Exercise, diet, and sleep habits of nurses working full-time during the COVID-19 pandemic: An observational study.

BACKGROUND: Healthy diet, exercise, and sleep practices may mitigate stress and prevent illness. However, lifestyle behaviors of acute care nurses working during stressful COVID-19 surges are unclear. PURPOSE: To quantify sleep, diet, and exercise practices of 12-hour acute care nurses working day or night shift during COVID-19-related surges. METHODS: Nurses across 10 hospitals in the United States wore wrist actigraphs and pedometers to quantify sleep and steps and completed electronic diaries documenting diet over 7-days. FINDINGS: Participant average sleep quantity did not meet national recommendations; night shift nurses (n = 23) slept significantly less before on-duty days when compared to day shift nurses (n = 34). Proportionally more night shift nurses did not meet daily step recommendations. Diet quality was low on average among participants. DISCUSSION: Nurses, especially those on night shift, may require resources to support healthy sleep hygiene, physical activity practices, and diet quality to mitigate stressful work environments.

Effectiveness of the DROP training for military behavioral health providers targeting therapeutic alliance and premature dropout.

AbstractPremature discontinuation from behavioral health treatment is a major problem reducing effectiveness of care in military populations. A training was developed and delivered to 622 behavioral health providers across 15 sites within the Army behavioral healthcare system. The training taught two techniques to foster treatment engagement: (1) Progress Informed Treatment, consisting of reviewing symptom assessments and outcome measures, and (2) assessment and discussion of the treatment alliance via a paper survey given near the end of each session. Eighty-five percent of providers indicated the training was useful and 89% of providers incorporated a technique into their practice. Dropout before the fourth session was significantly reduced in the six months following training, from 72.5% to 67.1% in Service Members (SM; X2(1, N=9127) = 39.58, p < .001). In both the pre and post-training periods, providers working at the Master's level, SM aged 17 or 46 or older, and clients receiving a mood, PTSD, anxiety, adjustment, substance or childhood/adolescent psychiatric diagnosis experienced significantly less dropout, while SM aged 18-21 had significantly more dropout. This training is a feasible and available option to increase treatment engagement and improve treatment outcomes for service members.

Origin of magnetism and quasiparticles properties in Cr-doped TiO2.

Combining the local spin density approximation (LSDA)+U and an analysis of superexchange interactions beyond density functional theory, we describe the magnetic ground state of Cr-doped TiO2, an intensively studied and debated dilute magnetic oxide. In parallel, we correct our LSDA+U (+ superexchange) ground state through GW corrections (GW@LSDA+U) that reproduce the position of the impurity states and the band gaps in satisfying agreement with experiments. Because of the different topological coordinations of Cr-Cr bonds in the ground states of rutile and anatase, superexchange interactions induce either ferromagnetic or antiferromagnetic couplings of Cr ions. In Cr-doped anatase, this interaction leads to a new mechanism which stabilizes a (nonrobust) ferromagnetic ground state, in keeping with experimental evidence, without the need to invoke F-center exchange. The interplay between structural defects and vacancies in contributing to the superexchange is also unveiled.

Geographic shifts in climatically suitable areas and loss of genetic variability in Dipteryx alata ("Baru" Tree; Fabaceae).

Many species are expected to suffer strong shifts in their geographic ranges due to climate changes in the next 50 years, with severe consequences for biodiversity patterns and population structure. We used here an ensemble forecast approach for obtaining species' range in which multiple species distribution models and climatic models were combined to model loss of genetic variability in Baru, Dipteryx alata (Fabaceae), an economically important Neotropical tree native to the Cerrado of Brazil. We estimated a series of genetic parameters (number of alleles per locus, expected heterozygosity under Hardy-Weinberg equilibrium and mutation-drift equilibrium) for this species based on eight microsatellite loci. We then recalculated these parameters assuming that local populations in areas of low future environmental suitability will go extinct. All genetic parameters remained approximately constant up to a 50% threshold of climatic suitability in the future; after this critical threshold there is an abrupt reduction in all parameters, although the magnitude of shift is only about 10% of current values, on average. Thus, despite the shifts in geographic range and climatically suitable areas towards southeastern Brazil, our analyses do not predict a strong loss of genetic diversity in D. alata because of the broad tolerance of this species, which ensures large future ranges, contrasting with other Cerrado species that have been analyzed in a similar manner.

