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Introduction: The current Spanish Clinical Guidelines on Vascular Access for Hemodialysis support the need for surveillance and monitoring of vascular access (VA) to avoid complications. Ultrasound dilution (UD) methods are accepted for the evaluation of VA flow and Transonic® has established the gold standard method for the measurement. The DMed NephroFlow (NIPRO®) device, based on UD method has recently been incorporated. We report a comparative study between the classic Transonic® versus the new NephroFlow® device.Material and methods: For two consecutive months, measurements of VA flow using both referred systems were performed in patients with a native arteriovenous fistula (AVF) or a graft (AVG) on hemodialysis (HD) in our unit. Both studies were undertaken according to the usual recommendations: VA flow of 250 ml/min, ultrafiltration rate without modifications, both needles in the same vein, and always in the first hour of the HD session.Results: Forty-five patients were included: 17 women and 28 men, mean age of 67 ± 12 years. Thirty patients were diabetic. The baseline meantime on HD was 51 ± 39 months (range: 3–163). Type of VA was: 17 patients radio-cephalic AVF, 17 brachiocephalic AVF, 7 brachiobasilic AVF, and 3 with a graft. The mean flow estimated by the Transonic® was 1222 ± 805 ml/min and the estimated flow by the NephroFlow® device was 1252 ± 975 ml/min. Good reliability between Transonic® and NephroFlow® was observed, with a reliability index of Cronbach’s Alpha of 0.927 and an Intraclass Correlation Index of 0.928.Conclusions: The NephroFlow® device seems comparable with the accepted gold standard UD method for estimating VA flow. More studies must be performed to verify these results. However, they should be considered for the surveillance and monitoring of VA flow, in agreement with the Spanish Guidelines.

ABSTRACTPredictive and condition-based maintenance is given more and more attention to further optimize the utilization of manufacturing and production equipment. Utilizing acoustic signals for equipment monitoring and condition-based maintenance has been proven effective in many applications. Many manufacturing and production setups consist of multiple alike machines (e.g. within injection moulding) where it would be beneficial to use the same monitoring setup and configuration on all machines. Based on an industrial application within injection moulding (using five different injection moulds), a methodology is proposed utilizing acoustic signals from injection moulds combined with generative Gaussian or autoencoder modeling. To improve the generalization ability of generative modeling to moulds not seen at training time, a simple yet effective model adaptation is proposed, which only requires a few faultless moulding cycles at runtime/test time. The best results are obtained using the Gaussian model, where area under the curve values close to one are achieved when employing a model adapted to the specific mould at test time to detect abnormal situations like mechanical-defective moulds (loose latch lock) and the need for lubrication. The proposed framework is light in terms of computation and makes the setup implementation practically feasible in a real industrial context with multiple similar machines.

El implante de stentes el tratamiento de elección en niños mayores y adultos con coartación aórtica (CoA). El objetivo fue determinar la incidencia de eventos tardíos después del tratamiento con stent.

As television transitions from analog to digital, questions arise as to how to best meet the needs of children. What are the potential benefits of digital television? How can the technology be used to serve children and families, while at the same time protect them from possible harm? The transition to digital television offers a unique opportunity to shape how this new technology can serve our nation's children. This issue of Media Now, a Children Now newsletter, focuses on digital television and its implications for kids and the programming designed for them. Also included in this issue are: "Programming Ahead of the Game" (Tom Ascheim); and "Digital Television Policy Recommendations" from the Children's Media Policy Coalition. (Contains 28 endnotes.)

The use of coronary physiology allows for rational decision making at the time of PCI, contributing to better patient outcomes. Yet, coronary physiology is only one aspect of optimal revascularization. State-of-the-art PCI must also consider other important aspects such as intracoronary imaging guidance and specific procedural expertise, as tested in the SYNTAX II study. In this review, we highlight the technical aspects pertaining to the use of physiology as used in that trial and offer a glimpse into the future with emerging physiologic metrics, including functional coronary angiography, which have already established themselves as useful indices to guide decision making.

In the evolution from Agriculture 2.0 to Agriculture 5.0, the agricultural sector has witnessed transformative changes. Agriculture 5.0 represents a revolutionary phase, integrating advanced technologies to enhance efficiency and sustainability adapted to individual field and livestock needs. The integration of robotics, extended reality, and 6G technologies marks a significant leap, enabling real-time monitoring and automation in farming practices. Artificial intelligence and big data are pivotal in Agriculture 5.0, offering insights for decision making and predictive analytics. Natural language processing plays a crucial role in facilitating efficient communication and data processing. The transition to Agriculture 5.0 should also consider societal challenges, in terms of technology lock-ins and the need for behavior shifts among stakeholders for faster adoption and customization of the solutions. This article presents a comprehensive description of Agriculture 5.0, underscoring the potential and hurdles in reshaping the future of farming.

