bluuebunny/crossref_metadata_2025 huggingface dataset:
Veiling and unveiling: Ill, dying, and dead bodies in contemporary elegies
Authors: Lambrecht Bram
Published: November 2021

According to Sandra Gilbert, one of the contemporary elegy’s most striking features is its obsession with the actual scene of dying and the actual body of the dead one. Gilbert interprets this obsession as an exponent of the modern elegy’s typical ambition of breaking the tenacious taboo on dying and grieving—an ambition that had been demonstrated earlier by Jahan Ramazani’s pioneering Poetry of Mourning. By explicitly showing ill, dying, or dead bodies, Gilbert contends, recent elegies confront us with what modern culture prefers to hide.

Concentrating on representations of the body in Intensive Care (2010) by the Dutch poet Vrouwkje Tuinman and Undying (2016) by the Scottish‐Dutch writer Michel Faber, the present article seeks to complicate dominant interpretations of the function of the corpse in recent poetry. Although Tuinman and Faber do show dying and dead bodies with meticulous attention, they also subtly open up reflections on the mimesis of illness and death. By alternately watching and veiling the body, approaching it as an abject object and an aesthetic artifact, Tuinman and Faber both challenge and confirm the problematic and ambiguous status of the corpse in the contemporary West.
COVID‐19 hospitalizations: Another adverse impact of ambient air pollution?
Authors: Perret Jennifer , Dharmage Shyamali
Published: November 2021

See related article
Personal values, trait emotional intelligence, and mental health problems
Authors: Jacobs Ingo , Wollny Anna
Published: November 2021

Personal values and personality traits are related yet distinguishable constructs linked to mental health. The present study extends the current literature on personal values and personality traits by investigating the associations between the higher‐order dimensions of personal values (i.e., general values factor, conservation, and self‐transcendence), trait emotional intelligence (TEI), and mental health problems (i.e., depressive, anxiety, and somatoform syndromes). The study draws on a cross‐sectional online sample of N = 618 young German adults. Global TEI and all four TEI factors (i.e., well‐being, sociability, emotionality, and self‐control) correlated positively with the g‐value factor but negatively with conservation. Emotionality was also positively related to self‐transcendence. Mental health problems correlated positively with conservation and negatively with the general values factor. When the effects of global TEI were accounted for, conservation but not the general values factor remained significantly related to mental health problems. Global TEI fully mediated the relationship between the g‐value factor and mental health problems and partially mediated the association between conservation and mental health problems. The implications of these results are discussed.
A Different Way to Execute Project Using a Product-Based Approach
Authors: Farina Cathy
Published: November 2021

The application of mega complex projects in the heavy industrial sector have been growing globally for the last ten years. Given there is growth of mega complex projects, the failure rate of these types of projects has also increased. According the EY (who have analyzed 500 completed mega projects from the previous five years): “Of the projects analyzed, 60% experienced schedule delays, and 38% had cost overruns.”

Based on research performed by McKinsey & Company, the construction industry needs to change to become more productive and as the industry changes it will look very different five to ten years from now. These changes will only be accelerated by the current COVID-19 pandemic. One solution is the application of smaller standard modular plants or trains that can be designed and constructed quicker and more efficiently.

A product-based approach will lead to more of a manufacturing style approach to not only improve productivity but to reduce overall lifecycle costs and schedules and improve overall quality and safety. Further, in times of economic uncertainty, it will reduce the business risk for the project as the business can break the project down into “bite-sized pieces”.

Companies will need to be innovative in order to be competitive and have a positive return on investment on their future programs and projects. In the current and future economic environment, an innovative way to execute projects is to utilize a product-based approach.

This paper will focus on how to develop a standard modular plant using a product-based approach and provide a case study from a small-scale LNG plant.
Small proline-rich protein 2A is a gut bactericidal protein deployed during helminth infection
Authors: Hu Zehan , Zhang Chenlu , Sifuentes-Dominguez Luis , Zarek Christina M. , Propheter Daniel C. , Kuang Zheng , Wang Yuhao , Pendse Mihir , Ruhn Kelly A. , Hassell Brian , Behrendt Cassie L. , Zhang Bo , Raj Prithvi , Harris-Tryon Tamia A. , Reese Tiffany A. , Hooper Lora V.
Published: November 2021

AMPlifying type 2 immunity

Antimicrobial proteins (AMPs) are a frontline defense against pathogenic microorganisms at mucosal surfaces. These cationic molecules inactivate their targets primarily by disrupting cell walls and membranes. Hu
et al
. found that small proline-rich protein 2A (SPRR2A) is a bactericidal protein produced in the gut that targets Gram-positive bacteria and is phylogenetically distinct from all other known AMPs (see the Perspective by Harris and Wickramasinghe). SPRR2A production is selectively enhanced by type 2 cytokines such as interleukin-4 and -13 that are elicited by helminth infection. Mice lacking SPRR2A are unable to prevent intestinal bacteria from invading the intestinal barrier after helminths damage the intestinal epithelium. SPRR2A is thus a critical component of type 2 immunity that protects against the bacterial invasion and dissemination that follow helminth infection. —STS
Convergence of adenosine and GABA signaling for synapse stabilization during development
Authors: Gomez-Castro Ferran , Zappettini Stefania , Pressey Jessica C. , Silva Carla G. , Russeau Marion , Gervasi Nicolas , Figueiredo Marta , Montmasson Claire , Renner Marianne , Canas Paula M. , Gonçalves Francisco Q. , Alçada-Morais Sofia , Szabó Eszter , Rodrigues Ricardo J. , Agostinho Paula , Tomé Angelo R. , Caillol Ghislaine , Thoumine Olivier , Nicol Xavier , Leterrier Christophe , Lujan Rafael , Tyagarajan Shiva K. , Cunha Rodrigo A. , Esclapez Monique , Bernard Christophe , Lévi Sabine
Published: November 2021

