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Abstract Introduction: Evidence suggests that herbivores, such as peccaries, shape vegetation structure and diversity through predation, trampling, dispersal, and rooting behavior. Objective: To evaluate the impact of peccaries (Dycotiles tajacu) on the understory vegetation of the tropical rainforest in the Nogal-La Selva Local Biological Corridor, Costa Rica, comparing a site with the absence of peccaries to another with the presence of these animals. Methodology: From June to November 2021, 20 experimental exclusions and 20 free access plots, each measuring 2 m2 were used to quantify herbivory, the number of leaf blades, damaged leaves, healthy leaves, sapling height, and fallen biomass at both sites. Results: A higher sapling density was found in the Nogal Reserve, but a lower sapling diversity, while in La Selva there was a higher sapling diversity, but a lower density of seedlings. Herbivory and sapling height in La Selva exceeded those in Nogal. The exclusion of peccaries reduced seedling damage but did not affect the dynamics of fallen biomass. Conclusion: For the design, implementation, and evaluation of the effectiveness of biological corridors, it is crucial to consider plant-animal interactions to enhance the flow of ecological processes through functional and structural connectivity, analyzed from interactions such as those presented in this paper.
Resumen Introducción: Existe evidencia que herbívoros, como los saínos, dan forma a la estructura y diversidad de la vegetación a través del comportamiento de depredación, pisoteo, dispersión y enraizamiento. Objetivo: Evaluar el impacto de los saínos (Dycotiles tajacu) en la vegetación del sotobosque del bosque tropical húmedo en el Corredor Biológico Local Nogal-La Selva, Costa Rica, en un sitio con ausencia y en otro con presencia de saínos. Métodos: De junio a noviembre de 2021 se utilizaron 20 exclusiones experimentales y 20 parcelas de acceso libre de 2 m2, se cuantifico la herbivoría, número de láminas foliares, hojas dañadas, hojas sanas, altura de brinzales y biomasa caída en ambos sitios. Resultados: Se encontró una mayor densidad de brinzales en Reserva Nogal pero una menor diversidad, contrario en La Selva donde se encontró una mayor diversidad de brinzales, pero una menor densidad de plántulas. La herbivoría y la altura de brinzales en La Selva fue mayor que en Nogal. La exclusión de los saínos disminuyó el daño a las plántulas, pero no afectó la dinámica de la biomasa caída. Conclusión: Es necesario contemplar para el diseño, implementación y evaluación de la efectividad de corredores biológicos, las interacciones planta-animal, para potencializar el flujo de procesos ecológicos mediante la conectividad funcional y estructural, analizada a partir de interacciones como las presentadas en este trabajo.
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Animales , Artiodáctilos , Bosques , Distribución Animal , Ecosistema Tropical , Costa RicaRESUMEN
La atrofia muscular espinal (AME) de presentación temprana representa la variante más severa, con una expectativa de vida generalmente no mayor a dos años sin soporte ventilatorio, debido a la insuficiencia respiratoria y la dificultad para toser. Tradicionalmente, el manejo respiratorio en muchos países ha incluido la traqueostomía para proporcionar asistencia ventilatoria invasiva de manera continua. No obstante, la introducción de medicamentos de precisión ha modificado la progresión natural de la enfermedad, evidenciando mejoras significativas en los hitos motores y beneficiando también la función respiratoria. A pesar de estas mejoras, en muchos casos sigue siendo necesaria la ventilación intermitente y/o continua, además de la facilitación de la tos. Estas necesidades pueden abordarse de forma no invasiva mediante el soporte ventilatorio no invasivo (SVN), la in-exsuflación mecánica (IEM) y el reclutamiento de volumen pulmonar (RVP), que son considerados pilares del tratamiento respiratorio en enfermedades neuromusculares. Estas estrategias promueven el desarrollo y mantenimiento de la función respiratoria, reduciendo el riesgo de exacerbaciones respiratorias que podrían llevar a intubaciones evitables. Comúnmente, los pacientes con AME experimentan intentos fallidos de extubación siguiendo protocolos tradicionales, siendo catalogados como no extubables y potenciales candidatos a traqueostomía. No obstante, existen protocolos de extubación específicos para AME que emplean SVN e IEM con un alto porcentaje de éxito, evitando traqueostomías innecesarias que pueden complicar la progresión de la enfermedad y afectar la calidad de vida. El enfoque respiratorio no invasivo es una opción de manejo segura tanto en el hospital como en el hogar, ofreciendo una mejor calidad de vida para los pacientes y sus familias.
