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The annual risks of colonization, skin infection, bloodstream infection (BSI), and disease burden from exposures to antibiotic-resistant and susceptible Staphylococcus aureus (S. aureus) were estimated using quantitative microbial risk assessment (QMRA). We estimated the probability of nasal colonization after immersion in wastewater (WW) or greywater (GW) treated across a range of treatment alternatives and subsequent infection. Horizontal gene transfer was incorporated into the treatment model but had little effect on the predicted risk. The cumulative annual probability of infection (resulting from self-inoculation) was most sensitive to the treatment log(10) reduction value (LRV), S. aureus concentration, and the newly calculated morbidity ratios and was below the health benchmark of 10(−4) infections per person per year (ppy) given a treatment LRV of roughly 3.0. The predicted annual disability-adjusted life years (DALYs), which were dominated by BSI, were below the health benchmark of 10(−6) DALYs ppy for resistant and susceptible S. aureus, given LRVs of 4.5 and 3.5, respectively. Thus, the estimated infection risks and disease burdens resulting from nasal colonization are below the relevant health benchmarks for risk-based, nonpotable, or potable reuse systems but possibly above for immersion in minimally treated GW or WW. Strain-specific data to characterize dose–response and concentration in WW are needed to substantiate the QMRA.

To make an effective transition towards a circular economy, we must have the responsibility and active participation of all the stakeholders involved, including customers. In this work, we seek to develop an agent-based model to describe and analyze an environmental awareness system in a population, whose behavior is based on an indicator that can change by agent’s interaction and modify its consumption habits. The model is described using the ODD + D protocol, and we use Netlogo software for coding. After model validation process, its results are analyzed to understand how can environmental awareness level, consumption habits and social skills of each individual influence on the average environmental awareness level of a heterogeneous population, which makes simple the identification of emerging behaviors and the forecasting of the potentially recyclable waste according to the quality in the separation at source.

Coronavirus disease (COVID-19) is caused by SARS-CoV-2 and represents the causative agent of a potentially fatal disease that is of great global public health concern. COVID-19 is a respiratory disease produced by the coronavirus family. The World Health Organization declared the disease a pandemic on 11 March 2020. Podiatrists are in a peculiar situation regarding the COVID-19 pandemic: that of a health professional aspect and the singularity that most of them practise as self-employed workers. The aim of the study is to evaluate in a group of podiatrists, working at a national level, their knowledge, perception and degree of anxiety related to the COVID-19 pandemic via the use of a questionnaire specifically developed to this end in the initial phase of the pandemic. We employed a transversal descriptive study with 302 participants, with a purposive sampling technique. The degree of perception and knowledge of the podiatrists about COVID-19 was analysed as well as the cognitive impact of the situation of confinement. The results showed that the podiatrists perceive this situation as serious at the economic and health level, that they have a thorough knowledge of the disease and that they are in a moderate to severe percentile of anxiety. Additionally, 76.2% cancelled their usual work. The COVID-19 pandemic is negatively perceived by this group of podiatrists at the personal, professional, health and economic level, with even a state of anxiety being produced.

The prevalence of burnout in midwives has been briefly studied. Given the negative effects of burnout syndrome in the physical and mental health, and also related to the quality of care provided, rates of absenteeism and sick leave; identifying related factors for the syndrome are needed. The aim was to determine the prevalence, levels, and factors related to the burnout syndrome, measured with the Copenhagen Burnout Inventory in midwives. A systematic review and meta-analysis were selected from CINAHL, LILACS, ProQuest, PsycINFO, PubMed, SciELO, and Scopus databases, with the search equation “burnout AND (midwife OR midwives OR nurses midwives)”. Fourteen articles were found with a total of 8959 midwives. Most of the studies showed moderate levels of personal burnout. The prevalence obtained was 50% (95% CI = 38–63) for personal burnout; 40% (95% CI = 32–49) for work-related burnout; and 10% (95% CI = 7–13) for client-related burnout. Midwives’ age, less experience, and living alone constitute the main related factors, as well as, the scarcity of resources, work environment, and the care model used. Most midwives present personal and work-related burnout, which indicates a high risk of developing burnout. Personal factors and working conditions should be taken into account when assessing burnout risk profiles of midwives.

