Conducta de los Enfermeros Frente a las Alarmas Clínicas en Unidades de Cuidados Intensivos: una Revisión Integradora

O presente estudo tem como propósito refletir sobre a prática de enfermagem no que concerne à temática da monitorização hemodinâmica. Pretendemos identificar a evidência empírica produzida sobre o comportamento dos enfermeiros perante os alarmes clínicos e, consequentemente, incentivar a adoção de estratégias que promovam um ambiente de cuidados intensivos menos ruidoso. Perspetivou-se um estudo de revisão sistemática da literatura. Selecionámos um conjunto de dezoito bases de dados eletrónicas, tendo recorrido a três idiomas. A colheita de informação decorreu entre dezembro de 2011 e janeiro de 2012 e, através de uma estratégia de cruzamento dos descritores selecionados, foram incluídos 5 artigos. Face a todo o corpo de discussão salientamos três categorias essenciais: opinião dos profissionais de saúde acerca dos alarmes clínicos; comportamento dos profissionais; estratégias promotoras de um ambiente menos ruidoso. Constatamos que os profissionais de saúde têm presente a bipolaridade dos alarmes clínicos e identificam limitações na sua gestão. Verificamos ainda que o comportamento dos profissionais nos estudos analisados não é linear, variando entre alterar os parâmetros no início de cada turno até ignorar uma grande maioria deles. Cientes desta realidade, os profissionais sugerem diversas estratégias passíveis de implementar, com vista a alarmes e comportamentos mais eficazes

Dynamics of Locomotor Fatigue during Supra-critical Power Exercise

Purpose; We aimed to measure 1) the dynamics of locomotor fatigue during constant supra-critical power cycling, and 2) the magnitude of any reserve in locomotor power at intolerance to constant and ramp-incremental cycling in recreationally-active volunteers. Methods; Fifteen participants (7 women and 8 men, 22±3 yr, 3.34±0.67 L.min-1 V[Combining Dot Above]O2peak) completed ramp-incremental and very-heavy constant power (205±46 W) exercise to the limit of tolerance. Immediately following intolerance, the ergometer was switched into the isokinetic mode and participants completed a short (~5 s) maximal isokinetic effort at 70 rpm. The time course of locomotor fatigue during constant supra-critical power exercise was characterized with these short maximal isokinetic sprints at 30, 60, 120, 180 s and at the limit of tolerance. Each bout was terminated following the isokinetic sprint. Results; Constant power exercise duration was 312±37 s. Isokinetic power production at 30, 60, 120, 180 s and the limit of tolerance (at 312±37 s) was 609±165, 503±195, 443±157, 449±133, and 337±94 W, respectively. Of the total decline in isokinetic power, ~36% occurred within the first minute of exercise and significant (p<0.05) reductions in isokinetic power occurred at all time-points vs the baseline maximal isokinetic power (666±158 W). Additionally, a significant power reserve of 132±74 W (64% of the task requirement) and 119±80 W (47%) was present at the limit of constant power and ramp-incremental exercise, respectively. Conclusions; Locomotor fatigue occurred rapidly during supra-critical power exercise with pseudo-exponential kinetics. Instantaneous isokinetic power production at the limit of tolerance exceeded that of the task requirement, regardless of the constant, or ramp work rate profile. Thus, the perceptual and physiologic limits were dissociated at the limit of tolerance in recreationally-active volunteers

a qualitative approach

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Entanglement in nuclear quadrupole resonance

Entangled quantum states are an important element of quantum information techniques. We determine the requirements for states of quadrupolar nuclei with spins >1/2 to be entangled. It was shown that entanglement is achieved at low temperature by applying a magnetic field to a quadrupolar nuclei possess quadrupole moments, which interacts with the electricfield gradient produced by the charge distribution in their surroundings.Comment: 9 pages, 5 figure

Population Genetics of Franciscana Dolphins (Pontoporia blainvillei): Introducing a New Population from the Southern Edge of Their Distribution

