Closing the gap between existing large-area imaging research and marine conservation needs.

Emerging technology has immense potential to increase the scale and efficiency of marine conservation. One such technology is large-area imaging (LAI), which relies on structure-from-motion photogrammetry to create composite products, including 3-dimensional (3-D) environmental models, that are larger in spatial extent than the individual images used to create them. Use of LAI has become widespread in certain fields of marine science, primarily to measure the 3D structure of benthic ecosystems and track change over time. However, the use of LAI in the field of marine conservation appears limited. We conducted a review of the coral reef literature on the use of LAI to identify research themes and regional trends in applications of this technology. We also surveyed 135 coral reef scientists and conservation practitioners to determine community familiarity with LAI, evaluate barriers practitioners face in using LAI, and identify applications of LAI believed to be most exciting or relevant to coral conservation. Adoption of LAI was limited primarily to researchers at institutions based in advanced economies and was applied infrequently to conservation, although conservation practitioners and survey respondents from emerging economies indicated they expect to use LAI in the future. Our results revealed disconnect between current LAI research topics and conservation priorities identified by practitioners, highlighting the need for more diverse, conservation-relevant research using LAI. We provide recommendations for how early adopters of LAI (typically Global North scientists from well-resourced institutions) can facilitate access to this conservation technology. These recommendations include developing training resources, creating partnerships for data storage and analysis, publishing standard operating procedures for LAI workflows, standardizing methods, developing tools for efficient data extraction from LAI products, and conducting conservation-relevant research using LAI.

Reducción de la brecha entre la investigación actual de imágenes de gran superficie y las necesidades de la conservación marina Resumen Las nuevas tecnologías tienen un enorme potencial para aumentar la escala y la eficiencia de la conservación marina. Una de ellas son las imágenes de gran superficie (IGS), que se basan en la fotogrametría de estructura a partir del movimiento para crear productos compuestos, incluidos modelos ambientales tridimensionales (3D), cuya extensión espacial es mayor que la de las imágenes individuales utilizadas para crearlos. El uso de las IGS se ha generalizado en determinados campos de las ciencias marinas, principalmente para medir la estructura tridimensional de los ecosistemas bentónicos y realizar un seguimiento de los cambios a lo largo del tiempo. Sin embargo, el uso de las IGS en el campo de la conservación marina parece limitado. Realizamos una revisión de la bibliografía sobre el uso de las IGS en los arrecifes de coral para identificar temas de investigación y tendencias regionales en las aplicaciones de esta tecnología. También encuestamos a 135 científicos de arrecifes de coral y profesionales de la conservación para determinar la familiaridad de la comunidad con las IGS, evaluar las barreras a las que se enfrentan los profesionales en el uso de las IGS e identificar sus aplicaciones consideradas como las más interesantes o relevantes para la conservación del coral. La adopción de las IGS se limitó principalmente a los investigadores de las instituciones con sede en las economías avanzadas y se aplicó con poca frecuencia a la conservación, aunque los profesionales de la conservación y los encuestados de las economías emergentes indicaron que esperan utilizar las IGS en el futuro. Nuestros resultados revelaron una desconexión entre los actuales temas de investigación de las IGS y las prioridades de conservación identificadas por los profesionales, lo que subraya la necesidad de una investigación más diversa y relevante para la conservación mediante el uso de las IGS.

A global community-sourced assessment of the state of conservation technology.

Conservation technology holds the potential to vastly increase conservationists' ability to understand and address critical environmental challenges, but systemic constraints appear to hamper its development and adoption. Understanding of these constraints and opportunities for advancement remains limited. We conducted a global online survey of 248 conservation technology users and developers to identify perceptions of existing tools' current performance and potential impact, user and developer constraints, and key opportunities for growth. We also conducted focus groups with 45 leading experts to triangulate findings. The technologies with the highest perceived potential were machine learning and computer vision, eDNA and genomics, and networked sensors. A total of 95%, 94%, and 92% respondents, respectively, rated them as very helpful or game changers. The most pressing challenges affecting the field as a whole were competition for limited funding, duplication of efforts, and inadequate capacity building. A total of 76%, 67%, and 55% respondents, respectively, identified these as primary concerns. The key opportunities for growth identified in focus groups were increasing collaboration and information sharing, improving the interoperability of tools, and enhancing capacity for data analyses at scale. Some constraints appeared to disproportionately affect marginalized groups. Respondents in countries with developing economies were more likely to report being constrained by upfront costs, maintenance costs, and development funding (p = 0.048, odds ratio [OR] = 2.78; p = 0.005, OR = 4.23; p = 0.024, OR = 4.26), and female respondents were more likely to report being constrained by development funding and perceived technical skills (p = 0.027, OR = 3.98; p = 0.048, OR = 2.33). To our knowledge, this is the first attempt to formally capture the perspectives and needs of the global conservation technology community, providing foundational data that can serve as a benchmark to measure progress. We see tremendous potential for this community to further the vision they define, in which collaboration trumps competition; solutions are open, accessible, and interoperable; and user-friendly processing tools empower the rapid translation of data into conservation action. Article impact statement: Addressing financing, coordination, and capacity-building constraints is critical to the development and adoption of conservation technology.

