Practical guide for pressure ulcers

La presente guía se integra dentro de la Colección de Guías Prácticas de Heridas del Servizo Galego de Saúde, de acuerdo con la estrategia y líneas de acción promovidas a través del Programa Ulceras Fuera que coordina la Subdirección Xeral de Ordenación Asistencial e Innovación Organizativa. Esta guía se conforma como una síntesis de las mejores intervenciones y prácticas preventivas o terapéuticas disponibles para el cuidado de las personas con úlceras pro presión o en riego de padecerlas.A presente guía intégrase dentro da Colección de Guías Prácticas de Feridas do Servizo Galego de Saúde; de acordo coas estratexias e liñas de acción promovida a través do Programa Úlceras Fóra que coordina a Subdirección Xeral de Ordenación Asistencial e Innovación Organizativa. Esta guía confórmase coma unha síntese das mellores intervencións e prácticas preventivas ou terapéuticas dispoñibles para o coidado das persoas con úlceras por presión ou con risco de padecelas

Moving forward on u-healthcare: A framework for patient-centric

Delivering remote healthcare services without deteriorating the ‘patient experience’ requires building highly usable and adaptive applications. Efficient context data collection and management make possible to infer extra knowledge on the user’s situation, making easier the design of these advanced ubiquitous applications. This contribution, part of a work in progress which aims at building an operative AmI middleware, presents a generic architecture to provide u-healthcare services, to be delivered both in mobile and home environments. In particular, we address the design of the Context Management Component (CMC), the module that takes context data from the sensing layer and performs data fusion and reasoning to build an aggregated ‘context image’. We especially explain the requirements on data modelling and the functional features that are imposed to the CMC. The resulting logical multilayered architecture -composed by acquisition and fusion, inference and reasoning levels- is detailed, and the technologies needed to develop the Context Management Component are finally specifie

Evaluación de la calidad global de la colección de guías prácticas de heridas del servicio gallego de salud

Objetivo: Evaluar el nivel de calidad global de la colección de guías prácticas de heridas del Servicio Gallego de Salud (Sergas) para la toma de decisiones clínicas. Método: Evaluación de guías basadas en la evidencia (GBP). Selección de todas las GBP que componen la colección sobre heridas publicadas por el Sergas. Valoración a través del instrumento AGREE II-GRS (Global Rating Scale). Revisión por tres experto/as. Resultados: Fueron evaluadas siete GBP: úlceras por presión, úlceras de la extremidad inferior, pie diabético, lesiones cutáneas neoplásicas, lesiones por quemadura, herida quirúrgica aguda y lesiones cutáneas asociadas a la humedad. Se evaluaron cuatro apartados: el proceso de desarrollo, el estilo de presentación, la integridad de la información y la validez clínica. Todas las GBP obtuvieron una puntuación entre 5 y 7. A nivel global se obtuvo una nota media de 6 (“calidad alta”). Conclusiones: Las GBP publicadas por el Sergas son guías de muy buena calidad, recomendables para el uso clínico y aconsejable su implementación en los procesos de toma de decisiones en el área de las úlceras y heridas.Objective: To appraise the quality global level of the collection of practical guides for wounds of the Galician Health Service (Sergas) for professional decision-making. Method: Evaluation of Best Practice Guidelines (BPG). Selection of all BPG of the collection on injuries/wounds published by Sergas. Valuation through the AGREE II-GRS instrument (Global Rating Scale). Review by three experts. Results: Seven BPG were evaluated: pressure ulcers, ulcers of the lower limb, diabetic foot, skin tumor lesions, burn injuries, acute surgical wound and skin lesions associated with humidity. Four sections were evaluated: the development process, the presentation style, the integrity of the information and the clinical validity. All the GBP obtained a score between 5 and 7. On a global level, an average score of 6 was obtained (High quality). Conclusions: The BPG published by Sergas are guides of very good quality, recommended for clinical use and advisable to implement them in decision-making processes in the area of ulcers and wounds

Spanish version of the Dundee Ready Education Environment Measure (DREEM) applied to undergraduate physical therapy students in Spain using Google Form

[Intro] The educational climate (EC) is an important factor in determining the effectiveness and success of the curriculum in a school of medical sciences. The Dundee Ready Education Environment Measure (DREEM) questionnaire was used to assess EC in a competency-based curriculum in the physical therapy program analyzing the mean total, subscale, and item scores, as well as response rates. To carry out a psychometric evaluation of the Spanish-language version of the DREEM applied to undergraduate physical therapy students, a total of 671 students enrolled on Degrees in Physiotherapy at 22 faculties across public and private universities in Spainresponded to the DREEM questionnaire using Google Form. (...

