Moral Distress in Critical Care Nursing: The State of the Science

Background: Moral distress is a complex phenomenon frequently experienced by critical care nurses. Ethical conflicts in this practice area are related to technological advancement, high intensity work environments, and end-of-life decisions. Objectives: An exploration of contemporary moral distress literature was undertaken to determine measurement, contributing factors, impact, and interventions. Review Methods: This state of the science review focused on moral distress research in critical care nursing from 2009 to 2015, and included 12 qualitative, 24 quantitative, and 6 mixed methods studies. Results: Synthesis of the scientific literature revealed inconsistencies in measurement, conflicting findings of moral distress and nurse demographics, problems with the professional practice environment, difficulties with communication during end-of-life decisions, compromised nursing care as a consequence of moral distress, and few effective interventions. Conclusion: Providing compassionate care is a professional nursing value and an inability to meet this goal due to moral distress may have devastating effects on care quality. Further study of patient and family outcomes related to nurse moral distress is recommended

Residual helicity at the active site of the histidine phosphocarrier, HPr, modulates binding affinity to its natural partners

The phosphoenolpyruvate-dependent phosphotransferase system (PTS) modulates the preferential use of sugars in bacteria. The first proteins in the cascade are common to all organisms (EI and HPr). The active site of HPr involves a histidine (His15) located immediately before the beginning of the first a-helix. The regulator of sigma D (Rsd) protein also binds to HPr. The region of HPr comprising residues Gly9-Ala30 (HPr9–30), involving the first a-helix (Ala16-Thr27) and the preceding active site loop, binds to both the N-terminal region of EI and intact Rsd. HPr9–30 is mainly disordered. We attempted to improve the affinity of HPr9–30 to both proteins by mutating its sequence to increase its helicity. We designed peptides that led to a marginally larger population in solution of the helical structure of HPr9–30. Molecular simulations also suggested a modest increment in the helical population of mutants, when compared to the wild-type. The mutants, however, were bound with a less favorable affinity than the wild-type to both the N-terminal of EI (EIN) or Rsd, as tested by isothermal titration calorimetry and fluorescence. Furthermore, mutants showed lower antibacterial properties against Staphylococcus aureus than the wild-type peptide. The refore, we concluded that in HPr, a compromise between binding to its partners and residual structure at the active site must exist to carry out its function. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

A separated representation involving multiple time scales within the Proper Generalized Decomposition framework

Solutions of partial differential equations can exhibit multiple time scales. Standard discretization techniques are constrained to capture the finest scale to accurately predict the response of the system. In this paper, we provide an alternative route to circumvent prohibitive meshes arising from the necessity of capturing fine-scale behaviors. The proposed methodology is based on a time-separated representation within the standard Proper Generalized Decomposition, where the time coordinate is transformed into a multi-dimensional time through new separated coordinates, each representing one scale, while continuity is ensured in the scale coupling. For instance, when considering two different time scales, the governing Partial Differential Equation is commuted into a nonlinear system that iterates between the so-called microtime and macrotime, so that the time coordinate can be viewed as a 2D time. The macroscale effects are taken into account by means of a finite element-based macro-discretization, whereas the microscale effects are handled with unidimensional parent spaces that are replicated throughout the time domain. The resulting separated representation allows us a very fine time discretization without impacting the computational efficiency. The proposed formulation is explored and numerically verified on thermal and elastodynamic problems. © 2021, The Author(s)

Looking into literature in the field of circular supply chain and the subtopic from a customers’ perspective: A bibliometric approach

In contemporary times, the integration of sustainable practices in supply chain operations constitutes a crucial factor that confers competitive advantages to enterprises. In this vein, circular supply chain strategies may lead to a reduction of waste and pollution by ensuring that resources are used efficiently and that products are designed to be reused, recycled, or repurposed. In this vein, customers are becoming more environmentally conscious and are increasingly seeking products and services that are produced sustainably, and demand transparency and accountability from the companies they purchase from. By implementing circular supply chain practices, companies can demonstrate their commitment to sustainability and build a positive reputation with customers. The main purpose of this research is to analyze the major contributions made in the field of circular supply chain, both from a general approach and from a customers' perspective (authors, affiliations, and countries), as well as the main areas analyzed by papers in both fields, and their intellectual structure. Data were extracted from the Web of Science database and analyzed using bibliometric techniques, particularly Bibliometrix® software in its version 4.2.1. The results show that these fields have increased in importance over time, especially in the last seven years, and that research trends are directed towards the implementation of new technologies that favor the circularity of the supply chain. It is concluded that the implementation of circular economy practices in the supply chain is vital for reducing waste and pollution by maximizing the use of resources and materials, requiring this approach the participation of all stakeholders, especially customers. In this respect, the subtopic from the customers' perspective demands further research efforts

