Noise Reduction in the Intensive Care Unit

Abstract The purpose of this study was to analyze the noise levels in an intensive care unit (ICU) in a metro atlanta medical facility and to establish interventions that could be used to reduce the noise. Determining the effects is significant because it can improve a patients’ outcome in the ICU. The challenge explored was evidenced by 15 out of 20 patients stating that they are suffering sleep deprivation due to excessive noise levels. After 3 days in the ICU, patients have developed confusion and delirium; they are not oriented to date and time without reminders. After 3 days in the ICU, patients\u27 aggravation levels increased due to sleep deprivation. Through this study, we explored surveys completed by the patients who were admitted to the ICU. In these surveys, 100 patients indicated how disruption of sleep from excessive noise levels impacted their progression. The patients eligible to participate were those who remained in the ICU for 10-20 days. Noise levels were measured using a sound level meter that continuously recorded noise levels in the ICU unit for 6 months. In this study, nurse case managers and registered nurses practicing in the critical care setting were interviewed and were asked to refer back to their documentation. The registered nurses who were participating in this study were asked to monitor the amount of times they disrupted the patients while they were sleeping with alarms and with excessive talking. The registered nurses were additionally asked to implement noise canceling earphones from 10pm-7am. The implementation of noise level meters and noise canceling earphones were listed in an excel sheet by the nurse manager. The goal is for noise level to be reduced by 75% and to increase patient satisfaction regarding noise levels in the department

Subaqueous landslides at the distal basin of Lago Nahuel Huapi (Argentina): Towards a tsunami hazard evaluation in Northern Patagonian lakes

The May 22nd, 1960 Valdivia earthquake, Chile (Mw 9.5) triggered a series of subaqueous mass-wasting processes (debris flows and slides) in Lago Nahuel Huapi (Argentina), generating a tsunami-like wave that hit the coasts of San Carlos de Bariloche. Aiming to provide a first preliminary insight into tsunami hazards for the lakeshore communities, in this paper we identify and characterize the subaqueous landslides at the populated distal basin of the lake. Swath bathymetric and seismic profiling surveys were carried out and high-resolution digital elevation models were derived from these data to perform a landslide inventory map. A series of morphometrical parameters (including the landslide area, the volume of displaced materials and the run-out distance, among others) were estimated upon selected events. The results indicated that landslide activity at the distal basin of Lago Nahuel Huapi has been concentrated in the vicinity of Bariloche (massive landslide triggered by the 1960 earthquake) and within steep delta fronts where the slope failures typically initiate at shallow waters (9–11 m depth). The sliding mass frequently travels basinward along a great distance (≥1000 m). At the delta fronts, the volume of material removed by landslides can reach ~40 × 104 m3 , leaving scar areas of up to 13 m thick. The periodic occurrence of rotational–translational mass movements initiating at the upper edge of the delta fronts, with vertical displacements of the mobilized materials reaching ~200 m, probably represents a potential tsunami hazard for the nearby populated coasts.Fil: Beigt, Debora. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto Andino Patagónico de Tecnologías Biológicas y Geoambientales. Universidad Nacional del Comahue. Instituto Andino Patagónico de Tecnologías Biológicas y Geoambientales.; ArgentinaFil: Villarosa, Gustavo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto Andino Patagónico de Tecnologías Biológicas y Geoambientales. Universidad Nacional del Comahue. Instituto Andino Patagónico de Tecnologías Biológicas y Geoambientales.; Argentina. Universidad Nacional del Comahue. Centro Regional Universitario Bariloche; ArgentinaFil: Gomez, Eduardo Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto Argentino de Oceanografía. Universidad Nacional del Sur. Instituto Argentino de Oceanografía; Argentina. Universidad Tecnológica Nacional; ArgentinaFil: Manzoni, Carolina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto Andino Patagónico de Tecnologías Biológicas y Geoambientales. Universidad Nacional del Comahue. Instituto Andino Patagónico de Tecnologías Biológicas y Geoambientales.; Argentina. Universidad Nacional del Comahue. Centro Regional Universitario Bariloche; Argentin

The sustainable supply chain's contributions to the development to Colombia and it's enterprises.

