Search

This work explores the meaning-making activities described by participants as they viewed a well-known painting. Research into aesthetic engagement has implicated an array of cognitive, affective, and perceptual processes. Types and aspects of artworks and of viewers have been investigated and a wide range of contextual factors have been identified as influential on viewer and viewed. The complexity of aesthetic experience is such that increasingly, a multidisciplinary approach toward its study has been encouraged. Despite this, experiential investigations into art-viewing are few. This study involves interviews with 12 participants, each conducted while viewing Las Meninas by Diego Velazquez. Using Interpretative Phenomenological Analysis, three Group Experiential Themes were derived. Of these, “Meaning-Making, Interpretative Content,” is presented singly to allow for depth of discussion. This theme captures participants’ interpretative activities during viewing, exploring how they made sense of what they saw. Considerations of temporality, historicity, and social context were particularly prominent. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Escrito y revisado entre 1918 y 1922, Trilce comparte y devora el fundamental tropo vanguardista: desistir de la representación mediante la opacidad del signo, protagonista ahora de su propia presencia, liberado del ancilar oficio mimético. Ante los discursos críticos y creativos de ese momento —en las artes literarias, plásticas y musicales—, destacamos la trayectoria de la andadura suelta y resuelta de César Vallejo.

El poeta peruano César Vallejo y el pintor belga René Magritte comparten querencias estéticas y vitales fundamentales, llevar al lector o el espectador por una serie de signos que chocan con el vacío aparente, el misterio, el surco prolífico. Una aracterística compartida es la frecuencia del motivo de la ropa masculina burguesa, signo de identidad del que el poeta se va despojando y en el cual el pintor insiste para dar con pasmoso aplomo en el misterio. ABSTRACTThe Peruvian poet, César Vallejo, and the Belgian painter, René Magritte share fundamental esthetic and vital lost homes, a yearning that takes the reader or viewer along a sequence of signs that crashes into an apparent emptiness, into mystery, the fertile furrow. One shared feature of their art is the frequent presence of male bourgeois clothing, identifying markers that the poet shucks off along the way, and the painter retains in order to approach, with amazing aplomb, mystery.Keywords: Vallejo, Magritte, poetics, breach, clothing.

Historically major social movements seeking change, equality, and social justice have been driven by youth. In more recent decades, youth have been at the forefront of challenging the social, political, and ethical blind spots of their age. Continuing the historical role of youth in facilitating social change, their relevance is particularly important today. Much like past movements, in recent years youth have continued to advance the human condition in existing and new, critical directions. Nonetheless, direct youth engagement in social change is far from encouraged, and has declined, especially in situations that question the prevailing social, political, economic, and other ideologies. Youth are also easily dismissed as being idealistic, ill-informed, and unrealistic in their calls for social justice. In most settings, youth are treated as adults in waiting with little voice or ownership over efforts that impact society. In this special issue, and in direct contrast to the scenario outlined above, we seek to present a series of theoretical, empirical, and policy/practice related articles surrounding youth citizenship and action in the context of advancing social justice. Such engagement places youth at the forefront of both grassroots youth lead change and adult led youth engagement as a mechanism for systemic change.

Ketone ingestion can alter metabolism but effects on exercise performance are unclear, particularly with regard to the impact on intermittent-intensity exercise and team-sport performance. Nine professional male rugby union players each completed two trials in a double-blind, randomized, crossover design. Participants ingested either 90 ± 9 g carbohydrate (CHO; 9% solution) or an energy matched solution containing 20 ± 2 g CHO (3% solution) and 590 mg/kg body mass β-hydroxybutyrate monoester (CHO + BHB-ME) before and during a simulated rugby union-specific match-play protocol, including repeated high-intensity, sprint and power-based performance tests. Mean time to complete the sustained high-intensity performance tests was reduced by 0.33 ± 0.41 s (2.1%) with CHO + BHB-ME (15.53 ± 0.52 s) compared with CHO (15.86 ± 0.80 s) placebo (p = .04). Mean time to complete the sprint and power-based performance tests were not different between trials. CHO + BHB-ME resulted in blood BHB concentrations that remained >2 mmol/L during exercise (p p

