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Patient Safety in the Use of Mechanical Restraints: Regulatory Compliance among Hospitals in the City of Buenos Aires and Proposal for Its Improvement

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Open Journal of Emergency Medicine 2024年第2期12卷 33-39页

作者： Martín Javier Mazzoglio y Nabar sergio Giordano Edgardo Knopoff Lorena Onofrio Oscar Agustín Porta Romina Rodríguez Emergency Service Torcuato de Alvear Psychiatric Emergency Hospital Buenos Aires Argentina Department of Psychiatry and Mental Health Faculty of Medicine University of Buenos Aires Buenos Aires Argentina

Introduction: Mechanical or physical restraint is an exceptional therapeutic resource to immobilize a subject and thus guarantee the safety of the patient and/or third parties in the face of high-risk behaviors, but it entails multiple crossings (bioethical, philosophical, medical, psychological, legal). Framed in the so-called “safety culture” developed by the WHO, based on the Protocol for its implementation of the CABA and attentive to its frequent use in CABA by different hospital services (medical clinic, geriatrics, intensive care and medical guards) we consider it necessary its study in terms of compliance with the risks it entails and its management. Objectives: Identify regulatory compliance with the GCABA Mechanical restraint (MR) Protocol from a patient safety perspective, as well as describe the clinical and medicolegal aspects, and propose the usefulness of a tool for its management and control. Methodology: Observational, descriptive, transversal and prospective work through the analysis of Clinical Records with indication of MR using a rubric-type form. 177 cases were analyzed between September-November 2023 from three hospitals of the Government of the City of Buenos Aires, statistical parameters were applied and graphs were made. Results: Only 12.99% complied with the Protocol. In the mental health specialized hospital compliance was almost 5 times greater than in the general one, and in the emergency services compliance was 12 times greater than in Inpatient services. We found that the start or end time of MR was not recorded and only 43% described the causes/justifications for the indication (mostly in Emergency and Specialized hospitals), with the MR average time being shorter in Emergency. Conclusions: Only 1.3 out of 10 patients reliably completed the Protocol and it was mostly in the mental health specialized hospital and the emergency services. The results show non-compliance behavior in the application and management of the risk that the use

关键词： Mechanical Containment Patient Safety Injuries in Custody Buenos Aires City Check List

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Past,present,and future perspectives of ultrasound-guided ablation of liver tumors:Where could artificial intelligence lead interventional oncology?

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Artificial Intelligence in Cancer 2024年第1期5卷 1-12页

作者： Paola Tombesi Andrea Cutini Valentina Grasso Francesca Di Vece Ugo Politti Eleonora Capatti Florence Labb Stefano Petaccia sergio Sartori Department of Internal Medicine Section of Interventional UltrasoundSt.Anna HospitalFerrara 44100Italy Esaote S.p.A. Genova 16100Italy

The first ablation procedures for small hepatocellular carcinomas were percutaneous ethanol injection under ultrasound(US)***,radiofrequency ablation was shown to achieve larger coagulation areas than percutaneous ethanol injection and became the most used ablation technique *** the past decade,microwave ablation systems have achieved larger ablation areas than radiofrequency ablation,suggesting that the 3-cm barrier could be broken in the treatment of liver ***,US techniques to guide percutaneous ablation have seen important ***-enhanced US(CEUS)can define and target the tumor better than US and can assess the size of the ablation area after the procedure,which allows immediate retreatment of the residual tumor ***,fusion imaging fuses real-time US images with computed tomography or magnetic resonance imaging with significant improvements in detecting and targeting lesions with low conspicuity on ***,software powered by artificial intelligence has been developed to allow three-dimensional segmentation and reconstruction of the anatomical structures,aiding in procedure planning,assessing ablation completeness,and targeting the residual viable foci with greater precision than ***,this could lead to the ablation of tumors up to 5-7 cm in size.