Este artículo muestra los beneficios tanto internos como externos de implementar una cadena de abastecimiento sostenible. Explorando todos los eslabones de la cadena y analizando las estrategias que conllevan al crecimiento de las compañías. Así mismo expone las diferentes certificaciones y sellos ambientales que existen, demostrando su importancia y validez para el mercado. Por otra parte hace alusión a cuatro casos sostenibles indicando una parte del informe de sostenibilidad de cada compañía y adicionalmente se exponen los principales indicadores ambientales que se deben contemplar.The following article identifies the internal and external benefits of the implementation of sustainable supply chains. This article explores the activities of the supply chain and analyzes the strategies that assist in entrepreneurial development. The ensuing discussion explores environmental certifications and their role in the market. This article details cases of four enterprises that utilize the sustainable supply chain and their sustainable annual report, also shows the environmental indicators to look at

Transboundary groundwater and unsustainable practices of water governance in the Guarani Aquifer : the case of the province of Misiones.

Recent changes in the governance of the Guarani Aquifer System - a transboundary groundwater resource in South America - reveal contradictory practices of water governance embedded in the individual politics and ideologies of sovereign states overlying the aquifer. Emerging practices of water marketization through the commodification of bottled groundwater at the provincial level in Misiones, Argentina, contest the current scale of transboundary groundwater governance, delimited by The Guarani Aquifer Agreement and its main principles of cooperation, equitable and reasonable utilization and the obligation not to harm - under the imperatives of the United Nations International Law Commission (UNILC) Law of Transboundary Aquifers. Embedded in discourses of neoliberal ideology, these practices naturalize an economic scale enclosed in multi-scalar networks of capital accumulation and profit-making, largely resulting in the unsustainable utilization of natural resources

Developing Animal Feed Preservatives From Paper Mill Byproducts

Our objectives were to evaluate the antifungal properties of technical lignins against 3 molds and 1 yeast causing hay spoilage, and for their ability to preserve alfalfa hay nutritive value. In experiment 1, 8 technical lignins and propionic acid (PRP; positive control) were tested at a dose of 40 mg/mL. The experiment had a randomized complete block design (RCBD, 4 runs) and a factorial arrangement of 3 molds × 10 additives (ADV). The effects of ADV on the yeast were also evaluated with a RCBD. Across fungi, sodium lignosulfonate (NaL) and PRP were the only treatments with a 100 ± 2.8% inhibition. In experiment 2, the minimum inhibitory (MIC) for selected technical lignins and PRP were determined. Among technical lignins, NaL had the lowest MIC across molds (\u3c 33.3 mg/mL) and MgL for the yeast (26.7). However, PRP had values that were several fold lower across all fungi (\u3c 3.33). In experiment 3, a RCBD (5 blocks) with a 3 (ADV; NaL, MgL, and PRP) × 4 (doses: 0, 0.5, 1, and 3% w/w fresh basis) factorial arrangement of treatments was used to evaluate the preservative effects of ADV in high moisture alfalfa hay inoculated with a mixture of the fungi previously tested and incubated under aerobic conditions. After 15 d, relative to untreated hay (14.9 ± 0.77%), DM losses were lessened by doses as low as 1% for NaL (3.39) and 0.5% for PRP (0.81). This was explained by a reduced mold count in both NaL at 3% (3.92 ± 0.55 log cfu/fresh g) and PRP as low as 0.5% (3.94) relative to untreated hay (7.76). Consequently, sugars were best preserved by NaL at 3% (10.1 ± 0.283% DM) and PRP as low as 0.5% (10.5) vs. untreated (7.99), while keeping NDF values lower in NaL (45.9 ± 0.66% DM) and PRP-treated (45.1) hays at the same doses, respectively, relative to untreated (49.7 ± 0.66% DM). Hay DMD was increased by doses as low as 3% for NaL (67.5± 0.77%), 1% MgL (67.0), and 0.5% PRP (68.5) vs. untreated hay (61.8). In the case of NDFD, 0.5% for MgL and PRP (30.5 and 30.1 ± 1.09% DM, respectively) and 1% for NaL (30.7) were the lowest doses increasing NDFD relative to untreated hay (23.3). Total volatile fatty acids were increased to the greatest extent by NaL at 3% (111.9 ± 1.3 mM) relative to spoiled hay (86.7). Across technical lignins, NaL was the best hay preservative. However, its effects were limited compared to PRP at equivalent doses. Despite not having an effect on preservation, MgL improved DMD by stimulating NDFD. Further research needs to be conducted to isolate the most antifungal fraction of NaL and to understand the stimulatory effects of MgL on fiber degradation. Keywords: hay preservation, technical lignins, ruminal digestibility

