Autori su u radu propitali dosege i ograničenja načela kontinuiteta državljanstva u hrvatskom pravnom poretku od završetka Drugog svjetskog rata pa sve do današnjih dana. U radu su stoga posebno ...analizirane promjene do kojih je došlo neposredno nakon Drugog svjetskog rata te stupanjem na snagu Zakona o hrvatskom državljanstvu 8. listopada 1991. godine. Na temelju provedene analize, autori su pokazali da je načelo kontinuiteta bilo važno načelo državljanskog prava u analiziranim razdobljima. Pored navedenog, autori su ukazali i na bitna ograničenja dosega tog načela.
In the paper the authors questioned significance and limits of the principle of continuity of
citizenship in the Croatian legal order in the period from the aftermath of the Second World War
until nowadays. The authors especially analyzed changes immediately after the Second World
War and after the Croatian Citizenship Act of 1991 entered into force. Based on the analysis, the
authors pointed out that the principle of continuity of citizenship was an important rule that secured
continuity of citizenship corpus during the analized period. On the other hand, the authors also
pointed out important limits of that principle.
Objective
This study was undertaken to describe long‐term clinical and developmental outcomes in pediatric refractory status epilepticus (RSE) and identify factors associated with new neurological ...deficits after RSE.
Methods
We performed retrospective analyses of prospectively collected observational data from June 2011 to March 2020 on pediatric patients with RSE. We analyzed clinical outcomes from at least 30 days after RSE and, in a subanalysis, we assessed developmental outcomes and evaluated risk factors in previously normally developed patients.
Results
Follow‐up data on outcomes were available in 276 patients (56.5% males). The median (interquartile range IQR) follow‐up duration was 1.6 (.9–2.7) years. The in‐hospital mortality rate was 4% (16/403 patients), and 15 (5.4%) patients had died after hospital discharge. One hundred sixty‐six (62.9%) patients had subsequent unprovoked seizures, and 44 (16.9%) patients had a repeated RSE episode. Among 116 patients with normal development before RSE, 42 of 107 (39.3%) patients with available data had new neurological deficits (cognitive, behavioral, or motor). Patients with new deficits had longer median (IQR) electroclinical RSE duration than patients without new deficits (10.3 2.1–134.5 h vs. 4 1.6–16 h, p = .011, adjusted odds ratio = 1.003, 95% confidence interval = 1.0008–1.0069, p = .027). The proportion of patients with an unfavorable functional outcome (Glasgow Outcome Scale‐Extended score ≥ 4) was 22 of 90 (24.4%), and they were more likely to have received a continuous infusion.
Significance
About one third of patients without prior epilepsy developed recurrent unprovoked seizures after the RSE episode. In previously normally developing patients, 39% presented with new deficits during follow‐up, with longer electroclinical RSE duration as a predictor.
To determine whether publication of evidence on delays in time to treatment shortens time to treatment in pediatric refractory convulsive status epilepticus (rSE), we compared time to treatment ...before (2011-2014) and after (2015-2019) publication of evidence of delays in treatment of rSE in the Pediatric Status Epilepticus Research Group (pSERG) as assessed by patient interviews and record review.
We performed a retrospective analysis of a prospectively collected dataset from June 2011 to September 2019 on pediatric patients (1 month-21 years of age) with rSE.
We studied 328 patients (56% male) with median (25th-75th percentile p
-p
) age of 3.8 (1.3-9.4) years. There were no differences in the median (p
-p
) time to first benzodiazepine (BZD) (20 5-52.5 vs 15 5-38 minutes,
= 0.3919), time to first non-BZD antiseizure medication (68 34.5-163.5 vs 65 33-142 minutes,
= 0.7328), and time to first continuous infusion (186 124.2-571 vs 160 89.5-495 minutes,
= 0.2236). Among 157 patients with out-of-hospital onset whose time to hospital arrival was available, the proportion who received at least 1 BZD before hospital arrival increased after publication of evidence of delays (41 of 81 50.6% vs 57 of 76 75%,
= 0.0018), and the odds ratio (OR) was also increased in multivariable logistic regression (OR 4.35 95% confidence interval 1.96-10.3,
= 0.0005).
Publication of evidence on delays in time to treatment was not associated with improvements in time to treatment of rSE, although it was associated with an increase in the proportion of patients who received at least 1 BZD before hospital arrival.
