Tornádo 2021 v České republice – psychosociální pomoc IZS v zasažených oblastech

The tornado hit the territory of several municipalities in South Moravia in the evening on Thursday, June 24, 2021. Although it was a relatively small area, the extent of the damage was extraordinary and of unprecedented proportions. Many people found themselves in direct danger of themselves and their loved ones. In psychology, we call such an event potentially traumatic, and we know from experience that it can have serious effects on the human psyche. The article aims to present how the system of psychosocial crisis intervention and psychological first aid provided by the Integrated Rescue System of the Czech Republic worked. This psychosocial assistance in the acute phase of a disaster builds the core of psychosocial help. There is a link to other organizations, which have their function mainly in the stabilization phase, in the medium and long-term care of the affected persons. We also consider it necessary to repeat the principles of psychosocial assistance in emergencies.

From theory to bedside: Implementation of fluid stewardship in a medical ICU pharmacy practice

Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Intravenous fluids are the most commonly prescribed medication in the intensive care unit (ICU) and can have a negative impact on patient outcomes if not utilized properly. Fluid stewardship aims to heighten awareness and improve practice in fluid therapy. This report describes a practical construct for implementation of fluid stewardship services and characterizes the pharmacist’s role in fluid stewardship practice. Summary Fluid stewardship services were integrated into an adult medical ICU at a large community hospital. Data characterizing these services over a 2-year span are reported and categorized based on the 4 rights (right patient, right drug, right route, right dose) and the ROSE (rescue, optimization, stabilization, evacuation) model of fluid administration. The review encompassed 305 patients totaling 905 patient days for whom 2,597 pharmacist recommendations were made, 19% of which were related to fluid stewardship. This corresponded to an average of 1.52 fluid stewardship recommendations per patient. Within the construct of the 4 rights, 39% of recommendations were related to the right patient, 33% were related to the right route, 17% were related to the right drug, and 11% were related to the right dose. By the ROSE model, 1% of recommendations were related to the rescue phase, 3% were related to optimization, 79% were related to stabilization, and 17% were related to evacuation. Conclusion Implementation of fluid stewardship pharmacy services in a community hospital medical ICU is feasible. Integration of this practice contributed to 19% of pharmacy recommendations. The most common recommendations involved evaluation of the patient for the appropriateness of fluid therapy during the stabilization phase. The impact of fluid stewardship on patient outcomes needs to be explored.

Lubricant Evaluation Technique for Single Point Incremental Forming Process

Single-point Incremental Forming (SPIF) is highly flexible dieless forming process suitable for a small batch production. The higher the feed rate and tool rotational speed, the higher the production rate will be. Therefore, the selection of the suitable lubricant is a key important factor to maintain the formability of the material when increasing the feed rate and tool rotational speed. This paper proposes the technique to evaluate and later on select the proper lubricant for these conditions. This technique was divided into two phases; 1) screening, and 2) stabilization. The screening phase is a quick method for preliminary selection of the lubricants. The stabilizing phase is a step to evaluate reliability as well as ensure efficiency of the lubricant throughout the process, because of the significant increase of the forming temperature which affects directly to the performance of the lubricant. Two types of lubricants, namely solid (Graphite) and liquid (Callington Calform NF-206) lubricants mixed with the base oil (coconut oil) at different ratios were tested. The cold rolled hot-dipped zinc-coated steel sheet with thickness of 0.176 mm. and wall angles of 45, 50, 55 and 60 degrees with the depth of each wall angle of 5 mm were used. During the screening phase, the fifteen mixtures firstly were tested by using the achieved maximum wall angles without fracture as a criterion. Later on, the lubricant mixtures which could successfully form at the wall angle of 60 degrees with the forming depth of 20 mm would be tested in the stabilization phase to evaluate the formability and the forming temperature. The results showed that during the screening phase 11 lubricants could perform successfully, while the stabilization phase with the wall angle of 60 degrees only 3 lubricants could successfully form the workpiece. Therefore, this evaluation technique could help to evaluate and, for later on, be a criterion to select the select lubricant.

Eurasian lynx populations in Western Europe: What prospects for the next 50 years?

