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The coronavirus disease 2019 (COVID-19) pandemic has resulted in shortages of personal protective equipment (PPE), underscoring the urgent need for simple, efficient, and inexpensive methods to decontaminate masks and respirators exposed to severe acute respiratory coronavirus virus 2 (SARS-CoV-2). We hypothesized that methylene blue (MB) photochemical treatment, which has various clinical applications, could decontaminate PPE contaminated with coronavirus.
The 2 arms of the study included (1) PPE inoculation with coronaviruses followed by MB with light (MBL) decontamination treatment and (2) PPE treatment with MBL for 5 cycles of decontamination to determine maintenance of PPE performance.
MBL treatment was used to inactivate coronaviruses on 3 N95 filtering facepiece respirator (FFR) and 2 medical mask models. We inoculated FFR and medical mask materials with 3 coronaviruses, including SARS-CoV-2, and we treated them with 10 µM MB and exposed them to 50,000 lux of white light or 12,500 lux of red light for 30 minutes. In parallel, integrity was assessed after 5 cycles of decontamination using multiple US and international test methods, and the process was compared with the FDA-authorized vaporized hydrogen peroxide plus ozone (VHP+O3) decontamination method.
Overall, MBL robustly and consistently inactivated all 3 coronaviruses with 99.8% to >99.9% virus inactivation across all FFRs and medical masks tested. FFR and medical mask integrity was maintained after 5 cycles of MBL treatment, whereas 1 FFR model failed after 5 cycles of VHP+O3.
MBL treatment decontaminated respirators and masks by inactivating 3 tested coronaviruses without compromising integrity through 5 cycles of decontamination. MBL decontamination is effective, is low cost, and does not require specialized equipment, making it applicable in low- to high-resource settings.
Traditional histories of German philosophy often present the development of German Idealism as a linear, teleological progression from Kant, through Fichte and Schelling, to Hegel.1 This approach originates in Hegel’s own history of philosophy, which portrays the history of German Idealism as a cumulative, dialectical progression that terminates – rather conveniently – in Hegel’s own absolute idealism. Over the past twenty years, there has been a growth of scholarship on the development of post-Kantian idealism, and a reappraisal of figures who were afforded only minor, supporting roles in the traditional narrative (figures such as K. L. Reinhold, S. Maimon, F. Schlegel, and Novalis).2 The effects of this revisionary scholarship have been salutary: it has resulted in a more nuanced picture of the development of German Idealism that challenges the standard Hegelian narrative;3 it has led to the recovery of important philosophical arguments and insights;4 it has made salient previously neglected continuities with earlier traditions (e.g., the Leibnizian-Wolffian and Spinozist traditions);5 and it has led to a deeper understanding of the philosophies of Fichte, Schelling, and Hegel by revealing their positions to be responses to hitherto unnoticed debates and questions.6
In his Foundations of Natural Right, J. G. Fichte advances the innovative thesis that the theory of right is independent of, or separate from, moral theory. Although Fichte is concerned to stress the originality of his approach, he refers approvingly to some “excellent hints” in the writings of J. B. Erhard. Given the recent scholarly interest in Fichte’s account of the relationship between right and morality, it is surprising that Erhard’s position is seldom discussed. Where it is discussed, it is often presented as merely a hesitant precursor of Fichte’s position. This paper argues that Erhard’s account of the relationship between right and morality constitutes a distinctive and philosophically compelling position. I reconstruct Erhard’s account of the relationship between right and morality. I argue that Erhard’s position is best characterized as focusing on the dynamic interplay between the theory of right and the requirements of morality as articulated by Kantian moral theory. I demonstrate the coherence and significance of Erhard’s position by considering it in relation to a central debate in the philosophy of law—the debate between legal positivism and natural law theory.
Scholarship on Kant's practical philosophy has often overlooked its reception in the early days of post-Kantian philosophy and German Idealism. This volume of new essays illuminates that reception and how it informed the development of practical philosophy between Kant and Hegel. The essays discuss, in addition to Kant, Hegel and Fichte, relatively little-known thinkers such as Pistorius, Ulrich, Maimon, Erhard, E. Reimarus, Reinhold, Jacobi, F. Schlegel, Humboldt, Dalberg, Gentz, Rehberg, and Möser. Issues discussed include the empty formalism objection, the separation between right and morality, freedom and determinism, nihilism, the right to revolution, ideology, and the limits of the liberal state. Taken together, the essays provide an historically informed and philosophically nuanced picture of the development of post-Kantian practical philosophy.
Despite evidence of gender differences in bipolar disorder characteristics and comorbidity, there is little research on the differences in treatment and service use between men and women with bipolar disorder.
To use routine data to describe specialist mental health service contact for bipolar disorder, including in-patient, community and support service contacts; to compare clinical characteristics and mental health service use between men and women in contact with secondary services for bipolar disorder.
Cross-sectional analysis of mental health patients with bipolar disorder in New Zealand, based on complete national routine health data.
A total of 3639 individuals were in contact with specialist mental health services with a current diagnosis of bipolar disorder in 2015. Of these 58% were women and 46% were aged 45 and over. The 1-year prevalence rate of bipolar disorder leading to contact with specialist mental health services was 1.56 (95% CI 1.50–1.63) per 100 000 women and 1.20 (95% CI 1.14–1.26) per 100 000 men. Rates of bipolar disorder leading to service contact were 30% higher in women than men (rate ratio 1.30, 95% CI 1.22–1.39). The majority (68%) had a diagnosis of bipolar I disorder. Women were more likely to receive only out-patient treatment and have comorbid anxiety whereas more men had substance use disorder, were convicted for crimes when unwell, received compulsory treatment orders and received in-patient treatment.
Although the prevalence of bipolar disorder is equal between men and women in the population, women were more likely to have contact with specialist services for bipolar disorder but had a lower intensity of service interaction.
Background: Healthcare exposure results in significant microbiome disruption, particularly in the setting of critical illness, which may contribute to risk for healthcare-associated infections (HAIs). Patients admitted to long-term acute-care hospitals (LTACHs) have extensive prior healthcare exposure and critical illness; significant microbiome disruption has been previously documented among LTACH patients. We compared the predictive value of 3 respiratory tract microbiome disruption indices—bacterial community diversity, dominance, and absolute abundance—as they relate to risk for ventilator-associated pneumonia (VAP) and adverse ventilator-associated events (VAE), which commonly complicate LTACH care. Methods: We enrolled 83 subjects on admission to an academic LTACH for ventilator weaning and performed longitudinal sampling of endotracheal aspirates, followed by 16S rRNA gene sequencing (Illumina HiSeq), bacterial community profiling (QIIME2) for diversity, and 16S rRNA quantitative PCR (qPCR) for total bacterial abundance. Statistical analyses were performed with R and Stan software. Mixed-effects models were fit to relate the admission MDIs to subsequent clinically diagnosed VAP and VAE. Results: Of the 83 patients, 19 had been diagnosed with pneumonia during the 14 days prior to LTACH admission (ie, “recent past VAP”); 23 additional patients were receiving antibiotics consistent with empiric VAP therapy within 48 hours of admission (ie, “empiric VAP therapy”); and 41 patients had no evidence of VAP at admission (ie, “no suspected VAP”). We detected no statistically significant differences in admission Shannon diversity, maximum amplicon sequence variant (ASV)–level proportional abundance, or 16S qPCR across the variables of interest. In isolation, all 3 admission microbiome disruption indices showed poor predictive performance, though Shannon diversity performed better than maximum ASV abundance. Predictive models that combined (1) bacterial diversity or abundance with (2) recent prior VAP diagnosis and (3) concurrent antibiotic exposure best predicted 14-day VAP (type S error < 0.05) and 30-day VAP (type S error < 0.003). In this cohort, VAE risk was paradoxically associated with higher admission Shannon diversity and lower admission maximum ASV abundance. Conclusions: In isolation, respiratory tract microbiome disruption indices obtained at LTACH admission showed poor predictive performance for subsequent VAP and VAE. But diversity and abundance models incorporating recent VAP history and admission antibiotic exposure performed well predicting 14-day and 30-day VAP.
