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Introduction: Acute stroke care delivered by interdisciplinary teams is time-sensitive. Simulation-based team training is a promising tool to improve team performance in medical operations. It has the potential to improve process times, team communication, patient safety, and staff satisfaction. We aim to assess whether a multi-level approach consisting of a stringent workflow revision based on peer-to-peer review and 2–3 one-day in situ simulation trainings can improve acute stroke care processing times in high volume neurocenters within a 6 months period.
Methods and Analysis: The trial is being carried out in a pre-test-post-test design at 7 tertiary care university hospital neurocenters in Germany. The intervention is directed at the interdisciplinary multiprofessional stroke teams. Before and after the intervention, process times of all direct-to-center stroke patients receiving IV thrombolysis (IVT) and/or endovascular therapy (EVT) will be recorded. The primary outcome measure will be the “door-to-needle” time of all consecutive stroke patients directly admitted to the neurocenters who receive IVT. Secondary outcome measures will be intervention-related process times of the fraction of patients undergoing EVT and effects on team communication, perceived patient safety, and staff satisfaction via a staff questionnaire.
Interventions: We are applying a multi-level intervention in cooperation with three “STREAM multipliers” from each center. First step is a central meeting of the multipliers at the sponsor's institution with the purposes of algorithm review in a peer-to-peer process that is recorded in a protocol and an introduction to the principles of simulation training and debriefing as well as crew resource management and team communication. Thereafter, the multipliers cooperate with the stroke team trainers from the sponsor's institution to plan and execute 2–3 one-day simulation courses in situ in the emergency department and CT room of the trial centers whereupon they receive teaching materials to perpetuate the trainings.
Clinical Trial Registration: STREAM is a registered trial at https://clinicaltrials.gov/ct2/show/NCT03228251.
CXCL12-CXCR4 signaling controls multiple physiological processes and its dysregulation is associated with cancers and inflammatory diseases. To discover as-yet-unknown endogenous ligands of CXCR4, we screened a blood-derived peptide library for inhibitors of CXCR4-tropic HIV-1 strains. This approach identified a 16 amino acid fragment of serum albumin as an effective and highly specific CXCR4 antagonist. The endogenous peptide, termed EPI-X4, is evolutionarily conserved and generated from the highly abundant albumin precursor by pH-regulated proteases. EPI-X4 forms an unusual lasso-like structure and antagonizes CXCL12-induced tumor cell migration, mobilizes stem cells, and suppresses inflammatory responses in mice. Furthermore, the peptide is abundant in the urine of patients with inflammatory kidney diseases and may serve as a biomarker. Our results identify EPI-X4 as a key regulator of CXCR4 signaling and introduce proteolysis of an abundant precursor protein as an alternative concept for chemokine receptor regulation.
Dihadron angular correlations in d + Au collisions at √sNN = 200 GeV are reported as a function of the measured zero-degree calorimeter neutral energy and the forward charged hadron multiplicity in the Au-beam direction. A finite correlated yield is observed at large relative pseudorapidity (η) on the near side (i.e. relative azimuth φ ∼ 0). This correlated yield as a function of η appears to scale with the dominant, primarily jet-related, away-side (φ ∼ π) yield. The Fourier coefficients of the φ correlation, Vn = (cosnφ), have a strong η dependence. In addition, it is found that V1 is approximately inversely proportional to the mid-rapidity event multiplicity, while V2 is independent of it with similar magnitude in the forward (d-going) and backward (Au-going) directions.
We report on a polarization measurement of inclusive J/ψ mesons in the di-electron decay channel at mid-rapidity at 2 < pT < 6 GeV/c in p + p collisions at √s = 200 GeV. Data were taken with the STAR detector at RHIC. The J/ψ polarization measurement should help to distinguish between different models of the J/ψ production mechanism since they predict different pT dependences of the J/ψ polarization. In this analysis, J/ψ polarization is studied in the helicity frame. The polarization parameter λθ measured at RHIC becomes smaller towards high pT , indicating more longitudinal J/ψ polarization as pT increases. The result is compared with predictions of presently available models.
We present a systematic analysis of two-pion interferometry in Au+Au collisions at sqrt[sNN]=200GeV using the STAR detector at Relativistic Heavy Ion Collider. We extract the Hanbury-Brown and Twiss radii and study their multiplicity, transverse momentum, and azimuthal angle dependence. The Gaussianness of the correlation function is studied. Estimates of the geometrical and dynamical structure of the freeze-out source are extracted by fits with blast-wave parametrizations. The expansion of the source and its relation with the initial energy density distribution is studied.
Measurement of cold nuclear matter effects for inclusive J/ψ in p+Au collisions at √sNN = 200 GeV
(2022)
Measurement by the STAR experiment at RHIC of the cold nuclear matter (CNM) effects experienced by inclusive J/ψ at mid-rapidity in 0-100% p+Au collisions at √sNN = 200 GeV is presented. Such effects are quantified utilizing the nuclear modification factor, RpAu, obtained by taking a ratio of J/ψ yield in p+Au collisions to that in p+p collisions scaled by the number of binary nucleon-nucleon collisions. The differential J/ψ yield in both p+p and p+Au collisions is measured through the dimuon decay channel, taking advantage of the trigger capability provided by the Muon Telescope Detector in the RHIC 2015 run. Consequently, the J/ψ RpAu is derived within the transverse momentum (pT) range of 0 to 10 GeV/c. A suppression of approximately 30% is observed for pT < 2 GeV/c, while J/ψ RpAu becomes compatible with unity for pT greater than 3 GeV/c, indicating the J/ψ yield is minimally affected by the CNM effects at high pT. Comparison to a similar measurement from 0-20% central Au+Au collisions reveals that the observed strong J/ψ suppression above 3 GeV/c is mostly due to the hot medium effects, providing strong evidence for the formation of the quark-gluon plasma in these collisions. Several model calculations show qualitative agreement with the measured J/ψ RpAu, while their agreement with the J/ψ yields in p+p and p+Au collisions is worse.
