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Background: The primary objective of this study is to comparatively assess the safety of nasogastric (NG) feeding versus nasojejunal (NJ) feeding in patients with acute pancreatitis (AP), with a special focus on the initiation of these feeding methods within the first 48 h of hospital admission. Methods: Studies were identified through a systematic search in PubMed, EMbase, Cochrane Central Register of Controlled Trials, and Web of Science. Four studies involving 217 patients were included. This systematic review assesses the safety and efficacy of nasogastric versus nasojejunal feeding initiated within 48 h post-admission in moderate/severe acute pancreatitis, with a specific focus on the timing of initiation and patient age as influential factors. Results: The results showed that the mortality rates were similar between NG and NJ feeding groups (RR 0.86, 95% CI 0.42 to 1.77, P = 0.68). Significant differences were observed in the incidence of diarrhea (RR 2.75, 95% CI 1.21 to 6.25, P = 0.02) and pain (RR 2.91, 95% CI 1.50 to 5.64, P = 0.002) in the NG group. The NG group also showed a higher probability of infection (6.67% vs. 3.33%, P = 0.027) and a higher frequency of multiple organ failures. Subgroup analysis for early intervention (within 48 h) showed a higher risk of diarrhea in the NG group (RR 2.80, P = 0.02). No significant differences were found in the need for surgical intervention, parenteral nutrition, or success rates of feeding procedures. Conclusion: This meta-analysis highlights the importance of considering the method and timing of nutritional support in acute pancreatitis. While NG feeding within 48 h of admission increases the risk of certain complications such as diarrhea and infection, it does not significantly impact mortality or the need for surgical intervention. [ABSTRACT FROM AUTHOR]

Background: Despite increasing evidence of the potential inaccuracy and unwarranted practice of regular GRV measurement in critically in adults, this practice persists within the United Kingdom., Aim: To explore adult intensive care nurses' decision-making around the practice of GRV measurement to guide enteral feeding., Study Design: A cross-sectional 16 item electronic survey in four adult intensive care units (ICUs) in England and Wales., Results: Two hundred and seventy-three responses were obtained across four ICUs with acceptable response rates for most [Unit 1 74 /127 = 58.2%; Unit 2 87/129 = 67.4%; Unit 3 77/120 = 64.1%; Unit 4 35/168 = 20.8%]. Most (243/273 (89%) reported measuring GRV 4-6 hourly, with most (223/273 82%) reporting that the main reason was to assess feed tolerance or intolerance and 37/273 (13.5%) saying their unit protocol required it. In terms of factors affecting decision-making, volume obtained was the most important factor, followed by the condition of the patient, with aspirate colour and appearance less important. When asked how they would feel about not measuring GRV routinely, the majority (78.2%) of nurses felt worried (140/273 = 51.2%) or very worried (74/273 = 27%)., Conclusions: Factors affecting the nurses' decision-making around GRV were based largely on fear of risk (around vomiting and pulmonary aspiration) and compliance with unit protocols., Relevance to Clinical Practice: Despite increasing evidence suggesting it is unnecessary, nurses' beliefs around the value of this practice persist and it continues to be embedded into unit protocols around feeding., (© 2024 The Authors. Nursing in Critical Care published by John Wiley & Sons Ltd on behalf of British Association of Critical Care Nurses.)

Copyright of Boletín Geológico y Minero is the property of Instituto Tecnologico Geominero De Espana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

During the 19th century, the flood was the natural disaster most often represented in pictures due to its greater visibility or its spectacular character. Thus, disasters occur in various discursive genres, such as in prints, in the press or in literary texts. The ecopoetic approach that we will adopt in this study will allow us to rethink our relationship to nature in such a way as to emphasize questions of form and writing to present nature through the prism of ecological problems including the disturbed relationship between human and non-human in natural, urban or industrial environments. It is in this spirit that we will propose to study here the questions of writing in various genres of discourse of the 19th century, relating to natural disasters, in particular in prints, short stories and naturalist novels. [ABSTRACT FROM AUTHOR]