La tecnología de conservación tiene el potencial para incrementar considerablemente la habilidad de los conservacionistas para entender y lidiar con los retos ambientales más importantes, pero las restricciones sistémicas parecen dificultar su desarrollo y adopción. La comprensión de estas restricciones y las oportunidades para el avance todavía son limitadas. Encuestamos en línea a 248 usuarios y programadores mundiales de tecnología de conservación para identificar las percepciones existentes del desempeño e impacto potencial de las herramientas actuales, restricciones para los usuarios y programadores y oportunidades clave para el crecimiento. También realizamos grupos de discusión con 45 expertos destacados para triangular los hallazgos. Las tecnologías con el potencial percibido más alto fueron el aprendizaje mecánico y la visión por computadora, la genómica y el eADN y los sensores en red. El 95%, 94% y 92% de los respondientes, respectivamente, clasificó estas tecnologías como muy útiles o como puntos de inflexión. Los retos más apremiantes que afectaron al área como conjunto fueron la competencia por el financiamiento limitado, la duplicación de esfuerzos y el desarrollo inadecuado de capacidades. El 76%, 67% y 55% de los respondientes, respectivamente, identificaron estos retos como de interés primario. Las oportunidades clave para el crecimiento que se identificaron en los grupos de diálogo fueron el incremento de la colaboración y la distribución de información, la mejoría de la operatividad entre herramientas y la potenciación de la capacidad de análisis de datos a escala. Algunas restricciones parecieron afectar desproporcionadamente a grupos marginalizados. Los respondientes de países con economías en desarrollo tuvieron mayor probabilidad de reportar la restricción por los costos iniciales, costos de mantenimiento y la financiación del desarrollo (p = 0.048, tasa de probabilidad [OR] = 2.78; p = 0.005, OR = 4.23; p = 0.024, OR = 4.26), y las mujeres respondientes tuvieron una mayor probabilidad de reportar restricciones por la financiación del desarrollo y habilidades técnicas percibidas (p = 0.027, OR = 3.98; p = 0.048, OR = 2.33). A nuestro entendimiento, este es el primero intento por capturar formalmente las perspectivas y necesidades de la comunidad mundial de la tecnología de conservación, proporcionando datos fundamentales que pueden servir como referencia para medir el progreso. Vemos un potencial tremendo para que esta comunidad amplíe la visión que definen, en la cual la colaboración se sobrepone a la competencia; las soluciones son abierta, accesibles e interoperativas; y las herramientas intuitivas de procesamiento capacitan la traducción veloz de datos a acciones de conservación.

Canine Skull Digitalization and Three-Dimensional Printing as an Educational Tool for Anatomical Study.

This article aims to standardize 3D scanning and printing of dog skulls for educational use and evaluate the effectiveness of these anatomical printed models for a veterinary anatomy course. Skulls were selected for scanning and creating 3D-printed models through Fused Deposition Modeling using acrylonitrile-butadiene-styrene. After a lecture on skull anatomy, the 3D-printed and real skull models were introduced during the practical bone class to 140 students. A bone anatomy practical test was conducted after a month; it consisted in identifying previously marked anatomical structures of the skull bones. The students were divided into two groups for the exam; the first group of students took the test on the real skulls, whereas the second group of students took the test on 3D-printed skulls. The students' performance was evaluated using similar practical examination questions. At the end of the course, these students were asked to answer a brief questionnaire about their individual experiences. The results showed that the anatomical structures of the 3D-printed skulls were similar to the real skulls. There was no significant difference between the test scores of the students that did their test using the real skulls and those using 3D prints. In conclusion, it was possible to construct a dynamic and printed digital 3D collection for studies of the comparative anatomy of canine skull species from real skulls, suggesting that 3D-digitalized and-printed skulls can be used as tools in veterinary anatomy teaching.

