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Presents a correction of errors contained in the article 'A High-Resolution Analysis of the ...[sup 2]A[sub 1]-...[sup 2]A[sub 1] Transition of CaNH[sub 2]: Pure Precession in Polyatomic Molecules,' by the authors, published in the 1997 issue of the 'Journal of Chemical Physics' periodical. Centrifugal distortion constants.

BackgroundChikungunya virus (CHIKV) has spread across Brazil with varying incidence rates depending on the affected areas. Due to cocirculation of arboviruses and overlapping disease symptoms, CHIKV infection may be underdiagnosed. To understand the lack of CHIKV epidemics in São José do Rio Preto (SJdRP), São Paulo (SP), Brazil, we evaluated viral circulation by investigating anti-CHIKV IgG seroconversion in a prospective study of asymptomatic individuals and detecting anti-CHIKV IgM in individuals suspected of dengue infection, as well as CHIKV presence in Aedes mosquitoes. The opportunity to assess two different groups (symptomatic and asymptomatic) exposed at the same geographic region aimed to broaden the possibility of identifying the viral circulation, which had been previously considered absent.Methodology/principal findingsBased on a prospective population study model and demographic characteristics (sex and age), we analyzed the anti-CHIKV IgG seroconversion rate in 341 subjects by ELISA over four years. The seroprevalence increased from 0.35% in the first year to 2.3% after 3 years of follow-up. Additionally, we investigated 497 samples from a blood panel collected from dengue-suspected individuals during the 2019 dengue outbreak in SJdRP. In total, 4.4% were positive for anti-CHIKV IgM, and 8.6% were positive for IgG. To exclude alphavirus cross-reactivity, we evaluated the presence of anti-Mayaro virus (MAYV) IgG by ELISA, and the positivity rate was 0.3% in the population study and 0.8% in the blood panel samples. In CHIKV and MAYV plaque reduction neutralization tests (PRNTs), the positivity rate for CHIKV-neutralizing antibodies in these ELISA-positive samples was 46.7%, while no MAYV-neutralizing antibodies were detected. Genomic sequencing and phylogenetic analysis revealed CHIKV genotype ECSA in São José do Rio Preto, SP. Finally, mosquitoes collected to complement human surveillance revealed CHIKV positivity of 2.76% of A. aegypti and 9.09% of A. albopictus (although it was far less abundant than A. aegypti) by RT-qPCR.Conclusions/significanceOur data suggest cryptic CHIKV circulation in SJdRP detected by continual active surveillance. These low levels, but increasing, of viral circulation highlight the possibility of CHIKV outbreaks, as there is a large naïve population. Improved knowledge of the epidemiological situation might aid in outbreaks prevention.

Although the term quality is ambiguous when applied to the forage in ruminant nutrition it is highly correlated with intake and digestibility. Both chemical and physical changes occur in forage as a result of plant maturity affecting, as a consequence, the dynamics of digestion and passage of rumen digesta, resulting in filling effects, reduction of feed intake and decrease of milk production. The effect of the inclusion of neutral detergent fiber levels from forage (fNDF) with advanced maturity (86.24% NDF; 6.47% CP) was evaluated in goat diets. Feed intake, digestibility of dry matter and of nutrients, nitrogen balance, milk production, efficiency of use of metabolizable energy consumed (ME), and feeding behavior were used as dependent variables. Five dairy goats were assigned to a 5 x 5 Latin square design, using dietary fNDF levels of 20, 28, 35, 43 and 49% as independent variables. The intakes of dry matter (DMI), of nutrients, and of net energy (NEl) were reduced (p<.05) as fiber was added to ration. Conversely, intake of NDF increased (p<.01)suggesting ability for accommodation of fiber in the rumen despite the negative effect on intake. The fNDF level influenced (p<.05) the digestibility coefficients of dry matter, organic matter, crude protein and nonfibrous carbohydrates. Intake of nitrogen (g/day) was influenced in a quadratic manner with no effect on retained nitrogen. Quadratic effects were observed for the nitrogen excreted in the feces and urine, and a linear effect on nitrogen produced in the milk. No influence of fNDF levels was observed for milk constituents (fat, protein and lactose). A quadratic effect of fiber in diet was observed for milk yield with higher values obtained at 28% of fNDF. The levels of forage fiber studied did not influence values of efficiency of use of ME consumed for milk production. A variation on feeding behavior was noticed by increased time of rumination and mastication with a reduction on idle time as fiber from forage increase in diets. [ABSTRACT FROM AUTHOR]

