Background Transcatheter Aortic Valve Implantation(TAVI)has changed the treatment paradigm of the aortic stenosis(AS).It has become the treatment of choice in patients with symptomatic AS and surgical high risk,and a ...Background Transcatheter Aortic Valve Implantation(TAVI)has changed the treatment paradigm of the aortic stenosis(AS).It has become the treatment of choice in patients with symptomatic AS and surgical high risk,and a valid alternative to surgical aortic valve replacement in patients with low and medium surgical risk.Despite numerous evidence on clinical results,indications and benefits,only a few studies analyse it from patient's perspective and the impact of TAVI on them.The objective of this study is to evaluate the experience of patients undergoing TAVI.Methods Cross-sectional,descriptive observational study in two Spanish hospitals,with a establish Nurse TAVI program,with100 patients undergoing TAVI.A specific questionnaire was designed(VALVEX questionnaire)and a pilot study was conducted by a multidisciplinary team of doctors,nurses and patients.The questionnaire was given to patients at 30 days after TAVI procedure during the follow up at the TAVI nurse clinic.Results The study demonstrated a mean satisfaction of 9 for the TAVI program,with 96%of patients that would recommend TAVI to other patients.Patients scored a high satisfaction on the information received prior to the procedure.During the procedure and admission,the satisfaction was high in relation to the care received.During the follow up,satisfaction was high in relation to the role of the TAVI nurse,for the information and continuation of care during the procedure,in reducing anxiety,organising their admission and understanding the process.However,questions with less scores were related to hospital catering,delay between diagnosed and treatment,and patient decision-making process.Conclusion The evaluation of patient experience allows us to improve the information given to the patient during their TAVI process and it can also allow patients to be more relax,aware and prepared for the procedure.Continuous follow up enables monitoring of patient recovery and helps to discuss any doubts improving patient's satisfaction.The use of PREMs and PROMs associated to TAVI pathway combined with an active participation of the patient on the design of the questionnaire is essential for keeping the patient in the centre of the TAVI pathway.展开更多
Objective: To describe the radiological, histological and immunohistochemical findings in a case of Progressive Multifocal Leukoencephalopathy (PML) affecting the cerebellar peduncles in a patient with chronic lymphoc...Objective: To describe the radiological, histological and immunohistochemical findings in a case of Progressive Multifocal Leukoencephalopathy (PML) affecting the cerebellar peduncles in a patient with chronic lymphocytic leukemia. Patient and Methods: Magnetic Resonance Imaging (MRI), histological picture (H.E., Kluver-Barrera) and immunohistochemical picture (GFAP, neurofilaments, CD68, JC virus) were obtained. Results: 1) Magnetic resonance imaging: Asymmetric and progressive lesions on middle cerebellar peduncles, that were hyperintense in T2/FLAIR, extended towards the pons, had no mass effect and were unmodified after intravenous contrast. 2) Histology: Marked reactive gliosis with cytopathic changes suggesting viral infection, plus demyelination areas with axonal preservation. 3) Immunohistochemistry: Marked positivity for viral (polyoma and JC virus) markers in glial cells showing cytopathic changes. Conclusions: The importance of histological and immunohistochemical diagnosis in everyday assistance;of the collaboration between clinicians, radiologists and pathologists;and the validity of postmortem studies as a key element for research and clinical quality assessment must be stressed.展开更多
Industrial,commercial,and residential facilities are progressively adopting automation and generation capabilities.By having flexible demand and renewable energy generation,traditional passive customers are becoming a...Industrial,commercial,and residential facilities are progressively adopting automation and generation capabilities.By having flexible demand and renewable energy generation,traditional passive customers are becoming active participants in electric power system operations.Through profound coordination among grid operators and active customers,the facilities’capability for demand response(DR)and distributed energy resource(DER)management will be valuable asset for ancillary services(ASs).To comply with the increasing demand and flexible energy,utilities urgently require standards,regulations,and programs to efficiently handle load-side resources without trading off stability and reliability.This study reviews different types of customers’flexibilities for DR,highlighting their capabilities and limitations in performing local ancillary services(LASs),which should benefit the power grid by profiting from it through incentive mechanisms.Different financial incentives and techniques employed around the world are presented and discussed.The potential barriers in technical and regulatory aspects are successfully identified and potential solutions along with future guidance are discussed.展开更多
We present a low-cost and easy-to-implement technique to fabricate large-area WS_(2) photodetector devices onto transparent and flexible polycarbonate substrates.The method relies on the deposition of large-area(in th...We present a low-cost and easy-to-implement technique to fabricate large-area WS_(2) photodetector devices onto transparent and flexible polycarbonate substrates.The method relies on the deposition of large-area(in the cm scale)thin films(~30 nm thick)of WS_(2) by a recently introduced abrasion-induced method.Interdigitated electrical contacts are then deposited by thermal evaporation through a shadow mask.The photodetectors present well-balanced performances with an good trade-off between responsivity(up to 144 mA/W at a source-drain voltage of 10 V and illumination power of 1μW)and response time(down to~70µs)and a detectivity value of 10^(8) Jones.We found that the devices perform very reversibly upon several illumination and straining cycles and we found a moderate device-to-device variation.展开更多
基金funded by a IBYE23_0002 grant supported by Instituto de investigación biom-édica de Salamanca IBSAL,Castilla y León (Spain) and by a GRS 2860/A1/2023 by Gerencia Regional de Salud o f Castilla y León (Spain)。
文摘Background Transcatheter Aortic Valve Implantation(TAVI)has changed the treatment paradigm of the aortic stenosis(AS).It has become the treatment of choice in patients with symptomatic AS and surgical high risk,and a valid alternative to surgical aortic valve replacement in patients with low and medium surgical risk.Despite numerous evidence on clinical results,indications and benefits,only a few studies analyse it from patient's perspective and the impact of TAVI on them.The objective of this study is to evaluate the experience of patients undergoing TAVI.Methods Cross-sectional,descriptive observational study in two Spanish hospitals,with a establish Nurse TAVI program,with100 patients undergoing TAVI.A specific questionnaire was designed(VALVEX questionnaire)and a pilot study was conducted by a multidisciplinary team of doctors,nurses and patients.The questionnaire was given to patients at 30 days after TAVI procedure during the follow up at the TAVI nurse clinic.Results The study demonstrated a mean satisfaction of 9 for the TAVI program,with 96%of patients that would recommend TAVI to other patients.Patients scored a high satisfaction on the information received prior to the procedure.During the procedure and admission,the satisfaction was high in relation to the care received.During the follow up,satisfaction was high in relation to the role of the TAVI nurse,for the information and continuation of care during the procedure,in reducing anxiety,organising their admission and understanding the process.However,questions with less scores were related to hospital catering,delay between diagnosed and treatment,and patient decision-making process.Conclusion The evaluation of patient experience allows us to improve the information given to the patient during their TAVI process and it can also allow patients to be more relax,aware and prepared for the procedure.Continuous follow up enables monitoring of patient recovery and helps to discuss any doubts improving patient's satisfaction.The use of PREMs and PROMs associated to TAVI pathway combined with an active participation of the patient on the design of the questionnaire is essential for keeping the patient in the centre of the TAVI pathway.