Analysis of the structure of scientific knowledge on wine tourism: A bibliometric analysis

This research offers a bibliometric analysis of 588 publications on wine tourism published between 1998 and 2021, highlighting the years of publication, the publication format, the fields of research, the authors, the institutions, the main journals and the country of origin of both the authors and the scientific production analyzed. To our knowledge, no bibliometric study has focused on the study of wine tourism, so this study aims to fill this research gap, serving as a reference guide for both academics and professionals in the wine sector who want to know in depth how the study of this type of tourism has been approached. The results of the research show that the academic study of wine tourism dates back to the end of the 1990s, with the New World countries standing out in its study, especially Australia as the country with the highest scientific production and the largest number of academics focused on the study of this type of tourism. The study allows us to highlight the value of academic articles as the main means of disseminating research results, these being focused on tourism, business, economic and cross-cutting research. The results reveal relevant conclusions for academics, winemakers and tourism managers on the knowledge structure of wine tourism activity

The Role of Green Agriculture and Green Supply Chain Management in the Green Intellectual Capital–Sustainable Performance Relationship: A Structural Equation Modeling Analysis Applied to the Spanish Wine Industry

The objective of this research is to analyze the mediating role of Green Supply Chain Management (GSCM) in the main Green Intellectual Capital (GIC) and Sustainable Performance (SP) relationship, as well as the moderating role of Green Agriculture (GA) in the GSCM–SP relationship. To achieve this objective, a theoretical model is proposed based on the literature review and then analyzed using structural equation modeling (PLS-SEM) based on a sample of 196 Spanish wineries collected from September 2022 to January 2023. The results reveal that while GSCM partially mediates the GIC–SP relationship, GA positively but not significantly moderates the GSCM–SP relationship. To the best of our knowledge, there are no previous studies that have contextualized the model proposed in the wine industry, so the study represents the generation of new knowledge about the meaning of the relationships presented. Furthermore, no previous research has analyzed the moderating role of GA in the GSCM–SP relationship, so the study advances understanding of the variables that may affect this link (GSCM–SP)

Assessing Emotional Distress in Adolescents: Psychometrics of the Spanish Version of the Social Emotional Distress Scale-Secondary

Background The Social Emotional Distress Scale-Secondary (SEDS-S) is a short measure designed for comprehensive school-based mental health screening, particularly for using very brief self-reported measures of well-being and distress. Whereas prior studies have shown validity and reliability evidence for the English version, there is a lack of literature about its psychometric properties for Spanish-speaking youths. Objective To examine the psychometric properties of the SEDS-S in a large sample of Spanish adolescents, providing evidence of its reliability, structure, convergent and discriminant validity, longitudinal and gender measurement invariance, and normative data. Methods Participants were 5550 adolescents aged 12–18 years old. Test–retest reliability was examined using Cronbach’s alpha and McDonald’s omega coefficients, and evidence for convergent and discriminant validity was measured using Pearson’s correlation. Confirmatory factor analysis (CFA) was used to examine structure validity, while multigroup and longitudinal measurement invariance analysis was conducted for longitudinal and gender latent structure stability. Results The CFA supported a unidimensional latent structure, which was also observed to be invariant between gender groups and over time. The scale showed evidence of reliability, with coefficients above .85. In addition, the SEDS-S score was positively related to measures assessing distress and negatively related to measures assessing well-being, thereby providing convergent/discriminant validity of the total scores. Conclusion This study provides the first evidence of the reliability and validity of the Spanish version of the SEDS-S for assessing emotional distress among adolescents, cross-sectionally and longitudinally. Furthermore, findings indicated that SEDS-S could be a suitable assessment tool for screening and program evaluation purposes at different contexts beyond the school setting

Polypharmacy Patterns: Unravelling Systematic Associations between Prescribed Medications