(1) Background: Inflammatory bowel diseases are pathologies of unknown etiology and auto-immune pathogenia. The use of probiotics is studied in order to increase the arsenal of treatments. The aim was to assess the efficacy of the probiotics in these diseases in the active or quiescent phases; (2) Methods: A systematic review with meta-analysis was performed by an exhaustive bibliographic search in Medline, Cinahl, Embase, Scopus, Web of Science, and Cochrane Library. The inclusion criteria were studies of more than 10 years, English/Spanish, clinical trials, and involving human beings. Relative risk was used to compare efficacy, which was meta-analyzed using a fixed effects model. Heterogeneity was evaluated with the Higgins I2 test; (3) Results: Nineteen studies were included in the systematic review and 17 in the meta-analysis, with a total of 1537 patients (nexperimental group = 762; nplacebo group = 775). There are significant remission differences in ulcerative colitis (relative risk (RR) = 0.81; 95% CI = 0.72–0.91; I2 = 32%; p = 0.16). However, no significant differences were found in the use of probiotics for the prevention of ulcerative colitis, and for the remission of Crohn’s disease; (4) Conclusions: There are data showing an additional beneficial effect of probiotics on active ulcerative colitis. More and better studies are needed which assess its possible therapeutic efficacy for quiescent ulcerative colitis and for Crohn’s disease.

Palliative care nurses are exposed to hard situations, death, and duel feelings in their daily practice. These, and other work stressors, can favor burnout development. Thus, it is important to analyze the prevalence and risk factors of burnout in palliative care nurses and estimate its prevalence. A systematic review and meta-analysis was done with quantitative primary studies. n = 15 studies were included with n = 6 studies including information for the meta-analysis. The meta-analytic prevalence estimation of emotional exhaustion was 24% (95% CI 16–34%), for depersonalization was 30% (95% CI 18–44%) and for low personal accomplishment was 28% with a sample of n = 693 palliative care nurses. The main variables related with burnout are occupational variables followed by psychological variables. Some interventions to improve working conditions of palliative care nurses should be implemented to reduce burnout.

Companies, in order to increase their competitiveness in a changing environment, demand innovative people. They must be able to measure the innovative competence of individuals. Universities, meanwhile, are training future professionals and have raised the need to strengthen and work the innovation skills of their students, thus promoting access to employment and in turn increasing the competitiveness of both companies and the society. Through this literature review (27 references), innovation competence in the professional field is addressed by studying how companies detect and measure competence of their workers. Moreover, it analyzes how universities work this competence with their students.

In this paper we present the creation process of a corpus of phrases (opinions) related to learning computer programming. Opinions (textual phrases) are categorized in different emotions related to learning such as frustration, boring, excitement, and engagement. The results shows that in 851 opinions (754 Positives and 97 Negatives), there was a neutral, excited and engaged emotional tendency which indicates that we must include resources that induce students to write negative comments. We tested the corpus with a set of machine learning classifiers where the classifier with the highest score was Bernoulli Naive Bayes with an accuracy of 76.77%.

Background: Nursing burnout is an important problem that affects nurses&rsquo, wellness, the quality of care and the health institutions. Study aims were to estimate levels of burnout, to determine the phase of burnout experienced by nurses in the medical area, to analyse the relationship between burnout and personality and psychological factors. Methods: Quantitative, cross-sectional, multicentre study. Hospitals from eight cities were included. The study sample was n = 301 nurses, working in the medical area of hospitals in the Andalusian Health Service during the second semester of 2017. Sociodemographic, occupational and personality variables were studied using the Revised NEO Personality Inventory together with the Educational-Clinical Questionnaire: Anxiety and Depression, and burnout was measured by the Maslach Burnout Inventory. Results: Almost 40% of the nurses presented high levels of burnout. The three burnouts (emotional exhaustion, depersonalisation and personal accomplishment) presented statistically significant correlations with the personality factors of neuroticism, extraversion, openness, agreeableness and conscientiousness, and also with the scores recorded for anxiety and depression. Multiple linear regression models showed agreeableness and depression to be statistically significant predictors of all dimensions of the syndrome. Conclusion: Hospital nurses working in the medical area in Andalusia experience high levels of burnout.

