Acoustic displacement triangle based on the individual element test

A three node, displacement based, acoustic element is developed. In order to avoid spurious rotational modes, a higher order stiffness is introduced. The higher order stiffness is developed from an incompatible strain field which computes element volume changes under nodal rotational displacements fields. The higher order strain satisfies the IET requirements, non affecting convergence. The higher order stiffness is modulated, element by element, with a factor. Thus, the displacement based formulation is capable of placing the spurious rotational modes over the range of physical compressional modes that can be accurately captured by the mesh

Tratamiento de fracturas de húmero proximal en hueso osteoporótico mediante fijación con sistema de aumentación

Introducción. Para el tratamiento de fracturas de húmero proximal en pacientes osteoporóticos, se han desarrollado fijaciones con aumentación que mejoran la estabilidad del implante. El objetivo de este estudio es analizar los resultados obtenidos con la técnica empleada. Material y métodos. Estudio descriptivo retrospectivo de 7 pacientes con fracturas en 3-4 fragmentos intervenidos mediante placa Philos (Synthes)® de aumentación. Seguimiento medio de 12 meses. Resultados. La puntuación media en la Escala Visual Analógica de dolor fue de 4,4. En la escala Quick Dash de 47,47. En la Escala Constant-Murley de 36,36. La abducción activa media fue de 95º; la flexión anterior media de 105º; la rotación externa media de 44,14º; la rotación interna alcanzó en tres pacientes S1, en dos L5, en uno L2 y en otro T10. En los controles radiográficos se mantuvo la reducción. Nos encontramos con un caso de consolidación parcial. Conclusión. Las técnicas de aumentación disminuyen el riesgo de fallos de fijación manteniendo la reducción.. Introduction. To treat proximal humerus fractures in patients with osteoporosis, the last few years, systems to improve implant stability by augmentation techniques have been developed. The aim of this study is to analyze the results obtained with the surgical technique employed. Materials and methods. Retrospective descriptive study. We selected 7 patients with 3 or 4- part fractures treated operatively with Philos Augmentation plate (Synthes)® fixation technique. Average follow-up was 12 months. Results. Pain measured with a Visual Analogical Scale (VAS) got a average value of 4,4. The mean Quick Dash Score was 47,47. The mean Constat-Murley modified was 36,36. The active articular balances showed a mean abduction of 91º; mean anterior flexion of 105º; mean external rotation of 44,14º; and finally the internal rotation achieved in three patients got to S1, in two patients to L5, in one patient to L2 and in other patient to T10. In X- Ray post-operative controls we can appreciate the reduction maintenance. In one case we observe a partial consolidation of the fracture. Conclusion. Surgical techniques that imply implant augmentation reduces the risk of implant failure and maintains the fracture reduction

Design and psychometric evaluation of the 'Clinical Communication Self-Efficacy Toolkit'

Nursing students experience difficulties when communicating in clinical practice. Their self-efficacy in clinical communication should be explored as part of their competence assessment before they are exposed to real human interactions in the clinical setting. The aim of this study was to design and psychometrically evaluate a toolkit to comprehensively assess nursing students’ self-efficacy in clinical communication. The study followed an observational cross-sectional design. A sample of 365 nursing students participated in the study. The ‘Clinical Communication Self-Efficacy Toolkit’ (CC-SET) was comprised of three tools: the ‘Patient-Centered Communication Self-efficacy Scale’ (PCC-SES), the ‘Patient clinical Information Exchange and interprofessional communication Self-Efficacy Scale’ (PIE-SES), and the ‘Intrapersonal communication and Self-Reflection Self-Efficacy Scale’ (ISR-SES). The tools’ reliability, validity (content, criterion, and construct) and usability were rigorously tested. The Cronbach’s alpha coefficient of the three tools comprising the CC-SET was very high and demonstrated their excellent reliability (PCC-SES = 0.93; PIE-SES = 0.87; ISR-SES = 0.86). The three tools evidenced to have excellent content validity (scales’ content validity index > 0.95) and very good criterion validity. Construct validity analysis demonstrated that the PCC-SES, PIE-SES, and ISR-SES have a clear and theoretically-congruent structure. The CC-SET is a comprehensive toolkit that allows the assessment of nursing students’ self-efficacy in interpersonal, interprofessional, and intrapersonal communication

