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重症监护室护士限制治疗努力的能力:整合性综述

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International Journal of nursing Sciences 2024年第1期11卷 143-154,I0003页

作者： Elvia R.Lopez-Panza Vanessa C.Pacheco-Roys Kelly J.Fernandez-Ahumada Diana C.Díaz-Mass maría y.exposito-concepcion Elizabeth Villarreal-Cantillo Cesar I.Aviles Gonzalez nursing Department Universidad del NorteBarranquillaColombia nursing Program Faculty of Health SciencesUniversidad Popular del CesarValleduparColombia Clínica Valledupar ValleduparColombia Hospital Universidad del norte SoledadColombia Department of Medical Sciences and Public Health University of CagliariCittadella Universitaria di MonserratoCagliariItaly

目的在重症监护病房(IntensiveCareUnit,ICU),护土难免会遇到需要限制治疗努力(limiting therapeutie efort,LTE)的患者,尽管多数护士还缺乏为这些临终患者及其家庭提供支持的准备。本综述旨在描述ICU护士在LTE中需要具备的能力。方法对... 详细信息

目的在重症监护病房(IntensiveCareUnit,ICU),护土难免会遇到需要限制治疗努力(limiting therapeutie efort,LTE)的患者,尽管多数护士还缺乏为这些临终患者及其家庭提供支持的准备。本综述旨在描述ICU护士在LTE中需要具备的能力。方法对2010年--2023年发表的文献进行综述。系统检索了5个数据库:Medline、Wiley Online Library、SciELO、ScienceDirect和Web of Science。使用关键评估项目工具西班牙语版(Critical Appraisal Skills Programme in Spanish,CASPe)作为评判性阅读工具。使用牛津循证医学中心(Center for Evidence-Based Medicine.,CEBM)评估工具确定证据级别和推荐强度。结果共纳入25篇文献。ICU护士LTE护理的能力包括对患者的直接护理、以家庭为中心的护理以及护士在团队中的作用。该综述确定了3个类别的能力:作为患者、家庭与跨学科团队之间维护者的能力,在LTE方面的决策能力,在患者生命末期治疗和护理干预的能力。结论ICU护士在LTE方面需要具备相应的能力,这对患者的生活质量死亡尊严以及患者家庭应对悲伤的全面支持至关重要。

关键词：重症监护家庭支持重症监护病房护士的作用安宁疗护专业能力

Estimation of Equivalent Model of Photovoltaic Array Using Unscented Kalman Filters

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Journal of Modern Power Systems and Clean Energy 2024年第3期12卷 819-827页

作者： M.A.González-Cagigal JoséA.Rosendo-Macías A.Gómez-expósito the Department of Electrical Engineering University of SevilleSpainand A.Gómez-Expósito is also with ENGREEN Laboratory of Engineering for Energy and Environmental SustainabilitySevilleSpain

This paper proposes the use of the unscented Kalman filter to estimate the equivalent model of a photovoltaic(PV)array,using external measurements of current and voltage at the inverter *** estimated model is of interest to predict the power output of PV plants,in both planning and operation scenarios,and thus improves the efficient operation of power systems with high penetration of renewable *** proposed technique has been assessed in several simulated scenarios under different operating *** results show that accurate estimates are provided for the model parameters,even in the presence of measurement noise and abrupt variations under the external conditions.

关键词： Equivalent model parameter estimation photovoltaic energy unscented Kalman filter

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From liver to hormones:The endocrine consequences of cirrhosis

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World Journal of Gastroenterology 2024年第9期30卷 1073-1095页

作者： Juan Eduardo Quiroz-Aldave Elman Rolando Gamarra-Osorio maría del Carmen Durand-Vásquez Luciana del Pilar Rafael-Robles Jhean Gabriel Gonzáles-yovera maría Alejandra Quispe-Flores Luis Alberto concepción-Urteaga Alejandro Román-González José Paz-Ibarra marcio José concepción-Zavaleta non-communicable Diseases Endocrinology Research LineHospital de Apoyo ChepénChepén 13871Peru Department of Endocrinology Hospital Víctor Lazarte EchegarayTrujillo 13006Peru Department of Endocrinology Clínica Javier PradoLima 15046Peru Department of Gastroenterology Hospital Nacional Guillermo Almenara IrigoyénLima 15018Peru Department of Endocrinology Hospital de Emergencias GrauLima 15001Peru Internal Medicine Hospital Regional Docente de TrujilloTrujillo 13011Peru Department of Endocrinology Hospital Universitario de San Vicente FundaciónMedellin 050010Colombia Internal Medicine Universidad de AntioquiaMedellín 050010Colombia School of Medicine Universidad Nacional Mayor de San MarcosLima 15081Peru Department of Endocrinology Hospital Nacional Edgardo Rebagliati MartinsLima 15072Peru Carrera de Medicina Humana Universidad Científica del SurLima 15067Peru

