This study examines how differently young residents’ experiential value and sense of community mediate the perceived positive and negative effects of a convention center on levels of overall ...community satisfaction in an integrative model based on social exchange theory. Results show that perceived positive convention center impacts, directly and indirectly, affect experiential value, sense of community, and overall community satisfaction. However, perceived negative convention center impacts, directly and indirectly, affect overall community satisfaction only through experiential value. This study provides both theoretical and practical implications, as well as directions for future research.
We describe the epidemiology of a coronavirus disease (COVID-19) outbreak in a call center in South Korea. We obtained information on demographic characteristics by using standardized epidemiologic ...investigation forms. We performed descriptive analyses and reported the results as frequencies and proportions for categoric variables. Of 1,143 persons who were tested for COVID-19, a total of 97 (8.5%, 95% CI 7.0%-10.3%) had confirmed cases. Of these, 94 were working in an 11th-floor call center with 216 employees, translating to an attack rate of 43.5% (95% CI 36.9%-50.4%). The household secondary attack rate among symptomatic case-patients was 16.2% (95% CI 11.6%- 22.0%). Of the 97 persons with confirmed COVID-19, only 4 (1.9%) remained asymptomatic within 14 days of quarantine, and none of their household contacts acquired secondary infections. Extensive contact tracing, testing all contacts, and early quarantine blocked further transmission and might be effective for containing rapid outbreaks in crowded work settings.
Aim
To investigate the relationships among structural empowerment, professional governance, autonomy and job satisfaction in the Korean nurses and to provide a more in‐depth explanation of the nature ...of professional governance as a process.
Background
Professional governance in nursing is a key component in the Magnet Recognition Program. However, little is known about professional governance in the Korean nursing.
Methods
A sequential, explanatory, mixed‐method study with the Korean nurses (n = 208).
Results
The quantitative findings showed that decision‐making among the Korean nurses fell on a continuum of professional governance directed by managers. The mediating effects of professional governance on the relationships between structural empowerment and autonomy and between structural empowerment and job satisfaction were significant. The qualitative findings described the inhibitors and facilitators of professional governance.
Conclusion
The findings of this study highlight the significance of professional governance in providing nurses with more control over nursing practice and patient care and in encouraging nurses’ involvement in organizational decision‐making.
Implications for Nursing Management
Health care organizations should establish internal policies that give nurses the power to voice their opinions on inpatient care, encourage unit managers to create a positive nursing work environment through support and recognition and have nurses set council activity goals based on their needs.
We analyzed reports for 59,073 contacts of 5,706 coronavirus disease (COVID-19) index patients reported in South Korea during January 20-March 27, 2020. Of 10,592 household contacts, 11.8% had ...COVID-19. Of 48,481 nonhousehold contacts, 1.9% had COVID-19. Use of personal protective measures and social distancing reduces the likelihood of transmission.
Control of the interlayer twist angle in two-dimensional van der Waals (vdW) heterostructures enables one to engineer a quasiperiodic moiré superlattice of tunable length scale
. In twisted bilayer ...graphene, the simple moiré superlattice band description suggests that the electronic bandwidth can be tuned to be comparable to the vdW interlayer interaction at a 'magic angle'
, exhibiting strongly correlated behaviour. However, the vdW interlayer interaction can also cause significant structural reconstruction at the interface by favouring interlayer commensurability, which competes with the intralayer lattice distortion
. Here we report atomic-scale reconstruction in twisted bilayer graphene and its effect on the electronic structure. We find a gradual transition from an incommensurate moiré structure to an array of commensurate domains with soliton boundaries as we decrease the twist angle across the characteristic crossover angle, θ
≈ 1°. In the solitonic regime (θ < θ
) where the atomic and electronic reconstruction become significant, a simple moiré band description breaks down and the secondary Dirac bands appear. On applying a transverse electric field, we observe electronic transport along the network of one-dimensional topological channels that surround the alternating triangular gapped domains. Atomic and electronic reconstruction at the vdW interface provide a new pathway to engineer the system with continuous tunability.