文摘Objective: To describe the radiological, histological and immunohistochemical findings in a case of Progressive Multifocal Leukoencephalopathy (PML) affecting the cerebellar peduncles in a patient with chronic lymphocytic leukemia. Patient and Methods: Magnetic Resonance Imaging (MRI), histological picture (H.E., Kluver-Barrera) and immunohistochemical picture (GFAP, neurofilaments, CD68, JC virus) were obtained. Results: 1) Magnetic resonance imaging: Asymmetric and progressive lesions on middle cerebellar peduncles, that were hyperintense in T2/FLAIR, extended towards the pons, had no mass effect and were unmodified after intravenous contrast. 2) Histology: Marked reactive gliosis with cytopathic changes suggesting viral infection, plus demyelination areas with axonal preservation. 3) Immunohistochemistry: Marked positivity for viral (polyoma and JC virus) markers in glial cells showing cytopathic changes. Conclusions: The importance of histological and immunohistochemical diagnosis in everyday assistance;of the collaboration between clinicians, radiologists and pathologists;and the validity of postmortem studies as a key element for research and clinical quality assessment must be stressed.
基金supported by the US Department of Defense(DOD)’s Environmental Security Technology Certification Program(ESTCP)(No.W912HQ20C0022)the support from the National Institute of Science and Technology on Distributed Generation Power Systems(INCT-GD)+3 种基金Higher Level Personnel Training Coordination(CAPES-No.23038.000776/2017-54)Foundation for Research of the State of Rio Grande do Sul(FAPERGS-No.17/2551-0000517-1)Federal University of Santa Maria(UFSM),(CAPES/PROEX)—Financial code 001 and CNPqthe Brazilian National Council for Scientific and Technological Development,process 465640/2014-1 and process CNPq PQ 1-D 310761/2018-2。
文摘Industrial,commercial,and residential facilities are progressively adopting automation and generation capabilities.By having flexible demand and renewable energy generation,traditional passive customers are becoming active participants in electric power system operations.Through profound coordination among grid operators and active customers,the facilities’capability for demand response(DR)and distributed energy resource(DER)management will be valuable asset for ancillary services(ASs).To comply with the increasing demand and flexible energy,utilities urgently require standards,regulations,and programs to efficiently handle load-side resources without trading off stability and reliability.This study reviews different types of customers’flexibilities for DR,highlighting their capabilities and limitations in performing local ancillary services(LASs),which should benefit the power grid by profiting from it through incentive mechanisms.Different financial incentives and techniques employed around the world are presented and discussed.The potential barriers in technical and regulatory aspects are successfully identified and potential solutions along with future guidance are discussed.
基金the Ministry of Science and Innovation (Spain)through the project PID2020-115566RB-I00.A.C.-G.,A.M.A.-E.A.N.extend their sincere appreciation to the Distinguished Scientist Fellowship Program (DSFP)at King Saud University for funding of this work+4 种基金support from the Spanish Ministry of Economy,Industry,and Competitiveness (MINECO)through a Juan de la Cierva-formación fellowship 2017 FJCI-2017-32919.J.Q.support from the Agencia Estatal de Investigación of Spain (Grants PID2019-106820RB,RTI2018-097180-B-100,and PGC2018-097018-BI00)the Junta de Castilla y León (Grants SA256P18 and SA121P20),including funding by ERDF/FEDER.J.Q.support from Universidad Complutense de Madrid and European Commision (MSCA COFUND UNA4CAREER grant.Project number 4129252)from MICINN (Spain)through the program Juan de la Cierva-Incorporación.
文摘We present a low-cost and easy-to-implement technique to fabricate large-area WS_(2) photodetector devices onto transparent and flexible polycarbonate substrates.The method relies on the deposition of large-area(in the cm scale)thin films(~30 nm thick)of WS_(2) by a recently introduced abrasion-induced method.Interdigitated electrical contacts are then deposited by thermal evaporation through a shadow mask.The photodetectors present well-balanced performances with an good trade-off between responsivity(up to 144 mA/W at a source-drain voltage of 10 V and illumination power of 1μW)and response time(down to~70µs)and a detectivity value of 10^(8) Jones.We found that the devices perform very reversibly upon several illumination and straining cycles and we found a moderate device-to-device variation.
