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Manejo del dolor en cirugía torácica
Full text linkIntroducción. El control adecuado del dolor postoperatorio en cirugía es fundamental para prevenir complicaciones respiratorias, mejorar la recuperación funcional y reducir la estancia hospitalaria. A pesar de que la analgesia epidural torácica (TEA) ha sido considerada la técnica de referencia durante años, su perfil de seguridad desfavorable y la aparición de técnicas regionales alternativas han impulsado la búsqueda de estrategias analgésicas más seguras y efectivas. Objetivo. Realizar una revisión sistemática de la literatura con el fin de comparar las diferentes modalidades de manejo del dolor en cirugía torácica, evaluando su eficacia, seguridad, facilidad técnica, duración y riesgo de complicaciones. Método. Se llevó a cabo una búsqueda bibliográfica en PubMed, Scopus y Cochrane Library, incluyendo estudios publicados en inglés y español con texto completo disponible, que comparasen técnicas analgésicas en pacientes adultos (18-75 años) sometidos a cirugía torácica. Se seleccionaron un total de 39 estudios tras aplicar los criterios de inclusión y exclusión. Se realizó una síntesis estructurada de los resultados. Resultados. Los estudios incluidos muestran que técnicas como el bloqueo paravertebral torácico (TPVB) y el bloqueo del plano erector de la espina (ESPB) ofrecen una eficacia analgésica comparable a la TEA, con un perfil de seguridad más favorable. El bloqueo del plano del serrato anterior (SAPB) y el bloqueo intercostal (ICNB) presentan una eficacia menor, pero pueden resultar útiles en procedimientos específicos o en un enfoque multimodal. La analgesia sistémica se asocia a mayor riesgo de efectos adversos si se utiliza como única estrategia. Conclusiones. El manejo del dolor en cirugía torácica debe basarse en un enfoque individualizado y multimodal, integrando técnicas regionales o analgésicos sistémicos según las necesidades del paciente y el tipo de intervención. Las técnicas interfasciales representan una alternativa eficaz y segura, especialmente el SAPB, que requieren mayor investigación para consolidar su uso como estándar clínico. Palabras clave: analgesia regional, cirugía torácica, dolor postoperatorio, bloqueo interfascial, analgesia epidural torácica, revisión sistemática. <br /
A novel biodegradable active packaging based on PHB/PCL for controlling Listeria monocytogenes in fresh salmon
Full text linkOur study was focused on developing a novel active packaging material with antibacterial properties to ensure food safety, especially against Listeria monocytogenes. For this purpose, blends formed by a mixture of biodegradable polymers, polyhydroxybutyrate (PHB) and polycaprolactone (PCL), and different ε-poly-L-lysine (EPL) concentrations, were produced by extrusion. Then, active laminates were prepared by thermoforming and characterized by TGA, DSC and FT-IR. Besides, an EPL release assay into food simulants was performed and a sustained release was observed. Laminates activity was evaluated against Listeria monocytogenes and Salmonella enterica, both in liquid and solid media, where they exhibited high antibacterial activities, especially in the case of Listeria. To further study whether the developed materials maintained their active properties when in contact with contaminated food, a challenge test was performed on Listeria monocytogenes-inoculated fresh salmon. For that purpose, tray packaging prototypes containing 3 and 5 % EPL were produced by injection moulding and used to store salmon for 12 days. Microbial counts (Listeria monocytogenes, Lactic Acid Bacteria, Pseudomonas spp. and Total Viable Counts), and total volatile basic nitrogen (TVB-N) were determined over time. Results showed that active tray prototypes did not affect the quality of the stored salmon in terms of TVB-N. Moreover, they yielded significant reductions on microbial counts for all bacterial groups when compared to control samples. Thus, biodegradable antimicrobial developed trays effectively controlled Listeria monocytogenes and other spoilage bacteria present in fresh salmon
Improved ESI-MS Sensitivity via an Imidazolium Tag (DAPMI-ITag) for Precise Sialic Acid Detection in Human Serum and CMAH-Null Mouse Tissues
