Electronic Access Research Articles

Abstract 13714: Clinical Characteristics and Comparative Outcomes of Patients Undergoing Angiovac Endovascular Debulking of Tricuspid Valve Endocarditis versus Medical Therapy in Patients Considered Non-Surgical Candidates

Introduction: There remains a paucity of research regarding clinical characteristics and comparative outcomes of patients with tricuspid valve (TV) endocarditis, considered non-surgical candidates, undergoing debulking of TV vegetations using the AV(AngiVac) device compared to medical therapy. Methods: We conducted a retrospective cohort study at a single tertiary referral center comparing patients with TV endocarditis who were not considered surgical candidates. We compared clinical characteristics and outcomes in patients who underwent debulking of TV vegetations with AV vs those who were treated with medical therapy. Results: A total of 75 patients with TV endocarditis were included in the study. At baseline, patients in the medical therapy group were younger (34.4 years ± 10.5 vs 48.6 years ± 21, p < 0.0003), more frequently male in gender (55.9% vs 44%, p < 0.39) and had higher incidence of intravenous drug use (93.2% vs 56%, p < 0.0002). Patients were more likely to have history of malignancy (6% vs 1.7%, p < 0.32), cardiac implantable electronic device (31% vs 8.5%, p = 0.02) and central venous access (19% vs 1.7%, p = 0.01) if they underwent AV. Medical therapy was more commonly used for relatively smaller TV vegetations (1.68 cm vs 2.9 cm, p < 0.0001). Medical therapy was also associated with higher complication rates including distal embolization (81.4% vs 0%, p < 0.0001) and cerebrovascular accidents (5.1% vs 0% p = 0.36). In hospital mortality was similar for both groups and length of stay remained unchanged. Conclusions: Debulking of TV endocarditis with AV is feasible in patients not deemed to be surgical candidates and is not associated with higher inpatient mortality or length of stay. There was a lower rate of distal embolization and cerebrovascular accident in patients undergoing AV. Larger, multi center studies are needed to evaluate whether AV might improve outcomes in patients with TV endocarditis and large vegetations not deemed surgical candidates.

Novel rhombus Co3O4-nanocapsule CuO heterohybrids for efficient photocatalytic water splitting and electrochemical energy storage applications

The most appealing and prominent approach for improving energy storage and conversion performance is the development of heterojunction interfaces with efficient and unique metal oxide nanostructures. Rhombus Co3O4, nanocapsule CuO, and their heterojunction composites were synthesized using a single-step hydrothermal process. The resulting heterojunction Co3O4–CuO nanocomposite outperformed the pristine Co3O4 and CuO nanostructures for the electrochemical supercapacitor and water splitting performances. The composite showed 2.4 and 1.3 times higher specific capacitance than the associated pristine CuO and Co3O4 nanostructures, while its capacitance was 395 F g−1 at a current density of 0.5 A g−1. In addition, long-term GCD results with more than 90% stability and significant capacity retention at higher scan rates revealed the unaffected structures interfaced during the electrochemical reactions. The composite photoelectrode demonstrated more than 20% of photocurrent response with light illumination than the dark condition in water splitting. Co3O4–CuO heterostructured composite electrode showed a 0.16 mA/cm2 photocurrent density, which is 3.2 and 1.7 times higher than the pristine CuO and Co3O4 electrodes, respectively. This performance was attributed to its unique structural composition, high reactive sites, strong ion diffusion, and fast electron accessibility. Electron microscopic and spectroscopic techniques confirmed the properties of the electrodes as well as their morphological properties. Overall, the heterojunction interface with novel rhombus and capsule structured architectures showed good electrochemical performance, suggesting their energy storage and conversion applications.