Synapse stabilization

Early in brain development, neurons connect to each other enthusiastically. With development, an overabundance of synapses is winnowed down to refine efficiently connected circuits. Inactive synapses are prime targets for elimination, whereas active synapses tend to be retained. Gomez-Castro
et al
. took a closer look at how those choices are made (see the Perspective by Blum and Lopes). When postsynaptic adenosine receptors are muted or do not find enough extracellular adenosine, synapses get eliminated. Neurotransmitter-dependent signaling pathways drive protein kinase A to phosphorylate the postsynaptic scaffolding molecule gephyrin. Together with a partner synaptogenic membrane protein, gephyrin is required for the stabilization of γ-aminobutyric acid receptors. Adenosine receptors thus detect synaptic activity and in turn drive the stabilization of synapses that produce such activity. —PJH
Enantioselective catalytic 1,2-boronate rearrangements
Authors: Sharma Hayden A. , Essman Jake Z. , Jacobsen Eric N.
Published: November 2021

Asymmetric carbon coupling at boron

The Matteson reaction produces carbon–carbon bonds by coupling halocarbons such as widely available dichloromethane with an alkyl substituent on boron. Sharma
et al
. report asymmetric catalysis of this reaction. Their catalyst, derived from a chiral thiourea, a boronic ester, and an alkyl lithium base, appears to accelerate a chloride abstraction step through its lithium center. The product, still bearing a chloride, can be further modified through stereospecific displacement to generate a wide variety of trisubstituted chiral centers. —JSY
National climate institutions complement targets and policies
Authors: Dubash Navroz K. , Pillai Aditya Valiathan , Flachsland Christian , Harrison Kathryn , Hochstetler Kathryn , Lockwood Matthew , MacNeil Robert , Mildenberger Matto , Paterson Matthew , Teng Fei , Tyler Emily
Published: November 2021

Institutions can affect coordination, consensus, and strategy
Fueling their own climate narrative
Authors: Supran Geoffrey
Published: November 2021

Using techniques from big data to decode Big Oil’s climate change propaganda
Complete Genome Sequence of Rickettsia parkeri Strain Black Gap
Authors: Karpathy Sandor E. , Paddock Christopher D. , Grizzard Stephanie L. , Batra Dhwani , Rowe Lori A. , Gauthier David T.
Published: November 2021

A unique genotype of
Rickettsia parkeri
, designated
R. parkeri
strain Black Gap, has thus far been associated exclusively with the North American tick,
Dermacentor parumapertus
. The compete genome consists of a single circular chromosome with 1,329,522 bp and a G+C content of 32.5%.
Complete Genome Sequence of Bacillus velezensis GMEKP1, Isolated from a Natural Bamboo Hive of Stingless Bees
Authors: Widada Jaka , Damayanti Ema , Mustofa
Published: November 2021

We report the complete genome sequence and annotation of
Bacillus velezensis
GMEKP1, which was isolated from a hive of stingless bees (
Trigona laeviceps
). This bacterium has a circular 4,014,839-nucleotide chromosome and two circular plasmids. Genome-mining analysis of the whole-genome sequence revealed that GMEKP1 has 12 biosynthetic gene clusters, dominated by genes encoding polyketide synthase hybrids.
Draft Genome Sequence of the Lichenized Fungus Bacidia gigantensis
Authors: Allen Jessica L. , Jones Steven J. M. , McMullin R. Troy
Published: November 2021

The draft genome sequence of
Bacidia gigantensis
, a lichenized fungus in the order Lecanorales, was sequenced directly from a herbarium specimen collected from the type locality at Sleeping Giant Provincial Park in Ontario, Canada. Using long-read sequencing on the Oxford Nanopore PromethION platform, we assembled a nearly complete genome sequence.
Complete Genome Sequence of a Novel
Dyadobacter
sp. Strain, NIV53, Isolated from 2-Meter Deep Subsurface Sediment
Authors: Bak Frederik , Henriksen Alexander Pil , Nielsen Tue Kjærgaard , Nicolaisen Mette Haubjerg
Published: November 2021

Here, we provide the complete genome sequence of the subsurface bacterial isolate
Dyadobacter
sp. strain NIV53, a candidate species from the
Spirosomaceae
family. The isolate contained one 7,587,604-bp chromosome, with a GC content of 40.4%, and one plasmid, pNIV1, with a size of 12,453 bp.
ggpubfigs: Colorblind-Friendly Color Palettes and ggplot2 Graphic System Extensions for Publication-Quality Scientific Figures
Authors: Steenwyk Jacob L. , Rokas Antonis
Published: November 2021

Clear and effective figures are central to successfully communicating scientific data. Here, we present ggpubfigs, an R package with colorblind-friendly color palettes and extensions of the ggplot2 graphic system, which helps make publication-quality scientific figures from quantitative data; ggpubfigs is an open-source and user-friendly tool that is available from
https://github.com/JLSteenwyk/ggpubfigs
.
Supplemental Material: Lateral variation in slab window viscosity inferred from global navigation satellite system (GNSS)–observed uplift due to recent mass loss at Patagonia ice fields
Authors: Russo Raymond M. , Mocanu Victor , al. et
Published: November 2021

