bluuebunny/crossref_metadata_2025 huggingface dataset:
Tecnologias Educacionais: Software Geogebra Auxiliando na Geometria Espacial do Ensino Médio / Educational Technologies: Geogebra Software Helping High School Spatial Geometry
Authors: Gondim Francisco de Assis Da Silva , Angelim Clenilson Panta
Published: November 2021

Resumo: A globalização trouxe uma grande abertura para os mercados internacionais, por ter descaracterizado as fronteiras físicas entre os países que trocam informações em alta velocidade e possibilitam ao comércio internacionalizar-se definitivamente. Por outro lado, disseminou a utilização das novas Tecnologias da Informação e da Comunicação indiscriminadamente, inclusive as instituições de ensino a buscarem estratégias para manterem seus alunos motivados para o aprendizado. Nesse contexto, as escolas têm que apoiar-se em recursos altamente tecnológicos para atender sua clientela ávida por tecnologias, mas que não têm background para utilizá-las de modo conveniente para buscar o conhecimento. São professores que devem esmerar-se no sentido de propiciar meios cada vez mais sofisticados para manterem alunos envolvidos. Esse trabalho tem por objetivo mostrar as vantagens da utilização das ferramentas tecnológicas no ensino da Geometria Espacial. A metodologia adotada para desenvolvimento dessa pesquisa é a pesquisa bibliográfica, mas especificamente, a pesquisa explioratória que tem por disciplina a coleta e seleção dos dados, a escolha das fontes bibliográficas compostas por livros e artigos referentes ao tema.Palavras-Chave: Geometria, espacial, ensino, TICs., Geogebra. Abstract: Globalization has brought a great opening to international markets, as it has de-characterized the physical borders between countries that exchange information at high speed and enable commerce to definitively internationalize. On the other hand, it disseminated the use of new Information and Communication Technologies indiscriminately, including educational institutions to seek strategies to  keep  their  students  motivated  for  learning.  In  this  context, schools have  to  relyon   highly technological resources to serve their clientele who are eager for technologies, but who do not have the background to use them in a convenient way to seek knowledge. They are teachers who must strive to provide increasingly sophisticated means to keep students involved. This work aims to show the advantages of using technological tools in teaching Spatial Geometry. The methodology adopted for the development of this research is the bibliographic research, but specifically, the exploratory research whose discipline is the collection and selection of data, the choice of bibliographic sources composed of books and articles referring to the theme.Keywords: Geometry, spatial, teaching, ICTs., Geogebra.
Apresentação
Authors: Nora Giseli Dalla , Rossetto Onélia Carmem , Lima Diogo Marcelo Delben Ferreira de , Cleps Junior João , Fernandes Bernardo Mançano
Published: November 2021

Este dossiê da Revista de Geografia Agrária Campo Território contém artigos que promovem um debate teórico-conceitual das análises feitas pela REDE DATALUTA, a partir de nosso banco de dados com o objetivo de fortalecer os estudos da geografia agrária e de outras áreas do conhecimento a respeito da questão agrária.
Reposicionamiento de ivermectina frente a COVID-19: evidencias científicas que avalan su potencial preventivo y terapéutico
Authors: LIFSCHITZ Adrián , ALVAREZ Luis , CEBALLOS Laura , LANUSSE Carlos
Published: November 2021

En el presente trabajo se presenta una revisión actualizada y esquemática de la información científica disponible sobre el efecto antiviral del fármaco ivermectina frente al SARS-CoV-2 y las propiedades farmacológicas que avalan este efecto. En el marco del reposicionamiento de fármacos, el efecto antiviral de la ivermectina contra diferentes virus ha sido estudiado en diversos modelos in vitro. Desde el punto de vista farmacodinámico, la ivermectina tendría una respuesta antiviral que podría combinar acciones sobre las células del hospedador (inhibición del transporte a través de la membrana nuclear) y efectos directos sobre blancos moleculares del propio virus. Diferentes esquemas de administración de ivermectina se han evaluado en diversos países del mundo como medida de prevención y como herramienta terapéutica contra SARS-CoV-2. Los resultados muestran efectos de ivermectina en la reducción de la carga viral, en la aceleración de la recuperación clínica y prevención del deterioro de los pacientes tratados en la etapa temprana de la enfermedad y en la disminución de la tasa de hospitalización y mortalidad.
Peculiarities of formation of competitive strategy of the enterprises of flour-milling branch of Ukraine
Authors: Kuznetsova Inna , Gorbatiuk Valentyna , Mulyk Tetiana , Piskun Alyona , Pashchenko Oksana , Hridin Oleksandr
Published: November 2021

