Obstetric shock (OS) has been defined as a life-threatening cardiovascular collapse syndrome associated with pregnancy, childbirth and puerperium (obstetrics causes), and is the most significant cause of high maternal mortality (MM) throughout human history. Shock in obstetrics (SIO) refers to indirect causes of non-obstetrics causes in pregnancy, childbirth and puerperium (polytrauma, aesthetic incidents, cardiovascular or cerebrovascular incidents, other septic syndromes). The goals of OS treatment are: to quickly detect the location or cause of bleeding / injury / inflammation, prevent the progression of shock, prevent massive transfusions, preserve the uterus (and adnexa), and preserve fertility if possible. Surgical treatment of septic shock includes exploratory laparotomy (laparoscopy), ectomy or resection of the necrotized organ, abdominal lavage with multiple drainages, continuous peritoneal drainage with lavation, extensive triple antibiosis per admission or per antibiogram and thromboprophylaxis. OS seems to remain a permanent miasma in practical clinical obstetrics, which we will not be able to influence, because we have obviously caused today's increase in MM from haemorrhagic OS by iatrogenic increase in the number of caesarean sections, especially elective ones.

Objectives Evidence on the current status of gender equity in academic rheumatology in Europe and potential for its improvement is limited. The EULAR convened a task force to obtain empirical evidence on the potential unmet need for support of female rheumatologists, health professionals and non-clinical scientists in academic rheumatology. Methods This cross-sectional study comprised three web-based surveys conducted in 2020 among: (1) EULAR scientific member society leaders, (2) EULAR and Emerging EULAR Network (EMEUNET) members and (3) EULAR Council members. Statistics were descriptive with significance testing for male/female responses assessed by χ2 test and t-test. Results Data from EULAR scientific member societies in 13 countries indicated that there were disproportionately fewer women in academic rheumatology than in clinical rheumatology, and they tended to be under-represented in senior academic roles. From 324 responses of EULAR and EMEUNET members (24 countries), we detected no gender differences in leadership aspirations, self-efficacy in career advancement and work–life integration as well as the share of time spent on research, but there were gender differences in working hours and the levels of perceived gender discrimination and sexual harassment. There were gender differences in the ranking of 7 of 26 factors impacting career advancement and of 8 of 24 potential interventions to aid career advancement. Conclusions There are gender differences in career advancement in academic rheumatology. The study informs a EULAR task force developing a framework of potential interventions to accelerate gender-equitable career advancement in academic rheumatology.

Addressing factors modulating COVID-19 is crucial since abundant clinical evidence shows that outcomes are markedly heterogeneous between patients. This requires identifying the factors and understanding how they mechanistically influence COVID-19. Here, we describe how eleven selected factors (age, sex, genetic factors, lipid disorders, heart failure, gut dysbiosis, diet, vitamin D deficiency, air pollution and exposure to chemicals) influence COVID-19 by applying the Adverse Outcome Pathway (AOP), which is well-established in regulatory toxicology. This framework aims to model the sequence of events leading to an adverse health outcome. Several linear AOPs depicting pathways from the binding of the virus to ACE2 up to clinical outcomes observed in COVID-19 have been developed and integrated into a network offering a unique overview of the mechanisms underlying the disease. As SARS-CoV-2 infectibility and ACE2 activity are the major starting points and inflammatory response is central in the development of COVID-19, we evaluated how those eleven intrinsic and extrinsic factors modulate those processes impacting clinical outcomes. Applying this AOP-aligned approach enables the identification of current knowledge gaps orientating for further research and allows to propose biomarkers to identify of high-risk patients. This approach also facilitates expertise synergy from different disciplines to address public health issues.

The architecture of the contemporary mosque is a popular form of self-expression in Muslim communities. Many societies, including Bosnia and Herzegovina, are divided over the mosque-style dilemma. Today's understanding of mosque architecture is quite varied. Some architects, as well as the vast majority of Muslims, believe that new mosques should always be modeled after popular historic styles. A smaller number of architects and others see the mosque as a modern concept devoid of the past. Yet the number of modern designs in newly constructed mosques is significantly lower. Given that the sources of Islam do not contain strict instructions on mosque design, there is no reason to design a mosque today in the styles of the past. The architectural vocabulary of a contemporary mosque should express the present while adhering to universal Islamic principles. In that sense, contemporary architectural language will best express the cultural identity of Muslim communities. A contemporary mosque, on the other hand, will emphasize the fundamental values of Islamic architectural history in this way.

We studied the efficiency of three culture series of the microalgae Phaeodactylum tricornutum (P. tricornutum) and bacteria Thalassospira sp. (axenic microalgae, bacterial culture and co-culture of the two) in removing bisphenols (BPs) from their growth medium. Bacteria were identified by 16S ribosomal RNA polymerase chain reaction (16S rRNA PCR). The microorganism growth rate was determined by flow cytometry. Cultures and isolates of their small cellular particles (SCPs) were imaged by scanning electron microscopy (SEM) and cryogenic transmission electron microscopy (Cryo-TEM). BPs were analyzed by gas chromatography coupled with tandem mass spectrometry (GC-MS/MS). Our results indicate that some organisms may have the ability to remove a specific pollutant with high efficiency. P. tricornutum in axenic culture and in mixed culture removed almost all (more than 99%) of BPC2. Notable differences in the removal of 8 out of 18 BPs between the axenic, mixed and bacterial cultures were found. The overall removals of BPs in axenic P. tricornutum, mixed and bacterial cultures were 11%, 18% and 10%, respectively. Finding the respective organisms and creating microbe societies seems to be key for the improvement of wastewater treatment. As a possible mediating factor, numerous small cellular particles from all three cultures were detected by electron microscopy. Further research on the mechanisms of interspecies communication is needed to advance the understanding of microbial communities at the nano-level.

The enhancement of boiling heat transfer has been extensively shown to be achievable through surface texturing or fluid property modification, yet few studies have investigated the possibility of coupling both enhancement approaches. The present work focuses on exploring the possibility of concomitant enhancement of pool boiling heat transfer by using TiO2-water nanofluid in combination with laser-textured copper surfaces. Two mass concentrations of 0.001 wt.% and 0.1 wt.% are used, along with two nanoparticle sizes of 4–8 nm and 490 nm. Nanofluids are prepared using sonification and degassed distilled water, while the boiling experiments are performed at atmospheric pressure. The results demonstrate that the heat transfer coefficient (HTC) using nanofluids is deteriorated compared to using pure water on the reference and laser-textured surface. However, the critical heat flux (CHF) is significantly improved at 0.1 wt.% nanoparticle concentration. The buildup of a highly wettable TiO2 layer on the surface is identified as the main reason for the observed performance. Multiple subsequent boiling experiments using nanofluids on the same surface exhibited a notable shift in boiling curves and their instability at higher concentrations, which is attributable to growth of the nanoparticle layer on the surface. Overall, the combination of nanofluids boiling on a laser-textured surface proved to enhance the CHF after prolonged exposure to highly concentrated nanofluid, while the HTC was universally and significantly decreased in all cases.

Standardni bosanski jezik pripada četveroakcenatskom novoštokavskom sistemu, od kojeg odstupa u prisutnosti silaznih akcenata u tuđicama, složenicama, genitivu jednine i akuzativu množine pojedinih riječi, neprenošenju akcenta na proklitiku, skraćenicama te dvosložnom refleksu jata. S obzirom na to da je uvjet da upotrebni oblik bude i normiran zapravo precizan opis kategorija, to se u ovom radu silaznom akcentu pristupa sistemski, tj. otkrivaju se moguće kategorije u kojima se silazni akcent javlja dosljedno izvan početnog sloga. Za konačno normiranje potrebno je ove kategorije ispitati na terenu, čime se ovaj rad neće baviti.Iz dosadašnjih istraživanja kao nedovoljno opisane izdvojile su se tuđice i silazni akcent u genitivu množine i vokativu jednine pojedinih riječi. S obzirom na to da se primjeri mogu grupisati prema sufiksima gotovo bez ostatka, a polazeći od teze da sufiksi mogu određivati akcenatsku sliku riječi, kategorije tuđica i riječi koje u genitivu množine i/li vokativu jednine imaju ili mogu imati silazni akcenat izvan početnog sloga kategorizirane su dakle prema sufiksima, koji su detaljno pobrojani. Korpus su činili opći rječnici bosanskog jezika, pa su date napomene i o trenutnom normativnom statusu pojedinih kategorija, od kojih su neke i normirane. Istraživanje je iznjedrilo i opći zaključak, a to je da se u bosanskom jeziku silazni akcenti izvan prvog sloga javljaju samo u trosložnim i višesložnim riječima.

Abstract Introduction Injuries around the elbow pose a challenging problem for orthopaedic surgeons. The complex bony architecture of the joint should be restored and the thin soft tissue envelope needs to be handled with meticulous care. Elbow instability is a complication seen after dislocations and fractures of the elbow and remains a treatment challenge. The purpose of this study was to provide subjective and objective results following the surgical treatment of unstable elbow dislocations with an external hinged fixation technique. Methods Forty-six consecutive patients with complex trauma of the elbow with instability after ligament reconstruction were enrolled between January 2017 and December 2019. The parameters used to quantify the subjective and objective functional results were the Mayo Elbow Score (MES, objective) and Oxford Elbow Score (OES, subjective), and clinical stability of the elbow joint. We also performed a radiological follow-up of the fractures. Results The mean MES and OES scores were good at the 12-month follow-up. We had 38 patients with stable joints and 8 patients with minor instability. Using the stress test, we saw a significant difference in the affected joint under varus stress (6.7 ± 1.8 mm) compared to the healthy joint (5.8 ± 1.2 mm) laterally. Furthermore, medially the gap was significantly larger (5.8 ± 0.8 mm, treated elbow) than the contralateral gap under valgus stress (4.3 ± 0.8 mm) (p <0.001). Twenty-one complications occurred in 46 patients (46%): Seven patients had a clinical change of elbow axis: Three valgus (6%), four varus (9%); Superficial wound infection occurred in one case (2%) and ulnar nerve dysfunction in two (4%). The most common medium-term complication was post-traumatic osteoarthritis in eight cases (17%). Heterotopic ossification occurred in five patients (11%) and elbow stiffness in five cases (11%). Conclusion The use of the hinged elbow external fixator in the treatment of complex elbow trauma is a valid therapeutic adjunct to ligamentous reconstruction showing encouraging results with acceptable complications. How to cite this article Meccariello L, Caiaffa V, Mader K, et al. Treatment of Unstable Elbow Injuries with a Hinged Elbow Fixator: Subjective and Objective Results. Strategies Trauma Limb Reconstr 2022;17(2):68–73.

ABSTRACT Emulsion explosives exhibit strong nonideal detonation behavior, which provides a challenge for accurate numerical modeling. We present a nonideal detonation model based on the Wood–Kirkwood detonation theory and EXPLO5, capable of modeling the effect of the charge diameter on steady-state detonation velocity. The elements of the model are calibrated based on experimental data for four different emulsion explosives. It was demonstrated that both simple pressure-dependent and Kirby and Chan’s two-step reaction rate models can satisfactorily reproduce the detonation velocity–charge diameter data of unconfined charges. In addition, the reaction rate parameters are found to be a function of the density of explosives.

Objective To describe the incidence of infertility, pregnancy complications, and breastfeeding practices among Australian and New Zealand doctors and identify factors associated with increased pregnancy complication rates. Methods A survey of ANZ doctors using an online questionnaire during November 2021. Results One thousand ninety-nine completed responses were received. The median age of female doctors at the time of their first child was 32.4. Fertility testing was undertaken by 37%, with 27% having in vitro fertilization. More than 60% of respondents delayed family planning due to work. Pregnancy loss occurred in 36% of respondents, and 50% suffered a pregnancy complication. There were significant differences between specialists, with surgeons working longer hours before and after pregnancy, but having greater access to maternity leave than general practitioners. Conclusion Female doctors delay starting and completing their family due to work-related demands and structural biases in career progression, which may result in higher infertility and pregnancy complication rates.

[This corrects the article DOI: 10.3389/fpubh.2022.795841.].