Causality in 3D Massive Gravity Theories

We study the constraints coming from local causality requirement in various $2+1$ dimensional dynamical theories of gravity. In topologically massive gravity, with a single parity non-invariant massive degree of freedom, and in new massive gravity, with two massive spin-$2$ degrees of freedom, causality and unitarity are compatible with each other and both require the Newton's constant to be negative. In their extensions, such as the Born-Infeld gravity and the minimal massive gravity the situation is similar and quite different from their higher dimensional counterparts, such as quadratic (e.g., Einstein-Gauss-Bonnet) or cubic theories, where causality and unitarity are in conflict. We study the problem both in asymptotically flat and asymptotically anti-de Sitter spaces.Comment: This version has significant improvements: causality discussion of all the well-known gravity theories in flat space is extended to the AdS space, references added, 29 pages, latest version matches the published on

Science dissemination videos as multimodal supporting resources for ESP teaching in higher education

In recent years, science dissemination has moved from printed to digital formats, and digital genres such as free access videos, along with their own multimodal characteristics (e.g. image, audio, movement, among others) are particularly relevant in order to meet 21st century users' (i.e., digital natives) learning needs (Prensky, 2017) and to make them aware of the use of the multimodal traits. However, only a few studies can be found on the use of videos for the dissemination of research in ESP teaching as learning resources in Higher Education (HE) contexts, nor have the multimodal connections embedded in videos which contribute to the engagement of their users been taken into account (Valeiras-Jurado & Bernad-Mechó, 2022). Considering a communicative multimodal procedure in the digital era (Kress, 2010), the objective of this research is to identify the criteria that ESP teachers take into account when selecting this type of video for their courses, as well as the multimodal characteristics of these videos that can be identified and taken into consideration in the classroom. To attain our aim, a questionnaire will be distributed to 10 ESP teachers asking about the criteria they use for the selection of videos (e.g., length, clarity of language, visual aids, subject matter appropriate to the content, difficulty, among other aspects). Secondly, a multimodal discourse analysis of an extract from one of the videos teachers use in their courses will be developed. The teacher who uses this video in his class will be interviewed before and after showing him the multimodal analysis in order to check whether being aware of the video's multimodal traits can change his criteria for video selection and for class activities related to it. The results of this investigation will serve to offer teachers some support in their selection of appropriate multimodal materials for their ESP courses, as well as pedagogical tips about activities that can enhance the multimodal features of this digital genre.Funding for open access charge: CRUE-Universitat Jaume

The Bremsstrahlung function of N ⁣= ⁣2\mathcal{N} \!= \!2 SCQCD

For $SU(N)$ superconformal QCD we perform a three-loop calculation of the generalized cusp anomalous dimension of the BPS Wilson loop operator using HQET formalism. We obtain an expression which is valid at generic geometric and internal angles and finite gauge group rank $N$. For equal and opposite angles this expression vanishes, proving that at these points the cusp becomes BPS. From its small angle expansion we derive the corresponding Bremsstrahlung function at three loops, matching the matrix model prediction given in terms of derivatives of the Wilson loop on the ellipsoid. Finally, we discuss possible scenarios at higher loops, with respect to the existence of a universal effective coupling in an integrable subsector of the model.Comment: 30 pages; v3: JHEP published versio