The impact of COVID-19 on levels of adherence to the completion of nursing records for inpatients in isolation

Producción CientíficaThe COVID-19 pandemic has led to an increased workload for nurses and organisational and structural changes, which have been necessary to meet the needs of inpatients in isolation. Aim: To describe the impact of the COVID-19 pandemic on levels of adherence to the completion of nursing records that document the risk of developing pressure ulcers, falling, and social vulnerability among hospitalised patients in isolation. Methods: Observational pre-post comparison study. Comparison between nursing records (the Braden, Downton, and Gijón scales) belonging to 1205 inpatients took place in two phases. Phase 1: 568 patients admitted in February 2020, prior to the COVID-19 pandemic, vs. phase 2: 637 patients hospitalised with COVID-19 in March–April 2020, during the peak of the first wave of the pandemic. This research adheres to the STROBE guidelines for the reporting of observational studies. Results: The degree of completion of the Braden, Downton, and Gijón scales decreased significantly in phase 2 vs. phase 1 (p < 0.001). The mean Downton and Gijón scale scores for patients admitted in phase 1 were higher compared to those of patients admitted in phase 2 (p < 0.001). The mean Braden scale score in phase 2 was higher than in phase 1 (p < 0.05). Conclusion: During the COVID-19 pandemic, there was a decrease in the completion of nursing records in the clinical records of patients in isolation. The levels of risk of developing PUs, falling, and social vulnerability of patients admitted to hospital were lower during the first wave of the pandemic

Impact of Nursing Methodology training sessions on completion of the Virginia Henderson assessment record

Producción CientíficaThe Virginia Henderson model, integrated in the computer application GACELA Care, helps to standardise the nursing assessment and establish precise and personalised nursing diagnoses. The aim was to determine the extent of completion of the initial patient assessment record after nurses following a training programme on nursing methodology. A quasi-experimental, retrospective, randomised, observational, single-group study was performed in two stages: pre-training and post-training. Voluntary training sessions were held for the nurses that work with GACELA Care. The completion of the initial patient assessment using the needs of Virginia Henderson and the Norton scale was evaluated before and after the training sessions. Completion of the needs of Virginia Henderson in the initial patient assessment increased from 94.2% to 100% (p = 0.014). Completion of “hygiene/skin” increased significantly from 83.3% to 95.8% (pre-training and post-training, respectively). The remaining needs did not show statistical significance. Recording of the Norton scale increased from 63.13% to 92.5% (p < 0.001). The training sessions on nursing methodology have improved the completion of records and inclusion of normal characteristics, defining characteristics and risk factors, and improving pressure ulcer risk assessment through the Norton scale

NURSES' evidence-based practice competence and hospital practice environment after specific training under the best practice spotlight organization® programme. A cross sectional study

Producción CientíficaThe aim of the study was to evaluate the impact of a specific training within the framework of the Best Practice Spotlight Organization® programme, on nurses' evidence-based practice competence and the practice environment in two hospitals. The study sample were 204 nurses working at medical and surgical inpatient units at two hospitals involved in the Best Practice Spotlight Organization® programme. They were classified into two groups: those who had received specific training within the framework of the programme, called trained-champions (n = 66), and those who had not yet received training, control group (n = 138). The trained-champions exhibited better evidence-based practice competence values than the control group in all dimensions (p < 0.001), with a higher difference in means in the “Utilisation” dimension (−0.80; CI:-0.99,-0.60) and the “Knowledge” dimension (−0.63; CI:-0.88,-0.38). The conclusions are that Specific EBP training within the framework of the Best Practice Spotlight Organization® programme has succeeded in nurses (trained-champions) obtaining better EBP competence than others without this training

Efficiency of the cerebroplacental ratio in Identifying high-risk late-term pregnancies

