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High-Resolution Reports of Healthy proteins in Organic Filters by simply Solid-State NMR.
Vascular access patterns in the intensive care unit (ICU) have shifted from non-tunneled central venous catheters (CVCs) towards peripherally inserted central catheters (PICCs). We evaluated perceptions of critical care practitioners regarding these devices and variation in evidence-based practice.

A 35-question survey on ICU vascular access was deployed in 13 Michigan hospitals. Descriptive statistics summarized responses. Differences in utilization, perceptions and evidence-based practices between PICCs and CVCs, by participant and site-level characteristics, were assessed.

314 of 621 eligible providers responded to the survey (response rate 51%). 15% of providers reported not routinely using ultrasound when placing CVCs. Respondents whom were trainees, from larger hospitals, and from closed ICUs were more likely to use ultrasound (p<0.001). Additionally, 21% of respondents stated they did not specify number of CVC lumens, while 46% did not specify number of PICC lumens (p<0.001). The likelihood of specifying PICC lumens increased when vascular access protocols were in place (p=0.001). 2/3 of respondents (n=173, 66%) stated more research on ICU vascular access was needed.

Variation in guideline-based vascular access practices exists in the ICU. Defined local protocols may improve guideline adherence. Studies evaluating vascular access decisions and patient safety in the ICU appear necessary.
Variation in guideline-based vascular access practices exists in the ICU. Defined local protocols may improve guideline adherence. EGFR activity Studies evaluating vascular access decisions and patient safety in the ICU appear necessary.Storytelling is one method of arts-based learning. The pedagogy of arts-based learning integrates the arts into another topic to enhance learning. Nursing students' experiences of clinical placement are often complex. Students may benefit not only from cognitive thinking, but also creative reflection. This integrative literature review explores storytelling as an arts-based approach to learning during clinical placements. A search of electronic databases focused on articles published in English during 2010-2020. The search identified thirteen international papers. The diversity of clinical environments included community mental health, overseas placement, community aged care, and acute care hospitals. The synthesis revealed four main themes arts-based learning in nurse education, student-patient communication, student-Registered Nurse communication, and student-educator communication. Engaging in stories as a means of reflection improved students' self-knowledge, identified their preconceptions and stereotyping of patients and so improving their patient interactions. Positive relationships between students and patients were not only necessary for caring practice, but also intrinsic to learning. Positive relationships between Registered Nurses and students reduced anxiety and encouraged students to focus on quality patient care. Storytelling provided a creative approach to reflect on practice. Reflection using the affective domain assisted students to reflect more broadly about their placement experience.In line with sustainable development principles and in order to combat climate change, which contributes to progressive soil depletion, various solutions are being sought to use treated sewage sludge as a soil amendment to improve soil quality and enrich arable soils with adequate amounts of biogenic compounds. This review article focuses on the effects of the agricultural use of biosolids on the environment. The article reviews the existing knowledge on selected emerging contaminants in treated sewage sludge and describes the impact of these pollutants on the environment and living organisms based on 183 publications selected from over 16,000 papers on related topics published over the last ten years. This study deals not only with chemical contaminants but also genetic determinants of resistance to these compounds. Current research has questioned the agricultural use of biosolids due to the presence of mutual interactions between antibiotics, heavy metals, the genetic determinants of resistance (antibiotic resistance genes - ARGs and heavy metal resistance genes - HMRGs) and non-steroidal anti-inflammatory drugs as well as the risks associated with their transfer to the environment. This study emphasizes the need for more extensive legal regulations that account for other pollutants of environmental concern (PEC), particularly in countries where sewage sludge is applied in agriculture most extensively. Future research should focus on more effective methods of eliminating PEC from sewage sludge, especially from the sludge that is used to fertilize agricultural land, because even small amounts of these micropollutants can have serious implications for the health and life of humans and animals.Antral follicle count (AFC) repeatability at the time of follicular wave emergence and duration of gonadotropin treatment in calves with small and large AFC affects the superstimulatory response of follicles. In Study I, the individual AFC was determined, calves were ranked as having a small, medium or large AFC, and a second count was performed prior to FSH treatments. There was a positive association between the number of follicles ≥1 mm after the first and second counts (r = 0.4; P = 0.003). In Study II, calves with small and large AFC were administered pFSH for 4 or 7 days, pLH 20 h after last pFSH administration and cumulus-oocyte-complexes (COC) were collected. In calves having large as compared with small AFC, number of follicles ≥6 mm were greater (P = 0.01) and COC collected were greater (P = 0.001). The proportion of large-sized follicles (>9 mm) was greater in the 7-day than in the 4-day gonadotropin treatment group (56.4 ± 8.3 and27.8 ± 7.5 %, respectively; P = 0.01). In Study III, there was a positive association between AFC and number of follicles ≥6 mm at the time of COC collection (r = 0.6; P = 0.003). In summary, the number of follicles at the time of follicular wave emergence was associated with the number of follicles recruited during subsequent waves of follicular development and ovarian response following gonadotropin superstimulation. Calves with a large AFC had more COC collected than calves with a small AFC.
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