Modeling method, Table S1 (newly obtained uplift rates for the ten continuous GNSS sites shown in Figure1A),Table S2 (slab window viscosity values and RMS data), supplemental figures, and the weekly solutions for GNSS data used in the study.
Cerebral lactate uptake during exercise is driven by the increased arterial lactate concentration
Authors: Siebenmann Christoph , Sørensen Henrik , Bonne Thomas Christian , Zaar Morten , Aachmann-Andersen Niels Jacob , Nordsborg Nikolai Baastrup , Nielsen Henning Bay , Secher Niels Henry , Lundby Carsten , Rasmussen Peter
Published: November 2021

During exercise the brain consumes lactate as a substitute for glucose. Propranolol has previously attenuated this cerebral lactate uptake, suggesting a β-adrenergic transport mechanism. However, in the present study, we demonstrate that the fractional extraction of arterial lactate by the brain is unaffected by propranolol throughout the incremental exercise to exhaustion. We conclude that cerebral lactate uptake during exercise is passively driven by the increasing arterial concentration, rather than by a β-adrenergic mechanism within the brain.
Effect of end-inspiratory lung volume and breathing pattern on neural activation of the diaphragm and extra-diaphragmatic inspiratory muscles in healthy adults
Authors: Niro Frank , Dubuc Benjamin , Sodeifi Kaveh Gaynor , Jensen Dennis
Published: November 2021

We examined the effect of changes in end-inspiratory lung volume (EILV) and breathing pattern on neural activation of the inspiratory muscles in healthy adults. We found that, at a constant ventilation, neural activation of the crural diaphragm and of the extra-diaphragmatic inspiratory muscles (sternocleidomastoid, scalene, and seventh external intercostals) increased as a function of increasing EILV, independent of changes in breathing pattern. Our results point to a critical mechanistic role of EILV in determining the level of central inspiratory neural drive needed to support ventilation.
Mobile Robot Obstacle Avoidance Based on Neural Network with a Standardization Technique
Authors: Farag Karoline Kamil A. , Shehata Hussein Hamdy , El-Batsh Hesham M.
Published: November 2021

Reactive algorithm in an unknown environment is very useful to deal with dynamic obstacles that may change unexpectantly and quickly because the workspace is dynamic in real-life applications, and this work is focusing on the dynamic and unknown environment by online updating data in each step toward a specific goal; sensing and avoiding the obstacles coming across its way toward the target by training to take the corrective action for every possible offset is one of the most challenging problems in the field of robotics. This problem is solved by proposing an Artificial Intelligence System (AIS), which works on the behaviour of Intelligent Autonomous Vehicles (IAVs) like humans in recognition, learning, decision making, and action. First, the use of the AIS and some navigation methods based on Artificial Neural Networks (ANNs) to training datasets provided high Mean Square Error (MSE) from training on MATLAB Simulink tool. Standardization techniques were used to improve the performance of results from the training network on MATLAB Simulink. When it comes to knowledge-based systems, ANNs can be well adapted in an appropriate form. The adaption is related to the learning capacity since the network can consider and respond to new constraints and data related to the external environment.
A Comparative Study of Nonsingular Terminal Sliding Mode and Backstepping Schemes for the Coupled Two‐Tank System
Authors: Choueikh Safa , Kermani Marwen , M’sahli Faouzi
Published: November 2021

This paper presents an implementation of two radically different control schemes for a state‐coupled two‐tank liquid‐level system. This is due to the purpose of transferring theoretical studies to industrial systems. The proposed schemes to be introduced and compared are the nonsingular terminal sliding mode control (NTSMC) and the backstepping control (BC). The performances of the developed methods are experimentally tested on a particular class of second‐order nonlinear systems. The main purpose of the considered control schemes is to achieve a tracking trajectory for a coupled‐tank system. It is proved that the designed robust controllers guarantee the stability of the corresponding closed loop systems. The obtained results are verified with the same setup test to ensure a suitable basis for their comparison. During the experiments, we resorted to adding an integrator to the backstepping control so that we improve the results, leading to the appearance of the integrator backstepping control (IBC). To focus on the adequacy and applicability of the suggested control layout, theoretical comparisons as well as experimental results are afforded and debated.
Preparation and Characterization of Antimony-Doped Tin Oxide Nanocrystallite Coatings on 316L Stainless Steel
Authors: Nguyen Truong Giang , Hoang Vinh Long , Huynh Thu Suong , Nguyen Thi Hong Phuong , Nguyen Quang Bac
Published: November 2021

The study on the coatings containing antimony-dope tin oxide mostly has been done on titanium and its alloys for preparation of electrode materials. In this study, we try to prepare the similar coatings on 316L stainless steel, which is more common than titanium, and investigate some characteristics of the formed coatings. The preparation of the coating is by the impregnation of the substrate in solution containing SnCl4 and SbCl3 with the ratio of 93/7, and the concentration of SbCl3, 10 g/L in isopropanol, pH of 1–1.2, and the annealed temperature of 450°C give suitable coating for electrode materials. Some coating features, such as the crystal structure (XRD), morphology (SEM), hardness, electrical resistant, and electrochemical behaviors of the coating on the substrate have been also investigated. The results of the study show that the coatings can be used as electrode materials for the effective treatment of organic colorants in water such as methylene blue in water treatment.
A Population Health Assessment in a Community Cancer Center Catchment Area: Triple-Negative Breast Cancer, Alcohol Use, and Obesity in New Castle County, Delaware
Authors: Siegel Scott D. , Brooks Madeline M. , Sims-Mourtada Jennifer , Schug Zachary T. , Leonard Dawn J. , Petrelli Nicholas , Curriero Frank C.
Published: November 2021

Background:

The NCI requires designated cancer centers to conduct catchment area assessments to guide cancer control and prevention efforts designed to reduce the local cancer burden. We extended and adapted this approach to a community cancer center catchment area with elevated rates of triple-negative breast cancer (TNBC).

