years in those without (p = 0.451). Based on all calculated scores, the majority of the patients improved after CGC, with a tendency to higher-grade improvements in those without EEG abnormalities (BI: 86.2% vs. 75.5%, p = 0.024; TUG: 53.3% vs. 31.9%, p < 0.001); for TBGT, only a gradual difference was detected (TBGT: 79.9% vs. 71.3%, p = 0.088). The presence of EEG abnormalities was associated with the parameters dementia (36.2% vs. 22.4%, p = 0.010), known epilepsy/seizure (19.1% vs. 5.9%, p < 0.001), structural brain lesion (47.9% vs. 19.7%, p < 0.001), and delirium (9.6% vs. 3.6%, p = 0.030) during hospitalization. Conclusions: We found EEG abnormalities in almost a quarter of the patients treated in the geriatric unit. In older patients, the presence of EEG abnormalities is associated with lower improvements after CGC.
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Nanofibers are drawing the attention of engineers and scientists because their large surface-to-volume ratio is favorable for applications in medicine, filter technology, textile industry, lithium-air batteries, and optical sensors. However, when transferring nanofibers to a technical product in the form of a random network of fibers, referred to as nonwoven fabric, the stickiness of the freshly produced and thus fragile nanofiber nonwoven remains a problem. This is mainly because nanofibers strongly adhere to any surface because of van der Waals forces. In nature, there are animals that are actually able to efficiently produce, process, and handle nanofibers, namely cribellate spiders. For that, the spiders use the calamistrum, a comb-like structure of modified setae on the metatarsus of the hindmost (fourth) legs, to which the 10-30 nm thick silk nanofibers do not stick due to a special fingerprint-like surface nanostructure. In this work, we present a theoretical model of the interaction of linear nanofibers with a sinusoidally corrugated surface. This model allows for a prediction of the adhesive interaction and, thus, the design of a suitable surface structure to prevent sticking of an artificially nonwoven of nanofibers. According to the theoretical prediction, a technical analogon of the nanoripples was produced by ultrashort pulse laser processing on different technically relevant metal surfaces in the form of so-called laser-induced periodic surface structures (LIPSS). Subsequently, by means of a newly established peel-off test, the adhesion of an electrospun polyamide fiber-based nonwoven was quantified on such LIPSS-covered aluminium alloy, steel, and titanium alloy samples, as well as on polished (flat) control samples as reference and, additionally, on samples with randomly rough surfaces. The latter revealed that the adhesion of electrospun nanofiber nonwoven is significantly lowered on the nanostructured surfaces compared with the polished surfaces.
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This paper presents two studies on the development and validation of a ten-item scale of epistemic vice and the relationship between epistemic vice and misinformation and fake news. Epistemic vices have been defined as character traits that interfere with acquiring, maintaining, and transmitting knowledge. Examples of epistemic vice are gullibility and indifference to knowledge. It has been hypothesized that epistemically vicious people are especially susceptible to misinformation and conspiracy theories. We conducted one exploratory and one confirmatory observational survey study on Amazon Mechanical Turk among people living in the United States (total N = 1737). We show that two psychological traits underlie the range of epistemic vices that we investigated: indifference to truth and rigidity. Indifference manifests itself in a lack of motivation to find the truth. Rigidity manifests itself in being insensitive to evidence. We develop a scale to measure epistemic vice with the subscales indifference and rigidity. The Epistemic Vice Scale is internally consistent; has good convergent, divergent, and discriminant validity; and is strongly associated with the endorsement of misinformation and conspiracy theories. Epistemic vice explains additional variance in the endorsement of misinformation and conspiracy theories over and above demographic and related psychological concepts and shows medium to large effect sizes across outcome measures. We demonstrate that epistemic vice differs from existing psychological constructs, and show that the scale can explain individual differences in dealing with misinformation and conspiracy theories. We conclude that epistemic vice might contribute to "postfactive" ways of thinking. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13164-021-00562-5.