Monitor, anticipate, respond, and learn: developing and interpreting a multilayer social network of resilience abilities

Resilient performance is influenced by social interactions of several types, which may be analysed as layers of interwoven networks. The combination of these layers gives rise to a “network of networks”, also known as a multilayer network. This study presents an approach to develop and interpret multilayer networks in light of resilience engineering. Layers correspond to the four abilities of resilient systems: monitor, anticipate, respond, and learn. The proposal is applied in a 34-bed intensive care unit. To map relationships between actors in each layer, a questionnaire was devised and answered by 133 staff members, including doctors, nurses, nurse technicians, and allied health professionals. Two multilayer networks were developed: one considering that actors are 100% available and reliable (work-as-imagined) and another considering suboptimal availability and reliability (work-as-done). The multilayer networks were analysed through actor-centred (Katz centrality, degree deviation, and neighbourhood centrality) and layer-centred metrics (inter-layer correlation, and assortativity correlation). Strengths and weaknesses of social interactions at the ICU are discussed based on the adopted metrics

Ocorrência de fungos micorrízicos em catuaba (Anemopaegma arvense (Vell.) Stell. ex de Souza - Bignoniaceae), uma planta medicinal do Cerrado em risco de extinção.

Este trabalho foi realizado com o objetivo de verificar a ocorrência de fungos micorrízicos, identificar suas espécies, e avaliar a colonização em raízes de plantas de diferentes populações e variedades de Anemopaegma arvense, uma planta medicinal do Cerrado em risco de extinção. As avaliações da colonização micorrízica e identificação de espécies de fungos micorrízicos arbusculares (FMAs) foram realizadas no Laboratório de Microbiologia do Solo da Universidade Federal de Lavras (UFLA). Foram utilizadas raízes de 10 plantas coletadas em diferentes locais juntamente com as amostras de solo próximo ao sistema radicular de populações naturais das variedades: glabra, puberula e petiolata. Os esporos foram extraídos do solo por meio da metodologia de peneiramento úmido e, para a avaliação e observação da colonização radicular, as raízes coradas foram observadas em microscópio estereoscópico (ampliação 10 a 40x). Em todas as amostras analisadas foi possível identificar espécies de FMAs, exceto para a variedade puberula, coletada no município de Mogi Guaçu-SP. O número de esporos variou de maneira significativa entre as amostras e os locais amostrados, não havendo distribuição regular. Acaulospora scrubiculata, A. spinosa, A. longula, Escustelospora heterogama, Paraglomus occultum, Gigaspora margarita, Gigaspora sp., dentre outros, encontram-se entre as espécies identificadas. Quanto à avaliação da colonização micorrízica nas raízes, observou-se que todas as variedades foram colonizadas no sitema radicular, verificada por meio da presença de hifas. No entanto, a colonização não foi constatada em todas as amostras avaliadas e também não foi observada a formação de arbúsculos e/ou vesículas.Suplemento 1

Otimização de protocolo para o enraizamento in vitro de jalapa (Mandevilla illustris) (Vell.) R. E. Woodson.

Suplemento. Edição dos Trabalhos do 49 Congresso Brasileiro de Olericultura, Águas de Lindóia, ago. 2009

Immune-related adverse events in the treatment of non-Hodgkin lymphoma with immune checkpoint inhibitors

Immune checkpoint inhibitors (ICIs) show efficacy in the treatment of non-Hodgkin lymphomas (NHL). However, these agents are associated with a unique group of side effects called immune-related adverse events (irAEs). We conducted an observational retrospective/prospective study on patients with relapsed/refractory NHL treated with ICI to determine the incidence of irAEs assessing the type, severity, and timing of onset, outcome and relationship with study drugs of these events. Thirty-two patients underwent ICI as single agent (N = 20) or in combination (N = 12). Ten patients (31.3%) developed at least one irAE for a total of 17 irAEs. Median time to presentation of irAEs was 69 days (range 0–407) with a median resolution time of 16 days (range 0–98). Progression free survival at 24 months for patients who developed an irAE was 40% and 31.8% for who did not. Overall survival for the two groups did not differ (at 24 months 40.0% and 62.5% for patients without and with irAE, respectively), but the median for who developed an irAE was not reached. The incidence of irAEs was associated with better long-term survival in NHL treated with ICIs but patients’ disease conditions need to be carefully evaluated to decide the optimal management

General Relativity as Classical Limit of Evolutionary Quantum Gravity

We analyze the dynamics of the gravitational field when the covariance is restricted to a synchronous gauge. In the spirit of the Noether theorem, we determine the conservation law associated to the Lagrangian invariance and we outline that a non-vanishing behavior of the Hamiltonian comes out. We then interpret such resulting non-zero ``energy'' of the gravitational field in terms of a dust fluid. This new matter contribution is co-moving to the slicing and it accounts for the ``materialization'' of a synchronous reference from the corresponding gauge condition. Further, we analyze the quantum dynamics of a generic inhomogeneous Universe as described by this evolutionary scheme, asymptotically to the singularity. We show how the phenomenology of such a model overlaps the corresponding Wheeler-DeWitt picture. Finally, we study the possibility of a Schr\"odinger dynamics of the gravitational field as a consequence of the correspondence inferred between the ensemble dynamics of stochastic systems and the WKB limit of their quantum evolution. We demonstrate that the time dependence of the ensemble distribution is associated with the first order correction in $\hbar$ to the WKB expansion of the energy spectrum.Comment: 23 pages, to appear on Class. Quant. Gra

