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Aim and objective We describe two cases demonstrating a new technique to permanently reverse a problematic trabeculectomy. Background Trabeculectomy-related complications are typically treated in a manner that preserves the initial surgical outcome; however, in certain cases a complete reversal of the trabeculectomy is preferable to revision. Technique Our technique involves seating a lamellar corneal graft into a partial thickness sclerectomy. Conclusion This method achieves permanent closure of large ostomies or areas of scleromalacia. Clinical significance This technique can be used on very anterior ostomies while still providing an excellent seal, patient comfort, and cosmesis without inducing astigmatism. How to cite this article Bakhsh SR, Rooney D, Goldman BA, et al. A Case Series Demonstrating a Novel Technique for Reversal of Trabeculectomy Using Lamellar Sclerectomy and Corneal Graft. J Curr Glaucoma Pract 2020;14(2):61-63.

Se sintetizaron nanopartículas de dos compósitos del sistema Fe2O3-Ni1-xZnxFe2O4, mediante el método de coprecipitación, empleando agitación por sonicación y burbujeo de nitrógeno. Los nanocompósitos sintetizados fueron caracterizados mediante: difracción de rayos-X, espectroscopia infrarroja por transformada de Fourier, espectroscopia de rayos-X por dispersión de energía, microscopía electrónica de transmisión y magnetometría de muestra vibrante. Ambos nanocompósitos presentaron las dos fases cristalinas correspondientes a las estructuras romboédrica y cúbica espinela, características de la hematita y las ferritas cúbicas. El parámetro de celda unidad (a) de la fase espinela aumenta con el incremento de la concentración de cationes Zn2+, indicando que se produce una expansión de la red. Los dos nanocompósitos están formados por nanopartículas aglomeradas, con formas irregulares y tamaños medios inferiores a 10 nm. Las medidas de magnetización en función del campo magnético aplicado sugieren que, a temperatura ambiente, las partículas de los dos nanocompósitos se encuentran en el régimen superparamagnético., {"references":["Smit J, Wijn HPJ. Ferrites, Eindhoven (Holanda): Philips Technical Library, 1959.","Hazra S, Ghosh NN. J. Nanosci. Nanotechnol. 2014; 14: 1983-2000.","Valenzuela R. Phys. Res. Int. 2012; 2012: 1-9.","Harris VG, Geiler A, Chen Y, Yoon SD, Wu M, Yang A, Chen Z, He P, Parimi PV, Zuo X, Patton CE, Abe M, Acher O, Vittoria C. J. Magn. Magn. Mater. 2009; 321: 2035-2047.","Sharifi I, Shokrollahi H, Amiri S. J. Magn. Magn. Mater. 2012; 324: 903-915.","Srinivas C, Tirupanyam BV, Satish A, Seshubai V, Sastry DL, Caltun OF. J. Magn. Magn. Mater. 2015; 382: 15-19.","Kavas H, Baykal A, Toprak MS, Köseoglu Y, Sertkol M, Aktas B. J. Alloys Compd. 2009; 479: 49-55.","Cullity BD, Graham CD. Introduction to Magnetic Materials, 2da Ed. New York (USA): IEEE Press, 2009, Cap. 6.","Velmurugan K, Venkatachalapathy VSK, Sendhilnathan S. Mater. Res. 2010; 13: 299-303.","Gul IH, Ahmed W, Maqsood A. J. Magn. Magn. Mater. 2008; 320: 270-275.","Zhang Y, Jiao Q, Zhai Y, Bai X, Du J, Zhai H. Mod. Phys. Lett. B. 2009; 23: 633-642.","Wongpratat U, Meansiri S, Swatsitang E. Microelectron. Eng. 2014; 126: 19-26.","Gao P, Hua X, Degirmenci V, Rooney D, Khraisheh M, Pollard R, Bowman RM, Rebrov EV. J. Magn. Magn. Mater. 2013; 348: 44-50.","Berkowitz AE, Takano K. J. Magn. Magn. Mater. 1999; 200: 552-570.","Xu S, Habib AH, Gee SH, Hong YK, McHenry ME. J. Appl. Phys. 2015; 117: 17A315-1.","Srivastava M, Chaubey S, Ojha AK. Mater. Chem. Phys. 2009; 118: 174-180.","Agouriane E, Essoumhi A, Razouk A, Sahlaoui M, Sajieddine M. J. Mater. Environ. Sci. 2016; 7: 4614-4619.","Morales F, Márquez G, Sagredo V, Torres TE, Denardin JC. Phys. B: Condens. Matter. 2019; 572: 214-219.","Guan BH, Chuan LK, Soleimani H. Am. J. Appl. Sci. 2014; 11: 878-882.","Pérez E, Márquez G, Sagredo V. Iraqi J. Appl. Phys. 2019; 15: 13-17.","Mohit K, Rout SK, Parida S, Singh GP, Sharma SK, Pradhan SK, Kim IW. Phys. B: Condens. Matter. 2012; 407: 935-942.","Jaimes C, Santiago E, Sagredo V, Márquez G. Cienc. e Ing. 2019; 40: 165-170.","Rietveld HM. J. Appl. Cryst. 1968; 2: 65-71.","Rodriguez-Carvajal J. Fullprof (version Julio 2019), Laboratoire Léon Brillouin (CEA-CNRS), France.","Klug HP, Alexander LE. X-Ray Diffraction Procedures: For Polycrystalline and Amorphous Materials, 2da Ed. New York (USA): Wiley-VCH, 1974.","Gul IH, Maqsood A. J. Magn. Magn. Mater. 2007; 316: 13-18.","Gul IH, Amin F, Abbasi AZ, Anis-ur-Rehman M, Maqsood A. Scr. Mater. 2007; 56: 497-500.","Waldron RD. Phys. Rev. 1955; 99: 1727-1735.","Battisha IK, Afify HH, Ibrahim M. J. Magn. Magn. Mater. 2006; 306: 211-217.","Abdullah Dar M, Shah J, Siddiqui WA, Kotnala RK. Appl. Nanosci. 2014; 4: 675-682.","Zhu M, Wang Y, Meng D, Qin X, Diao G. J. Phys. Chem. C. 2012; 116: 16276-16285.","Yu J, Yu X, Huang B, Zhang X, Dai Y. Cryst. Growth Des. 2009; 9: 1474-1480."]}

