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Embedding climate resilient development principles in planning, urban design, and architecture means ensuring that transformation of the built environment helps achieve carbon neutrality, effective adaptation, and well-being for people and nature. Planners, urban designers, and architects are called to bridge the domains of research and practice and evolve their agency and capacity, developing methods and tools consistent across spatial scales to ensure the convergence of outcomes towards targets. Shaping change necessitates an innovative action-driven framework with multi-scale analysis of urban climate factors and co-mapping, co-design, and co-evaluation with city stakeholders and communities. This Element provides analysis on how urban climate factors, system efficiency, form and layout, building envelope and surface materials, and green/blue infrastructure affect key metrics and indicators related to complementary aspects like greenhouse gas emissions, impacts of extreme weather events, spatial and environmental justice, and human comfort. This title is also available as open access on Cambridge Core.
The use of diagnostic technology at the bedside is increasingly common in hospitals and is spreading to EMS.
Objectives:
To detect the contexts in which the use of point-of-care blood test and ultrasound is feasible and provides benefit in an EMT1 fixed.
Method/Description:
Review of the procedures of the SAMUR-Protección Civil and the bibliography that supports them. Summary of the publications carried out by our group.
Results/Outcomes:
The basic blood analysis with blood gases, biochemistry and electrolytes allows to detect electrolyte disturbances secondary to gastrointestinal infection, diabetic decompensation, and others, to estimate the severity of a trauma patient that is not clearly unstable, to guide resuscitation in shock, to study the patient with chest pain, to assess organic involvement in infectious conditions, etc.
The use of ultrasound at the bedside has shown to be a great diagnostic aid in many pathologies: trauma (frequent in the context of a catastrophe), COVID-19 (detection of infiltrates), cardiorespiratory arrest (reversible causes), pulmonary embolism (high risk in people trapped), study of collections and abscesses, heart disease, etc. and it is useful for multiple techniques such as vascular cannulations (peripheral and central), orotracheal intubation, and drainage.
The ESP EMT1 SAMUR-PC is equipped with ultrasound and point-of care blood analysis, as well as our ALS units in Madrid.
Conclusion:
The inclusion of ultrasound and blood tests among the diagnostic capabilities of an EMT1 fixed can improve the ability to detect serious pathology and guide initial treatment.
Data-based methods have gained increasing importance in engineering. Success stories are prevalent in areas such as data-driven modeling, control, and automation, as well as surrogate modeling for accelerated simulation. Beyond engineering, generative and large-language models are increasingly helping with tasks that, previously, were solely associated with creative human processes. Thus, it seems timely to seek artificial-intelligence-support for engineering design tasks to automate, help with, or accelerate purpose-built designs of engineering systems for instance in mechanics and dynamics, where design so far requires a lot of specialized knowledge. Compared with established, predominantly first-principles-based methods, the datasets used for training, validation, and test become an almost inherent part of the overall methodology. Thus, data publishing becomes just as important in (data-driven) engineering science as appropriate descriptions of conventional methodology in publications in the past. However, in mechanics and dynamics, quite widely, still traditional publishing practices are prevalent that largely do not yet take into account the rising role of data as much as that may already be the case in pure data-scientific research. This article analyzes the value and challenges of data publishing in mechanics and dynamics, in particular regarding engineering design tasks, showing that the latter raise also challenges and considerations not typical in fields where data-driven methods have been booming originally. Researchers currently find barely any guidance to overcome these challenges. Thus, ways to deal with these challenges are discussed and a set of examples from across different design problems shows how data publishing can be put into practice.
The establishment of the possible presence of life on Mars (past or present) is based on the study of planetary analogues, which allow in situ analysis of the environments in which living organisms adapt to often extreme conditions. Although Mars has been a candidate for hosting life, based on observations made decades ago, it is thanks to the characteristics identified in environments, mainly volcanic, that it has been possible to calibrate instruments and detail the features of the red planet. In this paper, we present a review of the main characteristics of different planetary analogues, particularly deepening the study of Antarctica, to later expose the factors studied in Deception Island that have contributed to considering it as an analogue of Mars from different perspectives. Although geological and geomorphological studies on the analogies of the island already exist, detailed analyses that present the approach of astrobiological analogues are required, thus allowing further research.