The article deals with the peculiarities of formation of competitive strategy of the enterprises of flour-milling branch of Ukraine. The paper substantiates the necessity to determine the stage of the life cycle of the industry in the process of formation of the competitive strategy. The market analysis of flour-milling industry of Ukraine is carried out on indicators: size of the market, commodity nomenclature, buyers and their behavior, raw material base and intensity of competition.  The paper determines that the flour-milling industry of Ukraine is at the stage of growth and has a number of tendencies, such as: decrease
 
in sales volumes, increase in export volumes, standardization of products and average level of competition intensity. The following stages of the life cycle of the industry are studied: introduction, growth, maturity and decline. The paper proves the necessity of distinguishing the stage of renewal in the life cycle of the industry, which is implemented on the basis of modern technologies. The practical significance of the research consists in developing recommendations for choosing a competitive strategy of the flour mill enterprise in accordance with the stage of the life cycle of the industry. The enterprises of the flour-milling industry of Ukraine, in accordance with the stage of the life cycle of the industry are recommended to form competitive advantages on the basis of the concept of "lean production".
Optimization of economic and ecological components of using agricultural lands for balansed land use and rural areas development
Authors: Sydoruk Borys , Sava Andrii , Korzhenivska Nataliia , Zdyrko Nataliya , Khaіetska Olha
Published: November 2021

The study is devoted to solving a topical problem related to the deterioration of land quality in Ukraine and in many countries around the world. This article proposes the use of economic and mathematical modelling to optimize the structure of sown areas of crops on the example of the whole of Ukraine in the direction of ensuring the balance of humus in the soil depending on the influence of a number of environmental and economic factors. The formation of the economic and mathematical model was the basis of the research methodology in this work. Based on the use of a systematic approach to assessing the effectiveness of the agricultural land use system, a number of environmental and economic indicators were selected and three groups of restrictions in the field of intensification of agricultural land use were formed. The applied approach made it possible to develop a task to optimize the sown area of crops in order to preserve the quality of land. The results of solving the formed problem showed the need to limit the sown area under crops, the cultivation of which leads to the loss of humus in the soil; in particular, it is proposed to limit the sown area under sunflower. The results of the study allowed us to draw the following conclusions: a positive effect on the quality of soils from the cultivation of annual and perennial grasses was established, which requires an increase in sown areas under these crops; promising indicators for achieving a deficit-free balance of humus in soils during the cultivation of crops have been identified; an algorithm for choosing solutions to ensure balanced use of agricultural land in the agricultural sector has been developed that the presented procedure for choosing solutions will increase the environmental and economic efficiency of agricultural land use; it is established that for the realization of certain goals in the system of land use, the decisive importance should be given to the consideration and coordination of environmental, economic and social interests.
Accounting of real costs for the production of organic food: world experience and practice of Ukraine
Authors: Ishchenko Yana , Podolianchuk Olena , Struk Nataliya , Yasyshena Valentyna , Stender Svitlana
Published: November 2021

The purpose of the publication is to study the current state of the organization and methods of accounting for the costs of organic production from the point of view of environmental and economic accounting in Ukraine and recommendations for adapting accounting support for managing the costs of production of organic products to the requirements of the formation of integrated information of environmental and economic accounting. To determine the general trends in the development of accounting support for managing the costs of the production of organic products, the methods of induction and deduction were used. The economic and statistical method was used to analyse the state of production of organic products, and the observation method was used to study the state of accounting for the real costs of producing organic food. The state of development of organic production for the period from 2000 to 2019 in the world, Europe and Ukraine has been analysed. It has been determined that at the micro level, in the conditions of organic production, environmental and economic accounting is an information system that allows you to monitor compliance with the requirements of domestic and international legislation regarding the implementation of this type of activity, and, at the next stages, to form consistent and comparable statistical indicators to account for the relationship " links between the environment and the economy. In the absence of regulatory accounting in Ukraine in the conditions of organic production, the formation of internal regulatory accounting regulations is a prerequisite for the effective management of such production. The formed system of cost accounting objects, considering the specifics of technological processes of operators of organic production, will allow organizing a separate accounting of costs for the production of organic products, inorganic products, and products of the transition period. A nomenclature of cost accounting items in terms of production of organic production is proposed, the use of which will make it possible to distinguish in accounting the expenses allowed by legislation in terms of production of organic production from expenses for which there are certain restrictions. The features of the functions of primary documents reflecting the costs of organic production are determined and ways to improve the documentation of production processes are proposed. This will improve the information support for product quality control and will allow adapting the accounting support for managing the production costs of organic products to the requirements of the formation of integrated information on environmental and economic accounting.
Forecasting the time stock for chemical plant protection based on computer simulations
Authors: Тryhuba Anatolii , Tryhuba Inna , Mykhalchyshyna Larysa , Mushenyk Iryna , Koval Nonna , Haybura Yuliia
Published: November 2021

