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Arsenic and selenium are common metalloids released from mineral deposits through their extraction, processing, and waste. Arsenic is found at 1.5-2.0 ppm in the Earth's crust, primarily as arsenopyrite, in [...]

Author(s): Alayna Carrandi [sup.1], Christina Nguyen [sup.1] [sup.2], Wai Chung Tse [sup.1] [sup.2], Colman Taylor [sup.3], Forbes McGain [sup.4] [sup.5] [sup.6] [sup.7], Kelly Thompson [sup.3] [sup.8], Martin Hensher [sup.9], Scott [...], Purpose Health care is a major contributor to climate change, and critical care is one of the sector's highest carbon emitters. Health economic evaluations form an important component of critical care and may be useful in identifying economically efficient and environmentally sustainable strategies. The purpose of this scoping review was to synthesise available literature on whether and how environmental impact is considered in health economic evaluations of critical care. Methods A robust scoping review methodology was used to identify studies reporting on environmental impact in health economic evaluations of critical care. We searched six academic databases to locate health economic evaluations, costing studies and life cycle assessments of critical care from 1993 to present. Results Four studies met the review's inclusion criteria. Of the 278 health economic evaluations of critical care identified, none incorporated environmental impact into their assessments. Most included studies (n = 3/4) were life cycle assessments, and the remaining study was a prospective observational study. Life cycle assessments used a combination of process-based data collection and modelling to incorporate environmental impact into their economic assessments. Conclusions Health economic evaluations of critical care have not yet incorporated environmental impact into their assessments, and few life cycle assessments exist that are specific to critical care therapies and treatments. Guidelines and standardisation regarding environmental data collection and reporting in health care are needed to support further research in the field. In the meantime, those planning health economic evaluations should include a process-based life cycle assessment to establish key environmental impacts specific to critical care.

En el presente articulo propongo poner en contraste anotaciones que le sirvieron a Borges como borradores para algunas de sus clases y conferencias. No se trata de un trabajo aislado [...]

Diffuse gliomas (DGs) are primary central nervous system (CNS) neoplasms characterized by the widespread infiltration of individual tumor cells displaying cytologic and histologic features of glial differentiation. (1) These tumors [...], Context.--The diagnosis and clinical management of patients with diffuse gliomas (DGs) have evolved rapidly over the past decade with the emergence of molecular biomarkers that are used to classify, stratify risk, and predict treatment response for optimal clinical care. Objective.--To develop evidence-based recommendations for informing molecular biomarker testing for pediatric and adult patients with DGs and provide guidance for appropriate laboratory test and biomarker selection for optimal diagnosis, risk stratification, and prediction. Design.--The College of American Pathologists convened an expert panel to perform a systematic review of the literature and develop recommendations. A systematic review of literature was conducted to address the overarching question, "What ancillary tests are needed to classify DGs and sufficiently inform the clinical management of patients?" Recommendations were derived from quality of evidence, open comment feedback, and expert panel consensus. Results.--Thirteen recommendations and 3 good practice statements were established to guide pathologists and treating physicians on the most appropriate methods and molecular biomarkers to include in laboratory testing to inform clinical management of patients with DGs. Conclusions.--Evidence-based incorporation of laboratory results from molecular biomarker testing into integrated diagnoses of DGs provides reproducible and clinically meaningful information for patient management. (Arch Pathol Lab Med. 2022;146:547-574; doi: 10.5858/arpa.2021-0295-CP)

Author(s): Sarah R. Edmunds [sup.1] [sup.2] , Carly Colman [sup.1] , Paige Vidal [sup.1] , Susan Faja [sup.1] [sup.2] Author Affiliations: (1) grid.2515.3, 0000 0004 0378 8438, Division of Developmental [...], Deficits in working memory have not been fully explored in toddlers and preschoolers with autism spectrum disorder (ASD). We investigated the relationship between language (verbal ability, verbal self-talk) and visuospatial working memory in 2- and 4-year-olds with ASD (n = 65) and typical development (TD) (n = 54). Children with ASD displayed impairments in working memory and verbal ability, but not verbal self-talk, compared to TD peers. Verbal ability and working memory were positively correlated; this association was stronger for children with ASD. For 2-year-olds, self-talk and working memory were negatively correlated. Results suggest that verbal ability and working memory are linked, especially for young children with ASD. Self-talk may be a compensatory strategy for toddlers with less developed working memory.