Methods:

Cancer registry data for 462 TNBC and 2,987 “Not-TNBC” cases diagnosed between 2012 and 2020 at the Helen F. Graham Cancer Center & Research Institute (HFGCCRI), located in New Castle County, Delaware, were geocoded to detect areas of elevated risk (hot spots) and decreased risk (cold spots). Next, electronic health record (EHR) data on obesity and alcohol use disorder (AUD) and catchment area measures of fast-food and alcohol retailers were used to assess for spatial relationships between TNBC hot spots and potentially modifiable risk factors.

Results:

Two hot and two cold spots were identified for TNBC within the catchment area. The hot spots accounted for 11% of the catchment area but nearly a third of all TNBC cases. Higher rates of unhealthy alcohol use and obesity were observed within the hot spots.

Conclusions:

The use of spatial methods to analyze cancer registry and other secondary data sources can inform cancer control and prevention efforts within community cancer center catchment areas, where limited resources can preclude the collection of new primary data.

Impact:

Targeting community outreach and engagement activities to TNBC hot spots offers the potential to reduce the population-level burden of cancer efficiently and equitably.
Renal Replacement Therapy for Acute Kidney Injury in French Intensive Care Units: A Nationwide Survey of Practices
Authors: Quenot Jean-Pierre , Amrouche Idris , Lefrant Jean-Yves , Klouche Kada , Jaber Samir , Du Cheyron Damien , Duranteau Jacques , Maizel Julien , Rondeau Eric , Javouhey Etienne , Gaillot Théophile , Robert René , Dellamonica Jean , Souweine Bertrand , Bohé Julien , Barbar Saber Davide , Sejourné Caroline , Vinsonneau Christophe ,   for the DIAM Trial Investigators, in collaboration with the BOREAL research network
Published: November 2021

Background: The frequency of acute kidney injury (AKI) can be as high as 50% in the intensive care unit (ICU). Despite the publication of national guidelines in France in 2015 for the use of RRT, there are no data describing the implementation of these recommendations in real-life. Methods: We performed a nationwide survey of practices from November 15, 2019, to January 24, 2020, in France. An electronic questionnaire based on the items recommended in the national guidelines was sent using an online survey platform, to the chiefs of all ICUs in France. The questionnaire comprised a section for the Department Chief about local organization and facilities, and a second section destined for individual physicians about their personal practices. Results: We contacted the Department Chief in 356 eligible ICUs, of whom 88 (24.7%) responded regarding their ICU organization. From these 88 ICUs, 232/285 physicians (82%) completed the questionnaire regarding individual practices. The practices reported by respondent physicians were as follows: intermittent RRT was first-line choice in >75% in a patient with single organ (kidney) failure at the acute phase, whereas continuous RRT was predominant (>75%) in patients with septic shock or multi-organ failure. Blood and dialysate flow for intermittent RRT were 200–300 mL/min and 400–600 mL/min, respectively. The dose of dialysis for continuous RRT was 25–35 mL/kg/h (65%). Insertion of the dialysis catheter was mainly performed by the resident under echographic guidance, in the right internal jugular vein. The most commonly used catheter lock was citrate (53%). The most frequently cited criterion for weaning from RRT was diuresis, followed by a drop in urinary markers (urea and creatinine). Conclusion: This study shows a satisfactory level of reported compliance with French guidelines and recent scientific evidence among ICU physicians regarding initiation of RRT for AKI in the ICU.
Zuogui Pill Attenuates Neuroinflammation and Improves Cognitive Function in Cerebral Ischemia Reperfusion-Injured Rats
Authors: Liu Hong , Dai Qiaomei , Yang Jing , Zhang Yuwei , Zhang Bo , Zhong Lili
Published: November 2021

Introduction: Cerebral ischemia and reperfusion (CI/R) injury is a devasting cerebrovascular disease, accompanied with ischemia stroke, cerebral infarction. Zuogui Pill (ZGP), as a Chinese traditional medicine, is proved to be effective in many diseases and cancers. Our study aimed to detect the roles of ZGP in CI/R injury. Methods: Neural stem cells were isolated from rats and induced by oxygen and glucose deprivation and recovery. CCK-8 and flow cytometry were applied to assess the function of ZGP on cell viability and apoptosis. Rat CI/R injury models were established by the middle cerebral artery occlusion and reperfusion. The function of ZGP on CI/R injury was identified via evaluating modified neurological severity score, infarct area, and cognitive impairment. Results: Compared to the control, the cell viability was obviously decreased in the oxygen and glucose deprivation and recovery (OGD/R) group, while the adverse influence on cells was reversed by cultured plus 10% ZGP serum. Consistently, ZGP attenuated the influence of OGD/R on cell apoptosis. More importantly, ZGP could alleviate CI/R injury of rats by reducing neurological damage and infarct area and promoting cognitive function. Conclusion: This study provided protective roles of ZGP on cell viability and apoptosis induced by OGD/R. In addition, ZGP played protective roles on neuroinflammation and cognitive function in rats.
Ischemic Penumbra: A Personal View
Authors: Davis Stephen M. , Donnan Geoffrey A.
Published: November 2021