IntroductionManaging emergency situations in different simulated flight segments can entail a workload that could affect the performance of military pilots. The aim was to analyse the modifications in neurovegetative balance (using HR variability, HRV) of professional fighter pilots attending learning/training sessions on emergency situations in a flight simulator.MethodsA total of 18 pilots from the Spanish Air and Space Force were included. HRV was recorded simultaneously during diverse simulated emergency situations in three different flight segments: take-off, in-flight and landing.ResultsThe comparison between take-off and in-flight revealed a statistically significant increase (p<0.05) in percentage of consecutive RR intervals that differ by more than 50 ms from each other (pNN50), root mean square of the successive differences (rMSSD), standard desviation 1 and 2 (SD1 and SD2), and a statistically significant decrease (p<0.000) in stress score (SS) and in the sympathetic to parasympathetic ratio (S:PS). Between flight and landing, a statistically significant increase (p<0.05) in mean HR, minimum HR, maximum HR, SS and S:PS was shown, while experiencing a significant decrease (p<0.000) in pNN50, rMSSD and SD2. Finally, between take-off and landing, the variables which showed significant changes (p<0.05), with these changes being a significant increase, were mean HR, minimum HR, maximum HR, rMSSD, SD1 and SD2. SS and S:PS ratios showed a statistically significant decrease (p<0.000).ConclusionsAn emergency situation in a flight simulator manoeuvre produced an anticipatory anxiety response in pilots, demonstrated by low HRV, which increased during the flight segment and decreased during the landing segment of the flight.Trial registration numberNCT04487899.

The promotion of sustainable development is a paramount objective in Latin America, and it is crucial to comprehend how companies can contribute to this goal. This study examines the relationship between green management, perceived barriers to sustainability, and innovation performance in Latin American SMEs. Using a structural equation modelling methodology based on a primary dataset of 5,716 managers from 18 Latin American countries, the study finds that green management positively relates to SMEs' the innovation performance of SMEs in Latin America. However, perceived barriers to sustainability partially mediate this positive relationship. Theoretical implications suggest that sustainable practices can lead to improved innovation performance, while practical implications highlight the importance of addressing perceived barriers to sustainability in order to fully realise these benefits. This study fills a gap in the literature by providing evidence of the positive impact of green management on innovation performance in Latin American SMEs and offers suggestions for future research avenues.

Objectives: The purpose of this study was to evaluate the impact of pharmacist-driven naloxone training of resident physicians as part of discharge prescribing from an inpatient psychiatric unit. Methods: This is a prospective pilot study in which psychiatric resident physicians (N= 21) were educated on naloxone administration, prescribing, and counseling. A ten-question survey was designed and delivered immediately pre- and post-training to assess resident knowledge of and comfort with naloxone prescribing. Respondents were asked to rate ten statements on a scale from 1 to 5, with 1 corresponding to “strongly disagree” and 5 corresponding to “strongly agree.” The primary objective was to evaluate the impact of training on prescriber knowledge and attitudes using the designed questionnaire. The secondary objective was to assess the difference in naloxone prescribing pre- and post-training implementation. Descriptive statistics and paired t-tests were conducted to assess statistical significance. Results: Prior to training, 11 resident physicians (approximately 50%) agreed or strongly agreed that they felt knowledgeable about naloxone and approximately 70% (n= 15) felt confident identifying patients who would benefit from naloxone at discharge. Only 10% of resident physicians (n= 2) felt comfortable counseling patients on and administering naloxone during an overdose pre-training compared to 100% after training. Thirty-seven patients were discharged and counseled on naloxone use during the study period. Conclusion: Pharmacist-driven naloxone training significantly increased physician knowledge and comfort prescribing naloxone and resulted in an increase in naloxone prescriptions upon discharge from an inpatient psychiatric unit.

In this work, a depiction and analysis of the state of last mile logistics in Spain is presented. Through the study of the data from 12 Spanish provinces gathered by an IT service provider that enables the operation of 12 different carriers, the main characteristics of each region in Spain are analysed and discussed, portraying not only the geographical and demographic distinctions between the areas, but also the differences in operational efficiency between carriers. Furthermore, the posited metrics are collated with the population density indicators of the provinces, in an attempt to identify significant correlations and patterns that may bring light to the effect on the operation of the agencies of geographic concentration.