We have designed a highly twisted small thermally activated delayed fluorescence (TADF) emitter PXZ-[alpha]-DK based on an [alpha]-diketone ([alpha]-DK) as a strong acceptor and phenoxazine (PXZ) as a strong donor to obtain red-shifted emission in comparison with the equivalent [alpha]-diketone linked to 9,9-dimethyl-9,10-dihydroacridine (DMAC). The PXZ-[alpha]-DK shows emission at 586 nm and DMAC-[alpha]-DK shows emission at 548 nm in 1,3-bis(N-carbazolyl)benzene (mCP) host at 1.5 wt% doping of the emitter, with short-delayed lifetimes of 6.9 ls for PXZ-[alpha]-DK and 7.6 ls for DMAC-[alpha]-DK. Organic light-emitting diodes (OLEDs) fabricated using these emitters show green electroluminescence at 555 nm for DMAC-[alpha]-DK, with a maximum external quantum efficiency, [EQE.sub.max], of 6.3%, and orange electroluminescence at 585 nm for PXZ-[alpha]-DK, with an [EQE.sub.max] of 0.8%. We corroborate the optoelectronic properties of these emitters with DFT calculations. Key words: TADF, OLEDs, [alpha]-diketone, red-shifted emission. Nous avons concu un emetteur de fluorescence retardee activee thermiquement (TADF pour Thermally Activated Delayed Fluorescence) a haut degre de torsion, PXZ-[alpha]-DK, a partir d'une [alpha]-dicetone (aDK) comme groupe accepteur fort et de la phenoxazine (PXZ) comme groupe donneur fort pour obtenir une emission deplacee vers le rouge par rapport a l'analogue constitue de l' adicetone liee a la 9,9dimethyl-9,10dihydroacridine (DMAC). La PXZaDK presente une emission a 586 nm et la DMACaDK, une emission a 548 nm dans une matrice hote de 1,3bis(N-carbazolyl)benzene (mCP) a un taux de dopage de l'emetteur de 1,5 % p/p, le temps de vie retarde de courte duree etant de 6,9 ls pour la PXZaDK et de 7,6 ls pour la DMACaDK. Les diodes electroluminescentes organiques (DELO) fabriquees a l'aide de ces emetteurs presentent une electroluminescence verte a 555 nm avec une efficacite quantique externe maximale ([EQE.sub.max]) de 6,3 % dans le cas de la DMACaDK, et une electroluminescence orange a 585 nm avec une [EQE.sub.max] de 0,8 % dans le cas la PXZaDK. Nous corroborons les proprietes optoelectroniques de ces emetteurs par des calculs DFT. [Traduit par la Redaction] Mots-cles : TADF, DELO, [alpha]-dicetone, emission deplacee vers le rouge., Introduction Since the seminal report of Adachi and co-workers in 2012, (1) organic light-emitting diodes (OLEDs) employing organic thermally activated delayed fluorescence (TADF) emitters have received significant attention because of [...]