Twenty years ago, Northern Ireland’s previously prominent presence in the headlines of the yellow press dwindled to virtual non-existence. As the region’s three-decade long conflict went into abeyance and the daily death tally dropped, the vagaries of the region’s little-understood, political tensions were assigned to little-read columns hidden deep inside broadsheets. Brexit has, however, re-exposed the deep scars and political acrimony that still blight Northern Ireland. Northern Irish schools have seen the introduction of series of educational initiatives aimed at ameliorating enduring inter-community hostility, including the creation of a model of citizenship education designed to enhance pupils’ political understanding and literacy. Drawing on recent survey data on the attitudes and perspectives of 16-year-olds, this paper explores how citizenship is being delivered in schools in Northern Ireland and exposes young people’s level of engagement with current political issues, including the possibility of a united Ireland. Although results are largely in line with expectations, there are some indications that this generation may not be simply marching in step with the same drumbeat that has been followed by generations of their forebearers.

Previous studies have suggested that many burn patients undergo unnecessary intubation due to concern for inhalation injury. We hypothesized that burn surgeons would intubate burn patients at a lower rate than non-burn acute care surgeons (ACSs). We performed a retrospective cohort study of all patients admitted to an American Burn Association-verified burn center who presented emergently following burn injury from June 2015 to December 2021. Patients excluded include polytrauma patients, isolated friction burns, and patients intubated prior to hospital arrival. Our primary outcome was intubation rates between burn and non-burn ACSs. 388 patients met inclusion criteria. 240 (62%) patients were evaluated by a burn provider and 148 (38%) were evaluated by a non-burn provider; the groups were well-matched. In total, 73 (19%) of patients underwent intubation. There was no difference in the rate of emergent intubation, diagnosis of inhalation injury on bronchoscopy, time to extubation, or incidence of extubation within 48 hours between burn and non-burn ACSs. We found no difference between burn and non-burn ACSs in the airway evaluation and management of burn patients. Surgical providers with acute care surgery backgrounds and Advanced Trauma Life Support training are well-equipped for initial airway management in burn patients. Further studies should seek to compare other types of provider groups to identify opportunities for intervention and education in preventing unnecessary intubations.

Contemporary microbialite formation has been documented on rock coasts in a variety of geomorphic, oceanographic, and climatic settings. Based on a synthesis of these diverse occurrences plus new observations, a generalized model is presented. At each locality microbialite development is associated with discharge of mineralized freshwater in the coastal zone. Microbialite formation in the high intertidal and supratidal zones of rock coasts occurs in a variety of sub-environments (cliff face, shore platform surface, platform surface pools, boulder beach, and sand beach) and forms a variety of laminated rock encrustations and oncoids. Allochthonous microbialites occur on the backshore as breccias of reworked microbialite clasts, oncoids transported from rock pools, and partly encrusted boulders. The microbialite-influenced rock coast is a distinct type of siliciclastic environment that offers potential comparison for ancient microbialite occurrences. It has preservation potential in both transgressive and regressive settings. Potential ancient examples are suggested.