Pros and cons of innovations in medical education.

Medical education has implemented various innovative strategies with the purpose to attain better learning achievements. An evaluation is made of the experiences in the competencies approach, new learning technologies, curricular alternatives, professional evaluation and distance education technologies in order to locate them in the areas they belong.

La educación médica ha puesto en práctica diversas estrategias innovadoras con el propósito de alcanzar mejores logros de aprendizaje. Se hace una evaluación de las experiencias relacionadas con el enfoque por competencias, las nuevas tecnologías educativas, las alternativas curriculares, la profesionalización de la evaluación y las técnicas educativas a distancia, para ubicarlas en el lugar que les corresponde.

The ethics of genetic engineering and gene drives in conservation.

The ethical issues associated with using genetic engineering and gene drives in conservation are typically described as consisting of risk assessment and management, public engagement and acceptance, opportunity costs, risk and benefit distributions, and oversight. These are important, but the ethical concerns extend beyond them because the use of genetic engineering has the potential to significantly alter the practices, concepts, and value commitments of conservation. I sought to elucidate the broader set of ethical issues connected with a potential genetic engineering turn in conservation and provide an approach to ethical analysis of novel conservation technologies. The primary rationales offered in support of using genetic engineering and gene drives in conservation are efficiency and necessity for achieving conservation goals. The instrumentalist ethical perspective associated with these rationales involves assessing novel technologies as a means to accomplish desired ends. For powerful emerging technologies the instrumentalist perspective needs to be complemented by a form-of-life perspective frequently applied in the philosophy of technology. The form-of-life perspective involves considering how novel technologies restructure the activities into which they are introduced. When the form-of-life perspective is applied to creative genetic engineering in conservation, it brings into focus a set of ethical issues, such as those associated with power, meaning, relationships, and values, that are not captured by the instrumentalist perspective. It also illuminates why the use of gene drives in conservation is so ethically and philosophically interesting.

Ética de la Ingeniería Genética y la Transmisión de Genes en la Conservación Resumen Los temas éticos asociados con el uso de la ingeniería genética y la transmisión de genes en la conservación están típicamente descritos como evaluación y manejo de riesgos, participación pública y aceptación, costos de oportunidad, distribuciones de riesgos y beneficios, y omisiones. Todo lo anterior es importante, pero las preocupaciones éticas se extienden más allá de los temas previos porque el uso de la ingeniería genética tiene el potencial de alterar significativamente las prácticas, conceptos y compromisos de valor de la conservación. Busqué elucidar los temas éticos conectados con un giro potencial hacia la ingeniería genética en la conservación y también proporcionar una estrategia para el análisis ético de las novedosas tecnologías para la conservación. Las razones principales ofrecidas como apoyo para el uso de la ingeniería genética y la transmisión de genes en la conservación son la eficacia y la necesidad de lograr los objetivos de conservación. La perspectiva ética instrumentalista asociada con estas razones involucra la evaluación de las tecnologías novedosas como medio para obtener los fines deseados. Para las emergentes tecnologías poderosas, la perspectiva instrumentalista necesita estar complementada con una perspectiva de forma de vida, la cual se aplica frecuentemente en la filosofía de la tecnología. La perspectiva de forma de vida involucra la consideración de cómo las tecnologías novedosas reestructuran las actividades a las cuales son introducidas. Cuando en la conservación se aplica la perspectiva de forma de vida a la ingeniería genética creativa, trae hacia el foco un conjunto de temas éticos, como aquellos asociados con el poder, el significado, las relaciones y los valores, que no captura la perspectiva instrumentalista. Esta perspectiva también ilustra sobre el por qué el uso de la transmisión de genes en la conservación es tan interesante ética y filosóficamente.

South African International Migration and its Impact on Older Family Members.

In this article, we explore the impact of South African families' emigration on parents/grandparents who must renegotiate their lives in their loved ones' physical absence. We adopted a transnational perspective in a bigger qualitative project to consider both sides of the migratory spectrum. Here we focus on elderly family members who remain behind-a group largely neglected in prior research. Our findings illustrate the complex emotions and relational changes experienced by elderly people whose families emigrate. New technologies bridge distances, allowing new ways to connect and take care of each other, and of re-imagining transnational relationships and what constitutes family life, but these bridges cannot negate the loss experienced by those remaining. People have to make sense of the emigration and forge new relational bonds with remaining family members. Our findings stress grandparents' meaningful role in a family system and highlight some gendered and racial differences in families' experiences.

