Phylloplane Sterilization With Bleach Does Not Reduce Btk Toxicity for \u3ci\u3ePapilio Glaucus\u3c/i\u3e Larvae (Lepidoptera: Papilionidae)

Neonate tiger swallowtail larvae (Papilio glaucus) were used to bioassay the effects of Btk (Bacillus thuringiensis var. kurstaki) at 4 doses (0.268, 0.034, 0.008, and 0.004 BIU per cm leaf surface) with an untreated control. Larvae, obtained from females captured in Georgia and North Carolina, were fed leaves of either tulip tree (Liriodendron tulipfera) or black cherry (Prunus serotina) in experiments that either included a pre-treatment dip and rinse in 5% chlorox bleach or not, before the application of Btk (dipping leaves in serially diluted solutions of Foray 48B). The results show no difference between North Carolina and Georgia P. glaucus larval dosage sensitivities, but do illustrate a clear dosage effect for all 4 treatments (cherry with and without bleach pre-treatment; tulip tree with and without bleach pre-treatment). The larvae on the bleached leaves do not do better (for cherry or tulip tree host plant) as would be expected if microbial symbionts on the phylloplane synergize the Btk toxicity. These results show that Btk (at doses several thousand-fold less than aerial sprays across forests for gypsy moth control) will kill P. glaucus, with or without microbial synergism on leaf phylloplanes

Phylloplane Sterilization With Bleach Does Not Reduce Btk Toxicity for \u3ci\u3ePapilio Glaucus\u3c/i\u3e Larvae (Lepidoptera: Papilionidae)

Neonate tiger swallowtail larvae (Papilio glaucus) were used to bioassay the effects of Btk (Bacillus thuringiensis var. kurstaki) at 4 doses (0.268, 0.034, 0.008, and 0.004 BIU per cm leaf surface) with an untreated control. Larvae, obtained from females captured in Georgia and North Carolina, were fed leaves of either tulip tree (Liriodendron tulipfera) or black cherry (Prunus serotina) in experiments that either included a pre-treatment dip and rinse in 5% chlorox bleach or not, before the application of Btk (dipping leaves in serially diluted solutions of Foray 48B). The results show no difference between North Carolina and Georgia P. glaucus larval dosage sensitivities, but do illustrate a clear dosage effect for all 4 treatments (cherry with and without bleach pre-treatment; tulip tree with and without bleach pre-treatment). The larvae on the bleached leaves do not do better (for cherry or tulip tree host plant) as would be expected if microbial symbionts on the phylloplane synergize the Btk toxicity. These results show that Btk (at doses several thousand-fold less than aerial sprays across forests for gypsy moth control) will kill P. glaucus, with or without microbial synergism on leaf phylloplanes