The approach, algorithm, and intelligent system of support of decision-making of management for forecasting of time fund for the performance of the mechanized chemical protection of plants are offered. They are based on the formation of a database and knowledge of the weather from the Open Weather Map service for individual countries and their regions. They provide the formation of databases and knowledge for a given country or its region, taking into account the characteristics of natural, climatic, and industrial conditions based on computer modelling. Also, the proposed intelligent management decision support system provides a systematically accountable set of variable agrometeorological components of the mechanized chemical plant protection system and their impact on the projected time fund of the relevant work. Based on the use of the developed intelligent system of support of acceptance of administrative decisions forecasting of time fund for the performance of the mechanized chemical protection of plants and the set natural-climatic and industrial conditions is executed. The climatically admissible time fund model for mechanized chemical protection of plants during the day for May, which is described by Weibull distribution, is substantiated. The obtained research results can be used by managers of agricultural enterprises during the management processes of forecasting the time fund for the implementation of mechanized chemical plant protection. The developed intelligent decision support system provides further research on forecasting the time fund for the implementation of mechanized chemical plant protection and substantiation of its models for different countries and their regions.
Effects of Flywheel vs. Traditional Resistance Training on Neuromuscular Performance of Elite Ice Hockey Players
Authors: Puustinen Jari , Venojärvi Mika , Haverinen Marko , Lundberg Tommy R.
Published: November 2021

Puustinen, J, Venojärvi, M, Haverinen, M, and Lundberg, TR. Effects of flywheel versus traditional resistance training on neuromuscular performance of elite ice hockey players. J Strength Cond Res 37(1): 136–140, 2023—This study aimed to examine the effects of 8 weeks of flywheel (FW) vs. traditional resistance training on neuromuscular performance of elite ice hockey players during the off-season. Eighteen male players (U-18 to U-21) were assigned to a flywheel group (FG) or traditional training group (TG). The FG (n = 9) performed FW training with 4 different exercises (3–4 sets × 6–7 repetitions). The TG (n = 9) used barbells and free weights (4 sets × 4–12 repetitions). Outcome measures included loaded and unloaded countermovement jumps (CMJs) and a 200 m sprint test that included split times and direction changes. There were no group effects (analysis of covariance with adjustments for pretest values, all p > 0.05, all effect sizes <0.8), suggesting comparable performance improvements between groups. Within-group changes for the unloaded CMJ were 5.7% in FG vs. 4.8% in TG. Similar or slightly greater improvements were seen for the loaded CMJs. For sprint times, there were improvements in both groups for the split time of the first 20 m (FG: −3.2 vs. TG: −2.6%) and also for the 200 m total sprint time (FG −1.8% and TG −1.5%). In conclusion, although FW resistance training improves neuromuscular performance in elite ice hockey players, it does not elicit superior improvements compared with traditional resistance training in players with no prior experience with this training method.
Policing Hybridity
Authors: Shoffstall Grant W.
Published: November 2021

Cryonic suspension (“cryonics”) is the practice of freezing the deceased in hopes that scientists will eventually develop the levels of technology required to facilitate their revival and rejuvenation. By tracing the practice’s ties to transhumanism, this article advances an interpretation of cryonics as a hybrid of religion and technoscience. Scholars have converged on transhumanism’s hybridity; it evinces a transposition of religious themes, e.g., redemption, transcendence, and immortality, into the this-worldly register of technoscience. This hybridity, however, is thoroughly transgressive—it destabilizes the presumptive boundary between “science” and “religion” as purified categories. The practitioners of cryonics inherited this hybridity and, through the act of freezing the deceased, render it concrete. Cryonics destabilizes culturally legitimated definitions of life and death, living and dead, and furthermore comes into conflict with otherwise accepted scientific truths and authorized forms of religiosity. This is all borne out by the fact that cryonics has a tendency to be dually designated, i.e., policed, as both “cult” and “pseudoscience.”
Improving the designing method of thermal networks: bypass connection
Authors: Derevyanko Georgy V. , Mescheryakov Vladimir I.
Published: November 2021

The paper presents the results of the development of a model of a heat exchange system with a bypass connection of flows. An analytical model of a bypass for two heat exchange elements in the form of a relationship between the temperature ratio differencesof flows and efficiency has been developed. The resulting expression for the efficiency of energy exchange in the system depends on the distribution of elements and flows at the entrance to the system and does not depend on the distribution in the mixing unit. It is shown that the key factor determining both the operation of the designed system and its elements is the correspondence of thedirection of the processes in the real system with their direction, hypothetically chosen by the designer when specifying its topology. The distribution of the energy potential dictates the conditions for the operability of the system and its elements through the uncertainty of the values of the average energy measures. The statement of the problem of determining the matrix elements that satisfy the requirement of the minimum uncertainty of the average energy measures leads to the determination of the distribution of the efficiency of the system elements in its topological representation in accordance with the requirementsof the second law of thermodynamics. The formulated requirements for the minimality of the uncertainty of the average energy measures and the construction, based on the Shannon principle, make it possible to obtain a solution to the formulated problem as a finite subset of the values of the efficiency of the inter-network and intra-network energy exchange. In addition, the extremeness of solutions (minimum uncertainty of average energy measures) ensures the maximum efficiency of energy transfer from the “hot” network to the “cold” network in its elements and the minimum energy dissipation in the mixing nodes.The urgency of the topic is due to the fundamental need to reduce energy costs of systems. The applied aspect is to minimize the mass, dimensions and energy component in enterprises where thermal transformations are significant.
Effectiveness of stego images pre-noising with fractional noise for digital image steganalysis
Authors: Progonov Dmytro O.
Published: November 2021