En este artículo analizamos el efecto de la emigración de familias sudafricanas en los padres/abuelos que deben renegociar sus vidas ante la ausencia física de sus seres queridos. Nosotros adoptamos una perspectiva transnacional en un proyecto cualitativo más grande para tener en cuenta ambos lados del espectro migratorio. Aquí nos centramos en los integrantes ancianos de la familia que se quedan, un grupo en gran parte abandonado en investigaciones previas. Nuestros hallazgos ilustran las emociones complejas y los cambios relacionales sufridos por los ancianos cuyas familias emigran. Las nuevas tecnologías tienden puentes y acortan distancias, ya que permiten nuevas maneras de conectarse, de cuidarse mutuamente y de reinventar las relaciones transnacionales y lo que constituye la vida familiar, pero estos puentes no pueden anular la pérdida sufrida por los que se quedan. Las personas tienen que dar sentido a la emigración y forjar nuevos lazos relacionales con los familiares que se quedan. Nuestros resultados acentúan el papel significativo de los abuelos en un sistema familiar y destacan algunas diferencias por género y raza en las experiencias de las familias.

Behind the (Virtual) Mirror: Online Live Supervision in Couple and Family Therapy.

Online therapy and supervision, a rapidly rising practice in couple and family therapy, has been the subject of a growing body of literature. From its early days, family therapy training has included live supervision, which has typically been conducted by a supervisor and a team of trainees situated on the other side of a one-way mirror. With the outbreak of the COVID-19 global pandemic, we-the staff of supervisors at the Barcai Institute in Tel Aviv, Israel-were compelled to find solutions to continue meeting with clients and to provide supervision for family therapy trainees. To this end, we have shifted our live supervision courses ("practicums") to the virtual arena, adapting the popular application "Zoom" into what we call "PractiZoom." Based on over 100 PractiZoom sessions conducted between March and May 2020, involving 14 supervisors and 28 therapists-in-training and their clients, the article reflects on this pioneering online practicum for the online live supervision of therapists with geographically distributed participants. In this article, we outline our operational methods and adaptations for conducting live behind-the-mirror supervision online. Following a short theoretical background, we outline the process of online live supervision, discuss our reflections and those of our trainees on the challenges and possibilities it poses, and offer a number of preliminary conclusions and recommendations.

La terapia y la supervisión en línea, una práctica que está aumentando rápidamente en la terapia de pareja y familiar, ha sido tema de publicaciones crecientes. Desde sus primeros días, la capacitación en terapia familiar ha incluido la supervisión en vivo, que normalmente ha sido dirigida por un supervisor y un equipo de practicantes ubicados del otro lado de un vidrio de visión unilateral. En la medida de nuestro conocimiento, la bibliografía aún tiene que abordar la supervisión en línea en vivo que incluya una familia, un terapeuta, un supervisor y un equipo, todos en línea. Con el brote de la pandemia mundial de la COVID-19, nosotros─el personal de supervisores de Barcai Institute de Tel Aviv, Israel─nos vimos obligados a encontrar soluciones para continuar las reuniones con los pacientes y supervisar a los practicantes de terapia familiar. Con ese fin, hemos trasladado nuestros cursos de supervisión en vivo ("prácticas") al área virtual, adaptando la famosa aplicación "Zoom" a lo que nosotros llamamos "PractiZoom." Sobre la base de 100 sesiones en PractiZoom realizadas entre marzo y mayo de 2020, en las que participaron 14 supervisores y 28 terapeutas en prácticas y sus pacientes, el artículo reflexiona sobre esta práctica innovadora en línea para la supervisión en línea de terapeutas con participantes geográficamente dispersos. En este artículo, describimos nuestros métodos operativos y adaptaciones para llevar a cabo una supervisión en línea en vivo detrás del espejo. Después de un breve marco teórico, describimos el proceso de la supervisión en línea en vivo, debatimos nuestras reflexiones y las de nuestros practicantes sobre las dificultades y las posibilidades que plantea, y ofrecemos numerosas conclusiones y recomendaciones preliminares.

Aquaculture and the displacement of fisheries captures.