Abstract 14166: Predictors of Mortality in Patients With In-Hospital STEMI After Implementation of a Comprehensive STEMI Protocol

Introduction Patients who experience in-hospital ST-elevation myocardial infarction (iSTEMI) comprise a uniquely high-risk cohort owing to multiple factors including delays in diagnosis and treatment. Improvements in quality care metrics are needed to more fully understand the reasons for the poor outcomes, including high mortality, in this population. Methods Consecutive patients with iSTEMI who were treated with percutaneous coronary intervention (PCI) between 01/01/2011-07/15/2019 at a single, tertiary referral center were included. A comprehensive iSTEMI protocol (CSP) was implemented on 7/15/2014, incorporating: (1) nursing chest pain protocol, (2) improved electronic access to electrocardiographic studies, (3) checklist for initial triage and management, (4) 24/7/365 catheterization lab readiness, and (5) radial-first PCI approach. Process metrics and clinical outcomes were compared pre- and post-CSP implementation, and multivariable logistic regression analysis was performed to assess for predictors of in-hospital mortality. Results Among 125 iSTEMI patients, the post-CSP group (n=81) were younger with more active smoking and heart failure relative to the pre-CSP group (n=44). CSP implementation resulted in an increased use of trans-radial PCI (14.6 vs. 70.4%, p<0.001), greater rate of ECG-to-first device activation < 90 minutes (36.4% vs. 76.5%, p<0.001), and decreased median ECG-to-first device activation time (114 vs. 64 minutes, p<0.001). In-hospital mortality was numerically lower in the post-CSP group (18.2% vs. 9.9%, p=0.295). On multivariable analysis, the presence of shock was the only independent predictor of in-hospital mortality (OR: 26.05, 95% CI [5.5-211.6], p<0.001). Conclusions The adoption of a CSP conferred marked improvements in key care metrics in patients with iSTEMI. Its use holds promise in reducing mortality among a vulnerable population at high risk of death owing to underlying shock.

Conservation and the genomics of populations, 3rd edition, Allendorf F. W., Funk W. C., Aitken S. N., Byrne M., Luikart G.

Conservation and the genomics of populations, 3rd edition, Allendorf F. W., Funk W. C., Aitken S. N., Byrne M., Luikart G.

The Greenlight Plus Trial: Comparative effectiveness of a health information technology intervention vs. health communication intervention in primary care offices to prevent childhood obesity

BackgroundThe first 1000 days of a child's life are increasingly recognized as a critical window for establishing a healthy growth trajectory to prevent childhood obesity and its associated long-term comorbidities. The purpose of this manuscript is to detail the methods for a multi-site, comparative effectiveness trial designed to prevent childhood overweight and obesity from birth to age 2 years. MethodsThis study is a multi-site, individually randomized trial testing the comparative effectiveness of two active intervention arms: 1) the Greenlight intervention; and 2) the Greenlight Plus intervention. The Greenlight intervention is administered by trained pediatric healthcare providers at each well-child visit from 0 to 18 months and consists of a low health literacy toolkit used during clinic visits to promote shared goal setting. Families randomized to Greenlight Plus receive the Greenlight intervention plus a health information technology intervention, which includes: 1) personalized, automated text-messages that facilitate caregiver self-monitoring of tailored and age-appropriate child heath behavior goals; and 2) a web-based, personalized dashboard that tracks child weight status, progress on goals, and electronic Greenlight content access. We randomized 900 parent-infant dyads, recruited from primary care clinics across six academic medical centers. The study's primary outcome is weight for length trajectory from birth through 24 months. ConclusionsBy delivering a personalized and tailored health information technology intervention that is asynchronous to pediatric primary care visits, we aim to achieve improvements in child growth trajectory through two years of age among a sample of geographically, socioeconomically, racially, and ethnically diverse parent-child dyads.

Ni-Mn spinel aerogel catalysts with adsorption induced superior activity for Low-Temperature toluene oxidation

The development of a highly efficient oxide catalyst is crucial for thermal and environmental catalytic reactions. Herein, a facile and eco-friendly strategy is developed to synthesize a series of Au-modified hollow Ni–Mn spinel nanospheres decorated on graphene aerogels (GAs) (termed Auy-hNixMn3−x/GAz) composite catalysts for deep catalytic oxidation of Volatile organic compounds (VOCs). The introduction of hollow structure leads to a larger specific surface area and more accessible active sites. The subsequent cooperation of Au further strengthens the low-temperature reducibility along with more active surface oxygen species. After being embedded into the graphene network, the composite catalyst shows an improvement in electron transfer and accessibility to active metal sites. The adsorption capacity of the catalyst for toluene is greatly improved by the above steps, thus facilitating the catalytic performance. The resulting Au1-hNi1Mn2/GA0.5 composite catalyst exhibits optical activity for VOCs removal, reaching 100 % toluene and benzene (500 ppm) oxidation at 155 °C and 148 °C, respectively. Meanwhile, the catalyst shows extraordinary catalytic stability, selectivity, moisture tolerance and compressibility making it a promising catalyst for industrial thermal catalysis. Moreover, an in situ DRIFTS study is carried out for the exploration of the reaction pathway and a modified Mars van Krevelen (MVK) catalytic mechanism was proposed as well.

