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Management of hard-to-heal wounds remains a significant challenge for healthcare systems, with substantial economic burdens. Maggot debridement therapy, using sterile larvae of Lucilia sericata , effectively debrides necrotic tissue and promotes healing, yet its use is limited. This narrative review examines the influences on the use of this form of debridement by registered nurses, focusing on knowledge and attitudes, treatment-related pain, and practical issues. Findings indicate that wound specialist nurses are more knowledgeable and supportive of maggot debridement therapy compared with non-wound specialists, underscoring the need for targeted educational interventions. Pain management is critical, with mixed reports on pain levels, highlighting the necessity for tailored pain-relief strategies. Practical challenges include procurement difficulties and cost, suggesting a need for streamlined processes and clear clinical guidelines. Addressing these barriers through education, research, and improved logistics could enhance the acceptance and use of maggot debridement therapy, improving patient outcomes in wound management.

Objective: To better understand the value of DNR orders for critically ill infants in the NICU., Methods: A prospective mixed-methods approach was utilized including chart review of infants who died in a regional NICU over a twenty-six-month period and surveys of their neonatologists, neonatal fellows, and nurses., Results: 40 infants died during the study period and 120 staff surveys were completed. Infants with DNR orders were of a higher gestational age at birth and a higher chronological age at death. Nurses were more likely to perceive benefit from DNR orders than physicians. Medical staff recollection of the existence of DNR orders was not always accurate. Time and fear of adding unnecessary emotional burden to parents were identified as barriers to DNR order implementation. An advanced care planning model built on open communication instead of DNR order documentation was deemed the best approach., Conclusion: Though DNR orders are beneficial for a subset of infants, DNR orders are likely not applicable for all infants who die in the NICU. More important is supportive, individualized communication between families and the medical team to ensure quality end-of-life care., Impact: In the adult and pediatric ICU literature, DNR orders are associated with improved qualitative "good death" assessments and decreased familial decision regret. In the NICU, rates of DNR usage aren't well reported and their overall utility is unclear. Though DNR orders can help guide clinical decision making in the NICU and may be associated with higher quality ethical discussion, our data suggest that they are not applicable in all patient cases. We hope that this work will help guide approaches to end-of-life care in the NICU and underscore the importance of frequent, open communication between families and their medical team., (© 2024. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.)

We present linked field and laboratory studies investigating controls on enhanced nitrate processing during infiltration for managed aquifer recharge. We examine how carbon-rich permeable reactive barriers (PRBs) made of woodchips or biochar, placed in the path of infiltrating water, stimulate microbial denitrification. In field studies with infiltration of 0.2-0.3 m/day and initial nitrate concentrations of [NO 3 -N] = 20-28 mg/L, we observed that woodchips promoted 37 ± 6.6% nitrate removal (primarily via denitrification), and biochar promoted 33 ± 12% nitrate removal (likely via denitrification and physical absorption effects). In contrast, unamended soil at the same site generated <5% denitrification. We find that the presence of a carbon-rich PRB has a modest effect on the underlying soil microbial community structure in these experiments, indicating that existing consortia have the capability to carry out denitrification given favorable conditions. In laboratory studies using intact cores from the same site, we extend the results to quantify how infiltration rate influences denitrification, with and without a carbon-rich PRB. We find that the influence of both PRB materials is diminished at higher infiltration rates (>0.7 m/day) but can still result in denitrification. These results demonstrate a quantitative relationship between infiltration rate and denitrification that depends on the presence and nature of a PRB. Combined results from these field and laboratory experiments, with complementary studies of denitrification during infiltration through other soils, suggest a framework for understanding linked hydrologic and chemical controls on microbial denitrification (and potentially other redox-sensitive processes) that could improve water quality during managed recharge.

