Improving nutritional care quality in the orthopedic ward of a Septic Surgery Center by implementing a preventive nutritional policy using the Nutritional Risk Score: a pilot study.

Septic Surgery Center (SSC) patients are at a particularly high risk of protein-energy malnutrition (PEM), with a prevalence of 35-85% found in various studies. Previous collaboration between our hospital's SSC and its Clinical Nutrition Team (CNT) only focussed on patients with severe PEM. This study aimed to determine whether it was possible to improve the quality of nutritional care in septic surgery patients with help of a nutritional policy using the Nutritional Risk Score (NRS). Nutritional practices in the SSC were observed over three separate periods: in the 3 months leading up to the implementation baseline, 6 months after implementation of preventive nutritional practices, and at 3 years. The nutritional care quality indicator was the percentage of patients whose nutritional care, as prescribed by the SSC, was adapted to their specific requirements. We determined the septic surgery team's NRS completion rate and calculated the nutritional policy's impact on SSC length of stay. Data before (T <sub>0</sub> ) and after (T <sub>1</sub> + T <sub>2</sub> ) implementation of the nutritional policy were compared. Ninety-eight patients were included. The nutritional care-quality indicator improved from 26 to 81% between T <sub>0</sub> and T <sub>2</sub> . During the T <sub>1</sub> and T <sub>2</sub> audits, septic surgery nurses calculated NRS for 100% and 97% of patients, respectively. Excluding patients with severe PEM, SSC length of stay was significantly reduced by 23 days (p = 0.005). These findings showed that implementing a nutritional policy in an SSC is possible with the help of an algorithm including an easy-to-use tool like the NRS

Biochar: pyrogenic carbon for agricultural use: a critical review.

O biocarvão (biomassa carbonizada para uso agrícola) tem sido usado como condicionador do solo em todo o mundo, e essa tecnologia é de especial interesse para o Brasil, uma vez que tanto a ?inspiração?, que veio das Terras Pretas de Índios da Amazônia, como o fato de o Brasil ser o maior produtor mundial de carvão vegetal, com a geração de importante quantidade de resíduos na forma de finos de carvão e diversas biomassas residuais, principalmente da agroindústria, como bagaço de cana, resíduos das indústrias de madeira, papel e celulose, biocombustíveis, lodo de esgoto etc. Na última década, diversos estudos com biocarvão têm sido realizados e atualmente uma vasta literatura e excelentes revisões estão disponíveis. Objetivou-se aqui não fazer uma revisão bibliográfica exaustiva, mas sim uma revisão crítica para apontar alguns destaques na pesquisa sobre biochar. Para isso, foram selecionados alguns temaschave considerados críticos e relevantes e fez-se um ?condensado? da literatura pertinente, mais para orientar as pesquisas e tendências do que um mero olhar para o passad

Multi-messenger observations of a binary neutron star merger

On 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of ~1.7 s with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg2 at a luminosity distance of 40+8-8 Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 Mo. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at ~40 Mpc) less than 11 hours after the merger by the One- Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ~10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position ~9 and ~16 days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta

Estimating coastal recession due to sea level rise: Beyond the Bruun rule

Accelerated sea level rise (SLR) in the twenty-first century will result in unprecedented coastal recession, threatening billions of dollars worth of coastal developments and infrastructure. Therefore, we cannot continue to dep nd on the highly uncertain coastal recession estimates obtained via the simple, deterministic method (Bruun rule) that has been widely used over the last 50 years. Furthermore, the emergence of risk management style coastal planning frameworks is now requiring probabilistic (rather than deterministic, single value) estimates of coastal recession. This paper describes the development and application of a process based model (PCR model) which provides probabilistic estimates of SLR driven coastal recession. The PCR model is proposed as a more appropriate and defensible method for determining coastal recession due to SLR for planning purposes in the twenty-first century and beyond.Hydraulic EngineeringCivil Engineering and Geoscience

A method to estimate the longshore sediment transport at ebb‐tidal deltas based on their volumetric growth: application to the Guadiana (Spain–Portugal border)

Current techniques assessing longshore sediment transport rates have large uncertainties, pleading for the development of alternative and complementary approaches. The present study proposes a method to estimate the decadal average rate of longshore transport at modern ebb-tidal deltas based on a sediment budget analysis of the outer shoal growth. This transport is obtained as the balance of the other contributions to the shoal with the total sediment input rate obtained from an inverse application of the inlet reservoir model. The method is applied to the Guadiana ebb-tidal delta, yielding an average longshore sediment transport rate (~85 000 m3 year(-1)) in good agreement with expectations for the region. It is exemplified that this decadal averaged rate can be used to improve longshore sediment transport expressions in order to study its variability over shorter time scales. At the Guadiana, the yearly longshore sediment transport from the improved formula ranges from ~25 000 m(3) (westward) to ~245 000 m(3) (eastward) and is related to the North Atlantic Oscillation index. Overall, the proposed method constitutes an alternative tool to constrain the average longshore sediment transport rate over decades in the vicinity of tidal inlets. It is applicable to ebb-tidal deltas where the outer shoal growth (from an early to a mature stage) is well documented by bathymetric maps, and where the main transport pathways towards the outer shoal can be specified. (c) 2019 John Wiley & Sons, Ltd. (c) 2019 John Wiley & Sons, Ltd.info:eu-repo/semantics/publishedVersio