Aportes del pensamiento crítico en la enseñanza de la auditoría y el control

El medio en que vivimos nos presenta retos constantes que modifican nuestras percepciones de la realidad las cuales influyen en los propósitos de formación profesional, de esta manera el concepto de contexto es asumido según los planteamientos de Giroux, como aquellas interpretaciones de la realidad, que son interiorizadas por el individuo mediante el proceso de socialización, así mismo se considera que el contexto social, cultural y educativo permea de manera directa las representaciones internas y las actitudes ante la vida. Por lo tanto pensar en la educación contable, en particular el área de auditoría y control, nos conlleva a reflexionar en alternativas a la educación tradicional impartida en la formación del contador público y del Administrador de empresas desde el proceso de enseñanza y aprendizaje. En consecuencia, se reflexiona desde la óptica del pensamiento crítico, los aportes: Filosófico, psicológico, sociológico, pedagógico y didáctico en torno a la práctica de la enseñanza del área de auditoría en la Facultad de Ciencias Contables, Económicas y Administrativas de la Universidad de la Amazonia y se propone fomentar el pensamiento crítico, el trabajo colaborativo y la interacción entre los diversos actores, sujetos y objetos de la educación para coadyuvar a la autonomía y la democracia desde un enfoque pedagógico mediacional e interactivo

Design and psychometric analysis of the COVID-19 prevention, recognition and home-management self-efficacy scale

In order to control the spread of COVID-19, people must adopt preventive behaviours that can affect their day-to-day life. People’s self-efficacy to adopt preventive behaviours to avoid COVID-19 contagion and spread should be studied. The aim of this study was to develop and psychometrically test the COVID-19 prevention, detection, and home-management self-efficacy scale (COVID-19-SES). We conducted an observational cross-sectional study. Six-hundred and seventy-eight people participated in the study. Data were collected between March and May 2020. The COVID-19-SES’ validity (content, criterion, and construct), reliability (internal consistency and test-retest reliability), and legibility were studied. The COVID-19-SES’ reliability was high (Cronbach’s alpha = 0.906; intraclass correlation coefficient = 0.754). The COVID-19-SES showed good content validity (scale’s content validity index = 0.92) and good criterion validity when the participants’ results on the COVID-19-SES were compared to their general self-efficacy (r = 0.38; p 0.001). Construct validity analysis revealed that the COVID-19-SES’ three-factor structure explained 52.12% of the variance found and it was congruent with the World Health Organisation’s recommendations to prevent COVID-19 contagion and spread. Legibility analysis showed that the COVID-19-SES is easy to read and understand by laypeople. The COVID-19-SES is a psychometrically robust instrument that allows for a valid and reliable assessment of people’s self-efficacy in preventing, detecting symptoms, and home-managing COVID-19

Argonaute proteins: Why are they so important for the legume–rhizobia symbiosis?

Unlike most other land plants, legumes can fulfill their nitrogen needs through the establishment of symbioses with nitrogen-fixing soil bacteria (rhizobia). Through this symbiosis, fixed nitrogen is incorporated into the food chain. Because of this ecological relevance, the genetic mechanisms underlying the establishment of the legume–rhizobia symbiosis (LRS) have been extensively studied over the past decades. During this time, different types of regulators of this symbiosis have been discovered and characterized. A growing number of studies have demonstrated the participation of different types of small RNAs, including microRNAs, in the different stages of this symbiosis. The involvement of small RNAs also indicates that Argonaute (AGO) proteins participate in the regulation of the LRS. However, despite this obvious role, the relevance of AGO proteins in the LRS has been overlooked and understudied. Here, we discuss and hypothesize the likely participation of AGO proteins in the regulation of the different steps that enable the establishment of the LRS. We also briefly review and discuss whether rhizobial symbiosis induces DNA damages in the legume host. Understanding the different levels of LRS regulation could lead to the development of improved nitrogen fixation efficiency to enhance sustainable agriculture, thereby reducing dependence on inorganic fertilizers.Fil: Valdés-López, Oswaldo. Universidad Nacional Autónoma de México, Escuela Nacional de Estudios Profesionales Iztacala; MéxicoFil: Formey, Damien. Universidad Nacional Autónoma de México; MéxicoFil: Isidra-Arellano, Mariel C.. Universidad Nacional Autónoma de México, Escuela Nacional de Estudios Profesionales Iztacala; México. Universidad Nacional Autónoma de México; MéxicoFil: Reyero-Saavedra, Maria del Rocio. Universidad Nacional Autónoma de México, Escuela Nacional de Estudios Profesionales Iztacala; MéxicoFil: Fernandez Göbel, Tadeo Francisco. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Buenos Aires; Argentina. Instituto Nacional de Tecnologia Agropecuaria. Centro de Investigaciones Agropecuarias. Unidad de Estudios Agropecuarios. - Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - Cordoba. Unidad de Estudios Agropecuarios.; ArgentinaFil: Sánchez-Correa, Maria del Socorro. Universidad Nacional Autónoma de México, Escuela Nacional de Estudios Profesionales Iztacala; Méxic