Hepatocrinology.explores the intricate relationship between liver function and the endocrine *** liver diseases such as liver cirrhosis can cause endocrine disorders due to toxin accumulation and protein synthesis *** its importance,assessing endocrine issues in cirrhotic patients is frequently *** article provides a comprehensive review of the epidemiology,pathophysiology,diagnosis,and treatment of endocrine disturbances in liver *** review was conducted using the PubMed/Medline,EMBASE,and Scielo databases,encompassing 172 *** cirrhosis is associated with endocrine disturbances,including diabetes,hypoglycemia,sarcopenia,thyroid dysfunction,hypogonadotropic hypogonadism,bone disease,adrenal insufficiency,growth hormone dysfunction,and secondary *** optimal tools for diagnosing diabetes and detecting hypoglycemia are the oral glucose tolerance test and continuous glucose monitoring system,*** can be assessed through imaging and functional tests,while other endocrine disorders are evaluated using hormonal assays and imaging *** options include metformin,glucagon-like peptide-1 analogs,sodium-glucose co-transporter-2 inhibitors,and insulin,which are effective and safe for diabetes *** standards are followed for managing hypoglycemia,and hormone replacement therapy is often necessary for other endocrine *** transplantation can address some of these problems.

关键词： Diabetes mellitus Hypoglycemia Thyroid diseases Hypogonadism Metabolic bone diseases Liver cirrhosis

Calibration of the DEM sliding friction and rolling friction parameters of a cohesionless bulk material

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Particuology 2024年第9期92卷 126-139页

作者： Jonatan marín Pérez Tugrul Comlekci yevgen Gorash Donald MacKenzie University of Strathclyde 75 Montrose StreetG11XJGlasgowUnited Kingdom

The discrete element method(DEM)has become a valuable tool for understanding the mechanical behaviour of granular assemblies,however,the accuracy of the DEM simulations depends on several interaction parameters such as the sliding friction and rolling friction ***,these parameters are estimated using bulk calibration approach(BCA)where the draw down test has been suggested as an effective way to approach these *** test provides up to four bulk criteria,the angle of repose,shear angle,mass flow rate and the mass loss which are used to narrow down the possible ***,there is still more research needed around it to fully understand how this methodology *** experimental and numerical study was carried out using the draw down test to assess the influence of different mass flow rates and particle shapes on DEM parameters for a cohesionless bulk *** is concluded that use of multi-sphere particles and three aperture sizes in the draw down test to calibrate the sliding and rolling friction parameters of a cohesionless bulk material can converge to a small feasible region in which a single combination of the friction coefficients can be *** calibrated sliding and rolling friction coefficients were validated using multi-sphere particles,where the maximum deviation was 5.9%from the experimental values.

关键词： Discrete element method Calibration Draw down Sliding friction Rolling friction Particle shape

Habitat and food preferences of European rabbits in core and edge populations along the invasion front PatagoniaMonte,Argentina

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Current Zoology 2024年第3期70卷 310-319页

作者： Sabrina yasmin Bobadilla maría A.Dacar Fabián M.Jaksic Ricardo A.Ojeda maría Fernanda Cuevas Ecología de Mamíferos de Tierras Secas IADIZACCT-Mendoza CONICETAv.Ruiz Leal s/nParque General San MartínMendoza 5500MendozaArgentina Laboratorio de Filogeografía Taxonomía Integrativa y Ecología(LFTIE)IADIZACCT-Mendoza CONICETAv.Ruiz Leal s/nParque General San MartínMendoza 5500MendozaArgentina Center of Applied Ecology and Sustainability(CAPES) Pontifcia Universidad Católica de ChileAv.Libertador Bernardo O'Higgins 340Santiago 8320000Región MetropolitanaChile

The European rabbit Oryctolagus cuniculus is an exotic herbivorous mammal undergoing an active phase of geographical expansion in the arid ecosystems of *** Adaptive Flexibility Hypothesis states that populations at the range edge(new populations)will exhibit greater fexibility in the use of resources compared with populations located in the range core(older populations).The objective of this work was to compare the rabbit’s use of spatial and trophic resources in relation to the establishment time of their *** sampling was carried out for 2 years(2017 and 2018)in sites with different establishment times for rabbit *** sampling stratifed by type of habitat was applied using 115 fxed strip transects of 1,000 m^(2) laid out across the study *** rabbit signs were recorded in each transect,and environmental and anthropic variables were *** results show that the individuals from the range edge are more selective in the use of habitat than those from the range *** the microhabitat level,we observed a pattern in the particular components of habitat use by rabbits mainly linked to food availability and proximity to *** a trophic perspective,rabbits could show fexible adjustment to novel conditions and environments in the range *** variability in resource use by the European rabbit confrms its ecological fexibility,pivotal for their advance toward new environments in Argentina.