Palladium-based catalysts supported on hypercrosslinked polystyrene were studied in the hydroconversion processes of oilseed biomass: (I) deoxygenation in a conventional solvent; (II) deoxygenation in supercritical hexane; (III) hydrogenation in toluene. It was shown that the highest selectivity towards the formation of target product, as well as the highest rate of stearic acid conversion in all the investigated processes, was observed using a 1% -Pd/HPS catalyst., {"references":["Alonso, D. M., Bond, J. Q., & Dumesic, J. A. (2010). Catalytic conversion of biomass to biofuels. Green Chem., 12, 1493-1513. DOI: 10.1039/c004654j","Noweck, K. (2011). Production, technologies and applications of fatty alcohols. Lecture at the 4th workshop on fats and oils as renewable feedstock for the chemical industry. Karlsruhe. doi:10.1002/14356007.a10_277.pub2","Mudge, S. M. (2005). Fatty Alcohols - a review of their natural synthesis and environmental distribution. School of Ocean Sciences, University of Wales - Bangor. 2005.","Rios, L. A., Restrepo, G. M., Valencia, S. H., Franco, A. C., & Echeverri, D. A. Z. (2006). La hidrogenacion selectiva de aceites naturales a traves de catalizadores heterogeneos. Scientia et Technica Año XII, 31, 221-226.","Kalnes, T., Marker, T., & Shonnard, D. R. (2007). Green diesel: A second generation biofuel. Int. J. of Chem. React. Eng., 5, 748-750.","Snäre, M., Kubičkova, I., Mäki-Arvela, P., Eränen, K., & Murzin, D. Yu. (2006). Hydrocarbons for diesel fuel via decarboxylation of vegetable oils. Ind. Eng. Chem. Res., 45, (16), 5708-5719.","Holmgren, J., Gosling, C., Couch, K., Kalnes, T., Marker, T., McCall, M., & Marinangeli, R. (2007). Biorenewable integration in refineries is evaluated along with work to commercially produce green diesel. PTQ, 3, 119-125.","Manyar, H. G., Paun, C., Pilus, R., Rooney, D. W., Thompson, J. M., & Hardacre, Ch. (2010). Highly Selective and Efficient Hydrogenation of Fatty acids to Alcohols using Pt supported over TiO2 catalysts. Chem. Commun., 46, 6279-6281.","Klusoň, P., Červený, L. (1997). Ru-Sn catalyst - a new promising system for selective hvdrogenation of a carbonyl group. Chem. Listy, 91, 100-104.","Zhu, H. J., Pittman, Ch. U. Jr. (2003). Reductions of carboxylic acids and esters with NaBH4 in diglyme at 162 °C. Synthetic communications, 33, 10, 1733-1750.","Yoshino, K., Kajiwara, Y., Takaishi, N., Inamoto, Y., & Tsujia, J. (1990). Hydrogenation of Carboxylic Acids by Rhenium-Osmium Bimetallic Catalyst. JAOCS, 67, 1, 21-24.","Sad, M. R., Mazzieri, V. A., Vera, C. R., & Pieck, C. L. (2007). Hidrogenación selectiva de metil ésteres de ácidos grasos para obtención de alcoholes grasos. Perspectivas actuales, catalizadores y mecanismos de reacción. Avances en Química, 2, (2), 17-24.","Lee, D., Cho, S. I., Kim, G.-J., Kim, H., & Lee, I.-M. (2007). Efficient and Selective Hydrogenation of Carboxylic Acid Catalyzed by Ni or Pd on ZSM-5. J. Ind. Eng. Chem., V. 13, 7, 1067-1075.","Simasatitkul, L., Arpornwichanop, A., & Gani, R. (2013). Design methodology for bio-based processing: Biodiesel and fatty alcohol production. Computers and Chemical Engineering","van den Hark, S., Harrod, M. (2001). Fixed-Bed Hydrogenation at Supercritical Conditions To Form Fatty Alcohols: The Dramatic Effects Caused by Phase Transitions in the Reactor. Ind. Eng. Chem. Res., 40, 5052-5057","Sapunov, V. N., Stepacheva, А. А., Sulman, E. M., Sulman, M. G., Sidorov, A. I., Matveeva, V. G., Wärnå, J., Mäki-Arvela, P., Murzin, D. Y., & Stein, B. D. (2017). Stearic Acid Hydrodeoxygenation Over Pd Nanoparticles Embedded In Mesoporous Hypercrosslinked Polystyrene. Journal of Industrial and Engineering Chemistry, 46, P. 426-435.","Migunova, E. S., & Stepacheva, A. A. (2016). Hydrogenation of fatty acids using catalysts based on platinum group metals. Self-developing environment of a technical college: materials of the All-Russian Scientific and Practical Conference: at 3 part. 155-160. (in Russian)","Stepacheva, A. A., Migunova, E. S., Yudova, K. V., & Matveeva, V. G. (2016). Palladium catalysts based on super-cross-linked polystyrene in biofuel synthesis. Bulletin of Tver State University, 2, 151-156. (in Russian)"]}

Infusion pumps are often associated with poor usability and an increased likelihood of medication errors [1]. Critically ill patients in the intensive care unit (ICU) usually receive multiple infusions simultaneously, which increases the likelihood of pump-related errors. Furthermore, the ICU is frequently a hectic environment, compounding the likelihood of human error. Improving the usability of infusion pumps could help prevent injury or death in this vulnerable population. Where previous usability studies focused on individual pumps, this study focuses on the pump system as a whole, a situation more representative of the ICU.ObjectivesThe aim of this study is to develop and test a pump display that facilitates centralized monitoring and control of multiple infusion pumps to improve the safety and efficiency in the interaction with infusion technology.MethodA central pump