Hospital Disasters Preparedness for Mass-Casualty Incidents at Emergency Units in Northwest of Ethiopia: A Cross-Sectional Study

Abstract Background: Ethiopian policy and strategy aim to make health care systems capable of dealing with emergencies. However, Ethiopian health care still lacks a comprehensive “all-hazard” approach and a disaster preparedness program. Thus, this study aimed to assess the level of disaster preparedness in selected public hospitals for mass-casualty incidents (MCIs) in Amhara Regional State, Northwest Ethiopia. Methods: A descriptive cross-sectional study was conducted at general and comprehensive specialized hospitals (CSHs) in Amhara Regional State, Ethiopia using a World Health Organization (WHO) hospital emergency response checklist that included a domain on mass-casualty management (MCM) adapted from a literature review. Results: Seventeen (17) hospitals were evaluated (response rate: 81%). Five (29.4%) were teaching hospitals (tertiary health care) and 12 (70.5%) were non-teaching (secondary health care) hospitals. With an average mean of 97.3 (SD = 33.68; range 31-160), most hospitals underWHOrequired an Acceptable level of preparedness. Two were at an Unacceptable (0- 67) level of preparedness, 12 (70.5%) hospitals were at an Insufficient (68-134) state, while the other three had an Acceptable (135-192) level of preparedness. Conclusion: The preparedness level of hospitals is Insufficient for potential MCIs in this region and needs prior attention in implementing existing strategic guidelines to develop and activate hospital disaster plans if and when needed.Instituto de Investigación Sanitaria del Principado de Asturias (ISPA

Solución basada en tecnologías blockchain para la trazabilidad de productos de calidad protegida

El proyecto DOPCHAIN se plantea con el objetivo general de desarrollar una solución de trazabilidad basada en tecnologías Blockchain para mejorar la confianza de los consumidores en los productos agroalimentarios de calidad protegida.The DOPCHAIN project is conceived with the general objective of developing a traceability solution based on Blockchain technologies to enhance consumer trust in protected quality agri-food products

Experimental Models to Study Diabetes Mellitus and Its Complications: Limitations and New Opportunities

Abstract: Preclinical biomedical models are a fundamental tool to improve the knowledge and management of diseases, particularly in diabetes mellitus (DM) since, currently, the pathophysiological and molecular mechanisms involved in its development are not fully clarified, and there is no treatment to cure DM. This review will focus on the features, advantages and limitations of some of the most used DM models in rats, such as the spontaneous models: Bio-Breeding Diabetes-Prone (BB-DP) and LEW.1AR1-iddm, as representative models of type 1 DM (DM-1); the Zucker diabetic fatty (ZDF) and Goto-kakizaki (GK) rats, as representative models of type 2 DM (DM-2); and other models induced by surgical, dietary and pharmacological—alloxan and streptozotocin—procedures. Given the variety of DM models in rats, as well as the non-uniformity in the protocols and the absence of all the manifestation of the long-term multifactorial complications of DM in humans, the researchers must choose the one that best suits the final objectives of the study. These circumstances, added to the fact that most of the experimental research in the literature is focused on the study of the early phase of DM, makes it necessary to develop long-term studies closer to DM in humans. In this review, a recently published rat DM model induced by streptozotocin injection with chronic exogenous administration of insulin to reduce hyperglycaemia has also been included in an attempt to mimic the chronic phase of DM in humans.Instituto de Investigación Sanitaria del Principado de Asturias (ISPA

Synthesis of substituted benzylboronates by light promoted homologation of boronic acids with N-sulfonylhydrazones

The synthesis of benzylboronates by photochemical homologation of boronic acids with N-tosylhydrazones under basic conditions is described. The reaction involves the photolysis of the N-tosylhydrazone salt to give a diazoalkane followed by the geminal carboborylation of the diazoalkane. Under the mild reaction conditions, the protodeboronation of the unstable benzylboronic acid is circumvented and the pinacolboronates can be isolated after reaction of the benzylboronic acid with pinacol. The metholodogy has been applied to the reactions of alkylboronic acids with N-tosylhydrazones of aromatic aldehydes and ketones, and to the reactions of arylboronic acids with N-tosylhydrazones of aliphatic ketones. Moreover, the employment of the DBU/DIPEA bases combination allows for homogeneous reactions which have been adapted to photochemical continuous flow conditions. Additionally, the synthetic versatility of boronates enables their further transformation via Csp3–C or Csp3–X bond forming reactions converting this methodology into a novel method for the geminal difunctionalization of carbonyls via N-tosylhydrazones.Financial support of this work by Ministerio de Ciencia e Innovación of Spain (Agencia Estatal de Investigaci´on: PID2019-107580GB-I00/AEI/10.13039/501100011033). A FICYT (Principality of Asturias) “Margarita Salas Joven” postdoctoral grant to M. P. (AYUD/2021/58397) is gratefully acknowledged

