Context. Hot subluminous stars can be spectroscopically classified as subdwarf B (sdB) and O (sdO) stars. While the latter are predominantly hydrogen deficient, the former are mostly helium ...deficient. The atmospheres of most sdOs are almost devoid of hydrogen, whereas a small group of hot subdwarf stars of mixed H/He composition exists, showing extreme metal abundance anomalies. Whether such intermediate helium-rich (iHe) subdwarf stars provide an evolutionary link between the dominant classes is an open question. Aims. The presence of strong Ge, Sn, and Pb lines in the UV spectrum of HZ 44 suggests a strong enrichment of heavy elements in this iHe-sdO star and calls for a detailed quantitative spectral analysis focusing on trans-iron elements. Methods. Non-local thermodynamical equilibrium model atmospheres and synthetic spectra calculated with TLUSTY/SYNSPEC were combined with high-quality optical, ultraviolet (UV), and far-UV (FUV) spectra of HZ 44 and its hotter sibling HD 127493 to determine their atmospheric parameters and metal abundance patterns. Results. By collecting atomic data from the literature we succeeded in determining the abundances of 29 metals in HZ 44, including the trans-iron elements Ga, Ge, As, Se, Zr, Sn, and Pb and providing upper limits for ten other metals. This makes it the best-described hot subdwarf in terms of chemical composition. For HD 127493 the abundance of 15 metals, including Ga, Ge, and Pb and upper limits for another 16 metals were derived. Heavy elements turn out to be overabundant by one to four orders of magnitude with respect to the Sun. Zr and Pb are among the most enriched elements. Conclusions. The C, N, and O abundance for both stars can be explained by the nucleosynthesis of hydrogen burning in the CNO cycle along with the stars’ helium enrichment. On the other hand, the heavy-element anomalies are unlikely to be caused by nucleosynthesis. Instead diffusion processes are evoked, with radiative levitation overcoming gravitational settlement of the heavy elements.
To determine the feasibility of a nurse-led, primary care-based comprehensive geriatric assessment (CGA) intervention.
A feasibility cluster randomized controlled trial.
The trial was conducted in ...six general practices in the United Kingdom from May 2018 to April 2020. Participants were moderately/severely frail people aged 65 years and older living at home. Clusters were randomly assigned to the intervention arm control arms. A CGA was delivered to the intervention participants, with control participants receiving usual care. Study outcomes related to feasibility of the intervention and of conducting the trial including recruitment and retention. A range of outcome measures of quality of life, function, loneliness, self-determination, mortality, hospital admission/readmission and number of prescribed medications were evaluated.
All pre-specified feasibility criteria relating to recruitment and retention were met with 56 participants recruited in total (30 intervention and 26 control). Retention was high with 94.6% of participants completing 13-week follow-up and 87.5% (n = 49) completing 26-week follow-up. All outcome measures instruments met feasibility criteria relating to completeness and responsiveness over time. Quality of life was recommended as the primary outcome for a definitive trial with numbers of prescribed medications as a secondary outcome measure.
It is feasible to implement and conduct a randomized controlled trial of a nurse-led, primary care-based CGA intervention.
The study provided evidence on the feasibility of a CGA intervention for older people delivered in primary care. It provides information to maximize the success of a definitive trial of the clinical effectiveness of the intervention.
Patient and public representatives were involved in the study design including intervention development and production of participant-facing documentation. Representatives served on the trial management and steering committees and, as part of this role, interpreted feasibility data. ISRCTN Number: 74345449.
Despite the widespread use of triptans in the treatment of migraine during pregnancy, questions relating to their vasoconstrictive properties have been raised following recent reports of rare fetal ...deaths and intrauterine growth restrictions. However, to date, analysis of these data does not allow to conclude to a direct effect of triptans, which remain a second line treatment of migraine attacks during pregnancy at any term and under normal conditions of use.
Beam-to-column joints equipped with friction dampers are promising solutions to improve the performance of steel moment resisting frames due to the possibility to guarantee large dissipation capacity ...limiting the structural damage under severe seismic conditions. In this paper, the experimental tests and the numerical simulations of two types of joints are shown and discussed with the aim of developing pre-qualified configurations. The friction dampers are designed to be easily removable from both the lower beam flange and the column face by means of bolted connections. The devices are composed of a stack of steel plates conceived to assure symmetrical friction. The friction surface is set in vertical direction in first case and in horizontal direction in the second type. The experimental tests confirmed the effectiveness of both examined joints and the finite element analyses allowed characterizing their local response, thus providing additional insights to improve the design requirements.
•The behavior of steel beam-to-column joints equipped with friction dampers is investigated.•Dampers with both horizontal and vertical friction surface are investigated.•Experimental tests on joints equipped with friction dampers show satisfactory response with negligible damage.•The tested joints show non-symmetric response under hogging and sagging moment.•Finite element simulations show that the vertical friction damper exhibit plastic deformations lower than the horizontal friction damper.
