Optimizing and Sustaining Clinical Outcomes in 88 US Hospitals Post-Pandemic: A Quality Improvement Initiative.

Background: Optimizing outcomes of hospitalized patients anchors on standardizing processes in medical management, interventions to reduce the risk of decompensation, and prompt intervention when a patient decompensates.

Methods: A quality improvement initiative (optimized sepsis and respiratory compromise management, reducing health care-associated infection and medication risk, swift management of the deteriorating patient, feedback on performance, and accountability) was implemented in a multistate health system. The primary outcome was risk-adjusted in-hospital mortality.

Remote sensing and spatial analysis reveal unprecedented cyanobacteria bloom dynamics associated with elephant mass mortality.

The 2020 mass mortality of 350 African elephants (Loxodonta africana) in Botswana sparked global concern, with cyanotoxins in watering holes (pans) being a suspected cause, though evidence remains inconclusive. Combining remote sensing and spatial analysis, we examined the relationship between the ecohydrology of ∼3000 pans and the locations of deceased elephants. Our analysis revealed a significant difference in the spatial distribution of fresh versus decayed carcasses (p < 0.

AI can help humans find common ground in democratic deliberation.

Finding agreement through a free exchange of views is often difficult. Collective deliberation can be slow, difficult to scale, and unequally attentive to different voices. In this study, we trained an artificial intelligence (AI) to mediate human deliberation.

Mapping taste and flavour traits to genetic markers in lettuce .

Lettuce is the most highly consumed raw leafy vegetable crop eaten worldwide, making it nutritionally important in spite of its comparatively low nutrient density in relation to other vegetables. However, the perception of bitterness caused by high levels of sesquiterpenoid lactones and comparatively low levels of sweet tasting sugars limits palatability. To assess variation in nutritional and taste-related metabolites we assessed 104 members of a cv.

Insights from a 10-year Australasian idiopathic hypersomnia patient data registry study.

Study Objectives: Idiopathic hypersomnia (IH) is a disorder of central hypersomnolence that results in excessive daytime sleepiness in the absence of another identifying cause. Case studies from sleep clinic patients may not be a fair representation of the wider IH population. This study aims to better characterize patients diagnosed with IH in Australia and New Zealand using online patient-driven survey data.

Implementing Safewards on Children and Young People's Wards: A Process and Outcomes Evaluation.

Safewards reduces conflict and containment on adult inpatient wards but there is limited research exploring the model in Children and Young People (CYP) mental health services. We investigated whether Safewards can be successfully implemented on twenty CYP wards across England. A process and outcomes evaluation was employed, utilizing the Integrated Promoting Action on Research Implementation in Health Sciences (i-PARiHS) framework.

Differential effects of exercise intensity and tolerable duration on exercise-induced diaphragm and expiratory muscle fatigue.

We investigated the effect of exercise intensity and tolerable duration on the development of exercise-induced diaphragm and expiratory muscle fatigue. Ten healthy adults (25 ± 5 yr; 2 females) cycled to intolerance on three separate occasions: ) 5% below critical power ( View Article and Find Full Text PDF

Low-Cost Approach to an Instream Water Depth Sensor Construction Using Differential Pressure Sensors and Arduino Microcontrollers.

Accurate hydrological data with high spatial resolution is important for flood risk and water resource management, particularly under the context of climate change. The cost of monitoring networks, as well as the characteristics of the hydrological environment itself, can be a barrier to meeting these data requirements, however. This study covers the design and testing of a low-cost, "build-it-yourself", instream water depth sensor providing an assessment of its potential in future hydrological monitoring projects.

Productivity declines threaten East African soda lakes and the iconic Lesser Flamingo.

Soda lakes are some of the most productive aquatic ecosystems. Their alkaline-saline waters sustain unique phytoplankton communities and provide vital habitats for highly specialized biodiversity including invertebrates, endemic fish species, and Lesser Flamingos (Phoeniconaias minor). More than three-quarters of Lesser Flamingos inhabit the soda lakes of East Africa; however, populations are in decline.

Examining provider practice-level disparities in delivery outcomes among patients with a history of Cesarean Delivery.

Background: Choosing whether to pursue a trial of labor after cesarean (TOLAC) or scheduled repeat cesarean delivery (SRCD) requires prenatal assessment of risks and benefits. Providers and patients play a central role in this process. However, the influence of provider-associated characteristics on delivery methods remains unclear.

The Dynamics of Locomotor Neuromuscular Fatigue during Ramp-Incremental Cycling to Intolerance.

Introduction: Traditional neuromuscular fatigue assessments are not task-specific and are unable to characterize neuromuscular performance decline during dynamic whole-body exercise. This study used interleaved maximal isokinetic cycling efforts to characterize the dynamics of the decline in neuromuscular performance during ramp-incremental (RI) cycle ergometry exercise to intolerance.

Methods: Eleven young healthy participants (10 male/1 female) performed two RI cycle ergometry exercise tests to intolerance: [1] RI-exercise with peak isokinetic power (Piso) at 80 rev·min-1 measured at baseline and immediately at intolerance from a maximal ~6 s effort; [2] RI-exercise where additional Piso measurements were interleaved every 90 s to characterize the decline in neuromuscular performance during the RI-test.

Implementation of Body Worn Camera: Practical and Ethical Considerations.

Body-worn cameras are increasingly being used as a violence prevention tool in inpatient mental health wards. However, there remains a limited understanding of this technology from an implementation perspective, such as protocols and best practice guidance if cameras are to be used in these settings. This study explores the perspectives of patients, mental health staff, and senior management to understand the practical and ethical issues related to the implementation of body-worn cameras.