Counteraction to sensitive data leakage in cyber-physical systems is topical task today. Solving of the task is complicated to widely usage by attackers of novel steganographic methods for sensitive data embeddinginto innocuous (cover)files, such as digital images. Feature of these embedding methods isminimization of cover image’s parameters alterations during message hiding. This negatively affectsdetection accuracy of formed stego images bystate-of-the-art statistical stegdetectors. Therefore, advanced methods for detection and amplification of cover image’s parameters abnormal changes caused by data embedding are needed.The novel approach for solving of mentioned task is applying of image pre-processing (calibration) methods. These methods are aimed at estimation parameters either of cover, or stego images from current analysed image.The majority of known calibration methods are based on cover image content suppression by utilization of extensive set of high-pass filters. This makes possible close to state-of-the-art detection accuracy by the costof time consuming preselectionof appropriate filters. Therefore, this approach may be inappropriate in real cases, when fast re-train stegdetector for revealing of stego images formed by unknown embedding methodsis required.For overcoming this limitation, we proposed to calibrate an image by amplification of alterations caused by message hiding. This can be realized by data re-embedding into images or their pre-noising.The effectiveness of such approach was proved for wide range of modern embedding methods in the case of message re-embedding. The paper is aimed at performance analysis of image calibration by pre-noising, namely by using of non-stationary fraction noise.The performance analysis of proposed solution was performed for novel HUGO and MG adaptive embedding methods on standard VISION dataset. According to obtained results, we may conclude that applying of proposed solution allows achieving close to state-of-the-art detection accuracy for HUGO embedding method and low (less than 10%) cover image payload.Also, low computation complexity of proposed solution makes it an attractive alternative to novel cover rich models based stegdetectors. Nevertheless, solution’s performance concedes effectiveness of novel stegdetectorsfor medium(less than 20%) and high (more 25%) cover image payloadfor MG embedding method
Analysis of quasi-periodic space-time non-separable processes to support decision-making in medical monitoring systems
Authors: Franzheva Olena D.
Published: November 2021

In many decisionsupport systemsthere are processedchaotic spatial-time processes which are non-separable and quasi-periodic. Some examples of such systemsareepidemic spreading, population development, fire spreading, radio wave signals, image processing, information encryption, radio vision, etc. Processes in these systems have periodic character, e.g. seasonal fluctuations(epidemic spreading, population development), harmonic fluctuations (pattern recognition, image processing),etc. In simulation block the existing systems use separable process models which are presented as multiplication of spatialand temporal parts and are linearized. This significantly reduces the quality of spatial-time non-separable processes. The quality model building of chaotic spa-tial-time non-separable processwhich is processed by decisionsupport systemis necessary for getting of learning set. Itis really complicated especially if the random process is formed. The implementation ensemble of chaotic spatial-time non-separable process requires high costs what causes reduction of the system efficiency. Moreover, in many cases the implementation ensemble of spatial-time processes is impossible to get. In this workthemathematical model of a quasi-periodic spatial-time non-separable process has been developed. Based on it the formation method of this process has been developed and investigated. The epidemic spreading pro-cessed was presented as an example.
Razón natural y defensa de la costa. Los fundamentos del gobierno militar del reino de Valencia en el reinado de Felipe II
Authors: Pardo Molero Juan Francisco
Published: November 2021

En el siglo XVI la difusión de innovaciones militares alteró la administración la defensa de los reinos mediterráneos de la Monarquía Hispánica, en particular del reino de Valencia. Pero la adopción de novedades no fue solo consecuencia automática del peligro militar sufrido por los reinos, sino producto de negociaciones que intentaron integrar esas novedades dentro del orden social y político del reino, visto como parte del orden natural y universal. Fue mediante el uso de la razón natural, considerada de inspiración divina, y no mediante la moderna razón de estado, como se canalizaron y asumieron las innovaciones defensivas.
Who Speaks First? Promoting Senior Resident Autonomy on Family-Centered Rounds: A QI Initiative
Authors: Kilinsky Alexandra , Brandt Timothy , Fornari Alice , Goenka Pratichi , Jan Sophia , Kabra Rashi , Khalsa Dev Darshan , Liewehr Sheila , Palumbo Nancy , Subramony Anupama , Leone Nicole
Published: November 2021

BACKGROUND AND OBJECTIVES

Graduated autonomy is fundamental as trainees transition to independent practice. Family-centered rounds (FCR), the leading model of inpatient rounding in pediatrics, is an opportunity for trainees to demonstrate their competence in leading a health care team, which is an entrustable professional activity for all pediatric residents. At our institution, senior residents (SRs) at baseline performed at a novice level on the basis of the Senior Resident Empowerment Actions 21 (SREA-21), a validated tool that is used to assess SR autonomy during FCR. Our objective for this study was to increase the median percentage of SREA-21 domains in which SRs perform at a competent level from 38% to 75% within 6 months.

