Efectividad de morfina intratecal versus endovenosa / histerectomía vaginal en el Hospital Occidente de Kennedy

Introducción: la histerectomía vaginal es una cirugía frecuente, esta investigación comparo dos vías de suministro de opiáceos: intratecal y endovenosa en un estudio realizado en el Hospital Occidente de Kennedy. Método: Estudio prospectivo observacional comparando dolor utilizando la escala de dolor numérica verbal y determinando los requerimientos de morfina de rescate y o Aines, describiendo la presencia de efectos secundarios del uso de opiáceos en dos grupos. Resultados: Participaron 48 mujeres entre 40 y 65 años con ASA I y II. Manejadas con morfina intratecal fueron 28 y 20 con morfina intravenosa, la dosis intratecal fueron de 80 microgramos y las intravenosas de entre 3 y 5 mg en bolo. El dolor se evaluó a las 6, 12 y 24 horas del procedimiento quirúrgico. A las 6, 12 y 24 horas se encontró diferencia significativa p< 0.0001). Se presentaron 28% que usaron el rescate con intratecal, 100% de los casos con morfina endovenosa lo requirió. El uso de AINES se encontró que solo el 3,6% de los casos manejado con morfina intratecal requirieron uso de AINES en cambio las manejadas con endovenosa fue 80%. El tiempo trascurrido entre la dosis de opiáceos y el requerimiento de morfina tuvo una diferencia que fue significativa (p=0,000008). Las nauseas en 14% y el vomito en 7,1% de los manejados con opiáceos intratecales en cambio con endovenosos tuvieron 70% y 35% respectivamente. Se encontró diferencia significativa en estas dos variables pero no en el prurito, a pesar que se encontró más frecuente en los casos manejados con intratecal. Conclusión: pacientes con morfina intratecal tiene más efecto prolongado de analgesia y es probable que necesiten menos dosis de rescate, con igual nausea, vomito y mas prurito.

Buenas prácticas de gestión nutricional apoyadas en la logística hospitalaria

Todos y cada uno de los temas abordados y estudiados en el caso del Hospital Universitario Mayor Méderi, son la clara evidencia de como la logística hospitalaria es una herramienta importante dentro de las entidades hospitalarias, pues como puede verse la optimización de los procesos y recursos disponibles, y la integración de las diferentes áreas que intervienen en el desarrollo de los procesos, se da gracias a la aplicación de esta herramienta de gestión, que entiende la organización como un sistema complejo en el cual todas y cada una de las interacciones son vitales y deben ser atendidas con la misma importancia, por la alta dirección. Es entonces cuando la logística hospitalaria se convierte en un arma importante para los profesionales de la salud pues es el puente entre la importancia de unas buenas prácticas médicas y una buena gestión administrativa, que al final se convierten en ventajas competitivas para las instituciones que compiten en un sector que se debate entre la humanidad de su accionar y la rentabilidad obtenida por su funcionamiento.

Transmission properties of Iranian wheat stripe virus

Transmission properties of Iranian wheat stripe virus (IWSV), a tentative member of the genus Tenuivirus, were studied. Results showed that similar to other tenuiviruses, IWSV multiplies in its vector, Unkanodes tanasijevici. In bioassay experiments, IWSV transmission rate by individual U. tanasijevici showed an increase with time after acquisition. IWSV was transovarially transmitted to 88-100% of progeny. The nymphs continued to be infective in the adult stage but with decreased efficiency. Males and females transmitted the virus with equal efficiency. Transmission properties of IWSV confirm the position of the virus in the genus Tenuivirus.

Transmission properties of Iranian wheat stripe virus

Transmission properties of Iranian wheat stripe virus (IWSV), a tentative member of the genus Tenuivirus, were studied. Results showed that similar to other tenuiviruses, IWSV multiplies in its vector, Unkanodes tanasijevici. In bioassay experiments, IWSV transmission rate by individual U. tanasijevici showed an increase with time after acquisition. IWSV was transovarially transmitted to 88-100% of progeny. The nymphs continued to be infective in the adult stage but with decreased efficiency. Males and females transmitted the virus with equal efficiency. Transmission properties of IWSV confirm the position of the virus in the genus Tenuivirus.