Objective: Since the onset of COVID-19, the provision of psychotherapy services has shifted\ud online. Thus, telepsychotherapy has been the focus of much research to document therapists'\ud experiences; however, it has been mainly quantitative. In the Indian context, no known\ud empirical research has focused on the implications of this transition on psychotherapists.\ud Therefore, the present paper presents an in-depth idiographic study exploring\ud psychotherapists' experiences in India, who had to transition to telepsychotherapy rapidly.\ud Method: Ten novice psychotherapists providing clinical services virtually were individually\ud interviewed. The transcripts were analysed using interpretative phenomenological analysis.\ud Results: The main themes that emerged from the analysis were: negative impact on\ud therapeutic process, detrimental effect on personal and professional self, positive impact of\ud telepsychotherapy for therapist and, strategies for helping the adjustment to\ud telepsychotherapy practice.\ud Conclusion: The idiographic and psychological focus enabled a detailed exploration of the\ud profound impact the sudden transition had on novice psychotherapists’ work with clients and\ud their self-efficacy. Despite contextual constraints faced by the psychotherapy profession in\ud India, the participants demonstrated creative ways of working around the challenges\ud encountered during telepsychotherapy. Nonetheless, their experiences highlight the need to\ud initiate training programs in telepsychotherapy. The findings are considered in relation to\ud extant literature and provide fertile ground for novice practitioners to engage in thinking\ud about their own telepsychotherapy use.

IntroductionSignificant differences in outcomes for mothers and babies following obstetric surgical interventions between low- and middle-income countries and high-income settings have demonstrated a need for improvements in quality of care and training of obstetric surgical and anaesthetic providers. To address this a five-day face-to-face training intervention was developed. When the COVID-19 pandemic interrupted its roll-out, the course was redesigned for delivery by blended learning.MethodsThis 3-part blended-learning course (part-1: 15 hours self-directed online learning, part-2: 13 hours facilitated virtual workshops and part-3: 10 hours face-to-face delivery), was conducted in Kenya. We assessed the completion rate of part-1 (21 assignments), participation rate in parts 2 and 3, participant satisfaction, change in knowledge and skills and compared the cost of the blended delivery compared to the 5-day face-to-face delivery, in GB Pounds.Results65 doctors took part in part 1, 53 completing at least 90% of the assignments. 60 doctors participated in part 2, and 53 participated in part 3. Participants completing an evaluation reported (n=53) attending the training was a good use of their time (each of parts-1 and 3: 98%, part-2: 94%) and would recommend this to other colleagues (part-1 and 3: 98%, part-2: 90%). Mean (SD) knowledge score improved from 64% (7%) to 80% (8%) and practical skills from 44% (14%) to 87% (7%). The blended course achieved a cost-saving of £207 per participant compared to the 5-day face-to-face delivery approach.ConclusionWe have demonstrated that a blended learning approach to clinical training in a low resource setting is feasible, acceptable and more cost effective. More studies are required to investigate the effectiveness of this approach on health outcomes.

Explanatory leaflet to participants explaining sharing of data with family doctors and colonoscopy units where relevant

Colorectal cancer accounts for 11% of all cancer-related deaths in Ireland. With the aim of diagnosing these cancers at an earlier stage, and detecting premalignant lesions, the National Screening Service (NSS) offered a fecal immunochemical test (FIT) to all individuals aged 60 to 69. All individuals in the age range were contacted by post and invited to participate in the programme. Those with a positive FIT result were offered a colonoscopy in an internationally accredited unit. From an eligible population of 488,628, 196,238 individuals participated giving an uptake of 40.2%. Commencing at a FIT threshold of 20 μg Hg/g feces, the positivity rate was 8.6%, which overwhelmed colonoscopy capacity and, thus, the threshold was increased to 45 μg, resulting in an overall 5% positivity rate. A total of 520 individuals had cancer detected (68.3% stage I or II), of which 104 were removed endoscopically (pT1s). Adenomas were present in 54.2% of all colonoscopies, 17.4% deemed high risk. Despite a lower uptake, males were twice as likely to have colorectal cancers as females and had a 59% increased rate of high-risk adenomas diagnosed. Challenges facing the programme include increasing participation, especially among males, and increasing colonoscopy capacity. The ability to alter the sensitivity of FIT to match colonoscopy capacity is a valuable option for such a programme as it ensures that the maximum public health benefit can be achieved within available resources.

Supplementary Data 6: Monitoring of somatic genomic alterations in plasma during targeted therapy. Allele frequencies (AF) of identified mutations are represented on the left Y-axis while the sum of the target lesions on the CT scan, are represented on the right Y-axis.