Traditional approaches for evaluating the impact of scientific research – mainly scholarship (i.e., publications, presentations) and grant funding – fail to capture the full extent of contributions that come from larger scientific initiatives. The Translational Science Benefits Model (TSBM) was developed to support more comprehensive evaluations of scientific endeavors, especially research designed to translate scientific discoveries into innovations in clinical or public health practice and policy-level changes. Here, we present the domains of the TSBM, including how it was expanded by researchers within the Implementation Science Centers in Cancer Control (ISC3) program supported by the National Cancer Institute. Next, we describe five studies supported by the Penn ISC3, each focused on testing implementation strategies informed by behavioral economics to reduce key practice gaps in the context of cancer care and identify how each study yields broader impacts consistent with TSBM domains. These indicators include Capacity Building, Methods Development (within the Implementation Field) and Rapid Cycle Approaches, implementing Software Technologies, and improving Health Care Delivery and Health Care Accessibility. The examples highlighted here can help guide other similar scientific initiatives to conceive and measure broader scientific impact to fully articulate the translation and effects of their work at the population level.
Peanut (Arachis hypogaea L.) and maize (Zea mays L.) are essential crops for Ghana’s economy and food security, but weed infestation poses a significant threat to their cultivation. Crop rotations influence weed communities, but little is known about these processes in peanut-cropping systems in West Africa. This study investigated the impact of different crop rotations and input levels on weed communities in Ghana over 3 yr. Results showed that low inputs (absence of herbicide and fertilization) favored species richness, while higher input levels (weed control with herbicides and fertilizer use) reduced it. Diversity and evenness were also affected by inputs, with varying patterns across locations and seasons. Weed population growth rates (λ) varied significantly by location and treatment; all management programs resulted in increasing weed populations. Principal component analysis revealed distinct associations between weed species and crop management. The majority of weed species exhibited a generalist behavior and did not associate with a particular management. However, billygoat weed (Ageratum conyzoides L.) and Benghal dayflower (Commelina benghalensis L.) were positively associated with high-input systems, while purple nutsedge (Cyperus rotundus L.) exhibited strong associations with low and medium inputs. The weed–crop rotation dynamics described here demonstrate how management drives the selection of weed species that are more pervasive and interfere with important food crops in Ghanaian agriculture.
En este artículo se estudia la representación discursiva de las identidades no normativas en un producto paradigmático de la industria mediática colombiana, la revista SoHo. Las preguntas que guiaron esta investigación fueron: ¿Cómo la revista SoHo (1999–2014) representa a las mujeres trans y a las masculinidades no normativas, en particular al metrosexual?; ¿qué estrategias discursivas son usadas para construir dicha representación?; y, ¿cómo la revista SoHo contribuye a cuestionar o fortalecer la cisheteronormatividad? Se sostiene que en SoHo se construye discursivamente a dichos individuos desde una mirada espectacularizante, reivindicando la cisheterosexualidad como natural y normal, y la masculinidad como propia del cuerpo del hombre cisgénero. Para demostrar lo anterior, se examinaron las estrategias discursivas utilizadas para construir dichas identidades a través de un enfoque interdisciplinar que combina los estudios culturales (latinoamericanos) y de género/queer con la lingüística queer. Este trabajo es un aporte para nuevas investigaciones en torno a la representación de las identidades sexo-genéricamente marginalizadas en la industria mediática colombiana.
Knowledge of sex differences in risk factors for posttraumatic stress disorder (PTSD) can contribute to the development of refined preventive interventions. Therefore, the aim of this study was to examine if women and men differ in their vulnerability to risk factors for PTSD.
Methods
As part of the longitudinal AURORA study, 2924 patients seeking emergency department (ED) treatment in the acute aftermath of trauma provided self-report assessments of pre- peri- and post-traumatic risk factors, as well as 3-month PTSD severity. We systematically examined sex-dependent effects of 16 risk factors that have previously been hypothesized to show different associations with PTSD severity in women and men.