Isolation, fractionation and characterisation of proteins from Mucuna bean

The chemical composition and fractional distribution of protein isolates prepared from species of Mucuna bean were studied. Using six different extraction media, the yield of protein based on the Kjeldahl procedure varied from 8% to 34%, and the protein content varied from 75% to 95%. When the yields were high, the colour of the isolates generally tended to be dark and unsatisfactory. Hence, the use of chemical treatments and high pressure processing were explored. The solubility maxima for the protein isolates in water were found to occur at pH values of 2.0 and 11.0, while the pH corresponding to minimum solubility (i.e. isoelectric region) occurred at pH values of 4.0 and 5.0. The total essential amino acid in the isolates ranged from 495 to 557 mg g(-1) protein, which compares favourably with the recommended level for pre-school and school children. Methionine and cysteine were the limiting amino acids. A key nutritional attribute of the protein isolates was its high lysine content. The isolate can therefore complement cereal-based foods which are deficient in lysine. The proteins mainly consisted of albumins, glutelins and globulins. Prolamins were only present in trace concentration (< 0.3%). Gel filtration chromatograms of the isolates indicated the presence of major protein fractions with molecular weights of 40 and 15 kDa, while gel electrophoresis (SDS-PAGE) indicated a major broad zone with molecular weights of 36 +/- 7 and 17.3 +/- 13 kDa. (c) 2006 Elsevier Ltd. All rights reserved.

Comparison of extrasystolic ECG signal classifiers using discrete wavelet transforms

This work compares and contrasts results of classifying time-domain ECG signals with pathological conditions taken from the MITBIH arrhythmia database. Linear discriminant analysis and a multi-layer perceptron were used as classifiers. The neural network was trained by two different methods, namely back-propagation and a genetic algorithm. Converting the time-domain signal into the wavelet domain reduced the dimensionality of the problem at least 10-fold. This was achieved using wavelets from the db6 family as well as using adaptive wavelets generated using two different strategies. The wavelet transforms used in this study were limited to two decomposition levels. A neural network with evolved weights proved to be the best classifier with a maximum of 99.6% accuracy when optimised wavelet-transform ECG data wits presented to its input and 95.9% accuracy when the signals presented to its input were decomposed using db6 wavelets. The linear discriminant analysis achieved a maximum classification accuracy of 95.7% when presented with optimised and 95.5% with db6 wavelet coefficients. It is shown that the much simpler signal representation of a few wavelet coefficients obtained through an optimised discrete wavelet transform facilitates the classification of non-stationary time-variant signals task considerably. In addition, the results indicate that wavelet optimisation may improve the classification ability of a neural network. (c) 2005 Elsevier B.V. All rights reserved.

Oligosaccharides of pitaya (dragon fruit) flesh and their prebiotic properties

The major carbohydrates of white and red-flesh pitayas (dragon fruit) were glucose, fructose and some oligosaccharides (total concentrations of 86.2 and 89.6 g/kg, respectively). The molecular weight distribution of the extract was affected by the extraction solvent. The maximum oligosaccharides content (27.40%), which included fractions with molecular weights of 273–275, 448–500 and 787–911 Da, were obtained using 80% ethanol extraction at room temperature (28 ± 2 °C). The low molecular weight fraction, including glucose and fructose, was successfully removed by yeast cultivation. The molecular weights of mixed oligosaccharides (716, 700, 490 and 474 Da) were confirmed by mass spectrometry. The mixed oligosaccharides showed that they were resistant to hydrolysis by artificial human gastric juice and human α-amylase, giving maximum hydrolysis of 4.04% and 34.88%, respectively. The mixed oligosaccharides were also found capable of stimulating the growth of lactobacilli and bifidobacteria.