Early-onset spinal muscular atrophy (SMA) is the most severe variant, with a life expectancy generally not exceeding two years without ventilatory support due to respiratory insufficiency and difficulty in coughing. Traditionally, respiratory management in many countries has included tracheostomy to provide continuous invasive ventilatory support. However, the introduction of precision medicine has altered the natural progression of the disease, showing significant improvements in motor milestones and also benefiting respiratory function. Despite these improvements, many cases still require intermittent and/or continuous ventilation, as well as cough facilitation. These needs can be addressed non-invasively through non-invasive ventilatory support (NIV), mechanical insufflation-exsufflation (MIE), and lung volume recruitment (LVR), which are considered the pillars of respiratory treatment in neuromuscular diseases. These strategies promote the development and maintenance of respiratory function, reducing the risk of respiratory exacerbations that could lead to avoidable intubations. Commonly, SMA patients experience failed extubation attempts following traditional protocols, being labeled as non-extubatable and potential candidates for tracheostomy. Nevertheless, there are specific extubation protocols for SMA that employ NIV and MIE with a high success rate, avoiding unnecessary tracheostomies that can complicate disease progression and impact quality of life. The non-invasive respiratory approach is a safe management option both in the hospital and at home, offering a better quality of life for patients and their families.
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Humanos , Atrofia Muscular Espinal/terapia , Insuflación , Extubación Traqueal , Ventilación no Invasiva , Mediciones del Volumen PulmonarRESUMEN
BACKGROUND:De novo adipose regeneration induced by small extracellular vesicles has become a promising method for repairing soft tissue defects.However,due to different animal models and small extracellular vesicle application dosages,it is difficult to quantitatively compare the therapeutic effect of small extracellular vesicles from various sources on adipose regeneration. OBJECTIVE:To compare the regenerative effects of small extracellular vesicles derived from stem cells and small extracellular vesicles from tissue. METHODS:Small extracellular vesicles derived from adipose-derived stem cells and from adipose tissue were isolated by ultracentrifugation.The particle number,particle size,morphology,and protein expression of small extracellular vesicles were identified by nanoparticle tracking analysis,transmission electron microscopy and western blot assay.A quantitative and evaluative subcutaneous model for adipose regeneration in C57 mice was established using a customized silicone tube.The regenerative effects of induced de novo adipose were compared by cell counting and hematoxylin-eosin staining. RESULTS AND CONCLUSION:(1)Small extracellular vesicles derived from adipose-derived stem cells and from adipose tissue were isolated by ultracentrifugation.Both small extracellular vesicles were round-shape in transmission electron microscopy with particle size between 50-200 nm,and abundant with the small extracellular vesicles marker protein CD81,CD63 and TSG101.(2)An equal number of small extracellular vesicles were mixed with matrigel in customized silicone tubes,implanted subcutaneously in the back of mice to establish a cell-free and quantifiable adipose regeneration model.(3)On days 3 and 7 after implantation,the results of cell counting and hematoxylin-eosin staining showed that both small extracellular vesicle groups recruited more host cells than the blank group,and the small extracellular vesicles derived from adipose tissue group were superior to the small extracellular vesicles derived from adipose-derived stem cell group.(4)4 weeks after implantation,hematoxylin-eosin staining of the contents in silicone tubes showed that small extracellular vesicles induced de novo adipose regeneration in vivo,and the small extracellular vesicles derived from adipose tissue group were superior to the small extracellular vesicles derived from adipose-derived stem cell group.The above results indicated that small extracellular vesicles derived from tissues have a superior effect on inducing de novo adipose regeneration compared to small extracellular vesicles derived from stem cells.
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Objective:To explore the effect of neutrophil elastase(NE)on neutrophil inflammatory recruitment.Methods:Mice bone marrow-derived neutrophils were pretreated with an exogenous elastase inhibitor-sivelestat sodium.The effects of elastase inhibition on the in vivo inflammatory recruitment,chemotaxis,adhesion,cell polarization and spreading of NE were examined by peritonitis adoptive transfer assay,dunn chamber,flow chamber,immunofluorescence staining and spreading assay,respectively.The effects of elastase inhibition on NE phagocytosis and reactive oxygen species(ROS)release capacity were detected by flow cytom-etry and the luminol chemiluminescence system.Results:Sivelestat sodium pretreatment significantly attenuated neutrophil in vivo in-flammatory recruitment(P<0.001);impaired neutrophil perception of chemotaxis in vitro(P<0.05),slowed chemotactic velocity(P<0.05),and decreased the chemotactic distance(P<0.05);reduced the adhesion of neutrophils to inflamed endothelial cells(P<0.000 1)and inhibited the phagocytosis of bacteria by neutrophils(P<0.01);however,there was no significant effect on neutrophil spreading,polarization and ROS.Conclusion:NE inhibition significantly impaired the inflammatory recruitment cascade response and phagocyto-sis of neutrophils in vitro and in vivo but had no significant effect on the spreading,polarization and ROS release of neutrophils.