Results
Women reported higher PTSD severity at 3-months post-trauma. Z-score comparisons indicated that for five of the 16 examined risk factors the association with 3-month PTSD severity was stronger in men than in women. In multivariable models, interaction effects with sex were observed for pre-traumatic anxiety symptoms, and acute dissociative symptoms; both showed stronger associations with PTSD in men than in women. Subgroup analyses suggested trauma type-conditional effects.
Conclusions
Our findings indicate mechanisms to which men might be particularly vulnerable, demonstrating that known PTSD risk factors might behave differently in women and men. Analyses did not identify any risk factors to which women were more vulnerable than men, pointing toward further mechanisms to explain women's higher PTSD risk. Our study illustrates the need for a more systematic examination of sex differences in contributors to PTSD severity after trauma, which may inform refined preventive interventions.
Abdominal obesity (AO) is characterised by excess adipose tissue. It is a metabolic risk that affects the physical and mental health, particularly in women since they are more prone to mental health problems like depression. This study investigated the association between AO and depressive symptoms in Peruvian women of reproductive age (18–49 years).
Design:
This is a cross-sectional observational study.
Setting:
Peruvian women population of reproductive age.
Participants:
We used data from the Peruvian Demographic and Family Health Survey (DHS) for 2018 and 2019 to assess 17 067 women for the presence of depressive symptoms (using the Patient Health Questionnaire (PHQ-9): cut-off score ≥ 10) and AO (measured by abdominal circumference; cut-off score ≥88 cm).
Results:
We observed a 64·55 % prevalence of AO and 7·61 % of depressive symptoms in the study sample. Furthermore, 8·23 % of women with AO had depressive symptoms (P < 0·05). Initially, women with AO appeared to have a 26 % higher risk of depressive symptoms compared with women without AO (P = 0·028); however, after adjustment for covariates, no statistically significant association was observed.
Conclusions:
Therefore, although both conditions are common in women of this age group, no significant association was found between AO and depressive symptoms.
As a continuation of the work of the third author in [5], we make further observations on the features of Galois cohomology in the general model theoretic context. We make explicit the connection between forms of definable groups and first cohomology sets with coefficients in a suitable automorphism group. We then use a method of twisting cohomology (inspired by Serre’s algebraic twisting) to describe arbitrary fibres in cohomology sequences—yielding a useful “finiteness” result on cohomology sets.
Applied to the special case of differential fields and Kolchin’s constrained cohomology, we complete results from [3] by proving that the first constrained cohomology set of a differential algebraic group over a bounded, differentially large, field is countable.
Trematodes of the family Allocreadiidae are primarily found in the intestines of freshwater fishes around the world. The family includes 15 genera and c. 130 species. The last 2 decades have witnessed an increase in the genetic library of its species. Molecular data have been crucial for species delimitation and species description within Allocreadiidae and for understanding their evolutionary and biogeographical history and classification. Here, the mitogenomes of 3 species of allocreadiids were obtained using high throughput sequencing methods. Mitogenomes were compared with other members of the order Plagiorchiida to determine their molecular composition, gene rearrangement and phylogenetic interrelationships. The complete circular mitogenomes of Allocreadium lobatum, Creptotrematina aguirrepequenoi and Wallinia mexicana were 14 424, 13 769 and 13 924 bp long respectively, comprising 12 protein-coding genes, 22 transfer RNA genes, 2 ribosomal RNA genes and 2 non-coding regions. Gene arrangements were identical to other Xiphidiatan trematodes. Phylogenetic analyses using the mitogenomes revealed Allocreadiidae as a monophyletic group closely related to other members of the suborder Xiphidiata; A. lobatum was yielded as the sister taxon of C. aguirrepequenoi + W. mexicana. Our study increases the complete mitochondrial genome library of trematodes and strengthens our understanding of the phylogenetic relationships and classification of this parasite group.
Radiotherapy for pediatric brain tumor has been associated with late cognitive effects. Compared to conventional photon radiotherapy (XRT), proton radiotherapy (PRT) delivers less radiation to healthy brain tissue. PRT has been associated with improved long term cognitive outcomes compared to XRT. However, there is limited research comparing the effects of XRT and PRT on verbal memory outcomes.