Copyright of Clinical Science of Nutrition is the property of Aves Yayincilik Ltd. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of this study is to evaluate the level of heavy metal contamination in the spoil heaps of the former Ain Aouda mine (Taza). In this regard, solid samples of the study area were sampled. The set of analyses carried out have detected the presence of zinc (Zn), lead (Pb), copper (Cu), arsenic (As) and nickel (Ni) that remain in these metal discharges. The calculation of contamination/pollution indices: the Geo Accumulation Index (Igeo), the Enrichment Factor (EF) and the Pollution Index (IP) were used to predict the extent of heavy metal contamination. The results of this study suggest that the spoil heaps reveal polymetallic contaminations allowing the trace metal elements to be classified in the following order Zn ˃ Pb ˃ As ˃ Cu > Ni. Knowing well that the alteration and erosion of this stock of mine waste could contribute to the degradation of the natural environment by these elements that are present. [ABSTRACT FROM AUTHOR]

Background and Aim: Feeding interruptions in critical care patients are often unjustified. We aimed to determine the causes, duration, and frequency of enteral nutrition interruptions (ENIs) and to assess macronutrients and antioxidant deficits according to European Society of Parenteral Enteral Nutrition (ESPEN) guidelines. Methods: We prospectively enrolled Intensive Care Unit (ICU) patients admitted for more than 48 h with an inability to orally eat from April to December 2019. The type of enteral nutrition, the number of calories administered, the time of feeding initiation, the reasons for delaying feeding, and the causes for ENI were recorded. Results: 81 patients were enrolled, with a median duration of ENIs of 5.2 (3.4–7.4) hours/day. Gastric residual volume (GRV) monitoring—a highly controversial practice—was the most common cause of ENI (median duration 3 (2.3–3) hours/day). The mean energy intake was 1037 ± 281 kcal/day, while 60.5% of patients covered less than 65% of the total energy needs (1751 ± 295 kcal/day, according to mean Body Mass Index (BMI)). The median daily protein intake did not exceed 0.43 ± 0.3 gr/kg/day of the actual body weight (BW), whereas ESPEN recommends 1.3 gr/kg/day for adjusted BW (p < 0.001). The average administration of micronutrients and antioxidants (arginine, selenium, zinc, vitamins) was significantly less than the dietary reference intake (p < 0.01). Conclusion: ENIs lead to substantial caloric, protein, and antioxidant deficits. [ABSTRACT FROM AUTHOR]

Mining exploitation and its impact on global warming have become significant problems. The main objective of this study is to investigate the impact of mining industry equipment and natural resource demand on global warming in Congo. A cross-sectional survey was conducted from October 2021 to July 2022, using a self-administered questionnaire. The survey was carried out with 1360 respondents from Congo who worked in the mining sector for 18 years and above. For our research, we used the Partial least squares structural equation modeling approach (PLS-SEM) with SmartPLS software to analyze data. The results show that technological trends are the strongest predictor of global warming in Congo. Equipment was also the most significant predictor of climate change in Congo. Faced with this danger, we are sounding the alarm and asking for urgent intervention from the government. Moreover, all the scientific evidence on this subject is now irrefutable. Even if the climate of Congo may prove less worrying for the moment, the probability that it survives seems very low. However, the Congolese government must take immediate possible precautions to prevent Congo from finding itself in the same challenge currently faced by developed countries. [ABSTRACT FROM AUTHOR]

The article analyze the profiles of civil servants and temporary contract workers in the public service through the prism of labour market segmentation. It mentions profiles of temporary employees in the three public service sectors have points in common such as individual characteristics that are less favorable than those of civil servants, but also differentiating factors that may or not may enable them to access their internal labour market in terms of gender or qualifications.

Reactive blending is an efficient method for synthesizing polymer blends. Industrially, this process is carried out in extruders, where the reacting polymers and the generated copolymer are subjected to high shear stresses. The dynamics of the process, and the resulting morphology is dictated by a coupling of the hydrodynamic forces in the extruder, the thermodynamic interactions between species, and the reaction kinetics on a complex interfacial manifold. We use phase-field simulations to quantify the evolution of the reactive blending process under an external shear flow. Specifically, we consider a model system of two homopolymers of equal length, which react via an end-coupling reaction to form a diblock copolymer of double the length. We compare the morphology development in two different initial geometries of the homopolymers—a cylindrical thread and a drop of one homopolymer in a matrix of the second. We investigate the effect of flow strength, measured by the shear rate, and reaction kinetics, quantified by a Damkohler number, on the progress of the reaction and morphology development. Cylindrical threads are susceptible to breakup via the Rayleigh capillary instability. We demonstrate that this instability can be suppressed by imposing shear along the direction of the thread and increasing the extent of the reaction. The reaction rate in this geometry is unaffected by shear imposed along the cylinder axis. Drops deform significantly under an imposed flow, eventually stretching to long cylindrical threads for sufficient shear rates. In the case of drops, shear stresses enhance the reaction rate by deforming the drop, enabling more homopolymers to come in contact at the expanded interface. We show that shear stresses significantly impact the morphology development and reaction dynamics in reactive polymer blending. [ABSTRACT FROM AUTHOR]