Background: Nurses at the frontline of caring for COVID-19 patients might experience mental health challenges and supportive coping strategies are needed to reduce their stress and burnout. The aim ...of this study was to identify stressors and burnout among frontline nurses caring for COVID-19 patients in Wuhan and Shanghai and to explore perceived effective morale support strategies. Method: A cross-sectional survey was conducted in March 2020 among 110 nurses from Zhongshan Hospital, Shanghai, who were deployed at COVID-19 units in Wuhan and Shanghai. A COVID-19 questionnaire was adapted from the previous developed "psychological impacts of SARS" questionnaire and included stressors (31 items), coping strategies (17 items), and effective support measures (16 items). Burnout was measured with the Maslach Burnout Inventory. Results: Totally, 107 (97%) nurses responded. Participants mean age was 30.28 years and 90.7% were females. Homesickness was most frequently reported as a stressor (96.3%). Seven of the 17 items related to coping strategies were undertaken by all participants. Burnout was observed in the emotional exhaustion and depersonalization subscales, with 78.5 and 92.5% of participants presenting mild levels of burnout, respectively. However, 52 (48.6%) participants experienced a severe lack of personal accomplishment. Participants with longer working hours in COVID-19 quarantine units presented higher emotional exhaustion (OR = 2.72, 95% CI 0.02-5.42; p = 0.049) and depersonalization (OR = 1.14, 95% CI 0.10-2.19; p = 0.033). Participants with younger age experienced higher emotional exhaustion (OR = 2.96, 95% CI 0.11-5.82; p = 0.042) and less personal accomplishment (OR = 3.80, 95% CI 0.47-7.13; p = 0.033). Conclusions: Nurses in this study experienced considerable stress and the most frequently reported stressors were related to families. Nurses who were younger and those working longer shift-time tended to present higher burnout levels. Psychological support strategies need to be organized and implemented to improve mental health among nurses during the COVID-19 pandemic.Background: Nurses at the frontline of caring for COVID-19 patients might experience mental health challenges and supportive coping strategies are needed to reduce their stress and burnout. The aim of this study was to identify stressors and burnout among frontline nurses caring for COVID-19 patients in Wuhan and Shanghai and to explore perceived effective morale support strategies. Method: A cross-sectional survey was conducted in March 2020 among 110 nurses from Zhongshan Hospital, Shanghai, who were deployed at COVID-19 units in Wuhan and Shanghai. A COVID-19 questionnaire was adapted from the previous developed "psychological impacts of SARS" questionnaire and included stressors (31 items), coping strategies (17 items), and effective support measures (16 items). Burnout was measured with the Maslach Burnout Inventory. Results: Totally, 107 (97%) nurses responded. Participants mean age was 30.28 years and 90.7% were females. Homesickness was most frequently reported as a stressor (96.3%). Seven of the 17 items related to coping strategies were undertaken by all participants. Burnout was observed in the emotional exhaustion and depersonalization subscales, with 78.5 and 92.5% of participants presenting mild levels of burnout, respectively. However, 52 (48.6%) participants experienced a severe lack of personal accomplishment. Participants with longer working hours in COVID-19 quarantine units presented higher emotional exhaustion (OR = 2.72, 95% CI 0.02-5.42; p = 0.049) and depersonalization (OR = 1.14, 95% CI 0.10-2.19; p = 0.033). Participants with younger age experienced higher emotional exhaustion (OR = 2.96, 95% CI 0.11-5.82; p = 0.042) and less personal accomplishment (OR = 3.80, 95% CI 0.47-7.13; p = 0.033). Conclusions: Nurses in this study experienced considerable stress and the most frequently reported stressors were related to families. Nurses who were younger and those working longer shift-time tended to present higher burnout levels. Psychological support strategies need to be organized and implemented to improve mental health among nurses during the COVID-19 pandemic.
•The frictional behavior of steel, brass, sprayed aluminum and three types of rubber all sliding on steel is investigated.•The cyclic behavior of six interfaces is experimentally tested under cyclic ...loads.•Static and dynamic friction coefficient of the interfaces is evaluated.•The influence of flat washers or cone annular springs on the magnitude of the sliding force is investigated.•An analytical model able to predict the response of three of the investigated interfaces is proposed.
In this paper, the friction coefficient and the cyclic response of different interfaces for friction devices are investigated by means of experimental tests under displacement control. In particular, six interfaces have been tested: steel–steel, brass–steel, sprayed aluminum–steel and three different rubber based friction materials adopted, respectively, in automotive applications, electrical machines and applications requiring low wearing.