COGNITIVE DISORDERS IN PATIENTS INFECTED WITH COVID-19: A NARRATIVE REVIEW

Objective: The overactivated immune system due to COVID-19 may be responsible for most of its physiological manifestations, including the neurological ones. Methods: The scientific articles were searched by two independent researchers in the MEDLINE (PubMed), LILACS, SciELO, Scopus, Web of Science, and BIREME databases, with no restriction of language, period, or place of publication. To complement and avoid the bias of risk, gray literature was searched in Google Scholar. The narrative review followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The studies included in the research had scored ≥ 6 points in the qualitative protocol proposed by Pithon et al. (2015). Results: COVID-19 patients commonly have neurological manifestations. The patients’ age was an important risk factor for neuropsychological deficiencies due to COVID-19. Increased fatigability and deficits in concentration, memory, and overall cognitive speed are reported months after hospital discharge. Also, the studies showed that the phase of the disease in which the patient is found directly interferes with the manifestation of the cognitive changes. Conclusion: Cognitive changes are frequently found months after hospital discharge in COVID-19 patients. A slower cognitive processing speed and impaired memory may interfere with the patients’ daily functioning and their capacity to return to work. Hence, cognitive rehabilitation interventions aiming to increase the processing speed and memory must also be considered for this population.Objetivo: El sistema inmunitario sobreactivado debido al COVID-19 puede ser responsable de la mayoría de sus manifestaciones fisiológicas, incluidas las manifestaciones neurológicas. Métodos: Los artículos científicos fueron investigados por dos investigadores independientes en las bases de datos MEDLINE (PubMed), LILACS, SciELO, Scopus, Web of Science y BIREME, sin restricción de idioma, período o lugar de publicación. Para complementar y evitar el sesgo de riesgo, se buscó en la literatura gris en Google Scholar. La revisión narrativa siguió las recomendaciones de los ítems del informe preferidos para revisiones sistemáticas y metanálisis (PRISMA). Los estudios incluidos en el estudio obtuvieron ≥ 6 puntos en el protocolo cualitativo propuesto por Pithon et al. (2015). Resultados: Los pacientes con COVID-19 suelen presentar manifestaciones neurológicas. La edad de los pacientes fue un factor de riesgo importante para las deficiencias neuropsicológicas debido al COVID-19. El aumento de la fatigabilidad y los déficits en la concentración, la memoria y la velocidad cognitiva general se reportan meses después del alta hospitalaria. Además, los estudios han demostrado que la etapa de la enfermedad en la que el paciente está directamente en la manifestación de alteraciones cognitivas. Conclusión: Las alteraciones cognitivas a menudo se encuentran meses después del alta hospitalaria en pacientes con COVID-19. Una velocidad de procesamiento cognitivo más lenta y una memoria deteriorada pueden interferir con el funcionamiento diario de los pacientes y la capacidad de volver al trabajo. Por lo tanto, las intervenciones de rehabilitación.Objetivo: O sistema imunológico superativado devido ao COVID-19 pode ser responsável pela maioria de suas manifestações fisiológicas, incluindo as neurológicas. Métodos: Os artigos científicos foram pesquisados ​​por dois pesquisadores independentes nas bases de dados MEDLINE (PubMed), LILACS, SciELO, Scopus, Web of Science e BIREME, sem restrição de idioma, período ou local de publicação. Para complementar e evitar o viés do risco, a literatura cinzenta foi pesquisada no Google Scholar. A revisão narrativa seguiu as recomendações dos itens de relatório preferidos para revisões sistemáticas e meta-análises (PRISMA). Os estudos incluídos na pesquisa tiveram pontuação ≥ 6 pontos no protocolo qualitativo proposto por Pithon et al. (2015). Resultados: Os pacientes com COVID-19 comumente apresentam manifestações neurológicas. A idade dos pacientes foi um importante fator de risco para deficiências neuropsicológicas devido ao COVID-19. Fatigabilidade aumentada e déficits de concentração, memória e velocidade cognitiva geral são relatados meses após a alta hospitalar. Além disso, os estudos mostraram que a fase da doença em que o paciente se encontra interfere diretamente na manifestação das alterações cognitivas. Conclusão: Alterações cognitivas são frequentemente encontradas meses após a alta hospitalar em pacientes com COVID-19. Uma velocidade de processamento cognitivo mais lenta e memória prejudicada podem interferir com o funcionamento diário dos pacientes e sua capacidade de retornar ao trabalho. Assim, intervenções de reabilitação cognitiva com o objetivo de aumentar a velocidade de processamento e memória também devem ser consideradas para esta população

Changing mechanical properties of photopolymerized, dityrosine-crosslinked protein-based hydrogels

Hydrogels based on renewable resources are a promising class of materials for future applications in pharmaceutics, drug delivery and personalized medicine. Thus, optional adjustments of mechanical properties such as swelling behavior, elasticity and network strength are desired. In this context, hydrogels based on the biological raw materials bovine serum albumin and casein were prepared by dityrosine-crosslinking of their tyrosine residues through visible light-induced photopolymerization. Changing the tyrosine accessibility by urea addition before photopolymerization increased the storage modulus of the hydrogels by 650% while simultaneously being more elastic. Furthermore, contributions of the buffer system composition, variation of protein concentration and storage medium towards mechanical properties of the hydrogel such as storage moduli, elasticity, fracture strain, compressive strength and relative weight swelling ratio are discussed. It could be shown, that changes in precursor solution and storage medium characteristics are crucial parameters towards tuning the mechanical properties of protein-based hydrogels