Indaziflam, a PRE herbicide option for weed management on rangeland and natural areas, provides long-term control of invasive winter annual grasses (IWAGs). Because indaziflam only provides PRE control of IWAGs, POST herbicides such as glyphosate can be mixed with indaziflam to control germinated IWAG seedlings. Field trials were conducted at three sites on the Colorado Front Range to evaluate glyphosate dose required to provide adequate POST IWAG control and compare long-term downy brome (Bromus tectorum L.), Japanese brome (Bromus arvensis L.), and feral rye (Secale cereale L.) control with indaziflam and imazapic. Two of the three sites were void of desirable species, so species establishment through drill seeding was assessed, while the remnant native plant response was assessed at the third site. Herbicide applications were made March 2014 through April 2015, and two sites were drill seeded with native species 9 mo after herbicide application. Yearly visual control evaluations, biomass of all plant species, and drilled species stand counts were collected. Glyphosate at 474 g ae ha−1 reduced B. tectorum biomass to zero, while glyphosate at 631 g ae ha−1 was needed to reduce biomass to near zero at the S. cereale site. At all three sites, only indaziflam treatments had significant reductions in IWAG biomass compared with the nontreated check at 3 yr after treatment (YAT). By 3 YAT in the drill-seeded sites, cool-season grass frequency ranged from 37% to 69% within indaziflam treatments (73 and 102 g ai ha−1), while imazapic treatments ranged from 0% to 26% cool-season grass frequency. In the site with a remnant native plant community, indaziflam treatments resulted in a 3- to 4-fold increase in native grass biomass. These results indicate that the multiyear IWAG control provided by indaziflam can aid in desirable species reestablishment through drill seeding or response of the remnant plant community.
When at the end of the twelfth century the universities first emerged in Italy, Spain, and France, the culture of monastic learning was already centuries-old and clearly defined. Indeed, it was the monasteries’ lively discourse on the place and purpose of study in the years after the Gregorian reform that gave form and focus to the emerging intellectual program of the new, secular schools. Europe’s monasteries did not react to the rise of the universities; rather, they were active in their evolution, shaping their learned culture with a mature syllabus of their own. Secular masters fashioned an image which was set self-consciously in opposition to the professed path of humility. Yet as a corporate, and later collegiate, body, these masters found much inspiration in the monastery, from its cloister, a purpose-built study space, to its morning schedule of teaching and its seasonal circulation of books. In their turn, the schools extended the intellectual horizons of the monks and equipped them to participate in the clerical culture of the institutional Church.
The sermon was a feature of monastic life from early times as a vehicle for spiritual instruction, pastoral guidance, and formal ceremonial (for example, to mark the election of a superior), but it was only in the later Middle Ages that the practice of preaching to audiences inside and outside the cloister became a common occupation for monastic men and women.
Research on self-practice/self-reflection (SP/SR) programmes in training cognitive behavioural therapy (CBT) have shown promising outcomes over the past decade. To date, the SP/SR framework research has generally focused on entire programmes and has rarely assessed the utility of specific exercises as teaching tools. This study aimed to determine the utility of an exposure intervention known as a shame attack in helping to facilitate CBT training in a clinical psychology programe when delivered in a SP/SR framework. It also sought to examine the potential for the exercise to be used as a form of competency-based assessment. Forty-one student trainees engaged in self-directed shame attack exercises and provided written reflections on their experiences. The reflections were then studied via thematic analysis. The results indicate that the exercise provides an avenue for competency-based assessment of trainee therapists’ conceptual knowledge, formulation skills and intervention planning. It also promoted learning outcomes relating to a ‘deeper’ and more nuanced appreciation of CBT theory and practice. The shame attack exercise provided for personal development and the opportunity to experience typical client challenges with engaging in exposure interventions, which have the potential for enhancing empathy and cognitive behavioural skills.
Key learning aims
(1) To understand the usefulness of a shame attack exercise for training within a SP/SR framework.
(2) To examine the potential for using SP/SR as a form of competency-based training.
(3) To demonstrate the benefits of experiential learning through SP/SR in training CBT.