Global Island Monitoring Scheme (GIMS) : a proposal for the long-term coordinated survey and monitoring of native island forest biota

Islands harbour evolutionary and ecologically unique biota, which are currently disproportionately threatened by a multitude of anthropogenic factors, including habitat loss, invasive species and climate change. Native forests on oceanic islands are important refugia for endemic species, many of which are rare and highly threatened. Long-term monitoring schemes for those biota and ecosystems are urgently needed: (i) to provide quantitative baselines for detecting changes within island ecosystems, (ii) to evaluate the effectiveness of conservation and management actions, and (iii) to identify general ecological patterns and processes using multiple island systems as repeated 'natural experiments'. In this contribution, we call for a Global Island Monitoring Scheme (GIMS) for monitoring the remaining native island forests, using bryophytes, vascular plants, selected groups of arthropods and vertebrates as model taxa. As a basis for the GIMS, we also present new, optimized monitoring protocols for bryophytes and arthropods that were developed based on former standardized inventory protocols. Effective inventorying and monitoring of native island forests will require: (i) permanent plots covering diverse ecological gradients (e.g. elevation, age of terrain, anthropogenic disturbance); (ii) a multiple-taxa approach that is based on standardized and replicable protocols; (iii) a common set of indicator taxa and community properties that are indicative of native island forests' welfare, building on, and harmonized with existing sampling and monitoring efforts; (iv) capacity building and training of local researchers, collaboration and continuous dialogue with local stakeholders; and (v) long-term commitment by funding agencies to maintain a global network of native island forest monitoring plots.Peer reviewe

Natural History of MYH7-Related Dilated Cardiomyopathy

BACKGROUND Variants in myosin heavy chain 7 (MYH7) are responsible for disease in 1% to 5% of patients with dilated cardiomyopathy (DCM); however, the clinical characteristics and natural history of MYH7-related DCM are poorly described. OBJECTIVES We sought to determine the phenotype and prognosis of MYH7-related DCM. We also evaluated the influence of variant location on phenotypic expression. METHODS We studied clinical data from 147 individuals with DCM-causing MYH7 variants (47.6% female; 35.6 +/- 19.2 years) recruited from 29 international centers. RESULTS At initial evaluation, 106 (72.1%) patients had DCM (left ventricular ejection fraction: 34.5% +/- 11.7%). Median follow-up was 4.5 years (IQR: 1.7-8.0 years), and 23.7% of carriers who were initially phenotype-negative developed DCM. Phenotypic expression by 40 and 60 years was 46% and 88%, respectively, with 18 patients (16%) first diagnosed at <18 years of age. Thirty-six percent of patients with DCM met imaging criteria for LV noncompaction. During follow-up, 28% showed left ventricular reverse remodeling. Incidence of adverse cardiac events among patients with DCM at 5 years was 11.6%, with 5 (4.6%) deaths caused by end-stage heart failure (ESHF) and 5 patients (4.6%) requiring heart transplantation. The major ventricular arrhythmia rate was low (1.0% and 2.1% at 5 years in patients with DCM and in those with LVEF of <= 35%, respectively). ESHF and major ventricular arrhythmia were significantly lower compared with LMNA-related DCM and similar to DCM caused by TTN truncating variants. CONCLUSIONS MYH7-related DCM is characterized by early age of onset, high phenotypic expression, low left ventricular reverse remodeling, and frequent progression to ESHF. Heart failure complications predominate over ventricular arrhythmias, which are rare. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation

Differential cross section measurements for the production of a W boson in association with jets in proton–proton collisions at √s = 7 TeV

Measurements are reported of differential cross sections for the production of a W boson, which decays into a muon and a neutrino, in association with jets, as a function of several variables, including the transverse momenta (pT) and pseudorapidities of the four leading jets, the scalar sum of jet transverse momenta (HT), and the difference in azimuthal angle between the directions of each jet and the muon. The data sample of pp collisions at a centre-of-mass energy of 7 TeV was collected with the CMS detector at the LHC and corresponds to an integrated luminosity of 5.0 fb[superscript −1]. The measured cross sections are compared to predictions from Monte Carlo generators, MadGraph + pythia and sherpa, and to next-to-leading-order calculations from BlackHat + sherpa. The differential cross sections are found to be in agreement with the predictions, apart from the pT distributions of the leading jets at high pT values, the distributions of the HT at high-HT and low jet multiplicity, and the distribution of the difference in azimuthal angle between the leading jet and the muon at low values.United States. Dept. of EnergyNational Science Foundation (U.S.)Alfred P. Sloan Foundatio

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis