JURNAL AGROTEKNOLOGI
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The south in the world
No full textCentring its insights in the border-traversing, world-opening capacities of imaginative southern writing and reading, this chapter offers a closing meditation on some of the more elusive meanings and heuristics of the south that the collection calls up. Inspired by the same critical orientations that the collection explores, it questions the extent to which the conceptual and historical remoteness of the south can ever be fully perceived and understood in geo-epistemological terms, arguing that southness will perhaps always elude northern analysis to some degree, its local and indigenous detail always slipping just beyond the frame. Efforts to re-territorialise global intellectual production therefore face a significant philosophical challenge that cannot be solved by a critical theory predicated on dominant northern constructs. To see the ‘south in the world’ means not just contemplating the world from the various perspectives and orientations of its different southerly regions and their histories, but also looking to the side, beyond ‘centres in modernity’, towards ‘composite and overlapping’ Black and Indigenous realities. The south thus both invites and makes possible archipelagic readings and heuristics, encouraging us to think connectively and fluidly through and across its spaces. Resistance emerges out of the structural flaws, gaps, broken links, and ellipses that are endemic to any colonial-type assertion of planetary consciousness
Genetic diversity of dengue virus in clinical specimens from Bangkok, Thailand, during 2018–2020: Co-circulation of all four serotypes with multiple genotypes and/or clades
No full textDengue is an arboviral disease highly endemic in Bangkok, Thailand. To characterize the current genetic diversity of dengue virus (DENV), we recruited patients with suspected DENV infection at the Hospital for Tropical Diseases, Bangkok, during 2018–2020. We determined complete nucleotide sequences of the DENV envelope region for 111 of 276 participant serum samples. All four DENV serotypes were detected, with the highest proportion being DENV-1. Although all DENV-1 sequences were genotype I, our DENV-1 sequences were divided into four distinct clades with different distributions in Asian countries. Two genotypes of DENV-2 were identified, Asian I and Cosmopolitan, which were further divided into two and three distinct clades, respectively. In DENV-3, in addition to the previously dominant genotype III, a cluster of 6 genotype I viruses only rarely reported in Thailand was also observed. All of the DENV-4 viruses belonged to genotype I, but they were separated into three distinct clades. These results indicated that all four serotypes of DENV with multiple genotypes and/or clades co-circulate in Bangkok. Continuous investigation of DENV is warranted to further determine the relationship between DENV within Thailand and neighboring countries in Southeast Asia and Asia
Policy brief: No longer voting for the devil you know? Why the Balkans’ collective action problem might be easier to break than we think
No full textRecent electoral outcomes have challenged the notion that elections in the Balkans are not able to bring about change. How has the public responded? It is argued that, in spite of the manifest obstacles for challengers to prevail over incumbents, public opinion is contingent upon the recent experiences in each country. Once shown the way, and in spite of a long period of stasis (or even state capture), citizens start believing that change is possible. The findings of the brief indicate that, in relation to electoral participation, the ‘collective action’ problem in the Balkans – characterised as lack of confidence in the possibility of change, leading to disillusionment with the democratic process and individual unwillingness to act to bring about change – might not be as difficult to break as previous research had indicated
The impact of wearable continuous vital sign monitoring on deterioration detection and clinical outcomes in hospitalised patients: a systematic review and meta-analysis
No full textBackground
Timely recognition of the deteriorating inpatient remains challenging. Wearable monitoring systems (WMS) may augment current monitoring practices. However, there are many barriers to implementation in the hospital environment, and evidence describing the clinical impact of WMS on deterioration detection and patient outcome remains unclear.
Objective
To assess the impact of vital-sign monitoring on detection of deterioration and related clinical outcomes in hospitalised patients using WMS, in comparison with standard care.
Methods
A systematic search was conducted in August 2020 using MEDLINE, Embase, CINAHL, Cochrane Database of Systematic Reviews, CENTRAL, Health Technology Assessment databases and grey literature. Studies comparing the use of WMS against standard care for deterioration detection and related clinical outcomes in hospitalised patients were included. Deterioration related outcomes (primary) included unplanned intensive care admissions, rapid response team or cardiac arrest activation, total and major complications rate. Other clinical outcomes (secondary) included in-hospital mortality and hospital length of stay. Exploratory outcomes included alerting system parameters and clinical trial registry information.