We report on the measurements of directed flow v1 and elliptic flow v2 for hadrons (π±, K ±, K0 S , p, φ, Λ and ) from Au+Au collisions at √sN N = 3 GeV and v2 for (π±, K ±, p and p) at 27 and 54.4 GeV with the STAR experiment. While at the two higher energy midcentral collisions the numberof-constituent-quark (NCQ) scaling holds, at 3 GeV the v2 at midrapidity is negative for all hadrons and the NCQ scaling is absent. In addition, the v1 slopes at midrapidity for almost all observed hadrons are found to be positive, implying dominant repulsive baryonic interactions. The features of negative v2 and positive v1 slope at 3 GeV can be reproduced with a baryonic mean-field in transport model calculations. These results imply that the medium in such collisions is likely characterized by baryonic interactions.
In high-energy heavy-ion collisions, partonic collectivity is evidenced by the constituent quark number scaling of elliptic flow anisotropy for identified hadrons. A breaking of this scaling and dominance of baryonic interactions is found for identified hadron collective flow measurements in √sNN = 3 GeV Au+Au collisions. In this paper, we report measurements of the first- and second-order azimuthal anisotropic parameters, v1 and v2, of light nuclei (d, t, 3He, 4He) produced in √sNN = 3 GeV Au+Au collisions at the STAR experiment. An atomic mass number scaling is found in the measured v1 slopes of light nuclei at mid-rapidity. For the measured v2 magnitude, a strong rapidity dependence is observed. Unlike v2 at higher collision energies, the v2 values at mid-rapidity for all light nuclei are negative and no scaling is observed with the atomic mass number. Calculations by the Jet AA Microscopic Transport Model (JAM), with baryonic mean-field plus nucleon coalescence, are in good agreement with our observations, implying baryonic interactions dominate the collective dynamics in 3 GeV Au+Au collisions at RHIC.
In einem als Naturwaldreservat ausgewiesenen, relativ naturnahen Rotbuchenwald (Galio odorati-Fagetum) mit kontinuierlicher Waldgeschichte in den Stemweder Bergen (Nordwest-Deutschland) wurde die Vegetation und das Diasporenpotential des Bodens von 135-170jährigen Waldbereichen und von Sukzessionsflächen (ungeräumte Windwurfflächen) vergleichend untersucht. Die Vegetation der Waldflächen weist das typische Arteninventar eines Galio odorati-Fagetum Sougnez et Thill 1959 auf. Die Windwurfflächen zeigen in den schattigen Bereichen eine Artengemeinschaft, die sich dem Galio aparine-Impatientetum noli-tangere Tüxen 1975 zuordnen läßt, an sonnigen Standorten hat sich eine Urtica-Rubus-Flur entwickelt. Der Boden sowohl der Wald- als auch der Sukzessionsflächen erweist sich als sehr diasporenreich. Quantitativ dominiert aufgrund sehr großer Diasporenmengen der Flatterbinse (Juncus effusus) die soziologische Gruppe der Schlagflurarten (Epilobietea angustifolii] bzw. Schlagflurbegleiter. Qualitativ (Artenzahl) überwiegen die Waldarten. Tendenziell ist der Großteil der Arten, die in der Vegetation auftreten auch im Diasporenvorrat vorhanden, oft in Korrelation mit ihrer Artmächtigkeit. Das Diasporenreservoir der Sukzessionsflächen ist gegenüber dem der Waldbereiche größer, im Wald überwiegt die vegetative Ausbreitung und Vermehrung. Eine zweimalige Bodenprobennahme (Frühjahr und Herbst) konnte Hinweise auf den Strategietyp geben, den einige Arten verfolgen. Einige sich fakultativ generativ ausbreitende Arten (z. B. Stachys sylvatica, Milium effusum, Rubus ssp.) bilden persistente Diasporenbanken in Abhängigkeit ihres Standorts. Persistente Diasporenbanken von Waldarten zeichnen sich durch ihre relativ geringe Diasporenmenge und durch vergleichsweise große Diasporen aus. Die Diasporenuntersuchungen in der untersuchten Waldgesellschaft ermöglichen eine Bewertung des Bestandes auf seine Naturnähe und geben Einblick in dessen Nutzungsgeschichte. Der Vergleich zwischen räumlich benachbarten Wald- und Sukzessionsflächen weist auf eine geringe primäre Bedeutung des Diasporenpotentials des Bodens bei der Vegetationsentwicklung auf ungeräumten Windwürfen direkt nach der Störung (Sturm) hin. Gefährdete Arten, deren Etablierung in der Vegetation durch Managementmaßnahmen der Diasporenuntersuchung aufgrunf der punktuellen Probennahme nur einen Ausschnitt der gesamten Naturwaldzelle zeigen.
We report a high precision measurement of the transverse single spin asymmetry AN at the center of mass energy √s=200 GeV in elastic proton–proton scattering by the STAR experiment at RHIC. The AN was measured in the four-momentum transfer squared t range 0.003⩽|t|⩽0.035 (GeV/c)2, the region of a significant interference between the electromagnetic and hadronic scattering amplitudes. The measured values of AN and its t-dependence are consistent with a vanishing hadronic spin-flip amplitude, thus providing strong constraints on the ratio of the single spin-flip to the non-flip amplitudes. Since the hadronic amplitude is dominated by the Pomeron amplitude at this √s, we conclude that this measurement addresses the question about the presence of a hadronic spin flip due to the Pomeron exchange in polarized proton–proton elastic scattering.