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The extent to which citizens comply with newly-enacted public health measures such as social distancing or lockdowns strongly affects the propagation of the virus and the number of deaths from COVID-19. It is however very difficult to identify non-compliance through survey research because claiming to follow the rules is socially desirable. Using three survey experiments, we examine the efficacy of different “face-saving” questions that aim to reduce social desirability in the measurement of compliance with public health measures. Our treatments soften the social norm of compliance by way of a short preamble in combination with a guilty-free answer choice making it easier for respondents to admit non-compliance. We find that self-reported non-compliance increases by up to +11 percentage points when making use of a face-saving question. Considering the current context and the importance of measuring non-compliance, we argue that researchers around the world should adopt our most efficient face-saving question.
Following the previous article, here we describe the first field demonstration of the ELVIS system, performed at Newport Beach, CA. We examined ocean water to detect microorganisms using the combined holographic and light-field fluorescence microscope and successfully detected both eukaryotes and prokaryotes. The shared field of view provided simultaneous bright-field (amplitude), phase, and fluorescence information from both chlorophyll autofluorescence and acridine orange staining. The entire process was performed in a nearly autonomous manner using a specifically designed sample processing unit (SPU) and custom acquisition software. We also discuss improvements to the system made after the field test that will make it more broadly useful to other types of fluorophores and samples.
Introduction: This study aims to evaluate the accuracy of the Échelle québécoise de triage préhospitalier en traumatologie (EQTPT) to identify patients who will need urgent and specialized trauma care in the La Capitale-Nationale region, province of Quebec. Methods: A detailed review of prehospital and in-hospital medical charts was conducted for a sample of patients transported following a trauma by ambulance to one of the five CHU de Quebec's emergency departments (ED) between November 2016 and March 2017. Data related to the trauma mechanism, population, injuries sustained, diagnosis, intervention and patient outcomes were extracted. The study primary outcome was the use of at least one urgent and specialized trauma care defined as: admission to the intensive care unit (ICU), urgent surgery within less than 24 hours after arrival (excluding orthopedic surgery for one limb only), intubation in ED, angioembolization within 24 hours after ED arrival, activation of a massive transfusion protocol in the ED. Also, patients who died secondary to their trauma were also considered as requiring urgent care. Results: 902 patients were included. The mean age (SD) was 59 (28.5) years old, 494 (54.8%) were female. The main trauma mechanisms were falls (592 (65.6%)) followed by motor vehicle accident (201 (22%)). 367 (40.7%) patients were transported directly to the tertiary trauma centre from the field. 231 (25.6%) patients had at least one criteria included in the steps 1, 2 or 3 of the EQTPT. Subsequently, most patients (649 (71.9%) were discharged home from the ED while 177 (19.6%) patients were admitted to the hospital. 82 (9.1%) patients required urgent and specialized trauma care. Of these 82 patients, 27 patients (32%) were identified in step 1 of the protocol, 12 patients (14.6%) in step 2, 5 patients (6.1%) in step 3, 13 patients (15.9%) in step 4 and 2 patients (2.4%) in step 5 while 23 (28.0%) patients were not identified by any steps of the EQTPT protocol. Therefore, 44 (53.6%) of the patients requiring urgent and specialized trauma care were identified by the criteria proposed in the steps 1, 2 or 3. Conclusion: In this retrospective cohort study, the EQTPT was insensitive to identify trauma patients who will need prompt and complex trauma management. Studies are required to determine the factors that could help improve its accuracy.
Introduction: Suicidal thoughts and self-harm are disproportionately prevalent among older adults but are frequently overlooked by emergency physicians. Objective: This study aims to explore the characteristics of older adults visiting the ED for suicidal thoughts or voluntary intoxications. Methods: All older adults (□ 65 years old) who visited one of the five CHU de Quebec’ EDs in 2016 were eligible. The medical charts of patients who reported suicidal thoughts or intoxication in triage or received a relevant discharge diagnosis were reviewed. Involuntary intoxications were excluded. Descriptive statistics were used to present the results. Results: Results: A total of 478 ED visits were identified, of which 332 ED visits (n= 279 patients) were included. The mean age of the ED cohort was 72.6 (standard deviation 6.8) years old and 41.6% were female. Mood disorders (41.2%) and alcoholism (40.5%) were common. Most included patients had a diagnosis of voluntary intoxication (73.2%), including two suicides (0.6%). Following 109 ED visits (30.0%), patients were referred for a mental health assessment. Half of all ED visits resulted in a discharge by the emergency physician (50.0%), while 27.4% were admitted for in-patient care. In the subsequent year (2017), 38.4% returned to the ED for suicidal ideations or self-harm of which 7.9% attended the ED □ 5 times. Conclusion: ED visits for suicidal thoughts and voluntary intoxication in older adults are more common among men with known mood disorders or alcoholism. Referral for a mental health assessment is inconsistent. ED-initiated interventions designed for this population are needed.