The concept of the ischemic penumbra was defined over 40 years ago by Lindsay Symon and his group and is now an established principle of all acute ischemic stroke therapies. These reperfusion treatments rescue threatened, critically hypoperfused brain tissue and have been proven to improve clinical outcomes. We have been fortunate to have observed and played a small part in the penumbral story from its beginnings in the 1970s to its pivotal position today. Over this period, we have witnessed penumbral imaging evolve from positron emission tomography through to magnetic resonance imaging and now predominantly computed tomography perfusion, with the advent of automated imaging facilitating case selection for reperfusion therapies. We and others have conducted clinical trials using penumbral imaging to extend the time window for intravenous thrombolysis and select patients for thrombectomy. Together with the concept of fast- and slow-growing ischemic infarct patterns, this embeds the penumbral principle in everyday clinical management. The opportunity now exists to make penumbral imaging even more portable, affordable, and more widely available using mobile platforms, novel imaging techniques, digital linkage, and artificial intelligence.
Aspectos ambientais que influenciam o tratamento da saúde: uma revisão da literatura
Authors: Goulart Fernanda de Moraes , Ono Rosária
Published: November 2021

Estudos científicos que estabelecem relações entre variáveis espaciais, variáveis de comportamento e de percepção são poderosos subsídios para a construção de espaços eficientes e atentos às necessidades dos usuários. No caso de estabelecimentos assistenciais à saúde mental, o ambiente físico é um elemento essencial na garantia da qualidade do tratamento. Entretanto esse é frequentemente subestimado pelas partes interessadas. Este artigo relata o resultado da revisão de literatura de trabalhos que fornecem evidências científicas da influência do ambiente físico na percepção e no comportamento de pessoas em sofrimento psíquico e seus cuidadores. O método escolhido foi o integrativo, que permite a inclusão de estudos empíricos e teóricos para uma compreensão mais ampla do fenômeno analisado. O resultado apresenta a síntese de 32 trabalhos científicos publicados em periódicos, centrada em três situações, a saber: o bem-estar de pessoas em tratamento, o bem-estar de trabalhadores da saúde e os conflitos de interesse entre esses dois tipos de usuários. Pessoas em sofrimento psíquico podem se beneficiar de ambientes que apresentam: (a) Acolhimento e conforto (b) Facilitadores de interação social (c) Liberdade e regulação de espaço pessoal e (d) Distrações positivas. Dois aspectos são relevantes à equipe de cuidadores: (a) Inserção do cliente no processo de projeto e (b) Ambientes funcionais. Há conflitos de interesse entre os dois tipos de usuários, no que concerne ao (a) Grau de liberdade e segurança, (b) Designação/flexibilização dos espaços, (c) Acesso de pacientes às enfermarias e (d) Número de pacientes em dormitórios. Todos os aspectos são discutidos neste trabalho.
Reflexões sobre o planejamento de unidades de tratamento intensivo - UTIS - na perspectiva dos usuários
Authors: Cavalcanti Patrícia Biasi , Maçaneiro Camila , Postiglione Isabella , Palma Júlia Martan Nazário , Eli Julia Roberta
Published: November 2021

O presente trabalho discute o resultado da avaliação do ambiente físico de três unidades de tratamento intensivo (UTIs) de hospitais públicos da Grande Florianópolis. Objetivou-se identificar problemas recorrentes nessas unidades, a partir da percepção ambiental de seus profissionais de saúde e também da avaliação dos pesquisadores, e refletir sobre possíveis soluções. Para tanto, foram realizadas: revisão de literatura; visitas exploratórias a duas UTIs de hospitais particulares; e aplicada a metodologia de avaliação pós-ocupação em três estudos de caso de hospitais públicos, nos quais foram empregados o mapeamento visual e a análise walkthrough. Cabe destacar que, na análise walkthrough, as três unidades não atenderam plenamente aos aspectos mínimos necessários ao funcionamento do local, os quais dizem respeito, em sua maioria, a itens previstos em resoluções e normas. Dentre os problemas recorrentes encontrados nas três UTIs avaliadas estão: subdimensionamento de ambientes; insuficiência ou inadequação de móveis e equipamentos; ambientação pouco humanizada; sobreposição indesejável de usos; problemas de conservação e de manutenção; falta de visibilidade em relação aos leitos; acabamentos inadequados; e aspectos deficitários da infraestrutura. Espera-se, através da discussão dos problemas constatados e de possíveis soluções, contribuir para a atuação profissional, para a gestão pública desses locais e para a revisão da legislação vigente.
Early Endosomal GTPase Rab5 (Ras-Related Protein in Brain 5) Regulates GPIbβ (Glycoprotein Ib Subunit β) Trafficking and Platelet Production In Vitro
Authors: Bertović Ivana , Kurelić Roberta , Mahmutefendić Lučin Hana , Jurak Begonja Antonija
Published: November 2021

Objective:

Maturation of megakaryocytes culminates with extensive membrane rearrangements necessary for proplatelet formation. Mechanisms required for proplatelet extension and origin of membranes are still poorly understood. GTPase Rab5 (Ras-related protein in brain 5) regulates endocytic uptake and homotypic fusion of early endosomes and regulates phosphatidylinositol 3-monophosphate production important for binding of effector proteins during early-to-late endosomal/lysosomal maturation.

