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The rapid decline of coral reefs calls for cost-effective benthic cover data to improve reef health forecasts, policy building, management responses and evaluation. Reef monitoring has been largely based on divers' observations along transects, and secondarily on quadrat-based protocols, video and photographic records. However, the accuracy and precision of the most common sampling approaches are not yet fully understood. Here, we compared benthic cover estimates from three common sampling protocols: Reef Check (RC), Atlantic and Gulf Rapid Reef Assessment (AGRRA) and photoquadrats (PQ). The reef cover of two contrasting sites was reconstructed with ∼450 m 2 orthomosaics built with high resolution Structure-from-Motion (SfM) photogrammetry, which were used as references for comparisons among protocols. In addition, we explored sample size requirements for each protocol and provided cost-effectiveness comparisons. Our results evidenced between-reef differences in the accuracy and precision of estimates with the different protocols. The three protocols performed similarly in the reef with low macroalgal cover (<0.5%), but PQ were more accurate and precise in the reef with relatively high (∼20%) macroalgal cover. The sample size for estimating coral cover with a 20% error margin and a 0.05 significance level was lower for PQ, followed by AGRRA and RC. Considering performance, cost surrogates and equipment needs, cost-effectiveness was higher for PQ. We also discuss costs, limitations and advantages/disadvantages of SfM photogrammetry as a sampling approach for coral reef monitoring., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

Cocoa beans used for chocolate production are fermented seeds of Theobroma cacao obtained by a natural fermentation process. The flavors and chemical compounds produced during the fermentation process make this step one of the most important in fine chocolate production. Herein, an integrative analysis of the variation of microbial community structure, using a shotgun metagenomics approach and associated physicochemical features, was performed during fermentation of fine cocoa beans. Samples of Forastero variety (FOR) and a mixture of two hybrids (PS1319 and CCN51) (MIX) from Bahia, Brazil, were analyzed at 7 different times. In the beginning (0 h), the structures of microbial communities were very different between FOR and MIX, reflecting the original plant-associated microbiomes. The highest change in microbial community structures occurred at the first 24 h of fermentation, with a marked increase in temperature and acetic acid concentration, and pH decrease. At 24-48 h both microbial community structures were quite homogenous regarding temperature, acetic acid, succinic acid, pH, soluble proteins and total phenols. During 72-96 h, the community structure resembles an acidic and warmer environment, prevailing few acetic acid bacteria. Taxonomic richness and abundance at 72-144 h exhibited significant correlation with temperature, reducing sugars, succinic, and acetic acids. Finally, we recommend that dominant microbial species of spontaneous fine cocoa fermentations should be considered as inoculum in accordance with the farm/region and GMP to maintain a differential organoleptic feature for production of fine chocolate. In our study, a starter inoculum composed of Acetobacter pausterianus and Hanseniaspora opuntiae strains is indicated., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: There are no reliable estimates of hospital inpatient suicides in the United States. Understanding the rate and the methods used in suicides is important to guide prevention efforts. This study analyzed two national data sets to establish an evidence-based estimate of hospital inpatient suicides and the methods used., Methods: The study is designed as a cross-sectional analysis of data from 27 states reporting to the National Violent Death Reporting System (NVDRS) for 2014-2015, and from hospitals reporting to The Joint Commission's Sentinel Event (SE) Database from 2010 to 2017. Categorical variables and qualitative reviews of event narratives were used to identify and code suicide events occurring during hospital inpatient treatment., Results: Based on the hospital inpatient suicides reported in the NVDRS during 2014-2015, 73.9% of which occurred during psychiatric treatment, it is estimated that between 48.5 and 64.9 hospital inpatient suicides occur per year in the United States. Of these, 31.0 to 51.7 are expected to involve psychiatric inpatients. Hanging was the most common method of inpatient suicide in both the NVDRS and SE databases (71.7% and 70.3%, respectively)., Conclusion: The estimated number of hospital inpatient suicides per year in the United States ranges from 48.5 to 64.9, which is far below the widely cited figure of 1,500 per year. Analysis of inpatient suicide methods suggests that hospital prevention efforts should be primarily focused on mitigating risks associated with hanging, and additional suicide prevention efforts may be best directed toward reducing the risk of suicide immediately following discharge., (Copyright © 2018 The Joint Commission. Published by Elsevier Inc. All rights reserved.)