The financial and environmental performance of firms exposed to the EU Emissions Trading Scheme

This thesis is an empirical-based study of the European Union’s Emissions Trading Scheme (EU ETS) and its implications in terms of corporate environmental and financial performance. The novelty of this study includes the extended scope of the data coverage, as most previous studies have examined only the power sector. The use of verified emissions data of ETS-regulated firms as the environmental compliance measure and as the potential differentiating criteria that concern the valuation of EU ETS-exposed firms in the stock market is also an original aspect of this study. The study begins in Chapter 2 by introducing the background information on the emission trading system (ETS), which focuses on (i) the adoption of ETS as an environmental management instrument and (ii) the adoption of ETS by the European Union as one of its central climate policies. Chapter 3 surveys four databases that provide carbon emissions data in order to determine the most suitable source of the data to be used in the later empirical chapters. The first empirical chapter, which is also Chapter 4 of this thesis, investigates the determinants of the emissions compliance performance of the EU ETS-exposed firms through constructing the best possible performance ratio from verified emissions data and self-configuring models for a panel regression analysis. Chapter 5 examines the impacts on the EU ETS-exposed firms in terms of their equity valuation with customised portfolios and multi-factor market models. The research design takes into account the emissions allowance (EUA) price as an additional factor, as it has the most direct association with the EU ETS to control for the exposure. The final empirical Chapter 6 takes the investigation one step further, by specifically testing the degree of ETS exposure facing different sectors with sector-based portfolios and an extended multi-factor market model. The findings from the emissions performance ratio analysis show that the business model of firms significantly influences emissions compliance, as the capital intensity has a positive association with the increasing emissions-to-emissions cap ratio. Furthermore, different sectors show different degrees of sensitivity towards the determining factors. The production factor influences the performance ratio of the Utilities sector, but not the Energy or Materials sectors. The results show that the capital intensity has a more profound influence on the utilities sector than on the materials sector. With regard to the financial performance impact, ETS-exposed firms as aggregate portfolios experienced a substantial underperformance during the 2001–2004 period, but not in the operating period of 2005–2011. The results of the sector-based portfolios show again the differentiating effect of the EU ETS on sectors, as one sector is priced indifferently against its benchmark, three sectors see a constant underperformance, and three sectors have altered outcomes.

A Variance-Minimizing Filter for Large-Scale Applications

A truly variance-minimizing filter is introduced and its per for mance is demonstrated with the Korteweg– DeV ries (KdV) equation and with a multilayer quasigeostrophic model of the ocean area around South Africa. It is recalled that Kalman-like filters are not variance minimizing for nonlinear model dynamics and that four - dimensional variational data assimilation (4DV AR)-like methods relying on per fect model dynamics have dif- ficulty with providing error estimates. The new method does not have these drawbacks. In fact, it combines advantages from both methods in that it does provide error estimates while automatically having balanced states after analysis, without extra computations. It is based on ensemble or Monte Carlo integrations to simulate the probability density of the model evolution. When obser vations are available, the so-called importance resampling algorithm is applied. From Bayes’ s theorem it follows that each ensemble member receives a new weight dependent on its ‘ ‘distance’ ’ t o the obser vations. Because the weights are strongly var ying, a resampling of the ensemble is necessar y. This resampling is done such that members with high weights are duplicated according to their weights, while low-weight members are largely ignored. In passing, it is noted that data assimilation is not an inverse problem by nature, although it can be for mulated that way . Also, it is shown that the posterior variance can be larger than the prior if the usual Gaussian framework is set aside. However , i n the examples presented here, the entropy of the probability densities is decreasing. The application to the ocean area around South Africa, gover ned by strongly nonlinear dynamics, shows that the method is working satisfactorily . The strong and weak points of the method are discussed and possible improvements are proposed.