The thermal stability of black aluminum (Black Al) films deposited on unheated fused silica substrates by pulsed DC magnetron sputtering is investigated. The deposited films have porous moth‐eye ...morphology and a relatively soft surface that can be easily damaged mechanically. Photothermally stimulated exoelectron emission (PTSE) spectra of the films have emission peaks at 180 and 300 °C, which can be associated with processes of aluminum recrystallization occurring at these temperatures. The total emitted charge of PTSE decreases according to a power law with each subsequent heating, indicating that the most pronounced structural changes on the film surface occur during its first annealing. The shape of the mechanically intact pores of the films does not change after heating. However, spiral‐shaped aluminum nanowires grow from scratches and abrasions on the film surface already after heating up to 200 °C due to the stress‐induced migration of aluminum atoms. When scratches are deliberately applied to the surface of an already annealed film, the nanowires do not grow when the film is reheated. The results of this study show that mechanically intact as‐deposited Black Al films are thermally stable up to temperatures of at least 400 °C.
The thermal stability of black aluminum (Black Al) films is investigated by heating the films in a vacuum up to 400 °C. The surface morphology of mechanically intact films does not change after heating. Spiral‐shaped aluminum nanowires grow from scratches and abrasions on the film surface after heating up to 200 °C due to the stress‐induced migration of aluminum atoms.
The objective of this study was to determine patient-specific factors known proximate to the presentation to emergency care associated with the development of refractory convulsive status epilepticus ...(RSE) in children.
An observational case-control study was conducted comparing pediatric patients (1 month-21 years) with convulsive SE whose seizures stopped after benzodiazepine (BZD) and a single second-line antiseizure medication (ASM) (responsive established status epilepticus rESE) with patients requiring more than a BZD and a single second-line ASM to stop their seizures (RSE). These subpopulations were obtained from the pediatric Status Epilepticus Research Group study cohort. We explored clinical variables that could be acquired early after presentation to emergency medical services with univariate analysis of the raw data. Variables with
< 0.1 were retained for univariable and multivariable regression analyses. Multivariable logistic regression models were fit to age-matched and sex-matched data to obtain variables associated with RSE.
We compared data from a total of 595 episodes of pediatric SE. Univariate analysis demonstrated no differences in time to the first BZD (RSE 16 minutes IQR 5-45; rESE 18 minutes IQR 6-44,
= 0.068). Time to second-line ASM was shorter in patients with RSE (RSE 65 minutes; rESE 70 minutes;
= 0.021). Both univariable and multivariable regression analyses revealed a family history of seizures (OR 0.37; 95% CI 0.20-0.70,
= 0.0022) or a prescription for rectal diazepam (OR 0.21; 95% CI 0.078-0.53,
= 0.0012) was associated with decreased odds of RSE.
Time to initial BZD or second-line ASM was not associated with progression to RSE in our cohort of patients with rESE. A family history of seizures and a prescription for rectal diazepam were associated with a decreased likelihood of progression to RSE. Early attainment of these variables may help care for pediatric rESE in a more patient-tailored manner.
This study provides Class II evidence that patient and clinical factors may predict RSE in children with convulsive seizures.
Spiral‐shaped aluminum nanowires grow from scratches and abrasions on the surface of black aluminum film after heating the film in a vacuum. The growth of nanowires is driven by the stress‐induced ...migration of aluminum atoms. The mechanism of nanowire growth is studied in article number 2100467 by Marina Romanova and co‐workers. – This article belongs to the Special Section “Defect‐Induced Effects in Nanomaterials” (see the Guest Editorial, article number 2200283, by Nikolai A. Sobolev et al.) in this issue.
Purpose
There is disregard in the scientific literature for the evaluation of psychiatric in-patient care as rated directly by patients. In this context, we aimed to explore satisfaction of people ...treated in mental health in-patient facilities. The project was a part of the Young Psychiatrist Program by the Association for the Improvement of Mental Health Programmes.
Methods
This is an international multicentre cross-sectional study conducted in 25 hospitals across 11 countries. The research team at each study site approached a consecutive target sample of 30 discharged patients to measure their satisfaction using the five-item study-specific questionnaire. Individual and institution level correlates of ‘low satisfaction’ were examined by comparisons of binary and multivariate associations in multilevel regression models.
Results
A final study sample consisted of 673 participants. Total satisfaction scores were highly skewed towards the upper end of the scale, with a median total score of 44 (interquartile range 38–48) out of 50. After taking clustering into account, the only independent correlates of low satisfaction were schizophrenia diagnosis and low psychiatrist to patient ratio.
Conclusion
Further studies on patients’ satisfaction should additionally pay attention to treatment expectations formed by the previous experience of treatment, service-related knowledge, stigma and patients’ disempowerment, and power imbalance.
Objective
This study was undertaken to evaluate benzodiazepine (BZD) administration patterns before transitioning to non‐BZD antiseizure medication (ASM) in pediatric patients with refractory ...convulsive status epilepticus (rSE).
Methods
This retrospective multicenter study in the United States and Canada used prospectively collected observational data from children admitted with rSE between 2011 and 2020. Outcome variables were the number of BZDs given before the first non‐BZD ASM, and the number of BZDs administered after 30 and 45 min from seizure onset and before escalating to non‐BZD ASM.
Results
We included 293 patients with a median (interquartile range) age of 3.8 (1.3–9.3) years. Thirty‐six percent received more than two BZDs before escalating, and the later the treatment initiation was after seizure onset, the less likely patients were to receive multiple BZD doses before transitioning (incidence rate ratio IRR = .998, 95% confidence interval CI = .997–.999 per minute, p = .01). Patients received BZDs beyond 30 and 45 min in 57.3% and 44.0% of cases, respectively. Patients with out‐of‐hospital seizure onset were more likely to receive more doses of BZDs beyond 30 min (IRR = 2.43, 95% CI = 1.73–3.46, p < .0001) and beyond 45 min (IRR = 3.75, 95% CI = 2.40–6.03, p < .0001) compared to patients with in‐hospital seizure onset. Intermittent SE was a risk factor for more BZDs administered beyond 45 min compared to continuous SE (IRR = 1.44, 95% CI = 1.01–2.06, p = .04). Forty‐seven percent of patients (n = 94) with out‐of‐hospital onset did not receive treatment before hospital arrival. Among patients with out‐of‐hospital onset who received at least two BZDs before hospital arrival (n = 54), 48.1% received additional BZDs at hospital arrival.
Significance
Failure to escalate from BZDs to non‐BZD ASMs occurs mainly in out‐of‐hospital rSE onset. Delays in the implementation of medical guidelines may be reduced by initiating treatment before hospital arrival and facilitating a transition to non‐BZD ASMs after two BZD doses during handoffs between prehospital and in‐hospital settings.
More than 10% of Americans have diabetes, with higher rates in Hispanics and African Americans. National Healthy People 2030 goals for expected decrease in HbA 1c levels have not been met.
No ...standardized diabetes education or follow-up existed at a free clinic. Patients exhibited diabetic self-management inadequacies and elevated HbA 1c levels.
A pre/postimplementation study design was used to evaluate changes in HbA 1c levels, medication adherence, missed appointments, and emergency department visits.
Structured diabetes education and follow-up text/phone messages for patients with HbA 1c levels 8% or higher were implemented over 3 months.
Outcome data were available for 27 of the 34 participants. Postimplementation, there was a significant 1.7% decrease in mean HbA 1c levels ( P < .001). No significant differences were found for the other outcome measures.
Structured diabetes education and follow-up text/phone messages in a free clinic improved patients' HbA 1c levels.
Radiation resistance of nanolayered silicon nitride capacitors Romanova, Marina; Avotina, Liga; Andrulevicius, Mindaugas ...
Nuclear instruments & methods in physics research. Section B, Beam interactions with materials and atoms,
05/2020, Volume:
471
Journal Article
Peer reviewed
Single-layered and multi-layered 20–60 nm thick silicon nitride (Si3N4) dielectric nanofilms were fabricated using a low-pressure chemical vapour deposition (LPCVD) method. The X-ray photoelectron ...spectroscopy (XPS) confirmed less oxygen content in the multi-layered nanofilms. The capacitors with Si3N4 multilayer demonstrated a tendency to a higher breakdown voltage compared to the capacitors with Si3N4 single layer. Si3N4 nanofilms and capacitors with Si3N4 dielectric were exposed to 1 kGy dose of gamma photons. Fourier transform infrared (FTIR) spectroscopy analysis showed that no modifications of the chemical bonds of Si3N4 were present after irradiation. Also, gamma irradiation did not influence the breakdown voltage of the capacitors but decreased their capacitance measured at 1 MHz frequency. However, the multi-layered capacitors were not affected by radiation more than the single-layered capacitors. These findings suggest a promising process to fabricate nano-scaled multi-layered Si3N4 capacitors with improved breakdown voltage characteristics and resistance to ionizing radiation.
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