BackgroundContinuous vital sign monitoring by using wearable sensors may result in the earlier detection of patient deterioration and sepsis. Few studies have explored the perspectives of surgical team members on the use of such sensors in surgical patients. ObjectiveThis study aims to understand the views of surgical team members regarding novel wearable sensors for surgical patients. MethodsWearable sensors that monitor vital signs (heart rate, respiratory rate, and temperature) continuously were used by acute surgical patients. The opinions of surgical staff who were treating patients with these sensors were collated through in-depth semistructured interviews to thematic saturation. Interviews were audio recorded, transcribed, and analyzed via thematic analysis. ResultsA total of 48 interviews were performed with senior and junior surgeons and senior and junior nurses. The main themes of interest that emerged from the interviews were (1) problems with current monitoring, (2) the anticipated impact of wearables on patient safety, (3) the impact on staff, (4) the impact on patients overall, (5) potential new changes, and (6) the future and views on technology. ConclusionsOverall, the feedback from staff who were continuously monitoring surgical patients via wearable sensors was positive, and relatively few concerns were raised. Surgical staff members identify problems with current monitoring and anticipate that sensors will both improve patient safety and be the future of monitoring.

In 2020, the world was affected by the COVID-19 pandemic, which remains a major challenge for most countries today. In Brazil, football clubs' youth academies have faced a disruption of their regular activities. In order to study how the learning cultures of a Brazilian professional football club youth academy have been changed, and the alternatives created by the club's staff within this context, this perspective article aims to analyze how they have structured the Under-15 (U15) team learning culture during social isolation due to the COVID-19 pandemic. Through document and thematic analysis on a Brazilian professional football club's youth academy program, we promoted a dialogue between the process of adaptation to remote theoretical-tactical teaching with the learning theory proposed by Hodkinson and collaborators. The main theme of analysis of this study was the remote structure of the theoretical-tactical learning and physical training. Challenged with the need to transpose face-to-face activities into a learning culture based on remote communication, the U15 team coaching staff created a process to prescribe physical training, and to teach and discuss football tactical issues with young players during the period of social isolation. This perspective article shows that it is possible for sports institutions to create programs for the development of young athletes within the social isolation/distancing context, considering both theoretical-tactical learning and physical training processes. The adaptation to remote environments as structures for the learning culture seems a challenge, but is also a good alternative for young players to develop their interpretation and perception of football theoretical-tactical issues.