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【Objective】 To analyze the situation of regular whole blood donation in Tianjin between 2013 and 2022, in order to provide data support for improving the recruitment and retention measures of regular blood donors and ensuring safe clinical blood supply. 【Methods】 From 2013 to 2022, 185 639 regular whole blood donors in Tianjin were selected as the study group and 1 015 312 other whole blood donors in the same period were selected as the control group. The demographic data, blood collection volume and blood retest screening of blood donors in the two groups were statistically analyzed. 【Results】 The number of regular blood donors and the volume of blood donated in Tianjin increased year by year from 2013 to 2022, with an average annual growth rate of 6.22% and 6.18%, respectively. From 2013 to 2021, the retention rate of regular blood donors increased first and then decreased. The proportion of male blood donors in the study and control groups showed a decreasing trend but the proportion of female donors showed an increasing trend, with the proportion of male donors in the study group higher than that in the control group and the proportion of female donors lower than that in the control group (both P<0.05). In the study group, the majority of blood donors were in the age of 26-35 years old, followed by those of 36-45 years old; in the control group, the majority of blood donors were in the age of 18-25 years old, followed by those of 26-35 years old; the proportion of blood donors in the study group in the age of 18-25 years old was lower than that in the control group, while the proportion of blood donors of other age group was higher than that in the control group, and the difference was statistically significant (P<0.05). The rates of 200 mL and 300 mL blood donations and insufficient blood donations in the study group were lower than those in the control group, while the rate of 400 mL blood donations was higher than that in the control group, and the differences were statistically significant. Among the blood donors in the study group, the proportion of students, civil servants, medical workers, military personnel, teachers and others was lower than that of the control group, while the proportion of the rest occupations was higher in the study group than that of the control group, and the differences were all statistically significant. There was a significant difference in the proportion of regular blood donors among blood donors of different professions. The re-test deferral rates of ALT and anti-TP in the study group showed a decreasing trend followed by an increasing trend, and the re-test deferral rates of HBV, HCV and HIV showed an increasing trend followed by a decreasing trend, and all the re-test deferral rates in the study group were lower than those in the control group, and the differences were statistically significant (P<0.05) . 【Conclusion】 From 2013 to 2022, the situation of regular blood donors in Tianjin has a certain regularity, and there is certain room for growth. Precise recruitment strategies targeting different populations should be adopted to have more regular blood donors.
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@#Objective To explore the efficacy and safety of lung recruitment maneuver(LRM)on postoperative hypoxemia in patients with acute type A aortic dissection(ATAAD).Methods A total of 56 ATAAD patients with postoperative hypoxemia in the First Affiliated Hospital of Guangxi Medical University from November 2019 to May 2022 were selected and randomly divided into LRM group(n=36)and conventional treatment group(n=20).Patients in conventional treatment group received routine mechanical ventilation on the basis of lung protective ventilation.The patients in LRM group were treated with incremental positive end expiratory pressure(PEEP).Arterial blood gas analysis,respiratory parameters,hemodynamics parameters and serum interleukin(IL)-6 and IL-10 levels were compared between two groups before and after treatment.Results At 12h and 24h after treatment,arterial partial pressure of oxygen(PaO2),oxygenation index(OI),static compliance(Cstat)and dynamic compliance(Cdyn)in two groups were significantly higher than before treatment,the alveolar-arterial gradient of oxygen[PO2(A-a)],respiratory index(RI),peak inspiratory pressure(Ppeak)and plateau pressure(Pplat)were significantly lower than before treatment(P<0.05).PaO2,OI,Cstat and Cdyn in LRM group were significantly higher than those in conventional treatment group,PO2(A-a),RI,Ppeak and Pplat were significantly lower than those in conventional treatment group(P<0.05).Systolic blood pressure and mean arterial pressure decreased and central venous pressure increased during pulmonary reexpansion in LRM group(P<0.05),and all patients returned to baseline level after pulmonary reexpansion.At 12h after treatment,serum IL-6 and IL-10 levels in both groups were significantly lower than before treatment(P<0.05).Conclusion Incremental PEEP can improve oxygenation and lung compliance in patients with hypoxemia after ATAAD surgery,but it has transient effects on hemodynamics,and should be closely monitored during treatment.
