Generation of multiscroll attractors by controlling the equilibria

Investigació

A family of hyperchaotic multi-scroll attractors in Rn

Investigació

Generalized multistable structure via chaotic synchronization and preservation of scrolls

Investigació

Room temperature photo-response of titanium supersaturated silicon at energies over the bandgap

Silicon samples were implanted with high Ti doses and subsequently processed with the pulsed-laser melting technique. The electronic transport properties in the 15–300 K range and the room temperature spectral photoresponse at energies over the bandgap were measured. Samples with Ti concentration below the insulator-metal (I-M) transition limit showed a progressive reduction of the carrier lifetime in the implanted layer as Ti dose is increased. However, when the Ti concentration exceeded this limit, an extraordinary recovery of the photoresponse was measured. This result supports the theory of intermediate band materials and is of utmost relevance for photovoltaic cells and Si-based detectors

Current situation of sepsis care in Spanish emergency departments

Objective. To describe the approach to the patients with suspected sepsis in the Spanish emergency department hospitals (ED) and analyze whether there are differences according to the size of the hospital and the number of visits to the emergency room. Method. Structured survey of those responsible for the 282 public EDs that serve adults 24 hours a day, 365 days a year. It was asked about assistance and management in the emergency room in the care of patients with suspected sepsis. The results are compared according to hospital size (large = 500 beds vs medium-small <500) and influx to the emergency room (discharge = 200 visits / day vs medium-low <200). Results. A total of 250 Spanish EDs responded (89%). Sepsis protocols are available in 163 (65%) EDs median weekly sepsis treated ranged from 0-5 per week in 39 (71%) ED, 6-10 per week in 10 (18%), 11-15 per week in 4 (7%), and more than 15 activations per week in 3 centers (3.6%). The criteria used for sepsis diagnosis were the qSOFA/SOFA in 105 (63.6%) of the hospitals, SIRS in 6 (3.6%), while in 49 (29.7%) they used both criteria simultaneously. In 79 centers, the sepsis diagnosis was computerized, and in 56 there were tools to help decision-making. 48% (79 of 163) of the EDs had data on bundles compliance. In 61% (99 of 163) of EDs there was training in sepsis and in 56% (55 of 99) it was periodic. Considering the size of the hospital, large hospitals participated more frequently as recipients of patients with sepsis and had an infectious, sepsis and short-stay unit, a microbiologist and infectious disease specialist on duty. Conclusion. Most EDs have sepsis protocols, but there is room for improvement. The computerization and development of alerts for diagnosis and treatment still have a long way to go in EDs

Mycoplasma bovis in Spanish Cattle Herds: Two Groups of Multiresistant Isolates Predominate, with One Remaining Susceptible to Fluoroquinolones

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).This document is the Accepted version of a Published Work that appeared in final form in Pathogens. To access the final edited and published work see https://doi.org/10.3390/pathogens9070545Mycoplasma bovis is an important bovine pathogen causing pneumonia, mastitis, and arthritis and is responsible for major economic losses worldwide. In the absence of an efficient vaccine, control of M. bovis infections mainly relies on antimicrobial treatments, but resistance is reported in an increasing number of countries. To address the situation in Spain, M. bovis was searched in 436 samples collected from beef and dairy cattle (2016–2019) and 28% were positive. Single-locus typing using polC sequences further revealed that two subtypes ST2 and ST3, circulate in Spain both in beef and dairy cattle, regardless of the regions or the clinical signs. Monitoring of ST2 and ST3 isolates minimum inhibitory concentration (MIC) to a panel of antimicrobials revealed one major difference when using fluoroquinolones (FQL): ST2 is more susceptible than ST3. Accordingly, whole-genome sequencing (WGS) further identified mutations in the gyrA and parC regions, encoding quinolone resistance-determining regions (QRDR) only in ST3 isolates. This situation shows the capacity of ST3 to accumulate mutations in QRDR and might reflect the selective pressure imposed by the extensive use of these antimicrobials. MIC values and detection of mutations by WGS also showed that most Spanish isolates are resistant to macrolides, lincosamides, and tetracyclines. Valnemulin was the only one effective, at least in vitro, against both STs

Nursing care in the prevention of bloodstream infections associated with peripherally inserted central catheter

