Introduction: Chest trauma has a high incidence and pneumothorax is the most frequent finding. The literature is scarce on what to do with asymptomatic patients with pneumothorax due to penetrating chest trauma. The aim of this study was to evaluate what are the findings of the control radiography of patients with penetrating chest trauma who are not initially taken to surgery, and their usefulness in determining the need for further treatment. Methods: A retrospective cohort study was performed, including patients older than 15 years who were admitted for penetrating chest trauma between January 2015 and December 2017 and who did not require initial surgical management. We analyzed the results of chest radiography, the time of its acquisition, and the behavior decided according to the findings in patients initially left under observation. Results: A total of 1,554 patients were included, whose average age was 30 years, 92.5% were male and 97% had a sharp weapon wound. Of these, 186 (51.5%) had no alterations in their initial X-ray, 142 had pneumothorax less than 30% and 33 had pneumothorax greater than 30 %, hemopneumothorax or hemothorax. Closed thoracostomy was required as the final procedure in 78 cases, sternotomy or thoracotomy in 2 cases and discharged in 281. Conclusion: In asymptomatic patients with small or moderate pneumothorax and no other significant lesions, longer observation times, radiographs and closed thoracostomy may be unnecessary.
The use of artificial intelligence (AI) in the detection and diagnosis of plant diseases has gained significant interest in modern agriculture. The appeal of AI arises from its ability to rapidly and precisely analyze extensive and complex information, allowing farmers and agricultural experts to quickly identify plant diseases. The use of artificial intelligence (AI) in the detection and diagnosis of plant diseases has gained significant attention in the world of agriculture and agronomy. By harnessing the power of AI to identify and diagnose plant diseases, it is expected that farmers and agricultural experts will have improved capabilities to tackle the challenges posed by these diseases. This will lead to increased effectiveness and efficiency, ultimately resulting in higher agricultural productivity and reduced losses caused by plant diseases. The use of artificial intelligence (AI) in the detection and diagnosis of plant diseases has resulted in significant benefits in the field of agriculture. By using AI technology, farmers and agricultural professionals can quickly and accurately identify illnesses affecting their crops. This allows for the prompt adoption of appropriate preventative and corrective actions, therefore reducing losses caused by plant diseases.
Diagnosis-related groups (DRGs) are gaining prominence in healthcare systems worldwide to standardize potential payments to hospitals. This study, conducted across public hospitals, investigates the impact of DRG implementation on human resource allocation and management practices. The research findings reveal significant changes in job roles and skill requirements based on a mixed-methods approach involving 70 healthcare professionals across various roles. 50% of respondents reported changes in daily responsibilities, and 42% noted the creation of new roles in their organizations. Significant challenges include inadequate training (46%), and coding complexity (38%). Factor analysis revealed a complex relationship between DRG familiarity, job satisfaction, and staff morale. The study also found a moderate negative correlation between the impact on morale and years of service in the current hospital, suggesting that longer-tenured staff may require additional support in adapting to DRG systems. This study addresses a knowledge gap in the human resource aspects of DRG implementation. It provides healthcare administrators and policymakers with evidence to inform strategies for effective DRG adoption and workforce management in public hospitals.
The starting point is the presence of a widespread feeling of political confrontation and division among Spanish citizens. This is compounded by dissatisfaction with and distrust in a system that is perceived by many as elitist and out of touch with real needs. Several factors related to this perception of politics are explained and quantified. On the one hand, there are economic elements, such as the stagnation of GDP per capita, the persistence of a relatively high at-risk-of-poverty rate, and the rates of material deprivation. And in all these elements, a significant territorial inequality can be observed. There are significant differences between Spain, France and Germany over the period considered. On the other hand, political factors determine much of the public debate in Spain: Historical memory and the Spanish Civil War, as well as the terrorism of ETA and other terrorist groups. The emergence of new parties is analyzed, especially VOX. Finally, the enormous difficulty of finding a territorial structure of political power that would bring together the consensus of most political forces. It is necessary to find formulas for fiscal federalism that will make it possible to move away from the current decentralization of spending without the Autonomous Communities having their own tax capacity. This study concludes by pointing out the relevance of all these problems and the need to find solutions through democratic debate and deliberation with agreements.
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