Suitability of Foumban Clays (West Cameroon) for Production of Bricks and Tiles

peer reviewe

"Contemplating the next maneuver": functional neuroimaging reveals intraoperative decision-making strategies

OBJECTIVE: To investigate differences in the quality, confidence, and consistency of intraoperative surgical decision making (DM) and using functional neuroimaging expose decision systems that operators use. SUMMARY BACKGROUND DATA: Novices are hypothesized to use conscious analysis (effortful DM) leading to activation across the dorsolateral prefrontal cortex, whereas experts are expected to use unconscious automation (habitual DM) in which decisions are recognition-primed and prefrontal cortex independent. METHODS: A total of 22 subjects (10 medical student novices, 7 residents, and 5 attendings) reviewed simulated laparoscopic cholecystectomy videos, determined the next safest operative maneuver upon video termination (10 s), and reported decision confidence. Video paradigms either declared ("primed") or withheld ("unprimed") the next operative maneuver. Simultaneously, changes in cortical oxygenated hemoglobin and deoxygenated hemoglobin inferring prefrontal activation were recorded using Optical Topography. Decision confidence, consistency (primed vs unprimed), and quality (script concordance) were assessed. RESULTS: Attendings and residents were significantly more certain (P < 0.001), and decision quality was superior (script concordance: attendings = 90%, residents = 78.3%, and novices = 53.3%). Decision consistency was significantly superior in experts (P < 0.001) and residents (P < 0.05) than novices (P = 0.183). During unprimed DM, novices showed significant activation of the dorsolateral prefrontal cortex, whereas this activation pattern was not observed among residents and attendings. During primed DM, significant activation was not observed in any group. CONCLUSIONS: Expert DM is characterized by improved quality, consistency, and confidence. The findings imply attendings use a habitual decision system, whereas novices use an effortful approach under uncertainty. In the presence of operative cues (primes), novices disengage the prefrontal cortex and seem to accept the observed operative decision as correct

A comparison of vascular vegetation and protozoan communities in some freshwater wetlands of Northern Lower Michigan

Vascular vegetation and protozoan communities were sampled in seven wetland sites — two bogs, two fens, two marshes, and one ‘swamp’ — in summer 1977. Two similarity indices were used to compare vascular vegetation and Protozoa from each site with all the other sites. Bog sites were the most distinct from other wetland types with respect to chemical and physical characteristics, dominant vascular vegetation, and protozoan species composition. The ‘swamp’ site had the highest similarity to all other sites with respect to both dominant vascular vegetation and protozoan species. Protozoan communities from different wetland types were much more similar than dominant vascular species; however, the pattern of similarity between wetland sites was very similar for both groups (Pearson product-moment correlation coefficient = 0.76).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42912/1/10750_2004_Article_BF02187032.pd

Community-Guided Focus Group Analysis to Examine Cancer Disparities

Accountability for Cancer Care through Undoing Racism and Equity (ACCURE) is a systems-change intervention addressing disparities in treatment initiation and completion and outcomes for early stage Black and White breast and lung cancer patients. Using a community-based participatory research approach, ACCURE is guided by a diverse partnership involving academic researchers, a non-profit community-based organization, its affiliated broader-based community coalition, and providers and staff from two cancer centers

Application of Standardized Antimicrobial Administration Ratio as a Motivational Tool Within a Multi-Hospital Healthcare System

The standardized antimicrobial administration ratio (SAAR) is a novel antimicrobial stewardship metric that compares actual to expected antimicrobial use (AU). This prospective cohort study examines the utility of SAAR reporting and inter-facility comparisons as a motivational tool to improve overall and broad-spectrum AU within a three-hospital healthcare system. Transparent inter-facility comparisons were deployed during system-wide antimicrobial stewardship meetings beginning in October 2017. Stakeholders were advised to interpret the results to foster competition and incorporate SAAR data into focused antimicrobial stewardship interventions. Student\u27s -test was used to compare mean SAARs in the pre- (July 2017 through October 2017) and post-intervention periods (November 2017 through June 2019). The mean pre-intervention SAARs for hospitals A, B, and C were 0.69, 1.09, and 0.60, respectively. Hospital B experienced significant reductions in SAAR for overall AU (from 1.09 to 0.83; \u3c 0.001), broad-spectrum antimicrobials used for hospital-onset infections (from 1.36 to 0.81; \u3c 0.001), and agents used for resistant gram-positive infections in the intensive care units (from 1.27 to 0.72; \u3c 0.001) after the interventions. The alignment of the SAAR across the health-system and sustained reduction in overall and broad-spectrum AU through implementation of inter-facility comparisons demonstrate the utility in the motivational application of this antimicrobial use metric

Effect of an Antiracism Intervention on Racial Disparities in Time to Lung Cancer Surgery