This study addresses the wetting and adhesion of a low molecular mass poly(n‐butyl acrylate) homopolymer melt, used as a weak acrylic adhesive, on two types of textured polymer films prepared by the breath figure templating method. The first film is a polystyrene homopolymer honeycomb‐like structure with well‐defined porous structure and long‐range ordering. The second is a disordered poly(n‐butyl acrylate)‐block‐polystyrene diblock copolymer film featuring a broad distribution of pore diameters. Static contact angle measurements show that porous films repel better the polymer melt than the corresponding nontextured films. Contact angles and spreading of polymer melt droplets on these textured surfaces reveals a Cassie‐Baxter state on the ordered porous film and a partial Wenzel state on the disordered porous films. In addition, probe tack results show that the textured surfaces tend to induce cavitation. The correlation between the wetting and adhesion highlights the major role of melt insertion into the pores, which is primarily controlled by the pores' dimensions. [ABSTRACT FROM AUTHOR]

Background: Continuous enteral nutrition (CEN) remains standard practice in intensive care units (ICUs) worldwide. Intermittent enteral nutrition (IEN) may be a suitable alternative method. This meta‐analysis aims to investigate the safety, tolerance, and effectiveness of IEN compared with that of CEN in critically ill adults in the ICU. Methods: MEDLINE, CINAHL, Scopus, Embase, and Google Scholar were searched for studies published up until April 30, 2020, along with manual searches in bibliographies. Eligible studies were trials that compared CEN with IEN feeding in the ICU and reported on at least one of the relevant outcomes (nutrition intake, gastric residual volume [GRV], aspiration pneumonia, vomiting, diarrhea, abdominal distension, and glycemic variability). Secondary outcomes were ICU length of stay (LOS) and mortality. The Cochrane risk‐of‐bias tool for randomized trials was used to assess methodological quality. Results: Ten studies with 664 participants were included in the meta‐analysis. Most studies had an overall "high" risk of bias. Incidence of vomiting was significantly higher in CEN than in IEN groups (risk ratio, 2.76; 95% CI, 1.23–6.23). There were no significant differences between CEN and IEN groups for nutrition intake, GRV, incidence of aspiration pneumonia, diarrhea, abdominal distension, ICU LOS, and mortality. Definition and reporting of outcome measures were not standardized across studies; hence, this heterogeneity limits the generalizability of results. Conclusion: Overall, the safety, tolerance, and effectiveness of CEN and IEN were found to be comparable. Future studies should explore monitoring larger sample sizes to determine best feeding practices in the ICU. [ABSTRACT FROM AUTHOR]

Background: Multiple critical care guidelines support the elimination of routine gastric residual volume monitoring in patients receiving enteral nutrition. However, transitioning nursing practice away from routine gastric residual volume assessments has proved challenging. Objective: To evaluate outcomes after the elimination of routine gastric residual volume monitoring in a 14-bed adult intensive care unit at a large teaching hospital in the southeastern United States. Methods: Practice change was accomplished through in-service training and implementation of a validated protocol. Data were collected for 30 days before and 30 days after protocol implementation to determine effects on the total volume of enteral nutrition received as well as the rate of adverse events after elimination of routine gastric residual volume assessments (n = 22) as compared with previous standard practice (n = 25). Results: When gastric residual volume was not measured, the mean (SD) percentage of enteral nutrition delivery was 81% (12%) of the ordered volume, compared with 60% (18%) in the historic control group (P =.002). Eliminating gastric residual volume monitoring was not associated with an increased rate of adverse events (emesis, aspiration pneumonia) or a change in length of stay. Nursing staff demonstrated a high degree of compliance with this protocol change. Conclusion: The findings of this study indicate that the elimination of routine gastric residual volume assessment does not increase the rate of adverse events and results in increased nutrition provision. Use of a protocol for practice change as well as mandatory in-service training may effect changes in nursing practice. [ABSTRACT FROM AUTHOR]