Participants and Methods:
Survivors of pediatric brain tumor treated with either XRT (n = 29) or PRT (n = 51) completed neuropsychological testing > 1 year following radiotherapy. XRT and PRT groups were similar with respect to sex, handedness, race, age at diagnosis, age at evaluation, tumor characteristics, and treatment history (i.e., craniospinal irradiation, craniotomy, shunting, chemotherapy, radiation dose). Verbal learning and memory were assessed using the age-appropriate version of the California Verbal Learning Test (CVLT-II/CVLT-C). Measures of intellectual functioning, executive functioning, attention and adaptive behavior were also collected. Performance on neuropsychological measures was compared between treatment groups (XRT vs. PRT) using analysis of covariance (ANCOVA). On the CVLT, each participant was classified as having an encoding deficit profile (i.e., impaired learning, recall, and recognition), retrieval deficit profile (i.e., impaired recall but intact recognition), intact profile, or other profile. Chi-squared tests of independence were used to compare the probability of each memory profile between treatment groups. Pearson correlation was used to examine associations between memory performance and strategy use, intellectual functioning, adaptive behavior, attention, and executive functioning.
Results:
Overall, patients receiving PRT demonstrated superior verbal learning (CVLT Trials 1-5; t(76) = 2.61, p = .011), recall (CVLT Long Delay Free; t(76) = 3.57, p = .001) and strategy use (CVLT Semantic Clustering; t(76) = 2.29, p = .025) compared to those treated with XRT. Intact performance was more likely in the PRT group than the XRT group (71% PRT, 38% XRT; X2 = 8.14, p = .004). Encoding and retrieval deficits were both more common in the XRT group, with encoding problems being most prevalent (Encoding Deficits: 31% XRT, 12% PRT, X2 = 4.51, p = .034; Retrieval Deficits: 17% XRT, 4% PRT, X2 = 4.11, p = .043). Across all participants, semantic clustering predicted better encoding (r = .28, p = .011) and retrieval (r = .26, p = .022). Better encoding predicted higher intellectual (r = .56, p < .001) and adaptive functioning (r = .30, p = .011), and fewer parent-reported concerns about day-today attention (r = -.36, p = .002), and cognitive regulation (r = -.35, p = .002).
Conclusions:
Results suggest that PRT is associated with superior verbal memory outcomes compared to XRT, which may be driven by encoding skills and use of learning strategies. Moreover, encoding ability predicted general intellectual ability and day-to-day functioning. Future work may help to clarify underlying neural mechanisms associated with verbal memory decline following radiotherapy, which will better inform treatment approaches for survivors of pediatric brain tumor.
In Australia, 18F-fluorodeoxyglucose positron emission tomography with low-dose computed tomography (FDG-PET/CT) is currently only funded for cancer staging-related indications. A recent multicenter randomized trial demonstrated that FDG-PET/CT, compared with standard of care computed tomography (CT) imaging, improved antimicrobial management and the outcomes of patients with persistent and recurrent neutropenic fever. There is potential value in expanding the use of FDG-PET/CT as a diagnostic tool for this high-risk population. We conducted an economic evaluation from a healthcare perspective alongside the randomized trial and compared FDG-PET/CT with standard CT up to 6 months after the scans.
Methods
Case report forms were used to collect resource utilization data and length of hospitalization. Effectiveness was measured as the number of patients with antimicrobial rationalization and quality-adjusted life-years (QALYs) derived from patient-reported trial-based health-related quality of life. Generalized linear models (GLM) were used to analyze costs and outcomes. Incremental cost-effectiveness ratios (ICERs) for each of the outcomes were calculated and interpreted as the cost per patient with antimicrobial rationalization and cost per QALY gained. To account for sampling, we performed bootstrapping with 1,000 replications using the recycled predictions method.