Approach and Results:

To investigate the role of Rab5 in megakaryocytes, we expressed GFP (green fluorescent protein)-coupled Rab5 wild type and its point mutants Q79L (active) and N133L (inactive) in primary murine fetal liver-derived megakaryocytes. Active Rab5 Q79L induced the formation of enlarged early endosomes, while inactive Rab5 N133L caused endosomal fragmentation. Consistently, an increased amount of transferrin internalization in Rab5 Q79L was impaired in Rab5 N133L expressing megakaryocytes, when compared with GFP or Rab5 wild type. Moreover, trafficking of GPIbβ (glycoprotein Ib subunit beta), a subunit of major megakaryocytes receptor and membrane marker, was found to be mediated by Rab5 activity. While GPIbβ was mostly present along the plasma membrane, and within cytoplasmic vesicles in Rab5 wild type megakaryocytes, it accumulated in the majority of Rab5 Q79L enlarged endosomes. Conversely, Rab5 N133L caused mostly GPIbβ plasma membrane retention. Furthermore, Rab5 Q79L expression increased incorporation of the membrane dye (PKH26), indicating higher membrane content. Finally, while Rab5 Q79L increased proplatelet production, inactive Rab5 N133L strongly inhibited it and was coupled with a decrease in late endosomes/lysosomes. Localization of GPIbβ in enlarged endosomes was phosphatidylinositol 3-monophosphate dependent.

Conclusions:

Taken together, our results demonstrate that Rab5-dependent endocytosis plays an important role in megakaryocytes receptor trafficking, membrane formation, and thrombopoiesis.
Characteristics and Management Plan for the Distribution of Nelumbo nucifera community in Junam Wetland
Authors: Lee Soo-Dong , Kim Han , Cho Bong-Gyo , Lee Gwang-Gyu
Published: November 2021

Background and objective If the Nelumbo nucifera spreads in a wetland at a high density, it can have considerable positive and negative ecological effects on habitats. For this reason, it is necessary to precisely investigate the impacts of its rapid proliferation. This study was conducted to propose the distribution and management of N. nucifera, which can cause the degradation of wildlife habitats due to the rapid spread of internal and external environmental factors that may affect the Junam wetland ecosystem. Methods For the investigation and analysis of physical and ecological characteristics, factors of the abiotic environment such as general weather conditions, topography and water depth structure, and soil and water quality analysis, and bioenvironment characteristics such as changes in the N. nucifera community distribution were evaluated. To assess whether the differences in the soil depth and physicochemical characteristics between the N. nucifera community and the aquatic plant community are statistically significant, a One-way ANOVA was executed. Results N. nucifera was presumably introduced in approximately 2007 and observed at a prevalence of only 0.8% in 2009, but had expanded to 11.1% in 2014. After that, the area was increased to 19.3% in 2015 and 40.0% in 2017, about twice that of the previous survey year. The rapid diffusion of an N. nucifera colony can have adverse effects on wildlife habitats and biodiversity at Junam Wetland. To solve these problems, four management methods can be proposed; water level management, mowing management, installation of posts and removal of lotus roots. Control of the N. nucifera community using these methods was judged to be suitable for cutting and water level management when considering expansion rate, water level variation, and wildlife habitat impacts. Conclusion As the biotic and abiotic environmental factors are different for each wetland, it is necessary to determine the timing and method of management through a detailed investigation.
Development of Raising Seedling Technology for Veronica pyrethrina Nakai Using Plug Trays
Authors: Kwon Hyuck-Hwan , Oh Hye-Jin , Kim Jin-Ho , Kim Sang-Yong
Published: November 2021

Background and objective This study was carried out to develop an effective technique for raising seedlings of Veronica pyrethrina Nakai, a native plant species in the Korean Peninsula, in plug trays. Methods To investigate the optimum plug cell size and sowing media, we sowed seed in to plug trays with 34, 21, and 10 mL cells and filled with a commercial horticultural substrate and mixtures of peatmoss and perlite in 1:1, 3:1, and 4:1 ratios. Fertilization levels were set at 0, 500, 1000 and 2000 mg • L−1. Results Plug cell size did not significantly influence the seedling growth of V. pyrethrina. By substrate type, the growth rate was highest in the horticultural substrate, followed by 4:1, 3:1, and 1:1. Growth by fertilization level was higher in all fertilized treatment groups than in the control group, and there was no difference among 500, 1000, and 2000 mg • L−1. Conclusion The results of this study proved that it is most suitable for raising seedlings of V. pyrethrina to sow the seeds in a 10 mL cell plug tray filled with horticultural substrates, and apply fertilizers with less than 500 mg • L−1 concentration.
Religious and Spiritual Struggles in a German-Speaking Sample: a Validation Study
Authors: Lampe Jessica , Noth Isabelle , Znoj Hansjörg
Published: November 2021

This paper presents the German adaptation and validation of the Religious and Spiritual Struggles Scale (RSSS) (Exline et al. 2014). Religious and spiritual (r/s) struggles consist of inner conflicts regarding supernatural, interpersonal and intrapersonal concerns, which in the RSSS are categorized into six struggles: Divine, Demonic, Doubt, Interpersonal, Moral and Ultimate Meaning. The prevalence of these as well as mental health correlates and associations with centrality of religiosity were explored in a sample of 1359 German-speaking participants, primarily university students from Switzerland. Inner r/s struggles have primarily been studied in samples from the United States, and data are lacking for more secular societies such as Switzerland, where these struggles are experienced as well. For the first time, the RSSS was translated into and administered in the German language and its six-factor structure confirmed with confirmatory factor analysis.
Right Without Remedy? The Development of the Presumption of Innocence at the International Criminal Court
Authors: Coleman Michelle
Published: November 2021