display was developed according to the latest guidelines in user-centered design [2]. The usability of this display was compared to that of a conventional pump setup in a simulation study where 18 ICU nurses performed common pump-related tasks with either the central or conventional interface. Participants had a mean of 12 (±12) years of ICU work experience. Task execution times and key presses were recorded and logs were scanned for errors after the experiment. A usability questionnaire with a 5-point Likert scale was administered at the end of each experimental run to assess end-user satisfaction.ResultsOverall there was no difference in total task execution time between the central (M = 421 ± 107 seconds) and conventional system (M = 405 ± 119), p = 0.78. Fewer clicks were needed to execute the tasks with the centralized system compared to the conventional system (40 ± 3 and 73 ± 20 clicks respectively), p = 0.001. Fewer errors were made with the centralized system compared to the conventional system (0.9 ± 1 and 2.9 ± 2 errors respectively), p = 0.031. Questionnaire results indicated an overall preference towards the centralized system (4.6 ± 0.3 vs. 4.1 ± 0.5), p = 0.033.ConclusionsExpert users with significant experience using the conventional pump interface demonstrated a more efficient and safer performance using the central control display. The central control display had a better overall usability than the conventional pump control interface, despite participants never having used it before. The results of this study underline the importance of usability testing in the improvement of high-risk medical systems.References1. Husch M, Sullivan C, Rooney D, et al (2005) Insights from the sharp end of intravenous medication errors: implications for infusion pump technology. Qual Saf Health Care 14:80-6.2. Zhang J, Johnson TR, Patel VL, et al (2003) Using usability heuristics to evaluate patient safety of medical devices. J Biomed Inform 36:23-30.Grant acknowledgmentThis study was supported by a UMCG Healthy Ageing grant.

Infusion pumps are often associated with poor usability and an increased likelihood of medication errors [1]. Critically ill patients in the intensive care unit (ICU) usually receive multiple infusions simultaneously, which increases the likelihood of pump-related errors. Furthermore, the ICU is frequently a hectic environment, compounding the likelihood of human error. Improving the usability of infusion pumps could help prevent injury or death in this vulnerable population. Where previous usability studies focused on individual pumps, this study focuses on the pump system as a whole, a situation more representative of the ICU. Objectives The aim of this study is to develop and test a pump display that facilitates centralized monitoring and control of multiple infusion pumps to improve the safety and efficiency in the interaction with infusion technology. Method A central pump display was developed according to the latest guidelines in user-centered design [2]. The usability of this display was compared to that of a conventional pump setup in a simulation study where 18 ICU nurses performed common pump-related tasks with either the central or conventional interface. Participants had a mean of 12 (±12) years of ICU work experience. Task execution times and key presses were recorded and logs were scanned for errors after the experiment. A usability questionnaire with a 5-point Likert scale was administered at the end of each experimental run to assess end-user satisfaction. Results Overall there was no difference in total task execution time between the central (M = 421 ± 107 seconds) and conventional system (M = 405 ± 119), p = 0.78. Fewer clicks were needed to execute the tasks with the centralized system compared to the conventional system (40 ± 3 and 73 ± 20 clicks respectively), p = 0.001. Fewer errors were made with the centralized system compared to the conventional system (0.9 ± 1 and 2.9 ± 2 errors respectively), p = 0.031. Questionnaire results indicated an overall preference towards the centralized system (4.6 ± 0.3 vs. 4.1 ± 0.5), p = 0.033. Conclusions Expert users with significant experience using the conventional pump interface demonstrated a more efficient and safer performance using the central control display. The central control display had a better overall usability than the conventional pump control interface, despite participants never having used it before. The results of this study underline the importance of usability testing in the improvement of high-risk medical systems. References 1. Husch M, Sullivan C, Rooney D, et al (2005) Insights from the sharp end of intravenous medication errors: implications for infusion pump technology. Qual Saf Health Care 14:80-6. 2. Zhang J, Johnson TR, Patel VL, et al (2003) Using usability heuristics to evaluate patient safety of medical devices. J Biomed Inform 36:23-30. Grant acknowledgment This study was supported by a UMCG Healthy Ageing grant.

