Mind Your Steps

Abstract This thesis assesses the effectiveness of structured multi-professional medical ethical decision-making in diminishing problems experienced around medical ethical decisionmaking in the Erasmus MC NICU. Besides, it gives an overview of the patients discussed from 2009 to 2012, and their outcomes at two year follow-up. Patient care, especially in acute settings, is closely linked to emotional burden in nurses and physicians. The impacts of chronic and acute work-related stressors on moral distress, post-traumatic stress symptoms, anxiety, and depression were evaluated. The introduction illuminates the context and the pre-existing problems in the Erasmus MC NICU with respect to medical ethical decision-making. Besides, consequences of working in a highly demanding context for professionals’ well-being are presented against a practical and a theoretical background

A LOOK AT THE SOUTHERN CALIFORNIA CONVERSION TECHNOLOGY PROJECT

ABSTRACT This presentation provides an overview of conversion technologies, their potential benefits and applicability to solid waste management, and the efforts to develop conversion facilities around the country and specifically, California, including Los Angeles County's model for development. The Southern California Demonstration Project spearheaded by Los Angeles County is a unique project that proposes to develop up to four conversion technology demonstration facilities throughout Southern California, potentially the first of their kind anywhere in the U.S. These facilities will be collocated with material recovery facilities and will be designed specifically to process municipal solid waste residuals

Discrepancy between self-perceived mycophenolic acid-associated diarrhea and stool water content after kidney transplantation

BACKGROUND: Diarrhea is a well-known side effect of mycophenolic acid (MPA) use in kidney transplant recipients (KTRs). It is unknown whether self-reported diarrhea using the Modified Transplant Symptom Occurrence and Symptom Distress Scale (MTSOSD-59R) corresponds to stool water content and how both relate to MPA usage. METHODS: MTSOSD-59R questionnaires filled out by 700 KTRs from the TransplantLines Biobank and Cohort Study(NCT03272841) were analyzed and compared with stool water content. Stool samples(N=345) were freeze-dried and a water content ≥80% was considered diarrhea. RESULTS: Self-perceived diarrhea was reported by 46%, while stool water content ≥80% was present in 23% of KTRs. MPA use was not associated with self-perceived diarrhea (odds ratio(OR) 1.32; 95% confidence interval(CI), 0.87-1.99, P=0.2), while it was associated with stool water content ≥80% (OR 2.88; 95%CI, 1.41-5.89, P=0.004), independent of potential confounders. Adjustment for prior MPA discontinuation because of severe diarrhea, uncovered an association between MPA use and self-perceived diarrhea (OR 1.80; 95%CI, 1.13-2.89, P=0.01). CONCLUSIONS: These results suggest that reporting bias could add to the discrepancy between both methods for diarrhea assessment. We recommend use of objective biomarkers or more extensive questionnaires which assess information on stool frequency and stool consistency, to investigate post-transplantation diarrhea

Improving Summer/Autumn Feed Quality in New Zealand Hill Country

Pasture management in spring has a strong influence on pasture quality in summer and autumn in New Zealand hill country pastures. Manipulation of defoliation frequency and intensity during mid-late spring can impact summer and autumn pasture quality and quantity (Orr et al. 1988). Summer/autumn management is mainly concerned with maintaining herbage quality in summer wet areas and controlling animal pressure in summer dry areas for drought management and winter feed stocks (Clark 1994). Deferred grazing to transfer pasture growth from late spring into summer and autumn deficits is difficult due to detrimental effects on pasture quality, plant density and species composition (Sheath et al. 1987). Various grazing management models have been published to inform hill farmers of pasture management considerations during this period (Smith and Dawson 1977; Sheath and Bircham 1983; Sheath et al. 1987). It has previously been shown that management of late spring surpluses to restrict reproductive growth will increase summer pasture quality through a reduction in accumulated stem and dead material and an increase in clover content (Sheath et al. 1987). However, there is no information on the longevity of these effects. This trial aimed to determine the effect of different defoliation intensities during spring on herbage quality and composition throughout the subsequent summer-autumn period

Thermal stability of dialkylimidazolium tetrafluoroborate and hexafluorophosphate ionic liquids: ex situ bulk heating to complement in situ mass spectrometry

Thermal decomposition (TD) products of the ionic liquids (ILs) [CnC1Im][BF4] and [CnC1Im][PF6] ([CnC1Im]+ = 1-alkyl-3-methylimidazolium, [BF4]- = tetrafluoroborate, and [PF6]- = hexafluorophosphate) were prepared, ex situ, by bulk heating experiments in a bespoke setup. The respective products, CnC1(C3N2H2)BF3 and CnC1(C3N2H2)PF5 (1-alkyl-3-methylimidazolium-2-trifluoroborate and 1-alkyl-3-methylimidazolium-2-pentafluorophosphate), were then vaporized and analyzed by direct insertion mass spectrometry (DIMS) in order to identify their characteristic MS signals. During IL DIMS experiments we were subsequently able, in situ, to identify and monitor signals due to both IL vaporization and IL thermal decomposition. These decomposition products have not been observed in situ during previous analytical vaporization studies of similar ILs. The ex situ preparation of TD products is therefore perfectly complimentary to in situ thermal stability measurements. Experimental parameters such as sample surface area to volume ratios and heating rates are consequently very important for ILs that show competitive vaporization and thermal decomposition. We have explained these experimental factors in terms of Langmuir evaporation and Knudsen effusion-like conditions, allowing us to draw together observations from previous studies to make sense of the literature on IL thermal stability. Hence, the design of experimental setups are crucial and previously overlooked experimental factors

Tissue distribution and lipophorin transport of hydrocarbons and sex pheromones in the house fly, Musca domestica

We investigated the relationship between epicuticular and internal hydrocarbons in the adult house fly, Musca domestica and the distribution of hydrocarbons, including the female sex pheromone component, (Z)-9-tricosene, in tissues. Internal hydrocarbons increased dramatically in relation to sexual maturation and were found in the hemolymph, ovaries, digestive tract, and fat body. (Z)-9-Tricosene comprised a relatively large fraction of the hydrocarbons in the female carcass and hemolymph, and less so in other tissues, while other hydrocarbons were represented in greater amounts in the ovaries than in other tissues. It therefore appears that certain hydrocarbons were selectively provisioned to certain tissues such as the ovaries, from which pheromone was relatively excluded. Both KBr gradient ultracentrifugation and specific immunoprecipitation indicated that > 90% of hemolymph hydrocarbons were associated with a high-density lipophorin (density = 1.09 g ml(−1)), composed of two apoproteins under denaturing conditions, apolipophorin I (∼240 kD) and apolipophorin II (∼85 kD). Our results support a predicted model (Chino, 1985) that lipophorin is involved in the transport of sex pheromone in M. domestica. In addition to delivering hydrocarbons and sex pheromones to the cuticular surface, we suggest that lipophorin may play an important role in an active mechanism that selectively deposits certain subsets of hydrocarbons at specific tissues

Nitrogen Leaching from Cattle, Sheep and Deer Grazed Pastures in New Zealand

The impacts of intensified grazing in New Zealand are being reflected in declining quality of groundwater, streams and lake water. Manipulation of ratios of grazing animal species may be one way farmers can reduce nitrogen (N) emissions to ground water. The present research quantifies nitrate and ammonium leaching losses from rotationally grazed sheep, cattle and deer pastures in a common environment