Improving the OCL Semantics Definition by Applying Dynamic Meta Modeling and Design Patterns

OCL is a standard specification language, which will probably be supported by most software modeling tools in the near future. Hence, it is important for OCL to have a solid formal foundation, for its syntax and its semantic definition. Currently, OCL is being formalized by metamodels expressed in MOF, complemented by well formedness rules written in the own OCL. This recursive definition not only brings about formal problems, but also puts obstacles in language understanding. On the other hand, the OCL semantics metamodel presents quality weaknesses due to the fact that certain object-oriented design rules (patterns) were not obeyed in their construction. The aim of the proposal presented in this article is to improve the definition for the OCL semantics metamodel by applying GoF patterns and the dynamic metamodeling technique. Such proposal avoids circularity in OCL definition and increases its extensibility, legibility and accuracy

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Multiple factors associated with nest-site selection in a wetland-specialist, the Wren-like Rushbird (Phleocryptes melanops)

Diverse factors may limit nest-site selection; however, nest predation has long been considered a main factor driving nest-site selection in birds. Marsh-nesting birds face a particularly important trade-off between habitat features that impede their vision of the approach of potential predators and nest concealment from predators. Here, we analyse how different ecological variables influence nest-site selection in the habitat-specialist Wren-like Rushbird (Phleocryptes melanops) breeding in three different wetlands of the Pampas region of Argentina over 3 years. Rushbirds selected nest sites with higher heights and denser vegetation, compared to random sites. Nest height was positively associated with vegetation height and lower visibility from the point of view of aerial predators, and the nest entrance was oriented towards the region with greatest visibility of the nest from the point of view of Rushbirds. Rushbirds seem to flexibly adjust their nest location in response to high predation risk, building their nests under structures built by other birds when breeding colonies of herons and gulls (potential nest predators) are present. Initial nest-site selection is performed by males, which then attempt to attract females to a rudimentary nest. Females sometimes reject such sites and the male then selects a new nesting location. Our study highlights the potential for flexible sex differences in nest-site selection.Fil: Chiaradia, Nicolas Mariano. Universidad Nacional de Mar del Plata; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Investigaciones Marinas y Costeras; ArgentinaFil: Isacch, Juan Pablo. Universidad Nacional de Mar del Plata; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Investigaciones Marinas y Costeras; ArgentinaFil: Pretelli, Matías Guillermo. Universidad Nacional de Mar del Plata; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Investigaciones Marinas y Costeras; ArgentinaFil: Cardoni, Daniel Augusto. Universidad Nacional de Mar del Plata; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Investigaciones Marinas y Costeras; Argentin

Treatment of COVID-19 during the Acute Phase in Hospitalized Patients Decreases Post-Acute Sequelae of COVID-19

Background: The post-acute sequelae of SARS-CoV-2 (PASC) infection have caused a significant impact on our health system, but there is limited evidence of approved drugs focused on its prevention. Our objective was to identify risk factors that can determine the presence of PASC, with special attention to the treatment received in the acute phase, and to describe the profile of persistent symptoms in a multidisciplinary Post-Coronavirus Disease-19 (COVID-19) Unit. Methods: This one-year prospective observational study included patients following an acute COVID-19 infection, irrespective of whether they required hospital admission. A standardized symptom questionnaire and blood sampling were performed at the first follow-up visit, and demographic and clinical electronic data were collected. We compared subjects with PASC with those who had fully recovered. Multivariate logistic regression was performed to identify factors associated with PASC in hospitalized patients, and Kaplan–Meier curves were used to assess duration of symptoms according to disease severity and treatments received in the acute phase. Results: 1966 patients were evaluated; 1081 had mild disease, 542 moderate and 343 severe; around one third of the subjects had PASC, and were more frequently female, with obesity, asthma, and eosinophilia during acute COVID-19 disease. Patients who received treatment with dexamethasone and remdesivir during the course of the acute illness showed a lower median duration of symptoms, compared with those who received none of these treatments. Conclusion: Treatment with dexamethasone and/or remdesivir may be useful to reduce the impact of PASC secondary to SARS-CoV-2 infection. In addition, we identified female gender, obesity, asthma, and disease severity as risk factors for having PASC