Background: In intensive care units (ICUs), both continuous and intermittent feeding are commonly used for early enteral nutrition (EN). However, whether continuous feeding is a preferable feeding modality compared to intermittent feeding remains unclear. Therefore, this meta-analysis assessed the clinical efficacy of both EN feeding modalities in critically ill patients., Methods: The PubMed, Embase, and Cochrane Library databases were searched from their inception dates to December 29, 2022. The search did not involve language restrictions (PROSPERO CRD42022371756). Randomized controlled trials (RCTs) comparing the clinical efficacy and safety of continuous feeding and intermittent feeding in critically ill patients in ICUs were included., Results: We included 13 RCTs involving 785 patients. Compared with intermittent feeding, continuous feeding was associated with a lower mortality rate (relative risk [RR], 0.68; 95% confidence interval [CI], 0.47, 0.98; p = 0.04) but a higher risk of constipation (RR, 1.57; 95% CI, 1.02, 2.43; p = 0.04). Trial sequential analysis (TSA) for mortality rate presented a cumulative Z-curve crossing the traditional boundary, but the curve did not cross the TSA boundary for benefit. No significant differences were found in the aspiration/pneumonia rate (RR, 1.19; 95% CI, 0.51, 2.75; p = 0.69), diarrhea rate (RR, 0.82; 95% CI, 0.58, 1.16; p = 0.26), or increased gastric residual volumes (RR, 1.05; 95% CI, 0.58, 1.90; p = 0.86) between the groups., Conclusion: Despite the low certainty of evidence, compared with intermittent feeding, continuous feeding may reduce the mortality rate in critically ill patients in ICU. Additional studies are needed to provide more evidence and validate the findings., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

Background: The correlation between gastric residual volumes (GRVs) and markers of gastric emptying (GE) in critically ill patients is unclear. This particularly applies to critically ill surgical patients, as they are underrepresented in previous studies. Methods: We conducted a post hoc analysis of a multicenter trial that investigated the effectiveness of a promotility drug. Pharmacokinetic markers of GE (3‐O‐methylglucose [3‐OMG] and acetaminophen) were correlated with GRV measurements. High GRV was defined as one episode of >400 ml or two consecutive episodes of >250 ml, and delayed GE was defined as <20th percentile of the pharmacokinetic GE marker that had the strongest correlation with GE. Results: Of 77 patients, 8 (10.4%) had high GRV, and 15 (19.5%) had delayed GE. The 3‐OMG concentration at 60 min had the strongest correlation with GRV (ρ = −0.631), and high GRV had low sensitivity (46.7%) but high specificity (98.4%) in discriminating delayed GE. The positive (87.5%) and negative (88.4%) predictive values were similar. Compared with medical patients, surgical patients (n = 14, 18.2%), had a significantly higher incidence of high GRV (29% vs 6%, P =.032) and a trend toward delayed GE (36% vs 16%, P =.132). Conclusion: GRV reflects GE, and high GRV is an acceptable surrogate marker of delayed GE. From our preliminary observation, surgical patients may have a higher risk of high GRV and delayed GE. In summary, GRV should be monitored to determine whether complex investigations or therapeutic interventions are warranted. [ABSTRACT FROM AUTHOR]

The touching of fibrillar surfaces elicits a broad range of affective reactions, which range from the adverse stinginess of a stiff bristle brush to the pleasant feel of velvet. To study the tactile perception of model fibrillar surfaces, a unique set of samples carrying dense, regular arrays of cylindrical microfibrils with high aspect ratio made from different elastomer materials have been created. Fibril length and material compliance are varied independently such that their respective influence on tactile perception can be elucidated. This work finds that the tactile perception of similarity between samples is dominated by bending of the fibrils under sliding touch. The results demonstrate that variations of material stiffness and of surface structure are not necessarily perceived independently by touch. In the case of fibrillar elastomer surfaces, it is rather the ratio of fibril length and storage modulus which determines fibril bending and becomes the dominant tactile dimension. Visual access to the sample during tactile exploration improves the tactile perception of fibril bendability. Experiments with colored samples show a distraction by color in participants' decisions regarding tactile similarity only for yellow samples of outstanding brightness. [ABSTRACT FROM AUTHOR]