关键词： Artificial intelligence Fusion imaging Percutaneous thermal ablation Microwave ablation Radiofrequency ablation Ultrasound Contrast-enhanced ultrasound

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Cost-Effectiveness Analysis of Renalof® versus Extracorporeal Shockwave Lithotripsy (ESWL) for the Treatment of Kidney Stones ≤ 1 cm in Nicaragua

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Health 2024年第7期16卷 674-687页

作者： Mélida M. Aguilar Chamorro sergio Vargas Collado Leslie Pérez Ruíz David Márquez Soriano Jorge Luis Soriano García Clínica Senior Managua Nicaragua Centro de Inmunología Molecular Havana Cuba Catalysis S.L. Madrid Spain

Objectives: To assess the efficiency in terms of cost-effectiveness (CE) of oral Renalof® treatment versus extracorporeal shockwave lithotripsy (ESWL) in the treatment of kidney stones ≤ 1 cm in Nicaragua. Methods: A cost-effectiveness economic evaluation was carried out based on the results obtained in the randomised, prospective, observational, single-blind, prospective, phase 2 clinical trial. Cost-effectiveness and the incremental cost-effectiveness ratio (ICER) were calculated. Economic data were obtained from the Economics Department of Clínica Senior in Managua, Nicaragua. The monetary cost was expressed in US dollars (USD). Results: Treatment with Renalof® yielded a CE of $1,323.08/% remission, while ESWL was $9,498.54/% remission. The ICER shows that, in order to achieve a high percentage of kidney stone remission with ESWL, an extra $4,734.70 per patient must be invested. Conclusions: The use of Renalof® is shown to be a more cost-effective option than ESWL. It is recommended for the treatment of kidney stones ≤ 1 cm in size.

关键词： Economic Evaluation Pharmacoeconomics Renalof® Extracorporeal Shockwave Lithotripsy Kidney Stones

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Quantifying water stress effect on daily light use efficiency in Mediterranean ecosystems using satellite data

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International Journal of Digital Earth 2017年第6期10卷 623-638页

作者： sergio Sanchez-ruiz Alvaro Moreno Maria Piles Fabio Maselli Arnaud Carrara Steven Running Maria Amparo Gilabert Departament de Fisica de la Terra i Termodinamica Facultat de FisicaUniversitat de ValenciaBurjassotSpain Numerical Terradynamic Simulation Group University of MontanaMissoulaMTUSA Barcelona Expert Center Institut de Ciencies del MarICM-CSICBarcelonaSpain IBIMET-CNR Sesto FiorentinoItaly Fundacion CEAM PaternaSpain

The capacity of six water stress factors(ε′(i))to track daily light use efficiency(ε)of water-limited ecosystems was *** factors are computed with remote sensing operational products and a limited amount of ground data:ε′1 uses ground precipitation and air temperature,and satellite incoming global solar radiation;ε′(2) uses ground air temperature,and satellite actual evapotranspiration and incoming global solar radiation;ε′_(3) uses satellite actual and potential evapotranspiration;ε′_(4) uses satellite soil moisture;ε′_(5) uses satellite-derived photochemical reflectance index;and ε′_(6) uses ground vapor pressure *** factors were implemented in a production efficiency model based on Monteith’s approach in order to assess their performance for modeling gross primary production(GPP).Estimated GPP was compared to reference GPP from eddy covariance(EC)measurements(GPP EC)in three sites placed in the Iberian Peninsula(two open shrublands and one savanna).ε′_(i) were correlated to ε,which was calculated by dividing GPP EC by ground measured photosynthetically active radiation(PAR)and satellite-derived fraction of absorbed *** results were achieved by ε′(1),ε′(2),ε′(3) and ε′(4) explaining around 40% and 50% of ε variance in open shurblands and savanna,*** terms of GPP,R^(2)≈0.70 were obtained in these cases.

关键词： Light use efficiency water stress GPP Monteith Mediterranean ecosystems

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Physiological dormancy broken by endozoochory:Austral parakeets(Enicognathus ferrugineus)as legitimate dispersers of calafate(Berberis microphylla)in the Patagonian Andes

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Journal of Plant Ecology 2020年第5期13卷 538-544页