Persistence of viable populations may be uncertain for large carnivore species, especially for those established in human-dominated landscapes. Here, we studied the Eurasian lynx in Western Europe established in the Upper Rhine metapopulation (i.e., Jura, Vosges-Palatinian and Black Forest populations) and in the Alpine population. These populations are currently considered as endangered or critically endangered due to high anthropogenic mortality and isolation. We assessed lynx persistence over a 50-year time horizon by implementing a spatially-explicit individual-based model while accounting for road mortality and habitat selection. For the Alpine and Jura populations, forecasts showed a steady growth rapidly reaching a stabilization phase with high resident female occupancy, and a positive growth for the newly re-established Vosges-Palatinian population. Moreover, this population showed a difference in female occupancy between the northern part, where a recent reintroduction program was conducted in the Palatinate Forest, and the southern part. Only the group of individuals in the Black Forest had an irregular growth probably due to the small number of only male lynx at start of the simulation and poor connectivity to surrounding populations. Exchanges of individuals between populations were limited, and the Jura population played the role of a crossroad. Persistence of lynx in Western Europe seems likely on a large scale over the next 50 years. However, lynx persistence in the southern part of the Vosges-Palatinian population and in the Black Forest appears challenging without long-term conservation management.

The Leaf Microbiota of Arabidopsis Displays Reproducible Dynamics And Patterns Throughout The Growing Season

Background: Leaves are primarily responsible for the plant's photosynthetic activity. Thus, changes in the leaf microbiota, which includes deleterious and beneficial microbes, can have far reaching effects on plant fitness and productivity. Identifying the processes and microorganisms that drive these changes over a plant’s lifetime is, therefore, crucial. In this study we analyzed the temporal dynamics in the leaf microbiota of Arabidopsis thaliana, integrating changes in both, composition and microbe-microbe interactions via the study of microbial networks.Results: Field-grown Arabidopsis were used to monitor leaf bacterial, fungal and oomycete communities throughout the plant’s growing season (extending from November to March) over three consecutive years. Our results revealed the existence of conserved temporal patterns, with microbial communities and networks going through a stabilization phase of decreased diversity and variability at the beginning of the plant’s growing season. Despite a high turnover in these communities, we identified 19 'core' taxa persisting on Arabidopsis leaves across time and plant generations. With the hypothesis these microbes could be playing key roles in the structuring of leaf microbial communities, we conducted a time-informed microbial network analysis which showed core taxa are not necessarily highly connected network 'hubs' and 'hubs' alternate with time. Conclusions: Our study shows that leaf microbial communities exhibit reproducible dynamics and patterns, suggesting the possibility of predicting those patterns to drive microbial communities towards desired states.

Life on leaves : uncovering temporal dynamics in Arabidopsis' leaf microbiota

Leaves are primarily responsible for the plant′s photosynthetic activity. Thus, changes in the phyllosphere microbiota, which includes deleterious and beneficial microbes, can have far reaching effects on plant fitness and productivity. In this context, identifying the processes and microorganisms that drive the changes in the leaf microbiota over a plant′s lifetime is crucial. In this study we analyzed the temporal dynamics in the leaf microbiota of Arabidopsis thaliana, integrating both compositional changes and changes in microbe-microbe interactions via the study of microbial networks. Field-grown Arabidopsis were used to follow leaf bacterial, fungal and oomycete communities, throughout the plant′s growing season (extending from November to March), over three consecutive years. Our results revealed the existence of conserved time patterns, with microbial communities and networks going through a stabilization phase (decreasing diversity and variability) at the beginning of the plant′s growing season. Despite a high turnover in these communities, we identified 19 "core" taxa persisting in Arabidopsis leaves across time and plant generations. With the hypothesis these microbes could be playing key roles in the structuring of leaf microbial communities, we conducted a time-informed microbial network analysis which showed core taxa are not necessarily highly connected network "hubs" and "hubs" alternate with time. Our study shows that leaf microbial communities exhibit reproducible dynamics and patterns, suggesting it could be possible to predict and drive these microbial communities to desired states.