Introduction: Trauma care is highly complex and prone to medical errors. Accordingly, several studies have identified adverse events and conditions leading to potentially preventable or preventable deaths. Depending on the availability of specialized trauma care and the trauma system organization, between 10 and 30% of trauma-related deaths worldwide could be preventable if optimal care was promptly delivered. This narrative review aims to identify the main determinants and areas for improvements associated with potentially preventable trauma mortality. Methods: A literature review was performed using Medline, Embase and Cochrane Central Register of Controlled Trials from 1990 to a maximum of 6 months before submission for publication. Experimental or observational studies that have assessed determinants and areas for improvements that are associated with trauma death preventability were considered for inclusion. Two researchers independently selected eligible studies and extracted the relevant data. The main areas for improvements were classified using the Joint Commission on Accreditation of Healthcare Organizations patient event taxonomy. No statistical analyses were performed given the data heterogeneity. Results: From the 3647 individual titles obtained by the search strategy, a total of 37 studies were included. Each study included between 72 and 35311 trauma patients who had sustained mostly blunt trauma, frequently following a fall or a motor vehicle accident. Preventability assessment was performed for 17 to 2081 patients using either a single expert assessment (n = 2, 5,4%) or an expert panel review (n = 35, 94.6%). The definition of preventability and the taxonomy used varied greatly between the studies. The rate of potentially preventable or preventable death ranged from 2.4% to 76.5%. The most frequently reported areas for improvement were treatment delay, diagnosis accuracy to avoid missed or incorrect diagnosis and adverse events associated with the initial procedures performed. The risk of bias of the included studies was high for 32 studies because of the retrospective design and the panel review preventability assessment. Conclusion: Deaths occurring after a trauma remain often preventable. Included studies have used unstandardized definitions of a preventable death and various methodologies to perform the preventability assessment. The proportion of preventable or potentially preventable death reported in each study ranged from 2.4% to 76.5%. Delayed treatment, missed or incorrect initial diagnosis and adverse events following a procedure were commonly associated with preventable trauma deaths and could be targeted to develop quality improvement and monitoring projects.
This is the first of two articles on the Extant Life Volumetric Imaging System (ELVIS) describing a combined digital holographic microscope (DHM) and a fluorescence light-field microscope (FLFM). The instrument is modular and robust enough for field use. Each mode uses its own illumination source and camera, but both microscopes share a common objective lens and sample viewing chamber. This allows correlative volumetric imaging in amplitude, quantitative phase, and fluorescence modes. A detailed schematic and parts list is presented, as well as links to open-source software packages for data acquisition and analysis that permits interested researchers to duplicate the design. Instrument performance is quantified using test targets and beads. In the second article on ELVIS, to be published in the next issue of Microscopy Today, analysis of data from field tests and images of microorganisms will be presented.
Unlike the degenerative disorders that cause dementias, which stem from a modest number of aberrant processes, aging-related cognitive changes reflect a host of mechanisms. These include mechanisms associated with a person’s condition, e.g., drugs, pain, depression, and sleep disorders. They include mechanistic changes linked to the aging process, e.g., enhanced neural network noise, increased neighborhood density, age of acquisition effects, degraded selective engagement of neural networks, alteration of the balance between volitional and reactive intention and attention, declines in neurotransmitter function, and brain ontogenesis over the life span. They include changes best characterized as senescent physiology and best demonstrated in decline in functions essential to episodic memory formation related to impaired encoding in the hippocampal cornu amonis (CA) fields and slowed neurogenesis in the hippocampal dentate gyrus. Finally, they include processes best characterized as senescent pathology, the best understood being degradation of myelin and associated reduction of central conduction velocities and slowing of processing speed. No longer should cognitive changes associated with aging be viewed as a simple manifestation of a unitary aging process. The large number of mechanisms at play and their complexity offer many opportunities for therapeutic intervention.
Our brains are continuously changing and these changes alter brain functions. With maturation, there is growth and unfortunately, even with healthy aging, decline. Aging-related decrements affect neurons and their connectivity, neurotransmitter systems, and even support systems such as glia. Aging affects some brain regions (frontal lobes and hippocampi) more than others. This book reviews and discusses aging-related changes and their influence on the major neurobehavioral domains, beginning with reviews of aging-related changes in anatomy and physiology. Subsequent chapters review cross-sectional and longitudinal studies of aging-related changes in sensory perception (vision, hearing, touch, smell, taste) and cognitive functions (memory, language, motor planning, attention, executive functions, emotions, creativity). In each chapter, mechanisms that may account for these changes are discussed. Declines related to aging per se are distinguished from declines related to aging-associated diseases. Final chapters discuss what can potentially be done to slow or reverse aging-related decline of cognitive functions, including exercise, cognitive rehabilitation, and pharmacological agents. It is hoped this book will help clinicians differentiate between normal aging processes and brain diseases, reduce the adverse effects of brain aging, and stimulate further research on how adverse effects of brain aging can be reversed, stopped, modified, or best managed.