Static and kinetic friction coefficients have been evaluated and the influence of the interface pressure has been analyzed. The variation of the sliding force during the cyclic loading history has been investigated by comparing also the response coming from the use of different washers: circular flat washers and cone shaped annular disc springs.
The work is aimed at the investigation of friction materials to be applied within the connecting elements of beam-to-column joints according to the double split tee configuration with friction pads.
Little is known about the association between fear of movement (kinesiophobia) and objectively measured physical activity (PA), the first 12 weeks after cardiac hospitalization.
To assess the ...longitudinal association between kinesiophobia and objectively measured PA and to assess the factor structure of kinesiophobia.
We performed a longitudinal observational study. PA was continuously measured from hospital discharge to 12 weeks using the Personal Activity Monitor. The PAM measures time spent per day in PA-intensity categories: light, moderate and heavy. Kinesiophobia was assessed with the Tampa Scale for Kinesiophobia (TSK) at four time points (hospital discharge, 3, 6 and 12 weeks). The longitudinal association between PA-intensity and kinesiophobia was studied with a random intercept cross lagged panel model (RI-CLPM). A RI-CLPM estimates effects from kinesiophobia on objectively measured PA and vice versa (cross-over effects), and autoregressive effects (e.g. kinesiophobia from one occasion to the next).
In total, 116 patients (83.6% male) with a median age of 65.5 were included in this study. On no occasion did we find an effect of kinesiophobia on PA and vice versa. Model fit for the original model was poor (X2: = 44.646 P<0.001). Best model fit was found for a model were kinesiophobia was modelled as a stable between factor (latent variable) and PA as autoregressive component (dynamic process) (X2 = 27.541 P<0.12).
Kinesiophobia and objectively measured PA are not associated in the first 12 weeks after hospital discharge. This study shows that kinesiophobia remained relatively stable, 12 weeks after hospital discharge, despite fluctuations in light to moderate PA-intensity.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The intermediate He-enriched hot subdwarf star Feige 46 was recently reported as the second member of the V366 Aqr (or He-sdOBV) pulsating class. Feige 46 is very similar to the prototype of the ...class, LS IV − 14°116, not only in terms of pulsational properties, but also in terms of atmospheric parameters and kinematic properties. LS IV − 14°116 is additionally characterized by a very peculiar chemical composition, with extreme overabundances of the trans-iron elements Ge, Sr, Y, and Zr. We investigate the possibility that the similarity between the two pulsators extends to their chemical composition. We retrieved archived optical and UV spectroscopic observations of Feige 46 and performed an abundance analysis using model atmospheres and synthetic spectra computed with TLUSTY and SYNSPEC. In total, we derived abundances for 16 elements and provide upper limits for four additional elements. Using absorption lines in the optical spectrum of the star we measure an enrichment of more than 10 000× solar for yttrium and zirconium. The UV spectrum revealed that strontium is equally enriched. Our results confirm that Feige 46 is not only a member of the now growing group of heavy metal subdwarfs, but also has an abundance pattern that is remarkably similar to that of LS IV − 14°116.
Background Transition from paediatric to adult healthcare has received little attention in the Netherlands. This study aimed to: (i) map experiences with the transfer to adult care of young adults ...with chronic conditions; and (ii) identify recommendations for transitional care of young adults, their parents and healthcare providers.
Methods Semi‐structured interviews with 24 young adults after transfer (aged 15–22 years; diagnosed with haemophilia, diabetes mellitus, spina bifida, congenital heart disorders, cystic fibrosis, juvenile rheumatoid arthritis or sickle cell disease), 24 parents and 17 healthcare providers. Thematic analysis was performed.
Results Only the haemophilia department offered a structured transition programme, most patients had not been prepared for transition. Experiences and views of patients, parents and professionals mainly overlapped and were condensed into four core themes. Two are related to moving to adult care: (1) ‘leaving paediatric care is a logical step’. Leaving familiar surroundings was harder for parents than for young adults who displayed a positive ‘wait‐and‐see’ attitude; and (2) ‘transition is complicated by cultural gaps between paediatric and adult services’. Young adults and parents felt lost after transfer and recommended their peers ‘to be alert and involved’. Providers also recognized the cultural chasm between both services and worried about non‐compliance, lost to follow‐up and lack of independence. Two other themes indicated priorities for improvement: (3) ‘better patient and parent preparation’ for differences between healthcare settings and for new roles and responsibilities with respect to self‐management; and (4) ‘more collaboration and personal links’ between paediatric and adult care providers.
Conclusions Action is required to cross the chasm between paediatric and adult‐oriented care. Preparation for transition should start early and focus on strengthening adolescents' independency without undermining parental involvement. Building bridges between services, gaining trust and investing in new personal relations is a challenge for all parties involved: transition is about responding and bonding.
PDF