In modern aquaculture, animal-production technology is used to increase aquatic food sources. Such controlled rearing of seafood can, in principle, shift the pressure off wild stocks and aquatic ecosystems by reducing fishing activities, which may advance marine conservation goals. We examined resource displacement-the reduced consumption of a resource due to its replacement with a more environmentally benign substitute-in fisheries. We employed panel regression techniques in an analysis of time-series data from 1970 through 2014 to assess the extent to which aquaculture production displaced fisheries captures for all nations for which data were available. We estimated 9 models to assess whether aquaculture production suppresses captures once other factors related to demand have been controlled for. Only 1 model predicted significant suppression of fisheries captures associated with aquaculture systems within nations over time. These results suggest that global aquaculture production does not substantially displace fisheries capture; instead, aquaculture production largely supplements fisheries capture.

La Acuacultura y el Desplazamiento de Capturas de las Pesquerías Resumen En la acuacultura moderna, la tecnología de producción animal se usa para incrementar las fuentes acuáticas de alimento. Tal crianza controlada de peces puede, en principio, modificar la presión que afecta los stocks silvestres y los ecosistemas acuáticos al reducir las actividades de pesca, lo que podría acercarnos a la obtención de las metas de conservación. Examinamos el desplazamiento de recursos - el consumo reducido de un recurso debido a su reemplazo con un sustituto más benigno con el ambiente - en las pesquerías. Empleamos técnicas de regresión de paneles en un análisis de datos de series de tiempo de 1970 a 2014 para evaluar hasta dónde ha llegado el desplazamiento de las capturas de las pesquerías en todos los países que tenían datos disponibles. Estimamos nueve modelos para evaluar si la producción de la acuacultura suprime las capturas una vez que otros factores relacionados con la demanda han sido controlados. Solamente un modelo pronosticó la supresión de las capturas de las pesquerías asociadas con los sistemas de acuacultura en los países a lo largo del tiempo. Estos resultados sugieren que la producción acuícola no desplaza sustancialmente la captura de las pesquerías; en su lugar, la producción acuícola complementa en gran parte a estas capturas.

IMPLEMENTATION AND SUSTAINABILITY OF CHILD-PARENT PSYCHOTHERAPY: THE ROLE OF REFLECTIVE CONSULTATION IN THE LEARNING COLLABORATIVE MODEL.

Recent implementation science in mental health has focused on identifying the most effective strategies to disseminate and implement evidence-based treatments (EBTs) into real-world practice settings. The learning collaborative training methodology and its use of expert trainers/consultants have become increasingly popular as one of these approaches. Moreover, there is preliminary evidence that ongoing expert consultation may increase the adoption, learning, and sustainability of EBTs by an already practicing workforce and, consequently, help trainers, practitioners, and organizations address implementation barriers. This article describes the authors' experiences in facilitating Child-Parent Psychotherapy (CPP) training and explores the role of reflective clinical consultation as an active process that supports the implementation of a rich, but complex, model that requires sophisticated knowledge and skills from practitioners. It examines the intricate range of the CPP consultant's functions, which ultimately support clinicians' reflective practice as they learn and adopt this EBT. Reflective consultation is proposed as an essential component for the integration of knowledge, experience, and emotions in practitioners and as a catalyst for organizational change. Using their voices as trainers-consultants and those of their trainees, the authors discuss the implications of reflective consultation for the effective implementation and sustainability of CPP. Reflections are offered on lessons learned.

Digitalização e Impressão Tridimensional de Crânio Canino como Ferramenta Educacional para Estudo Anatômico.

Este trabalho teve como objetivo padronizar a digitalização e impressão 3D de crânios de cães para uso educacional e avaliar a eficácia de modelos anatômicos impressos na disciplina de anatomia do curso de medicina veterinária. Os crânios foram selecionados para escaneamento e criação dos modelos impressos 3D modelados por fusão de deposição (FDM) utilizando acrilonitrila butadieno estireno. Após uma aula teórica sobre anatomia do crânio os modelos impressos 3D e os modelos reais do crânio de cães foram apresentados aos 140 alunos durante a aula prática de ossos. Uma avaliação prática de osteologia foi realizada após um mês que consistiu na identificação de estruturas anatômicas dos ossos do crânio identificados por alfinetes. Os alunos foram divididos em duas turmas para a realização da avaliação; o primeiro grupo fez os testes usando os crânios reais, enquanto o segundo grupo os crânios impressos 3D. O desempenho dos alunos foi avaliado conforme as suas performances no exame prático. No final da disciplina, eles foram convidados a responder a um breve questionário sobre suas experiências individuais. Os resultados do estudo demonstram que as estruturas anatômicas dos crânios impressos 3D eram semelhantes aos crânios reais. Não houve diferença significativa quando se analisou o grau de acertos e erros durante a realização do exame entre aqueles que identificaram as estruturas nos crânios reais ou nos impressos 3D. Conclui-se que é possível construir um acervo dinâmico digital e impresso tridimensional (3D) para estudos da anatomia comparada da espécie canina a partir de crânios reais, e que os crânios 3D podem ser usados como uma excelente ferramenta alternativa ao ensino na anatomia veterinária.

