•Sustainability challenges require both specialized and integrative approaches.•Domination of specialism and reductionism calls for emphasis on comprehensiveness.•The GHH framework can be used as a ...tool to add comprehensiveness in education.•The framework consists of three dimensions: generalism, holism, and holarchism.•The dialectical approach combines comprehensive and differentiative approaches.
Sustainability challenges such as climate change, biodiversity loss, poverty and rapid urbanization are complex and strongly interrelated. In order to successfully deal with these challenges, we need comprehensive approaches that integrate knowledge from multiple disciplines and perspectives and emphasize interconnections. In short, they aid in observing matters in a wider perspective without losing an understanding of the details. In order to teach and learn a comprehensive approach, we need to better understand what comprehensive thinking actually is. In this paper, we present a conceptual framework for a comprehensive approach, termed the GHH framework. The framework comprises three dimensions: generalism, holism, and holarchism. It contributes to the academic community’s understanding of comprehensive thinking and it can be used for integrating comprehensive thinking into education. Also, practical examples of the application of the framework in university teaching are presented. We argue that an ideal approach to sustainability challenges and complexity in general is a balanced, dialectical combination of comprehensive and differentiative approaches. The current dominance of specialization, or the differentiative approach, in university education calls for a stronger emphasis on comprehensive thinking skills. Comprehensiveness should not be considered as a flawed approach, but should instead be considered as important an aspect in education as specialized and differentiative skills.
•We assessed history of fair shares of the SOS in access to nutrients to produce food.•Planetary boundaries were transgressed in 1970 (nitrogen) and 1964 (phosphorus).•Since then, the activation has ...doubled (nitrogen) and tripled (phosphorus).•History of nutrient activation shows clear disparities between countries and regions.
The activation of nitrogen and phosphorus for food production has caused the transgression of the safe operating space of the Earth system. However, countries differ in the use of their fair share of global nutrient activation, causing a disparity that has severe implications for the environment, land degradation and food security. Both the impact on Earth system processes as well as productivity gains and losses and the consequent socio-economic impacts depend on past use. Therefore, in this study, we examined how the activation of nitrogen and phosphorus for food production in relation to countries’ fair shares has evolved globally. The first transgressions of the planetary boundaries occurred in 1970 and 1964 for nitrogen and phosphorus, respectively. Since then, activation has increased 160% and 200%, respectively. Further, notable differences were observed between countries, in which high-income regions such as western Europe and North America had the highest cumulative transgression and sub-Saharan Africa and Oceania had the greatest deficit relative to their fair shares. The main driver for transgression was economic growth rather than population growth or the relatively recent fertiliser subsidies. Although the use of fertilisers has decreased in areas with previous high use, past usage will slow down the effects of fertiliser reductions on ecosystem recovery and maintain a legacy of inequality. Consequently, in addition to reductions in nitrogen and phosphorus activation, recycling accumulated nutrients to regions operating below their fair shares should be explored and economically enabled in order to secure Earth system functioning while eradicating hunger.
The aim of the present study was to investigate how abdominal aortic aneurysm (AAA) affects the patient's functional status, health and well-being. Forty-two consecutive patients at a university ...clinic were included. Twenty were operated on and 22 were on regular, conservative check-ups. The patients answered questionnaires regarding perceived functional status (Sickness Impact Profile, SIP), general health (Health Index, HI) and psychological well-being. Two reference groups were used. The non-operated patients scored significantly worse for functional status on the psycho-social subscale than the operated patients. In comparison with the reference group they had the worst scores for functional status on the overall SIP scale and the physical, eating and home-management scales. Regarding the HI, there was no difference between the patient groups themselves, but as a whole they had significantly lower scores than the reference group. Thus, the patients perceived their well-being as worse than a healthy reference group. In their attitudes to well-being, the non-operated patients, were significantly less hopeful than the operated patients. It is obvious that asymptomatic AAA has a significant effect on the patient's self-perceived, functional status and well-being, irrespective of the surgical or conservative management.