Autoregressive modelling of species richness in the Brazilian Cerrado.

Spatial autocorrelation is the lack of independence between pairs of observations at given distances within a geographical space, a phenomenon commonly found in ecological data. Taking into account spatial autocorrelation when evaluating problems in geographical ecology, including gradients in species richness, is important to describe both the spatial structure in data and to correct the bias in Type I errors of standard statistical analyses. However, to effectively solve these problems it is necessary to establish the best way to incorporate the spatial structure to be used in the models. In this paper, we applied autoregressive models based on different types of connections and distances between 181 cells covering the Cerrado region of Central Brazil to study the spatial variation in mammal and bird species richness across the biome. Spatial structure was stronger for birds than for mammals, with R(2) values ranging from 0.77 to 0.94 for mammals and from 0.77 to 0.97 for birds, for models based on different definitions of spatial structures. According to the Akaike Information Criterion (AIC), the best autoregressive model was obtained by using the rook connection. In general, these results furnish guidelines for future modelling of species richness patterns in relation to environmental predictors and other variables expressing human occupation in the biome.

Autoregressive modelling of species richness in the Brazilian Cerrado / Modelagem por auto-regressão da riqueza de espécies no Cerrado Brasileiro

Spatial autocorrelation is the lack of independence between pairs of observations at given distances within a geographical space, a phenomenon commonly found in ecological data. Taking into account spatial autocorrelation when evaluating problems in geographical ecology, including gradients in species richness, is important to describe both the spatial structure in data and to correct the bias in Type I errors of standard statistical analyses. However, to effectively solve these problems it is necessary to establish the best way to incorporate the spatial structure to be used in the models. In this paper, we applied autoregressive models based on different types of connections and distances between 181 cells covering the Cerrado region of Central Brazil to study the spatial variation in mammal and bird species richness across the biome. Spatial structure was stronger for birds than for mammals, with R² values ranging from 0.77 to 0.94 for mammals and from 0.77 to 0.97 for birds, for models based on different definitions of spatial structures. According to the Akaike Information Criterion (AIC), the best autoregressive model was obtained by using the rook connection. In general, these results furnish guidelines for future modelling of species richness patterns in relation to environmental predictors and other variables expressing human occupation in the biome.

Autocorrelação espacial é definida como a falta de independência entre pares de observações a uma dada distância geográfica e é um fenômeno muito freqüente em dados ecológicos. É importante levar em consideração os efeitos de autocorrelação espacial em ecologia geográfica, tanto para realizar uma descrição mais detalhada dos dados quanto para corrigir estimativas enviesadas do erro Tipo I das análises estatísticas convencionais. Entretanto, para resolver efetivamente esses problemas, é preciso avaliar a melhor forma de incorporar estruturas espaciais nos modelos. Neste estudo, modelos autoregressivos, baseados em diferentes tipos de conexões e distâncias entre 181 células de uma rede cobrindo a região do Cerrado brasileiro, foram ajustados para avaliar a variação espacial de riqueza de mamíferos e aves dentro do bioma. A estrutura espacial foi ligeiramente mais forte para aves do que para mamíferos, com valores de R² variando entre 0,77 e 0,94 para mamíferos e 0,77 e 0,97 para aves, em modelos baseados em diferentes formas de conexão espacial. Segundo o Critério de Informação Akaike (AIC), o modelo autoregressivo melhor ajustado foi obtido através da conexão "em torre". Em geral, esses resultados fornecem diretrizes para futuras modelagens dos padrões de riqueza de espécies que estão associados a preditores ambientais e/ou a variáveis que expressam a ocupação humana no Cerrado.

The association of aldose reductase gene (AKR1B1) polymorphisms with diabetic neuropathy in adolescents.