Abstract
For steady electroconversion to value-added chemical products with high efficiency, electrocatalyst reconstruction during electrochemical reactions is a critical issue in catalyst design ...strategies. Here, we report a reconstruction-immunized catalyst system in which Cu nanoparticles are protected by a quasi-graphitic C shell. This C shell epitaxially grew on Cu with quasi-graphitic bonding via a gas–solid reaction governed by the CO (g) - CO
2
(g) - C (s) equilibrium. The quasi-graphitic C shell-coated Cu was stable during the CO
2
reduction reaction and provided a platform for rational material design. C
2+
product selectivity could be additionally improved by doping
p
-block elements. These elements modulated the electronic structure of the Cu surface and its binding properties, which can affect the intermediate binding and CO dimerization barrier. B-modified Cu attained a 68.1% Faradaic efficiency for C
2
H
4
at −0.55 V (vs RHE) and a C
2
H
4
cathodic power conversion efficiency of 44.0%. In the case of N-modified Cu, an improved C
2+
selectivity of 82.3% at a partial current density of 329.2 mA/cm
2
was acquired. Quasi-graphitic C shells, which enable surface stabilization and inner element doping, can realize stable CO
2
-to-C
2
H
4
conversion over 180 h and allow practical application of electrocatalysts for renewable energy conversion.
Summary Background The irreversible ErbB family blocker afatinib and the reversible EGFR tyrosine kinase inhibitor gefitinib are approved for first-line treatment of EGFR mutation-positive ...non-small-cell lung cancer (NSCLC). We aimed to compare the efficacy and safety of afatinib and gefitinib in this setting. Methods This multicentre, international, open-label, exploratory, randomised controlled phase 2B trial (LUX-Lung 7) was done at 64 centres in 13 countries. Treatment-naive patients with stage IIIB or IV NSCLC and a common EGFR mutation (exon 19 deletion or Leu858Arg) were randomly assigned (1:1) to receive afatinib (40 mg per day) or gefitinib (250 mg per day) until disease progression, or beyond if deemed beneficial by the investigator. Randomisation, stratified by EGFR mutation type and status of brain metastases, was done centrally using a validated number generating system implemented via an interactive voice or web-based response system with a block size of four. Clinicians and patients were not masked to treatment allocation; independent review of tumour response was done in a blinded manner. Coprimary endpoints were progression-free survival by independent central review, time-to-treatment failure, and overall survival. Efficacy analyses were done in the intention-to-treat population and safety analyses were done in patients who received at least one dose of study drug. This ongoing study is registered with ClinicalTrials.gov , number NCT01466660. Findings Between Dec 13, 2011, and Aug 8, 2013, 319 patients were randomly assigned (160 to afatinib and 159 to gefitinib). Median follow-up was 27·3 months (IQR 15·3–33·9). Progression-free survival (median 11·0 months 95% CI 10·6–12·9 with afatinib vs 10·9 months 9·1–11·5 with gefitinib; hazard ratio HR 0·73 95% CI 0·57–0·95, p=0·017) and time-to-treatment failure (median 13·7 months 95% CI 11·9–15·0 with afatinib vs 11·5 months 10·1–13·1 with gefitinib; HR 0·73 95% CI 0·58–0·92, p=0·0073) were significantly longer with afatinib than with gefitinib. Overall survival data are not mature. The most common treatment-related grade 3 or 4 adverse events were diarrhoea (20 13% of 160 patients given afatinib vs two 1% of 159 given gefitinib) and rash or acne (15 9% patients given afatinib vs five 3% of those given gefitinib) and liver enzyme elevations (no patients given afatinib vs 14 9% of those given gefitinib). Serious treatment-related adverse events occurred in 17 (11%) patients in the afatinib group and seven (4%) in the gefitinib group. Ten (6%) patients in each group discontinued treatment due to drug-related adverse events. 15 (9%) fatal adverse events occurred in the afatinib group and ten (6%) in the gefitinib group. All but one of these deaths were considered unrelated to treatment; one patient in the gefitinib group died from drug-related hepatic and renal failure. Interpretation Afatinib significantly improved outcomes in treatment-naive patients with EGFR -mutated NSCLC compared with gefitinib, with a manageable tolerability profile. These data are potentially important for clinical decision making in this patient population. Funding Boehringer Ingelheim.