Building dialogue on complex conservation issues in a conference setting.

Dialogue about complex science and society issues is important for contemporary conservation agendas. Conferences provide an appropriate space for such dialogue, but despite its recognized worth, best practices for facilitating active dialogue are still being explored. Face-to-face (FTF) and computer-mediated communication (CMC) are two approaches to facilitating dialogue that have different strengths. We assessed the use of these approaches to create dialogue on cultural perspectives of conservation and biodiversity at a national ecology conference. In particular, we aimed to evaluate their potential to enhance dialogue through their integrated application. We used an interactive blog to generate CMC on participant-sourced issues and to prime subsequent discussion in an FTF conference workshop. The quantity and quality of both CMC and FTF discussion indicated that both approaches were effective in building dialogue. Prior to the conference the blog averaged 126 views per day, and 44 different authors contributed a total of 127 comments. Twenty-five participants subsequently participated in active FTF discussion during a 3-h workshop. Postconference surveys confirmed that CMC had developed participants' thinking and deepened FTF dialogue; 88% indicated specifically that CMC helped facilitate the FTF discussion. A further 83% of respondents concluded that preliminary blog discussion would be useful for facilitating dialogue at future conferences.

Innovation and technology transfer in the health sciences: a cross-sectional perspective.

This article is based on the strategic reflection and discussion that took place on occasion of the first conference on innovation and technology transfer in the health sciences organized by the REGIC-ENS-FENIN-SEMICYUC and held in Madrid in the Instituto de Salud Carlos III on May 7th, 2013, with the aim of promoting the transfer of technological innovation in medicine and health care beyond the European program "Horizon 2020". The presentations dealt with key issues such as evaluation of the use of new technologies, the need to impregnate the decisions related to adoption and innovation with the concepts of value and sustainability, and the implication of knowledge networks in the need to strengthen their influence upon the creation of a "culture of innovation" among health professionals. But above all, emphasis was placed on the latent innovation potential of hospitals, and the fact that these, being the large companies that they are, should seriously consider that much of their future sustainability may depend on proper management of their ability to generate innovation, which is not only the generation of ideas but also their transformation into products or processes that create value and economic returns.

Intensive care unit without walls: seeking patient safety by improving the efficiency of the system.

The term "ICU without walls" refers to innovative management in Intensive Care, based on two key elements: (1) collaboration of all medical and nursing staff involved in patient care during hospitalization and (2) technological support for severity early detection protocols by identifying patients at risk of deterioration throughout the hospital, based on the assessment of vital signs and/or laboratory test values, with the clear aim of improving critical patient safety in the hospitalization process. At present, it can be affirmed that there is important work to be done in the detection of severity and early intervention in patients at risk of organ dysfunction. Such work must be adapted to the circumstances of each center and should include training in the detection of severity, multidisciplinary work in the complete patient clinical process, and the use of technological systems allowing intervention on the basis of monitored laboratory and physiological parameters, with effective and efficient use of the information generated. Not only must information be generated, but also efficient management of such information must also be achieved. It is necessary to improve our activity through innovation in management procedures that facilitate the work of the intensivist, in collaboration with other specialists, throughout the hospital environment. Innovation is furthermore required in the efficient management of the information generated in hospitals, through intelligent and directed usage of the new available technology.

Gasserian ganglion stimulation for refractory trigeminal neuropathic pain.

BACKGROUND AND OBJECTIVE: Painful trigeminal neuropathy is a complex clinical entity due to its severity and refractoriness to pharmacological and interventional management. We describe our experience in treating refractory painful trigeminal neuropathy (RPTN) with gasserian ganglion stimulation (GGS). MATERIALS AND METHODS: Six patients with RPTN were treated with GGS in our Unit between 2019 and 2022. The following data were collected: socio-demographic characteristics, triggering event, duration of the disease and treatment received prior to surgery, pre- and post-intervention visual analogue scale (VAS) score, follow-up time, and pre- and post-intervention functionality and quality of life. RESULTS: All patients were women who had received aggressive first-, second-, and third-line pharmacological, non-pharmacological, and interventional management before being referred for GGS. Patients reported a 50%-72% decrease in pain on VAS and improved functionality during follow-up. CONCLUSIONS: GGS is a promising therapeutic alternative for patients with RPTN. Although the initial outcomes and experience are encouraging, RPTN is recommended on the basis of safety, reproducibility, and trends observed in clinical practice.

