Formation of critical thinking related to the energetic efficiency of applied physics processes of civil engineering works

Current problems associated to contamination and climate change claim for urgent solutions to make real a sustainable development of modern societies. To answer that call, the efficiency of applied physics processes must be continuously evaluated. Particularly, engineering programs are called to strengthen the training offer related to basic and applied physics sciences considering energetic transformation and transferring processes. In the civil engineering field, design, construction, functioning, and final disposition of buildings can be understood as applied physics processes. This work proposes an approach for defining and studying possible variables related to energetic processes and their mutual relationship. Such variables must be able to describe the processes of energetic changes which can occur during construction of civil works. To do so, qualitative analysis of mathematic expressions is done to promote the formation of abstract mental connections made of sensitivity and logical thinking. The methodology is based on four moments: (a) students’ brainstorming related to a particular issue, (b) identification of main topics related to energy transformation, (c) variable operationalization, (d) proposal of mathematical expressions. This proposal is expected to facilitate the construction of concepts related to sustainable development and help students to trust themselves when taking well thought out risks.

A survey of Midwest physicians’ experiences with patients in psychiatric distress in the emergency department

Context Emergency medicine (EM) physicians commonly stabilize patients with acute psychiatric distress, such as suicidal ideation. Research has shown that suicidal ideation is difficult to manage in emergency department (ED) settings and that patients in psychiatric distress are often “boarded” in the ED while awaiting more definitive care. Objectives To examine the attitudes and experiences of emergency physicians regarding the care of patients in psychiatric distress. Special attention is given to suicidal ideation due to its prevalence in the United States. Methods A 19 question anonymous survey was sent via email to 55 emergency medicine residency directors throughout Michigan, Ohio, Indiana, and Illinois, who were identified using an Internet search of residency programs in the region. The program directors were asked to distribute the survey to their colleagues and residents. The intent of this procedure was to generate as many survey responses as possible, while obscuring the identities of the respondents. Responses were gathered from October 29, 2019 until January 16, 2020. The survey was designed to assess respondents’ self-reported demographic data as well as their experiences with the boarding process, initial examination, final disposition, reevaluation of the patient, physician training and resources, and follow up care. Statistical analysis was performed using a Mann–Whitney U test, significance was set at p<0.01. Results In total, 47 EM physicians responded to the survey; however, not all of the respondents completed all 19 questions. Ten of 44 respondents (22.7%) reported that they do not perform the initial psychiatric examination themselves and instead defer to a nurse or social worker. Twenty-two of 44 respondents (50.0%) reported that they defer to a social worker when determining the final disposition of psychiatric patients. Respondents reevaluated patients in psychiatric distress statistically significantly less often (p=0.01) compared with patients with cardiac pathology. Additionally, 15 of 38 respondents (39.5%) reported that they did not feel adequately trained to handle psychiatric emergencies, and 36 of 39 respondents (92.3%) of physicians felt that their facility would benefit from additional mental health resources. Thirty five of 39 respondents (89.7%) reported that their facility did not have a system in place to follow up with suicidal patients upon discharge. Conclusions Caring for patients who are acutely suicidal or in psychiatric distress is complex and more research is needed to optimize treatment strategies. The results of this study indicate that EM physicians may regularly defer to nonphysician providers when evaluating and treating patients in psychiatric distress. A perceived lack of training in psychiatry may contribute to this practice. The results of this study are in accord with previous research that indicated a need for additional psychiatry training in EM residencies.

DNA Based and Stimuli-Responsive Smart Nanocarrier for Diagnosis and Treatment of Cancer: Applications and Challenges

The rapid development of multidrug co-delivery and nano-medicines has made spontaneous progress in tumor treatment and diagnosis. DNA is a unique biological molecule that can be tailored and molded into various nanostructures. The addition of ligands or stimuli-responsive elements enables DNA nanostructures to mediate highly targeted drug delivery to the cancer cells. Smart DNA nanostructures, owing to their various shapes, sizes, geometry, sequences, and characteristics, have various modes of cellular internalization and final disposition. On the other hand, functionalized DNA nanocarriers have specific receptor-mediated uptake, and most of these ligand anchored nanostructures able to escape lysosomal degradation. DNA-based and stimuli responsive nano-carrier systems are the latest advancement in cancer targeting. The data exploration from various studies demonstrated that the DNA nanostructure and stimuli responsive drug delivery systems are perfect tools to overcome the problems existing in the cancer treatment including toxicity and compromised drug efficacy. In this light, the review summarized the insights about various types of DNA nanostructures and stimuli responsive nanocarrier systems applications for diagnosis and treatment of cancer.

Diversity by Design: Improving Access to Justice in Online Courts with Adaptive Court Interfaces

Recent years have seen the emergence of online courts and tribunals: digital platforms that enable self-represented litigants (SRLs) to complete electronically the entire court (or tribunal) process, from filing through final disposition. This article proposes that the unique nature of online courts as digital interfaces enables them to implement a new strategy—diversity by design—to improve access to justice and procedural justice for a diverse population of SRLs. Reflecting a human-centered legal design approach, and building on research in human-computer interaction and digital choice architecture, this strategy entails embedding diversity accommodating features in the technological design of court platforms. Specifically, building on the empirical relationship between users’ demographic attributes and their digital usability and aesthetics judgments, this article suggests that online courts can dynamically adapt their interfaces according to the attributes of a given user in ways that help diverse SRLs engage with online courts, support their effective participation in proceedings, and improve their procedural experiences. The potential impacts include enhancing SRLs’ confidence and trust in using online courts and ameliorating their ability to process information, deliberate, make informed decisions and communicate them. Finally, the article discusses concerns regarding the desirability and ethicality of dynamically adapting, that is—personalizing, court interfaces.