Somatoform Dissociative Symptoms Have No Impact on the Outcome of Trauma-Focused Treatment for Severe PTSD

For patients with complex or other severe forms of PTSD, particularly in cases with dissociative symptoms, different treatment approaches have been suggested. However, the influence of somatoform dissociation on the effectiveness of trauma-focused treatment has hardly ever been studied. This study aims to test the hypotheses that (1) PTSD patients reporting a low level and those reporting a high level of somatoform dissociative symptoms would both benefit from an intensive trauma-focused treatment, and that (2) somatoform dissociative symptoms would alleviate. Participants were 220 patients with severe PTSD, enrolled in an intensive treatment program combining EMDR therapy and prolonged exposure therapy, without a preceding stabilization phase. Trauma history was diversified, and comorbidity was high. PTSD symptoms (CAPS-5 and PCL-5) and somatoform dissociative symptoms (SDQ-5 and SDQ-20) were assessed at pre-treatment, post-treatment and at six months after completion of treatment. The course of both PTSD and somatoform dissociative symptoms was compared for individuals reporting low and for those reporting high levels of somatoform dissociative symptoms. Large effect sizes were observed regarding PTSD symptoms reduction for patients with both low and high levels of somatoform dissociation. Somatoform dissociation did not impact improvement in terms of PTSD symptom reduction. The severity of somatoform dissociative symptoms decreased significantly in both groups. This decrease was greater for those with a positive screen for a dissociative disorder. These results add further support to the notion that the presence of strong somatoform dissociative symptoms in patients with PTSD does not necessarily call for a different treatment approach. Clinical implications are discussed.

Association between psychomotor disturbance and treatment outcome in psychotic depression: a STOP-PD II report

Background Little is known about the relationship between psychomotor disturbance (PMD) and treatment outcome of psychotic depression. This study examined the association between PMD and subsequent remission and relapse of treated psychotic depression. Methods Two hundred and sixty-nine men and women aged 18–85 years with an episode of psychotic depression were treated with open-label sertraline plus olanzapine for up to 12 weeks. Participants who remained in remission or near-remission following an 8-week stabilization phase were eligible to participate in a 36-week randomized controlled trial (RCT) that compared the efficacy and tolerability of sertraline plus olanzapine (n = 64) with sertraline plus placebo (n = 62). PMD was measured with the psychiatrist-rated sign-based CORE at acute phase baseline and at RCT baseline. Spearman's correlations and logistic regression analyses were used to analyze the association between CORE total score at acute phase baseline and remission/near-remission and CORE total score at RCT baseline and relapse. Results Higher CORE total score at acute phase baseline was associated with lower frequency of remission/near-remission. Higher CORE total score at RCT baseline was associated with higher frequency of relapse, in the RCT sample as a whole, as well as in each of the two randomized groups. Conclusions PMD is associated with poorer outcome of psychotic depression treated with sertraline plus olanzapine. Future research needs to examine the neurobiology of PMD in psychotic depression in relation to treatment outcome.

Use of Orthodontic Methods in the Treatment of Dental Luxations: A Scoping Review

(1) Background: Treating dental luxation injuries is challenging for the clinician. Dental luxations account for 18–33% of injuries to permanent teeth and can be addressed using different therapeutic approaches. The present work was conducted with two aims: (i) to evaluate, through a scoping review, current knowledge of the orthodontic methods (repositioning and stabilization splinting) that can be used at the time of the trauma, and (ii) to investigate the frequency and type of pulp consequences arising after these traumatic injuries. (2) Methods: The literature search was conducted in the period June 2020–December 2020 using the PubMed/MEDLINE, SCOPUS and Web of Science databases. The research questions were formulated according to the PICO (Population, Intervention, Comparison, Outcomes) method and considered the following aspects: type of luxation injury and stage of root development; use of orthodontic repositioning and splinting techniques; frequency and type of pulp consequences; and compliance of treatments with international guidelines. (3) Results: The initial screening of the databases, using the selected search keywords, yielded a total of 587 articles, just 8 fully met the inclusion criteria. Closer analysis of these 8 publications revealed that they would not produce clear meta-analytical data. This made it necessary to limit the data collected to the following six items: number and type of injuries, initial therapeutic intervention, duration of follow-up, number, and type of different pulp consequences. (4) Conclusions: While orthodontic techniques are commonly used to treat dental intrusions, in the case of extrusive and lateral luxation injuries, they are less frequently used and the orthodontic approach is generally confined to the stabilization phase. Among the various possible pulp consequences, many authors consider only pulp canal obliteration (PCO) and pulp necrosis (PN), often tending to overlook physiological healing (pulp survival) and the possible development of PN after PCO. There is therefore a clear need for new, high-quality clinical studies of this topic based on systematic and standardized data collection.