88 NATIONAL ANTIMICROBIAL POINT PREVALENCE SURVEY IN HSE OLDER PERSONS RESIDENTIAL CARE FACILITIES (OPS-RCFS)

Abstract Background The HALT study in 2016 found that residents in Irish OPS RCFs were twice as likely to be on systemic antimicrobial compared with European average (10% v 5%). National antibiotic prescribing guidelines are available at www.antibioticprescribing.ie and prescribers are encouraged to choose ‘green’ (preferred) over ‘red’ (reserved) agents. HSE Community Antimicrobial Pharmacists (AMPs) have been employed since 2020. We aimed to establish the quality and quantity of antimicrobial prescribing in OPS-RCFs to inform antimicrobial stewardship activities. Methods All residents in HSE OPS-RCFs were surveyed between October 2020 and August 2021. AMPs reviewed all medication charts for systemic antimicrobials prescribed within previous 30 days. Medical notes +/- laboratory results were reviewed for persons on antimicrobials. Adherence to guidelines was assessed and information obtained on practices related to antimicrobial use. Results The survey included 4,448 individuals in 121 OPS RCFs. 12% were on systemic antimicrobial at time of survey. 27% received an antimicrobial in the previous 30 days. 50% of antibiotic use on survey day was for prophylaxis (6.3% of all residents). Prophylaxis exceeded 6 months in 66% persons, and 12 months in 57%. There was high usage of green versus red agents (65% vs 30%). Co-amoxiclav (red) was most commonly prescribed antimicrobial to treat infection (19%). 42% of sites reported routine use of dipstick urinalysis to support diagnosis of UTI in asymptomatic residents. 36% of sites did not have onsite electronic laboratory access. 61% of facilities did not record residents’ pneumococcal vaccination status. Conclusion Key national recommendations: Review all UTI prophylaxis within 6 months of initiation with view to de-prescribing.Cease routine use of dipstick urinalysis to support diagnosis of UTI for asymptomatic persons.Electronic access to laboratory results on-site required to support timely decision-making.All staff should be aware of the national antimicrobial guidelines.Pneumococcal vaccine status should be determined, and provided as necessary.

Impact factors in open access: the value, frustrations, and new paths forward

The age-old metric associated with traditional print academic journals—the journal impact factor (JIF)—has carried over into some electronic open access journals (OA). JIF receives a fair share of criticism (e.g., easy to manipulate, relied on too much for academic promotions), but while some OA journals continue to embrace the system to validate their relevance, others are embracing new metrics, such as alternative journal impact factors (A-JIFs). This essay examines the suitability, validation, and problems with journal impact factors and alternative measures of impact and considers whether traditional metrics can continue to be a useful measure of impact. The piece concludes with the suggestion that qualitative and quantitative measures will need to be employed and perfected to ensure impact factor methods can achieve better validation. Academic librarians will need to be especially aware of all these methods as they advise their tenure-track faculty on the preferred publishing methods and metrics available to them.

Rapid complete reconfiguration induced actual active species for industrial hydrogen evolution reaction

Rational regulation of electrochemical reconfiguration and exploration of activity origin are important foundations for realizing the optimization of electrocatalyst activity, but rather challenging. Herein, we potentially develop a rapid complete reconfiguration strategy for the heterostructures of CoC2O4 coated by MXene nanosheets (CoC2O4@MXene) during the hydrogen evolution reaction (HER) process. The self-assembled CoC2O4@MXene nanotubular structure has high electronic accessibility and abundant electrolyte diffusion channels, which favor the rapid complete reconfiguration. Such rapid reconfiguration creates new actual catalytic active species of Co(OH)2 transformed from CoC2O4, which is coupled with MXene to facilitate charge transfer and decrease the free energy of the Volmer step toward fast HER kinetics. The reconfigured components require low overpotentials of 28 and 216 mV at 10 and 1000 mA cm−2 in alkaline conditions and decent activity and stability in natural seawater. This work gives new insights for understanding the actual active species formation during HER and opens up a new way toward high-performance electrocatalysts.