Background and Objectives: Over the last few years, great interest has arisen in the role of the cerebroplacental ratio (CPR) to identify low-risk pregnancies at higher risk of adverse pregnancy outcomes. This study aimed to assess the predictive capacity of the CPR for adverse perinatal outcomes in all uncomplicated singleton pregnancies attending an appointment at 40–42 weeks. Materials and Methods: This is a retrospective cohort study including all consecutive singleton pregnancies undergoing a routine prenatal care appointment after 40 weeks in three maternity units in Spain and the United Kingdom from January 2017 to December 2019. The primary outcome was adverse perinatal outcomes defined as stillbirth or neonatal death, cesarean section or instrumental delivery due to fetal distress during labor, umbilical arterial cord blood pH &lt; 7.0, umbilical venous cord blood pH &lt; 7.1, Apgar score at 5 min &lt; 7, and admission to the neonatal unit. Logistic mixed models and ROC curve analyses were used to analyze the data. Results: A total of 3143 pregnancies were analyzed, including 537 (17.1%) with an adverse perinatal outcome. Maternal age (odds ratio (OR) 1.03, 95% confidence interval (CI) 1.01 to 1.04), body mass index (OR 1.04, 95% CI 1.03 to 1.06), racial origin (OR 2.80, 95% CI 1.90 to 4.12), parity (OR 0.36, 95% CI 0.29 to 0.45), and labor induction (OR 1.79, 95% CI 1.36 to 2.35) were significant predictors of adverse perinatal outcomes with an area under the ROC curve of 0.743 (95% CI 0.720 to 0.766). The addition of the CPR to the previous model did not improve performance. Additionally, the CPR alone achieved a detection rate of only 11.9% (95% CI 9.3 to 15) when using the 10th centile as the screen-positive cutoff. Conclusions: Our data on late-term unselected pregnancies suggest that the CPR is a poor predictor of adverse perinatal outcomes

Wind park reliable energy production based on a hydrogen compensation system. Part I: Technical viability

Power production from renewable energy resources is increasing day by day. In the case of Spain, in 2009, it represents the 26.9% of installed power and 20.1% of energy production. Wind energy has the most important contribution of this production. Wind generators are greatly affected by the restrictive operating rules of electricity markets because, as wind is naturally variable, wind generators may have serious difficulties on submitting accurate generation schedules on a day ahead basis, and on complying with scheduled obligations. Weather forecast systems have errors in their predictions depending on wind speed. Thus, if wind energy becomes an important actor in the energy production system, these fluctuations could compromise grid stability. In this study technical and economical viability of a large scale compensation system based on hydrogen is investigated, combining wind energy production with a biomass gasification system. Combination of two systems has synergies that improve final results. In the economical study, it is considered that all hydrogen production that is not used to compensate wind energy could be sold to supply the transportation sector.Sánchez Díaz, C.; Abad, B.; Hübner, S.; Alfonso-Solar, D.; Segura Heras, I. (2011). Wind park reliable energy production based on a hydrogen compensation system. Part I: Technical viability. International Journal of Hydrogen Energy. 36(24):15548-15560. doi:10.1016/j.ijhydene.2011.09.014S1554815560362

Identificación de plagas de chapulín en el norte–centro de México

Short carbon nanotubes (CNTs) are desired for a variety of applications. As a consequence, several strategies have been reported to cut and shorten the length of as-produced CNTs via chemical and physical routes. The efficiency of a given strategy largely depends on the physico-chemical characteristics of the CNTs employed. In order to be able to directly compare the advantages and disadvantages of commonly used protocols, a single batch of chemical vapor deposition single-walled CNTs (SWCNTs) and a batch of multi-walled CNTs (MWCNTs) were subjected to four cutting/shortening strategies, namely acid cutting, piranha treatment, steam shortening and ball milling. The length distribution was assessed by means of scanning electron microscopy. Sample purity and CNT wall structure were determined by Raman spectroscopy, thermogravimetric analysis and magnetic measurements. Within the employed experimental conditions, piranha treatment turned out to be the most efficient to achieve short SWCNTs with a narrow length distribution in a good yield, whereas a mixture of sulfuric/nitric acid was preferred in the case of MWCNTs. A subsequent short steam treatment allowed to remove functional groups present in the samples, leading to median length distributions of 266 nm and 225 nm for SWCNTs and MWCNTs respectively after the combined protocols