PURPOSE Timely lung cancer surgery is a metric of high-quality cancer care and improves survival for early-stage non-small-cell lung cancer. Historically, Black patients experience longer delays to surgery than White patients and have lower survival rates. Antiracism interventions have shown benefits in reducing racial disparities in lung cancer treatment.METHODSWe conducted a secondary analysis of Accountability for Cancer Care through Undoing Racism and Equity, an antiracism prospective pragmatic trial, at five cancer centers to assess the impact on overall timeliness of lung cancer surgery and racial disparities in timely surgery. The intervention consisted of (1) a real-time warning system to identify unmet care milestones, (2) race-specific feedback on lung cancer treatment rates, and (3) patient navigation. The primary outcome was surgery within 8 weeks of diagnosis. Risk ratios (RRs) and 95% CIs were estimated using log-binomial regression and adjusted for clinical and demographic factors.RESULTSA total of 2,363 patients with stage I and II non-small-cell lung cancer were included in the analyses: intervention (n = 263), retrospective control (n = 1,798), and concurrent control (n = 302). 87.1% of Black patients and 85.4% of White patients in the intervention group (P =.13) received surgery within 8 weeks of diagnosis compared with 58.7% of Black patients and 75.0% of White patients in the retrospective group (P <.01) and 64.9% of Black patients and 73.2% of White patients (P =.29) in the concurrent group. Black patients in the intervention group were more likely to receive timely surgery than Black patients in the retrospective group (RR 1.43; 95% CI, 1.26 to 1.64). White patients in the intervention group also had timelier surgery than White patients in the retrospective group (RR 1.10; 95% CI, 1.02 to 1.18). CONCLUSION Accountability for Cancer Care through Undoing Racism and Equity is associated with timelier lung cancer surgery and reduction of the racial gap in timely surgery

Manganese and cobalt redox cycling in laterites; Biogeochemical and bioprocessing implications

This research was developed during the PhD studies of Agustín Solano Arguedas in the University of Manchester, United Kingdom. PhD scholarship was funded by the Ministerio de Ciencia, Tecnología y Telecomunicaciones (MICITT) of the Government of Costa Rica and the Universidad de Costa Rica (UCR). Agustín Solano Arguedas is a researcher at the Unidad de Recursos Forestales (Reforesta, Unit of Forest Resources) of the Instituto de Investigaciones en Ingeniería (INII, Engineering Research Institute), UCR.Cobalt is essential for the modern technology that underpins the decarbonisation of our economies, but its supply is limited leading to its designation as a critical metal. Cobalt biogeochemistry is poorly understood, yet knowledge of how biogeochemical cycling impacts cobalt behaviour could assist the development of new techniques to recover cobalt from ores, and so improve the security of supply. Laterites are an important source of cobalt, they are primarily processed for nickel using energy or chemical intensive processes, with cobalt recovered as a by-product. Metal-reducing conditions were stimulated in laterite sediment microcosms by the addition of simple and cheaply available organic substrates (acetate or glucose). At the end of the experiment the amount of easily recoverable cobalt (aqueous or extractable with acetic acid) increased from < 1% to up to 64%, which closely mirrored the behaviour of manganese, while only a small proportion of iron was transformed into an easily recoverable phase. Sequencing of the microbial community showed that the addition of organic substrates stimulated the growth of indigenous prokaryotes closely related to known manganese(IV)/iron(III)-reducers, particularly from the Clostridiales, and that fungi assigned to Penicillium, known to produce organic acids beneficial for leaching cobalt and nickel from laterites, were identified. Overall, the results indicate that the environmental behaviour of cobalt in laterites is likely to be controlled by manganese biogeochemical cycling by microorganisms. These results are compelling given that similar behaviour was observed in four laterites (Acoje, Çaldağ, Piauí and Shevchenko) from different continents. A new bioprocessing strategy is proposed whereby laterites are treated with an organic substrate to generate metal-reducing conditions, then rinsed with acetic acid to remove the cobalt. Not only are organic substrates environmentally-friendly and potentially sourced from waste carbon substrates, a minimal amount of iron oxides was mobilised and consequently less waste generated.Natural Environment Research Council/[CoG3 NE/M011518/1]/NERC/Reino UnidoDiamond Light Source/[SP16735]//Reino UnidoDiamond Light Source/[SP17313]//Reino UnidoOffice of Science User Facility/[DE-AC02-05CH11231]//Estados UnidosUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ingeniería::Instituto Investigaciones en Ingeniería (INII

Ecological implications of pedogenesis and geochemistry of ultramafic soils in Kinabalu Park (Malaysia)