Full text linkSialic acids (Sias), consisting primarily of N-acetylneuraminic acid (Neu5Ac) and N-glycolylneuraminic acid (Neu5Gc), play crucial roles in many biological processes. The detection and quantification of Sias are essential for understanding their roles in health and disease progression. Although numerous techniques have been developed to enhance the specificity and sensitivity of Sias analysis, traditional methods such as derivatization with fluorescent tags coupled with HPLC-MS analysis often suffer from low limits of detection, limiting the quantification of Sias in trace samples. Here, we introduce DAPMI, a novel imidazolium-based ITag for sensitive Sia detection. We demonstrate its utility in the detection and quantification of Sia composition in human serum, and in different tissues from CMAH (cytidine monophosphate-N-acetylneuraminic acid hydroxylase) knockout mice, using ESI-MS analysis and with a limit of detection (LOD) down to the low fmol range. The results showed that both Neu5Ac and Neu5Gc were present in varying proportions in wild-type mice and CMAH heterogeneous mice. Trace amounts of Neu5Gc were also detected in the tissues of CMAH null homogeneous mice (CMAH–/−) and in human blood serum using ESI-ToF-MS, suggesting its presence may be linked to dietary intake of Neu5Gc-containing foods, as Neu5Gc cannot be synthesized endogenously in CMAH–/– mice, and in humans. The DAPMI-ITag and the labeling technology developed in this study significantly improve the sensitivity of Sias detection compared to conventional tags such as o-phenylenediamine (OPD), and provide a new chemical tool for the exploration of Sias’ biological role
Quaternary tufas of the Inglares River valley: An example of changing slope stepped fluvial system, Álava, N Spain
Full text linkThis study examines the factors that controlled the formation of Quaternary calcareous tufa deposits along the valley of the Inglares River (Álava, north Spain), currently fed by a karst-carbonate aquifer. It is based on stratigraphic, chronological (Amino Acid Racemisation, AAR), sedimentological, and δ13C and δ18O analyses, complemented by palaeontology (molluscs, ostracods and charophytes). The examined deposits occur as isolated bodies in the uppermost and downmost stretches of the valley, reaching 45 and 25m in thickness, respectively. AAR dating classified them into two groups: Middle Late Pleistocene (MIS 5e) and Middle and Late Holocene (MIS 1). The former only occurred in the downstream stretch. Up to eleven carbonate facies and minor allochthonous coarse detrital facies have been characterised and arranged into four distinct facies associations. Their features and bedding geometries suggested two main depositional settings: a low- to moderate-slope stepped stretch with small barrage cascades, dammed areas, and abundant palustrine zones (downstream system) and a high-slope stretch with steep stepped cascades and pools (upstream system). These settings respond to bedrock lithology and structural changes throughout the valley, which appear to be the principal factors controlling the tufa depositional architecture. Based on δ13C, an increase in aridity was inferred from the Middle–Late Pleistocene to Holocene. The isotopic differences between the upstream and downstream Holocene tufa might reflect the spatial evolution of δ13C and δ18O in stream water through the approximately 8km long surveyed transect. Erosion due to sudden changes in water discharge may have caused the stratigraphic gap between the two tufa groups
Recycling Properties of Iridium Nanoparticles Anchored on Graphene as Catalysts in Alcohol Oxidation
Full text linkIn this paper, we describe the synthesis, characterization, and recycling properties of iridium nanoparticles (IrNPs) anchored on graphene (IrNPs@GNPs) as a catalyst for alcohol oxidation. The formation of this hybrid material (comprising metal nanoparticles on graphene) is achieved in a single step under mild conditions. Graphene serves not only as a support for metal nanoparticles but also plays a critical role in controlling nanoparticle growth and nucleation while enhancing stability by preventing sintering. The IrNPs exhibit a spherical morphology with a small average size distribution (2.1 nm). The IrNPs@GNPs is an efficient catalytic material in the conversion of alcohols to the corresponding carbonyls in a sustainable manner, as supported by quantitative sustainability metrics. Oxidation reactions proceed at room temperature, using water as the solvent and atmospheric oxygen as the terminal oxidant. We detail the catalytic activity, substrate scope, and reuse/recycling of this hybrid material. Furthermore, we identify the primary deactivation pathway of the catalyst and present a regeneration protocol that restores its initial activity. The reuse and recyclability of iridium nanoparticles on graphene represent a significant advancement in the sustainable application of iridium-based catalysts
