El Primer pas

Presentació del taller sobre consciència sostenible que es realitza a l'ETSAV.Peer Reviewe

The ecological matrix, part of the land plan for the metropolitan Region of Barcelona

Postprint (published version

Diseño y construcción de un vehículo de tres ruedas seguidor de trayectoria seleccionable

Este proyecto consiste en el diseño y construcción de un sistema electrónico basado en un microcontrolador que maneje el movimiento de un vehículo de tres ruedas, dos de ellas movidas por motores de corriente continua. La trayectoria y el tipo de desplazamiento podrán ser determinados de forma automática o manual. Si el vehículo se encuentra en modo de conducción manual, el usuario es el que dirige los movimientos escogiéndolos de entre una serie de opciones predeterminadas mediante una aplicación para smartphone Android. Por otro lado, si se encuentra en modo de conducción automática, el propio vehículo mediante un sensor digital identificará diferentes colores que se le presenten a tal efecto y ejecutará, para cada color, una acción predeterminada. El microcontrolador de 8 bits que se utiliza es de la familia PIC del fabricante Microchip. La comunicación entre el usuario y el vehículo se realiza mediante tecnología bluetooth por vía de un teléfono con sistema operativo Android. Se han escogido estos componentes por su disponibilidad y bajo coste económico. Se ha diseñado una aplicación para dispositivo Android que permite dar instrucciones al vehículo utilizando el software App Inventor 2 del MIT. En este documento se detallan los componentes utilizados para la construcción de este vehículo así como los pasos que se han ido siguiendo para implementarlo. También se explica la aplicación de Android que se ha creado para manejar el vehículo y la programación del microcontrolador

Safety of arteriovenous fistulae and grafts for continuous renal replacement therapy: The Michigan experience

Introduction: Arteriovenous fistula or graft (AVF/AVG) use is widely considered contraindicated for continuous renal replacement therapy (CRRT), yet insertion of hemodialysis (HD) catheters can carry high complication risk in critically ill end‐stage renal disease (ESRD) patients.Methods: Single‐center analysis of 48 consecutive hospitalized ESRD patients on maintenance HD who underwent CRRT using AVF/AVG from 2012 to 2013. Primary outcome was access‐related complications.Findings: Mean age was 60 years, 48% were male, and 88% required vasopressor support. Median duration of AVF/AVG use for CRRT was 4 days (range 1–34). Ten (21%) patients had access complications (5 bleeding, 5 infiltration, 1 thrombosis); 5 (10.4%) required catheter placement. Overall 31 (65%) patients survived to hospital discharge and AVF/AVG access was functional at the time of discharge in 29 (94%) patients.Discussion: In our experience, use of AVF/AVG for CRRT can be performed with a low serious complication rate and low risk of access loss, potentially avoiding catheter‐related complications.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141192/1/hdi12550_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141192/2/hdi12550.pd

Acute respiratory failure in kidney transplant recipients: a multicenter study

International audienceINTRODUCTION: Data on pulmonary complications in renal transplant recipients are scarce. The aim of this study was to evaluate acute respiratory failure (ARF) in renal transplant recipients. METHODS: We conducted a retrospective observational study in nine transplant centers of consecutive kidney transplant recipients admitted to the intensive care unit (ICU) for ARF from 2000 to 2008. RESULTS: Of 6,819 kidney transplant recipients, 452 (6.6%) required ICU admission, including 200 admitted for ARF. Fifteen (7.5%) of these patients had combined kidney-pancreas transplantations. The most common causes of ARF were bacterial pneumonia (35.5%), cardiogenic pulmonary edema (24.5%) and extrapulmonary acute respiratory distress syndrome (ARDS) (15.5%). Pneumocystis pneumonia occurred in 11.5% of patients. Mechanical ventilation was used in 93 patients (46.5%), vasopressors were used in 82 patients (41%) and dialysis was administered in 104 patients (52%). Both the in-hospital and 90-day mortality rates were 22.5%. Among the 155 day 90 survivors, 115 patients (74.2%) were dialysis-free, including 75 patients (65.2%) who recovered prior renal function. Factors independently associated with in-hospital mortality were shock at admission (odds ratio (OR) 8.70, 95% confidence interval (95% CI) 3.25 to 23.29), opportunistic fungal infection (OR 7.08, 95% CI 2.32 to 21.60) and bacterial infection (OR 2.53, 95% CI 1.07 to 5.96). Five factors were independently associated with day 90 dialysis-free survival: renal Sequential Organ Failure Assessment (SOFA) score on day 1 (OR 0.68/SOFA point, 95% CI 0.52 to 0.88), bacterial infection (OR 0.43, 95% CI 0.21 to 0.90), three or four quadrants involved on chest X-ray (OR 0.44, 95% CI 0.21 to 0.91), time from hospital to ICU admission (OR 0.98/day, 95% CI 0.95 to 0.99) and oxygen flow at admission (OR 0.93/liter, 95% CI 0.86 to 0.99). CONCLUSIONS: In kidney transplant recipients, ARF is associated with high mortality and graft loss rates. Increased Pneumocystis and bacterial prophylaxis might improve these outcomes. Early ICU admission might prevent graft loss

The dark side of the moon: explorar la vessant nord de Collserola

Informe docent tallers PC-h i PU-dPreprin

Interventions to improve hand hygiene compliance in patient care

Four studies met the criteria for the review: two from the original review and two from the update. Two studies evaluated simple education initiatives, one using a randomized clinical trial design and the other a controlled before and after design. Both measured hand hygiene compliance by direct observation. The other two studies were both interrupted times series studies. One study presented three separate interventions within the same paper: simple substitutions of product and two multifaceted campaigns, one of which included involving practitioners in making decisions about choice of hand hygiene products and the components of the hand hygiene program. The other study also presented two separate multifaceted campaigns, one of which involved application of social marketing theory. In these two studies follow-up data collection continued beyond 12 months, and a proxy measure of hand hygiene compliance (product use) was recorded. Microbiological data were recorded in one study. Hand hygiene compliance increased for one of the studies where it was measured by direct observation, but the results from the other study were not conclusive. Product use increased in the two studies in which it was reported, with inconsistent results reported for one initiative. MRSA incidence decreased in the one study reporting microbiological data