Factores asociados al dolor crónico posoperatorio en pacientes llevados a herniorrafia inguinal

Introducción: La herniorrafia inguinal se asocia hasta en un 50% de los casos con dolor crónico posoperatorio (DCP), y en algunos puede ser incapacitante. En este estudio se evaluaron los factores asociados al DCP en pacientes llevados a herniorrafia inguinal. Métodología: Se realizó un estudio de cohorte multicéntrico. Se obtuvo información sociodemográfica y de antecedentes personales. Se determinó la presencia e intensidad de dolor agudo posoperatorio (DAP) y se evaluaron los factores asociados al DCP con seguimiento a los dos meses del posoperatorio. Se establecieron asociaciones con la prueba chi cuadrado. Mediante una regresión lineal se evaluó el papel de los factores de confusión. Resultados: Se analizaron 108 pacientes. 54.7% presentaron DCP. La edad menor de 40 años, el DAP no controlado, el DAP severo, y el dolor no controlado entre la primera y tercera semanas del POP se relacionaron con mayor riesgo de DCP. La edad mayor a 65, el uso de opioides intratecales, la visualización y preservación de los nervios durante la cirugía, y el uso de tres o más analgésicos intravenosos con bloqueo ilioinguinal/iliohipogástrico fueron factores protectores. Discusión: El DCP es frecuente en nuestro medio. La prevención y manejo eficientes del DAP utilizando analgesia multimodal, el uso de opioide intratecal, y la identificación y preservación de los nervios en el área quirúrgica ayudan a prevenir el desarrollo de DCP. Estudios de este tipo realizados a una escala más grande, permitirán identificar otros factores relacionados con esta patología. Palabras clave: Dolor crónico postoperatorio, herniorrafia inguinal, inguinodina, factores asociados.

Eficacia de la melatonina en insomnio primario en el adulto mayor: revisión sistemática de la literatura

Introducción: La melatonina, una sustancia cronobiótica endógena, es cada vez más empleada para el manejo de los problemas del sueño en adultos mayores por su aparente eficacia y buen perfil de eventos adversos. En este sentido, se intentó evaluar la eficacia de la melatonina en el tratamiento del insomnio primario en el adulto mayor (≥55 años) comparado con benzodiacepinas, zopiclona y placebo a la luz de la evidencia disponible en los últimos cinco años. Métodos: Revisión sistemática de la literatura. Resultados: En comparación con placebo, al parecer la melatonina mejora la calidad y los hábitos de sueño, no así la latencia de inicio de sueño en mediciones subjetivas ni objetivas (polisomnografía); a diferencia de otros medicamentos hipnóticos, no altera la arquitectura del sueño ni genera síntomas diurnos. Conclusiones: No se encontró evidencia que soporte el uso de melatonina en adultos mayores de 55 años para la reducción de la latencia de sueño, aumento del tiempo total de sueño, mejoría de la eficiencia del sueño, disminución de despertares nocturnos o mejoría de la calidad de sueño. Es necesario adelantar más estudios en comparación con placebo y otros medicamentos.

Cultura e innovación en empresas con relaciones de cooperación inter organizacional

Un gran número de empresas están inmersas actualmente en espacios de mercado conocidos y saturados de competidores. La innovación constituye una de las principales alternativas de las empresas para encontrar su posicionamiento estratégico y adaptarse a los cambios del entorno (Kim & Mauborgne, 2005). Igualmente, Demirci (2013) asegura que la cultura es un factor clave en la innovación, dado que está fuertemente asociada con los valores, actitudes, comportamientos y prácticas organizacionales. Esta investigación abarca el estudio de la cultura organizacional y la innovación en el marco de estrategias de cooperación inter-organizacional donde se plantea que el grado de cooperación que existe entre las empresas tiene un efecto sobre los valores culturales y la incorporación de innovaciones en cada organización. Para esto se llevó a cabo una investigación cuantitativa con un alcance de tipo descriptivo y de carácter no experimental y trans seccional, cuya unidad de análisis fueron 20 empresas de la red ParqueSoft Manizales. Para la medición de las variables de innovación se aplicó un instrumento basado en el Manual de Oslo de la OECD y Eurostat (2005) el cual contempla la innovación de producto, proceso, mercadotecnia y organización. A nivel de los valores culturales, la medición se realizó a través de un cuestionario inspirado en el modelo de Hofstede (1980). Los resultados obtenidos permiten demostrar que existe un grado de relación entre la cooperación y los valores culturales ‘distancia al poder’ y ‘tolerancia a la incertidumbre´, sin poder determinar la relación con la generación de innovación de producto, proceso, mercadotecnia y organización, así como con las otras dimensiones del modelo de valores de Hofstede.

Electric field alignment in thin films of cylinder-forming diblock copolymer

We investigate thin films of cylinder-forming diblock copolymer confined between electrically charged parallel plates, using self-consistent-field theory ( SCFT) combined with an exact treatment for linear dielectric materials. Our study focuses on the competition between the surface interactions, which tend to orient cylinder domains parallel to the plates, and the electric field, which favors a perpendicular orientation. The effect of the electric field on the relative stability of the competing morphologies is demonstrated with equilibrium phase diagrams, calculated with the aid of a weak-field approximation. As hoped, modest electric fields are shown to have a significant stabilizing effect on perpendicular cylinders, particularly for thicker films. Our improved SCFT-based treatment removes most of the approximations implemented by previous approaches, thereby managing to resolve outstanding qualitative inconsistencies among different approximation schemes.