Author(s): Rennan Yanlin Du [sup.1] , Weipeng Yang [sup.2] , Phoebe Pui Ying Lam [sup.1] , Cynthia Kar Yung Yiu [sup.1] , Colman Patrick McGrath [sup.3] Author Affiliations: (1) grid.194645.b, [...], Visual pedagogy and social stories have been widely used to assist children with Autism Spectrum Disorder (ASD) in learning various skills. A toothbrushing visual pedagogy (TBVP) was developed adapting existing toothbrushing social stories for children with ASD. This TBVP consists of 13 toothbrushing steps with scripts describing the toothbrushing technique. To evaluate its feasibility, a review panel was formed to provide feedback on the TBVP and three other published toothbrushing social stories. Effectiveness of the TBVP was further evaluated among 119 preschool children with ASD with significant improvements in toothbrushing skills observed at 3-month and 6-month follow-ups. It is concluded that TBVP is a feasible and an effective educational means that assists children with ASD in learning toothbrushing skills.

Al hojear el cuaderno Avon (MSS 678-09) perteneciente a la serie de manuscritos y notas de Borges que se encuentran en Michigan State University desde 2019, observo que en el [...]

Author(s): Naomi E. Hammond [sup.1] [sup.2], Simon R. Finfer [sup.1] [sup.2], Qiang Li [sup.1], Colman Taylor [sup.1], Jeremy Cohen [sup.3], Yaseen Arabi [sup.4], Rinaldo Bellomo [sup.5], Laurent Billot [sup.1], Meg [...], Purpose To investigate the impact of hydrocortisone treatment and illness severity on health-related quality of life (HRQoL) at 6 months in septic shock survivors from the ADRENAL trial. Methods Using the EuroQol questionnaire (EQ-5D-5L) at 6 months after randomization we assessed HRQoL in patient subgroups defined by hydrocortisone or placebo treatment, gender, illness severity (APACHE II < or [greater than or equal to] 25), and severity of shock (baseline peak catecholamine doses < or [greater than or equal to] 15 mcg/min). Additionally, in subgroups defined by post-randomisation variables; time to shock reversal (days), treatment with renal replacement therapy (RRT), and presence of bacteremia. Results At 6 months, there were 2521 survivors. Of these 2151 patients (85.3%-1080 hydrocortisone and 1071 placebo) completed 6-month follow-up. Overall, at 6 months the mean EQ-5D-5L visual analogue scale (VAS) was 70.8, mean utility score 59.4. Between 15% and 30% of patients reported moderate to severe problems in any given HRQoL domain. There were no differences in any EQ-5D-5L domain in patients who received hydrocortisone vs. placebo, nor in the mean VAS (p = 0.6161), or mean utility score (p = 0.7611). In all patients combined, males experienced lower pain levels compared to females [p = 0.0002). Neither higher severity of illness or shock impacted reported HRQoL. In post-randomisation subgroups, longer time to shock reversal was associated with increased problems with mobility (p = < 0.0001]; self-care (p = 0.0.0142), usual activities (p = Conclusions Approximately one fifth of septic shock survivors report moderate to extreme problems in HRQoL domains at 6 months. Hydrocortisone treatment for septic shock was not associated with improved HRQoL at 6 months. Female gender was associated with worse pain at 6 months.

Author(s): Ni Zhou [sup.1] [sup.2] , Hai Ming Wong [sup.3] , Colman McGrath [sup.4] Author Affiliations: (1) grid.194645.b, 0000000121742757, Paediatric Dentistry & Orthodontics, Faculty of Dentistry, The University of Hong [...], Objectives To investigate the impact of adaptive functioning and oral hygiene practices on tooth-brushing performance among preschool children with special health care needs (SHCN). Methods A cross-sectional study was conducted in Special Child Care Centers. Children&apos;s tooth-brushing performance was assessed by a standardized 13-step pro forma. Information regarding children&apos;s socio-economic status, adaptive skills, and oral hygiene practices were collected. Bivariate analysis and ANCOVA were used to explore the potential factors which might be associated with children&apos;s tooth-brushing performance. Results The tooth-brushing assessment was provided to 379 children with SHCN. Approximately 3% of the recruited children performed the whole tooth-brushing procedure independently. The number of tooth-brushing steps practiced by those children was 4.47 ± 3.56. Children who had established tooth-brushing habit before age one practiced more tooth-brushing steps than children who brushed their teeth after age one (p = 0.029). When children&apos;s age, gender, and socio-economic status were adjusted, children who had established regular tooth-brushing habit or children who had high levels of adaptive skills showed better tooth-brushing performance than their peers. Children who used gauze, cotton swab, or dental floss to clean their teeth practiced fewer key tooth-brushing steps than their peers who had never used additional cleaning approaches (p = 0.038). Conclusions for Practice Children&apos;s tooth-brushing performance was associated with adaptive skills and oral hygiene practices. Tooth-brushing training should be provided to children with SHCN in early childhood. For children who had limitations in adaptive functioning, parental assistance or supervision is recommended to guarantee the efficacy and safety of daily tooth brushing.