DESENVOLVIMENTO DE INDICADORES PARA GESTÃO DE FORNECEDORES DE INSUMOS INDIRETOS

This research addresses the proposal of developing a prototype for managing indirect input suppliers from the development of indicators that allow a visual management of their performance, as well as the standardization of activities related to such management in order to make it effective and efficient. The study was conducted in a multinational industry that produces refrigeration equipment. This is an action research, with a case study design, where primary data were produced through unstructured interviews with procurement managers and analysts, and secondary data collected from a review of literature and information made available in a shared folder on the company’s network. In the discussion, the impact of the proposed model on the efficiency and effectiveness of the indirect input procurement process of the organization was verified. The research shows that the importance of this study lies in the fact that it presents a strategic model developed through a tool already used by the company to systematize the creation of evaluative indicators. The alignment of suppliers on their performance is also emphasized, obtaining the initially proposed improvement. The results obtained in this research recommend the use of this management method to indirect input suppliers.Esta investigação aborda a proposta de desenvolvimento de um protótipo para gestão de fornecedores de insumos indiretos a partir do desenvolvimento de indicadores que permitam uma gestão visual do desempenho daqueles, bem como a padronização das atividades relacionadas a tal gestão com o intuito de torná-la eficaz e eficiente. O estudo foi realizado em uma indústria multinacional produtora de equipamentos para refrigeração. Trata-se de uma pesquisa ação, com um delineamento de uma pesquisa do tipo estudo de caso, onde os dados primários foram produzidos através de entrevistas não estruturadas com gestores e analistas da área de suprimentos, e os dados secundários coletados a partir de uma revisão da literatura e de informações disponibilizadas em uma pasta compartilhada na rede da empresa. Na discussão, foi feita a verificação do impacto do modelo proposto sobre a eficiência e eficácia do processo de compras de insumos indiretos da organização. Na pesquisa efetuada pode-se perceber que a importância deste estudo reside no fato de apresentar um modelo estratégico desenvolvido através de uma ferramenta já utilizada pela empresa para sistematização da criação de indicadores de desempenho. O modelo proposto também facilita o entendimento do desempenho dos fornecedores por parte da empresa estudada. Os resultados obtidos nesta pesquisa recomendam a utilização deste método de gestão para os fornecedores de insumos indiretos

Too Big Too Fast? Potential Implications of the Rapid Increase in Emergency Medicine Residency Positions

Emergency medicine (EM) has expanded rapidly since its inception in 1979. Workforce projections from current data demonstrate a rapid rise in the number of accredited EM residency programs and trainee positions. Based on these trends, the specialty may soon reach a point of saturation, particularly in urban areas. This could negatively impact future trainees entering the job market as well as the career plans of medical students. More time and resources should be devoted to obtaining accurate projections, assessing the distribution of emergency physicians in rural versus urban settings, and implementing central workforce planning to protect the future of graduating trainees.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154425/1/aet210400.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154425/2/aet210400_am.pd

Optimizing Strategies for Care Coordination and Transition Management: Recommendations for Nursing Education

The purpose of this descriptive qualitative study was to explore nurse and healthcare leaders\u27 experiences and perceptions of care coordination and transition management (CCTM®). Four barriers emerged that added insight into the lack of adopting and integrating CCTM knowledge, skills, and attitudes in nursing education in the following categories: curriculum redesign, silos of care settings and care providers, knowledge gap, and faculty development/resistance. Recommendations and implications for education, for both nursing students and practicing nurses, are described

Outcome of all-inside second-generation meniscal repair: Minimum five-year follow-up

BACKGROUND: Meniscal repair and preservation are the goal, when possible, of the treatment of meniscal injury. Current research on second-generation all-inside repair systems has been limited to a maximum of three years of follow-up. The purpose of this study was to evaluate the mid-term clinical success (at more than five years) of meniscal repair performed with a second-generation all-inside repair device, both as an isolated procedure and with a concomitant anterior cruciate ligament (ACL) reconstruction. METHODS: This is a retrospective review of patients who underwent meniscal repair with use of the all-inside FAST-FIX Meniscal Repair System (Smith & Nephew Arthroscopy, Andover, Massachusetts) from December 1999 to January 2007. Eighty-three meniscal repairs (in eighty-one patients) were identified, and follow-up data were obtained for seventy-five (90%). Twenty-six (35%) of the meniscal repairs were performed as isolated procedures. Clinical failure was defined as repeat surgical intervention involving resection or revision repair. Clinical outcomes were also assessed with the Knee injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) score, and the Marx activity score. RESULTS: The minimum duration of follow-up was five years (average, seven years). Twelve patients (16%) had failure of the meniscal repair, at an average of forty-seven months (range, fifteen to ninety-five months). The data did not offer enough statistical evidence, at alpha = 0.05, to establish a difference in average patient age, patient sex, or number of sutures utilized between successful repairs and failures. There was no difference in the failure rate between isolated repairs (12%; 95% confidence interval [CI]: −0.76% to 23.76%) and those performed with concurrent ACL reconstruction (18%; 95% CI: 7.47% to 29.13%), and the average time to failure was similar between these two groups (48.1 months versus 46.6 months, p = 0.939). Postoperative KOOS and IKDC outcome scores were also similar between the groups. CONCLUSIONS: This report of mid-term follow-up results of primary second-generation all-inside meniscal repair demonstrates its effectiveness both as an isolated procedure and when it is performed with concurrent ACL reconstruction. After a minimum of five years of follow-up, 84% of the patients continued to demonstrate successful repair. Treatment success was further supported by favorable results on patient-based outcome measures. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence

QUALITY OF LIFE RELATED TO BREAST CANCER IN WOMEN IN POSTMENOPAUSE: A SYSTEMATIC REVIEW

Objective: To verify the quality of life related to post-menopausal breast cancer in women using HT, through a systematic review. Methods: For the selection of studies, the combination [(Hormone Replacement Therapy) AND (use) AND (breast cancer) AND (menopausal women) AND (quality of life) AND (randomized controlled trial)) was used]. The search was performed in the Medline, LILACS, Bireme, SciELO, ScienceDirect and Google Scholar databases as a gray search. Randomized articles were included, without language restriction, published between January 2010 and March 2020, which obtained a minimum score of 10 on the modified scale of the literature. Articles that did not have a title, abstract or body of the article related to the research objective were excluded. Result: 1217 articles were retrieved, however two articles met the inclusion criteria, being classified as high quality. It has been observed that HT increases the risk of developing breast cancer during post-menopause. Conclusion: HT combined with different progestogens improves symptoms caused by postmenopause. However, one should evaluate the advantages and disadvantages of use among women, especially when they present some risk factor for developing the disease. Lower rates of breast cancer risk were observed when HT administered with estrogen alone.Objetivo: Verificar la calidad de vida relacionada con el cáncer de mama en mujeres posmenopáusicas que utilizan TH, a través de una revisión sistemática. Métodos: Para la selección del estudio, se utilizó la combinación [(terapia de reemplazo hormonal) Y (uso) Y (cáncer de mama) Y (mujeres menopáusicas) Y (calidad de vida) Y (ensayo clínico aleatorizado)]. La búsqueda se realizó en las bases de datos Medline, LILACS, Bireme, SciELO, ScienceDirect y Google Scholar en el formulario de búsqueda gris. Se incluyeron artículos aleatorizados sin restricción de idioma, publicados entre enero de 2010 y marzo de 2020, con una puntuación mínima de 10 en la escala modificada de la literatura. Se excluyeron los artículos que no contenían el título, resumen o cuerpo del artículo relacionado con el objetivo de la investigación. Resultado: se recuperaron 1217 artículos, pero dos artículos cumplieron los criterios de inclusión y se clasificaron como de alta calidad. Se ha demostrado que la TH aumenta el riesgo de desarrollar cáncer de mama durante las mujeres posmenopáusicas. Conclusión: la TH combinada con diferentes progestágenos mejora los síntomas post menopáusicos. Sin embargo, se deben evaluar las ventajas y desventajas de su uso entre las mujeres, especialmente cuando presentan algún factor de riesgo para el desarrollo de la enfermedad. Se observaron tasas de riesgo de cáncer de mama más bajas cuando se administró TH solo con estrógeno.Objetivo: Verificar a qualidade de vida relacionada ao câncer de mama na pós-menopausa em mulheres usuárias de TH, por meio de revisão sistemática. Métodos: Para a seleção do estudo, a combinação [(terapia de reposição hormonal) AND (uso) AND (câncer de mama) AND (mulheres na menopausa) AND (qualidade de vida) AND (ensaio clínico randomizado)] foi usada. A busca foi realizada nas bases de dados Medline, LILACS, Bireme, SciELO, ScienceDirect e Google Scholar na forma de busca cinza. Foram incluídos artigos randomizados, sem restrição de idioma, publicados entre janeiro de 2010 e março de 2020, com pontuação mínima de 10 na escala modificada da literatura. Foram excluídos os artigos que não continham título, resumo ou corpo do artigo relacionado ao objetivo da pesquisa. Resultado: Foram recuperados 1217 artigos, porém dois artigos atenderam aos critérios de inclusão e foram classificados como de alta qualidade. Foi demonstrado que a TH aumenta o risco de desenvolver câncer de mama durante a pós-menopausa. Conclusão: A TH combinada com diferentes progestagênios melhora os sintomas causados ​​pela pós-menopausa. Porém, deve-se avaliar as vantagens e desvantagens do uso entre as mulheres, principalmente quando estas apresentam algum fator de risco para o desenvolvimento da doença. Taxas mais baixas de risco de câncer de mama foram observadas quando o HT foi administrado apenas com estrogêni