Copyright of Periférica Internacional. Revista para el Análisis de la Cultura y el Territorio is the property of Universidad de Cadiz and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Gestion et Management Public is the property of Association Internationale de Recherche en Management Public (AIRMAP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Several measures have been taken to prevent the onset of ventilator-associated pneumonia (VAP), one of which is measuring the gastric residual volume. The purpose of this study is to compare the effect of two tube feeding methods with and without gastric residual volume measurement on VAP. Materials and Methods: This clinical trial was performed on the study population of patients with endotracheal tubes hospitalized in Intensive Care Units 1 and 2 of Golestan hospital, Ahvaz, Iran. Overall, 70 patients who met the inclusion criteria were randomly divided into groups 1 and 2. Groups 1 and 2 were fed with and without measuring gastric residual volume, respectively. The incidence of pneumonia was assessed using the Modified Clinical Pulmonary Infection Score prior to the intervention and on the fifth day postintervention. The data were analyzed by the SPSS software version 22. Results: The incidence of VAP was 9.12% in the group with gastric residual volume measurement and 7.14% in the other group. There was no significant difference between the two groups (P=0.827) regarding VAP prevalence. Conclusion: Monitoring gastric residual volume requires aspiration and repeated measurements of gastric contents, resulting in increased nursing workload. Moreover, if the gastric residual volume is high, the patient will be deprived of calorie intake and subjected to malnutrition. As a result, removing the monitoring of gastric residual volume from the care setting and focusing on interventions proven to reduce VAP can be more helpful. [ABSTRACT FROM AUTHOR]

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created as revised from J-SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high-quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J-SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU-acquired weakness [ICU-AW], post-intensive care syndrome [PICS], and body temperature management). The J-SSCG 2020 covered a total of 22 areas with four additional new areas (patient- and family-centered care, sepsis treatment system, neuro-intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large-scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members. As a result, 79 GRADE-based recommendations, 5 Good Practice Statements (GPS), 18 expert consensuses, 27 answers to background questions (BQs), and summaries of definitions and diagnosis of sepsis were created as responses to 118 CQs. We also incorporated visual information for each CQ according to the time course of treatment, and we will also distribute this as an app. The J-SSCG 2020 is expected to be widely used as a useful bedside guideline in the field of sepsis treatment both in Japan and overseas involving multiple disciplines. [ABSTRACT FROM AUTHOR]

Background: An isovolumetric intragastric balloon to continuously measure gastric phasic contractility was recently developed by us. We aimed to investigate the readout of this technique in relation to gastric content and gastric emptying. Methods: In this crossover investigation, the VIPUNTM Gastric Monitoring System, which comprises a double lumen nasogastric feeding tube with integrated intragastric balloon, was used to assess phasic gastric contractility by interpretation of the pressure in an isovolumetric balloon in 10 healthy subjects. Balloon pressure was recorded in fasted state, during a 2‐hour intragastric nutrient infusion (1 kcal/ml at 25, 75, or 250 ml/h) and 4 hours post‐infusion, and quantified as Gastric Balloon Motility Index (GBMI), ranging from 0 (no contractility) to 1 (maximal contractility). Gastric accumulation was quantified with magnetic resonance imaging and gastric emptying with a13C‐breath test. Results are expressed as mean(SD). Key Results: GBMI was significantly lower during infusion at 250 ml/h compared to baseline (0.13(0.05) versus 0.46(0.12)) and compared to infusion at 25 (0.54(0.21)) and 75 ml/h (0.43(0.20)), all P < 0.005. Gastric content volume was larger after infusion at 250 versus 75 ml/h (P < 0.001). Half‐emptying time and accumulation were both negatively correlated with postprandial contractility. Postprandial GBMI was significantly lower when GCV>0 ml compared to when the stomach was empty. Conclusions and Inferences: Enteral nutrition dose‐dependently decreased the contractility readout. This decrease was linked to gastric accumulation of enteral nutrition. [ABSTRACT FROM AUTHOR]

Copyright of Governance Review / Revue Gouvernance is the property of University of Ottawa, Center on Governance and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

It is nearly impossible to separate two interleaved phonebooks by pulling their spines. The very slight force exerted by the outer sheets of the assembly is amplified as the exponential of the square of the number of sheets, meaning that even a small number of sheets can create a highly resistant system. We present a systematic and detailed study of the influences of the normal external force and the geometrical parameters of the booklets on the assembly strength. We conclude that the paper-paper adhesion force between the two outer sheets, on the order of a few mN , is the one amplified by the interleaved-book system. The two-phonebook experiment—which has attracted the attention of students and the non-scientific public all around the world as an outstanding demonstration of the strength of friction—appears to also be a spectacular macroscopic manifestation of the microscopic coupling of friction and adhesion. [ABSTRACT FROM AUTHOR]