METHODS

Researchers observed 4 FCR encounters weekly and calculated SREA-21 scores after 2 weeks on the basis of actions promoting SR autonomy performed by the SR-hospitalist dyad. The primary outcome measure was the percentage of SREA-21 domains in which the SR achieved a competent score on the SREA-21. We used the model for improvement to identify key drivers and test proposed interventions using serial plan-do-study-act cycles. Interventions included creation of unified inpatient SR expectations, introduction of a SR-hospitalist pre-FCR huddle, auditing of FCR interruptions, and direct feedback to the SR-hospitalist dyad after FCR. Run charts were used to track SR and hospitalist scores on the SREA-21.

RESULTS

After multiple plan-do-study-act cycles, there was special cause improvement with a desirable shift upward in the centerline to 100%, which correlated with the project’s interventions and surpassed our goal.

CONCLUSIONS

Using quality improvement methodology, we improved SR autonomy during FCR, as measured by the SREA-21.
Ethnic Disparities in the Care of Opioid-Exposed Newborns in Colorado Birthing Hospitals
Authors: Weikel Blair W. , Palau Mauricio A. , Hwang Sunah S.
Published: November 2021

OBJECTIVES

Investigate disparities by Hispanic ethnicity in the care of opioid exposed newborns (OENs) in Colorado birthing hospitals within a statewide quality improvement collaborative.

METHODS

This study is a secondary analysis of a quality improvement initiative aimed at standardizing hospital-based care of OENs through implementation of the Eat, Sleep, Console Model. We used statistical process control charts to compare time to special cause variation by Hispanic ethnicity for outcomes including infant length of stay, use of pharmacologic therapy, and breastfeeding eligibility and receipt. Only hospitals that delivered both Hispanic and non-Hispanic OENs during the study period were included, documented maternal ethnicity was required for inclusion. We investigated hospital variation in these outcomes among 4 hospitals that cared for Hispanic OENs for most of the study period.

RESULTS

We analyzed 799 mother–OEN dyads, 241 Hispanic and 558 non-Hispanic. Both Hispanic and non-Hispanic OENs experienced decreases in length of stay overall and among those who received postnatal opioids, although Hispanic OENs achieved these decreases 3 annual quarters after non-Hispanic OENs. Pharmacologic therapy use decreased by 55% for Hispanic OENs and 60% for non-Hispanic OENs. Hispanic OENs experienced a 1-quarter delay for this decrease.

CONCLUSIONS

Although this quality improvement initiative resulted in positive outcomes for Hispanic and non-Hispanic OENs, improvement was delayed among Hispanic infants, indicating a need to explore and address care practices of Hispanic mothers and infants affected by opioid use disorders.
Use of a Sterile Collection Process to Reduce Contaminated Peripheral Blood Cultures
Authors: Bram Sarah , Schmidt Teresa M. , Lloyd Justin P. , Ellsworth Samantha , Quayle Kimberly , Srinivasan Mythili
Published: November 2021

BACKGROUND

Contaminated blood cultures pose a significant burden by subjecting children to unnecessary testing, procedures, and antibiotics and increasing health care costs. The aim of our quality improvement (QI) initiative was to decrease the percentage of contaminated peripheral blood cultures in our pediatric emergency department (ED) from an average of 6.7% to <3% over a 16-month period.

METHODS

The QI initiative was implemented in the pediatric ED of a tertiary care children’s hospital. Interventions included change of the peripheral blood culture collection from a clean to a sterile process, nursing education, and individualized feedback. The primary outcome measure was the percentage of contaminated peripheral blood cultures. The process measure was the percentage of nurses who completed 75% to 100% of the steps of the sterile collection process, as measured by self-reporting in audit cards. The balancing measures were time from antibiotic ordering to time of administration and ED length of stay.

RESULTS

We decreased the percentage of contaminated peripheral blood cultures threefold from a baseline (June 2, 2018, to December 31, 2018) of 6.7% to 2.1% during the intervention period (January 1, 2019, to April 30, 2020). Ninety-eight percent of nurses who completed audit cards reported performing 75% to 100% of the steps of the new sterile process. There was no significant difference in the average time from antibiotic ordering to antibiotic administration or ED length of stay between the baseline and intervention periods.

CONCLUSIONS

Use of a sterile blood culture collection process, in addition to nursing education and individualized feedback, is an effective method to decrease peripheral blood culture contamination rates in a pediatric ED.
Creation and Implementation of a Hospitalist-Run Propofol Sedation Program
Authors: McAndrew Lisa , Patel Melissa , Werner Amy , Aredas Brenna , Winser Kyle , Dubow Scott
Published: November 2021

BACKGROUND

Pediatric hospitalists increasingly provide sedation outside the operating room. Given the large body of safety data available, propofol was identified as a beneficial addition to our hospitalist-run sedation service’s medication repertoire. Currently, the training required for hospitalists to provide sedation is defined and determined locally by individual institutions.

METHODS

We convened a task force to develop and implement training for hospitalists in the use of propofol for deep sedation. After implementing training, we analyzed the outcome of patients receiving propofol for deep sedation for MRI, including the adverse event rate and successful completion rate. An adverse event was defined as a significant desaturation, persistent upper airway obstruction, laryngospasm, administration of neuromuscular blockade, conversion to anesthesia, call for additional backup, or if the procedure was not able to be completed. Successful completion was defined as any patient being able to complete the imaging study or procedure with sedation performed by a hospitalist physician.