Characterizing and learning from medical malpractice cases against medical oncologists using a national claims database.

318 Background: Malpractice cases may contain valuable information to inform safety improvement efforts in cancer care. No analyses of malpractice cases have been published focusing on medical oncologists as the primary defendant. The recent development of a new safety incident taxonomy for medical oncology enabled us to classify malpractice cases and identify patient safety improvements.1. Methods: We conducted a qualitative analysis of case vignettes naming medical oncologists as the primary defendant. Case vignettes were obtained from CRICO’s Candello database. Of 452 cases against medical oncologists, a random sample of 100 cases was selected. Cases were coded for the type of safety incident, and whether a system solution could plausibly reduce the risk of a future event. Coding was performed by 3 physicians with experience caring for patients with cancer. Two reviewers reviewed each case; discrepancies were resolved by the third reviewer. Results: Ninety-nine cases were included in the final analysis; 1 was determined to be misassigned to medical oncology as the primary defendant when the case vignette was entirely about radiation oncology treatment and side effects. The most frequent cancer types were breast (16%), acute leukemia (9%), aggressive lymphoma (8%), and gynecologic malignancies (7%). The most common safety incidents identified were provider clinical management errors (41%), adverse drug reactions (20%), relational issues among providers, patients, and other healthcare staff (13%), and prescriber ordering errors (6%). 47 case vignettes described safety incidents that might have been prevented by a systems intervention. The most common interventions were “tumor board or expert review of rare or uncertain cases” (19%), “pharmacist review for safe prescribing of chemotherapy” (17%), “cancer navigator for appointment scheduling in high-risk settings” (9%), “closed loop communication with radiology” (6%), and “electronic patient portal access to all test results” (6%). Conclusions: Using a new medical oncology-focused incident coding taxonomy, we were able to classify all 99 malpractice cases. Human factors issues accounted for the majority of claims. We determined that more comprehensive use of existing improvement interventions might substantially reduce the risk of future events. 1 Jacobson, J. et al. Development of a taxonomy for characterizing medical oncology-related patient safety and quality incidents: A novel approach. BMJ Open Quality. [Manuscript in press]. Accepted June 10, 2022. DOI 10.1136/bmjoq-2022-001828.R2.

A framework for privacy preserving digital trace data collection through data donation

A potentially powerful method of social-scientific data collection and investigation has been created by an unexpected institution: the law. Article 15 of the EU’s 2018 General Data Protection Regulation (GDPR) mandates that individuals have electronic access to a copy of their personal data, and all major digital platforms now comply with this law by providing users with “data download packages” (DDPs). Through voluntary donation of DDPs, all data collected by public and private entities during the course of citizens’ digital life can be obtained and analyzed to answer social-scientific questions – with consent. Thus, consented DDPs open the way for vast new research opportunities. However, while this entirely new method of data collection will undoubtedly gain popularity in the coming years, it also comes with its own questions of representativeness and measurement quality, which are often evaluated systematically by means of an error framework. Therefore, in this paper we provide a blueprint for digital trace data collection using DDPs, and devise a “total error framework” for such projects. Our error framework for digital trace data collection through data donation is intended to facilitate high quality social-scientific investigations using DDPs while critically reflecting its unique methodological challenges and sources of error. In addition, we provide a quality control checklist to guide researchers in leveraging the vast opportunities afforded by this new mode of investigation.

3D porous structure assembled from MXene via breath figure method for electrochemical detection of dopamine

Restacking or aggregation inhibition of MXene nanosheets is crucial to the maintenance of their excellent electrochemical performance during use. In this study, a positively charged surfactant is inserted into the MXene nanolayers through a simple self-assembly process based on electrostatic interaction, producing a MXene/surfactant complex with enlarged interlayer spacing. Then 3D MXene-based porous structure could be prepared by the facile and low-cost breath figure method, in which MXene/surfactant complex is used as a casting material, therefore the inhibition of restacking or aggregation and increase of surface area at multiscale are realized in one system at the same time. Benefiting from the high conductivity of MXene and increased surface area of 3D porous structure that can provide massive active sites and facilitate the electrolyte infiltration and ion or electron access, enhanced electrochemical performance, for instance, electrochemical sensing of dopamine (DA) is shown. A low detection limit of 36.8 nM with excellent anti-interference, reproducibility, repeatability and long-term stability is realized. Good accuracy for DA detection in real biological samples is also confirmed by determining DA concentration in complex human urine samples. More importantly, porous structure such as pore size, uniformity, order and porosity can be adjusted through tuning the fabrication conditions, thereby regulating its electrochemical properties. This work not only provides a high-performance electrode for electrochemical sensing, but also offers a simple and practical strategy for the construction of 3D porous MXene film that holds great potential in electromagnetic interference shielding, supercapacitors and batteries.