We present results from field experiments linking hydrology, geochemistry, and microbiology during infiltration at a field site that is used for managed aquifer recharge (MAR). These experiments measured how a horizontal permeable reactive barrier (PRB) made of woodchips impacted subsurface nitrate removal and microbial ecology. Concentrations of dissolved organic carbon consistently increased in infiltrating water below the PRB, but not in un-amended native soil. The average nitrate removal rate in soils below the PRB was 1.5 g/m 2 /day NO 3 -N, despite rapid infiltration (up to 1.9 m/d) and a short fluid residence time within the woodchips (≤6 h). In contrast, 0.09 g/m 2 /day NO 3 -N was removed on average in native soil. Residual nitrate in infiltrating water below the PRB was enriched in δ 15 N and δ 18 O, with low and variable isotopic enrichment factors that are consistent with denitrification during rapid infiltration. Many putative denitrifying bacteria were significantly enhanced in the soil below a PRB; Methylotenera mobilis and genera Microbacterium, Polaromonas, and Novosphingobium had log 2 fold-changes of +4.9, +5.6, +7.2, and +11.8, respectively. These bacteria were present before infiltration and were not enhanced in native soil. It appears that the woodchip PRB contributed to favorable conditions in the underlying soil for enhanced nitrate removal, quantitatively shifting soil microbial ecology. These results suggest that using a horizontal PRB could improve water quality during rapid infiltration for MAR., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Citrobacter sp. strain TSA-1 is an enteric bacterium isolated from the hindgut of the termite. Strain TSA-1 displays anaerobic growth with selenite, fumarate, tetrathionate, nitrate, or arsenate serving as electron acceptors, and it also grows aerobically. In regards to arsenate, genome sequencing revealed that strain TSA-1 lacks a homolog for respiratory arsenate reductase, arrAB, and we were unable to obtain amplicons of arrA. This raises the question as to how strain TSA-1 achieves As(V)-dependent growth. We show that growth of strain TSA-1 on glycerol, which it cannot ferment, is linked to the electron acceptor arsenate. A series of transcriptomic experiments were conducted to discern which genes were upregulated during growth on arsenate, as opposed to those on fumarate or oxygen. For As(V), upregulation was noted for 1 of the 2 annotated arsC genes, while there was no clear upregulation for tetrathionate reductase (ttr), suggesting that this enzyme is not an alternative to arrAB as occurs in certain hyperthermophilic archaea. A gene-deletion mutant strain of TSA-1 deficient in arsC could not achieve anaerobic respiratory growth on As(V). Our results suggest that Citrobacter sp. strain TSA-1 has an unusual and as yet undefined means of achieving arsenate respiration, perhaps involving its ArsC as a respiratory reductase as well as a detoxifying agent.

Failure carries undeniable stigma and is difficult to confront for individuals, teams, and organizations. Disciplines such as commercial and military aviation, medicine, and business have long histories of grappling with it, beginning with the recognition that failure is inevitable in every human endeavor. Although conservation may arguably be more complex, conservation professionals can draw on the research and experience of these other disciplines to institutionalize activities and attitudes that foster learning from failure, whether they are minor setbacks or major disasters. Understanding the role of individual cognitive biases, team psychological safety, and organizational willingness to support critical self-examination all contribute to creating a cultural shift in conservation to one that is open to the learning opportunity that failure provides. This new approach to managing failure is a necessary next step in the evolution of conservation effectiveness., (© 2017 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.)

The hope for creating widespread change in social values has endured among conservation professionals since early calls by Aldo Leopold for a "land ethic." However, there has been little serious attention in conservation to the fields of investigation that address values, how they are formed, and how they change. We introduce a social-ecological systems conceptual approach in which values are seen not only as motivational goals people hold but also as ideas that are deeply embedded in society's material culture, collective behaviors, traditions, and institutions. Values define and bind groups, organizations, and societies; serve an adaptive role; and are typically stable across generations. When abrupt value changes occur, they are in response to substantial alterations in the social-ecological context. Such changes build on prior value structures and do not result in complete replacement. Given this understanding of values, we conclude that deliberate efforts to orchestrate value shifts for conservation are unlikely to be effective. Instead, there is an urgent need for research on values with a multilevel and dynamic view that can inform innovative conservation strategies for working within existing value structures. New directions facilitated by a systems approach will enhance understanding of the role values play in shaping conservation challenges and improve management of the human component of conservation., (© 2016 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.)

Anisotropic conductive adhesives (ACAs) are widely used as interconnect materials in the manufacturing of LCD screens. To be integrated in a broader range of applications, several technical and economical issues still need to be addressed. Encapsulating the polymer particles within continuous, compact, and adhering metallic conductive shells is one of these challenges. This work describes a method for depositing nickel layers with different thickness (30-120nm) onto monosized polymer particles. The novelty of the approach consists in modifying the surface of polymer particles with linear polymeric amines. We show that by increasing amine chain length the structure and adhesion of deposited nickel shell are significantly improved. The effect of key parameters of the electroless Ni plating are discussed and illustrated., (Copyright © 2012 Elsevier Inc. All rights reserved.)