PICC vs Catéter central insertado en vena subclavia en pacientes críticos

[Es]Introducción: actualmente, en servicios como UCIs, quirófanos y Urgencias cada vez es más común el empleo de CVCS y PICC. Ambos están asociados a graves complicaciones como CLABSI, TVP, EP, arritmia, etc. Dado que la enfermería juega un papel importante tanto en la inserción de estos dispositivos, como en el mantenimiento y prevención de las adversidades, es necesario poseer los conocimientos y habilidades adecuados para su afrontamiento. Objetivo y metodología: determinar cuál de los dos supone menor riesgo de complicaciones en pacientes críticos mediante la evidencia científica y utilizando la EBE. Para ello se ha realizado una revisión bibliográfica de estudios encontrados en bases de datos como Pubmed, Cochrane y Cinhal mediante la combinación de términos MeSH y palabras clave con operadores booleanos. Resultados y discusión: se han incluido en total 13 publicaciones (6 RS, 4 estudios de cohorte, 1 ECA y 2 GPC), de las cuales 3 poseen calidad alta, 3 media y 5 baja. Tanto los PICC como los CVCS implican diversas complicaciones, divididas en infecciosas, trombo-embolicas y mecánicas/otras. Existe insuficiente evidencia científica y gran heterogeneidad entre los artículos, lo que dificulta su extrapolación. Conclusiones: en pacientes críticos los PICC poseen mayor riesgo de TVP, los CVCS de complicaciones mecánicas, y ambos presentan tasas similares de CLABSI. Es importante escoger de forma individualizada el catéter a implantar, estimando los riesgos-beneficios de cada uno. Los cuidados preventivos son fundamentales en la reducción de estas contingencias. Son necesarios más estudios prospectivos comparativos.

"Orden de la Dirección" de la Prisión Central Provisional de Nanclares de la Oca, y "Proyecto de Reglamento" de la misma.

Fecha: 21-4/22-7-1938 (>1965/70 copia) / Unidad de instalación: Carpeta 45 - Expediente 2-22 / Nº de pág.: 35 (mecanografiadas)

Transformaciones económicas en el sector costero guipuzcoano central durante el siglo XVII

[ES]El presente artículo pretende analizar cómo se desarrolló en el sector costero central de Guipúzcoa (Orio, Zarauz y Guetaria) la llamada «crisis del XVII» y qué mecanismos arbitraron sus habitantes para sobreponerse a las dificultades. En realidad, se trata de analizar y descubrir qué mecanismos utilizaron para llevar a cabo la reconversión y transformación de sus actividades. En el mencionado ámbito tres fueron las principales actividades económicas relacionadas con el mar: el comercio, la construcción naval y la pesca. Las tres actividades tuvieron que llevar a cabo una serie de reestructuraciones y amoldarse continuamente a lo cambiante de la realidad económica de la época a fin de perdurar y sobrevivir.

Parametric Study of the Device Angle Dependency of a Single Vortex Generator on a Flat Plate

Ponencia presentada en el 10th World Congress on Computational Mechanics (WCCM 2012), Sao Paulo (Brazil).Publicados los abstracts en documento con ISBN: 978-85-86686-69-6.

Role of G protein coupled inwardly rectifier K+ channels (GIRK) on the neurobiology depression

353 págs.

The cross layer RMPA handover: a reliable mobility pattern aware handover strategy for broadband wireless communication in a high-speed railway domain

Enhancing the handover process in broadband wireless communication deployment has traditionally motivated many research initiatives. In a high-speed railway domain, the challenge is even greater. Owing to the long distances covered, the mobile node gets involved in a compulsory sequence of handover processes. Consequently, poor performance during the execution of these handover processes significantly degrades the global end-to-end performance. This article proposes a new handover strategy for the railway domain: the RMPA handover, a Reliable Mobility Pattern Aware IEEE 802.16 handover strategy "customized" for a high-speed mobility scenario. The stringent high mobility feature is balanced with three other positive features in a high-speed context: mobility pattern awareness, different sources for location discovery techniques, and a previously known traffic data profile. To the best of the authors' knowledge, there is no IEEE 802.16 handover scheme that simultaneously covers the optimization of the handover process itself and the efficient timing of the handover process. Our strategy covers both areas of research while providing a cost-effective and standards-based solution. To schedule the handover process efficiently, the RMPA strategy makes use of a context aware handover policy; that is, a handover policy based on the mobile node mobility pattern, the time required to perform the handover, the neighboring network conditions, the data traffic profile, the received power signal, and current location and speed information of the train. Our proposal merges all these variables in a cross layer interaction in the handover policy engine. It also enhances the handover process itself by establishing the values for the set of handover configuration parameters and mechanisms of the handover process. RMPA is a cost-effective strategy because compatibility with standards-based equipment is guaranteed. The major contributions of the RMPA handover are in areas that have been left open to the handover designer's discretion. Our simulation analysis validates the RMPA handover decision rules and design choices. Our results supporting a high-demand video application in the uplink stream show a significant improvement in the end-to-end quality of service parameters, including end-to-end delay (22%) and jitter (80%), when compared with a policy based on signal-to-noise-ratio information.