RESULTS

Between September 2015 and September 2018, sedation services sedated 12 979 patients, 3929 of whom were deeply sedated with propofol. During this period, the trained hospitalists had an adverse event rate of 3.6% and a 98.9% rate of successful completion of all studies or procedures when using propofol for deep sedation.

CONCLUSION

With a comprehensive training program for hospitalists in the administration of propofol, we provided effective sedation for a selective population of patients. We now have a standard approach that uses credentialed hospitalists to train new faculty for propofol administration.
Improving Discharge Instructions for Hospitalized Children With Limited English Proficiency
Authors: Choe Angela Y. , Schondelmeyer Amanda C. , Thomson Joanna , Schwieter Andy , McCann Erin , Kelley Jodi , Demeritt Brenda , Unaka Ndidi I.
Published: November 2021

BACKGROUND AND OBJECTIVES

Patients with limited English proficiency (LEP) have increased risk of adverse events after hospitalization. At our institution, LEP families did not routinely receive translated discharge instructions in their preferred language. Our objective for this study was to increase the percentage of patients with LEP on the hospital medicine (HM) service receiving translated discharge instructions from 12% to 80%.

METHODS

Following the Model for Improvement, we convened an interdisciplinary team that included HM providers, pediatric residents, language access services staff, and nurses to design and test interventions aimed at key drivers through multiple plan-do-study-act cycles. Interventions addressed the translation request process, care team education, standardizing discharge instructions for common conditions, and identification and mitigation of failures. We used established rules for analyzing statistical process control charts to evaluate the percentage of patients with translated discharge instructions for all languages and for Spanish.

RESULTS

During the study period, 540 patients with LEP were discharged from the HM service. Spanish was the preferred language for 66% of patients with LEP. The percentage of patients with LEP who received translated discharge instructions increased from 12% to 50% in 3 months and to 77% in 18 months. For patients whose preferred language was Spanish, the percentage increased from 16% to 69% in 4 months and to 96% in 18 months.

CONCLUSIONS

Interventions targeting knowledge of the translation process and standardized Spanish discharge instructions were associated with an increased percentage of families receiving translated discharge instructions. Future work will be used to assess the impact of these interventions on postdischarge disparities, including emergency department revisits and readmissions.
Placenta Accreta Spectrum
Authors: Donovan Bridget M. , Shainker Scott A.
Published: November 2021

Placenta accreta spectrum (PAS) refers to the range of pathologic adherence of the placenta to the uterine myometrium, including the placenta accreta, increta, and percreta. The incidence of PAS is rising primarily because of an increase in related risk factors, such as the rate of cesarean deliveries and pregnancies resulting from assisted reproductive technology. The maternal risks associated with PAS are significant, including hemorrhage, hysterectomy, and death. Fetal and neonatal risks are primarily the result of premature delivery. Antenatal diagnosis via ultrasonography and magnetic resonance imaging remains imperfect. Management of PAS varies, however, and there is a clear improvement in maternal outcomes with an antenatal diagnosis compared with unexpected diagnosis at the time of delivery. Studies that evaluate the balance between maternal and fetal/neonatal risks of expectant management versus preterm delivery have found that planned delivery between 34 and 35 weeks’ gestation optimizes outcomes. Multidisciplinary PAS care teams have become the norm and recommended approach to management, given the complexity of caring for this obstetrical condition. Although significant advances have been made over the years, large knowledge gaps remain in understanding the pathophysiology, diagnosis, and clinical management.
Preventing Home Medication Administration Errors
Authors: Yin H. Shonna , Neuspiel Daniel R. , Paul Ian M. , Franklin Wayne , Tieder Joel S. , Adirim Terry , Alvarez Francisco , Brown Jeffrey M. , Bundy David Gordon , Ferguson Laura Elizabeth , Gleeson Sean Patrick , Leu Michael , Mueller Brigitta U. , Connor Phillips Shannon , Quinonez Ricardo A. , Rea Corinna , Rinke Michael L. , Shaikh Ulfat , Shiffman Richard N. , Vickers Saarel Elizabeth , Spencer Cockerham Sandra P. , Mack Walsh Kathleen , Jones Bridgette , Adler Adam C. , Foster Jennifer H. , Green Thomas P. , Houck Constance S. , Laughon Matthew M. , Neville Kathleen , Reigart John R. , Shenoi Rohit , Sullivan Janice E. , Van Den Anker John N. , Verhoef Philip A.
Published: November 2021