COVID-19 e o olho: quanto sabemos realmente? Uma revisão das melhores evidências

To identify and classify available information regarding COVID-19 and eye care according to the level of evidence, within four main topics of interest: evidence of the virus in tears and the ocular surface, infection via the conjunctival route, ocular manifestations, and best practice recommendations. A structured review was conducted in PubMed, ScienceDirect, LILACS, SciELO, the Cochrane Library and Google Scholar on COVID-19 and ophthalmology. The Oxford Centre for Evidence Based Medicine 2011 Levels of Evidence worksheet was used for quality assessments. 1018 items were identified in the search; 26 records were included in the qualitative synthesis, which encompassed 6 literature reviews, 10 case series or cross-sectional studies, 4 case reports, and 6 intervention descriptions. Seventeen out of 26 records (65%) were categorized as level 5 within the Oxford CBME methodology grading system, the rest were level 4. The evidence generated on COVID-19 and ophthalmology to date is limited, although this is understandable given the circumstances. Both the possible presence of viral particles in tears and conjunctiva, and the potential for conjunctival transmission remain controversial. Ocular manifestations are not frequent and could resemble viral infection of the ocular surface. Most recommendations are based on the strategies implemented by Asian countries during previous coronavirus outbreaks. There is a need for substantive studies evaluating these strategies in the setting of SARS-CoV-2. In the meantime, plans for applying these measures must be implemented with caution, taking into account the context of each individual country, and undergo regular evaluation.Identificar e classificar as informações disponíveis sobre o COVID-19 e o tratamento oftalmológico de acordo com o nível de evidência, dentro de quatro tópicos principais de interesse: evidência do vírus nas lágrimas e na superfície ocular, infecção pela via conjuntival, manifestações oculares e recomendações de melhores práticas. Foi realizada uma revisão estruturada no PubMed, ScienceDirect, LILACS, SciELO, Biblioteca Cochrane e Google Scholar no COVID-19 e oftalmologia. A planilha de Níveis de Evidência 2011 do Oxford Centre for Evidence Based Medicine 2011 foi usada para avaliações de qualidade. Mil e dezoito itens foram identificados na busca; Foram incluídos 26 registros na síntese qualitativa, que incluiu 6 revisões de literatura, 10 séries de casos ou estudos transversais, 4 relatos de casos e 6 descrições de intervenções. Dezessete dos 26 registros (65%) foram classificados como nível 5 no sistema de classificação da metodologia Oxford CBME, o restante foi no nível 4. As evidências geradas no COVID-19 e na oftalmologia até o momento são limitadas, embora isso seja compreensível dadas as circunstâncias. Tanto a possível presença de partículas virais em lágrimas e conjuntiva quanto o potencial de transmissão conjuntival permanecem controversos. As manifestações oculares não são frequentes e podem se assemelhar a infecção viral da superfície ocular. A maioria das recomendações baseia-se nas estratégias implementadas pelos países asiáticos durante surtos anteriores de coronavírus. Há necessidade de estudos aprofundados avaliando essas estratégias no cenário da SARS-CoV-2. Enquanto isso, os planos para a aplicação dessas medidas devem ser implementados com cautela, levando em consideração o contexto de cada país e submetidos a auditorias periódicas

Carbapenem resistance in Enterobacterales bloodstream infections among children with cancer or post-haematopoietic stem cell transplant: a retrospective cohort study