Due to anthropogenic factors, the franciscana dolphin, Pontoporia blainvillei, is the most threatened small cetacean on the Atlantic coast of South America. Four Franciscana Management Areas have been proposed: Espiritu Santo to Rio de Janeiro (FMA I), São Paulo to Santa Catarina (FMA II), Rio Grande do Sul to Uruguay (FMA III), and Argentina (FMA IV). Further genetic studies distinguished additional populations within these FMAs. We analyzed the population structure, phylogeography, and demographic history in the southernmost portion of the species range. From the analysis of mitochondrial DNA control region sequences, 5 novel haplotypes were found, totalizing 60 haplotypes for the entire distribution range. The haplotype network did not show an apparent phylogeographical signal for the southern FMAs. Two populations were identified: Monte Hermoso (MH) and Necochea (NC)+Claromecó (CL)+Río Negro (RN). The low levels of genetic variability, the relative constant size over time, and the low levels of gene flow may indicate that MH has been colonized by a few maternal lineages and became isolated from geographically close populations. The apparent increase in NC+CL+RN size would be consistent with the higher genetic variability found, since genetic diversity is generally higher in older and expanding populations. Additionally, RN may have experienced a recent split from CL and NC; current high levels of gene flow may be occurring between the latter ones. FMA IV would comprise four franciscana dolphin populations: Samborombón West+Samborombón South, Cabo San Antonio+Buenos Aires East, NC+CL+Buenos Aires Southwest+RN and MH. Results achieved in this study need to be taken into account in order to ensure the long-term survival of the species.Fil: Gariboldi, María Constanza. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Maimónides. Área de Investigaciones Biomédicas y Biotecnológicas. Centro de Estudios Biomédicos, Biotecnológicos, Ambientales y de Diagnóstico; ArgentinaFil: Tunez, Juan Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Luján; ArgentinaFil: Dejean, Cristina Beatriz. Universidad Maimónides. Área de Investigaciones Biomédicas y Biotecnológicas. Centro de Estudios Biomédicos, Biotecnológicos, Ambientales y de Diagnóstico; Argentina. Universidad de Buenos Aires. Facultad de Filosofía y Letras. Instituto de Ciencias Antropológicas. Sección Antropología Biológica; ArgentinaFil: Failla, Mauricio. Fundación Cethus; ArgentinaFil: Vitullo, Alfredo Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Maimónides. Área de Investigaciones Biomédicas y Biotecnológicas. Centro de Estudios Biomédicos, Biotecnológicos, Ambientales y de Diagnóstico; ArgentinaFil: Negri, Maria Fernanda. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales ; ArgentinaFil: Cappozzo, Humberto Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Maimónides. Área de Investigaciones Biomédicas y Biotecnológicas. Centro de Estudios Biomédicos, Biotecnológicos, Ambientales y de Diagnóstico; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales ; Argentin

a quantitative approach

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Massively parallel computing on an organic molecular layer

Current computers operate at enormous speeds of ~10^13 bits/s, but their principle of sequential logic operation has remained unchanged since the 1950s. Though our brain is much slower on a per-neuron base (~10^3 firings/s), it is capable of remarkable decision-making based on the collective operations of millions of neurons at a time in ever-evolving neural circuitry. Here we use molecular switches to build an assembly where each molecule communicates-like neurons-with many neighbors simultaneously. The assembly's ability to reconfigure itself spontaneously for a new problem allows us to realize conventional computing constructs like logic gates and Voronoi decompositions, as well as to reproduce two natural phenomena: heat diffusion and the mutation of normal cells to cancer cells. This is a shift from the current static computing paradigm of serial bit-processing to a regime in which a large number of bits are processed in parallel in dynamically changing hardware.Comment: 25 pages, 6 figure

A generic materials and operations planning approach for inventory turnover optimization in the chemical industry

Chemical industries usually involve continuous and large-scale production processes that require demanding inventory control systems. This paper aims to show the results of the implementation of a mixed-integer programming model (MIP) based on the Generic Materials and Operations Planning Problem (GMOP) for optimizing the inventory turnover in a fertilizer company. Results showed significant improvements for Inventory Turnover Ratios and overall costs when compared with an empirical production planning method