Medication administration errors that take place in the home are common, especially when liquid preparations are used and complex medication schedules with multiple medications are involved; children with chronic conditions are disproportionately affected. Parents and other caregivers with low health literacy and/or limited English proficiency are at higher risk for making errors in administering medications to children in their care. Recommended strategies to reduce home medication errors relate to provider prescribing practices; health literacy–informed verbal counseling strategies (eg, teachback and showback) and written patient education materials (eg, pictographic information) for patients and/or caregivers across settings (inpatient, outpatient, emergency care, pharmacy); dosing-tool provision for liquid medication measurement; review of medication lists with patients and/or caregivers (medication reconciliation) that includes prescription and over-the-counter medications, as well as vitamins and supplements; leveraging the medical home; engaging adolescents and their adult caregivers; training of providers; safe disposal of medications; regulations related to medication dosing tools, labeling, packaging, and informational materials; use of electronic health records and other technologies; and research to identify novel ways to support safe home medication administration.
Synthesis and behavior of bulk iron nitride soft magnets via high-pressure spark plasma sintering
Authors: Monson Todd C. , Zheng Baolong , Delaney Robert E. , Pearce Charles J. , Zhou Yizhang , Atcitty Stanley , Lavernia Enrique
Published: November 2021

In this study, dense bulk iron nitrides (FexN) were synthesized for the first time ever using spark plasma sintering (SPS) of FexN powders. The Fe4N phase of iron nitride in particular has significant potential to serve as a new soft magnetic material in both transformer and inductor cores and electrical machines. The density of SPSed FexN increased with SPS temperature and pressure. The microstructure of the consolidated bulk FexN was characterized with X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), and superconducting quantum interference device (SQUID) magnetometry. XRD revealed a primary phase of Fe4N with secondary phases of Fe3N and metallic iron. Finite element analysis (FEA) was also applied to investigate and explain localized heating and temperature distribution during SPS. The effects of processing on interface bonding formation and phase evolution were investigated and discussed in detail to provide insight into fundamental phenomena and microstructural evolution in SPSed FexN.

Graphic abstract
Healthy People 2020 Final Review
Authors: Hubbard Kate , Huang David
Published: November 2021

This report provides a quantitative end-of-decade assessment of the nation’s progress toward achieving health goals set by the U.S. Department of Health and Human Services.
A ERA DOS INQUÉRITOS: LIVROS, LEITURA E LEITORES EM SÃO PAULO, ANOS 1920.
Authors: SCHAPOCHNIK NELSON
Published: November 2021

RESUMO: Este ensaio debruça-se sobre um conjunto de textos publicados em revistas e na imprensa dos anos 1920 por um editor (Monteiro Lobato), um crítico literário (José Maria Bello), um ensaísta (Antonio de Alcântara Machado) e um pedagogo (Manoel Bergstrom Lourenço Filho). Embora não seja possível indicar uma relação dialógica entre a totalidade dos textos, a sua leitura cerrada permite destacar algumas afinidades seletivas entre eles. Este elemento comum traduz-se na busca de instrumentos de sondagem capazes de produzir dados, apontar tendências e projeções, traçar diagnósticos sobre as práticas editoriais e a formação dos leitores na cidade de São Paulo. Atento simultaneamente à referencialidade e aos modos de argumentação empregados por estes mediadores culturais, é possível compreender a tal Era dos Inquéritos como a ascensão de discursos que forjarão uma política cultural visando articular a reflexão sobre os livros e o campo editorial, a formação dos leitores e equipamentos culturais na cidade. Lido de um ponto de vista retrospectivo, a Era dos Inquéritos pode ser considerada como um conjunto de reflexões que forneceram iluminações para a elaboração do programa do Departamento de Cultura e Recreação, dirigido por Mário de Andrade nos anos 30.
A new approach to mark termites (Cornitermes cumulans (Kollar) Blattodea: Isoptera) for laboratory bioassays
Authors: Marins A. , Cristaldo P. F. , Paiva L. R. , Miramontes O. , DeSouza O.
Published: November 2021

Abstract Behavioral lab bioassays involving termites must be promptly performed to allow intended observations prior to death from dissecation, typical of these soft-bodied insects. To this end, topic markers have been proposed as an alternative to histological stains which, while not always toxic are inevitably lengthy to apply. Among recommended topic markers, gouache is easy to apply, dries out quickly, but it is known affect termites in the long run, being suitable only to short-term bioassays. Its alternative, colored glue, is also easy to apply, but it takes long to dry and it is too dense and heavy, being thus prone to affect termite walking patterns. Here we tested a mix of gouache and colored glue aiming to combine the qualities of both into a suitable topical marker for Cornitermes cumulans termites. Similar patterns of survival presented by marked and unmarked termites ruled out concerns about toxicity of this mixture. Such results were consistent across distinct group densities evidencing that the mixture does not interfere with, nor it is affected by, crowding effects. Because crowding regulates interindividual interactions and these underlie most behaviors, the mixture can be thought to be suitable to behavioral studies. We argue that this 1:2 glue:gouache mixture is an excellent alternative to mark termites for lab bioassays. Being atoxic, cheap, easy to apply, and non-invasive, this mixture may happen to be useful not only for termites but also in bioassaying other similarly soft-bodied insects.
Significant production of vanillin and in vitro amplification of ech gene in local bacterial isolates
Authors: Mazhar B. , Jahan N. , Chaudhry M. , Liaqat I. , Dar M. , Rehman S. , Andleeb S. , Ali N. M.
Published: November 2021