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Considerando-se os desafios da composição de grupos de diálogos em temas socialmente polêmicos, este estudo teve como objetivo apresentar as estratégias utilizadas para compor um grupo de diálogo a partir da metodologia do Projeto de Conversações Públicas entre pessoas com distintas opiniões sobre a abordagem do tema da diversidade sexual e de gênero nas escolas brasileiras. As transcrições das audiogravações das conversas preparatórias e dos encontros grupais e as anotações de diário de campo compuseram o corpus de análise deste estudo. A análise temática de conteúdo serviu para o destaque das seguintes estratégias consideradas úteis para a composição grupal: 1) Reconhecendo as pessoas envolvidas no conflito; 2) Entrando em contato com pessoas-chave; 3) Recrutando participantes reservas; 4) Pensando formas alternativas de presença no grupo; 5) Reconhecendo quem precisaria estar na conversa; 6) Flexibilidade com relação a entrada de novas/os participantes; 7) Lidando com os estereótipos com relação as/aos facilitadoras/es; 8) Co-construindo estratégias para maior adesão grupal. Esses eixos analíticos foram discutidos a partir da literatura da área.
Considering the challenges of composing dialogue groups in polemic issues, this study aimed to present the strategies used to compose a dialogue group based on the methodology of the Public Conversations Project among people with different opinions on the approach to the topic of sexual and of gender in Brazilian schools. Transcripts of audio recordings of preparatory conversations and group meetings and field diary notes composed the corpus of analysis of this study. The thematic content analysis served to highlight the following strategies considered useful for group composition: 1) Recognizing the people involved in the conflict; 2) Contacting key people; 3) Recruiting reserve participants; 4) Thinking about alternative forms of presence in the group; 5) Recognizing who would need to be in the conversation; 6) Flexibility regarding the entry of new participants; 7) Dealing with stereotypes regarding facilitators; 8) Co-building strategies for greater group membership. The selected material was discussed based on the literature in the area.
Considerando los desafíos de la composición de grupos de diálogo, este estudio tuvo como objetivo presentar las estrategias utilizadas para la composición de un grupo de diálogo basado en la metodología del Proyecto Conversaciones Públicas entre personas con opiniones diferentes sobre el abordaje del tema sexual y de género en las escuelas brasileñas. Transcripciones de grabaciones de audio de conversaciones preparatorias y reuniones grupales y notas del diario de campo componen el corpus de análisis de este estudio. El análisis de contenido temático sirvió para resaltar las siguientes estrategias consideradas útiles para la composición del grupo: 1) Reconocimiento de las personas involucradas en el conflicto; 2) Ponerse en contacto con personas clave; 3) Reclutamiento de participantes de reserva; 4) Pensar en formas alternativas de presencia en el grupo; 5) Reconocer quién debería estar en la conversación; 6) Flexibilidad en la entrada de nuevos participantes; 7) Abordar los estereotipos sobre los facilitadores; 8) Estrategias de co-construcción para una mayor membresía del grupo. El material seleccionado se discutió con base en la literatura en el área.
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Humanos , Negociación , Selección de Paciente , Relaciones InterpersonalesRESUMEN
La selección de personal ha demostrado ser un procedimiento de incalculable valor para las organizaciones. Sin embargo, en la práctica los empleadores suelen (y prefieren) utilizar los métodos de selección de escaza y cuestionable evidencia. En el contexto boliviano, el uso de preguntas personales relacionadas a la edad, estado civil, sexo, raza, embarazo, entre otros, parece estar bastante extendido. Aunque, la utilidad que justifique su inclusión sigue sin demostrarse. En el presente artículo, analizo la relevancia y el soporte de las preguntas personales en función de su contribución para tres propósitos de la selección de personal: validez para predecir el desempeño laboral, reclutamiento y discriminación. Finalmente, proporciono algunas sugerencias: (1) para mejorar la eficiencia de los procesos de selección, y (2) para enmendar y fortalecer las leyes contra la discriminación en la selección de la legislación laboral boliviana.