Results
The adjusted healthcare costs were lower in the FDG-PET/CT group (mean AUD49,563, 95% confidence interval [CI]: 36,867, 65,133; equivalent to USD34,268, 95% CI: 25,490, 45,033) compared with the standard CT group (mean AUD57,574, 95% CI: 44,837, 73,347; equivalent to USD39,807, 95% CI: 31,000, 50,712). The magnitude of differences in QALYs between the two groups was small (0.001; 95% CI: -0.001, -0.001). When simulated 1,000 times, our analysis showed that across both outcomes FDG-PET/CT was the dominant strategy as it was cheaper and had better outcomes than standard CT in 74 percent of simulations.
Conclusions
FDG-PET/CT is cost effective when compared with standard CT for investigating persistent or recurrent neutropenic fever in high-risk patients. Aligning economic evaluations with clinical studies is key to an integrated evidence generation approach for supporting funding for FDG-PET/CT in this patient group.
Palmer amaranth (Amaranthus palmeri S. Watson) is the most problematic weed of cotton (Gossypium hirsutum L.)-cropping systems in the U.S. Southeast. Heavy reliance on herbicides has selected for resistance to multiple herbicide mechanisms of action. Effective management of this weed may require the integration of cultural practices that limit germination, establishment, and growth. Cover crops have been promoted as a cultural practice that targets these processes. We conducted a 2-yr study in Georgia, USA, to measure the effects of two annual cover crops (cereal rye [Secale cereale L.] and crimson clover [Trifolium incarnatum L.]), a perennial living mulch (‘Durana®’ white clover [Trifolium repens L.]), and a bare ground control on A. palmeri population dynamics. The study was conducted in the absence of herbicides. Growth stages were integrated into a basic demographic model to evaluate differences in population trajectories. Cereal rye and living mulch treatments suppressed weed seedling recruitment (seedlings seed−1) 19.2 and 13 times and 12 and 25 times more than the bare ground control, respectively. Low recruitment was correlated positively with low light transmission (photosynthetic active radiation: above canopy photosynthetically active radiation [PAR]/below cover crop PAR) at the soil surface. Low recruitment rates were also negatively correlated with high survival rates. Greater survival rates and reduced adult plant densities resulted in greater biomass (g plant−1) and fecundity (seeds plant−1) in cereal rye and living mulch treatments in both years. The annual rate of population change (seeds seed−1) was equivalent across all treatments in the first year but was greater in the living mulch treatment in the second year. Our results highlight the potential of annual cover crops and living mulches for suppressing A. palmeri seedling recruitment and would be valuable tools as part of an integrated weed management strategy.
Edited by
Dennis S. Chi, Memorial Sloan-Kettering Cancer Center, New York,Nisha Lakhi, Richmond University Medical Center, Staten Island,Nicoletta Colombo, University of Milan-Bicocca
Treatment of platinum-resistant ovarian cancer poses a challenge to oncologists, as this type of cancers is incurable, and no optimal or standard treatment exists. The available cytotoxic drugs show similar progression-free survival and overall survival rates; therefore, oncologists should consider each case individually and assess not only efficacy but also the possible impact on patient’s quality of life and risks of toxicity. This chapter explores the different treatment options for platinum-resistant ovarian cancer.
It has been estimated that 11% of United States ED patients have substance use disorder. One urban ED estimated that nearly 7% of visits were due to illicit drug use. In a large statewide review of ED visits, alcohol use disorder was more prevalent in rural settings while opioid use disorder was more prevalent in urban settings. Substance use leads to harmful outcomes such as acute injuries, overdose, and medical complications. Forensic laboratory data offers some insight on which drugs are commonly used in US cities. (Ethanol is not included in these reports, but is used ubiquitously and considered to be the most commonly used intoxicating drug.) Opioids, sympathomimetics, cannabinoids, and sedatives classes predominate in all US cities, although there is some regional variation of the specific drugs used among cities. In Baltimore, for example, the top four drugs identified are cocaine, fentanyl, heroin, and tramadol; in Phoenix, the top four are cannabis, fentanyl, heroin, and methamphetamines.