Polyacrylate polymers as immobilizing agents to aid phytostabilization of two mine soils

We evaluated the effect of polyacrylate polymers as immobilizing agents to aid phytostabilization of two mine soils. One soil had a very low pH (3.7) and a large Pb content, while the other was less acidic but had a greater content of Cu and Zn. Growth of perennial ryegrass (Lolium perenne L. cv. Victorian) was stimulated in polymer-amended soils. After ryegrass had been growing for 35 days, the amounts of water-extractable Cu, Zn and Pb (one soil only) present in the polymer-amended soils were smaller than those from soil without polymer. The number of culturable heterotrophic bacteria and the activities of dehydrogenase and b-glucosidase increased following polymer application. In contrast, the urease activity was impaired by polymer application, presumably because of the presence of ammonium as a counter ion. In another experiment, the acidic soil was limed to pH 6.5 before growth of perennial ryegrass took place. Liming the soil greatly enhanced plant growth, but by the third cut, differences between treatments became apparent, with plants from polymer-amended limed soil accumulating a greater biomass compared with limed soil without polymer. After ryegrass had been growing for 119 days (five cuts), the amount of water-extractable Pb and the urease activity in the polymer-amended soil were smaller than those from limed soil without polymer. The numbers of culturable heterotrophic bacteria and the activities of dehydrogenase, b-glucosidase and acid phosphatase increased following polymer application. The results are consistent with phytostabilization being achieved by the application of polyacrylate polymers, improving soil chemical and biological properties. In very acidic soils, the use of both a liming material and polymer together appears to give a considerable advantage

Randomized crossover pharmacokinetic evaluation of subcutaneous versus intravenous granisetron in cancer patients treated with platinum-based chemotherapy

BACKGROUND: 5-HT3-receptor antagonists are one of the mainstays of antiemetic treatment, and they are administered either i.v. or orally. Nevertheless, sometimes neither administration route is feasible, such as in patients unable to admit oral intake managed in an outpatient setting. Our objective was to evaluate the bioavailability of s.c. granisetron. PATIENTS AND METHODS: Patients receiving platinum-based chemotherapy were randomized to receive 3 mg of granisetron either s.c. or i.v. in a crossover manner during two cycles. Blood and urine samples were collected after each cycle. Pharmacokinetic parameters observed with each administration route were compared by analysis of variance. RESULTS: From May to November 2005, 31 patients were included and 25 were evaluable. Subcutaneous granisetron resulted in a 27% higher area under the concentration-time curve for 0-12 hours (AUC(0-12h)) and higher levels at 12 hours, with similar values for AUC(0-24h). The maximum concentration was lower with the s.c. than with the i.v. route and was observed 30 minutes following s.c. administration. CONCLUSION: Granisetron administered s.c. achieves complete bioavailability. This is the first study that shows that s.c. granisetron might be a valid alternative to i.v. delivery. Further trials to confirm clinical equivalence are warranted. This new route of administration might be especially relevant for outpatient management of emesis in cancer patients

Viral RNA load in plasma is associated with critical illness and a dysregulated host response in COVID‑19

