A new squat lobster of the genus Munidopsis (Crustacea, Decapoda, Munidopsidae) from the Mediterranean Sea

8 páginas, 4 figuras[EN]A new species of Munidopsis Whiteaves, 1874 is reported from the south of Crete, at 2046-2104 m, in the eastern Mediterranean Sea. The species (M. ariadne) is morphologically closely related to M. maunga Schnabel and Bruce, 2006, from New Zealand. The species is also close to M. polymorpha Koelbel, 1892, from Lanzarote, Canary Islands, and M. talismani A. Milne Edwards and Bouvier, 1894, from the NW Africa. The new species is described and illustrated and a diagnosis along with full illustration is provided for the latter 2 species.[ES]Una nueva especie de crustáceo del género Munidopsis (Crustacea: Decapoda: Munidopsidae) del mar Mediterráneo. – Se describe una especie nueva de Munidopsis Whiteaves, 1874 capturada al sur de Creta, a 2046-2104 m, en el Mediterráneo oriental. La especie (M. ariadne) es próxima morfológicamente a M. maunga Schnabel and Bruce, 2006, de Nueva Zelanda. La especie está también relacionada con M. polymorpha Koelbel, 1892, de Lanzarote, Islas Canarias, y M. talismani A. Milne Edwards and Bouvier, 1894, del NO de África.Peer reviewe

Interventions to Reduce Medication Dispensing, Administration, and Monitoring Errors in Pediatric Professional Healthcare Settings: A Systematic Review

Introduction: Pediatric patients cared for in professional healthcare settings are at high risk of medication errors. Interventions to improve patient safety often focus on prescribing; however, the subsequent stages in the medication use process (dispensing, drug administration, and monitoring) are also error-prone. This systematic review aims to identify and analyze interventions to reduce dispensing, drug administration, and monitoring errors in professional pediatric healthcare settings. Methods: Four databases were searched for experimental studies with separate control and intervention groups, published in English between 2011 and 2019. Interventions were classified for the first time in pediatric medication safety according to the "hierarchy of controls" model, which predicts that interventions at higher levels are more likely to bring about change. Higher-level interventions aim to reduce risks through elimination, substitution, or engineering controls. Examples of these include the introduction of smart pumps instead of standard pumps (a substitution control) and the introduction of mandatory barcode scanning for drug administration (an engineering control). Administrative controls such as guidelines, warning signs, and educational approaches are lower on the hierarchy and therefore predicted by this model to be less likely to be successful. Results: Twenty studies met the inclusion criteria, including 1 study of dispensing errors, 7 studies of drug administration errors, and 12 studies targeting multiple steps of the medication use process. A total of 44 interventions were identified. Eleven of these were considered higher-level controls (four substitution and seven engineering controls). The majority of interventions (n = 33) were considered "administrative controls" indicating a potential reliance on these measures. Studies that implemented higher-level controls were observed to be more likely to reduce errors, confirming that the hierarchy of controls model may be useful in this setting. Heterogeneous study methods, definitions, and outcome measures meant that a meta-analysis was not appropriate. Conclusions: When designing interventions to reduce pediatric dispensing, drug administration, and monitoring errors, the hierarchy of controls model should be considered, with a focus placed on the introduction of higher-level controls, which may be more likely to reduce errors than the administrative controls often seen in practice. Trial Registration Prospero Identifier: CRD42016047127

Low Serum Levels of Soluble Receptor Activator of Nuclear Factor κ B Ligand (sRANKL) Are Associated with Metabolic Dysregulation and Predict Long-Term Mortality in Critically Ill Patients

Soluble receptor activator of nuclear factor κ B ligand (sRANKL) is a member of the tumor necrosis factor receptor superfamily, and therefore, involved in various inflammatory processes. The role of sRANKL in the course of bone remodeling via activation of osteoclasts as well as chronic disease progression has been described extensively. However, the potential functional importance of sRANKL in critically ill or septic patients remained unknown. Therefore, we measured sRANKL serum concentrations in 303 critically ill patients, including 203 patients with sepsis and 100 with non-sepsis critical illness. Results were compared to 99 healthy controls. Strikingly, in critically ill patients sRANKL serum levels were significantly decreased at intensive care unit (ICU) admission (p = 0.011) without differences between sepsis and non-sepsis patients. Inline, sRANKL was correlated with markers of metabolic dysregulation, such as pre-existing diabetes and various adipokines (e.g., adiponectin, leptin receptor). Importantly, overall mortality of critically ill patients in a three-year follow-up was significantly associated with decreased sRANKL serum concentrations at ICU admission (p = 0.038). Therefore, our study suggests sRANKL as a biomarker in critically ill patients which is associated with poor prognosis and overall survival beyond ICU stay

Decoherence, einselection, and the quantum origins of the classical

Decoherence is caused by the interaction with the environment. Environment monitors certain observables of the system, destroying interference between the pointer states corresponding to their eigenvalues. This leads to environment-induced superselection or einselection, a quantum process associated with selective loss of information. Einselected pointer states are stable. They can retain correlations with the rest of the Universe in spite of the environment. Einselection enforces classicality by imposing an effective ban on the vast majority of the Hilbert space, eliminating especially the flagrantly non-local "Schr\"odinger cat" states. Classical structure of phase space emerges from the quantum Hilbert space in the appropriate macroscopic limit: Combination of einselection with dynamics leads to the idealizations of a point and of a classical trajectory. In measurements, einselection replaces quantum entanglement between the apparatus and the measured system with the classical correlation.Comment: Final version of the review, with brutally compressed figures. Apart from the changes introduced in the editorial process the text is identical with that in the Rev. Mod. Phys. July issue. Also available from http://www.vjquantuminfo.or

Medication safety in a German telemedicine centre: Implementation of a telepharmaceutical expert consultation in addition to existing tele-intensive care unit services

Introduction Tele-intensive care unit (tele-ICU) services offer the possibility to provide specialized medical care in remote areas and to improve patient outcomes. The aim of this study was to implement and evaluate an additional telepharmaceutical expert consultation as part of tele-ICU services. Methods This is a prospective observational study conducted in the telemedicine centre of the University Hospital RWTH Aachen, Germany. Between March and July 2015, all tele-ICU patients of one internal and two remote ICUs received telepharmaceutical consultation. Number and type of drug related problems (DRPs) were identified in a comprehensive medication safety check. Implementation of DRPs was discussed interdisciplinarily by tele-ICU pharmacist, tele-ICU physician and remote ICU physician. Special focus was on drug-drug interactions (DDIs) and dosage adjustment in renal and liver failure. Results A total of 210 DRPs in 103 patients were identified and discussed. On average, 2.0 (range 0-17) DRPs per patient were found. At least one DRP was found in 62% of patients. Antibacterials for systemic use were most involved in DRPs. A total of 1129 DDI-alerts were generated by ID PHARMA CHECK (R). Fifty-six DDIs (5%) were discussed in tele-ICU rounds. The tele-ICU team discussed 28 cases of dosage adjustment in organ failure. Discussion Telepharmaceutical consultation as part of tele-ICU services was successfully implemented and can improve medication safety. Telemedicine infrastructure provides the possibility to implement guidelines recommending pharmaceutical service in the ICU in remote hospitals not having access to clinical pharmacists. Thus, quality of care can be improved