Predicting the critical behavior of complex dynamic systems via learning the governing mechanisms
No full textCritical points separate distinct dynamical regimes of complex systems, often delimiting functional or macroscopic phases in which the system operates. However, the long-term prediction of critical regimes and behaviors is challenging given the narrow set of parameters from which they emerge. Here, we propose a framework to learn the rules that govern the dynamic processes of a system. The learned governing rules further refine and guide the representative learning of neural networks from a series of dynamic graphs. This combination enables knowledge-based prediction for the critical behaviors of dynamical networked systems. We evaluate the performance of our framework in predicting two typical critical behaviors in spreading dynamics on various synthetic and real-world networks. Our results show that governing rules can be learned effectively and significantly improve prediction accuracy. Our framework demonstrates a scenario for facilitating the representability of deep neural networks through learning the underlying mechanism, which aims to steer applications for predicting complex behavior that learnable physical rules can drive
Actitudes de los consumidores hacia las hortalizas ecológicas: segmentación y potencial de mercado
Full text linkEl objetivo de este trabajo es analizar las actitudes de los consumidores aragoneses hacia las hortalizas ecológicas y segmentarlos en función de dichas actitudes. Para ello se llevó a cabo una encuesta online a consumidores de hortalizas mayores de 18 años en Aragón. Los resultados indican que las actitudes se pueden agrupar en dos factores, uno que recoge los aspectos positivos y otro, los negativos. Se obtuvieron dos segmentos de consumidores, uno de ellos el de consumidores potenciales de hortalizas ecológicas al mostrar una mayor disposición a comprarlas y una mayor preocupación por su salud y el medioambiente.
The aim of this study is to analyse the attitudes of Aragonese consumers towards organic vegetables and to segment them according to these attitudes. To this end, an online survey was carried out among vegetable consumers over 18 years of age in Aragon. The results indicate that attitudes can be grouped into two factors, one reflecting positive aspects and the other negative. Two consumer segments were obtained, one of which was that of potential consumers of organic vegetables, showing a greater willingness to buy them and a greater concern for their health and the environment
Unveiling the association between chronotype and emotional eating in Spanish adolescents: The EHDLA study
No full textEmotional eating has been associated with a range of negative health outcomes. Research regarding chronotype and emotional eating among adolescents is limited. Thus, this study aimed to verify the association between chronotype and emotional eating in a sample of Spanish adolescents aged 12–17 years. This research used cross-sectional data obtained from the Eating Healthy and Daily Life Activities (EHDLA) study, including 820 students (55.5 % girls) from the three secondary schools in the Valle de Ricote (Region of Murcia, Spain). Chronotype was evaluated using the Morningness/Eveningness Scale in Children (MESC). Emotional eating was assessed using the Emotional Eating Scale Adapted for Use in Children and Adolescents (EES-C). Adolescents with a morning chronotype exhibited lower scores in overall emotional eating and specific domains—such as anxiety, depression, and restlessness—compared to those with an intermediate chronotype. Additionally, those with morning chronotypes showed a lower score in the restlessness domain compared to those with evening chronotypes. These findings suggest that adolescents with morning chronotypes may have enhanced emotional regulation and healthier eating behaviors. This study highlights the importance of considering chronotypes when developing personalized interventions for mental health and nutrition among adolescents
Artificial intelligence: Redefining the retirement pattern