Presented here are preliminary results on the use of the cellulose-extruding bacteria Gluconoacetobacter xylinus as a sustainable tool for manufacturing carbon fibers. G. xylinus has the natural ability to extrude highly crystalline cellulose nanofibers with higher purity and superior mechanical properties compared to cellulose extracted from plants [1]. Traditionally, the movement of the bacteria within a cellulose culture is random and leads to a porous cellulose scaffold with no apparent order. Light induced dielectrophoresis (LiDEP), or the movement of electrically polarized cells in response to a non-uniform electric field created by incident light, will permit controllable cell movement. LiDEP will be utilized to selectively position G. xylinus at specified locations. A microfluidic chamber will be used to perfuse the trapped G. xylinus in a continuous flow of nutrient-rich media, allowing for the continuous extrusion of straight cellulose fibers (figure 1). These fibers are carbonized using an optimized pyrolysis protocol at 900 oC in a nitrogen atmosphere. This technology is important because it utilizes G. xylinus as the enabling tool for fiber extrusion and thus eliminates the need for expensive machinery and its’ associated processes [2-3]. Air, water, and soil pollution created by oil refineries and diminishing supplies of petroleum has sparked a push towards the development of sustainable approaches for manufacturing carbon fibers. Our end goal is to develop such an approach. To the authors best knowledge, no technique to pattern a single bacterial cellulose fiber exists. However, wet spinning and drawing processes have been used to align and assemble bacterial cellulose bundles into high performance macro fibers [3]. Cellulose has also been cultivated on an agarose film with honeycomb microgrooves to form a cellulose bundle with honeycombed architecture [4]. In this work, we present the initial characterization of the response of G. xylinus to electrical stimuli of varying frequencies as well as the heat treatment protocol developed for carbonizing bacterial cellulose. The dielectrophoretic response was characterized using AC signals from 1-20MHz frequencies at a constant voltage of 20 . The results indicate a positive DEP response across the spectrum of 7.5-20 MHz with the largest DEP force at a frequency of 20 MHz (figure 2). Frequencies above 20 MHz were not investigated because the voltage generator used in this experiment is limited to generating frequencies below 20 MHz. Additional work focused on the carbonization of bacterial cellulose nanofibers. Amorphous carbon was successfully obtained through heat treatment of bacterial cellulose in a nitrogen atmosphere to 900⁰C with 5 ⁰C/min heating ramp. A dwell time of 30 minutes at 300 ⁰C was included to enable the release of oxygen from the sample and prevent burning at higher temperatures. Such a step is also pertinent because the removal of the hydroxyl groups stabilizes the carbon polymer by producing conjugated double bonds, thus forming an aromatic structure [5]. An optimal heating rate was determined to be 5 ⁰C/min to achieve high carbon yield without making the process prohibitively long. Although we observed cellulose to carbonize at around 400 ⁰C, 900 ⁰C was used to ensure a high degree of carbonization [6]. Ongoing work is on developing the infrastructure to reliably position individual G. xylinus bacteria, as well as characterizing the fiber properties and dimensions depending on the suspending media and its flow rate over the cells. The goal is to understand how the conditions in the microfluidic chamber lead to the tailoring of the fiber properties and a maximized throughput. References “Recent advances in bacterial cellulose,” Y. Huang, C. Zhu, J. Yang, Y. Nie, C. Chen, D. Sun, Cellulose, 21, 1 (2014). “Manufacture and application of lignin-based carbon fibers (LCFs) and lignin-based carbon nanofibers (LCNFs),” W. Fang, S. Yang, X. L. Wang, T. Q. Yuan, R. C. Sun, Green Chemistry, 19, 1794 (2017). “Macrofibers with High Mechanical Performance Based on Aligned Bacterial Cellulose Nanofibers,” J. Yao, Chen, Y. Chen, B. Wang, Q. Pei, & H. Wang, ACS Applied Materials & Interfaces, (2017). “Honeycomb-like architecture produced by living bacteria, Gluconacetobacter xylinus,” Y. Uraki, J. Nemoto, H. Tamai, J. Sugiyama, T. Kishimoto, ... & M. Shimomura, Carbohydrate polymers, 69, 1 (2007). “Low temperature mechanism for the formation of polycyclic aromatic hydrocarbons from the pyrolysis of cellulose,” T. E. McGrath, W. G. Chan, & M. R. Hajaligol, Journal of Analytical and Applied Pyrolysis, 66, 1 (2003). “Changes in the thermophysical properties of microcrystalline cellulose as function of carbonization temperature, Y. R. Rhim, D. Zhang, M. Rooney, D. C. Nagle, D. H. Fairbrother, C. Herman, & D. G. Drewry, Carbon, 48, 1 (2010). Figure 1