作者： Carolina Bravo Daniel Chamorro Fernando Hiraldo Karina Speziale sergio A.Lambertucci JoséL.Tella Guillermo blanco Department of Evolutionary Ecology Museo Nacional de Ciencias NaturalesCSICJoséGutiérrez Abascal 228006 MadridSpain Centre d’Etudes Biologiques de Chizé UMR 7372CNRS and La Rochelle UniversitéF-79360 Beauvoir-sur-NiortFrance Departamento de Ciencias Ambientales Universidad de Castilla-La ManchaAv.Carlos III s/n45071 ToledoSpain Department of Conservation Biology Estación Biológica de DoñanaCSICAmérico Vespucio 2641092 SevillaSpain Grupo de Investigaciones en Biología de la Conservación Departamento de EcologíaINIBIOMA(CONICET-National University of Comahue)Pasaje Gutiérrez 11258400 BarilocheArgentina

Aims Seed dispersal by endozoochory is an important process in plant regeneration and the establishment of new *** with dormancy may especially benefit after disperser gut ***,the ways in which gut passage affect the germination of plant species with physiological dormancy remain ***,we experimentally assessed the mutualistic interaction between the Austral parakeet(Enicognathus ferrugineus)as a disperser of calafate(Berberis microphylla),a thorny bush inhabiting the understory of the Austral temperate forests of South America with seeds that are characterized by deep physiological *** Germination success and viability of calafate seeds obtained from faeces and from intact fruits were tested under four treatments:(i)digested seeds,(ii)digested seeds with faecal extract,(iii)intact seeds from fruit and(iv)intact seeds from fruit with *** Findings About 65%of the Austral parakeet droppings contained calafate *** of seeds did not differ between ***,germination was significantly higher in digested seeds than in intact seeds from fruits,while no difference was found between faecal and pulp *** faecal matter nor fruit pulp provided seeds with any ecological advantages derived from enhancing germinability,but did confer some disadvantage in germination *** matter is expected to be completely lacking around seeds after several months under snow before germinating in the following spring,given intense washing due to persistent rain and the spring thaw in the Patagonian *** higher germinability along with faster germination of digested seeds supports the hypothesis of a legitimate mutualistic interaction between Austral parakeets and *** hypothesized that the passage through the disperser digestive tract might break physiological dormancy as differences in germinability between ingested and non-ingested *** results highlight the relevant role of endoz

关键词： seed dispersal Austral forest mutualism gut passage viability germination success germinability

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喜马拉雅山不同森林群落主要树种叶片元素性状与生物量之间的关系

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中国科学：地球科学 2024年第5期54卷 1544-1555页

作者： Nita DYOLA 梁尔源 Josep PEÑUELAS JJulio CAMARERO Shalik Ram SIGDEL Sugam ARYAL 林文涛刘向刘永稳徐兴良 sergio ROSSI 中国科学院青藏高原研究所青藏高原地球系统与资源环境全国重点实验室北京100101 中国科学院大学北京100049 Laboratoire sur lesécosystèmes terrestres boréaux Département des Sciences FondamentalesUniversitédu QuébecàChicoutimi555Boulevard de l′UniversitéChicoutimi(QC)G7H2B1Canada CSIC Global Ecology Unit CREAF-CSIC-UABBellaterraE-08193 CataloniaSpain CREAF Cerdanyola del VallèsE-08193 CataloniaSpain Instituto Pirenaico de Ecología(IPE-CSIC) Avenida Montañana 1005Zaragoza 50059Spain Friedrich-Alexander-Universität Erlangen-Nürnberg Institut für GeographieErlangen 91058Germany 兰州大学生态学院草种创新与草地农业生态系统全国重点实验室兰州730000 中国科学院地理科学与资源研究所生态系统网络观测与模拟重点实验室北京100101

植物需要多种基本元素调节并保持其特定比例以维持生长发育,叶片元素含量反映了植物的功能及其对环境的适应性.然而,在森林海拔梯度上,我们对于资源获取、光合作用和生长相关的叶片元素如何调节森林生物量仍知之甚少.本研究在喜马拉雅... 详细信息