Design and synthesis of quasi-diastereomeric molecules with unchanging central, regenerating axial and switchable helical chirality via cleavage and formation of Ni(II)–O and Ni(II)–N coordination bonds

9 p.

A novel form of human disease with a protease-sensitive prion protein and heterozygosity methionine/valine at codon 129: Case report

Background: Sporadic Creutzfeldt-Jakob disease (sCJD) is a rare neurodegenerative disorder in humans included in the group of Transmissible Spongiform Encephalopathies or prion diseases. The vast majority of sCJD cases are molecularly classified according to the abnormal prion protein (PrPSc) conformations along with polymorphism of codon 129 of the PRNP gene. Recently, a novel human disease, termed "protease-sensitive prionopathy", has been described. This disease shows a distinct clinical and neuropathological phenotype and it is associated to an abnormal prion protein more sensitive to protease digestion. Case presentation: We report the case of a 75-year-old-man who developed a clinical course and presented pathologic lesions compatible with sporadic Creutzfeldt-Jakob disease, and biochemical findings reminiscent of "protease-sensitive prionopathy". Neuropathological examinations revealed spongiform change mainly affecting the cerebral cortex, putamen/globus pallidus and thalamus, accompanied by mild astrocytosis and microgliosis, with slight involvement of the cerebellum. Confluent vacuoles were absent. Diffuse synaptic PrP deposits in these regions were largely removed following proteinase treatment. PrP deposition, as revealed with 3F4 and 1E4 antibodies, was markedly sensitive to pre-treatment with proteinase K. Molecular analysis of PrPSc showed an abnormal prion protein more sensitive to proteinase K digestion, with a five-band pattern of 28, 24, 21, 19, and 16 kDa, and three aglycosylated isoforms of 19, 16 and 6 kDa. This PrPSc was estimated to be 80% susceptible to digestion while the pathogenic prion protein associated with classical forms of sporadic Creutzfeldt-Jakob disease were only 2% (type VV2) and 23% (type MM1) susceptible. No mutations in the PRNP gene were found and genotype for codon 129 was heterozygous methionine/valine. Conclusions: A novel form of human disease with abnormal prion protein sensitive to protease and MV at codon 129 was described. Although clinical signs were compatible with sporadic Creutzfeldt-Jakob disease, the molecular subtype with the abnormal prion protein isoforms showing enhanced protease sensitivity was reminiscent of the "protease-sensitive prionopathy". It remains to be established whether the differences found between the latter and this case are due to the polymorphism at codon 129. Different degrees of proteinase K susceptibility were easily determined with the chemical polymer detection system which could help to detect proteinase-susceptible pathologic prion protein in diseases other than the classical ones.

Skeleton based visual pattern recognition. Applications to tabletop interaction

211 p. :il.

Android App para Multilingual Central Repository

El objetivo del proyecto es crear una aplicación Android usando la base de conocimiento multilingüe Multilingual Central Repository 3.0 (MCR 3.0).

Competing Ecosystem services: an Assessment of Carbon and timber in the Tropical forests of Central America

4 p.

Competing Ecosystem Services: an Assessment of Carbon and Timber in the Tropical Forests of Central America

29 p.

Recursos de combustible en central nuclear de fusión en el País Vasco

[ES]Este trabajo surge de la inquietud del alumno sobre la energía nuclear y mas concretamente sobre la energía de fusión. Esta inquietud se plasma en una recopilación de información sobre los combustibles necesarios , su abundancia y su forma de obtención actual. Analizaremos la posibilidad de implantar alguna de estas plantas de combustible en el País Vasco, junto con un estudio de una posible central nuclear de fusión con la suma de la potencia de cada uno de los reactores de fisión que se encuentran actualmente en funcionamiento en el estado Español. Compararemos las cantidades de combustible necesarias en un año de uranio y el combustible de fusión, así como el coste de construcción de cada una.

Competitive issue of money & abolition of central banks

The aim of this work is to analyze the main characteristics of the current financial system and to investigate the arising of critical voices with respect this system. In particular, we analyze some historical facts that have been important in the creation of this financial order. We analyze the new digital currency, known as Bitcoin, as the basic ingredient in the formation of a new alternative and decentralized international financial system. In 10 years Bitcoin has expanded its influence to many economic activities. We also analyzed briefly the classic liberal theory that criticizes the intervention of governments in the markets. Finally, we consider relevant the arising of a group of countries (BRICS) that may challenge the current system where the position of USA is privileged.

Estudio de viabilidad de la central hidroeléctrica de Plazakola

[ES]El objeto del presente estudio de viabilidad es estudiar la eficiencia y productividad de la Central Hidroeléctrica de Plazakola aportando diversas alternativas posibles que puedan ser técnica y económicamente viables. Para cada una de las soluciones propuestas se analizará la producción de energía así como el presupuesto estimado de las obras y equipos necesarios, comparándose entre ellas y determinando la solución óptima, que será desarrollada en el anteproyecto.