关键词： Arid ecosystems invasive species novel environments range invasion spatial use trophic use

Omics-based biomarkers as useful tools in metabolic dysfunctionassociated steatotic liver disease clinical practice:How far are we?

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World Journal of Gastroenterology 2024年第14期30卷 1982-1989页

作者： Julieta Trinks maría F Mascardi Adrián Gadano Sebastián marciano Instituto de Medicina Traslacional e Ingeniería Biomédica-Consejo nacional de Investigaciones Científicas y Técnicas-Instituto Universitario del Hospital Italiano-Hospital Italiano de Buenos Aires Ciudad Autónoma de Buenos Aires C1199ACLArgentina Consejo nacional de Investigaciones Científicas y Técnicas Ciudad Autónoma de Buenos Aires C1425FQBArgentina Liver Unit Hospital Italiano de Buenos AiresCiudad Autónoma de Buenos Aires C1199DFArgentina Department of Research Hospital Italiano de Buenos AiresCiudad Autónoma de Buenos Aires C1199DFArgentina

Unmet needs exist in metabolic dysfunction-associated steatotic liver disease(MASLD)risk *** ability to identify patients with MASLD with advanced fibrosis and at higher risk for adverse outcomes is still *** novel biomarkers could represent a meaningful improvement to current risk *** this aim,omics technologies have revolutionized the process of MASLD biomarker discovery over the past *** the research in this field is thriving,much of the publication has been haphazard,often using single-omics data and specimen sets of convenience,with many identified candidate biomarkers but lacking clinical validation and *** we incorporate these biomarkers to direct patients’management,it should be considered that the roadmap for translating a newly discovered omics-based signature to an actual,analytically valid test useful in MASLD clinical practice is rigorous and,therefore,not easily *** article presents an overview of this area’s current state,the conceivable opportunities and challenges of omics-based laboratory diagnostics,and a roadmap for improving MASLD biomarker research.

关键词： Metabolic dysfunction-associated steatotic liver disease non-alcoholic steatohepatitis Biomarker Risk stratification Omics

Engineering hyaluronic acid-based nanoassemblies for monoclonal antibody delivery-design,characterization,and biological insights

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nano Research 2024年第10期17卷 9111-9125页

作者： Ana M.López-Estévez y.Zhang maría Medel Iker Arriaga Lucía Sanjurjo Cristian Huck-Iriart nicola G.A.Abrescia maría J.Vicent Defang Ouyang Dolores Torres maría José Alonso Center for Research in Molecular Medicine and Chronic Diseases(CiMUS) University of Santiago de CompostelaSantiago de Compostela 15782Spain Department of Pharmacology Pharmacy and Pharmaceutical TechnologySchool of PharmacyUniversity of Santiago de CompostelaSantiago de Compostela 15782Spain Health Research Institute of Santiago de Compostela(IDIS) Santiago de Compostela 15782Spain State Key Laboratory of Quality Research in Chinese Medicine Institute of Chinese Medical Sciences(ICMS)University of MacaoMacao 999078China Polymer Therapeutics Laboratory and CIBEROnC Prince Felipe Research Centre Valencia E-46012Spain Structure and Cell Biology of Viruses Lab CIC bioGUNEBasque Research and Technology Alliance(BRTA)Derio 48160Spain ALBA Synchrotron Light Source Experiments DivisionCerdanyola del VallèsBarcelona 08290Spain IKERBASQUE Basque Foundation for ScienceBilbao 48009Spain

The current spotlight of cancer therapeutics is shifting towards personalized medicine with the widespread use of monoclonal antibodies(mAbs).Despite their increasing potential,mAbs have an intrinsic limitation related to their inability to cross cell membranes and reach intracellular *** offers promising solutions to overcome this limitation,however,formulation challenges *** challenges are the limited loading capacity(often insufficient to achieve clinical dosing),the complex formulation methods,and the insufficient characterization of mAb-loaded ***,we present a new nanocarrier consisting of hyaluronic acid-based nanoassemblies(HAnAs)specifically designed to entrap mAbs with a high efficiency and an outstanding loading capacity(50%,w/w).HAnAs composed by an mAb,modified HA and phosphatidylcholine(PC)resulted in sizes of~100 nm and neutral surface *** modeling identified the principal factors governing the high affinity of mAbs with the amphiphilic HA and *** composition and structural configuration were analyzed using the orthogonal techniques cryogenic transmission electron microscopy(cryo-TEM),asymmetrical flow field-flow fractionation(AF4),and small-angle X-ray scattering(SAXS).These techniques provided evidence of the formation of core-shell nanostructures comprising an aqueous core surrounded by a bilayer consisting of phospholipids and amphiphilic *** vitro experiments in cancer cell lines and macrophages confirmed HAnAs’low toxicity and ability to transport mAbs to the intracellular *** reproducibility of this assembling process at industrial-scale batch sizes and the long-term stability was *** conclusion,these results underscore the suitability of HAnAs technology to load and deliver biologicals,which holds promise for future clinical translation.

