Nutritional and metabolic characteristics of critically ill patients admitted for severe toxidermia.

Drug-induced toxidermia is an idiosyncratic adverse skin reaction that may become life-threatening in a small portion of patients, requiring intensive care unit (ICU) admission. The treatment recommendations are extrapolated from those of major burns, while prospective data remain sparse. The objective was to observe the application of these recommendations in patients treated in a burn ICU. Retrospective cohort study including patients requiring ICU between 2006 and 2020 in a tertiary university hospital. Age >18 years. Patients were categorized as Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN), or other toxidermia. severity scores, body surface area (BSA) involvement, nutritional and metabolic variables, trace element status, outcome variables. Descriptive statistics: median [IQR]. Altogether 35 patients were included (27 SJS/TEN and 8 "other"), aged 58 [48; 69] years. Skin involvement was 45% [30; 60] of body surface, 17 patients required mechanical ventilation, and length of ICU stay was 16 [6.5; 26] days. Hospital mortality was 23%. Fluid resuscitation requirements were moderate, despite intense inflammation (admission CRP (144 [89; 218] mg/L). The first 2 weeks' energy and protein intakes were below recommendations (p < 0.0001), lowest with oral feeding. Indirect calorimetry showed high energy expenditure in 11 patients (30.4 [23.9; 35.5] kcal/kg) resulting in negative energy balances (mean -245 kcal/day). Copper and zinc levels were below reference range during the first week, the low copper values being a novel finding. Trace elements should be monitored. The cohort was underfed with intakes lower than our ICU protocols, partly explained by short intubation times, and mucocutaneous involvement complicating the management and placement of feeding tubes. Oral feeding was least efficient and may become an indication for supplemental parenteral nutrition in the absence of an enteral feeding tube. gov Identifier: NCT05320653

Honey bee colony winter loss rates for 35 countries participating in the COLOSS survey for winter 2018–2019, and the effects of a new queen on the risk of colony winter loss

peer-reviewedThis article presents managed honey bee colony loss rates over winter 2018/19 resulting from using the standardised COLOSS questionnaire in 35 countries (31 in Europe). In total, 28,629 beekeepers supplying valid loss data wintered 738,233 colonies, and reported 29,912 (4.1%, 95% confidence interval (CI) 4.0–4.1%) colonies with unsolvable queen problems 79,146 (10.7%, 95% CI 10.5–10.9%) dead colonies after winter and 13,895 colonies (1.9%, 95% CI 1.8–2.0%) lost through natural disaster. This gave an overall colony winter loss rate of 16.7% (95% CI 16.4–16.9%), varying greatly between countries, from 5.8% to 32. 0%. We modelled the risk of loss as a dead/empty colony or from unresolvable queen problems and found that, overall, larger beekeeping operations with more than 150 colonies experienced significantly lower losses (p<0.001), consistent with earlier studies. Additionally, beekeepers included in this survey who did not migrate their colonies at least once in 2018 had significantly lower losses than those migrating (p<0.001). The percentage of new queens from 2018 in wintered colonies was also examined as a potential risk factor. The percentage of colonies going into winter with a new queen was estimated as 55.0% over all countries. Higher percentages of young queens corresponded to lower overall losses (excluding losses from natural disaster), but also lower losses from unresolvable queen problems, and lower losses from winter mortality (p<0.001). Detailed results for each country and overall are given in a table, and a map shows relative risks of winter loss at regional level

Local Customary Institutions as the Basis for Natural Resource Management Among Boran Pastoralists in Northern Kenya

This paper argues, ors the basis of a specific case of a pastoral economy in northern Kenya, that customary natural resource management rules and institutions may provide a better starting point for development policies and programmes than the more familiar technocratic/bureaucratic model hitherto adopted in African drylands.European Research Council (ERC

Analyzing Contours of Freedom of Press

Freedom of the press and restrictions which could be imposed on the press have always been a volatile subject. Supreme Court in literally every decade has tried to restrict this freedom by judicial pronouncement, by which they have tried tracing the contours of freedom of the press. Recently, the Supreme Court in the Sahara real estate v. Securities exchange board took a giant leap by developing the principle ‘Postponement of Publication’ by extending a 50-year-old doctrine of ‘Prior Restraint. The Supreme Court is not only the guardian of fundamental rights but also a balancing wheel between the rights. Freedom of expression is one of the most cherished values of a free democratic society. It includes the right to receive information and ideas of all kinds from different sources. In essence, the freedom of expression embodies the right to know. Freedom of expression is not an absolute principle under our Constitution. Further, it may also happen one right to freedom of expression may hinder another right like the right to a fair trial. At present, the system which is followed is the ‘open justice system ‘which permits fair and accurate reports of court proceedings to be published except in cases of in-camera proceedings. The media has a right to know what is happening in courts and to disseminate the information to the public which enhances the public confidence in the transparency of court proceedings

Impact of oceanic floods on particulate metal inputs to coastal and deep-sea environments: A case study in the NW Mediterranean Sea