Introducción: En el ámbito de la atención integral, los catéteres centrales de inserción periférica (PICC) han emergido como medio para garantizar un acceso venoso seguro tanto en pacientes críticos en unidades de cuidados intensivos (UCI) como pacientes con enfermedades crónicas que requieren cuidados paliativos. Sin embargo, estos dispositivos conllevan un riesgo inherente: la posibilidad de infección del torrente sanguíneo asociada a catéter central (ITSAC), que actualmente se sigue presentando. Así, se hace necesaria la actualización y revisión de evidencia científica desde un enfoque mixto sobre los factores determinantes en el desarrollo de ITSAC asociadas a PICC. Objetivo: Identificar la atención de enfermería orientada a la prevención de infecciones del torrente sanguíneo asociadas a PICC en Unidades de Cuidado Intensivo y Unidades de Cuidado Paliativo mediante una revisión sistemática mixta en el año 2023. Materiales y métodos: Se desarrolló una Revisión Sistemática Mixta basada en los planteamientos de Quan (2020), que incluyó estudios de fuentes primarias con diseño metodológico cuantitativo, cualitativo o mixto, publicados en revistas científicas de diversas bases de datos en idioma inglés, español y portugués. Se utilizó la herramienta Mixed Methods Appraisal Tool (MMAT) en su versión 2018, para evaluar la calidad de los estudios, con un total de 32 artículos que se incluyeron para el desarrollo de la presente revisión la cual se llevó a cabo entre mayo y septiembre de 2023 utilizando una metodología de síntesis convergente. 21 Resultados: Los resultados revelaron que en cuanto a los factores determinantes en el desarrollo de ITSAC, los factores favorables se basaban en el conocimiento y experticia de las enfermeras sobre el procedimiento, así como el uso de nuevas tecnologías como el ultrasonido, el uso de PICC´s antimicrobianos, conectores, apósitos, entre otros. En cuanto a los factores desfavorables, se evidenciaron temáticas como la falta de uso de práctica basada en evidencia (PBE) y las múltiples actividades a desarrollar por las profesionales, adicional a esto, como factores desfavorables, la condición clínica del paciente. Conclusiones: Se ratifica la seguridad, efectividad y eficacia del uso de catéteres centrales de inserción periférica en pacientes oncológicos, no oncológicos, y en estado crítico. Dado que es una temática compleja, se requiere una perspectiva que permita la integración de múltiples aspectos que van desde el ámbito técnico-científico, hasta contemplar condiciones propias del entorno social y de conocimientos de las enfermeras sobre el uso de los catéteres PICC´s.Introduction: In the field of comprehensive care, peripherally inserted central catheters (CCIP) have emerged to ensure safe venous access both in critically ill patients in intensive care units (ICU) and in patients with chronic diseases requiring palliative care. However, these devices carry an inherent risk: the possibility of central line-associated bloodstream infection (CLABSI), which continues to occur today. Thus, it is necessary to update and review scientific evidence from a mixed approach on the determining factors in the development of CLABSI associated with PICC. Objective: Identify nursing care aimed at preventing bloodstream infections associated with CCIP in Intensive Care Units and Palliative Care Units through a mixed systematic review in 2023. Materials and methods: A Mixed Systematic Review was developed based on the approaches of Quan (2020), which included studies from primary sources with quantitative, qualitative or mixed methodological design, published in scientific journals from various databases in English, Spanish and Portuguese. The Mixed Methods Appraisal Tool (MMAT) in its 2018 version was used to evaluate the quality of the studies, with a total of 32 articles that were included for the development of this review, which was carried out between May and September. 2023 using a convergent synthesis methodology. 23 Results: The results revealed that regarding the determining factors in the development of CLABSI, the favorable factors were based on the knowledge and expertise of the nurses about the procedure, as well as the use of new technologies such as ultrasound, the use of CCIP antimicrobials, connectors, dressings, among others. Regarding the unfavorable factors, issues such as the lack of use of evidence-based practice (EBP) and the multiple activities to be carried out by the professionals were evident, in addition to this, as unfavorable factors, the clinical condition of the patient. Conclusions: The safety, effectiveness and efficacy of the use of peripherally inserted central catheters in oncological, non-oncological and critically ill patients is confirmed. Given that it is a complex topic, a perspective is required that allows the integration of multiple aspects that range from the technical-scientific field, to considering conditions specific to the social environment and nurses' knowledge about the use of CCIP cathetersMagíster en Enfermería en Cuidado CríticoMaestrí

Las alternativas ciudadanas para otros mundos posibles: pensamiento y experiencias

El documento está conformado por tres partes: la primera define algunos conceptos y expone ciertas teorías sobre el desarrollo y las alternativas (los artículos que componen este apartado son: "Diversidad y dinamismo de las alternativas ciudadanas", "¿Desarrollo alternativo o alternativas al desarrollo? repensando el concepto desde el territorio y el sur global"); la segunda, hace referencia a la construcción de algunas experiencias concretas relacionadas con las alternativas ciudadanas ("La gestión compleja del agua", "La alternativa educativa intercultural wixárika"; "Los procesos sociales en la construcción de alternativas a conflictos ambientales en la cuenca alta del río Santiago"). La tercera parte consiste en una propuesta de investigación sobre las alternativas ciudadanas ("Las alternativas ciudadanas: una propuesta de análisis").ITESO, A.C

Hypotension Prediction Index Software to Prevent Intraoperative Hypotension during Major Non-Cardiac Surgery: Protocol for a European Multicenter Prospective Observational Registry (EU-HYPROTECT)

Intraoperative hypotension is common in patients having non-cardiac surgery and associated with postoperative acute myocardial injury, acute kidney injury, and mortality. Avoiding intraoperative hypotension is a complex task for anesthesiologists. Using artificial intelligence to predict hypotension from clinical and hemodynamic data is an innovative and intriguing approach. The AcumenTM Hypotension Prediction Index (HPI) software (Edwards Lifesciences; Irvine, CA, USA) was developed using artificial intelligence-specifically machine learning-and predicts hypotension from blood pressure waveform features. We aimed to describe the incidence, duration, severity, and causes of intraoperative hypotension when using HPI monitoring in patients having elective major non-cardiac surgery