Full text linkAn endogenous economic growth model is developed, where the decisions to use artificial intelligences (AIs) in the workplace and to extend working life are endogenous and interdependent. There are four sources of heterogeneity among workers: differences in initial productivity, variations in the aging process, restricted access to jobs with AI investment, and uneven impact of AIs among those who have access. It is shown that those who do not use AIs in their jobs maintain a traditional pattern of retirement, with the most educated and/or healthy among them extending their working lives. In contrast, the retirement pattern for AI-using workers changes, and it is the users who derive the most benefit from AIs who will extend their working lives. This is because AIs compensate for the skills that tend to deteriorate with age, thus allowing for greater permanence in the labour market
Implementation of ISO 7101 clause 8.10.5, validation of the HLS19-Q12, and health literacy of patients pre-and post-nursing interventions in specialty consultations in Spain
Full text linkAntecedentes Las organizaciones sanitarias se esfuerzan por proporcionar una atención sanitaria de alta calidad centrada en las personas. La ISO 7101 es una norma internacional para la calidad de la asistencia sanitaria que describe los requisitos para la atención centrada en las personas. Un tema discutido en la subcláusula 8.10.5 de la norma es la alfabetización en salud (AS). La AS afecta tanto a la salud individual como a la de la población en numerosos niveles y se ha demostrado que una AS general baja conduce a un aumento de la morbilidad, una mala utilización de los servicios de salud y un mayor gasto sanitario. Este estudio describió el proceso de implementación de la norma subcláusula 8.10.5 Alfabetización en salud en consultas especializadas en un hospital de tercer nivel en Aragón, España. Además, determinó los efectos de la implementación en las puntuaciones generales de AS de los y las pacientes, así como las percepciones de la calidad de la atención. El estudio también estableció las propiedades psicométricas de la encuesta HLS19-Q12 utilizada en esta investigación.Métodos Una muestra de 150 pacientes de consulta especializada completaron el HLS19-Q12 validado internacionalmente. Se utilizó el análisis factorial y el alfa de Cronbach para validar la versión española del HLS19-Q12. Las puntuaciones de EA se calcularon mediante la ficha de la escala y el perfil sociodemográfico de la población de pacientes se determinó mediante análisis de frecuencias. Se realizó una prueba t de muestra independiente, un ANOVA de un factor y un análisis de modelo lineal generalizado (MLG) para examinar las relaciones clave con respecto a las variables sociodemográficas y las puntuaciones de AS. La prueba t de muestras pareadas evaluó la diferencia entre las puntuaciones de AS del paciente antes y después de las intervenciones de enfermería. El análisis de frecuencias y la correlación de Pearson se utilizaron para examinar las frecuencias de las estrategias de EA de enfermería utilizadas y las asociaciones con las puntuaciones de AS. Las muestras pareadas, la prueba t y la prueba de rangos con signo de Wilcoxon determinaron las relaciones entre la implementación de la subcláusula 8.10.5 de la norma ISO 7101, las puntuaciones de AS y la calidad de la atención percibida.Resultados Se encontró que el HLS19-Q12 utilizado en España en lengua española es válido y fiable (¿ = 0,87). La EA general de los y las pacientes fue limitada, con un 60% de los participantes con EA general categorizada como inadecuada o problemática, y un 40% suficiente o excelente. El nivel de ingresos tuvo un efecto significativo en los puntajes de AS, F= 2,129, (p Conclusiones Los resultados del HLS19-Q12 en esta población específica proporcionan una visión única de las puntuaciones de EA de los y las pacientes en consultas especializadas, proporcionando datos de EA para los responsables de la toma de decisiones en este sector sanitario de Aragón, España. El estudio revela además que la implementación de la norma ISO 7101, subcláusula 8.10.5 Alfabetización en salud tuvo un efecto significativo y positivo en las puntuaciones generales de AS y en las percepciones de los y las pacientes sobre la calidad de la atención recibida. Al considerarse esta la primera investigación académica publicada sobre la implementación de la norma ISO 7101, sus hallazgos se pueden utilizar para informar la toma de decisiones por parte de los responsables de las políticas y la gestión de la atención sanitaria, al ofrecer una base de evidencia científica que proporciona estrategias efectivas para aumentar la AS y mejorar las percepciones de los y las pacientes sobre la calidad de la atención.<br /