Aging is associated with decline in a number of domains of language function, most conspicuously lexical-semantic function (manifesting as word-finding difficulty), but also semantics, phonological sequence, grammatic morphology, language comprehension, syntax (so far linked only to working memory deficits), and narrative discourse. There is evidence of a number of non-disease-related mechanisms that could account for this, including increased neural network noise, age of acquisition effects, deterioration of mechanisms of selective neural network engagement, deterioration in episodic memory, alteration of the balance between volitional and reactive intention, lifelong ontogenesis of language networks, and reduction of white matter conduction velocities.
The aim of this study is to investigate the range, the degree of variability, and a possible time or species dependence of wood and charcoal δ13C values within one small study area. To achieve this, we used δ13C and 14C determinations of more than 400 archaeological samples from a ca. 300 ha area in Denmark, spanning 5000 years and covering several different species. The δ13C values of the wood and charcoal range from −32.8‰ to −21.2‰. We found no time-dependence of wood and charcoal δ13C values, neither in general nor within one species. The mean δ13C of all wood samples is −28.5‰, while the means of individual species range from −30.6‰ to −26.3‰. The mean of all charcoal samples is −25.7‰, with the means of individual species ranging from −28.1‰ to −24.3‰. The wood δ13C values can be used to infer the possible range of plant δ13C values, which otherwise are not available. They imply that a high degree of variability can be expected at the base of the food chain. This is relevant for palaeodietary studies that rely on the measurement of baseline isotope values.
Information about the global climate, the carbon cycle, changes in solar activity, and a number of other atmospheric processes are preserved in the carbon-14 and the beryllium-10 records. However, these isotope datasets are large and cumbersome to work with. We have designed a self-contained, easy-to-use application that allows for more efficient analysis of different periods and patterns of interest. For several applications in atmospheric modelling, a pre-processing stage is applied to the isotope datasets in order to interpolate the data and mitigate their low temporal resolution. In CHRONOscope, we included linear and non-linear methods of interpolation with interactive parameter optimization. The resultant interpolated data can be extracted for further use. The main functionalities of CHRONOscope include the importation and superimposition of external data, quick navigation through the data with the use of markers, expression of the carbon-14 results in both Δ14C and yr BP form, separation of the data by source, and the visualization of associated error bars. We make this free software available in standalone applications for both Windows and Mac operating systems.
The ENEA Radiocarbon Laboratory (Bologna, Italy) has been operating since 1985; it is the oldest among such laboratories operating in Italy and has been active for about 30 years in the field of dating of different types of samples with the radiocarbon (14C) liquid scintillation method. This study shows the detailed procedure for radiocarbon analysis on bioplastic materials by means of the synthesis of benzene, which includes CO2 production and purification, synthesis of acetylene, and synthesis and collection of benzene. The changes made to the original design of the synthesis procedures and the operational parameters adopted to optimize the combustion of the plastic materials are described. The measurement of 14C activity was performed using the liquid scintillation counting technique by a QuantulusTM 1220 low-background counter. The δ13C content was compared with the percentage of 14C concentration for the characterization of the bio content in plastic used in the food packaging.
A collision-radiation model of the solid sample cesium sputter ion source led to the rediscovery of anion production by ion-pair production. The model revealed physical processes that may produce high current outputs from such sources and suggested new ways of obtaining high outputs at lower heat and conductive stress to the source. Primary among these solutions is the electron excitation of primary Cs0 recycled from the sample to provide states that efficiently create chosen anions. Here we look at how the processes might apply to gas-fed ion sources.
Areas affected by routine radiocarbon (14C) discharges from the Fukushima Dai-ichi Nuclear Power Plant (FDNPP) and accidental releases in March 2011 were investigated by analysis of cores from Japanese cypress and cedar trees growing at sites 9 and 24 km northwest of the plant. 14C concentrations in tree rings from 2008–2014 (before and after the accident) were determined by accelerator mass spectrometry, with 14C activities in the range 231–256 Bq kg−1 C. Activities during the period 2012–2014, after FDNPP shutdown, represent background levels, while the significantly higher levels recorded during 2008–2010, before the accident, indicate uptake of 14C from routine FDNPP operations. The mean excess 14C activity for the pre-accident period at the sites 9 and 24 km northwest of the plant were 21 and 12 Bq kg−1 C, respectively, indicating that the area of influence during routine FDNPP operations extended at least 24 km northwest. The mean excess tree-ring 14C activities in 2011 were 10 and 5.8 Bq kg−1 C at 9 and 24 km northwest, respectively, documenting possible impact of the FDNPP accident on 14C levels in trees.
Historical sources reveals that Copenhagen was founded in the late 12th century AD by Bishop Absalon. However, during the excavation for the new metro in central Copenhagen a previously unknown early medieval cemetery was discovered and excavated at the Town Hall Square. Radiocarbon (14C) analysis was conducted on the 9 individuals found in situ, together with 11 individuals from the other early medieval cemetery in Copenhagen, belonging to the St Clemens church. The radiocarbon analysis places the onset of the cemeteries to the early 11th century AD and therefore questions the age of Copenhagen and hence the archaeological and historical perception of the Danish historical record. Here a detailed account of the radiocarbon-based Bayesian model is presented.