This article examines the presumption of innocence’s development at the International Criminal Court. While the presumption of innocence was hardly debated at the Rome Conference, several issues surrounding the presumption have been open to wide interpretation by the Court. This article argues that since the Rome Statute’s entry into force, the presumption of innocence goes beyond the text of Article 66 and has become a robust right that has application both inside and outside of the courtroom and has effect during the Situation, Pre-Trial and Trial phases. Despite these developments, what happens when the right is violated remains an open question. The paper will conclude that while the presumption of innocence may be better defined and more protective than it was 20 years ago, what happens in the case of a violation continues to be an area for further development.
Jacob Ṣemaḥ, Humanist
Authors: Chajes J. H.
Published: November 2021

Jacob Ṣemaḥ (ca. 1578–1667), an erudite physician-kabbalist, was raised amongst the conversos of Viana de Caminha in northwest Portugal. He fled the country in his mid-thirties to live openly as a Jew, arriving first in Salonica. Ṣemaḥ was responsible for the consolidation of the Lurianic literary corpus in the second third of the seventeenth century. His contribution, I argue, should be situated in the broader context of a scholarly curriculum vitae that began decades before his flight from Portugal, as Ṣemaḥ embraced Jewish life as a humanist. Coupled with his natural gifts and genius, Ṣemaḥ’s humanist education served him remarkably well in his new life. The interesting question is therefore not “how might he have learned Torah in Portugal” but “how did his Portuguese educational background affect—indeed, effect may be the more apt term—his Jewish scholarship?”
Forecasting Northern Australian Summer Rainfall Bursts Using a Seasonal Prediction System
Authors: Cowan Tim , Wheeler Matthew C. , Sharmila S. , Narsey Sugata , de Burgh-Day Catherine
Published: November 2021

Rainfall bursts are relatively short-lived events that typically occur over consecutive days, up to a week. Northern Australian industries like sugar farming and beef are highly sensitive to burst activity, yet little is known about the multiweek prediction of bursts. This study evaluates summer (December–March) bursts over northern Australia in observations and multiweek hindcasts from the Bureau of Meteorology’s multiweek to seasonal system, the Australian Community Climate and Earth-System Simulator, Seasonal version 1 (ACCESS-S1). The main objective is to test ACCESS-S1’s skill to confidently predict tropical burst activity, defined as rainfall accumulation exceeding a threshold amount over three days, for the purpose of producing a practical, user-friendly burst forecast product. The ensemble hindcasts, made up of 11 members for the period 1990–2012, display good predictive skill out to lead week 2 in the far northern regions, despite overestimating the total number of summer burst days and the proportion of total summer rainfall from bursts. Coinciding with a predicted strong Madden–Julian oscillation (MJO), the skill in burst event prediction can be extended out to four weeks over the far northern coast in December; however, this improvement is not apparent in other months or over the far northeast, which shows generally better forecast skill with a predicted weak MJO. The ability of ACCESS-S1 to skillfully forecast bursts out to 2–3 weeks suggests the bureau’s recent prototype development of a burst potential forecast product would be of great interest to northern Australia’s livestock and crop producers, who rely on accurate multiweek rainfall forecasts for managing business decisions.
Emergency General Surgery Procedures and Cost of Care for Older Adults in the State of Maryland
Authors: Ghneim Mira H. , Kufera Joseph A. , Clark Jaclyn , Harfouche Melike N. , Hendrix Cheralyn J. , Diaz Jose J.
Published: November 2021

Background

Older adults (OAs) ≥ 65 years of age, representing the fastest growing segment in the United States, are anticipated to require a greater percentage of emergency general surgery procedures (EGSPs) with an associated increase in health care costs. The aims of this study were to identify the frequency of EGSP and charges incurred by OA compared to their younger counterparts in the state of Maryland.

Methods

A retrospective review of the Maryland Health Services Cost Review Commission from 2009 to 2018 was undertaken. Patients undergoing urgent or emergent ESGP were divided into 2 groups (18-64 years and ≥65 years). Data collected included demographics, APR-severity of illness (SOI), APR-risk of mortality (ROM), the EGSP (partial colectomy [PC], small bowel resection [SBR], cholecystectomy, operative management of peptic ulcer disease, lysis of adhesions, appendectomy, and laparotomy), length of stay (LOS), and hospital charges. P-values ( P < .05) were significant.

Results

Of the 181,283 patients included in the study, 55,401 (38.1%) were ≥65 years of age. Older adults presented with greater APR-SOI (major 37.7% vs 21.3%, extreme 5.2% vs 9.3%), greater APR-ROM (major 25.3% vs 8.7%, extreme 22.3% vs 5.3%), underwent PC (24.5% vs 10.9%) and SBR (12.8% vs 7.0%) more frequently, and incurred significantly higher median hospital charges for every EGSP, consistently between 2009 and 2018 due to increased LOS and complications when compared to those ≤65 years of age.

Conclusion

These findings stress the need for validated frailty indices and quality improvement initiatives focused on the care of OAs in emergency general surgery to maximize outcomes and optimize cost.
Increases in Violence and Changes in Trauma Admissions During the COVID Quarantine
Authors: Klutts Garrett N. , Deloach Joe , McBain Sacha A. , Jensen Hanna , Sexton Kevin W. , Kalkwarf Kyle J. , Karim Saleema , Bhavaraju Avi
Published: November 2021

Background

The COVID-19 pandemic caused an abrupt change to societal norms. We anecdotally noticed an increase in penetrating and violent trauma during the period of stay-at-home orders. Studying these changes will allow trauma centers to better prepare for future waves of COVID-19 or other global catastrophes.