Supplementary Data 1: Primers and probes for ddPCR assay Supplementary Data 2: Consort Diagram Supplementary Data 3: List of drugs Supplementary Data 4: Cross validation of PGM sequencing assay with ddPCR Supplementary Data 5: To test intra-run assay performance, 3 different libraries were prepared using the same plasma cfDNA from a single patient Supplementary Data 6: See figure 6 below. Supplementary Data 7: Time to progression for patients having a 30% decrease in plasma mutation AF, following targeted drug administration, and association with time to progression by RECIST evaluation.

We develop a new method to analyze the total electron content (TEC) depression in the ionosphere after a tsunami occurrence. We employ Gaussian process regression to accurately estimate the TEC disturbance every 30 s using satellite observations from the global navigation satellite system (GNSS) network, even over regions without measurements. We face multiple challenges. First, the impact of the acoustic wave generated by a tsunami onto TEC levels is nonlinear and anisotropic. Second, observation points are moving. Third, the measured data are not uniformly distributed in the targeting range. Nevertheless, our method always computes the electron density depression volumes, along with estimated uncertainties, when applied to the 2011 Tohoku-Oki earthquake, even with random selections of only 5 % of the 1000 GPS Earth Observation Network System receivers considered here over Japan. Also, the statistically estimated TEC depression area mostly overlaps the range of the initial tsunami, which indicates that our method can potentially be used to estimate the initial tsunami. The method can warn of a tsunami event within 15 min of the earthquake, at high levels of confidence, even with a sparse receiver network. Hence, it is potentially applicable worldwide using the existing GNSS network.

Becoming a parent creates a new phase in adult development where the creation of a family brings new meanings and relational dimensions to one’s life. For people who are involuntarily childless, however, the absence of children can have a multifaceted impact on their everyday lives. Although extensive studies concerning childlessness have been conducted, past work has tended to have a clinical focus on women's infertility and fertility treatments and much less attention has been paid to how involuntarily childless people live beyond the phase of trying for a child while contemporaries pursue their lives with children. This study explores the experience of 11 White, heterosexual British women in midlife living with involuntary childlessness. To gain experiential insights, semi-structured interviews were conducted and transcripts analyzed using interpretive phenomenological analysis. Analysis reveals two interrelated key patterns exemplifying intrapersonal and interpersonal features. This paper focuses on the latter. The findings bring to light not only layers of complex relational issues caused by being involuntarily childless, but also different ways of reconstructing meaning in relational reconnections that impacted positively on developing generativity. The paper presents the dynamics unique to each woman and offers micro-level understandings helpful for health professionals, family therapists, life coaches, and researchers looking into childlessness and midlife/adult development.

This article extends Michael L. Radelet’s 1989 study of rare cases in which Whites have been executed for committing capital crimes against Blacks to include an assessment of White executions involving Latinx and Asian victims. The threefold aim is to (1) establish the frequency of such rare cases, and (2) explore the extent to which status characteristics (beyond race, ethnicity or gender) are present for these rare events; and (3) offer social dominance theory as a viable explanation for the patterns found in the data. An analysis of unique data from the Texas Department of Criminal Justice shows that out of 570 executions imposed between April 1982 and July 2020, only six cases led to the execution of Whites for crimes against Blacks (1.1%), sixteen cases for crimes against Hispanics (2.8%), and one case for crimes against an Asian American (0.18%). Beyond the minority status of the victim, two or more status markers were present when Whites were executed for crimes against people of color. The results, which are consistent with expectations drawn from social dominance theory, highlight the differential value placed on minority lives and call into question the legitimacy of the death penalty in the United States.