Positive surgical margin during radical prostatectomy: overview of sampling methods for frozen sections and techniques for the secondary resection of the neurovascular bundles

Objective: The aim of the paper is to provide an overview of intraoperative sampling methods for frozen section (FS) analysis and of surgical techniques for a secondary neurovascular bundle (NVB) resection, as the method of surgical margin (SM) sampling and the management of a positive SM (PSM) at the nerve-sparing (NS) area are under evaluated issues. FS analysis during radical prostatectomy (RP) can help to tailor the plane of dissection based on cancer extension and thus extend the indications for NS surgery. Evidence Acquisition: We performed a PubMed/Medical Literature Analysis and Retrieval System Online (MEDLINE), Web of Science, Cochrane Library, and Elton B. Stephens Co. (EBSCO)host search to include articles published in the last decade, evaluating FS analysis in the NS area and surgical attempts to convert a PSM to a negative status. Evidence Synthesis: Overall, 19 papers met our inclusion criteria. The ways to collect samples for FS analysis included: systematic (analysing the whole posterolateral aspect of the prostate specimen, i.e., neurovascular structure-adjacent frozen-section examination [NeuroSAFE]); magnetic resonance imaging (MRI)-guided (biopsies from MRI-suspicious areas, retrieved by the surgeon in a cognitive way); and random biopsies from the soft periprostatic tissues. Techniques to address a PSM in the NS area included: full resection of the spared NVB, from its caudal to cranial aspect, often including the rectolateral part of the Denonvilliers’ fascia; partial resection of the NVB, in cases where sampling attempts to localise a PSM; incremental approach, meaning a partial or full resection that extends until no prostate tissue is found in the soft periprostatic environment. Conclusions: There is no homogeneity in prostate sampling for FS analysis, although most recent evidence is moving toward a systematic sampling of the entire NS area. The management of a PSM is variable and can be affected by the sampling strategy (difficult localisation of the persisting tumour at the NVB). The difficult identification of the exact soft tissue location contiguous to a PSM could be considered as the critical point of FS analysis and of spared-NVB management

Emergent Semiclassical Time in Quantum Gravity. Full Geometrodynamics and Minisuperspace Examples

I apply the preceding paper's semiclassical treatment to geometrodynamics. The analogy between the two papers is quite useful at the level of the quadratic constraints, while I document the differences between the two due to the underlying differences in their linear constraints. I provide a specific minisuperspace example for my emergent semiclassical time scheme and compare it with the hidden York time scheme. Overall, interesting connections are shown between Newtonian, Leibniz--Mach--Barbour, WKB and cosmic times, while the Euler and York hidden dilational times are argued to be somewhat different from these.Comment: References Update

Emergent Semiclassical Time in Quantum Gravity. I. Mechanical Models

Strategies intended to resolve the problem of time in quantum gravity by means of emergent or hidden timefunctions are considered in the arena of relational particle toy models. In situations with `heavy' and `light' degrees of freedom, two notions of emergent semiclassical WKB time emerge; these are furthermore equivalent to two notions of emergent classical `Leibniz--Mach--Barbour' time. I futhermore study the semiclassical approach, in a geometric phase formalism, extended to include linear constraints, and with particular care to make explicit those approximations and assumptions used. I propose a new iterative scheme for this in the cosmologically-motivated case with one heavy degree of freedom. I find that the usual semiclassical quantum cosmology emergence of time comes hand in hand with the emergence of other qualitatively significant terms, including back-reactions on the heavy subsystem and second time derivatives. I illustrate my analysis by taking it further for relational particle models with linearly-coupled harmonic oscillator potentials. As these examples are exactly soluble by means outside the semiclassical approach, they are additionally useful for testing the justifiability of some of the approximations and assumptions habitually made in the semiclassical approach to quantum cosmology. Finally, I contrast the emergent semiclassical timefunction with its hidden dilational Euler time counterpart.Comment: References Update

Hamiltonian formalism for the Oppenheimer-Snyder model

A family of effective actions in Hamiltonian form is derived for a self-gravitating sphere of isotropic homogeneous dust. Starting from the Einstein-Hilbert action for barotropic perfect fluids and making use of the symmetry and equation of state of the matter distribution we obtain reduced actions for two canonical variables, namely the radius of the sphere and its ADM energy, the latter being conserved along trajectories of the former. These actions differ by the value of the (conserved) geodesic energy of the radius of the sphere which defines (disconnected) classes of solutions in correspondence to the inner geometry and proper volume of the sphere. Each class is thus treated as one constrained dynamical system and the union of all classes covers the full phase space of the model. Generalization to the (inhomogeneous) Tolman model is shown to be straightforward. Quantization is also discussed.Comment: RevTeX, 10 pages, no figure

Micorrizas arbusculares em populações naturais de catuaba (Anemopaegma arvense (Vell.) Stell. ex de Souza).

O objetivo deste trabalho foi verificar a ocorrência, identificar espécies de fungosmicorrízicos (MAs) e avaliar a colonização em raízes de plantas de diferentes populações evariedades deAnemopaegma arvense(Vell.) Stell. ex de Souza