DNA barcoding indicates multiple invasions of the freshwater snail Melanoides tuberculata sensu lato in Florida.

Melanoides tuberculata sensu lato (Thiaridae) are polymorphic female-clonal snails of Asian and African origins that have invaded freshwaters worldwide, including those in Florida. Although the snails have been documented in Florida for at least 70 years, no studies have investigated whether the observed distribution is due to a single introduction or multiple independent invasions. Here, cytochrome oxidase I was used to measure genetic diversity within and among sites in Florida and compare genetic diversity between Florida and other regions of the world.

Genotypes of subsp. grown in contrasting field environments differ on transcriptomic and metabolomic levels, significantly impacting nutritional quality.

Rocket ( subsp. ) is a source of sulfur-containing glucosinolates (GSLs). GSLs and their breakdown hydrolysis products (GHPs) are responsible for health-related benefits, such as anti-cancer and anti-neurodegenerative properties.

Establishing the health and wellbeing needs of mining host community in Brazil, Chile and Peru: a mixed-method approach to identify priority areas for action to help communities meet their SDG3 targets.

Background: The global mining industry is an important partner in advancing the 2030 Agenda for Sustainable Development. In 2018, Anglo American plc published their Sustainable Mining Plan, containing a goal for improving health and wellbeing aligned with the Sustainable Development Goal 3 (SDG3) targets. Having formed an independent multidisciplinary research consortium, we designed and implemented a mixed-methods approach to attain a deeper understanding of SDG3 priorities within the local context of communities hosting Anglo American mining operations located in Latin America.

Quantitative trait loci analysis of glucosinolate, sugar, and organic acid concentrations in Eruca vesicaria subsp. sativa.

Eruca vesicaria subsp. sativa is a leafy vegetable of the Brassicaceae family known for its pungency. Variation in growing conditions, leaf age, agronomic practices, and variety choice lead to inconsistent quality, especially in content of isothiocyanates (ITCs) and their precursor glucosinolates (GSLs).

A systematic review of economic evaluations of pharmacist services.

Background: Challenges to the provision of health care are occurring internationally and are expected to increase in the future, further increasing health spending. As pharmacist roles are evolving and expanding internationally to provide individualised pharmaceutical care it is important to assess the cost-effectiveness of these services.

Objectives: To systematically synthesise the international literature regarding published economic evaluations of pharmacy services to assess their cost-effectiveness and clinical outcomes.

Using the Veil of Ignorance to align AI systems with principles of justice.

The philosopher John Rawls proposed the Veil of Ignorance (VoI) as a thought experiment to identify fair principles for governing a society. Here, we apply the VoI to an important governance domain: artificial intelligence (AI). In five incentive-compatible studies ( = 2, 508), including two preregistered protocols, participants choose principles to govern an Artificial Intelligence (AI) assistant from behind the veil: that is, without knowledge of their own relative position in the group.

Exploring the use of body-worn cameras in acute mental health wards: A qualitative interview study with mental health patients and staff.

Background: Body-worn cameras are increasingly being used as a violence prevention tool in inpatient mental health wards. However, there is a dearth of research on their use in these settings, particularly when it comes to patient perspectives.

Objective: This study aimed to explore the perspectives of patients, mental health staff, and senior management on body-worn cameras to identify the possible impacts of this technology in inpatient mental health settings.

A function-based typology for Earth's ecosystems.

As the United Nations develops a post-2020 global biodiversity framework for the Convention on Biological Diversity, attention is focusing on how new goals and targets for ecosystem conservation might serve its vision of 'living in harmony with nature'. Advancing dual imperatives to conserve biodiversity and sustain ecosystem services requires reliable and resilient generalizations and predictions about ecosystem responses to environmental change and management. Ecosystems vary in their biota, service provision and relative exposure to risks, yet there is no globally consistent classification of ecosystems that reflects functional responses to change and management.

Corrigendum: The genome and transcriptome: A targeted analysis of sulfur metabolism and glucosinolate biosynthesis pre and postharvest.

[This corrects the article DOI: 10.3389/fpls.2020.

Hormone replacement therapy subcutaneous implants for refractory menopause symptoms; the patient's perspective.

Objective: For women with menopause symptoms refractory to standard hormone replacement therapy (HRT) preparations, HRT implants offer an alternative. The primary objective of this study was to evaluate women's perceptions regarding efficacy, tolerability, satisfaction and safety of implant therapy.

Study Design: A single centre service evaluation study performed at Birmingham Women's & Children's Foundation Hospital Trust.

KRAS mutation allele frequency threshold alters prognosis in right-sided resected pancreatic cancer.

Background: Next-generation sequencing (NGS) provides information on genetic mutations and mutant allele frequency in tumor specimens. We investigated the prognostic significance of KRAS mutant allele frequency in patients with right-sided pancreatic ductal adenocarcinoma (PDAC) treated with surgical resection.

Methods: A retrospective study reviewed patients who underwent surgical resection for PDAC and analyzed tumors with an in-house mutational panel.

Historical Analysis Exposes Catastrophic Seagrass Loss for the United Kingdom.

The spatial extent of seagrass is poorly mapped, and knowledge of historical loss is limited. Here, we collated empirical and qualitative data using systematic review methods to provide unique analysis on seagrass occurrence and loss in the United Kingdom. We document 8,493 ha of recently mapped seagrass in the United Kingdom since 1998.