The interfacial atomic structure and misfits of Omega precipitates formed in the face-centered cubic Al in the Al-Cu-Mg-Ag alloy have been determined by combining scanning transmission electron ...microscopy (STEM) Z-contrast imaging with chemical analysis and ab initio density functional theory (DFT) calculations. Precipitates of several thicknesses formed after heat treatment at 250 degree C, starting from 0 to 2 unit cells of Omega phase, were examined by STEM in four different projections. The results show that a remarkably stable double-layered interface is formed at all observed thicknesses, which separates the Omega phase from the Al matrix. The outermost interfacial layer next to Al is composed of Ag atoms in a hexagonal structure and Mg or Cu atoms below the center of the hexagon. Structural models constructed based on the experimental data were relaxed using DFT-based molecular dynamics calculations. The results show that interfacial Mg atoms, together with Ag atoms, greatly stabilize the interface structure and consequently the Omega phase on the Al {111} habit planes. Comparison between the measured and calculated precipitate misfit along the thickness direction suggests that atomic substitutions of light atoms, Al and Mg, at the interface mediate the misfit strain and free energy, which is further supported by experimental evidence obtained from STEM. Thus, we have identified here: (i) the driving force for the Ag and Mg segregation in the formation of the Omega phase; (ii) the precipitation sequence characterized by a stable interfacial double-layer; and (iii) an interfacial substitution mechanism for misfit accommodation.
Summary Background Afatinib—an oral irreversible ErbB family blocker—improves progression-free survival compared with pemetrexed and cisplatin for first-line treatment of patients with EGFR ...mutation-positive advanced non-small-cell lung cancer (NSCLC). We compared afatinib with gemcitabine and cisplatin—a chemotherapy regimen widely used in Asia—for first-line treatment of Asian patients with EGFR mutation-positive advanced NSCLC. Methods This open-label, randomised phase 3 trial was done at 36 centres in China, Thailand, and South Korea. After central testing for EGFR mutations, treatment-naive patients (stage IIIB or IV cancer American Joint Committee on Cancer version 6, performance status 0–1) were randomly assigned (2:1) to receive either oral afatinib (40 mg per day) or intravenous gemcitabine 1000 mg/m2 on day 1 and day 8 plus cisplatin 75 mg/m2 on day 1 of a 3-week schedule for up to six cycles. Randomisation was done centrally with a random number-generating system and an interactive internet and voice-response system. Randomisation was stratified by EGFR mutation (Leu858Arg, exon 19 deletions, or other; block size three). Clinicians and patients were not masked to treatment assignment, but the independent central imaging review group were. Treatment continued until disease progression, intolerable toxic effects, or withdrawal of consent. The primary endpoint was progression-free survival assessed by independent central review (intention-to-treat population). This study is registered with ClinicalTrials.gov , NCT01121393. Findings 910 patients were screened and 364 were randomly assigned (242 to afatinib, 122 to gemcitabine and cisplatin). Median progression-free survival was significantly longer in the afatinib group (11·0 months, 95% CI 9·7–13·7) than in the gemcitabine and cisplatin group (5·6 months, 5·1–6·7; hazard ratio 0·28, 95% CI 0·20–0·39; p<0·0001). The most common treatment-related grade 3 or 4 adverse events in the afatinib group were rash or acne (35 14·6% of 239 patients), diarrhoea (13 5·4%), and stomatitis or mucositis (13 5·4%), compared with neutropenia (30 26·5% of 113 patients), vomiting (22 19·5%), and leucopenia (17 15·0%) in the gemcitabine and cisplatin group. Treatment-related serious adverse events occurred in 15 (6·3%) patients in the afatinib group and nine (8·0%) patients in the gemcitabine and cisplatin group. Interpretation First-line afatinib significantly improves progression-free survival with a tolerable and manageable safety profile in Asian patients with EGFR mutation-positive advanced lung NSCLC. Afatinib should be considered as a first-line treatment option for this patient population. Funding Boehringer Ingelheim.
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