关键词： monoclonal antibody nanoparticles hyaluronic acid characterization particle size computational modeling

experimental implementation of phase triplicator gratings in a spatial light modulator

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Chinese Optics Letters 2024年第2期22卷 64-69页

作者：高尚 maría del mar Sánchez-López Ignacio Moreno Instituto de Bioingeniería Universidad Miguel HernándezElche 03202Spain Departamento de Física Aplicada Universidad Miguel HernándezElche 03202Spain Departamento de Ciencia de Materiales Óptica y Tec.Electr´onicaUniversidad Miguel HernándezElche 03202Spain

In this work,we compare different methods for implementing a triplicator,a phase grating that generates three equiintense diffraction *** design with optimal efficiency features a continuous phase profile,which cannot be easily reproduced,and is typically affected by *** compare its performance with binary and sinusoidal phase *** also analyze the effect of quantizing the phase ***,a random approach is adopted to eliminate the additional harmonic *** all cases,a liquid-crystal-on-silicon spatial light modulator is employed to experimentally verify and compare the different approaches.

关键词： diffraction gratings phase modulation triplicator spatial light modulators

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Clinical profile and outcomes in very elderly patients with atrial fibrillation anticoagulated with rivaroxaban: data from the EMIR study

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Journal of Geriatric Cardiology 2024年第7期21卷 723-732页

作者： Francisco marín Manuel Anguita Sánchez Iñaki Lekuona marcelo Sanmartín Fernán-dez Vivencio Barrios Carlos Perez Muñoz Juan Cosín-Sales Alejandro IPérez Cabeza Vanesa Roldán Schilling Carles Rafols Priu Esteban Orenes-Piñero maría Asunción Es-teve-Pastor Department of Cardiology Hospital Clínico Universitario Virgen de la ArrixacaIMIB-ArrixacaUniversity of MurciaCIBERCVMurciaSpain Department of Cardiology Hospital Reina Sofía CórdobaIMIBICUniversity of CordobaCIBERCVCórdobaSpain Hospital Galdakao-Usansolo BizkaiaSpain Department of Cardiology Hospital Uni-versitario Ramony CajalCIBERCVMadridSpain Department of Cardiology University Hospital Ramóny CajalAl-caláUniversityMadridSpain Medical Center La Capillita Sanlúcar de Barrameda.Private cardiology clinicJerez de la FronteraSpain Department of Cardiology Hospital Arnau de VilanovaValenciaSpain Department of Car-diology Virgen de la Victoria University HospitalCIBERCV.MalagaSpain Department of Haematology Hospital Clínico Universitario Virgen de la ArrixacaUniversity of MurciaMurciaSpain Department of Medical Affairs Bayer HispaniaBarcelonaSpain Department of Biochemistry and Molecular Biology-A University of MurciaMurciaSpain

Objectives To analyze the clinical profile,adequacy of treatment with rivaroxaban and outcomes in octogenarians with atrial fibrillation(AF),taking rivaroxaban in clinical *** Observational and non-interventional study that included AF adults recruited from 79 Spanish centers,anticoagulated with rivaroxaban ≥ 6 months before being *** were analyzed according to age(≥ 80 vs.years) at *** Out of 1433 patients,453(31.6%) were octogenarians at *** to younger patients,octogenarians had more comorbidities,higher CHA2DS2-VASc(4.5 ± 1.3 vs.3.0 ± 1.4;P nd HAS-BLED scores(2.0 ± 1.0 vs.1.4 ± 1.0;P n was adequately prescribed in 83.4% of patients,but more frequently in the younger population(71.1% vs.89.1%;P = 0.039).After a mean follow-up of 2.2 ± 0.6 years,annual rates of stroke + systemic embolism + transient ischemic attack,MACE,cardiovascular death and major bleeding were 1.03%,1.24%,1.03% and 1.75%,respectively,in octogenarian *** for progressive heart failure death and major bleeding,rates of outcomes in octogenarians were similar compared to younger *** octogenarians,the concomitant use of antiplatelet agents and non-severe dementia were independently associated with the development of ischemic stroke,whereas previous coronary revascularization and heart failure with MACE,and higher HAS-BLED score with major *** In clinical practice,around one third of patients taking rivaroxaban are *** patients have many comorbidities and a high thromboembolic *** that,rates of adverse events remain *** is adequately prescribed in the majority of octogenarians.

关键词： patients atrial bleeding

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