Objectives: The aim of this study was to demonstrate the existence of systematic associations in drug prescription that lead to the establishment of patterns of polypharmacy, and the clinical interpretation of the associations found in each pattern. Methods: A cross-sectional study was conducted based on information obtained from electronic medical records and the primary care pharmacy database in 2008. An exploratory factor analysis of drug dispensing information regarding 79,089 adult patients was performed to identify the patterns of polypharmacy. The analysis was stratified by age and sex. Results: Seven patterns of polypharmacy were identified, which may be classified depending on the type of disease they are intended to treat: cardiovascular, depression-anxiety, acute respiratory infection (ARI), chronic obstructive pulmonary disease (COPD), rhinitis-asthma, pain, and menopause. Some of these patterns revealed a clear clinical consistency and included drugs that are prescribed together for the same clinical indication (i.e., ARI and COPD patterns). Other patterns were more complex but also clinically consistent: in the cardiovascular pattern, drugs for the treatment of known risk factors—such as hypertension or dyslipidemia—were combined with other medications for the treatment of diabetes or established cardiovascular pathology (e.g., antiplatelet agents). Almost all of the patterns included drugs for preventing or treating potential side effects of other drugs in the same pattern. Conclusions: The present study demonstrated the existence of non-random associations in drug prescription, resulting in patterns of polypharmacy that are sound from the pharmacological and clinical viewpoints and that exist in a significant proportion of the population. This finding necessitates future longitudinal studies to confirm some of the proposed causal associations. The information discovered would further the development and/or adaptation of clinical patient guidelines to patients with multimorbidity who are taking multiple drugs

Mytilus galloprovincialis Myticin C: A Chemotactic Molecule with Antiviral Activity and Immunoregulatory Properties

Previous research has shown that an antimicrobial peptide (AMP) of the myticin class C (Myt C) is the most abundantly expressed gene in cDNA and suppressive subtractive hybridization (SSH) libraries after immune stimulation of mussel Mytilus galloprovincialis. However, to date, the expression pattern, the antimicrobial activities and the immunomodulatory properties of the Myt C peptide have not been determined. In contrast, it is known that Myt C mRNA presents an unusual and high level of polymorphism of unidentified biological significance. Therefore, to provide a better understanding of the features of this interesting molecule, we have investigated its function using four different cloned and expressed variants of Myt C cDNA and polyclonal anti-Myt C sera. The in vivo results suggest that this AMP, mainly present in hemocytes, could be acting as an immune system modulator molecule because its overexpression was able to alter the expression of mussel immune-related genes (as the antimicrobial peptides Myticin B and Mytilin B, the C1q domain-containing protein MgC1q, and lysozyme). Moreover, the in vitro results indicate that Myt C peptides have antimicrobial and chemotactic properties. Their recombinant expression in a fish cell line conferred protection against two different fish viruses (enveloped and non-enveloped). Cell extracts from Myt C expressing fish cells were also able to attract hemocytes. All together, these results suggest that Myt C should be considered not only as an AMP but also as the first chemokine/cytokine-like molecule identified in bivalves and one of the few examples in all of the invertebrates

New silica based adsorbent material from rice straw and its in-flow application to nitrate reduction in waters: Process sustainability and scale-up possibilities

[EN] This paper shows a particular example to move to a sustainable circular economical process from valorization of rice straw ashes by developing a green synthesis for obtaining a useful sub-product. This strategy can palliate negative effects of the agriculture waste practices on the environment and also the obtained silica reduced nitrate content in waters. It is demonstrated that the silica synthesis developed at lab was scalable more than a hundred times with good results. Adsorption studies of nitrate in standards and real well waters at lab scale and scaling-up provided similar results. Adsorption values near to 15 mg/g for nitrate standards and 8.5 mg/g for well water were obtained until achieving the initial nitrate concentration. Experimental breakthrough curves fitted to Thomas model, which gave similar results for adsorption capacities. The adsorption capacity was checked with that obtained by a commercial resin, providing improved results. The method at large scale was compared with industrial traditional methods and green adsorbents.The authors are grateful to EU (EASME LIFE and CIP ECO-Innovation) LIBERNITRATE. LIFE 16 ENV/ES/000419; EU FEDER and the Gobierno de Espana MCIU-AEI (CTQ2017-90082-P) and the Generalitat Valenciana (PROMETEO 2020/078) and EU FEDER-Generalitat Valenciana (ID-FEDER/2018/049) for the financial support received. H. R. Robles-Jimarez expresses his grateful to EU-LIBERNITRATE. L. Sanjuan-Navarro expresses his gratitude for the FPU-grant (MCIU-AEI) .Robles-Jimarez, H.; Sanjuan-Navarro, L.; Jornet-Martínez, N.; Primaz, C.; Teruel-Juanes, R.; Molins-Legua, C.; Ribes-Greus, A.... (2022). New silica based adsorbent material from rice straw and its in-flow application to nitrate reduction in waters: Process sustainability and scale-up possibilities. Science of The Total Environment. 805:1-12. https://doi.org/10.1016/j.scitotenv.2021.15031711280