Kongim, Bangon, Sutcharit, Chirasak, Tongkerd, Piyoros, Panha, Somsak (2013): Karyotypes Of The Snorkel Snail Genera Pterocyclos And Rhiostoma (Prosobranchia: Cyclophoridae). Raffles Bulletin of Zoology 61 (1): 13-20, DOI: http://doi.org/10.5281/zenodo.5351498, {"references":["Barsien , J., G. Ribi & D. Barsyte, 2000. Comparative karyological analysis of five species of Viviparus (Gastropoda: Prosobranchia). Journal of Molluscan Studies, 66: 259-271.","Blanford, W. T., 1902. On Rhiostoma daily, n. sp., and Sesara megalodon, n. sp., obtained of the late Mr. W. M. Daily in Siam. Proceedings of the Malacological Society of London, 5: 34-35.","Burch, J. B., 1967. Cytological relationship of Pacific gastropods. Venus, 25: 118-135.","Choundhury, R. C. & R. K. Pandit, 1997. Chromosome of prosobranch gastropods from Viviparidae, Pilidae and Cyclophoridae (Order Mesogastropoda). Caryologia, 50: 303-315.","Clark, M. S. & W. J. Wall, 1996. Chromosome: The Complex Code. Alden Press, Oxford. 345 pp.","Dillon, R. T., 1991. Karyotypic evolution in pleurocerid snails. II. Pleurocera, Goniobasis and Juga. Malacologia, 33: 339-344.","Griffiths, A. J. F., S. R. Wessler, R. C. Lewontin & S. B. Carroll, 2008. Introduction to Genetic Analysis. W. H. Freeman. 864 pp.","Halnan, C. R. E., 1989. Cytogenetics of Animal. CAB International. 519 pp.","Ieyama, H. & H. Ogaito, 1998. Chromosomes and nuclear DNA contents of two species in the Diplommatinidae. Venus, 57: 133-136.","Ieyama, H. & H. Ogaito, 2000. Chromosomes and nuclear DNA contents of some species in the Diplommatinidae. Venus, 59: 217-224.","Ieyama, H. & A. Tada, 1991. Chromosomal studies and the quantitative evaluation of nuclear images stained with Feulgen dye of the Dipplommatinidae. Venus, 50: 68-78.","Kasinathan, R. & R. Natarajan, 1975. Chromosome numbers of five species of Cyclophoridae (Prosobranchia: Mesogastropoda) from South India. Malacological Review, 8: 109-110.","King, M., 1993. Species Evolution: The Role of Chromosome Change. Cambridge University Press. 336 pp.","Kolnicki, R. L., 2000. Kinetochore reproduction in animal evolution: Cell biological explanation of karyotypic fission theory. Cell Biology, 97: 9493-9497.","Kongim, B., S. Panha & F. Naggs, 2006. Karyotype of land operculate snails of the genus Cyclophorus (Prosobranchia: Cyclophoridae) in Thailand. Invertebrate Reproduction and Development, 49: 1-8.","Kongim, B., C. Sutcharit, P. Tongkerd, S. H. A. Tan, N. X. Quynh, F. Naggs & S. Panha, 2010. Karyotype variation in the genus Pollicaria (Caenogastropoda: Pupinidae). Zoological Studies, 49: 125-131.","Kongim, B., C. Sutcharit, P. Tongkerd & S. Panha, 2009. Karyotype differentiation within the elephant pupinids snail, Pollicaria mouhoti (Pfeiffer, 1862) (Caenogastropoda: Pupinidae). The Natural History Journal of Chulalongkorn University, 9: 201-208.","Lee, Y. C., K. Y. Lue & W. L. Wu, 2008. 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INTRODUCCIÓN: El aumento progresivo de la prevalencia de la insuficiencia cardiaca (IC), principalmente en mayores de 75 años, unido al envejecimiento de la población, hacen que esta patología esté presente en un alto número de nuestros pacientes, lo que condiciona una serie de cuidados médicos y sociales y una atención tanto intra como extrahospitalaria. Esto pone de manifiesto la necesidad de una buena comunicación entre los distintos niveles asistenciales por los que va a circular el paciente, teniendo el informe de alta hospitalaria (IAH) como herramienta fundamental en esa transmisión de la información para garantizar un cuidados óptimo de los pacientes. Son varios los autores que han visto la necesidad de determinar cuáles son los pacientes con IC con alto riesgo de fallecimiento o reingreso tras una descompensación aguda, sobre los que intensificar los cuidados ambulatorios y hacer un seguimiento estrecho. Para ello se han propuesto escalas a partir de marcadores pronósticos conocidos, como el MUSIC Risk Score o las propuestas en los estudios EVEREST y OPTIMIZE-HF. Los reingresos hospitalarios por descompensaciones de patologías crónicas tienen su mayor incidencia durante los meses posteriores al alta hospitalaria, en el caso de la IC existe un 12-24% de reingreso a los 30 días. Varias son las causas que pueden motivar el reingreso: la hospitalización como expresión de los estadios finales de la enfermedad en algunos casos (que hace que los tratamientos se vuelvan ineficaces), un alivio incompleto de la sobrecarga de líquidos, una educación insuficiente del paciente tras el alta respecto a su enfermedad, la falta de implementación de tratamientos basados en la evidencia, y un plan de seguimiento tras el alta poco definido. Aunque algunos autores afirman que una explicación exhaustiva al alta, recogida en el IAH, con una monitorización ambulatoria del estado del paciente y un meticuloso seguimiento, reducen la frecuencia con la que los pacientes vuelven a urgencias o son rehospitalizados por una