Effects of Familial Alzheimer's Disease Mutations on the Folding Free Energy and Dipole-Dipole Interactions of the Amyloid β-Peptide.

Familial Alzheimer's disease (FAD) mutations of the amyloid β-peptide (Aβ) are known to lead to early onset and more aggressive Alzheimer's disease. FAD mutations such as "Iowa" (D23N), "Arctic" (E22G), "Italian" (E22K), and "Dutch" (E22Q) have been shown to accelerate Aβ aggregation relative to the wild-type (WT). The mechanism by which these mutations facilitate increased aggregation is unknown, but each mutation results in a change in the net charge of the peptide. Previous studies have used nonpolarizable force fields to study Aβ, providing some insight into how this protein unfolds. However, nonpolarizable force fields have fixed charges that lack the ability to redistribute in response to changes in local electric fields. Here, we performed polarizable molecular dynamics simulations on the full-length Aβ42 of WT and FAD mutations and calculated folding free energies of the Aβ15-27 fragment via umbrella sampling. By studying both the full-length Aβ42 and a fragment containing mutations and the central hydrophobic cluster (residues 17-21), we were able to systematically study how these FAD mutations impact secondary and tertiary structure and the thermodynamics of folding. Electrostatic interactions, including those between permanent and induced dipoles, affected side-chain properties, salt bridges, and solvent interactions. The FAD mutations resulted in shifts in the electronic structure and solvent accessibility at the central hydrophobic cluster and the hydrophobic C-terminal region. Using umbrella sampling, we found that the folding of the WT and E22 mutants is enthalpically driven, whereas the D23N mutant is entropically driven, arising from a different unfolding pathway and peptide-bond dipole response. Together, the unbiased, full-length, and umbrella sampling simulations of fragments reveal that the FAD mutations perturb nearby residues and others in hydrophobic regions to potentially alter solubility. These results highlight the role electronic polarizability plays in amyloid misfolding and the role of heterogeneous microenvironments that arise as conformational change takes place.

Hearing Technologies and Practices of Care in a Jordanian Audiology Department

Based on five months of ethnographic fieldwork at an audiology department in Amman, Jordan, this paper anthropologically examines the provision of hearing technologies to deaf Jordanians as forms and practices of care (Livingston, 2012; McKay, 2018; Stevenson, 2014). Aside from hearing aids, the department also provides cochlear implants—medical devices implanted via surgery that aim to provide people with hearing loss with some electronic access to sound—to deaf Jordanians, in partnership with a state-affiliated initiative that has distributed more than 1,170 cochlear implants since its establishment in 2010. I ask: how do deaf Jordanians engage with the cochlear implant and other medical technologies, and the biomedical imaginaries in which they are embedded, within and outside the clinical encounter? The cochlear implant and, to a lesser degree, the hearing aid (Edwards, 2010), was controversial when it was first introduced in North America, where some deaf people saw cochlear implantation as a form of cultural “genocide” (Ladd, 2003; Lane et al., 1996; Padden & Humphries, 1988). The cochlear implant has not only become increasingly normalized in the U.S. (Mauldin, 2016) but has also spread transnationally as a medical technology for deaf people in Japan (Nakamura, 2006), India (Friedner, 2018), Mexico (Pfister, 2019), and elsewhere. As cochlear implants have become more prevalent in Jordan, they have become linked not only to debates about language—as I found during preliminary research in 2019 (Loh, 2022)—but also to broader questions about development (cf. Sargent, 2019b) and political economy in a materially under-resourced context where unemployment rates are high. Based on participant observation at the hospital and interviews with clinicians and patients, I argue that care is a useful analytic tool to understand the ambivalence with which many deaf Jordanians view these technologies, in its doublehanded recognition of how such technologies can be useful developmentally—in potentially providing access to speech and presumably better integration into society—but also problematic socio-politically—in diminishing their sense of belonging to broader deaf collectivities. I draw upon medical anthropology, science and technology studies, and “a disability-centered anthropology of the Middle East” (Sargent, 2019a) to ethnographically demonstrate the social life of these hearing technologies in Jordan.