Public concern regarding the use of herbicides in urban areas (e.g., golf courses, parks, lawns) is increasing. Thus, there is a need for alternative methods for weed control that are safe for the public, effective against weeds, and yet selective to turfgrass and other desirable species. New molecular tools such as ribonucleic acid interference (RNAi) have the potential to meet all those requirements, but before these technologies can be implemented, it is critical to understand the perceptions of key stakeholders to facilitate adoption as well as regulatory processes. With this in mind, turfgrass system managers, such as golf course superintendents and lawn care providers, were surveyed to gain insight into the perception and potential adoption of RNAi technology for weed management. Based on survey results, turfgrass managers believe that cost of weed management and time spent managing weeds are the main challenges faced in their fields. When considering new weed management tools, survey respondents were most concerned about cost, efficacy, and efficiency of a new product. Survey respondents were also optimistic toward RNAi for weed management and would either use this technology in their own fields or be willing to conduct research to develop RNAi herbicides. Although respondents believed that the general public would have some concerns about this technology, they did not believe this to be the most important factor for them when choosing new weed management tools. The need for new herbicides to balance weed control challenges and public demands is a central factor for turfgrass managers’ willingness to use RNAi-based weed control in turfgrass systems. They believe their clientele will be accepting of RNAi tools, although further research is needed to investigate how a wider range of stakeholders perceive RNAi tools for turfgrass management more broadly.
Several hypotheses may explain the association between substance use, posttraumatic stress disorder (PTSD), and depression. However, few studies have utilized a large multisite dataset to understand this complex relationship. Our study assessed the relationship between alcohol and cannabis use trajectories and PTSD and depression symptoms across 3 months in recently trauma-exposed civilians.
Methods
In total, 1618 (1037 female) participants provided self-report data on past 30-day alcohol and cannabis use and PTSD and depression symptoms during their emergency department (baseline) visit. We reassessed participant's substance use and clinical symptoms 2, 8, and 12 weeks posttrauma. Latent class mixture modeling determined alcohol and cannabis use trajectories in the sample. Changes in PTSD and depression symptoms were assessed across alcohol and cannabis use trajectories via a mixed-model repeated-measures analysis of variance.
Results
Three trajectory classes (low, high, increasing use) provided the best model fit for alcohol and cannabis use. The low alcohol use class exhibited lower PTSD symptoms at baseline than the high use class; the low cannabis use class exhibited lower PTSD and depression symptoms at baseline than the high and increasing use classes; these symptoms greatly increased at week 8 and declined at week 12. Participants who already use alcohol and cannabis exhibited greater PTSD and depression symptoms at baseline that increased at week 8 with a decrease in symptoms at week 12.
Conclusions
Our findings suggest that alcohol and cannabis use trajectories are associated with the intensity of posttrauma psychopathology. These findings could potentially inform the timing of therapeutic strategies.
The Galapagos Islands lie within the oceanic ecoregion of the Tropical Eastern Pacific, which has a unique fish assemblage composition due to the influence of several ocean currents and El Niño Southern Oscillation (ENSO) events. In the El Niño phase of these events, water temperature changes facilitate the movement of fish species between oceanic ecoregions, as well as across the Eastern Pacific Barrier. Here, we present five new fish records for the Galapagos Marine Reserve based on underwater imagery. These include two rays (Mobula thurstoni and Myliobatis longirostris) and three bony fishes (Lobotes pacifica, Lutjanus colorado and Sphyraena stellata). Of these, the first species is proposed as potentially resident to the Galapagos, and the latter four as vagrant species in the Galapagos until further sightings can conclusively determine their status. The effects of ENSO, the use of underwater video technology, and the importance of up-to-date and accurate species listings to understand the impact of the climate crisis are discussed.
Studies on antiquities trafficking have often been overshadowed by research looking at the trafficking of human beings, drugs, and weapons, a fact partly motivated by the arguably higher relevance and greater security implications involved in these other forms of illicit trade. However, the past decade of conflicts in the Middle East has revived an interest in the study of antiquities trafficking networks.1 The association between the growing size of the illicit antiquities market and conflicts in the region did not go unnoticed by crime scientists and criminologists looking deeper at the relation between the trafficking of antiquities and transnational organized crime.2