Self-concept clarity and compulsive Internet use: the role of preference for virtual interactions and employment status in British and North-American samples

Background and Aims Compulsive Internet Use (CIU) describes a maladaptive relationship with the Internet characterised by loss of control and conflict. Although also affecting adults, most studies use teenage samples, and theoretical development on risk factors is scarce. According to Davis (2001), the social connectivity function of the Internet is key in identifying traits associated with CIU. Since Self-Concept Clarity (SCC) is strongly related to social anxiety, and virtual interactions allow “self-edition”, we hypothesized that individuals low in SCC could choose virtual interactions as safer alternative to satisfy their social needs. This could in turn increase the risk of CIU. Building on a previous study, we also expected CIU to be more harmful in the unemployed. Methods We collected samples from the UK (N = 532) and US (N = 502) with equal distribution of employed and unemployed individuals. We ran Measurement Invariance tests to confirm that the constructs were equivalent across countries. Subsequently, we conducted mediation and moderation analysis to test our hypothesis with Multigroup Confirmatory Factor Analysis. Results Measurement Invariance was confirmed. The relationship between SCC and CIU was partially mediated by preference of virtual interactions in both countries. This preference was significantly related to lower social support. Short term unemployment seemed to accentuate the negative impact of CIU on life satisfaction in both countries, although only marginally significantly in the US. The unemployed reported significantly lower levels of life satisfaction. Conclusion We demonstrated that SCC is a key vulnerability factor to CIU in adults, and confirmed the additional risks for the unemployed.

Phylogenetic relationships of the Neotropical spider genus Itatiaya (Araneae)

A cladistic analysis using parsimony under equal weights is applied to test the phylogenetic relationships of Itatiaya Mello-Leitao, previously described in Ctenidae. The data matrix comprised 25 taxa scored for a total of 47 characters. The cladistic analysis yielded two equally parsimonious trees of 124 steps. The consensus of the two most parsimonious trees is used to discuss the phylogenetic relationships and justify taxonomic modifications. The results indicate that this genus is a representative of Zoropsidae, which is newly recorded from the Neotropical region. The monophyly of Itatiaya is supported by three non-ambiguous synapomorphies and three homoplastic synapomorphies. A new diagnosis is provided for Itatiaya. Itatiaya pucupucu is placed as sister species to the remaining species of the genus. A polytomic clade composed of Itatiaya modesta, Itatiaya iuba, Itatiaya apipema and the clade formed by Itatiaya tacamby + Itatiaya pykyyra is supported by the presence of modified cylindrical gland spigots. Additionally, the male of I. pykyyra Polotow & Brescovit is described for the first time.

Dipeptidyl peptidase IV inhibition downregulates Na(+)-H(+) exchanger NHE3 in rat renal proximal tubule

In the microvillar microdomain of the kidney brush border, sodium hydrogen exchanger type 3 (NHE3) exists in physical complexes with the serine protease dipeptidyl peptidase IV (DPPIV). The purpose of this study was to explore the functional relationship between NHE3 and DPPIV in the intact proximal tubule in vivo. To this end, male Wistar rats were treated with an injection of the reversible DPPIV inhibitor Lys [Z(NO(2))]-pyrrolidide (I40; 60 mg center dot kg(-1)center dot day(-1) ip) for 7 days. Rats injected with equal amounts of the noninhibitory compound Lys[ Z(NO(2))]-OH served as controls. Na(+) -H(+) exchange activity in isolated microvillar membrane vesicles was 45 +/- 5% decreased in rats treated with I40. Membrane fractionation studies using isopycnic centrifugation revealed that I40 provoked redistribution of NHE3 along with a small fraction of DPPIV from the apical enriched microvillar membranes to the intermicrovillar microdomain of the brush border. I40 significantly increased urine output ( 67 +/- 9%; P < 0.01), fractional sodium excretion ( 63 +/- 7%; P < 0.01), as well as lithium clearance ( 81 +/- 9%; P < 0.01), an index of end-proximal tubule delivery. Although not significant, a tendency toward decreased blood pressure and plasma pH/HCO(3)(-) was noted in I40-treated rats. These findings indicate that inhibition of DPPIV catalytic activity is associated with inhibition of NHE3-mediated NaHCO(3) reabsorption in rat renal proximal tubule. Inhibition of apical Na(+) -H(+) exchange is due to reduced abundance of NHE3 protein in the microvillar microdomain of the kidney brush border. Moreover, this study demonstrates a physiologically significant interaction between NHE3 and DPPIV in the intact proximal tubule in vivo.

Influence of surface texture on the galling characteristics of lean duplex and austenitic stainless steels

Two simulative test methods were used to study galling in sheet forming of two types of stainlesssteel sheet: austenitic (EN 1.4301) and lean duplex LDX 2101 (EN 1.4162) in different surface conditions. Thepin-on-disc test was used to analyse the galling resistance of different combinations of sheet materials and lubricants. The strip reduction test, a severe sheet forming tribology test was used to simulate the conditionsduring ironing. This investigation shows that the risk of galling is highly dependent on the surface texture of theduplex steel. Trials were also performed in an industrial tool used for high volume production of pumpcomponents, to compare forming of LDX 2101 and austenitic stainless steel with equal thickness. The forming forces, the geometry and the strains in the sheet material were compared for the same component.It was found that LDX steels can be formed to high strain levels in tools normally applied for forming ofaustenitic steels, but tool adaptations are needed to comply with the higher strength and springback of thematerial.

Strategier för presentationav arbetsprover inom grafiskdesign : hur en arbetssökande grafiskdesigner bäst ”säljer sig själv” tillanställning

För att få drömjobbet inom en konkurrenskraftig bransch som grafiskdesign krävs det lilla extra. Syftet med denna undersökning är att ta redapå vad detta extra är och därigenom underlätta för arbetssökandegrafiska designers på vägen till drömjobbet.Genom tre djupgående intervjuer med anställda på medelstora byråer iMellansverige undersöktes vad arbetsgivare uppskattar och förväntar sigav en arbetssökande grafisk designer. Frågeställningen behandladeportfolions framtid med branschens digitalisering som bakgrund, samthur en arbetssökande fångar arbetsgivarens intresse.Resultatet visar att även om portfolion utgör en stor del av underlaget förrekrytering av personal, är personen bakom portfolion och vad den haratt berätta om innehållet det som är viktigast. En portfolio som intebeskriver sammanhang duger inte som marknadsföringsmaterial. Attvårda det personliga varumärket framstår som viktigt för framgång. Dendigitala portfolion dominerar marknaden, men fysiska arbetsproverupplevs som ett möjligt sätt att stå ut från mängden. Digitala nätverkmottas positivt av branschen, men webbplatser anses ha mer substans.

Modelling dominance in a flexible intercross analysis

The aim of this paper is to develop a flexible model for analysis of quantitative trait loci (QTL) in outbred line crosses, which includes both additive and dominance effects. Our flexible intercross analysis (FIA) model accounts for QTL that are not fixed within founder lines and is based on the variance component framework. Genome scans with FIA are performed using a score statistic, which does not require variance component estimation. RESULTS: Simulations of a pedigree with 800 F2 individuals showed that the power of FIA including both additive and dominance effects was almost 50% for a QTL with equal allele frequencies in both lines with complete dominance and a moderate effect, whereas the power of a traditional regression model was equal to the chosen significance value of 5%. The power of FIA without dominance effects included in the model was close to those obtained for FIA with dominance for all simulated cases except for QTL with overdominant effects. A genome-wide linkage analysis of experimental data from an F2 intercross between Red Jungle Fowl and White Leghorn was performed with both additive and dominance effects included in FIA. The score values for chicken body weight at 200 days of age were similar to those obtained in FIA analysis without dominance. CONCLUSION: We have extended FIA to include QTL dominance effects. The power of FIA was superior, or similar, to standard regression methods for QTL effects with dominance. The difference in power for FIA with or without dominance is expected to be small as long as the QTL effects are not overdominant. We suggest that FIA with only additive effects should be the standard model to be used, especially since it is more computationally efficient.