The selection of personnel has proven to be an invaluable procedure for organizations. However, in practice employers often (and prefer) to use the selection methods of scarce and questionable evidence. In the Bolivian context, the use of personal questions related to age, marital status, sex, race, pregnancy, among others, seems to be quite widespread. Although the usefulness that justifies its inclusion remains unproven. In this article, I analyze the relevance and support of personal questions based on their contribution to three purposes of personnel selection: validity to predict job performance, recruitment, and discrimination. Finally, I provide some suggestions: (1) to improve the efficiency of the selection processes, and (2) to amend and strengthen the laws against discrimination in the selection of Bolivian labor law.
A seleção de pessoal provou ser um procedimento inestimável para as organizações. No entanto, na prática, os empregadores costumam (e preferem) usar métodos de seleção de evidências escassas e questionáveis. No contexto boliviano, o uso de perguntas pessoais relacionadas à idade, estado civil, sexo, raça, gravidez, entre outros, parece ser bastante difundido. Embora a utilidade que justifique a sua inclusão permaneça não comprovada. Neste artigo, analiso a relevância e o suporte de perguntas pessoais com base em sua contribuição para três propósitos de seleção de pessoal: validade para prever o desempenho no trabalho, recrutamento e discriminação. Finalmente, apresento algumas sugestões: (1) melhorar a eficiência dos processos de seleção e (2) alterar e fortalecer as leis contra a discriminação na seleção da legislação trabalhista boliviana.
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Humanos , Estado Civil/estadística & datos numéricos , Legislación LaboralRESUMEN
Abstract Objective: The vestibular recruitment observed in caloric testing is a new tool in the study of the vestibulo-ocular reflex. This study aimed to determine the sensitivity and specificity of the video head impulse test to detect post-caloric vestibular recruitment. Method: In this cross-sectional study, all participants underwent the standard otoneurological assessment of the service, caloric test, and video head impulse test. A non-linear mixed model was used to test for associations. Results: The study group consisted of 250 (89 male and 161 female) patients, with a mean age of 54.84 years. The control group comprised 35 participants, 18 men and 17 women, with a mean age of 40.42 years. Sex and age had no effect on group responses. There was no difference between the study and control groups regarding the interaction between recruitment and gain (p = 0.7487); recruitment and overt (p = 0.7002) and covert saccades (p = 1.0000); and recruitment and anti-compensatory saccades in the contralateral ear (p = 0.3050). The video head impulse test had a sensitivity of 51% and a specificity of 50% as a predictor of post-caloric recruitment. Conclusion: The video head impulse test results showed no relevance in predicting post-caloric vestibular recruitment.
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Abstract Introduction The demand for apheresis platelets has increased in the recent past and the shrinking donor pool has shifted the trend to collection of double-dose or higher yield of platelets. Objective The present study aimed to determine the effect of double-dose plateletpheresis on the target yield and donor platelet recovery. Methods The study was conducted on 100 healthy plateletpheresis donors, 50 of whom were in the study group, which underwent double-dose plateletpheresis (DDP), and 50 of whom were in the control group for single-donor plateletpheresis. Pre- and post-procedure samples of donors were subjected to a complete blood count. The DDP product was sampled for platelet yield and then split into two parts. Platelet yield, collection efficiency, collection rate, recruitment factor and donor platelet loss were calculated. Results The mean platelet yield in the SDP was 4.09 ± 1.15 × 1011 and in the DDP, 5.93 ± 1.04 × 1011. There was a significant correlation between the pre-donation platelet count and platelet yield. The total of platelets processed for the SDP were 5.42 ± 1.08 × 1011 and for the DDP, 7.94 ± 0.77 × 1011. The collection efficiency was 71.93 ± 25.14% in the SDP and 72.94 ± 16.28% in the DDP, while the collection rates were 0.78 × 1011 and 0.94 × 1011 per minute, respectively. The average recruitment factor observed was 0.98 in the SDP, while it was 0.99 in the DDP. The mean platelet loss observed in the SDP was 35.55 ± 8.53% and in the DDP, 37.76 ± 8.65%. Conclusion The double-dose plateletpheresis supplements the platelet inventory in developing countries where the apheresis donor pool is limited. It is prudent to ensure stringent donor selection criteria for donors donating high-yield platelet products, thus enhancing donor safety and retention.