AIMS: Variants in the aldose reductase gene (AKR1B1) have been implicated in the development of diabetic retinopathy and nephropathy, with the most convincing data identifying a (CA)(n) repeat microsatellite allele (Z-2), which has a functional role in gene expression. In this study the association between polymorphisms in the AKR1B1 gene and diabetic neuropathy was investigated. METHODS: The pupillary response to light was used as the major outcome in this study along with abnormal hot thermal threshold. Three hundred and sixty-three adolescents underwent genotyping of the AKR1B1 gene. The microsatellite (CA)(n) repeat was sequenced and two single nucleotide polymorphisms, -106C-->T and -12C-->G, were investigated by restriction fragment length polymorphism. RESULTS: Seventy-six percent of participants had pupillary abnormalities (45% with two, 15% with three abnormalities). Presence of the Z-2/Z-2 genotype increased the risk nearly three-fold for pupillary abnormalities [odds ratio (OR) 3.02, 95% confidence interval (CI) 1.14, 7.98). The susceptibility genotypes (Z-2/Z-2 with -106C/-106C, Z-2/Z with -106C/-106C or Z/Z with -106C/-106C) were associated with resting pupil diameter abnormalities when compared with the protective genotypes (Z+2/Z+2 or -106T/-106T) (OR 2.83, 95% CI 1.25, 6.41). The combination of Z+2/-106T reduced the risk of abnormal heat discrimination (OR 0.48, 95% CI 0.23, 0.99). CONCLUSIONS: In this study we have shown that Z-2/Z-2 genotype is significantly associated with the development of pupillary abnormality, an early indicator of diabetic autonomic neuropathy, in adolescent Australian patients with Type 1 diabetes.

Worldwide patterns in species richness of Falconiformes: analytical null models, geometric constraints, and the mid-domain effect.

Recently, the hypothesis that the geographic distribution of species could be influenced by the shape of the domain edges, the so-called Mid-Domain Effect (MDE), has been included as one of the five credible hypotheses for explaining spatial gradients in species richness, despite all the unsuccessful current attempts to prove empirically the validity of MDE. We used data on spatial worldwide distributions of Falconiformes to evaluate the validity of MDE assumptions, incorporated into two different sorts of null models at a global level and separately across five domains/landmasses. Species richness values predicted by the null models of the MDE and those values predicted by Net Primary Productivity, a surrogate variable expressing the effect of available energy, were compared in order to evaluate which hypothesis better predicts the observed values. Our tests showed that MDE continues to lack empirical support, regardless of its current acceptability, and so, does not deserve to be classified as one possible explanation of species richness gradients.

Worldwide patterns in species richness of falconiformes: analytical null models, geometric constraints, and the mid-domain effect

Recentemente, a hipótese de que a distribuição geográfica das espécies poderia ser influenciada pela forma das bordas continentais, conhecida como Efeito do Domínio Médio (EDM), foi incluída como uma das cinco hipóteses prováveis para explicar os gradientes espaciais de riqueza de espécies, apesar das últimas tentativas infrutíferas de prová-la empiricamente. Usamos os dados globais de distribuição espacial dos Falconiformes para avaliar os pressupostos do EDM, por meio de dois tipos de modelos nulos, em uma análise global e, também, separadamente por cinco domínios/continentes. Os valores de riqueza de espécies preditos pelos modelos nulos do EDM e pela produtividade primária líquida, uma variável substitutiva para expressar o efeito da energia disponível, foram comparados para avaliar qual hipótese prediz melhor os valores observados. Nossos testes mostraram que o EDM permanece sem suporte empírico, apesar da corrente notoriedade, não merecendo, portanto, ser classificado como uma das explicaçäes possíveis para os gradientes de riqueza de espécies.