Background: Routine measurement of gastric residual volume to guide feeding is widespread in neonatal units but not supported by high-quality evidence. Outcome selection is critical to trial design.Objective: To determine optimal outcome measures for a trial of not routinely measuring gastric residual volume in neonatal care.Design: A focused literature review, parent interviews, modified two-round Delphi survey and stakeholder consensus meeting.Participants: Sixty-one neonatal healthcare professionals participated in an eDelphi survey; 17 parents were interviewed. 19 parents and neonatal healthcare professionals took part in the consensus meeting.Results: Literature review generated 14 outcomes, and parent interviews contributed eight additional outcomes; these 22 outcomes were then ranked by 74 healthcare professionals in the first Delphi round where four further outcomes were proposed; 26 outcomes were ranked in the second round by 61 healthcare professionals. Five outcomes were categorised as 'consensus in', and no outcomes were voted 'consensus out'. 'No consensus' outcomes were discussed and voted on in a face-to-face meeting by 19 participants, where four were voted 'consensus in'. The final nine consensus outcomes were: mortality, necrotising enterocolitis, time to full enteral feeds, duration of parenteral nutrition, time feeds stopped per 24 hours, healthcare-associated infection; catheter-associated bloodstream infection, change in weight between birth and neonatal discharge and pneumonia due to milk aspiration.Conclusions and Relevance: We have identified outcomes for a trial of no routine measurement of gastric residual volume to guide feeding in neonatal care. This outcome set will ensure outcomes are important to healthcare professionals and parents. [ABSTRACT FROM AUTHOR]

The rocks are likely to give a geochemical signature to the groundwater circulating there. Therefore the hydro geochemistry of the mine's water is influenced by the mining method. The continuous pumping of the mine water gives discharges that induce harmful impacts on the environment. The Sebou basin is subjected to strong industrial and urban pollution, but in the literature, the evaluation of the mining impact on this area is neglected. This paper is dedicated to this issue and as part of the evaluation of the mining impact on the Sebou watershed, the haut Beht mine was chosen among the four mines which include the watershed, and then we proceeded, as the purpose of this work, to evaluate the physicochemical quality of this mine's water discharges and their metallic trace elements (MTE) load (As, Pb, Cd, Zn, and Cu) through monitoring of four locations during two analysis campaigns in 2014 and 2015. This monitoring was performed by ICP-MS analysis. The results showed absenteeism of the acidic nature of mine's water, characterizing acid mine drainage (AMD). The majority of the analyzed water presents important concentrations of sulfate. During the 2014 campaign, the examination of trace metal element concentrations showed, at station 2, contamination of Iron, Aluminum, Manganese and, Arsenic. However, the concentrations of Pb, Cd, Zn, and Cu elements remain conform and very low compared to the limit of standards. The monitoring of the overtake elements made it possible to identify the degree of contamination of the mine's water discharges and to note an improvement in time in the mine water discharges quality. [ABSTRACT FROM AUTHOR]

Background: Choosing trial outcome measures is important. When outcomes are not clinically relevant or important to parents/patients, trial evidence is less likely to be implemented into practice. This study aimed to determine optimal outcome measures for a trial of no routine gastric residual volume (GRV) measurement in critically ill children.Methods: A mixed-methods approach was used: a focused literature review, parent and clinician interviews, a modified 2-round Delphi, and a stakeholder consensus meeting.Results: The review generated 13 outcomes. Fourteen pediatric intensive care unit (PICU) parents proposed 3 additional outcomes; these 16 were then rated by 28 clinicians in Delphi round 1. Six further outcomes were proposed, and 22 outcomes were rated in the second round. No items were voted "consensus out." The 18 "no-consensus" items were voted in a face-to-face meeting by 30 participants. The final 12 outcome measures were time to reach energy targets, ventilator-associated pneumonia, vomiting, time enteral feeds withheld per 24 hours, necrotizing enterocolitis, length of invasive ventilation, PICU length of stay, mortality, change in weight and markers of feed intolerance (parenteral nutrition administered), feed formula altered, and change to postpyloric feeds all secondary to feed intolerance.Conclusion: We have identified 12 outcomes for a trial of no GRV measurement through a multistage process, seeking views of parents and clinicians. [ABSTRACT FROM AUTHOR]