Orbital congestion, contestation and competition are on the rise, and space activities are expected to align with treaties, arrangements, and guidelines elaborated at a time when the space ecosystem was simpler - and it is becoming more complex. To cope efficiently with this changing situation, at a time when space systems have become an indispensable enabler for an ever-increasing range of socio-economic activities, new rules of the road are necessary. Indeed, these should ensure the sustained stability and security of the space environment, providing norms and standards beyond transparency and confidence building measures, laying the ground for the founding elements of a space traffic coordination (management?). Hence, for us to be dependent on a reliable space-enabled information flow will require a significant decrease of their vulnerability; protection as well as “fail safe” are becoming the chief concerns. This paper will first review the current legal and regulatory provisions under which space activities take place, pointing out some limitations of the international dialogue, which is quite complex, anarchic, and with no clear global leadership, complicated by the dual use (civil and military) of space. Moreover, enforcement appears to be ineffective. It will then consider new public, as well as private, initiatives that are underway, evaluating the robustness of their foundations. Possible avenues are proposed in support of the most recent prominent initiatives, including the possibility for an international agreement on standards and behaviours, or an international civil space organisation inspired by the International Civil Aviation Organisation - ICAO. Emphasis will be placed on the urgency of bringing together these initiatives and processes under a common umbrella, or at least to achieve the convergence of a set of rules noting that international hard law provisions are far reaching. A step-by-step approach is suggested, addressing immediate, mid-term, and long-term actions to provide a stable space environment favourable to LEO large constellations, in-orbit refuelling/repairing, active debris removal, human commercial space-flight, cis-lunar/interplanetary traffic, space resources exploitation, and security/defence operations.

The current national burden of emergency general surgery (EGS) illnesses and the extent of surgeon involvement in the care of these patients remain largely unknown. To inform needs assessments, research, and education, we sought to: (1) translate previously developed International Classification of Diseases (ICD), 9th Revision, Clinical Modification (ICD-9-CM) diagnosis codes representing EGS conditions to ICD 10th Revision, CM (ICD-10-CM) codes and (2) determine the national burden of and assess surgeon involvement across EGS conditions.We converted ICD-9-CM codes to candidate ICD-10-CM codes using General Equivalence Mappings then iteratively refined the code list. We used National Inpatient Sample 2016 to 2017 data to develop a national estimate of the burden of EGS disease. To evaluate surgeon involvement, using Wisconsin Hospital Association discharge data (January 1, 2016 to June 30, 2018), we selected adult urgent/emergent encounters with an EGS condition as the principal diagnosis. Surgeon involvement was defined as a surgeon being either the attending provider or procedural physician.Four hundred and eighty-five ICD-9-CM codes mapped to 1,696 ICD-10-CM codes. The final list contained 985 ICD-10-CM codes. Nationally, there were 2,977,843 adult patient encounters with an ICD-10-CM EGS diagnosis. Of 94,903 EGS patients in the Wisconsin Hospital Association data set, most encounters were inpatient as compared with observation (75,878 [80.0%] vs. 19,025 [20.0%]). There were 57,780 patients (60.9%) that underwent any procedure. Among all Wisconsin EGS patients, most had no surgeon involvement (64.9% [n = 61,616]). Of the seven most common EGS diagnoses, surgeon involvement was highest for appendicitis (96.0%) and biliary tract disease (77.1%). For the other five most common conditions (skin/soft tissue infections, gastrointestinal hemorrhage, intestinal obstruction/ileus, pancreatitis, diverticular disease), surgeons were involved in roughly 20% of patient care episodes.Surgeon involvement for EGS conditions ranges from highly likely (appendicitis) to relatively unlikely (skin/soft tissue infections). The wide range in surgeon involvement underscores the importance of multidisciplinary collaboration in the care of EGS patients.Prognostic/epidemiological, Level III.

Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed drugs for treating human depression, but the role of serotonin—often called the happy chemical—is complex, associated with the regulation of appetite, anxiety, aggression, and more. With such psychoactive pharmaceuticals being increasingly detected in aquatic environments and their effects on non-target species an uncertainty, this study seeks to investigate how inhibiting the serotonin pathway with the SSRI fluoxetine affects territorial aggression, using the cichlid fishNyassachromiscf.microcephalusas a model. Males of this sand-dwelling Lake Malawi species build bowers to attract females within a lekking system, where male-male competition is intense. Being aggressive in defending against intruders would serve to maximise mating opportunities and reproductive success for the territory holding male. However, after a one-week exposure to fluoxetine at environmentally relevant concentrations, a decline in aggression was observed in the male cichlids. This implies the serotonergic system plays an important role in modulating aggression and therefore sexual selection in cichlid fishes, and that environmental pollution has the potential to disrupt these behaviours.

ESA’s PLATO mission aims the detection and characterization of terrestrial planets around solar-type stars as well as the study of host star properties. The noise-to-signal ratio (NSR) is the main performance parameter of the PLATO instrument, which consists of 24 Normal Cameras and 2 Fast Cameras. In order to justify, verify and breakdown NSR-relevant requirements the software simulator PINE was developed. PINE models the signal pathway from a target star to the digital output of a camera based on physical models and considers the major noise contributors. In this paper, the simulator’s coarse mode is introduced which allows fast performance analyses on instrument level. The added value of PINE is illustrated by exemplary applications.

Autism Spectrum Disorder (ASD or autism) is a clinically and etiologically heterogeneous condition. Stratification of autistic individuals into subpopulations with shared metabolic phenotypes can improve understanding of the underlying pathophysiology leading to more precise interventions. We performed metabolomic profiling of 499 autistic and 209 typically developing children, ages 18-48 months, enrolled in the Children’s Autism Metabolome Project (CAMP). Through application of plasma metabolomic analyses of a large population of autistic and typically developing children, individuals were stratified using metabolic phenotypes (metabotypes). Metabotypes associated with autism provide insight into the heterogeneity of this condition. Fifty-four metabolites, mainly associated with amino acid, organic acid, acylcarnitine, and purine metabolism, were quantified using liquid chromatography-tandem mass spectrometry, including important metabolites and ratios related to energy homeostasis not evaluated in earlier studies. Quantitative thresholds of the concentrations of 4 metabolites and 149 ratios of concentrations of metabolites were identified that could stratify CAMP participants into metabolic subpopulations of primarily autistic individuals. One or more metabotypes were present in 83% of the autistic participants. based on the similarity of metabotype profiles of the participants. The metabotypes were grouped into 30 clusters based on the similarity of metabotype profiles of the participants. The clusters displayed 7 broader metabolic patterns of changes in metabolites associated with glycolysis, tricarboxylic acid cycle (TCA), amino acid, purine, and acylcarnitine metabolism. Metabolic phenotypes related to cellular bioenergetics, especially mitochondrial dysmetabolism, were commonly observed in this large cohort of autistic participants. A subset of 42 metabotypes could identify CAMP autistic individuals with 72% sensitivity and 90% specificity. As the number of metabotype clusters increased in each individual, so did the autism severity. Metabolic profiling of autistic children can support diagnosis, enhance understanding of the underlying pathophysiology and suggest targeted metabolic treatments.