A heuristic-based approach for assessing usability in electric powered wheelchairs: A preliminary investigation.

OBJECTIVE: An important issue related to electric powered wheelchair (EPW) is usability. Recent studies did not use heuristic evaluation and did not consider users' and developers' participation in the usability evaluation process of the EPW, especially when it has to be driven using alternative commands. Thus, this study investigates the use of heuristics to evaluate the usability of EPW driven by alternative commands, considering the opinion of users and assistive technology (AT) development professionals. METHODS: The study was carried out with 54 participants: 28 EPW users (Group I) and 26 AT developers (Group II). We built a set of 25 heuristics that affects EPW usability. Participants rated each of the 25 heuristics according to their importance for the usability of EPW using the five-point Likert scale. We used the R Software to perform the Wilcoxon Mann-Whitney test as a statistical comparisons test between Group I and II. RESULTS: The results showed a statistically significant difference (p<0.05) between Group I and II in the evaluation of 16 heuristics. We identified an important set of heuristics that could help evaluate and improve the usability of EPW. CONCLUSION: The findings highlighted the importance of considering users' and developers' points of view in developing an EPW and its evaluation criteria. It could help the design of the device match the user's needs and expectations. The set of heuristics in this study can be adapted to evaluate other devices' usability using the heuristic evaluation approach.

Association of remnant cholesterol with glycemic control and presence of microvascular complications in individuals with type 1 diabetes mellitus.

INTRODUCTION: This study examines the relationship between remnant cholesterol, glucose metrics, and chronic complications of type 1 diabetes in users of glucose monitoring systems. MATERIAL AND METHODS: Clinical variables and glucose metrics were collected from individuals using glucose sensors. Statistical models were employed to investigate the association of remnant cholesterol with glucose metrics, diabetic retinopathy, and diabetic nephropathy. RESULTS: A total of 383 individuals, aged 48.3 ±â€¯16.2 years, with 54.1% women, and a remnant cholesterol level of 16 ±â€¯10 mg/dL, were included. The results demonstrated that remnant cholesterol was associated with less time within the target range (p = 0.015) and more time above the target range (p = 0.003). Diabetic nephropathy was the only complication associated with remnant cholesterol levels exceeding 30 mg/dL, OR 8.93, 95% CI (2.99-26.62), p < 0.001. CONCLUSION: Remnant cholesterol is independently associated with hyperglycemia and diabetic nephropathy in individuals with type 1 diabetes.

Critical appraisal of the Colombian clinical practice guide for the prevention, diagnosis and treatment of suicidal ideation and/or behaviour (adoption).

INTRODUCTION: Suicide is a complex, global public health problem. The Colombian clinical practice guideline provides relevant input for its prevention, diagnosis and treatment. The objective was to evaluate the methodological quality, credibility and applicability of the Colombian clinical practice guideline for suicidal behaviour. METHODS: An academic group of 12 evaluators was established to assess the guide and its recommendations in a standardised way, using the AGREE-II and AGREE-REX instruments. The evaluations were given in the range of 0.0-1.0 with 0.7 as a cut-off point for appropriate quality. RESULTS: The global assessment of the AGREE-II was greater than 0.7 in the dimensions: "scope and objective" (0.86), "clarity of presentation" (0.89), "applicability" (0.73) and "editorial independence" (0.89). The lowest scores were for "participation of those involved" (0.67) and "rigour in preparation" (0.69). With the AGREE-REX, the results in all dimensions were below 0.70, which indicates lower quality and suitability for use. CONCLUSIONS: The adoption process of the Colombian guideline for suicidal behaviour was a rigorous methodological process, while the practice recommendations were valued as of low applicability due to low support in local evidence. It is necessary to strengthen the generation and synthesis of evidence at the national level to give greater support and applicability to the practice recommendations.

Impact of new technologies on neurology in Spain. Review by the New Technologies Ad-Hoc Committee of the Spanish Society of Neurology.