Background Risk factors for carbapenem resistance in Enterobacterales bloodstream infections among children with cancer or post-HSCT have not been thoroughly explored. Methods All children with cancer or post-HSCT who developed Enterobacterales bloodstream infections in two cancer referral centres in major Colombian cities between 2012 and 2021 were retrospectively examined. When the infection episode occurred, carbapenem resistance mechanisms were evaluated according to the available methods. Data were divided in a training set (80%) and a test set (20%). Three internally validated carbapenem-resistant Enterobacterales (CRE) prediction models were created: a multivariate logistic regression model, and two data mining techniques. Model performances were evaluated by calculating the average of the AUC, sensitivity, specificity and predictive values. Results A total of 285 Enterobacterales bloodstream infection episodes (229 carbapenem susceptible and 56 carbapenem resistant) occurred [median (IQR) age, 9 (3.5–14) years; 57% male]. The risk of CRE was 2.1 times higher when the infection was caused by Klebsiella spp. and 5.8 times higher when a carbapenem had been used for ≥3 days in the previous month. A model including these two predictive variables had a discriminatory performance of 77% in predicting carbapenem resistance. The model had a specificity of 97% and a negative predictive value of 81%, with low sensitivity and positive predictive value. Conclusions Even in settings with high CRE prevalence, these two variables can help early identification of patients in whom CRE-active agents are unnecessary and highlight the importance of strengthening antibiotic stewardship strategies directed at preventing carbapenem overuse.Q1Q1Los factores de riesgo de resistencia a los carbapenémicos en las infecciones del torrente sanguíneo por Enterobacterales entre niños con cáncer o después de un TCMH no se han explorado a fondo. Métodos Se examinaron retrospectivamente todos los niños con cáncer o post-TCMH que desarrollaron infecciones del torrente sanguíneo por Enterobacterales en dos centros de referencia de cáncer en las principales ciudades de Colombia entre 2012 y 2021. Cuando ocurrió el episodio de infección, se evaluaron los mecanismos de resistencia a los carbapenémicos según los métodos disponibles. Los datos se dividieron en un conjunto de entrenamiento (80%) y un conjunto de prueba (20%). Se crearon tres modelos de predicción de Enterobacterales resistentes a carbapenémicos (CRE) validados internamente: un modelo de regresión logística multivariante y dos técnicas de minería de datos. El rendimiento del modelo se evaluó calculando el promedio del AUC, la sensibilidad, la especificidad y los valores predictivos. Resultados Se produjeron un total de 285 episodios de infección del torrente sanguíneo por Enterobacterales (229 susceptibles a carbapenémicos y 56 resistentes a carbapenémicos) [mediana de edad (RIQ), 9 (3,5 a 14) años; 57% hombres]. El riesgo de CRE fue 2,1 veces mayor cuando la infección fue causada por Klebsiella spp. y 5,8 veces mayor cuando se había utilizado un carbapenem durante ≥3 días en el mes anterior. Un modelo que incluía estas dos variables predictivas tuvo un rendimiento discriminatorio del 77% en la predicción de la resistencia a los carbapenémicos. El modelo tuvo una especificidad del 97% y un valor predictivo negativo del 81%, con baja sensibilidad y valor predictivo positivo. Conclusiones Incluso en entornos con una alta prevalencia de CRE, estas dos variables pueden ayudar a la identificación temprana de pacientes en quienes los agentes activos de CRE son innecesarios y resaltar la importancia de fortalecer las estrategias de administración de antibióticos dirigidas a prevenir el uso excesivo de carbapenémicos.N/AS

Atracción de escolítidos a trampas cebadas con etanol y monoterpenos en montes de Pinus pinea

Se presentan resultados de ensayos de campo para la atracción de escolítidos mediante el empleo de trampas cebadas (tipo Crossvane) con compuestos de presumible actividad cairomonal. Se realizaron tres experimentos (diciembre-2010 a enero-2011, abril a mayo de 2011 y octubre a noviembre de 2011) en cuatro parcelas con actividad relevante de Tomicus destruens y similar estado selvícola (términos municipales de Cartaya y Aljaraque. Huelva). Los objetivos parciales fueron: comparar la evolución temporal de capturas, probar la eficacia de distintas dosis de etanol y su actividad sinérgica con a-pineno, y explorar la actividad de monoterpenos en solitario o combinados (a-pineno, limoneno y terpinoleno). Seis especies de Scolytinae fueron capturadas de forma mayoritaria: T. destruens, Orthotomicus erosus, Hylastes linearis, Crypturgus mediterraneus, Carphoborus pini e Hylurgus ligniperda. Las combinaciones que emitieron la mezcla de etanol y a-pineno en diversas dosis capturaron más T. destruens y O. erosus que las que emitieron etanol solamente, aunque las diferencias no fueron significativas. En primavera abundaron H. linearis y C. mediterraneus. La presencia de limoneno pareció reducir las capturas de T. destruens. El impacto de captura de varias especies depredadoras (Thanasimus formicarius, Rhizophagus spp. y Aulonium ruficorne) que se redujo notablemente en trampas provistas de rejilla y ranuras de escape