Influencia de los determinantes sociales de la salud en la elección de tratamiento renal sustitutivo en la enfermedad renal crónica avanzada: necesidad de un enfoque multidisciplinar

Abstract Introduction: The influence of socioeconomic and cultural barriers in the choice of renal replacement therapy (RRT) techniques in advanced chronic kidney disease (ACKD) has been scarcely explored, which can generate problems of inequity, frequently unnoticed in health care. The aim of this study is to identify the “non-medical” barriers that influence the choice of RRT in an ACKD consultation in Spain. Material and methods: Retrospective analysis including the total number of patients seen in the ACKD consultation in a tertiary hospital from 2009 to 2020. Inclusion in the ACKD consultation began with an eligibility test and a decision-making process, conducted by a specifically trained nurse. The variables considered for the study were: age, sex, etiology of CKD, level of dependence for basic activities of daily living (Barthel scale) and instrumental activities of daily living (Lawton and Brody scale), Spanish versus foreign nationality, socioeconomic level and language barrier. The socioeconomic level was extrapolated according to home and health district by primary care center to which the patients belonged. Results: A total of 673 persons were seen in the ACKD consultation during the study period, of whom 400 (59.4%) opted for hemodialysis (HD), 156 (23.1%) for peritoneal dialysis (PD), 4 (0.5%) for early living donor renal transplantation and 113 (16.7%) chose conservative care (CC). The choice of PD as the chosen RRT technique (vs. HD) was associated with people with a high socioeconomic level (38.7 vs. 22.5%) (p = 0.002), Spanish nationality (91 vs. 77.7%) (p < 0,001), to a lower language barrier (0.6 vs. 10.5%) (p < 0.001), and to a higher score on the Barthel scale (97.4 vs. 92.9) and on the Lawton and Brody scale (7 vs. 6.1) (p < 0.001). Neither age nor sex showed significant differences in the choice of both techniques. Patients who opted for CC were significantly older (81.1 vs. 67.7 years; p < 0.001), more dependent (p < 0.001), with a higher proportion of women (49.6 vs. 35.2%; p = 0.006) and a higher proportion of Spaniards (94.7 vs. 81%, p = 0.001) in relation to the choice of other techniques (PD and HD). Socioeconomic level did not influence the choice of CC. Conclusion: Despite a regulated decision-making process, there are factors such as socioeconomic status, migration, language barrier and dependency of the population that influence the type of RRT chosen. To address these aspects that may cause inequity, an intersectoral and multilevel intervention is required with interdisciplinary teams that include, among others, social workers, to provide a more holistic and person-centered assessment.Instituto de Investigación Sanitaria del Principado e Asturias (ISPA

Pathophysiology of bone disease in chronic kidney disease: from basics to renal osteodystrophy and osteoporosis

Chronic kidney disease (CKD) is a highly prevalent disease that has become a public health problem. Progression of CKD is associated with serious complications, including the systemic CKD-mineral and bone disorder (CKD-MBD). Laboratory, bone and vascular abnormalities define this condition, and all have been independently related to cardiovascular disease and high mortality rates. The "old" cross-talk between kidney and bone (classically known as "renal osteodystrophies") has been recently expanded to the cardiovascular system, emphasizing the importance of the bone component of CKD-MBD. Moreover, a recently recognized higher susceptibility of patients with CKD to falls and bone fractures led to important paradigm changes in the new CKD-MBD guidelines. Evaluation of bone mineral density and the diagnosis of "osteoporosis" emerges in nephrology as a new possibility "if results will impact clinical decisions". Obviously, it is still reasonable to perform a bone biopsy if knowledge of the type of renal osteodystrophy will be clinically useful (low versus high turnover-bone disease). However, it is now considered that the inability to perform a bone biopsy may not justify withholding antiresorptive therapies to patients with high risk of fracture. This view adds to the effects of parathyroid hormone in CKD patients and the classical treatment of secondary hyperparathyroidism. The availability of new antiosteoporotic treatments bring the opportunity to come back to the basics, and the knowledge of new pathophysiological pathways [OPG/RANKL (LGR4); Wnt-beta-catenin pathway], also affected in CKD, offers great opportunities to further unravel the complex physiopathology of CKD-MBD and to improve outcomes.Instituto de Investigación Sanitaria del Principado de Asturia