Recently, plant surfaces have attracted attention given their fascinating functionalities, particularly adhesive properties, which largely result from their diverse surface structuring. This paper contributes to the adhesion mechanics investigation on complex biological surface morphologies. Elastomeric replica of three different plant leaves, comprising morphologies at a broad scale (0.5–100 µm), with distinct shapes and complexity, and of a smooth surface are studied in contact with an adhesive probe. To perform precise adhesion measurements, an ultra‐nanoindenter is modified based on the Johnson–Kendall–Roberts (JKR) mechanics and equipped with an in situ real‐contact visualization system. The adhesion force on all surfaces is systematically investigated regarding the preload conditions. The results are analyzed in the light of Hertzian and JKR theories, and underlying morphology‐specific mechanisms are identified. A close examination of contact image–force reveals attachment–detachment mechanisms, arising from different preloads and topographies. A significant influence of preload on adhesion is observed on the surface with fine microstructuring and complex morphology, no specific influence is recorded for the remaining two. An overall comparison demonstrates a significant reduction in adhesion on coarse cone‐shape patterns and complex microstructures. The specific adhesion mechanisms arising from biological morphologies may offer assistance to design bioinspired interfaces. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of high-flow nasal cannula oxygen (HFNO) therapy on hospital length of stay (LOS) and postoperative pulmonary complications (PPCs) in adult postoperative patients. Data Sources: PubMed, Embase, the Cochrane Library, Web of Science of Studies, China National Knowledge Index, and Wan Fang databases were searched until July 2018. Study Selection: Randomized controlled trials (RCTs) comparing HFNO with conventional oxygen therapy or noninvasive mechanical ventilation in adult postoperative patients were included. The primary outcomes were hospital LOS and PPCs; shortterm mortality (defined as intensive care unit, hospital, or 28-day mortality) and intubation rate were the secondary outcomes. Data Extraction: Demographic variables, high-flow oxygen therapy application, effects, and side effects were retrieved. Data were analyzed by the methods recommended by the Cochrane Collaboration. The strength of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation. Random errors were evaluated with trial sequential analysis. Data Synthesis: Fourteen studies (2568 patients) met the inclusion criteria and were included. Compared to the control group, the pooled effect showed that HFNO was significantly associated with a shorter hospital stay (mean difference: -0.81; 95% confidence interval [CI]: -1.34 to -0.29, P = .002), but not mortality (risk ratio [RR]: 1.0, 95% CI: 0.63 to 1.59, P = 1.0). Weak evidence of a reduction in reintubation rate (RR: 0.76, 95% CI: 0.57-1.01, P = .06) and PPC rate (RR: 0.89, 95% CI: 0.75-1.06, P = .18) with HFNO versus control group was recorded. Conclusions: The available RCTs suggest that, among the adult postoperative patients, HFNO therapy compared to the control group significantly reduces hospital LOS. [ABSTRACT FROM AUTHOR]

In this study, the dynamic friction performance of frog toe‐pad inspired surface patterns is investigated in three folds. First, frog toe‐pad morphology is mimicked, designed, and fabricated using 3D printing technology. Friction coefficients of the models are measured experimentally over a wet medium, with varying velocity, load, and sliding direction. Furthermore, time is recorded to reach a 5 mm height by the water flow through a steady model in another experimental set‐up. Second, numerical simulation is employed to study the contact area, sliding displacement, and frictional stress of the model tread patterns. Surfaces with different low frictional coefficients are considered to simulate the presence of wet medium and surface roughness. Third, an analytical model is utilized to calculate the water squeeze‐out time, as well as the height difference of drained water during wet surface conditions. Among three different bioinspired models, built to compare with a sample tire design, the double‐layered studded hexagonal pattern shows the best wet traction performance. This study demonstrates that the bioinspired hierarchical studded hexagonal model can provide design solutions for future tire treads with enhanced wet friction performances, as well as applications in products requiring surface wet traction enhancement, including boot soles, roller surfaces, and surgical grippers. [ABSTRACT FROM AUTHOR]