PELAKSANAAN PROGRAM TAHFIDZ AL-QUR’AN DALAM MEMBENTUK KARAKTER RELIGIUS SANTRI PADA PONDOK PESANTREN DDI (DARUD DA’WAH WAL-IRSYAD) MATTOANGING KABUPATEN BANTAENG

This study discusses the implementation of the Tahfidz Al-Qur'a>n program in shaping the religious character of students at the DDI Islamic Boarding School (Daarud Da'wah Wal-Irsyad) Mattoanging, Bantaeng Regency with the aim of: 1) describing the Tahfidz Al-Qur'a> program. n at the DDI Mattoanging Islamic Boarding School, Bantaeng Regency. 2) describe the religious character of the Santri at the DDI Mattoanging Islamic Boarding School in Bantaeng Regency. 3) describe the implementation of the Tahfidz Al-Qur'a>n program in shaping the religious character of students at the DDI Mattoanging Islamic Boarding School, Bantaeng Regency. The results of this study indicate that: 1) the Tahfidz Al-Qur'a>n program is a program of mentoring and fostering tahfidz Al-Qur'a>n which is always carried out as a forum in creating a generation of memorizing Al-Qur'a>n through takhassus memorization. and non takhassus. The implementation of tahfidz with takhassus criteria is 15 people with the highest memorization of 9 juz and the lowest 1 juz and non takhassus totaling 19 people with the highest memorization of 1 juz and the lowest half juz. tahsin Al-Qur'a>n; b bilghaib (memorizing) or Ziadah (adding memorization); c) muraja'ah/takrir and d) simaan; 2) Religious character is considered very important and is always taught, preserved and practiced for santri and female students which includes discipline, honesty, courtesy, sincerity and istiqomah, patient, humble / humble, obedient to worship and responsible; 3) the implementation of the Tahfidz Al-Qur'an program in shaping the religious character of students is carried out in several ways, namely conveying the traditions of the Prophet about adab, advice, conducting supervision and attention, giving punishment and keeping away from electronic access and the like.

Addressing Electron Spins Embedded in Metallic Graphene Nanoribbons.

Spin-hosting graphene nanostructures are promising metal-free systems for elementary quantum spintronic devices. Conventionally, spins are protected from quenching by electronic band gaps, which also hinder electronic access to their quantum state. Here, we present a narrow graphene nanoribbon substitutionally doped with boron heteroatoms that combines a metallic character with the presence of localized spin 1/2 states in its interior. The ribbon was fabricated by on-surface synthesis on a Au(111) substrate. Transport measurements through ribbons suspended between the tip and the sample of a scanning tunneling microscope revealed their ballistic behavior, characteristic of metallic nanowires. Conductance spectra show fingerprints of localized spin states in the form of Kondo resonances and inelastic tunneling excitations. Density functional theory rationalizes the metallic character of the graphene nanoribbon due to the partial depopulation of the valence band induced by the boron atoms. The transferred charge builds localized magnetic moments around the boron atoms. The orthogonal symmetry of the spin-hosting state’s and the valence band’s wave functions protects them from mixing, maintaining the spin states localized. The combination of ballistic transport and spin localization into a single graphene nanoribbon offers the perspective of electronically addressing and controlling carbon spins in real device architectures.

Evidence Based Practice: Assessing the educational outcome

Healthcare providers and patients strive for optimal outcomes with a growing trend to embed the principles of evidence-based practice (EBP) into mainstream care delivery by practicing dentists. The foundations of future best practice are built at dental school. How do we evaluate the outcome of an EBP syllabus? This study describes the use of the KACE assessment tool to assess the learning outcomes of final year DDS students who had completed an EBP program. The use of a validated instrument to measure four dimensions, knowledge, attitudes about it, familiarity with sources for accessing evidence and confidence in critical appraisal skills can be an important outcomes assessment tool. 90 dental students from the final year completed the questionnaire in 2016. 84% demonstrated good knowledge of evidence hierarchy. 92% agreed of the value to future practice and improvement in quality of patient care with 88% agreeing with the value of it as an integral part of a dental school curriculum. Students demonstrate confidence in appraising study design, recognizing bias, generalizability and value of the research report. However, even with electronic access to databases, when it came to accessing evidence over 75% would ask a friend with less than 25% consulting the Cochrane Database. The outcome of the training had been positive in providing the skills for EBP. The use of a validated tool ensured the graduating students received a good foundation to provide their future patients with the best clinical evidence for optimal and cost-effective dental care.