An exceptional flood event, accompanying a marine storm, was investigated simultaneously at the entrance and the exit of the Gulf of Lion's hydrosystem (NW Mediterranean) in December 2003. Cs, Cr, Co, Ni, Cu, Zn, Cd and Pb signatures of both riverine and shelf-exported particles indicate that continental inputs and resuspended prodeltaic sediments were intensively mixed with resuspended sediments from middle/outer shelf areas during advective transport. As a result, particles leaving the Gulf of Lion inherited the mean signature of shelf bottom sediments, exporting anthropogenic Pb and Zn out into the open sea. When assessing the particulate metal budget in relation with the event, it appears that the output fluxes accounted for between 15% and 60% of the input fluxes, depending on the element and the period of reference. This trend is also observed for annual budgets, which were drawn up by compiling the data from this study and the literature. Results evidenced that, except some element fluxes during extreme output scenario, outputs never counter-balance the inputs. In its current functioning, the Gulf of Lion's shelf seems to act as a retention/sink zone for particulate metals. Regarding anthropogenic fluxes, the contribution of the oceanic flood of December 2003 to the mean annual scenario is considerable. Environmental impacts onto coastal and deep-sea ecosystems should therefore tightly depend on both the intensity and the frequency of event-dominated sediment transport

Five-brane webs, Higgs branches and unitary/orthosymplectic magnetic quivers

We study the Higgs branch of 5d superconformal theories engineered from brane webs with orientifold five-planes. We propose a generalization of the rules to derive magnetic quivers from brane webs pioneered in arXiv:2004.04082, by analyzing theories that can be described with a brane web with and without O5 planes. Our proposed magnetic quivers include novel features, such as hypermultiplets transforming in the fundamental-fundamental representation of two gauge nodes, antisymmetric matter, and $\mathbb{Z}_2$ gauge nodes. We test our results by computing the Coulomb and Higgs branch Hilbert series of the magnetic quivers obtained from the two distinct constructions and find agreement in all cases.Comment: 67 pages, 57 figures, 24 tables, 4 appendices, minor corrections, matches with the published versio

A set of satellite experiments for studying the magnetosphere-ionosphere communications

Magnetospheric substorms are one of the basic problems in the physics of near earth space. They appear as magnetic and ionospheric perturbations, disturbances in radio communication, polar auroras and electromagnetic radiation in different frequency ranges. These phenomena were studied from single satellites. However, it is impossible to study these phenomena adequately without simultaneous measurements from at least two different positions with identical instruments. A suitable program can be developed based on the Interkosmos work using new achievements in electronics

Pollinators in life cycle assessment: towards a framework for impact assessment

Abstract Human activities are threatening biodiversity at an unprecedented scale and pace, thus potentially affecting also the provision of critical ecosystem services, including insect pollination. Insect pollinators play an essential functional role in terrestrial ecosystems, supporting ecological stability and food security worldwide. Therefore, assessing impact on pollinators is fundamental in any effort aiming at enhancing the environmental sustainability of human production and consumption, especially in the agri-food supply chains. Different drivers are leading to pollinator populations' declines. Improving a supply-chain oriented assessment of the occurrence of pressure and impacts on pollinators is needed. However, current methodologies assessing impact along supply chains, such as life cycle assessment (LCA), miss to assess impact on pollinators. In fact, none of the existing life cycle impact assessment (LCIA) models effectively accounts for pollinators. Some LCIA models have mentioned pollination, but none has presented key drivers of impact and a proposal for integrating pollinators as target group for biodiversity protection within an LCIA framework. In order to devise a pathway towards the inclusion of impacts on pollinators in LCIA, we conducted a literature review of environmental and anthropogenic pressures acting on insect pollinators, potentially threatening pollination services. Based on the evidence in literature, we identified and described eight potential impact drivers, primarily deriving from industrial development and intensive agricultural practice: 1) intensified land use as a result of uncontrolled expansion of urban areas and modern agricultural practices; 2) use of pesticides; 3) presence of invasive alien plants; 4) competition with invasive alien pollinator species; 5) global and local climate change; 6) spread of pests and pathogens; 7) electro-magnetic pollution and 8) genetically modified crops. To account for these drivers in LCIA, there are specific modeling needs. Hence, the current study provides recommendation on how future research should be oriented to improve the current models and how novel indicators should be developed in order to cover the existing conceptual and methodological gaps

Gestión educativa y clima institucional en dos instituciones educativas de la Red 1 – Ugel 06, año 2019

La presente investigación tuvo como objetivo general determinar la relación que existe entre la Gestión educativa y el clima institucional en dos Instituciones Educativas de la Red 1 – Ugel 06, año 2019, del Distrito de Cieneguilla. Es una investigación básica, descriptiva – correlacional, cuantitativo, no experimental. Cuya población estuvo basada en 80 docentes pertenecientes a dichas instituciones. La técnica aplicada para la recopilación de datos fue la encuesta para ello se aplicó instrumentos para cada una de las variables, que fueron validados previamente bajo el criterio de expertos, que determinaron la confiabilidad a través de la estadística de fiabilidad Alfa de Cronbach. El instrumento que mide la gestión educativa presenta un índice de fiabilidad de 0,827; el instrumento que mide el clima institucional presenta un índice de fiabilidad de 0.896; la primera variable fue medida en base a cuatro dimensiones: institucional, administrativa, pedagógica y comunitaria; el instrumento de la variable siguiente también tuvo cuatro dimensiones: comunicación, motivación, confianza y participación. Los resultados demuestran la existencia de una correlación entre gestión educativa y clima institucional de (r = 0,752), así mismo el clima institucional con la gestión institucional muestran una correlación (r = 0,605), de igual modo existe una correlación entre clima institucional y gestión administrativa (r = 0,616), también existe correlación entre clima institucional y gestión pedagógica (r = 0,582), finalmente se halla correlación entre clima institucional y gestión comunitaria (r = 0,630), resultados que se determinan al 99% de intervalo de confianza