INTRODUCTION: New technologies are increasingly widespread in biomedicine. Using the consensus definition of new technologies established by the New Technologies Ad-Hoc Committee of the Spanish Society of Neurology (SEN), we evaluated the impact of these technologies on Spanish neurology, based on communications presented at Annual Meetings of the SEN. MATERIAL AND METHODS: We defined the concept of new technology in neurology as a novel technology or novel application of an existing technology, characterised by a certain degree of coherence persisting over time, with the potential to have an impact on the present and/or future of neurology. We conducted a descriptive study of scientific communications presented at the SEN's annual meetings from 2012 to 2018, analysing the type of technology, the field of neurology, and the geographical provenance of the studies. RESULTS: We identified 299 communications related with new technologies from a total of 8139 (3.7%), including 120 posters and 179 oral communications, ranging from 1.6% of all communications in 2012 to 6.8% in 2018. The technologies most commonly addressed were advanced neuroimaging (24.7%), biosensors (17.1%), electrophysiology and neurostimulation (14.7%), and telemedicine (13.7%). The neurological fields where new technologies were most widely employed were movement disorders (18.4%), cerebrovascular diseases (15.7%), and dementia (13.4%). Madrid was the region presenting the highest number of communications related to new technologies (32.8%), followed by Catalonia (26.8%) and Andalusia (9.0%). CONCLUSIONS: The number of communications addressing new technologies follows an upward trend. The number of technologies used in neurology has increased in parallel with their availability. We found scientific communications in all neurological subspecialties, with a heterogeneous geographical distribution.

Performance in prognostic capacity and efficiency of the Thoracic Care Suite GE AI tool applied to chest radiography of patients with COVID-19 pneumonia.

OBJECTIVE: Rapid progression of COVID-19 pneumonia may put patients at risk of requiring ventilatory support, such as non-invasive mechanical ventilation or endotracheal intubation. Implementing tools that detect COVID-19 pneumonia can improve the patient's healthcare. We aim to evaluate the efficacy and efficiency of the artificial intelligence (AI) tool GE Healthcare's Thoracic Care Suite (featuring Lunit INSIGHT CXR, TCS) to predict the ventilatory support need based on pneumonic progression of COVID-19 on consecutive chest X-rays. METHODS: Outpatients with confirmed SARS-CoV-2 infection, with chest X-ray (CXR) findings probable or indeterminate for COVID-19 pneumonia, who required a second CXR due to unfavorableclinical course, were collected. The number of affected lung fields for the two CXRs was assessed using the AI tool. RESULTS: One hundred fourteen patients (57.4±14.2 years, 65-57%-men) were retrospectively collected. Fifteen (13.2%) required ventilatory support. Progression of pneumonic extension ≥0.5 lung fields per day compared to pneumonia onset, detected using the TCS tool, increased the risk of requiring ventilatory support by 4-fold. Analyzing the AI output required 26s of radiological time. CONCLUSIONS: Applying the AI tool, Thoracic Care Suite, to CXR of patients with COVID-19 pneumonia allows us to anticipate ventilatory support requirements requiring less than half a minute.

Patient satisfaction in three advanced hybrid closed-loop systems at 6 months of treatment in adults with type 1 diabetes mellitus: a follow-up study.

INTRODUCTION: Advanced hybrid closed-loop (AHCL) systems have demonstrated improved glycemic control in individuals with Type 1 Diabetes Mellitus. The aim of this study is to compare patient satisfaction among three available AHCL systems (Medtronic Minimed780 G, Roche Diabeloop DBLG1, and Tandem t:slim X2 Control IQ) after six months of treatment and to determine if it is related to glycemic control. METHODS: The data of 75 individuals were analyzed, including 15 using the DBLG1 system, 9 using Control IQ, and 51 using MM780 G. Patient satisfaction was assessed using the Diabetes Treatment Satisfaction Questionnaire for Diabetes Mellitus (DTSQc), a validated instrument. RESULTS: All systems demonstrated treatment satisfaction. The DBLG-1 system scored 14 (-15-21) points, while Control IQ scored 21 (9-24) and M780 G scored 19 (11-24) (p = 0.004). The multivariate analysis revealed that the DBLG-1 system is associated with a lower DTSQc score (OR 0.19, p = 0.019) independent of glycemic control, sex, age, duration of diabetes, duration as an insulin pump user, and daily insulin dose. CONCLUSION: AHCL systems are satisfactory treatments for users, with potential variations observed between each system regardless of the achieved glycemic control.