Estudio del efecto de ivermectina en helmintos intestinales en comunidades yanomamis del Alto Orinoco Estado Amazonas Venezuela / Study of effect of ivermectin in helminths intestinal in communities yanomami of High Orinoco State Amazonas Venezuela

Altas prevalencia de infecciones helmínticas intestinales han sido observadas entre la población amerindia de la Amazonía venezolana, siendo ascaris lumbricoides, trichuris trichiura y los anquilostomídes los helmintos más frecuentes en estas poblaciones. Una muestra de heces de individuos de la etnia Yanomami, de la región de Ocamo, Alto Orinoco, fue examinada para helmintos instestinales mediante la técnica de Kato-Katz, para determinar el efecto de la ivermectina sobre los parásitos antes mencionados, después de una dosis de éste fármaco. La droga tuvo un efecto importante sobre A. lumbricoides y T. trichiura, reduciendo la prevalencia y la carga parasitaria, a los 15 días después del tratamiento, de 64,70 a 7,56 por ciento, la prevalencia, y de 6.422,32 a 995,50 huevos/g de heces a la carga parasitaria para A. lumbricoides. Para T. trichiura, la prevalencia disminuyó de 89,07 a 45,38 por ciento y la carga parasitaria se redujo de 2.495 a 549,96 huevos/g de heces. No hubo un efecto significativo sobre los anquilostomídeos. Dos meses después del tratamiento, hubo un incremento de la prevalencia de T. trichiura a niveles pre-tratamiento (80,67 por ciento), mientras que la carga parasitaria se mantuvo reducida (615,73 huevos/g de heces). La prevalencia y la carga parasitaria de A. lumbricoides no se incrementó (9,24 por ciento; 478,39 huevos/g de heces). Los resultados de este estudio muestran que el tratamiento con invermectina tiene un efecto apreciable sobre la prevalencia y la carga parasitaria de estas infecciones helmínticas

Gas-permeable scleral contact lens therapy in ocular surface disease.

PURPOSE: To describe the therapeutic benefits of nonfenestrated gas-permeable scleral contact lenses in the management of patients with ocular surface disease. METHODS: The charts of 49 consecutive patients (76 eyes) with ocular surface disease whose management included the use of gas-permeable scleral contact lenses were reviewed. We also developed a questionnaire to assess the impact of lens wear on subjective aspects of activities of daily living. RESULTS: The mean age of the 49 patients was 44.6 years (range, 3 to 87 years); 31 patients were female and 18 were male. The most common indication for fitting of the lenses was Stevens-Johnson syndrome (54 [71%] of the 76 eyes). Other indications included ocular cicatricial pemphigoid, exposure keratitis, toxic epidermal necrolysis, postherpetic keratitis, congenital deficiency of meibomian glands, superior limbal keratoconjunctivitis, Sjögren syndrome, and inflammatory corneal degeneration. The mean follow-up was 33.6 months (range, 2 to 144 months). Improvement in best-corrected visual acuity (defined as a gain of 2 or more Snellen lines) was observed in 40 (53%) of the eyes. In eight (53%) of the 15 eyes with active corneal epithelial defects at the time of lens fitting, the defects healed, whereas in the remaining seven eyes the corneal epithelial defects remained unchanged. Forty-five (92%) of the 49 patients reported improvement in their quality of life as a result of reduction of photophobia and discomfort. The mean wearing time of the gas-permeable scleral contact lenses was 13.7 hours per day (range, 4 to 18 hours). Many patients had preparatory surgical procedures before lens fitting (for example, punctal occlusion or mucous membrane grafting), and some had visual rehabilitation surgical procedures (for example, keratoplasty and/or cataract surgery) after lens fitting. CONCLUSIONS: Gas-permeable scleral contact lens wear provides an additional effective strategy in the surface management and visual rehabilitation of patients with severe ocular surface disease.

Orthopaedic manifestations of Rett syndrome.

We reviewed nine patients with Rett syndrome, a progressive encephalopathy that is being diagnosed more frequently in the United States. It occurs in females, causing mental deterioration, autistic behavior, and classic hand-wringing motion. The orthopaedic manifestations include scoliosis, lower extremity contracture, and coxa valga. Bracing and surgery are indicated to prevent or correct deformity and maintain ambulation.