Results
Of 8706 citations, 10 studies with different designs met the inclusion criteria, of which 7 were included in the meta-analyses. Overall study quality was moderate. The meta-analysis indicated that the WMS, when compared with standard care, was not associated with significant reductions in intensive care transfers (risk ratio, RR 0.87; 95% confidence interval, CI 0.66–1.15), rapid response or cardiac arrest team activation (RR 0.84; 95% CI 0.69–1.01), total (RR 0.77; 95% CI 0.44–1.32) and major (RR 0.55; 95% CI 0.24–1.30) complications prevalence. There was also no statistically significant association with reduced mortality (RR 0.48; 95% CI 0.18–1.29) and hospital length of stay (mean difference, MD − 0.09; 95% CI − 0.43 to 0.44).
Conclusion
This systematic review indicates that there is no current evidence that implementation of WMS impacts early deterioration detection and associated clinical outcomes, as differing design/quality of available studies and diversity of outcome measures make it difficult to reach a definite conclusion. Our narrative findings suggested that alarms should be adjusted to minimise false alarms and promote rapid clinical action in response to deterioration
Enhancing psychological safety in mental health services
No full textBackground
Psychological safety—speaking up about ideas and concerns, free from interpersonal risk—are essential to the high-risk environment, such as healthcare settings. Psychologically safe working is particularly important in mental health where recovery-oriented approaches rely on collaborative efforts of interprofessional teams to make complex decisions. Much research focuses on antecedents and outcomes associated with psychological safety, but little focus on the practical steps for how to increase psychological safety across and at different levels of a healthcare organisation.
Aims
We explore how a mental health organisation creates an organisation-wide plan for building the foundations of mental health and how to enhance psychological safety.
Methods
This review encompasses strategies across psychological safety and organisational culture change to increase psychological safety at an individual, team and organisational level.
Summary
We set out a comprehensive overview of the types of strategies and interventions for increasing the ethos of psychological safety and setting the foundations for delivering an organisation-wide programme on this topic. We also provide a list of key targeted areas in mental health that would maximally benefit from increasing psychological safety—both in clinical and non-clinical settings.
Conclusions
Psychological safety is a crucial determinant of safe and effective patient care in mental health services. This paper provides the key steps and considerations, creating a large-scale programme in psychological safety with a focus on mental health and drawing from the current literature, providing concrete steps for how our current understanding of psychological safety into practice
Identifiability of stochastically modelled reaction networks
No full textChemical reaction networks describe interactions between biochemical species. Once an underlying reaction network is given for a biochemical system, the system dynamics can be modelled with various mathematical frameworks such as continuous-time Markov processes. In this manuscript, the identifiability of the underlying network structure with a given stochastic system dynamics is studied. It is shown that some data types related to the associated stochastic dynamics can uniquely identify the underlying network structure as well as the system parameters. The accuracy of the presented network inference is investigated when given dynamical data are obtained via stochastic simulations
Time to reconsider the routine use of tourniquets in total knee arthroplasty surgery: an abridged version of a Cochrane systematic review and meta-analysis
No full textAims
Many surgeons choose to perform total knee arthroplasty (TKA) surgery with the aid of a tourniquet. A tourniquet is a device that fits around the leg and restricts blood flow to the limb. There is a need to understand whether tourniquets are safe, and if they benefit, or harm, patients. The aim of this study was to determine the benefits and harms of tourniquet use in TKA surgery.
Methods
We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled trials, and trial registries up to 26 March 2020. We included randomized controlled trials (RCTs), comparing TKA with a tourniquet versus without a tourniquet. Outcomes included: pain, function, serious adverse events (SAEs), blood loss, implant stability, duration of surgery, and length of hospital stay.