Biodegradation of Hemicellulose-Cellulose-Starch-Based Bioplastics and Microbial Polyesters

The volume of discarded solid wastes, especially plastic, which accumulates in large quantities in different environments, has substantially increased. Population growth and the consumption pattern of societies associated with unsustainable production routes have caused the pollution level to increase. Therefore, the development of materials that help mitigate the impacts of plastics is fundamental. However, bioplastics can result in a misunderstanding about their properties and environmental impacts, as well as incorrect management of their final disposition, from misidentifications and classifications. This chapter addresses the aspects and factors surrounding the biodegradation of bioplastics from natural (plant biomass (starch, lignin, cellulose, hemicellulose, and starch) and bacterial polyester polymers. Therefore, the biodegradation of bioplastics is a factor that must be studied, because due to the increase in the production of different bioplastics, they may present differences in the decomposition rates.

Abstract 15096: Electrocardiographic QRS Amplitude Predicts Mortality in Hospitalized Patients With CoViD-19

Introduction: In a variety of cardiovascular diseases, low QRS voltage amplitude on the 12-lead ECG is associated with poor prognosis. We studied the relative frequency and importance of this phenomenon in hospitalized patients with SARS-coronavirus 2019 (CoViD-19) - a condition associated with myocardial injury in ~1/3 of patients. Methods: We performed a retrospective analysis of 800 consecutive patients with laboratory-confirmed CoViD-19 hospitalized from Mar 7 and Apr 12, 2020. Patients without a final disposition or telemetry data were excluded, resulting in 140 patients. On 12-lead ECG, low amplitude was defined as QRS amplitude <5mm in II/III/aVF, <10 mm in V1-V6, or a ≥50% decrease in amplitude on follow-up ECG during hospitalization, relative to the baseline/admission ECG. The association of 14 clinical variables to mortality was tested in multivariable logistic regression models. Results: Among 140 patients, 33 (23.6%) met criteria for low QRS amplitude. Compared to patients without low amplitude, these patients had a higher risk of in-hospital mortality (72.7% vs 26.2%; p<0.0001) and mechanical ventilation (63.3% vs 32.4%; p=0.002). In multivariable models, there were only 3 independent predictors of in-hospital death: age (OR=1.1, 95% CI 1.0-1.1, p<0.001), BMI (OR=1.1, 95% CI 1.1-1.2, p0.001), and the strongest predictor, low amplitude (OR=7.2; 95% CI 2.3-23.0). Low amplitudes in either the limb or precordial leads both predicted death (Table). Conclusions: A reduction in electrocardiographic QRS amplitude in patients with CoViD-19 is the strongest clinical predictor of death, and may be useful for risk stratification during hospitalization. Further study is needed to elucidate the mechanisms underlying changes in QRS amplitude, and their relationship to disease severity.

Have Racial and Ethnic Disparities in Juvenile Justice Declined Over Time? An Empirical Assessment of the DMC Mandate

The present study examines whether racial and ethnic disparities in juvenile justice declined significantly in a state that has made substantial reform efforts in compliance with the Disproportionate Minority Contact (DMC) mandate. Using a sample of all referrals in Connecticut with final disposition in 2000 (N = 18,458) or 2010 (N = 12,265), the study employed multilevel modeling with cross-level interactions to assess whether disparities changed over time for five outcomes: detention, petition, adjudication, commitment, and waiver to criminal court. Findings indicated that Black-White disparities in detention decreased over time, while Black-White disparities increased for petition, adjudication, and waiver. Findings also indicated that Hispanic-White disparities increased for adjudication (while not changing for other outcomes). The limited success of the DMC mandate may be explained by implementation failure or theory failure. Adjudicating between these alternative explanations is needed to guide future reform efforts. Several implications for research and policy are discussed, including whether reform efforts should focus on overall harm reduction rather than proportional representation.

Incorporating of Two Waste Materials for the Use in Fine-Grained Soil Stabilization

The present experimental work briefly aimed to utilize two different waste materials; calcium carbide residue (CCR) and the locally available rice husk ash (RHA) to produce an eco-friendly binder for the use in fine-grained soil stabilization. The effect of different binary mixtures, produced by mixing CCR and RHA with different proportion, on the geotechnical properties of a fine-grained soil was investigated. For the unconfined compressive strength (UCS) test, the soil specimens were subjected to various curing periods (7, 21, 28 and 90 days). The microstructure of the soil treated with the optimum mixture was carried out by utilizing scanning electron microscopy (SEM) test. Results of UCS test showed an interesting growth after the treatment of binary mixtures relative to those samples treated with only CCR. Plasticity index (PI) was found to decrease noticeably with use of CCR only while further reductions in PI were achieved after the RHA incorporation. Clear variations in the microstructure of the treated soil were revealed from SEM testing approving the creation of cementitious products. The results of the current study indicated that the wastes utilized in this investigation could be potentially used as alternatives to the conventional binders and final disposition with economic and environmental advantages.