Background. COVID-19 can course with respiratory and extrapulmonary disease. SARS-CoV-2 RNA is detected in respiratory samples but also in blood, stool and urine. Severe COVID-19 is characterized by a dysregulated host response to this virus. We studied whether viral RNAemia or viral RNA load in plasma is associated with severe COVID-19 and also to this dysregulated response. Methods. A total of 250 patients with COVID-19 were recruited (50 outpatients, 100 hospitalized ward patients and 100 critically ill). Viral RNA detection and quantification in plasma was performed using droplet digital PCR, targeting the N1 and N2 regions of the SARS-CoV-2 nucleoprotein gene. The association between SARS-CoV-2 RNAemia and viral RNA load in plasma with severity was evaluated by multivariate logistic regression. Correlations between viral RNA load and biomarkers evidencing dysregulation of host response were evaluated by calculating the Spearman correlation coefficients. Results. The frequency of viral RNAemia was higher in the critically ill patients (78%) compared to ward patients (27%) and outpatients (2%) (p < 0.001). Critical patients had higher viral RNA loads in plasma than non-critically ill patients, with non-survivors showing the highest values. When outpatients and ward patients were compared, viral RNAemia did not show significant associations in the multivariate analysis. In contrast, when ward patients were compared with ICU patients, both viral RNAemia and viral RNA load in plasma were associated with critical illness (OR [CI 95%], p): RNAemia (3.92 [1.183–12.968], 0.025), viral RNA load (N1) (1.962 [1.244–3.096], 0.004); viral RNA load (N2) (2.229 [1.382–3.595], 0.001). Viral RNA load in plasma correlated with higher levels of chemokines (CXCL10, CCL2), biomarkers indicative of a systemic inflammatory response (IL-6, CRP, ferritin), activation of NK cells (IL-15), endothelial dysfunction (VCAM-1, angiopoietin-2, ICAM-1), coagulation activation (D-Dimer and INR), tissue damage (LDH, GPT), neutrophil response (neutrophils counts, myeloperoxidase, GM-CSF) and immunodepression (PD-L1, IL-10, lymphopenia and monocytopenia). Conclusions. SARS-CoV-2 RNAemia and viral RNA load in plasma are associated with critical illness in COVID-19. Viral RNA load in plasma correlates with key signatures of dysregulated host responses, suggesting a major role of uncontrolled viral replication in the pathogenesis of this disease.This work was supported by awards from the Canadian Institutes of Health Research, the Canadian 2019 Novel Coronavirus (COVID-19) Rapid Research Funding initiative (CIHR OV2 – 170357), Research Nova Scotia (DJK), Atlantic Genome/Genome Canada (DJK), Li-Ka Shing Foundation (DJK), Dalhousie Medical Research Foundation (DJK), the “Subvenciones de concesión directa para proyectos y programas de investigación del virus SARS‐CoV2, causante del COVID‐19”, FONDO–COVID19, Instituto de Salud Carlos III (COV20/00110, CIBERES, 06/06/0028), (AT) and fnally by the “Convocatoria extraordinaria y urgente de la Gerencia Regional de Salud de Castilla y León, para la fnanciación de proyectos de investigación en enfermedad COVID-19” (GRS COVID 53/A/20) (CA). DJK is a recipient of the Canada Research Chair in Translational Vaccinology and Infammation. APT was funded by the Sara Borrell Research Grant CD018/0123 funded by Instituto de Salud Carlos III and co-fnanced by the European Development Regional Fund (A Way to Achieve Europe programme). The funding sources did not play any role neither in the design of the study and collection, not in the analysis, in the interpretation of data or in writing the manuscript

An insertional mutagenesis programme with an enhancer trap for the identification and tagging of genes involved in abiotic stress tolerance in the tomato wild-related species Solanum pennellii

Salinity and drought have a huge impact on agriculture since there are few areas free of these abiotic stresses and the problem continues to increase. In tomato, the most important horticultural crop worldwide, there are accessions of wild-related species with a high degree of tolerance to salinity and drought. Thus, the finding of insertional mutants with other tolerance levels could lead to the identification and tagging of key genes responsible for abiotic stress tolerance. To this end, we are performing an insertional mutagenesis programme with an enhancer trap in the tomato wild-related species Solanum pennellii. First, we developed an efficient transformation method which has allowed us to generate more than 2,000 T-DNA lines. Next, the collection of S. pennelli T0 lines has been screened in saline or drought conditions and several presumptive mutants have been selected for their salt and drought sensitivity. Moreover, T-DNA lines with expression of the reporter uidA gene in specific organs, such as vascular bundles, trichomes and stomata, which may play key roles in processes related to abiotic stress tolerance, have been identified. Finally, the growth of T-DNA lines in control conditions allowed us the identification of different development mutants. Taking into account that progenies from the lines are being obtained and that the collection of T-DNA lines is going to enlarge progressively due to the high transformation efficiency achieved, there are great possibilities for identifying key genes involved in different tolerance mechanisms to salinity and drought