descompensación cardiaca, otros concluyen que los reingresos están determinados por la comorbilidad del paciente y la adecuación del tratamiento a las guías de práctica clínica. Numerosos estudios recogen datos acerca de la ausencia de información descrita en los IAH y de la recepción del informe por parte del médico de Atención Primaria (MAP). Un 10% de los IAH no llegan al MAP, un 20% no detalla el tratamiento al alta, un 14% no indica un pan de seguimiento, un 65% de los IAH no especifican las pruebas pendientes al alta. La pérdida de elementos importantes en el IAH relacionados con la IC, condiciona un impacto negativo en la transmisión de la información, y su consecuente repercusión sobre la morbilidad y el desarrollo posterior del proceso. Esta situación puede ser modificable mediante determinadas actuaciones dirigidas a sensibilizar y concienciar al personal sanitario del valor del informe de alta y de la importancia de su contenido. HIPÓTESIS DE TRABAJO: El IAH que se entrega a los pacientes con diagnóstico principal de ICC, adolece de la información necesaria e imprescindible desde el punto de vista diagnóstico, pronóstico y terapéutico, para proporcionar una continuidad de cuidados de calidad entre los distintos niveles asistenciales. Por lo tanto, se considera que los IAH son susceptibles de mejora. OBJETIVOS: Analizar si una intervención puntual sobre el personal sanitario involucrado en el cuidado de los pacientes con ICC es capaz de mejorar la calidad de la información recogida en el IAH. MÉTODOS: análisis retrospectivo de IAH con diagnóstico principal de IC correspondientes a los meses de enero a abril de 2007 del Hospital Clínico Universitario ¿Lozano Blesa¿ de Zaragoza, comunicación de los resultados en una sesión clínica con los facultativos de Medicina Interna de dicho hospital, y análisis prospectivo (tras la intervención) de los IAH con diagnóstico principal de IC correspondientes a los meses de octubre a diciembre de 2011. A partir de unos indicadores de calidad propuestos por la Joint Commission on Accreditation of Healthcare Organizations (JCAHO), la American Heart Association/American College of Cardiology y el Proyecto ACOVE, se ha elaborado un Conjunto Mínimo de Datos con la información considerada como imprescindible en un IAH. RESULTADOS: Análisis de la muestra previa a la intervención: la calidad de los IAH es baja, es decir, la información que se describe acerca de los datos considerados imprescindibles para un manejo adecuado de los pacientes con ICC es susceptible de mejorar. En este sentido, los datos más llamativos son los que hacen referencia al tratamiento: en un tercio de los IAH no se prescriben IECA o ARAII, los BB solo se prescriben en un tercio de los IAH, y solo en un 10% de los casos en los que no prescriben IECA/ARAII y BB hay explicación sobre esa decisión. En el caso de los IAH de pacientes con FA, más del 10% no reciben tratamiento anticoagulante y/o antiagregante, y solo en un 3% de estos se detalla la decisión de no hacerlo. Además, menos de la mitad de los IAH recogen la descripción de un ecocardiograma, y solo en un tercio se especifica la FEVI. La mayoría de los IAH no recogen la clasificación funcional de la NYHA. Teniendo en cuenta este hecho, en ninguna de los casos detallados en clases III y IV se prescribe el tratamiento correcto según las guías clínicas. Análisis posterior a la intervención: En conjunto, la sesión de intervención ha mejorado la calidad de los IAH, aumentando la cantidad de los datos recogidos considerados como imprescindibles (CMD). Pero a pesar de estas mejoras, hay datos cuya recogida sigue siendo deficitaria, como son la descripción de un ecocardiograma, la indicación de tratamiento con IECA/ARAII y BB y una justificación al hecho de no hacerlo, una explicación de la no anticoagulación/antiagregación en los casos de FA y la explicación de la monitorización del peso corporal. La intervención no ha conseguido mejorar el número de IAH que recogen la clase funcional, de forma que siguen siendo la mayoría los informes que no la especifican. De los casos en los que sí se detalla, para las clases funcionales III y IV tampoco hay tratamientos adecuados. 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Knowledge management (KM) is generally considered to be a positive process in an organisation, facilitating opportunities to achieve competitive advantage via better quality information handling, compilation of expert know-how and rapid response to fluctuations in the business environment. The KM paradigm as portrayed in the literature informs the processes that can increase intangible assets so that corporate knowledge is preserved. However, in some instances, knowledge management exists in a universe of dynamic tension among the conflicting needs to respect privacy and intellectual property (IP), to guard against data theft, to protect national security and to stay within the