植物需要多种基本元素调节并保持其特定比例以维持生长发育,叶片元素含量反映了植物的功能及其对环境的适应性.然而,在森林海拔梯度上,我们对于资源获取、光合作用和生长相关的叶片元素如何调节森林生物量仍知之甚少.本研究在喜马拉雅山干城章嘉峰地区沿热带森林(海拔80m)至高山树线(海拔4200m)设置海拔梯度样带,每间隔海拔100m设置一个样点,对116个树种的1859个个体测定了叶片中10种元素(C、N、P、K、Ca、Mg、Zn、Fe、Cu和Mn)的含量,通过计算叶片元素含量的群落加权平均值(反映优势物种的性状优势度,表征质量比效应)和功能离散度(反映物种在生态位空间内的聚集或者离散程度,表征互补效应),探究叶片元素含量及其离散程度沿海拔梯度分异特征,解析其对森林群落生物量的影响.研究结果表明,较强的叶片元素质量比效应和较弱的互补效应有利于森林群落生物量的积累.叶片元素性状多样性与海拔的共同作用对生物量的解释量(解释方差:52.2%)高于元素性状多样性的解释量(解释方差:0.05%~21%).海拔调节了树种性状多样性在生物量积累中的作用,互补效应在低海拔和高海拔地区对生物量的影响分别体现为积极和消极作用,这表明海拔和互补效应之间也存在交互作用.此外,海拔和质量比效应的交互作用对海拔梯度上生物量的影响也存在异质性.本研究表明,不同森林群落生物量的积累可能受到由海拔调控的性状多样性的影响.尽管较高的性状分异不利于生物量的积累,但能增强高海拔地区树种对胁迫环境的适应性.

关键词：生态系统功能海拔梯度功能多样性功能性状叶片元素生态位互补

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An Optimal Design Method Based on Small Amplitude Homogenization

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Chinese Annals of Mathematics,Series B 2015年第5期36卷 843-854页

作者： sergio GUTIERREZ Department of Structural and Geotechnical Engineering Pontificia Universidad Catolica de Chile

An optimal design method for two materials based on small amplitude homogenization is presented. The method allows to use quite general objective functions at the price that the two materials should have small contrasts in their relevant physical parameters. The following two applications are shown: Stress constrained compliance minimization and defect location in elastic bodies.

关键词： Homogenization Inverse problems Relaxation Stress concentration

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Aortic valve stenosis provides complementary information to bleeding risk scores in non-valvular atrial fibrillation patients initiating anticoagulation

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Journal of Geriatric Cardiology 2020年第3期17卷 141-148,I0005-I0007页

作者： Gines Elvira-ruiz Cesar Caro-Martinez Pedro JoseFlores-blanco Juan JoseCerezo-Manchado Helena Albendin-Iglesias Alejandro Lova-Navarro Francisco Arregui-Montoya Francisca Maria Munoz-Franco Natalia Garcia-Iniesta Arcadio Garcia-Alberola JoseLuis Bailen-Lorenzo Domingo Andres Pascual-Figal sergio Manzano-Fernández Department of Cardiology University Hospital Virgen de la ArrixacaMurciaSpain Instituto Murciano de Investigación en Biomedicina(IMIB) MurciaSpain Department of Cardiology University Hospital Morales MeseguerMurciaSpain Department of Hematology University Hospital Virgen de la ArrixacaMurciaSpain Department of Internal Medicine University Hospital Virgen de la ArrixacaMurciaSpain School of Medicine University of MurciaMurciaSpain Department of Cardiology Hospital Vega BajaAlicanteSpain

Background The identification of modifiable bleeding risk factors may be of *** aim is to evaluate if aortic stenosis(AS)provides additional information to bleeding risk scores for predicting major bleeding(MB)in non-valvular atrial fibrillation(AF).Methods We designed a retrospective multi-center study including 2880 consecutive non-valvular AF patients initiating oral anticoagulation between January 2013 and December *** was defined as moderate or severe according to European echocardiography guidelines ***,ATRIA and ORBIT scores were used to evaluate the bleeding *** was defined according to the International Society on Thrombosis and Haemostasia criteria and registered at 18 months of *** 168(5.8%)patients had *** with AS had higher risk for MB compared to those without AS(HR=2.13,95%CI:1.40-3.23,P<0.001).Patients without AS and low-intermediate bleeding risk(0 points)showed the lowest MB rate,whereas the MB rate observed among patients with AS and high bleeding risk(2 points)was the highest *** and reclassification analyses showed that AS provided additional information to bleeding risk scores for predicting MB at 18 months of *** In this population,AS was associated with an increased risk for MB at midterm *** three scoring systems showed a moderate discriminatory ability for ***,the addition of AS was associated with a significant improvement in their predictive *** suggest that the presence of this valvulopathy should be taken into account for bleeding risk assessment.