Results
We included 41 RCTs with 2,819 participants. SAEs were significantly more common in the tourniquet group (53/901 vs 26/898, tourniquet vs no tourniquet respectively) (risk ratio 1.73 (95% confidence interval (CI) 1.10 to 2.73). The mean pain score on the first postoperative day was 1.25 points higher (95% CI 0.32 to 2.19) in the tourniquet group. Overall blood loss did not differ between groups (mean difference 8.61 ml; 95% CI -83.76 to 100.97). The mean length of hospital stay was 0.34 days longer in the group that had surgery with a tourniquet (95% CI 0.03 to 0.64) and the mean duration of surgery was 3.7 minutes shorter (95% CI -5.53 to -1.87).
Conclusion
TKA with a tourniquet is associated with an increased risk of SAEs, pain, and a marginally longer hospital stay. The only finding in favour of tourniquet use was a shorter time in theatre. The results make it difficult to justify the routine use of a tourniquet in TKA surgery
Reciprocal-log approximation and planar PDE solvers
No full textThis article is about both approximation theory and the numerical solution of partial differential equations (PDEs). First we introduce the notion of reciprocal-log or log-lightning approximation of analytic functions with branch point singularities at points by functions of the form , which have poles potentially distributed on different sheets of a Riemann surface. We prove that the errors of minimax reciprocal-log approximations decrease exponentially with respect to and that exponential or near-exponential convergence (i.e., at a rate ) also holds for near-best approximations constructed by linear least-squares fitting on the boundary with suitably chosen preassigned singularities. We then apply these results to derive a “log-lightning method” for the numerical solution of Laplace and related PDEs in two-dimensional domains with corner singularities. The convergence is near-exponential, in contrast to the root-exponential convergence for the original lightning methods based on rational functions
‘This is time we’ll never get back’: a qualitative study of mothers’ experiences of care associated with neonatal death
No full textAims To explore the perceptions and experience of women whose baby died in the neonatal period about their care in the perinatal period, on delivery suite, in the neonatal unit and afterwards, expressed in their own words.
Design Secondary analysis of the Listening to Parents study, using thematic analysis based on the open text responses from a postal survey of parents whose baby died in the neonatal period in England. Women were asked about care during the pregnancy, labour and birth, around the time the baby died and about neonatal care. Women whose pregnancy was terminated for fetal abnormality were excluded from this analysis.
Results Completed questionnaires were received from 249 mothers of whom most (78%) responded with open text. Overarching themes identified were ‘the importance of proximity’, ‘recognition of role and identity as a parent’ and ‘the experience of care’ and subthemes included ‘hours and moments’, ‘barriers to contact’, ‘ being able to parent, even for a short time’, ‘missed opportunities’, ‘being heard’ and ‘sensitive and responsive care’.
Conclusion The findings identify what is most important for mothers in experiencing the life and death of a baby as a newborn. Physical contact with the baby was paramount, as was being treated as a mother and a parent and being able to function as such. The way in which healthcare staff behaved and how their babies were cared for was critical to how mothers felt supported and enabled at this time. If all women whose babies die in the neonatal period after birth are to receive the responsive care they need, greater understanding of the primary need for closeness and proximity, for active recognition of their parental role and staff awareness of the limited time window available is essential
Computational modelling of chromosome re-replication in mutant strains of fission yeast
No full textTypically cells replicate their genome only once per division cycle, but under some circumstances, both natural and unnatural, cells synthesize an overabundance of DNA, either in a disorganized fashion (‘over-replication’) or by a systematic doubling of chromosome number (‘endoreplication’). These variations on the theme of DNA replication and division have been studied in strains of fission yeast, Schizosaccharomyces pombe, carrying mutations that interfere with the function of mitotic cyclin-dependent kinase (Cdk1:Cdc13) without impeding the roles of DNA-replication loading-factor (Cdc18) and S-phase cyclin-dependent kinase (Cdk1:Cig2). Some of these mutations support endoreplication, and some over-replication. In this paper, we propose a dynamical model of the interactions among the proteins governing DNA replication and cell division in fission yeast. By computational simulations of the mathematical model, we account for the observed phenotypes of these re-replicating mutants, and by theoretical analysis of the dynamical system, we provide insight into the molecular distinctions between over-replicating and endoreplicating cells. In case of induced over-production of regulatory proteins, our model predicts that cells first switch from normal mitotic cell cycles to growth-controlled endoreplication, and ultimately to disorganized over-replication, parallel to the slow increase of protein to very high levels