MOFs encapsulated nanorods derived CoNi@CN composites with open structure as highly efficient bifunctional catalysts for rechargeable Zn-air batteries

Constructing highly efficient cathode catalysts is of significance for the practical application of Zn-air batteries, while the accessibility of electrons and electrolyte to catalytic active sites is essential for the electrocatalytic processes of Zn-air battery. Herein, we established a novel strategy to construct CoNi@CN composites with open structure through template-modulating thermal transformation of Co-NRs@Co-Ni-MOF. The internal elongated Co-NRs will convert into carbon nanotubes to create an open channel to the metal active sites needed for the oxygen reduction reaction (ORR) and oxygen evolution reaction (OER) processes, thereby increasing the O-containing intermediates transmission and boosting the ORR/OER performances. Surprisingly, the optimal Co3Ni1@CN-900 composites deliver excellent ORR/OER activities, affording a high half-wave potential (E1/2) of 0.869 V for ORR and a low overpotential of 366 mV for OER, as well as a narrow potential gap between ORR and OER of 0.727 V. Most impressively, the optimal Co3Ni1@CN-900 based aqueous and solid-state Zn-air batteries achieve outstanding battery properties with high OCVs, enhanced peak power densities and specific capacities, and excellent long-term charge-discharge stabilities. Meanwhile, the Co3Ni1@CN-900 based ZAB also exhibits an impressive practicality.

Model Layanan PPID Bawaslu dalam Menjamin Hak Penyandang Disabilitas Mengakses Informasi Publik

Access to public information is every citizen’s right. For this purpose, law No. 14/2008 stipulates that any public institution must offer public information services. However, there are no facilities that provide attention and access to disabilities. This study aims to explore the PPID Bawaslu RI service model in ensuring access to public information for persons with disabilities. This research uses the case study technique. The results showed that the PPID Bawaslu RI had enforced the fulfillment of disability information rights. This can be seen from various policies, including; (1) physical or electronic accessibility, consisting of website, email, WhatsApp, SMS, and telephone, although some are still in the optimization process, such as screen readers, glass magnifying features, and keyboard navigation; (2) non-physical accessibility, i.e., assistance to move through the stages of requesting information for the applicant. The effectiveness of the information service model for disabilities has also been applied to the oral and electronic aspects

Does the deployment of algorithms combined with direct electronic access increase conduct risk? Evidence from the LME

PurposeThe purpose of this paper is to examine the effectiveness of two regulatory initiatives in developing awareness of conduct risk associated with algorithmic and direct-electronic access (DEA) trading at broker-dealers: the UK Financial Conduct Authority’s algorithmic trading compliance in the wholesale markets and Commission Delegated Regulation 2017/589 (CDR 589) to the second Markets in Financial Instruments Directive.Design/methodology/approachA qualitative examination of 15 semi-structured interviews with representatives of London Metal Exchange member firms, their clients and regulators.FindingsThis paper finds that the key conduct related messages in algorithmic trading compliance in the wholesale markets may not yet be fully embedded at broker–dealers. This is because of a perceived simplicity of the algorithms deployed by broker dealers or, alternatively, a lack of reflection on their impact. Conversely, a concern exists that clients’ deployment of algorithms on DEA channels provided by broker–dealers increase conduct risk. However, the threat of harm posed by clients is not envisaged in current definitions of conduct risk. Accordingly, CDR 2017/589 does not currently require firms to evaluate clients’ awareness of it.Research limitations/implicationsThis study’s findings are limited to the insights provided by 15 participants.Originality/valueThis paper contributes to existing research by deepening understanding of conduct risk arising from algorithmic trading and DEA. To account for the potential harm arising from clients’ activities, this paper proposes a revision to Miles’s definition of conduct risk. This is complemented by a proposed amendment to CDR 2017/589 to require evaluation of clients’ understanding of conduct risk.