Methods

We queried our institutional database for all level 1 and 2 trauma activations presenting from the scene within our local county from March 18 to May 21, 2020 and matched time periods from 2016 to 2019. Primary outcomes were overall trauma volume, rates of penetrating trauma, rates of violent trauma, and transfusion requirements.

Results

The number of penetrating and violent traumas at our trauma center during the period of societal quarantine for the COVID-19 pandemic was more than any historical total. During the COVID-19 time period, we saw 39 penetrating traumas, while the mean value for the same time period from 2016 to 2019 was 26 ( P = .03). We saw 45 violent traumas during COVID; the mean value from 2016 to 2019 was 32 ( P = .05). There was also a higher rate of trauma patients requiring transfusion in the COVID cohort (6.7% vs 12.2%).

Discussion

Societal quarantine increased the number of penetrating and violent traumas, with a concurrent increased percentage of patients transfused. Despite this, there was no change in outcomes. Given the continuation of the COVID-19 pandemic, quarantine measures could be re-implemented. Data from this study can help guide expectations and utilization of hospital resources in the future.
Readability of Online Patient Material Provided by Reflux Centers in the United States
Authors: Ekkel Elisabeth , Seeras Kevin
Published: November 2021

The American Medical Association (AMA) and the National Institutes of Health (NIH) suggest patient education materials should not exceed the sixth-grade reading level. Several studies have shown that patient information has been written well above this reading level across multiple specialties. A search was conducted utilizing the Google Chrome browser and the Google search engine. The key words “Reflux Center” and “GERD Center” were used to identify links to programs within the United States. The web site’s general description of reflux or gastroesophageal reflux disease was copied and pasted into the Readable.io service, and the readability tests were conducted via the program. Of 52 web sites, none had fulfilled the recommended reading level. Our results reveal that readability related to reflux pathology on center web sites is too difficult for the average patient. In order to improve patient education regarding reflux pathology and treatment, reading materials should be improved.
Intravenous Lidocaine for Rib Fractures: Effect on Pain Control and Outcome
Authors: King Sarah , Smith Lou , Harper Christopher , Beam Zachary , Heidel Eric , Carico Genevieve , Wahler Kelsey , Daley Brian
Published: November 2021

Background

Multimodal analgesia in rib fractures (RFs) is designed to maximize pain control while minimizing narcotics. Prior research with intravenous lidocaine (IVL) efficacy produced conflicting results. We hypothesized IVL infusion reduces opioid utilization and pain scores.

Methods

A retrospective review of RF patients at an ACS-verified Level I trauma center from April 2018 to 2/2020 was conducted. Patients (pts) stratified as receiving IVL vs no IVL. Initial lidocaine dose: 1 mg/kg/hr with a maximum of 3 mg/kg/hr. Duration of infusion: 48 h. Pain quantified by the Stanford Pain Score system (PS). Bivariate and multivariate analyses of variables were performed on SPSS, version 21 (IBM Corp).

Results

414 pts met inclusion criteria: 254 males and 160 females. The average age for the non-IVL = 67.4 ± 15.2 years vs IVL = 58.3 ± 17.1 years ( P < .001). There were no statistically significant differences between groups for ISS, PS for initial 48 h, and ICU length of stay (LOS). There was a difference in morphine equivalents per hour: non-IVL = 1.25 vs IVL = 1.72 ( P = .004) and LOS non-IVL = 10.2+/−7.6 vs IVL = 7.82+/−4.94. By analyzing IVL pts in a crossover comparison before and after IVL, there was reduction in opiates: 3.01 vs 1.72 ( P < .001) and PS: 7.0 vs 4.9 ( P < .001). Stanford Pain Score system reduction in the IVL = 48.3 ± 23.9%, but less effective in narcotic dependency (27 ± 22.9%, P = .035); IVL pts had hospital cost reduction: $82,927 vs $118,202 ( P < .01).

Discussion

In a crossover analysis, IVL is effective for reduction of PS and opiate use and reduces hospital LOS and costs. Patient age may confound interpretation of results. Our data support IVL use in multimodal pain regimens. Future prospective study is warranted.
Have Students Used Techniques to Stop the Bleed?
Authors: Kelley Katherine , Martinson James , Henry Sharon , Scalea Thomas , Park Habeeba
Published: November 2021

Introduction

The Stop the Bleed course was initiated in response to the Hartford Consensus and over 1 million people have been taught basic bleeding control techniques. Our study sought to determine the extent to which this training has been utilized.

Methods

Surveys were sent by email to students that had taken the Stop the Bleed course through our institution in 2017 or 2018. Data were collected utilizing the REDCap system and statistical calculations were performed.

Results

2505 surveys were sent with 445 (18%) responses. The mean age of respondents was 48 years of age, 343 (77%) were female, and 230 (52%) were in the medical field. There were 17 respondents (3.8%) that stated they had utilized the techniques taught in the course; 16 out of 17 put pressure on a wound, 7 packed a wound, and 6 used a tourniquet. Patients had been injured by a variety of mechanisms including gunshot wound, stabbing, accidental laceration, and motor vehicle collision. Patients had good outcomes with 3 out of 17 surviving to emergency medical services arrival without known final outcome and the remaining 14 were known to do well.

Conclusion

The Stop the Bleed course is important to enable bystanders to provide hemorrhage control. Our study shows that the techniques have been utilized with 17 treated patients having a good outcome and while a utilization rate of 3.8% may appear low, it is similar to the utilization rate of cardiopulmonary resuscitation instruction of 2%.