Background: An understanding of how health information technology (health IT) can contribute to sentinel events is necessary to learn how to safely implement and use health IT. An analysis was conducted to explore how health IT may contribute to adverse events that result in death or severe harm to the patient., Methods: For 3,375 de-identified sentinel events voluntarily reported to The Joint Commission between January 1, 2010, and June 30, 2013, categorical and keyword queries were used to search for potential health IT-related events. Each of the identified events was reviewed on the basis of findings from root cause analyses (RCAs) to determine if health IT contributed to or caused the event, and if so, how and why. The contributing factors were classified using a composite of existing classification schemes., Results: A total of 120 health IT-related sentinel events (affecting 125 patients) were identified. More than half resulted in patient death, 30% resulted in unexpected or additional care, and 11% resulted in permanent loss of function. The three most frequently identified event types were (1) medication errors, (2) wrong-site surgery (including the wrong side, wrong procedure, and wrong patient), and (3) delays in treatment. Contributing factors were most frequently associated with the human-computer interface, workflow and communication, and clinical content-related issues., Conclusions: The classification of health IT-related contributing factors indicates that health IT-related events are primarily associated with the sociotechnical dimensions of human-computer interface, workflow and communication, and clinical content. Improved identification of health IT-related contributing factors in the context of the sociotechnical dimensions may help software developers, device manufacturers, and end users in health care organizations proactively identify vulnerabilities and hazards, ultimately reducing the risk of harm to patients.

Background: Infection with human T-lymphotropic virus 1 or 2 (HTLV-1/2) is a major health problem. There is a public health policy defining measures for state hematology and hemotherapy centers in Brazil, in order to avoid virus transmission through blood donors., Objective: This study aimed to evaluate the seroprevalence of HTLV -1/2 in blood donors in the State of Maranhão, Brazil, during routine blood unit screening., Methods: Screening tests of blood donors using the enzyme-linked immunosorbent assay (ELISA) to detect seropositivity for HTLV-1/2 performed at the Hematology and Hemotherapy Center of the State of Maranhão (HEMOMAR) between July of 2003 and December of 2009 were retrospectively evaluated., Results: Of the 365,564 blood donors, 561 (0.15%) were HTLV-1/2-positive, of whom 72 (12.8%) performed the confirmatory test (Western blot). In donors who had a confirmatory test, 53 (73.6%) were positive. The ages of the infected individuals ranged from 18 to 65 years; 305 (54%) were aged over 40 years. Among the infected individuals, 309 (55%) were male, 399 (71%) were mixed-race, and 259 (46%) were single. Co-infections were frequently found, especially with hepatitis B (in 68.6% of the cases)., Conclusion: The results obtained will contribute to the planning and implementation of control measures by the epidemiological surveillance agency of Maranhão, and will also contribute to reducing morbidity. The high seropositivity in a small sample in donors who had confirmatory tests indicates the need for confirmatory tests for all donors who initially test as seropositive.

In phagocytic cells evidence for properties of Ca2+-sensitive K+-selective channels comes mostly from electrophysiological studies. Macrophages and macrophage-like cells are compared with fibroblasts (L-cells) where the Ca+-dependent K+ conductance is better understood. This model shares a mesenchymal origin and an accessory phagocytic capacity with the professional phagocytes. In macrophages several values of transmembrane potentials have been measured by different groups, using various techniques. Microelectrode measurements have demonstrated a voltage-dependent K+ conductance involved in transition from low to high membrane potentials. Current-voltage relationships in mouse peritoneal exudate cells have revealed a region of negative slope resistance. Slow calcium spikes were found in a subpopulation of cells from human dialysis fluid that appear to be distinct from typical macrophages. Action potentials have been recorded from human monocyte-derived macrophages. Their ionic mechanism has not yet been established. Spontaneous and electrically elicited slow membrane hyperpolarizations have been described in macrophages and macrophage-like cells. Similar activity is well known in L-cells and in both cases it is possible to identify a Ca2+-sensitive K+ conductance as the underlying mechanism. Phagocytosis is a cell function that has been related to membrane hyperpolarization and to slow hyperpolarizing activity. In some cases no changes of electrical activity have been observed during the phagocytic process. Chemotactic factors induce membrane hyperpolarizations in macrophages, but the relation between electrical change and cell motility has not been established. Exocytosis, a is another Ca2+ sensitive cell function that awaits correlation with electrochemical changes. The evidences accumulated to date are compatible with several models for gating and modulation of the voltage-independent K+ conductance by Ca2+. The use of higher resolution techniques, such as patch-clamp, with well defined subpopulations of phagocytic cells may produce the missing link in the transduction of membrane signals into the specifically targeted cell functions.