Author(s): Kelly Thompson [sup.1] [sup.2], Balasubramanian Venkatesh [sup.1] [sup.2] [sup.3] [sup.4], Naomi Hammond [sup.1] [sup.2] [sup.5] [sup.6], Colman Taylor [sup.1] [sup.2], Simon Finfer [sup.1] [sup.2] [sup.6], Severine Bompoint, Cheryl Carcel, [...]

Dear AMS Members, It is with deepest sadness in our hearts that we announce that Heather Lazrus passed away on Sunday, February 26, 2023. Heather was a mother, partner, friend, [...]

Author(s): Kelly Thompson [sup.1] [sup.2], Colman Taylor [sup.1] [sup.2], Stephen Jan [sup.1] [sup.2], Qiang Li [sup.1], Naomi Hammond [sup.1] [sup.2] [sup.3] [sup.4], John Myburgh [sup.1] [sup.2] [sup.5], Manoj Saxena [sup.1] [...], Purpose To determine differences in health-related quality of life (HRQoL), survival and healthcare resource use of critically ill adults with and without sepsis. Methods We conducted a primary propensity score matched analysis of patients with and without sepsis enrolled in a large multicentre clinical trial. Outcomes included HRQoL at 6 months, survival to 2 years, length of ICU and hospital admission and cost of ICU and hospital treatment to 2 years. Results We obtained linked data for 3442 (97.3%) of 3537 eligible patients and matched 806/905 (89.0%) patients with sepsis with 806/2537 (31.7%) without. After matching, there were no significant differences in the proportion of survivors with and without sepsis reporting problems with mobility (37.8% vs. 38.7%, p = 0.86), self-care (24.7% vs. 26.0%, p = 0.44), usual activities (44.5% vs. 46.8%, p = 0.28), pain/discomfort (42.4% vs. 41.6%, p = 0.54) and anxiety/depression (36.9% vs. 37.7%, p = 0.68). There was no significant difference in survival at 2 years: 482/792 (60.9%) vs. 485/799 (60.7%) (HR 1.01, 95% CI 0.86-1.18, p = 0.94). The initial ICU and hospital admission were longer for patients with sepsis: 10.1 ± 11.9 vs. 8.0 ± 9.8 days (p < 0.0001) and 22.8 ± 21.2 vs. 19.1 ± 19.0 days, (p = 0.0003) respectively. The cost of ICU admissions was higher for patients with sepsis: A$43,345 ± 46,263 ([euro]35,109 ± 35,043) versus 34,844 ± 38,281 ([euro]28,223 ± 31,007), mean difference $8501 ([euro]6885), 95% CI $4342-12,660 ([euro]3517 ± 10,254), p < 0.001 as was the total cost of hospital treatment to 2 years: A$74,120 ± 60,750 ([euro]60,037 ± 49,207) versus A$65,806 ± 59,856 ([euro]53,302 ± 48,483), p = 0.005. Conclusions Critically ill patients with sepsis have higher healthcare resource use and costs but similar survival and HRQoL compared to matched patients without sepsis.

Raccoons shatter glass in the dark screeching their plots, spring roughed out like gangland. Feel their small fists owning. Do I listen better now, without you? So many days your [...]