Objective: Assess whether fully-immersive simulation training with structured debriefing of a standardized emergency thoracic endovascular aortic repair (TEVAR) scenario improves team-work performance of the lead surgeon. Secondary aims: assess whether technical skills (TS) and radiation safety behaviors (RSB) improved concurrently., Design: Pre-post study., Setting: UK-based training days., Participants: General and vascular surgical trainees (n = 16)., Intervention(s): Fully-immersive simulation training with structured debriefing of a standardized emergency TEVAR scenario. Following standardized emergency TEVAR technical training, trainees led 2 standardized fully-immersive endovascular surgery simulations, with scripted support from a passive surgical team. A non-TS (NTS) structured debrief was delivered following simulations. NTS were assessed using the validated observational teamwork assessment for surgery tool post hoc using video recordings of simulations. TS were assessed through time taken to complete each step of the procedure, as defined during technical training. RSB were assessed through checking for presence of pre-defined actions and the length of time fluoroscopy was used during each simulation., Results: Total observational teamwork assessment for surgery scores improved following structured debrief (p = 0.005, median 52.55/90 vs 73.0/90), alongside all constituent domains - communication (p < 0.001, median 11.7/20 vs 16.6/20), coordination (p < 0.001, median 8.6/15 vs 13.4/15), cooperation (p < 0.001, median 13.15/20 vs 16.35/20), leadership (p < 0.001, median 8.70/15 vs 11.30/15) and monitoring (p < 0.001, median 9.85/20 vs 14.85/20). TS improved; time to complete 12 of 13 procedural steps improved (p < 0.027). Fluoroscopy time (seconds) decreased (p = 0.339, 543.6 vs 495.5), frequency lead surgeons checked the team were wearing leads increased (p = 0.125, 3 vs 7) and asked the team to step back before screening increased (p = 0.003, frequency team asked to step back/total angiography runs before = 2/36 vs after = 14/44)., Conclusions: fully-immersive endovascular simulation with structured debrief is a robust tool to improve NTS and TS. Incorporation into surgical training may reduce operating theatres errors, increase efficiency, and improve RSB. However effective translation into the clinical workplace must be demonstrated to see these benefits., (Copyright © 2020 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Background and Objective: There is increasing emphasis in cancer care globally for care to be reviewed and managed by multidisciplinary teams (ie, in tumor boards). Evidence and recommendations suggest that the complexity of each patient case needs to be considered as care is planned; however, no tool currently exists for cancer teams to do so. We report the development and early validation of such a tool., Methods: We used a mixed-methods approach involving psychometric evaluation and expert review to develop the Measure of case-Discussion Complexity (MeDiC) between May 2014 and November 2016. The study ran in six phases and included ethnographic interviews, observations, surveys, feasibility and reliability testing, expert consensus, and multiple expert-team reviews., Results: Phase-1: case complexity factors identified through literature review and expert interviews; Phase-2: 51 factors subjected to iterative review and content validation by nine cancer teams across four England Trusts with nine further items identified; Phase 3: 60 items subjected to expert review distilled to the most relevant; Phase 4: item weighing and further content validation through a national UK survey; Phases 5 and 6: excellent interassessor reliability between clinical and nonclinical observers, and adequate validity on 903 video case discussions achieved. A final set of 27 factors, measuring clinical and logistical complexities were integrated into MeDiC., Conclusions: MeDiC is an evidence-based and expert-driven tool that gauges the complexity of cancer cases. MeDiC may be used as a clinical quality assurance and screening tool for tumor board consideration through case selection and prioritization., (© 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

Background: The aim of this paper is to review the potential role of endovascular interventions for young patients with lower-limb ischaemia., Methods: A literature search was performed of PubMed and Medline databases using appropriate search terms and limits. Case reports, retrospective studies, and prospective studies evaluating treatment of lower-limb ischemia in patients aged <50 years were scrutinized. Articles published between 1966 and 2010 were included in this review., Results: Premature atherosclerosis is likely to represent the commonest cause of lower-limb ischemia in patients aged <50 years, although the incidence of nonatherosclerotic causes such as popliteal entrapment syndrome, cystic adventitial disease, and arteritis in these patients is greater than in older patients. As with older patients, endovascular interventions may be beneficial for patients with symptoms secondary to atherosclerosis. At present, the perceived durability of open surgery may be more preferable to patients aged <50 years, but the development of new endovascular technology is challenging this view. Endovascular interventions such as catheter-directed thrombolysis have specific roles in the treatment of lower-limb ischemia due to nonatherosclerotic causes., Conclusion: The use of angioplasty and stenting procedures to treat young patients with lower-limb ischemia is increasing and has specific roles. However, many developmental causes and nonatherosclerotic conditions still require primary surgical correction., (Copyright © 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.)