In Sabah, Malaysia, ultramafic rock outcrops are widespread (totalling 3500 km2, one of the main outcrops in the tropical zone), and predominantly of the peridotite type. However, strongly serpentinised peridotite is also locally common, particularly along fault lines in the Mt. Kinabalu area. This study aimed to determine the extent of chemical variation in ultramafic soils in relation to the degree of serpentinisation and the weathering intensity, and consequent potential ecological implications linked to resulting soil chemical fertility. It was hypothesized that young soils and soils derived from bedrock with a significant degree of serpentinisation strongly differ from typical Geric Ferralsols and result in soil chemistries with more adverse properties to plant life (e.g. low availability of the essential nutrients N, P, K and Ca and high concentrations of potentially phytotoxic Mg and Ni). Ultramafic soil diversity linked to the age of the soil or the degree of serpentinisation would thus be a main factor of plant diversity and distribution. The diverse topography of Kinabalu Park (ultramafic soils present between 400 and 2950 m asl) has given rise to high pedodiversity with the broad overall ultramafic soil types being: (i) deep laterite soils (Geric Ferralsols); (ii) moderately deep montane soils (Dystric Cambisols) with mor humus; (iii) shallow skeletal soils at high altitude (Eutric Cambisols Hypermagnesic); and (iv) bare serpentinite soils (Hypereutric Leptosols Hypermagnesic) at low altitude (200–700 m asl). Leptosols on serpentinite and Eutric Cambisols have the most extreme chemical properties in the whole Kinabalu Park area both with very high Mg:Ca molar quotients, with either high available Ni (Cambisols) or high pH (Leptosols). These soils host specific and adapted vegetation (high level of endemism) that tolerates geochemical peculiarities, including Ni hyperaccumulators. Geric Ferralsols present far less chemical constraints than Hypermagnesian Cambisols soils to the vegetation and host a tall and very diverse rainforest, not so different than that on non-ultramafic soils. It therefore appears that altitude, soil age and degree of bedrock serpentinisation are the main determining factors of soil properties: the qualifier “ultramafic” alone is not sufficient to define soil geochemical and ecological conditions in the Kinabalu Park area, probably more than in any other ultramafic region in the world

Expanding the Reach of an Evidence-Based, System-Level, Racial Equity Intervention: Translating ACCURE to the Maternal Healthcare and Education Systems

The abundance of literature documenting the impact of racism on health disparities requires additional theoretical, statistical, and conceptual contributions to illustrate how anti-racist interventions can be an important strategy to reduce racial inequities and improve population health. Accountability for Cancer Care through Undoing Racism and Equity (ACCURE) was an NIH-funded intervention that utilized an antiracism lens and community-based participatory research (CBPR) approaches to address Black-White disparities in cancer treatment completion. ACCURE emphasized change at the institutional level of healthcare systems through two primary principles of antiracism organizing: transparency and accountability. ACCURE was successful in eliminating the treatment completion disparity and improved completion rates for breast and lung cancer for all participants in the study. The structural nature of the ACCURE intervention creates an opportunity for applications in other health outcomes, as well as within educational institutions that represent social determinants of health. We are focusing on the maternal healthcare and K-12 education systems in particular because of the dire racial inequities faced by pregnant people and school-aged children. In this article, we hypothesize cross-systems translation of a system-level intervention exploring how key characteristics of ACCURE can be implemented in different institutions. Using core elements of ACCURE (i.e., community partners, milestone tracker, navigator, champion, and racial equity training), we present a framework that extends ACCURE's approach to the maternal healthcare and K-12 school systems. This framework provides practical, evidence-based antiracism strategies that can be applied and evaluated in other systems to address widespread structural inequities

Corticosteroids and regional variations in thickness of the human cerebral cortex across the lifespan

International audienceExposures to life stressors accumulate across the lifespan, with possible impact on brain health. Little is known, however, about the mechanisms mediating age-related changes in brain structure. We use a lifespan sample of participants (n = 21 251; 4–97 years) to investigate the relationship between the thickness of cerebral cortex and the expression of the glucocorticoid- and the mineralocorticoid-receptor genes (NR3C1 and NR3C2, respectively), obtained from the Allen Human Brain Atlas. In all participants, cortical thickness correlated negatively with the expression of both NR3C1 and NR3C2 across 34 cortical regions. The magnitude of this correlation varied across the lifespan. From childhood through early adulthood, the profile similarity (between NR3C1/NR3C2 expression and thickness) increased with age. Conversely, both profile similarities decreased with age in late life. These variations do not reflect age-related changes in NR3C1 and NR3C2 expression, as observed in 5 databases of gene expression in the human cerebral cortex (502 donors). Based on the co-expression of NR3C1 (and NR3C2) with genes specific to neural cell types, we determine the potential involvement of microglia, astrocytes, and CA1 pyramidal cells in mediating the relationship between corticosteroid exposure and cortical thickness. Therefore, corticosteroids may influence brain structure to a variable degree throughout life