Introduction Studies have demonstrated an increased prevalence of depression and PTSD in individuals with burn injuries during the first year of recovery. Mental health screening of patients at all burn centers is recommended. With the addition of an outpatient social worker, our burn center identified a need to standardize the burn clinic’s mental health screening process to address the mental health needs of patients. This performance improvement project sought to improve mental health screening in the burn clinic and subsequent referrals to community resources. Methods From March to August of 2022, the PHQ-2 and PC-PTSD were administered to 99 clinic patients during one of the patient’s initial visits. Patients completed the screening independently using a paper form. For pediatric patients < 12 years old, the primary caregiver filled out the form. Of the 99 patients who completed the screening, 51 were previously admitted to our inpatient burn center and 48 were treated only as outpatients (F=36, M=63). The age range of patients was 10 months to 88 years old. TBSA % burned ranged from .15% to 70%. A score of 2 or more on either of the screening tools resulted in further assessment by the social worker to determine appropriate next steps. The chi-square test was used to analyze the data collected. Results A total of 36/99 patients screened positive for depressive symptoms, 33/99 screened positive for Acute Stress Disorder (ASD)/Post Traumatic Stress Disorder (PTSD) symptoms, and 23/99 screened positive for both depressive and ASD/PTSD symptoms. All patients with a positive screen on either tool were provided with education regarding mental health resources and offered a referral for services. Of the 99 patients screened, 26 accepted a referral to the local burn foundation and/or an alternate mental health provider for support services. The other 73/99 declined a referral for follow up. There were statistically significant correlations between positive ASD/PTSD screenings and inpatient hospitalization (22/99 p=0.033), PTSD and median TBSA (p= 0.011), and PTSD and age (45-64yo, p=0.028). Females (19/36, p=0.01) were more likely than males to report symptoms of depression and both PTSD & depression (p=0.001), while females (12/36) and males (21/63) were equally likely to report symptoms of PTSD. Conclusions Mental health screening of individuals in our burn clinic yielded a significant number of positive screens for depression and ASD/PTSD symptoms, validating the need for a standardized screening process. Positive screens resulted in increased referrals to community and mental health resources. Applicability of Research to Practice Performing mental health screenings in the outpatient arena is vital to address the mental health needs of individuals with burn injuries.

Introduction Previous studies have suggested many burn patients undergo unnecessary intubation due to concern for inhalation injury. There is a lack of clear consensus guidelines for intubation and thus there is significant variation in practice pattern. In this study we hypothesized intubation rates would differ between Acute Care Surgeons with specialized burn training and those without. Methods A retrospective analysis of 388 patients admitted to an ABA verified level 1 burn center who presented emergently following burn injury from 7/2015 to 12/2021 was performed. Patients excluded include polytrauma patients, isolated friction burns, and patients intubated prior to hospital arrival. All providers performing initial evaluation are Acute Care Surgeons, with a subset having additional specialized fellowship training and/or extensive burn experience. Our primary outcome was intubation rates between burn and non-burn trained providers. The Chi-Square and Mann-Whitney U statistical tests were used to compare categorical and continuous variables, respectively. Results There were 465 major burn patients admitted through the trauma bay and screened during the study period with 388 patients meeting inclusion criteria. The population was 72% male, with mean age of 44 years +- 21, TBSA of 12%, and COHgb level of 2.9%. In total, 73 (19%) of patients underwent intubation. The patients in the two provider groups did not differ in terms of age, gender, race, TBSA, COHgb level, or airway exam findings. 240 (62%) patients were evaluated by a burn provider and 148 (38%) were evaluated by a non-burn provider. There was no significant difference in the rate of emergent intubation of patients treated by burn vs non-burn trained providers (RR 0.71, CI 0.47 - 1.07). Of the patients who were intubated, there was no significant difference between burn and non-burn providers in the diagnosis of inhalation injury on bronchoscopy (RR 1.3, CI 0.91-1.85). In both groups, objective evidence of inhalation injury was found in only 68% of patients undergoing routine bronchoscopy following emergent intubation. Conclusions There was no significant difference in intubation rates between burn and non-burn trained acute care surgeons. This demonstrates that following standard ATLS and ABLS principles provides appropriate training in the evaluation, diagnosis, and treatment of inhalation injury. Interestingly, 32% of all patients intubated did not have evidence of inhalational injury on bronchoscopy following intubation. This study suggests that further research is needed to determine objective criteria for intubation guidelines when inhalation injury is suspected in the acute burn patient population. Applicability of Research to Practice Applicable

En el presente artículo se presenta un sucinto estudio de las variantes entre «Terceto autóctono», de Los heraldos negros, de César Vallejo, y su versión primitiva, a saber, el poema «Fiestas aldeanas».