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Humanos , Masculino , Femenino , Plaquetoferesis , Eliminación de Componentes Sanguíneos , Plaquetas , Donación de SangreRESUMEN
Background@#Blood donation practice in the Philippines is low despite numerous efforts to recruit potential donors and increase blood supply.@*Objectives@#This study aimed to explore the sociodemographic profile of potential donors and their perceived level of knowledge, motivators, and hindrances on blood donation practice to recommend improvements in policies and strategies regarding blood donation recruitment.@*Methods@#A descriptive study design was utilized to attain the objectives of the study. A piloted questionnaire was floated through various social media platforms to gather data. Data were analyzed using descriptive statistics and Pearson's product-moment correlation.@*Results@#We included 260 Metro Manila residents, 18 to 65 years old and without conditions that merited permanent deferral in blood donation. Overall, the respondents had an adequate perceived level of knowledge (x̄ = 3.13, SD = 0.70) on blood donation but the lowest level of knowledge on the interval between successive blood donations (x̄ = 2.71, SD = 1.04). Furthermore, respondents were considerably motivated to donate blood (x̄ = 2.67, SD = 0.42) mainly due to relatives and friends requiring blood (x̄ = 3.73, SD = 0.60), and have minimal discernment of being discouraged from blood donation (x̄ = 2.09, SD = 0.48) mainly due to time constraints (x̄ = 3.23, SD = 0.78). Moreover, there is a significant but low inverse correlation (r = -0.151, p = 0.015) between age and motivation, suggesting younger individuals have more motivation to donate blood. Thus, policies and strategies that target young donors are highly suggested.@*Conclusion@#Poor blood donation practices in the Philippines suggest recalibration of policies and strategies by targeting young individuals and showcasing altruism to improve donor recruitment. Moreover, it is recommended to strategically establish blood service facilities in accessible areas with flexible operating hours to accommodate potential donors with hectic schedules.
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Donación de Sangre , FilipinasRESUMEN
Introduction@#Laparoscopic Cholecystectomy uses carbon dioxide (CO2) which affects the respiratory, cardiovascular and renal system. The residual CO2 induces phrenic nerve irritation, manifesting as shoulder and abdominal pain. Recruitment maneuvers opens the lungs and helps expelling this residual carbon dioxide. However, there are limited studies on its role to hemodynamics especially in patients undergoing abdominal laparoscopic procedures.@*Methods@#Sixty patients (51 15.1) scheduled for laparoscopic cholecystectomy under General Endotracheal Anesthesia were randomly allocated to two groups. The control group (Group C) underwent standard laparoscopic cholecystectomy procedures. The experimental group (Group R) was placed in a Trendelenburg and was given 4-5 manual pulmonary inflations at a pressure of 40cmH20. The blood pressure, heart rate, respiratory rate and oxygen saturation, as well as the post operative site pain and shoulder pain were measured using the Numerical Pain Scale (NPS) were monitored at 0, 1 and 2 hours post operatively.@*Results@#The demographics and preoperative vital signs were comparable. The mean systolic blood pressure [119.5 vs 131.5; p=0.002], mean arterial pressure [91.8 vs 95.3; p=0.049], heart rate [74.9 vs 87.5; p <0.001] and respiratory rate [15.7 vs 16.2; p=0.02] were all differrent only during the immediate post operative period. The mean shoulder pain was lower in Group R immediately [1.9 ± 1.2; p=0.01] and 1 hour after surgery [0.7 ± 0.8; p=0.01].@*Conclusion@#Recruitment maneuver significantly reduces the shoulder pain scores after laparoscopic cholecystectomy. It causes a decrease in blood pressure, heart rate and mean arterial pressure in the immediate post operative period.
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Colecistectomía Laparoscópica , Dolor de Hombro , Hemodinámica , Dióxido de CarbonoRESUMEN
Objective To analyse the effects of the lung recruitment manoeuvre(RM)mode implemented by ICU specialist nurses on remission of the patients with acute respiratory distress syndrome(ARDS),with the aim to explore the safety,feasibility and effectiveness of clinical implementation,and to further provide a new mode for patient management in nursing practice.Methods A total of 40 ARDS patients admitted into the ICU from January 2018 to August 2021 were randomly selected and divided into control group and trial group in equal number with a random number table.Patients in the control group was treated with a conventional RM mode implemented by doctors,and the RM mode implemented by the ICU specialist nurses was applied to the patients in trial group.The indexes of arterial blood gas analysis,mechanical ventilation time,length of ICU stay,number of RM,number of adjustments to a RM plan,and complication rate were compared between the two groups after the second RM implementation.Results There was no statistically significant difference in arterial partial pressure of oxygen,arterial partial pressure of carbon dioxide and oxygenation index between the groups at 1h and 24h after the second RM implementation(P>0.05).There was no statistically significant difference in the number of RM,mechanical ventilation and length of ICU stay between the groups(P>0.05).The number of modifications of the RM plan in the trial group was significantly more than that in the control group(P<0.05).There was no complication of RM in both groups.Conclusions The RM mode implemented by ICU specialist nurses could achieve good clinical effects in the treatment of patients with ARDS. The approach is safe and practicable.
