38 research outputs found

    Projeto PiwkeyewĂŒn: Lineamentos para o co-design de sistemas de cultivo vegetal tecnolĂłgico indĂ­gena

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    El Proyecto PiwkeyewĂŒn busca generar una metodologĂ­a para que diferentes colectivos indĂ­genas ideen y representen formas de cultivo vegetal que, sin dejar de articular lĂłgicas, prĂĄcticas y sentidos culturalmente significativos, incorporen materiales contemporĂĄneos y elementos provenientes de tendencias tecnolĂłgicas (digitalidad e «internet de las cosas»). A travĂ©s de estas acciones nos preguntamos por las condiciones de posibilidad de las expresiones materiales indĂ­genas actuales, su relaciĂłn con discursos asociados a la ancestralidad y por los posibles diĂĄlogos entre cosmovisiĂłn y tecnologĂ­a. El siguiente artĂ­culo expone cruces entre las disciplinas del diseño y la antropologĂ­a, utilizando como eje articulador el contexto e historia del pueblo mapuche en Chile, mediante el anĂĄlisis de los resultados de un taller aplicado de diseño, desarrollado en un contexto universitario durante el año 2021, donde se aborda, mediante actividades lectivas y prĂĄcticas, diversos componentes identitarios, ambientales, materiales, territoriales, tecnolĂłgicos y de diseño.The PiwkeyewĂŒn Project aims to generate a methodology for different indigenous groups to devise and represent forms of vegetable cultivation that, while articulating culturally significant logics, practices, and meanings, incorporate contemporary materials and elements from technological trends (digitality and the «internet of things»). With these actions, we ask ourselves about the conditions of possibility of the current indigenous material expressions, their relationship with discourses associated with ancestry, and the possible dialogues between worldview and technology. The following article exposes intersections between the disciplines of design and anthropology, using the context and history of the Mapuche people in Chile as the articulating axis, with an analysis of the results of a participatory design workshop, developed in a university context during the year 2021, where several identity, environmental, material, territorial, technological and design components are addressed through teaching activities and proposals.O Projeto PiwkeyewĂŒn procura gerar uma metodologia para que diferentes coletivos indĂ­genas ideiem e representem formas de cultivo vegetal que, sem deixar de articular lĂłgicas, prĂĄticas e sentidos culturalmente significativos, incorporem materiais contemporĂąneos e elementos procedentes de tendĂȘncias tecnolĂłgicas (digitalidade e «internet das coisas»). AtravĂ©s destas açÔes nos perguntamos pelas condiçÔes de possibilidade das expresĂ”es materiais indĂ­genas atuais, sua relação com discursos associados Ă  ancestralidade e pelos possĂ­veis diĂĄlogos entre cosmovisĂŁo e tecnologia. O seguinte artigo expĂ”e cruzamentos entre as disciplinas do design e a antropologia, utilizando como eixo articulador o contexto e historia do povo mapuche em Chile, mediante o anĂĄlise dos resultados de um workshop aplicado de design, desenvolvido num contexto universtitĂĄrio durante o ano 2021, onde sĂŁo abordados, mediante atividades lectivas e prĂĄticas, diversos componentes identitĂĄrios, ambientais, materiais, territoriais, tecnolĂłgicos e de design

    Early rise in central venous pressure during a spontaneous breathing trial: A promising test to identify patients at high risk of weaning failure?

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    Background The spontaneous breathing trial (SBT) assesses the risk of weaning failure by evaluating some physiological responses to the massive venous return increase imposed by discontinuing positive pressure ventilation. This trial can be very demanding for some critically ill patients, inducing excessive physical and cardiovascular stress, including muscle fatigue, heart ischemia and eventually cardiac dysfunction. Extubation failure with emergency reintubation is a serious adverse consequence of a failed weaning process. Some data suggest that as many as 50% of patients that fail weaning do so because of cardiac dysfunction. Unfortunately, monitoring cardiovascular function at the time of the SBT is complex. The aim of our study was to explore if central venous pressure (CVP) changes were related to weaning failure after starting an SBT. We hypothesized that an early rise on CVP could signal a cardiac failure when handling a massive increase on venous return following a discontinuation of positive pressure ventilation. This CVP rise could identify a subset of patients at high risk for extubation failure. Methods Two-hundred and four mechanically ventilated patients in whom an SBT wa