The basidiomycete fungus Lentinula novae-zelandiae is endemic to New Zealand and is a sister taxon to Lentinula edodes, the second most cultivated mushroom in the world. To explore the biology of this organism, a high-quality chromosome level reference genome of L. novae-zelandiae was produced. Macrosyntenic comparisons between the genome assembly of L. novae-zelandiae, L. edodes and a set of three genome assemblies of diverse species from the Agaricomycota reveal a high degree of macrosyntenic restructuring within L. edodes consistent with signal of domestication. These results show L. edodes has undergone significant genomic change during the course of its evolutionary history, likely a result of its cultivation and domestication over the last 1000 years.

Neutrophils protect against invading bacteria, and their unique role in adipose tissue inflammation and insulin resistance (IR) in obesity is increasingly recognized. We found that visceral adipose tissue (VAT) of obese (n=83) compared to lean (n=13) individuals had higher neutrophil abundance, correlating with IR. The obese subjects had elevated circulating plasma zonulin, a marker of intestinal permeability, and lipopolysaccharide-binding protein (LPSBP) , a marker of bacterial presence, consistent with evidence suggesting that changes in the microbiome and gut permeability in obesity permits the entry of gut bacteria and bacterial products into the circulation. Therefore, we tested for bacterial presence in VAT under sterile conditions. 16s rRNA analyses revealed that the family Streptococcaceae and an unnamed genus in the family Ruminococaceae were enriched in obese VAT contrary to order Bacilliales and genus Marvinobryantia in lean VAT, majorly originating from the GI tract. To confirm whether higher bacterial load is causal for VAT neutrophil abundance in obesity, we gavaged high-fat diet fed mice with fecal material from an obese human, which increased neutrophil, but not macrophage recruitment to VAT. As VAT is highly vascularized, we used RNA-seq to compare the gene expression signature of VAT neutrophils to peripheral blood neutrophils to eliminate the possibility that VAT neutrophils were circulating cells. Evidently, VAT neutrophils had a differential activation state compared to the circulating neutrophils, with a distinct gene expression pattern representing upregulated inflammatory, chemotactic, extracellular matrix, and ROS generation pathways. Overall, we find that that increased gut bacterial translocation enhances the recruitment of VAT specific neutrophils in obesity offering novel targets for managing VAT inflammation and comorbidities of obesity. Disclosure D.Shantaram: None. N.F.Williams: None. D.Spakowicz: None. W.Hsueh: None. A.M.Blaszczak: None. R.Hoyd: None. A.Smith: None. L.Antwi: None. J.Z.Liu: None. V.P.Wright: None. D.Bradley: None. Y.Liu: None.

Purpose — The objective of the study is to construct a hierarchical pyramid of corporate social responsibility which provides a new model from economic to spiritual obligation of a corporation. Design/methodology/approach — The research method of the study utilizes an imaginary dialogue of the postmodernist paradigm. The imaginary dialogue is used of two persons which are an accountant and a stockholder of a company. Findings — The result of the study is a hierarchical pyramid of corporate social responsibility constructed. The study also defines detail of the levels. Firstly, the legal obligation is the basic obligation which a corporation has responsible for obeying the law. Secondly, the economic obligation is a corporate responsibility for accelerating economically and profitably for the corporation going concerned. Thirdly, the social philanthropic obligation is responsible for caring for society at a large. Fourthly, the environmental obligation is responsible for preserving natural environments like a large. Lastly, the spiritual obligation is responsible for being fully aware of the internal corporation, society, environments, state, and God. Practical Implications — The hierarchical pyramid is a model of corporation obligations started from the level of legal, economic, Social philanthropic, environmental, and spiritual obligations. Originality/value — The model of this study is derived from the analysis of corporate obligation using a postmodernist paradigm. Keywords: corporate, economics, postmodernism, economic obligation, spiritual obligation Paper Type Research Paper.