Background: Awake craniotomy requires specific sedation procedure in an awake patient who should be able to cooperate during the intraoperative neurological assessment. Currently, limited number of literatures on the application of high-flow nasal cannula (HFNC) in the anesthetic management for awake craniotomy has been reported. Hence, we carried out a prospective study to assess the safety and efficacy of humidified high-flow nasal cannula (HFNC) airway management in the patients undergoing awake craniotomy. Methods: Sixty-five patients who underwent awake craniotomy were randomly assigned to use HFNC with oxygen flow rate at 40 L/min or 60 L/min, or nasopharynx airway (NPA) device in the anesthetic management. Data regarding airway management, intraoperative blood gas analysis, intracranial pressure, gastric antral volume, and adverse events were collected and analyzed. Results: Patients using HFNC with oxygen flow rate at 40 or 60 L/min presented less airway obstruction and injuries. Patients with HFNC 60 L/min maintained longer awake time than the patients with NPA. While the intraoperative PaO2 and SPO2 were not significantly different between the HFNC and NPA groups, HFNC patients achieved higher PaO2/FiO2 than patients with NPA. There were no differences in Brain Relaxation Score and gastric antral volume among the three groups as well as before and after operation in any of the three groups. Conclusion: HFNC was safe and effective for the patients during awake craniotomy. Trial registration: Chinese Clinical Trial Registry, CHiCTR1800016621. Date of Registration: 12 June 2018. [ABSTRACT FROM AUTHOR]

Spain is a country with a vast folklore tradition characterized by deep regional contrasts. The role of folklore museums as a nationalizing tool of the central government and by regional governments (e.g. Catalan and Basque) to support a diversity of projects for identity construction requires renewed analysis. Examined here is the history of the Museo del Pueblo Español (MPE), a national folklore museum created during the Second Republic (1931–1939) to broadcast the wealth of folkloric tradition within the country. Currents of change in national politics during the 20th century have re-oriented the MPE depending on the contrasting perspectives of Spanish identity that prevailed at different times in the past. In Catalonia and the Basque country, where identity claims have been repeatedly asserted since the 19th century, folklore heritage and its representations were seen by nationalist political movements as useful platforms to support a message of 'difference.' We propose to use Tony Bennett's concepts of the museum as an 'exhibitionary complex' and 'governmental assemblages' to further clarify the evolution of folklore museums and their role in the development of identity politics in Spain. [ABSTRACT FROM AUTHOR]

Nutrition therapy during critical illness has been a focus of recent research, with a rapid increase in publications accompanied by two updated international clinical guidelines. However, the translation of evidence into practice is challenging due to the continually evolving, often conflicting trial findings and guideline recommendations. This narrative review aims to provide a comprehensive synthesis and interpretation of the adult critical care nutrition literature, with a particular focus on continuing practice gaps and areas with new data, to assist clinicians in making practical, yet evidence-based decisions regarding nutrition management during the different stages of critical illness. [ABSTRACT FROM AUTHOR]

Copyright of Medicina Neotloznyh Sostoanij is the property of Zaslavsky O.Yu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Whether providing nutrition support is beneficial or deleterious during targeted temperature management (TTM) after cardiac arrest is unclear. We therefore performed a retrospective observational study to determine whether early nutrition was beneficial or deleterious during TTM.Methods: We retrospectively studied patients admitted to our intensive care unit (ICU) between 2008 and 2014 after successfully resuscitated cardiac arrest. We compared the group given nutrition within 48 hours after ICU admission (E+ group) to the group given nutrition later on or not at all (E- group).Results: Of the 203 included patients, 143 were in the E+ group and 60 in the E- group. The E+ group had a significantly higher proportion of patients with a good 3-month neurological outcome (42.7% vs 16.7%, P < 0.001). The difference remained significant after adjustment on a propensity score (odds ratio, 3.47; 95% confidence interval, 1.48-8.14; P = 0.004). The cumulative energy deficit for an energy goal of 20 kcal/kg/d from admission to day 7 was significantly lower in the E+ group (3304 ± 2863 kcal vs 5017 ± 2655 kcal, P < 0.001). Within the E+ group, the subgroups with nutrition initiation when body temperature was <36°C vs ≥36°C were not significantly different regarding the frequencies of early-onset pneumonia, ventilator-associated pneumonia, vomiting, and prokinetic drug use (all P-values > 0.05).Conclusions: Early nutrition after cardiac arrest during TTM appears safe and may be associated with better neurological outcomes. These findings warrant a randomized controlled trial to resolve the remaining issues. [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Arts Management is the property of International Journal of Arts Management and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)