laws. While the Knowledge Management literature focuses on the bright side of the paradigm, there is also a different side in which knowledge is distorted, suppressed or misappropriated due to personal or organisational motives (the paradox). This paper describes the ethical paradoxes that occur within the taxonomy and deontology of knowledge management and suggests that recognising both the promises and pitfalls of KM requires wisdom., {"references":["Alter, S. (2006). Goals and Tactics on the Dark Side of Knowledge\nManagement. Proceedings of the 39th Hawaii International Conference\non Systems Sciences.","Argandona, A. (2003). The New Economy: Ethical Issues. Journal of\nBusiness Ethics, 44:3-22.","Baskerville, R. & Dulipovici, A. (2006). The Ethics of Knowledge\nTransfers and Conversions: Property or Privacy Rights? Proceedings of\nthe 39th Hawaii International Conference on System Sciences.","Blodgett, J.G., Lu, L-C., Rose, G.M. & Vitell, S.J. (2001). Ethical\nSensitivity to Stakeholder Interests: A Cross-Cultural Comparison.\nJournal of the Academy of Marketing Science, 29 (2): 190-202","Choi, S.Y., Kang, Y.S. & Lee, H. (2008). The effects of socio-technical\nenablers on knowledge sharing: an exploratory examination. 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Contents: K. Phalet, Foreword. Preface. J.W. Berry, J.S. Phinney, K. Kwak, D.L. Sam, Introduction: Goals and Research Framework for Studying Immigrant Youth. J.W. Berry, C. Westin, E. Virta, P. Vedder, R. Rooney, D. Sang, Design of the Study: Selecting Societies of Settlement and Immigrant Groups. P. Vedder, F.J.R. van de Vijver, Methodological Aspects: Studying Adolescents in 13 Countries. J.S. Phinney, J.W. Berry, P. Vedder, K. Liebkind, The Acculturation Experience: Attitudes, Identities, and Behaviors of Immigrant Youth. D.L. Sam, P. Vedder, C. Ward, G. Horenczyk, Psychological and Sociocultural Adaptation of Immigrant Youth. P. Vedder, F.J.R. van de Vijver, K. Liebkind, Predicting Immigrant Youth's Adaptation Across Countries and Ethnocultural Groups. J.S. Phinney, P. Vedder, Family Relationship Values of Adolescents and Parents: Intergenerational Discrepancies and Adaptation. P. Vedder, D.L. Sam, F.J.R. van de Vijver, J.S. Phinney, Vietnamese and Turkish Immigrant Youth: Acculturation and Adaptation in Two Ethnocultural Groups. J.S. Phinney, J.W. Berry, D.L. Sam, P. Vedder, Understanding Immigrant Youth: Conclusions and Implications. Appendices.

Preface. Obituary: Prof. Murray H. Brooker. Introductory Address. Potential for Use of Ionic Liquids in Czech Industry J. Kotlan. Potential to Apply Ionic Liquids in Industry: Exemplified for the Use as Solvents in Industrial Applications of Homogeneous Catalysis P. Wasserscheid. Ionic Liquids as Catalysts for Ethylbenzene Production M.P. Atkins, C. Bowlas, B. Ellis, F. Hubert, A. Rubatto, P. Wasserscheid. Applications of Ionic Liquids to Biphasic Catalysis H. Olivier-Bourbigou, F. Hugues. High-Temperature NMR Studies of Ionic-Liquid Catalysts O.B. Lapina, V.V. Terskikh, B.S. Bal'zhinimaev, K.M. Eriksen, R. Fehrmann. Ionic Liquids as Alternatives to Traditional Organic and Inorganic Solvents R. Pagni. The Pros and Cons of Using Ionic Liquids in the Pharmaceutical Industry R.M. Freer, A. Curzons. Room Temperature Ionic Liquids as Replacements for Traditional Organic Solvents and their Applications towards 'Green Chemistry' in Separation Processes A.E. Visser, R.P. Swatloski, W.M. Reichert, H.D. Willauer, J.G. Huddleston, R.D. Rogers. Application of Room-Temperature Ionic Liquids to the Chemical Processing of Biomass-Derived Feedstocks L. Moens, N. Khan. Room-Temperature Sulfur Chloride Ionic Liquids in Processes for the Isolation of Noble and Other Metals V.I. Pekhnyo, S.V. Volkov, N.G. Alexandrova. Ionic Liquids for Oil Shale Treatment M. Koel, K. Hollis, J. Rubin, T. Lombardo, B. Smith. Ionic Liquids in the Nuclear Industry: Solutions for the Nuclear Fuel Cycle W.R. Pitner, A.E. Bradley, D.W. Rooney, D. Sanders, K.R. Seddon, R.C. Thied, J.E. Hatter. Non-Invasive Spectroscopic On-Line Methods to Monitor Industrial Processes: A Review M.H. BrookerDAGGER, R.W. Berg. Ionic Liquids as Catalysts for Sulfuric Acid Production and Cleaning ofFlue Gases R. Fehrmann, K.M. Eriksen, S.B. Rasmussen. Modelling the Liquid Behaviour of Ionic Liquids E.A. Gontcharenko, P.F. Zil'berman, V.S. Znamenskii. The Challenges of Building a Molten Salt Database J. Fuller, M. Gaune-Escard. The Past, Present and Future of Ionic Liquids as Battery Electrolytes J. Wilkes. Radical-Ion Melts of Aluminium, Gallium and Sulfur Halides for Novel Power Sources S.V. Volkov, Z.A. Fokina, O.G. Yanko. Electrochemistry of Niobium, Tantalum and Titanium in Low-Temperature Carbamide-Halide Melts N. Tumanova, O. Boyko, N. Buryak, S. Kochetova. Electrochemistry of Niobium in Rubidium and Caesium Halide and Oxohalide Melts, and the Electrochemical Synthesis of Novel Niobium Compounds