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Objective:This study is to understand the hot spots and trends in the recruitment of clinical trial subjects in China over the past 20 years, explore the existing problems and countermeasures, and provide scientific ideas for domestic clinical trial institutions to effectively solve the problem of subject recruitment.Methods:Bibliometric analysis was used to study the relevant literature from three major domestic databases from 2001 to 2021, analyzing key indicators such as annual publication volume, journal distribution, institutional distribution, regional distribution, and high-frequency keyword co-occurrence.Results:A total of 162 articles were selected. The results showed that the overall publication volume in this field showed an upward trend, and the research institutions were diversified, with a concentration of medical and pharmaceutical institutions and universities. The current research hotspots in this field focused on quality and efficiency improvement of subject recruitment, with themes of subject protection, ethical review, regulation development, standardized management, etc.Conclusions:The research in this field has made significant progress, but the overall research level is still relatively weak. Therefore, it is suggested that the country should play a role in macro-regulation, on the one hand, starting with top-level design, promoting the construction of a standardized management system for subject recruitment, continuously strengthening subject protection, and enhancing the effectiveness of scientific recruitment. On the other hand, releasing the potential of grassroots institutions and giving full play to the volume advantage by promoting the sinking of advantageous resources. Meanwhile, great importance should be attached to the development of Phase I clinical trials, giving full play to the strong internal energy of traditional medicine and promoting the development of Chinese traditional medicine. These multi-measures should provide a theoretical basis for exploring the transformation of ′clinical research hospitals′, and promote the high-quality development of new drug research and development in China.
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【Objective】 To investigate the HBV infection markers detection and demographic characteristics of first-time blood donors, so as to provide evidence for blood donor recruitment. 【Methods】 HBsAg was detected by ELISA, HBsAg negative samples were tested for HBV DNA, and chemiluminescence method was used to detect HBsAg, HBsAb, HBcAb, HBeAg and HBeAb in first-time blood donor HBsAg-/HBV DNA+ samples. Demographic information of HBsAg positive first-time donors was analyzed. 【Results】 From 2018 to 2022, a total of 502 739 people participated in voluntary blood donation, and first-time blood donors accounted for 33.79%. The HBsAg positive rate of first-time donors(28.37/10 000, 482/169 897)was higher than that of repeated blood donors(3.46/10 000, 115/332 842) (OR=8.23, 95%CI: 6.72~10.09), and the HBV DNA positive rate of first-time blood donors(4.83/10 000, 82/169 897)was lower than that of repeated blood donors(6.52/10 000, 217/332 842)(OR=0.74, 95%CI: 0.57~0.95). The positive rate of HBcAb in HBsAg-/HBV DNA+ samples of first-time blood donors was 73.17%. Significant differences were noticed in HBsAg-/HBV DNA+ and HBsAg positive rate among first-time blood donors among gender, age, education background and occupation (all P<0.05). 【Conclusion】 Low risk first-time blood donor recruitment is important for blood donation. Strengthening HBV screening before blood donation and detection after blood donation is beneficial to improve the safety of blood transfusion.
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【Objective】 To explore the recruitment strategy of blood donors under the situation of blood supply shortage during the COVID-19 epidemic. 【Methods】 The theory of planned behavior and the stage change model of behavior were used to analyze the recruitment strategy of blood donors during the COVID-19 epidemic. The recruitment practice strategies of some countries or regions, i. e. the United States, Japan, South Korea, and the European Union, during this period were investigated. Based on the theoretical analysis results and practical status, relevant reference strategies were proposed. 【Results】 The theoretical analysis showed that attitude, subjective norms and ethical norms played an important role in the recruitment of blood donors during the COVID-19 epidemic, but blood donation self-efficacy and promoting blood donation behavior were the two key factors. According to the survey, in terms of enhancing and maintaining attitudes, subjective norms, ethical norms and other elements that were jointly affected by the same strategy, most countries continued previous policies while some updated recruitment ideas. In terms of enhancing and maintaining the key elements of blood donation self-efficacy, more human and material support had been made. 【Conclusion】 During the COVID-19 pandemic, enhancing and maintaining blood donation self-efficacy and promoting blood donation behavior are the key elements to effectively improve the blood supply shortage. The blood donor recruitment strategy constructed accordingly has reference value for China.