Research findings concerning burnout prevalence rate among nurses from the medical area are contradictory. The aim of this study was to analyse associated factors, to determine nurse burnout levels and to meta-analyse the prevalence rate of each burnout dimension. A systematic review, with meta-analysis, was conducted in February 2018, consulting the next scientific databases: PubMed, CUIDEN, CINAHL, Scopus, LILACS, PsycINFO and ProQuest Health &amp, Medical Complete. In total, 38 articles were extracted, using a double-blinded procedure. The studies were classified by the level of evidence and degrees of recommendation. The 63.15% (n = 24) of the studies used the MBI. High emotional exhaustion was found in the 31% of the nurses, 24% of high depersonalisation and low personal accomplishment was found in the 38%. Factors related to burnout included professional experience, psychological factors and marital status. High emotional exhaustion prevalence rates, high depersonalisation and inadequate personal accomplishment are present among medical area nurses. The risk profile could be a single nurse, with multiple employments, who suffers work overload and with relatively little experience in this field. The problem addressed in this study influence the quality of care provided, on patients&rsquo, well-being and on the occupational health of nurses.

Background . This study aimed to clarify the combinatorial treatment effect of agents as aspirin and ticlopidine associated with vincristine in the management of Kasabach–Merritt phenomenon (KMP), a severe thrombocytopenic coagulopathy that occurs in the presence of an enlarging vascular tumor such as kaposiform hemangioendothelioma (KHE) and tufted angioma (TA). Procedure . A retrospective review was conducted of medical records of all children with diagnosis of KHE or TA associated with KMP treated with vincristine–aspirin–ticlopidine (VAT) therapy at two different institutions in the same country from 1994 to 2011. Clinical features, response to VAT therapy and outcomes were recorded. Results . Eleven patients (mean age 11 months, range 0–36), including seven females (64%) and four males (36%), were identified. Seven patients underwent incisional biopsy and two different histologies were found, KHE in four patients and TA in three patients. Tumors were located in the head and neck (n = 5), chest wall (n = 2), arm (n = 2) and retroperitoneum (n = 2). Mean platelet level was 10,200/mm3 (range 4,000–21,000). A plaque-like lesion with ecchymosis was the most common cutaneous manifestation (63%). All patients underwent VAT therapy. Mean duration of treatment was 3.9 months for vincristine, 13.9 months for aspirin, and 13.4 months for ticlopidine. All patients are alive with a mean follow-up of 4.5 years (range, 2–17). Conclusions . Antiaggregant therapy is helpful in combination with vincristine in the treatment of KMP associated with KHE and TA. Prognosis is excellent if severe thrombocytopenia is controlled despite failure in reduction of tumor size. Pediatr Blood Cancer 2013;60:1478–1481. © 2013 Wiley Periodicals, Inc.

This paper describes the basic design, implementation, and testing of a polarization difference imaging system for use on aqueous targets. The ultimate performance limitation of THz imaging in many active areas of research is clutter from surface geometry. While the signal to nose ratio (SNR) of standard THz imaging systems is quite large, the signal to clutter ratio (SCR) often faced in an imaging application is orders of magnitude lower and, in many cases, lower than the contrast to noise (CNR) resulting in imagery where the contrast mechanism of interest does not significantly contribute to the overall observed contrast. To overcome these limitations we develop a system that uses a circularly polarized source and linearly polarized detectors to acquire images of transverse electric (TE) and transverse magnetic (TM) reflectivities of the target over the same field of view. Geletin based tissue mimicking phantoms are fabricated with spatially varying water content and modified with a range of surface topologies and surface roughness. TE and TM images are combined to yield self-calibrated clutter-suppressed images. The resulting image indicates that the imaging field clutter affected both polarization channels nearly equally allowing the system to resolve differences in phantom water content. This design is a step toward windowless THz imaging capability critical for clinical translation where patient imaging is dominated by clutter.

This report describes the development of the design of an advanced dry feed system that was carried out under Task 4.0 of Cooperative Agreement DE-FE0007902 with the US DOE, “Scoping Studies to Evaluate the Benefits of an Advanced Dry Feed System on the use of Low- Rank Coal.” The resulting design will be used for the advanced technology IGCC case with 90% carbon capture for sequestration to be developed under Task 5.0 of the same agreement. The scope of work covered coal preparation and feeding up through the gasifier injector. Subcomponents have been broken down into feed preparation (including grinding and drying), low pressure conveyance, pressurization, high pressure conveyance, and injection. Pressurization of the coal feed is done using Posimetric1 Feeders sized for the application. In addition, a secondary feed system is described for preparing and feeding slag additive and recycle fines to the gasifier injector. This report includes information on the basis for the design, requirements for down selection of the key technologies used, the down selection methodology and the final, down selected design for the Posimetric Feed System, or PFS.