Objectives:to relate the 30-day perioperative rate of stroke or death in Carotid endarterectomy (CEA) to preoperative qualifying symptoms and to the presence of cerebral infarction (CI) demonstrated ...on computed tomography (CT).Design:retrospective clinical study.Material and methods:two hundred and seventy-two consecutive CEAs for symptomatic stenosis in 262 patients were analysed.Results:the total complication rate was 5.9%. Patients with retinal symptoms (n=81) had no complications, TIA patients (n=76) had 6.6% (p<0.001). Patients qualifying with minor stroke (n=113) had complications in 9.7% (n.s.compared to TIA patients). Patients qualifying with cortical symptoms had a significantly higher complication rate compared to those with retinal (8.4% vs. 0%,p=0.004). The presence of a preoperative CT-verified infarction resulted in a higher risk for stroke or death (9.8% vs 2.8%,p=0.008). Within the subgroup presenting with minor stroke, the presence of CI resulted in stroke or death in 13.9%. In patients without CI the corresponding figure was 2.4% (p=0.017).Conclusion:the qualifying symptoms and the presence of CI visualized by CT influence the complication rate in CEA. When evaluating risk and comparing outcome, these parameters should be included in reporting standards.
A multimodel controller design procedure based on robust LQ design is evaluated for a highly nonlinear chemical process. The procedure is combined with two gain-scheduling methods: a fixed robust ...controller with scheduled output gain, and complete scheduling of locally optimal controllers. The performances obtained with the fixed controller, the gain scheduled controllers and conventional PID control are compared and tested on a simulated pH neutralization process.
A substantial proportion of individuals in the general population have tinnitus and 1-3% suffer from severe tinnitus affecting sleep, concentration, and mood. For a majority of patients with tinnitus ...degree of hearing loss plays a significant role. Several potential causes and aggravating factors have been suggested, but there is still not a single theory available to explain why tinnitus is so bothersome for some individuals. Recent research has investigated neural correlates of tinnitus, mainly involving primary and secondary auditory cortex. Several treatments have been tested with modest results. However, for the alleviation of tinnitus-related distress there is now empirical support for the use of cognitive-behavioural treatment methods. Future efforts should focus on prevention of noise-induced hearing loss and ways to foster habituation to tinnitus.
Internal model control is applied to stable nonlinear systems described by linear parameter-varying models. Velocity-based linearizations are applied to construct a set of linearized models which ...provides a global description of the nonlinear system dynamics. The velocity-form linear parameter-varying system description gives an exact relation between the input and the output changes, while steady-state information is captured in an offset term. From the model structure it follows that an internal model controller based on the velocity-form linear parameter-varying model representation fails to eliminate steady-state offsets. In order to achieve a zero steady-state error when using velocity-based linearized models a modified internal model control structure is introduced. The proposed method is applied to a strongly nonlinear simulated pH neutralization process.
Aim. This paper reports on a study which aimed to evaluate the effects of structured written preoperative information on patients’ postoperative psychological and physical wellbeing after surgery ...for abdominal aortic aneurysm (AAA).
Background. The possible benefits of current booklets written by professionals on postoperative psychological and physical wellbeing in patients with AAA are unknown. Previous studies have shown that preoperative information has a favourable effect on both mood state and physical mobilization.
Method. Fifty‐two patients admitted for elective repair of AAA were selected consecutively and randomized to receive only verbal (control group), or verbal and written information in booklet form (experimental group). The booklet contained procedural and sensory information about the disease and its treatment. Two questionnaires were used to establish whether the booklet had any effect on perceived health, psychological and physical wellbeing postoperatively.
Results. The two groups were similar regarding their perceived health but differed significantly regarding psychological wellbeing pre‐ and postoperatively. Patients in the experimental group were significantly sadder both pre‐ and postoperatively compared with those in the control group. Both groups were similar in postoperative physical wellbeing.
Conclusion. This group of patients often has asymptomatic disease, with a short interval between diagnosis and major surgery. When patients receive an information booklet during this period, this seems to cause more worries than anticipated. Hence, a more supportive educational programme might benefit this patient group, both pre‐ and postoperatively.
Drugs targeting SARS-CoV-2 could have saved millions of lives during the COVID-19 pandemic, and it is now crucial to develop inhibitors of coronavirus replication in preparation for future outbreaks. ...We explored two virtual screening strategies to find inhibitors of the SARS-CoV-2 main protease in ultralarge chemical libraries. First, structure-based docking was used to screen a diverse library of 235 million virtual compounds against the active site. One hundred top-ranked compounds were tested in binding and enzymatic assays. Second, a fragment discovered by crystallographic screening was optimized guided by docking of millions of elaborated molecules and experimental testing of 93 compounds. Three inhibitors were identified in the first library screen, and five of the selected fragment elaborations showed inhibitory effects. Crystal structures of target-inhibitor complexes confirmed docking predictions and guided hit-to-lead optimization, resulting in a noncovalent main protease inhibitor with nanomolar affinity, a promising in vitro pharmacokinetic profile, and broad-spectrum antiviral effect in infected cells.
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