RESUMEN
【Objective】 To investigate the situation of whole blood collection in Tianjin after COVID-19 prevention and control measures were fully lifted. 【Methods】 The relevant data on whole blood collection of voluntary blood donors in Tianjin 15 days before Spring Festival (2023.01.07-2023.01.21, when China has managed COVID-19 with measures against Class B infectious disease instead of Class A infectious diseases) and 15 days before Spring Festival in 2018 (2018.02.01- 2018.02.15) and 2019 (2019.01.21-2019.02.04) before the breakout of COVID-19 were retrospectively collected and compared. 【Results】 The comparison between the above period in 2023, 2018 and 2019 was as follows: the number of blood donors was 6 124 vs 3 940 vs 4 069; blood collection volume (U) was 9 623 vs 7 378 vs 7 808; the proportion of first-time blood donors, local blood donors and group blood donors was 69.17% (4 236/6 124) vs 65.86% (2 595/3 940) vs 62.05% (2 525/4 069), 59.31% (3 632/6 124) vs 23.27% (9170) vs 18.19% (740/4 069) and 43.42% (2 659/6 124) vs 8.05% (317/2 595) vs 0.15% (6/4 069) (all P<0.05). 【Conclusion】 The adjustment of COVID-19 prevention and control policy has a significant impact on voluntary blood donation, and the corresponding adjustment of blood donor recruitment strategy in blood centers should be conducted to increase the whole blood collection.
RESUMEN
【Objective】 To analyze the demographic characteristics of apheresis platelet donors who participated in the Partnership Plan Competition(PPC) of Beijing Red Cross Blood Center, and to analyze the effect of publicity and recruitment of apheresis platelet donors, so as to provide reference for formulating recruitment strategy of apheresis platelet donation. 【Methods】 Apheresis blood donors who participated in PPC from March 18, 2021 to May 18, 2021 were selected as research subjects, and their demographic data in terms of gender, age, occupation and education, and relevant blood donation data within 12 months such as the number of blood donations, whether they were regular blood donors were collected. The demographic characteristics of PPC donors and promising groups were analyzed. 【Results】 There were 58 recruiters participating in the PPC, and a total of 170 people were recruited; 53.53%(91/170) successfully participated in the donation of apheresis platelets, and 35.16%(32/91) became regular blood donors. Those 18-30 years old college male students were promising group in the PPC, and were more willing to participate in the recruitment and donation of apheresis platelets. 【Conclusion】 The PPC has significant effect on the promotion and recruitment of apheresis platelets donation. Measures such as setting the types of souvenirs according to the preferences of promising groups, strengthening publicity of PPC, encouraging non-blood donors to participate and expanding targeted recruitment can be taken in the future to increase the success rate of blood donation of the recruitment.
RESUMEN
【Objective】 To discuss the practice of emergency recruitment of blood donors through TikTok by shooting short videos, and evaluate the recruitment effect. 【Methods】 The completed short videos about blood donor emergency recruitment were released by major media official accounts on TikTok on New Year′s Day, May Day and National Day in 2022. Blood collection data within 10 days before and after the release were collected, and data within 7 days after the release were selected as the experimental group and the same period in last year as the control group to compare the blood collection units, donation frequency, gender and age of blood donors. 【Results】 The units of daily blood collection was the largest on day 1 after the release of TikTok short video, which was 3 times that of the previous day, and then decreased day by day, until to the same level as before the release on day 7. The daily blood collection, the proportion of first-time blood donors, donors aged 26 to 55 years old in the experimental group were all higher than those of the control group, but the proportion of blood donors aged 18 to 25 years old was lower than that of the control group. There was no significant difference in gender between the two groups. 【Conclusion】 Releasing short videos of blood donor emergency recruitment through TikTok, with fast dissemination and wild audience, can increase the blood inventory in a short time and is worthy of promotion.
RESUMEN
Drug clinical trials need to recruit suitable subjects to verify the safety and effectiveness of new drugs. Subject recruitment is a very important and challenging link in the whole process of drug clinical trials, and even directly affects the progress and final results of the trials. The medical ethics committee should give full play to the important function of ethical review, carefully review the whole process of subject recruitment from the perspective of science and ethics, and do a good job in the protection of the health and rights of subjects. This paper mainly discussed the basic principles of subject recruitment, the main problems existing in the recruitment process and the key contents of ethical review, so as to provide scientific references and suggestions for standardizing subject recruitment, protecting the rights and interests of subjects, and promoting the efficient and high-quality completion of drug clinical trials.