V.V. Grinevitch, A.V. Arakcheeva, S.A. Kuznetsov. Photochemistry in Ionic Liquids C.M. Gordon. Ionic Liquids Derived from Natural Products and Other Novel Chemistries: Synthesis and Chemistry of Ionic Liquids Composed of Functionalised Ions J.H. Davis, Jr. Ionic Liquids and Supercritical CO2 L.A. Blanchard, Z. Gu, J.F. Brennecke, E.J. Beckman. Acids and Bases in Ionic Liquids K.E. Johnson. Ionic Liquid Crystals as Universal Matrices (Solvents): Main Criteria for Ionic Mesogenicity T.A. Mirnaya, S.V. Volkov. Ionic Liquids as Solvents for Organic Synthesis A.R. Sethi, P. Smith, N. Srinivasan, T. Welton. East-West Collaboration within the NATO Science Programme: Opportunities and Project Management S. Boghosian. Alkane and Cycloalkane Transformations in Superelectrophilic Liquids I.S. Akhrem, A.V. Orlinkov, M.E. Vol'pin. The Dissolution of Kerogen in Ionic Liquids Y. Patell, K.R. Seddon, L. Dutta, A. Fleet. Electrochemical Synthesis of Volatile Metal Complexes, as Precursors for Functional

Inositol 1,4,5-trisphosphate (InsP3) functions as a second messenger to mobilize Ca2+ from intracellular reservoirs. The release mechanism displays all-or-none characteristics, that may account for other observations that the InsP3-induced mobilization of Ca2+ is quantal. Quantal release may depend on the sensitivity of the InsP3 receptor being regulated by the Ca2+ concentration in the lumen of the endoplasmic reticulum. We report here that the InsP3-sensitive store in hepatocytes discharges spontaneously when overloaded with Ca2+. The release, which is blocked by heparin, is preceded by an increasing sensitivity of the InsP3 receptor to endogenous InsP3, and is promoted by those sulphydryl reagents (oxidized glutathione and thimerosal) that induce Ca2+ oscillations in intact cells (ref. 8, and T. A. Rooney, D. C. Renard, E. J. Sass and A. P. Thomas, manuscript in preparation). This novel process could have a role in generating both Ca2+ oscillations and Ca2+ waves.

Infusion pumps are often associated with poor usability and an increased likelihood of medication errors [1]. Critically ill patients in the intensive care unit (ICU) usually receive multiple infusions simultaneously, which increases the likelihood of pump-related errors. Furthermore, the ICU is frequently a hectic environment, compounding the likelihood of human error. Improving the usability of infusion pumps could help prevent injury or death in this vulnerable population. Where previous usability studies focused on individual pumps, this study focuses on the pump system as a whole, a situation more representative of the ICU. Objectives The aim of this study is to develop and test a pump display that facilitates centralized monitoring and control of multiple infusion pumps to improve the safety and efficiency in the interaction with infusion technology. Method A central pump display was developed according to the latest guidelines in user-centered design [2]. The usability of this display was compared to that of a conventional pump setup in a simulation study where 18 ICU nurses performed common pump-related tasks with either the central or conventional interface. Participants had a mean of 12 (±12) years of ICU work experience. Task execution times and key presses were recorded and logs were scanned for errors after the experiment. A usability questionnaire with a 5-point Likert scale was administered at the end of each experimental run to assess end-user satisfaction. Results Overall there was no difference in total task execution time between the central (M = 421 ± 107 seconds) and conventional system (M = 405 ± 119), p = 0.78. Fewer clicks were needed to execute the tasks with the centralized system compared to the conventional system (40 ± 3 and 73 ± 20 clicks respectively), p = 0.001. Fewer errors were made with the centralized system compared to the conventional system (0.9 ± 1 and 2.9 ± 2 errors respectively), p = 0.031. Questionnaire results indicated an overall preference towards the centralized system (4.6 ± 0.3 vs. 4.1 ± 0.5), p = 0.033. Conclusions Expert users with significant experience using the conventional pump interface demonstrated a more efficient and safer performance using the central control display. The central control display had a better overall usability than the conventional pump control interface, despite participants never having used it before. The results of this study underline the importance of usability testing in the improvement of high-risk medical systems. References 1. Husch M, Sullivan C, Rooney D, et al (2005) Insights from the sharp end of intravenous medication errors: implications for infusion pump technology. Qual Saf Health Care 14:80-6. 2. Zhang J, Johnson TR, Patel VL, et al (2003) Using usability heuristics to evaluate patient safety of medical devices. J Biomed Inform 36:23-30. Grant acknowledgment This study was supported by a UMCG Healthy Ageing grant.