Abstract Vanillin is the major component which is responsible for flavor and aroma of vanilla extract and is produced by 3 ways: natural extraction from vanilla plant, chemical synthesis and from microbial transformation. Current research was aimed to study bacterial production of vanillin from native natural sources including sewage and soil from industrial areas. The main objective was vanillin bio-production by isolating bacteria from these native sources. Also to adapt methodologies to improve vanillin production by optimized fermentation media and growth conditions. 47 soil and 13 sewage samples were collected from different industrial regions of Lahore, Gujranwala, Faisalabad and Kasur. 67.7% bacterial isolates produced vanillin and 32.3% were non-producers. From these 279 producers, 4 bacterial isolates selected as significant producers were; A3, A4, A7 and A10. These isolates were identified by ribotyping as A3 Pseudomonas fluorescence (KF408302), A4 Enterococcus faecium (KT356807), A7 Alcaligenes faecalis (MW422815) and A10 Bacillus subtilis (KT962919). Vanillin producers were further tested for improved production of vanillin and were grown in different fermentation media under optimized growth conditions for enhanced production of vanillin. The fermentation media (FM) were; clove oil based, rice bran waste (residues oil) based, wheat bran based and modified isoeugenol based. In FM5, FM21, FM22, FM23, FM24, FM30, FM31, FM32, FM34, FM35, FM36, and FM37, the selected 4 bacterial strains produced significant amounts of vanillin. A10 B. subtilis produced maximum amount of vanillin. This strain produced 17.3 g/L vanillin in FM36. Cost of this fermentation medium 36 was 131.5 rupees/L. This fermentation medium was modified isoeugenol based medium with 1% of isoeugenol and 2.5 g/L soybean meal. ech gene was amplified in A3 P. fluorescence using ech specific primers. As vanillin use as flavor has increased tremendously, the bioproduction of vanillin must be focused.
Clinical findings of equine leukoencephalomalacia
Authors: Albertino Lukas G. , Dias Natália M. , Moreira Juliana J. , Oliveira-Filho José P. , Takahira Regina K. , Laufer-Amorim Renée , Borges Alexandre S. , Amorim Rogério M.
Published: November 2021

ABSTRACT: Equine leukoencephalomalacia (LEM) is a disease caused by the ingestion of food, especially corn, contaminated by fumonisin, a Fusarium verticillioides (synonymous with F. moniliforme) metabolite. The clinical signs of brain injuries have an acute onset and rapid evolution. This study aimed to describe the clinical findings in 11 animals diagnosed with LEM, including cerebrospinal fluid (CSF) analysis. Of these animals, 91% (10/11) were horses, and only 9% (1/11) were asinine. The clinical localization of the lesions was 64% (7/10) cerebral, manifested mainly by altered mental state and behavioral disturbance, and 36% (4/11) were brainstem lesions, manifested by incoordination, head tilt, nystagmus, facial hypoalgesia, difficulty in apprehension, chewing, and swallowing food. Postmortem findings revealed that 82% (9/11) of the lesions were in the cerebrum and 18% (2/11) in the brainstem. CSF findings, such as xanthochromia (43%, 3/7), hyperproteinorrachia (50%, 3/6), and pleocytosis (43%, 3/7) were observed. The affected animals showed neurological signs that were compatible with cerebral and/or brainstem injuries. The CSF from animals with LEM may present with xanthochromia, hyperproteinorrachia, and pleocytosis, reinforcing the fact that this disease should be included in the differential diagnosis of encephalomyelopathies.
Métodos de previsão de prêmios para o Seguro Agrícola e destinação de recursos públicos ao Programa de Subvenção ao Prêmio do Seguro Rural
Authors: Mota Arthur Augusto Lula , Ozaki Vitor , Miquelluti Daniel Lima
Published: November 2021

Resumo: A previsão dos prêmios do seguro agrícola tem impacto relevante no dimensionamento orçamentário do Programa de Subvenção ao Prêmio do Seguro Rural (PSR). Pela ótica da responsabilidade e do planejamento do gasto público, é preciso estimar com relativa precisão quanto se pretende despender com o Programa no curto e médio prazo (Emenda Constitucional nº 95, de 2016). O presente estudo faz uma comparação de métodos para a projeção do prêmio do seguro agrícola por região. Foram utilizados os modelos SARIMA e os algoritmos NNAR, TBATS, MAPA e ELM, com e sem a covariável de subsídio. As metodologias foram aplicadas aos dados mensais do volume de prêmio do seguro agrícola das regiões Sul, Sudeste, Centro-Oeste e Nordeste do Brasil de 2006 a 2018. Foi observado que o modelo SARIMA univariado mostrou o melhor resultado nas regiões Centro-Oeste e Nordeste, ao passo que o SARIMA e o ELM com a covariável foram superiores na região Sul e Sudeste, respectivamente. A partir desses resultados, foi possível discutir a relevância da subvenção para a ampliação do seguro nas regiões analisadas.