Bronchoscopist's perception of the quality of the single-use bronchoscope (Ambu aScope4™) in selected bronchoscopies: a multicenter study in 21 Spanish pulmonology services

Background: The disposable bronchoscope is an excellent alternative to face the problem of SARS-CoV-2 and other cross infections, but the bronchoscopist's perception of its quality has not been evaluated. Methods: To evaluate the quality of the Ambu-aScope4 disposable bronchoscope, we carried out a cross-sectional study in 21 Spanish pulmonology services. We use a standardized questionnaire completed by the bronchoscopists at the end of each bronchoscopy. The variables were described with absolute and relative frequencies, measures of central tendency and dispersion depending on their nature. The existence of learning curves was evaluated by CUSUM analysis. Results: The most frequent indications in 300 included bronchoscopies was bronchial aspiration in 69.3% and the median duration of these was 9.1 min. The route of entry was nasal in 47.2% and oral in 34.1%. The average score for ease of use, image, and aspiration quality was 80/100. All the planned techniques were performed in 94.9% and the bronchoscopist was satisfied in 96.6% of the bronchoscopies. They highlighted the portability and immediacy of the aScope4TM to start the procedure in 99.3%, the possibility of taking and storing images in 99.3%. The CUSUM analysis showed average scores > 70/100 from the first procedure and from the 9th procedure more than 80% of the scores exceeded the 80/100 score. Conclusions: The aScope4™ scored well for ease of use, imaging, and aspiration. We found a learning curve with excellent scores from the 9th procedure. Bronchoscopists highlighted its portability, immediacy of use and the possibility of taking and storing images

Bronchoscopist's perception of the quality of the single-use bronchoscope (Ambu aScope4™) in selected bronchoscopies: a multicenter study in 21 Spanish pulmonology services

Background: The disposable bronchoscope is an excellent alternative to face the problem of SARS-CoV-2 and other cross infections, but the bronchoscopist’s perception of its quality has not been evaluated. Methods: To evaluate the quality of the Ambu-aScope4 disposable bronchoscope, we carried out a cross-sectional study in 21 Spanish pulmonology services. We use a standardized questionnaire completed by the bronchoscopists at the end of each bronchoscopy. The variables were described with absolute and relative frequencies, measures of cen‑ tral tendency and dispersion depending on their nature. The existence of learning curves was evaluated by CUSUM analysis. Results: The most frequent indications in 300 included bronchoscopies was bronchial aspiration in 69.3% and the median duration of these was 9.1 min. The route of entry was nasal in 47.2% and oral in 34.1%. The average score for ease of use, image, and aspiration quality was 80/100. All the planned techniques were performed in 94.9% and the bronchoscopist was satisfed in 96.6% of the bronchoscopies. They highlighted the portability and immediacy of the aScope4TM to start the procedure in 99.3%, the possibility of taking and storing images in 99.3%. The CUSUM analysis showed average scores>70/100 from the frst procedure and from the 9th procedure more than 80% of the scores exceeded the 80/100 score

Bronchoscopist's perception of the quality of the single-use bronchoscope (Ambu aScope4™) in selected bronchoscopies : a multicenter study in 21 Spanish pulmonology services

Background: The disposable bronchoscope is an excellent alternative to face the problem of SARS-CoV-2 and other cross infections, but the bronchoscopist's perception of its quality has not been evaluated. Methods: To evaluate the quality of the Ambu-aScope4 disposable bronchoscope, we carried out a cross-sectional study in 21 Spanish pulmonology services. We use a standardized questionnaire completed by the bronchoscopists at the end of each bronchoscopy. The variables were described with absolute and relative frequencies, measures of central tendency and dispersion depending on their nature. The existence of learning curves was evaluated by CUSUM analysis. Results: The most frequent indications in 300 included bronchoscopies was bronchial aspiration in 69.3% and the median duration of these was 9.1 min. The route of entry was nasal in 47.2% and oral in 34.1%. The average score for ease of use, image, and aspiration quality was 80/100. All the planned techniques were performed in 94.9% and the bronchoscopist was satisfied in 96.6% of the bronchoscopies. They highlighted the portability and immediacy of the aScope4TM to start the procedure in 99.3%, the possibility of taking and storing images in 99.3%. The CUSUM analysis showed average scores > 70/100 from the first procedure and from the 9th procedure more than 80% of the scores exceeded the 80/100 score. Conclusions: The aScope4™ scored well for ease of use, imaging, and aspiration. We found a learning curve with excellent scores from the 9th procedure. Bronchoscopists highlighted its portability, immediacy of use and the possibility of taking and storing images

Sustainable Development Opportunities at the Climate, Land, Energy and Water Nexus in Nicaragua  ,  Lopez,  F. , Luger, and Daniel M. Kammen

There are strong interconnections between the practices needed to sustainably manage land, energy, and water resources, which become even more pronounced when the many implications of climate change are taken into consideration. An exploration of these resource sectors in Nicaragua, a country at high risk from climate change, shows how their linkages directly impact the opportunities for development available to a rapidly growing economy. In particular, these linkages may shape solutions for sustainably managing agriculture, confronting water scarcity, and promoting local energy resources, which together can provide independence from global market volatility. Here we synthesize the state of climate, land, energy, and water issues in Nicaragua and highlight the potential for integrated resource planning in the country. We focus on three ongoing, sustainable development initiatives as case studies: rain-water harvesting in the Pacific Mountain Corridor, community-scale breadfruit processing in the Caribbean Coast region, and national bioenergy production using sugarcane bagasse.&nbsp

Sustainable Development Opportunities at the Climate, Land, Energy and Water Nexus in Nicaragua

There are strong interconnections between the practices needed to sustainably manage land, energy, and water resources, which become even more pronounced when the many implications of climate change are taken into consideration. An exploration of these resource sectors in Nicaragua, a country at high risk from climate change, shows how their linkages directly impact the opportunities for development available to a rapidly growing economy. In particular, these linkages may shape solutions for sustainably managing agriculture,confronting water scarcity, and promoting local energy resources, which together can provide independence from global market volatility. Here we synthesize the state of climate, land,energy, and water issues in Nicaragua and highlight the potential for integrated resource planning in the country. We focus on three ongoing, sustainable development initiatives as case studies: rain-water harvesting in the Pacific Mountain Corridor, community-scale breadfruit processing in the Caribbean Coast region, and national bioenergy production using sugarcane bagasse.Fil: Gourdji, Sharon. University of Stanford; Estados UnidosFil: Craig, Mathias. Blue Energy; Estados UnidosFil: Shirley, Rebekah. University of California at Berkeley; Estados UnidosFil: Ponce de Leon Barido, Diego. University of California at Berkeley; Estados UnidosFil: Campos, Eleonora. Instituto Nacional de Tecnología Agropecuaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Giraldo, Mauricio. Universidad Pontificia Bolivariana; ColombiaFil: Lopez, Mauricio. Pontificia Universidad Católica de Chile; ChileFil: Pereira de Lucena, Andre F.. Universidade Federal do Rio de Janeiro; BrasilFil: Luger, Martina. Horizont3000; NicaraguaFil: Kammen, Daniel M.. University of California at Berkeley; Estados Unido

New directions in the political history of the Spanish-Atlantic world, c. 1750–1850

Peer Reviewe