ABSTRACT
The integration of monitoring technologies in the last decades has been a key factor in the development of new ways to track air pollutants and supplementing the network of traditional monitoring systems. In this regard, the appearance of affordable and accurate sensor devices to monitor air quality has made possible to obtain relevant data about the state of the air, and moreover, eminent institutions are interested in promoting the use of novel and more affordable tools for air pollution, such as the United States Environmental Protection Agency and European institutions, within a new approach to environmental surveillance, known as Next Generation Compliance and Enforcement technologies. On other hand, in order to get more reliable measurements, the use of machine learning to support adjustment or calibration process has been used in some studies to improve the performance of monitoring devices. On this paper, led by a group of specialists of the Chilean Superintendence of Environment (henceforth, SMA from its Spanish initials), a first approach case study related to the convenience of the usage of low-cost devices in environmental enforcement will be presented. The study was made in the Metropolitan Region of Santiago and considers the spatial distribution of different particulate matter sensors in the region. Some aspects regarding communication and technical issues are presented as well as the main findings about their performance. Results illustrate that low-cost sensors, aided by machine learning algorithms, could provide a reliable enough general screening of particulate matter within a large city, constituting a valuable decision-making tool for environmental oversight, as well as a powerful preventive and deterrent approach for compliance.
Subject(s)
Air Pollutants/analysis , Air Pollution/analysis , Environmental Monitoring/methods , Particulate Matter/analysis , Algorithms , Chile , Cities , Decision Making , Machine Learning , United States , United States Environmental Protection AgencyABSTRACT
INTRODUCCIÓN: Una de las vías de acceso a la cavidad abdominal es la laparotomía media, siendo uno de los riesgos más temidos las complicaciones postoperatorias, las cuales pueden disminuirse con difusión de una adecuada técnica quirúrgica. OBJETIVO: Generar un consenso de expertos con pasos clave para realizar una laparotomía media supra-infraumbilical, a través de la metodología Delphi. MATERIALES Y MÉTODO: Por medio de una revisión de la literatura se extrajo el detalle de 37 pasos considerados en el procedimiento, organizado en secciones de preparación, apertura y cierre, siendo evaluados por un grupo de cirujanos de 7 hospitales docentes de Chile, mediante una encuesta online. RESULTADOS: El consenso se alcanzó en dos rondas, con 28 de los 37 pasos extraídos de la literatura, considerados importantes o muy importantes para la enseñanza de la técnica. Discusión: De los 28 pasos identificados como importantes, existe un alto grado de acuerdo para la preparación y apertura de una laparotomía, a diferencia del cierre en el cual no se observa una preferencia clara entre el cierre en una o varias capas entre el peritoneo y la fascia, debiendo analizarse en cada caso específico. CONCLUSIÓN: La identificación de 28 pasos estandarizados constituye un aporte en los programas de formación de residentes y en el desarrollo de modelos de simulación adecuados para la replicación del procedimiento. El aprendizaje correcto de la técnica basado en evidencia es fundamental para disminuir el riesgo de complicaciones asociadas, especialmente en el postoperatorio.
INTRODUCTION: Traditionally, the main surgical technique to access the abdominal cavity has been midline incision laparotomy, being postoperative complications a main concern. Proper teaching-learning methods could help improving the success of this procedure. AIM: Establish an expert's consensus throughout the Delphi Methodology regarding the main steps that need to be considered in a midline laparotomy. MATERIALS AND METHOD: Literature review was conducted, 37 steps were identified and grouped in 3 sections; preparation of the skin, opening incision, and closure. These steps were evaluated online by surgeons of 7 teaching hospitals in Chile. RESULTS: Consensus was reached in two rounds, 28 of the 37 steps were identified as important or very important for the procedure. DISCUSSION: There is a high level of agreement in steps related to preparation of the skin and opening incision. However, there is not a consensus regarding closure of the peritoneum and fascia in one or more layers, being a case to case decision. CONCLUSIONS: Establishment of 28 standardized steps constitutes a contribution to resident teaching programs and the development of simulation materials as an active learning strategy. Satisfactory learning outcomes have a direct impact in the success of the procedure and a lower rate of complications.