    Self Assessment in Insects: Honeybee Queens Know Their Own Strength

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    Contests mediate access to reproductive opportunities in almost all species of animals. An important aspect of the evolution of contests is the reduction of the costs incurred during intra-specific encounters to a minimum. However, escalated fights are commonly lethal in some species like the honeybee, Apis mellifera. By experimentally reducing honeybee queens' fighting abilities, we demonstrate that they refrain from engaging in lethal contests that typically characterize their reproductive dominance behavior and coexist peacefully within a colony. This suggests that weak queens exploit an alternative reproductive strategy and provides an explanation for rare occurrences of queen cohabitation in nature. Our results further indicate that self-assessment, but not mutual assessment of fighting ability occurs prior to and during the agonistic encounters

    Transposable Elements Are a Major Cause of Somatic Polymorphism in Vitis vinifera L.

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    Through multiple vegetative propagation cycles, clones accumulate mutations in somatic cells that are at the origin of clonal phenotypic diversity in grape. Clonal diversity provided clones such as Cabernet-Sauvignon N°470, Chardonnay N° 548 and Pinot noir N° 777 which all produce wines of superior quality. The economic impact of clonal selection is therefore very high: since approx. 95% of the grapevines produced in French nurseries originate from the French clonal selection. In this study we provide the first broad description of polymorphism in different clones of a single grapevine cultivar, Pinot noir, in the context of vegetative propagation. Genome sequencing was performed using 454 GS-FLX methodology without a priori, in order to identify and quantify for the first time molecular polymorphisms responsible for clonal variability in grapevine. New generation sequencing (NGS) was used to compare a large portion of the genome of three Pinot noir clones selected for their phenotypic differences. Reads obtained with NGS and the sequence of Pinot noir ENTAV-INRAŸ 115 sequenced by Velasco et al., were aligned on the PN40024 reference sequence. We then searched for molecular polymorphism between clones. Three types of polymorphism (SNPs, Indels, mobile elements) were found but insertion polymorphism generated by mobile elements of many families displayed the highest mutational event with respect to clonal variation. Mobile elements inducing insertion polymorphism in the genome of Pinot noir were identified and classified and a list is presented in this study as potential markers for the study of clonal variation. Among these, the dynamic of four mobile elements with a high polymorphism level were analyzed and insertion polymorphism was confirmed in all the Pinot clones registered in France

    Preload responsiveness–guided fluid removal in mechanically ventilated patients with fluid overload:A comprehensive clinical–physiological study

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    This study investigated fluid removal strategies for critically ill patients with fluid overload on mechanical ventilation. Traditionally, a negative fluid balance (FB) is aimed for. However, this approach can have drawbacks. Here, we compared a new approach, namely removing fluids until patients become fluid responsive (FR) to the traditional empiric negative balance approach. Twelve patients were placed in each group (n = 24). FR assessment was performed using passive leg raising (PLR). Both groups maintained stable blood pressure and heart function during fluid management. Notably, the FR group weaned from the ventilator significantly faster than negative FB group (both for a spontaneous breathing trial (14 h vs. 36 h, p = 0.031) and extubation (26 h vs. 57 h, p = 0.007); the difference in total ventilator time wasn't statistically significant (49 h vs. 62 h, p = 0.065). Additionally, FR group avoided metabolic problems like secondary alkalosis and potential hypokalemia seen in the negative FB group. FR-guided fluid-removal in fluid overloaded mechanically ventilated patients was a feasible, safe, and maybe superior strategy in facilitating weaning and disconnection from mechanical ventilation than negative FB-driven fluid removal. FR is a safe endpoint for optimizing cardiac function and preventing adverse consequences during fluid removal.</p

    Engaging Stakeholders to Optimize Sleep Disorders\u27 Management in the U.S. Military: A Qualitative Analysis