关键词： Anticoagulants Aortic stenosis Atrial fibrillation Major bleeding Valvular disease

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Effect of Mushroom Extract Hericium erinaceus on Spatial Memory and Morphology of Neurons in the CA1 and CA3 Regions of the Hippocampus in Ovariectomized Rats

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Open Journal of Veterinary Medicine 2024年第7期14卷 163-179页

作者： Lucia Garcia-Delgado Mariana Monserrath Verdía-Venegas Jacinto Bañuelos-Pineda Esther Albarrán-Rodríguez Guillermo Nolasco-Rodriguez José Ricardo Cuellar-Pérez sergio Fausto-Guerra Manuel Rosales-Cortés Master in Behavioral Sciences Institute of Neurosciences University of Guadalajara Zapopan Mexico Department of Veterinary Medicine Division of Veterinary Sciences CUCBA University of Guadalajara Zapopan Mexico Botany and Zoology Laboratory CUCBA University of Guadalajara Zapopan Mexico

Various studies indicate that low levels of estradiol negatively impact cognitive abilities. Extracts from the fungus Hericium erinaceus (HE) contain bioactive components that promote the proper functioning of the nervous system and potential effects on protection against neurodegenerative diseases, including dementia and motor dysfunctions. The objective was to evaluate the effects of the administration of the HE mushroom extract on visuospatial memory and morphology of neurons in the CA1 and CA3 regions of the hippocampus in ovariectomized rats. 40 young Wistar rats weighing 90 ± 10 g BW were used, which were distributed into four groups of 10 animals;Control Group, non-ovariectomized and untreated rats;Group E2, ovariectomized rats treated with estradiol (2 μg/kg/body weight);Group HE, ovariectomized rats treated with the extract of the fungus Hericium erinaceus (0.5 mg/kg body weight) and Group Ovx/ST, ovariectomized rats, without treatment. The animals were tested in the Barnes and Open Field maze, then they were sacrificed, and their brains were obtained to perform a histological analysis of neuronal morphology in the CA1 and CA3 areas of the hippocampus. The most outstanding results showed that the Ovx/ST group recorded the longest time to arrive at the escape box and stay in the Barnes maze. A correlation was observed between neuronal damage and function;in the groups that did not present satisfactory performance in the maze tests, morphological alterations were identified such as the presence of some neuronal somata with degeneration characteristics such as pyknosis, nuclear basophilia and shrinkage of the cells. Its soma, as well as a decrease in the nuclear area of CA1 and CA3 neurons. It is concluded that the fungus Hericium erinaceus exerted a neuroprotective effect on the neuronal bodies of the hippocampus, associated with better performance in the visuospatial recognition memory test.

关键词： Ovariectomized Rats Ovarian Hypofunction Estradiol Hericium erinaceus Barnes Circular Labyrinth Open Field Labyrinth

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Molecular and crystal assembly inside the carbon nanotube:encapsulation and manufacturing approaches

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Advances in Manufacturing 2013年第3期1卷 198-210页

作者： sergio Manzetti Fjordforsk A.S. Institute of Science and Technology6896 FresvikNorway Van der Spoel Lab.Computational Systems and Biology Biomedical CentreUniversity of UppsalaP.O.Box 25675105 UppsalaSweden

Encapsulation of different guestspecies such as molecules and ions inside carbon nanotubes （CNTs） has been reported in the literatures during the last 15 years and repre sents an exciting development of nanoengineering of novel materials and composites. The reported nanocomposite mate rials show the semiconducting properties with potential applications in nanosensors, nanounits and nanocircuits as well as advanced energy transfer and storage properties, and encompass manufacturing for novel nanowires, nanoelectronic devices with properties designed with optoelectronic, spin tronic and nanomagnetic qualities. This review reports on a wide range of encapsulation references with particular focus on single molecules, atomic chains, metal halides and polymers encapsulated inside CNTs. The encapsulation methods and the chemical and physical qualities of these novel materials are crucial for the future manufacturing of novel innovations in nanotechnology, and represent therefore the current stateof theart of encapsulation methods in advanced manufacturing.

关键词： Encapsulation Carbon nanotubes (CNTs)Composites conductive Molecules

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