Oportunidades en la misión regional de longevidad y envejecimiento activo habilitadas por la investigación en Inteligencia Artificial

El proyecto SENIOR.IA se plantea con el objetivo general de promover una longevidad saludable, abordando diferentes retos que actualmente limitan esta meta, aplicando para ello técnicas avanzadas de Inteligencia Artificial (IA) sobre conjuntos de datos poblacionales existentes que aporten evidencias para la prevención bajo un enfoque de medicina personalizada de precisión.The SENIOR.IA project is conceived with the overarching goal of promoting healthy longevity, addressing various challenges that currently hinder this goal by applying advanced Artificial Intelligence (AI) techniques to existing population datasets, providing evidence for prevention under a precision personalized medicine approach

The Role of Social Work for Emergency Medical Services (EMS): A Systematic Review

Abstract Introduction: Emergency Medical Services (EMS) are integrated services involving doctors, paramedics, nurses, and social workers. This research was carried out to synthesize the evidence concerning social work roles for EMS. The aim of this study was to synthesize literature on the social worker’s role in EMS settings. Methods: The study was a systematic review. Data were collected through selected databases. The researcher used Scopus, Sociology Database, Social Science Database, and Public Health Database related to EMS and social work settings. English papers were selected, without restrictions on publication time, place, and year. The searched keywords were: “Social Work ANDEmergency Medical ServicesANDAmbulance Services,” “Social Worker AND Emergency Medical Systems AND Ambulance Services,” “Social Work AND EMS,” “Social Worker AND EMS,” “Social Work OR Social Worker,” “Social Work Role AND EMS,” Social Worker AND EMS,” “Emergency Medical Services OR/ AND Emergency Medical Systems.” Results: The study synthesized the literature about the social work role in pre-EMS, during emergency, and post-EMS. The following themes were highlighted: social workers act as cultural liaisons, effective communicators, emergency workers, and mental health practitioners, collaborating with other disciplines and researchers, for this study. In preemergency stages, social workers have roles as educators, communicators, advocates, and awareness builders. During an emergency, social workers act as search and rescue workers, advocates, facilitators, networkers, psychosocial assessors, consultants, counselors, and liaisons for referral activities. And in the post-emergency period, social workers have roles as planners, liaisons, interdisciplinary collaborators, researchers, evaluators, and individuals responsible for follow up. Conclusion: This study synthesizes the roles of social workers inEMSsettings. It is the first study on this topic, aiming to produce new knowledge, evidence, and an EMS practice framework for the social worker.Instituto de Investigación Sanitaria del Principado de Asturias (ISPA

On the role of continuing currents in lightning-induced fire ignition

Lightning flashes are an important source of wildfires worldwide, contributing to the emission of trace gases to the atmosphere. Based on experiments and field observations, continuing currents in lightning have since a long time been proposed to play a significant role in the ignition of wildfires. However, simultaneous detections of optical and radio signals from fire-igniting lightning confirming the role of continuing currents in igniting wildfires are rare. In this work, we first analyze the optical signal of the lightning-ignited wildfires reported by the Geostationary Lightning Mapper over the Contiguous United States (CONUS) during the summer of 2018, and we then analyze the optical and the Extremely Low Frequency signal of a confirmed fire-igniting lightning flash in the Swiss Alps. Despite data uncertainties, we found that the probability of ignition of a lightning flash with Continuing Current (CC) lasting more than 10 ms is higher than that of cloud-to-ground lightning in CONUS. Finally, we confirm the existence of a long CC (lasting about 400 ms) associated with a long-lasting optical signal (lasting between 2 and 4 s) of a video-recorded fire-igniting lightning flash