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    INTRODUCTION: Sleep disorders\u27 are highly prevalent among U.S. active duty service members (ADSMs) and present well-documented challenges to military health, safety, and performance. In addition to increased need for sleep medicine services, a major barrier to effective sleep management has been a lack of alignment among patients, health providers, and economic-decision-makers. To address this gap in knowledge, the purpose of the present study was to engage diverse stakeholders vested in improving sleep disorders\u27 management in the military. MATERIALS AND METHODS: We elicited feedback from ADSMs with sleep disorders (five focus group discussion, n = 26) and primary care managers (PCMs) (11 individual semi-structured interview) in two military treatment facilities (MTFs) in the National Capitol Region, in addition to national level military and civilian administrative stakeholders (11 individual semi-structured interview) about their experiences with sleep disorders\u27 management in U.S. MTFs, including facilitators and barriers for reaching a definitive sleep diagnosis, convenience and effectiveness of sleep treatments, and key desired outcomes from interventions designed to address effectively sleep disorders in the U.S. military health care system (MHS). Recordings from focus groups and semi-structured interviews were transcribed verbatim and analyzed using QSR International\u27s NVivo 12 software using inductive thematic analysis. The study was approved by Walter Reed National Military Medical Center Department of Research Programs. RESULTS: Active duty service members with sleep disorders often fail to recognize their need for professional sleep management. Whereas PCMs identified themselves as first-line providers for sleep disorders in the military, patients lacked confidence that PCMs can make accurate diagnoses and deliver effective sleep treatments. Active duty service members cited needs for expeditious treatment, educational support and care coordination, and support for obtaining sleep treatments during deployment. Challenges that PCMs identified for effective management include insufficient time during routine care visits, delays in scheduling testing procedures, and limited number of sleep specialists. Primary care managers suggested offering evidence-based telehealth tools and enhanced care coordination between PCMs and specialists; standardized medical education, materials, and tools; patient preparation before appointments; self-administered patient education; and including behavioral sleep specialists as part of the sleep management team. For administrative stakeholders, key outcomes of enhanced sleep management included (1) improved resource allocation and cost savings, and (2) improved ADSM safety, productivity, and combat effectiveness. CONCLUSION: Current military sleep management practices are neither satisfactory nor maximally effective. Our findings suggest that solving the military sleep problem will require sustained effort and ongoing collaboration from ADSM patients, providers, and health systems leaders. Important potential roles for telehealth and technology were identified. Future research should seek to enhance implementation of sleep management best practices to improve outcomes for patients, providers, MHS, and the military as a whole

    Active Duty Service Members, Primary Managers, and Administrators\u27 Perspectives on a Novel Sleep Telehealth Management Platform in the U.S. Military Healthcare System

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    INTRODUCTION: Sleep disorders are common in the military, and there is a gross shortage of sleep specialists in the military health system. The purposes of the present study were to (1) understand perceptions and expectations surrounding sleep telehealth approaches and (2) solicit feedback to optimize and refine a proposed novel sleep telehealth management platform. To accomplish these objectives, we investigated the perceptions, expectations, and preferences of active duty service members (ADSMs) with sleep disorders, primary care managers (PCMs), and administrative stakeholders regarding sleep telehealth management. MATERIALS AND METHODS: Using convenience sampling, we conducted five focus groups with 26 ADSMs and 11 individual interviews with PCMs from two military treatment facilities in the U.S National Capital Region and 11 individual interviews with administrative sleep stakeholders (9 military and 2 civilian). RESULTS: Active duty service members, PCMs, and administrative stakeholders provided insight regarding expectations for sleep telehealth as well as suggestions to optimize the novel sleep telehealth platform. In terms of outcomes, ADSMs expected sleep telehealth to improve sleep and convenience. Primary care managers expected improved sleep and other comorbidities, enhanced operational readiness, and reduced mortalities among their patients. Administrators expected increased access to care, optimized utilization of health services, realized cost savings, reduced accidents and errors, and improved military performance. In terms of the platform, for ADSMs, desired characteristics included delivery of timely clinical reports, improved patient-provider communication, and enhanced continuity of care. For PCMs and administrators,an ideal sleep telehealth solution will improve the diagnosis and triage of sleep patients, save PCM time, be easy to use, and integrate with the electronic health record system. CONCLUSION: The proposed sleep telehealth platform appealed to nearly all participants as a significant force multiplier to enhance sleep disorder management in the military. Stakeholders offered valuable recommendations to optimize the platform to ensure its successful real-world implementation
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