Combined affinity labelling and mass spectrometry analysis of differential cell surface protein expression in normal and prostate cancer cells

Differences in the expression of cell surface proteins between a normal prostate epithelial (1542-NP2TX) and a prostate cancer cell line (1542-CP3TX) derived from the same patient were investigated. A combination of affinity chromatographic purification of biotin-tagged surface proteins with mass spectrometry analysis identified 26 integral membrane proteins and 14 peripheral surface proteins. The findings confirm earlier reports of altered expression in prostate cancer for several cell surface proteins, including ALCAM/CD166, the Ephrin type A receptor, EGFR and the prostaglandin F2 receptor regulatory protein. In addition, several novel findings of differential expression were made, including the voltage-dependent anion selective channel proteins Porin 1 and 2, ecto-5'-nucleotidase (CD73) and Scavenger receptor B1. Cell surface protein expression changed both qualitatively and quantitatively when the cells were grown in the presence of either or both interferon INFalpha and INFgamma. Costimulation with type I and II interferons had additive or synergistic effects on the membrane density of several, mainly peripherally attached surface proteins. Concerted upregulation of surface exposed antigens may be of benefit in immuno-adjuvant-based treatment of interferon-responsive prostate cancer. In conclusion, this study demonstrates that differences in the expression of membrane proteins between normal and prostate cancer cells are reproducibly detectable following vectorial labelling with biotin, and that detailed analysis of extracellular-induced surface changes can be achieved by combining surface-specific labelling with high-resolution two-dimensional gel electrophoresis and mass spectrometry.

Combined affinity labelling and mass spectrometry analysis of differential cell surface protein expression in normal and prostate cancer cells

Differences in the expression of cell surface proteins between a normal prostate epithelial (1542-NP2TX) and a prostate cancer cell line (1542-CP3TX) derived from the same patient were investigated. A combination of affinity chromatographic purification of biotin-tagged surface proteins with mass spectrometry analysis identified 26 integral membrane proteins and 14 peripheral surface proteins. The findings confirm earlier reports of altered expression in prostate cancer for several cell surface proteins, including ALCAM/CD166, the Ephrin type A receptor, EGFR and the prostaglandin F2 receptor regulatory protein. In addition, several novel findings of differential expression were made, including the voltage-dependent anion selective channel proteins Porin 1 and 2, ecto-5'-nucleotidase (CD73) and Scavenger receptor B1. Cell surface protein expression changed both qualitatively and quantitatively when the cells were grown in the presence of either or both interferon INF alpha and INF gamma. Costimulation with type I and II interferons had additive or synergistic effects on the membrane density of several, mainly peripherally attached surface proteins. Concerted upregulation of surface exposed antigens may be of benefit in immuno-adjuvant-based treatment of interferon-responsive prostate cancer. In conclusion, this study demonstrates that differences in the expression of membrane proteins between normal and prostate cancer cells are reproducibly detectable following vectorial labelling with biotin, and that detailed analysis of extracellular-induced surface changes can be achieved by combining surface-specific labelling with high-resolution two-dimensional gel electrophoresis and mass spectrometry.

Position paper on the future of social networking

Social networking mediated by web sites is a relatively new phenomenon and as with all technological innovations there continues to be a period of both technical and social adjustment to fit the services in with people’s behaviours, and for people to adjust their practices in the light of the affordances provided by the technology. Social networking benefits strongly from large scale availability. Users gain greater benefit from social networking services when more of their friends are using them.This applies in social terms, but also in eLearning and professional networks. The network effect provides one explanation for the popularity of internet based social networking sites (SNS) because the number of connections between people which can be maintained by using them is greatly increased in comparison to the networks available before the internet. The ability of users to determine how much they trust information available to them from contacts within their social network is important in almost all modes of use. As sources of information on a range of topics from academic to shopping advice, the level of trust which a user can put in other nodes is a key aspect of the utility of the system.

Remote control systems laboratory

Control systems theory can be a discipline difficult to learn without some laboratory help. With the help of focused laboratories this discipline turns to be very interesting to the students involved. The main problem is that laboratories aren't always available to students, and sometimes, when they are available, aren't big enough to a growing student population. Thus, with computer networks growing so fast, why don't create remote control labs that can be used by a large number of students? Why don't create remote control labs using Internetⓒ Copyright ?2001 IFAC Keywords: Remote Control, Computer Networks, Database, Educational Aids, Laboratory Education, Communication Control Applications.

Taking the shopping centre online: new models in e-commerce

Purpose – This paper aims to provide a brief re´sume´ of previous research which has analysed the impact of e-commerce on retail real estate in the UK, and to examine the important marketing role of the internet for shopping centre managers, and retail landlords. Design/methodology/approach – Based on the results from a wider study carried out in 2003, the paper uses case studies from two different shopping centres in the UK, and documents the innovative uses of both web-based marketing and online retailing by organisations that historically have not directly been involved in the retailing process. Findings – The paper highlights the importance of considering online sales within a multi-channel approach to retailing. The two types of emerging shopping centre model which are identified are characterised by their ultimate relationship with the physical shopping centre on whose web site they reside. These can be summarised as: the “centre-led” approach, and the “brand-led” or “marketing-led” approach. Research limitations/implications – The research is based on a limited number of in-depth case studies and secondary data. Further research is needed to monitor the continuing impact of e-commerce on retail property and the marketing strategies of shopping centre managers and owners. Practical implications – Internet-based sales provide an important adjunct to conventional retail sales and an important source of potential risk for landlords and tenants in the real estate investment market. Regardless of whether retailers use the internet as a sales channel, as a product-sourcing tool, or merely to provide information to the consumer, the internet has become a keystone within the greater retail marketing mix. The findings have ramifications for understanding the way in which landlords are structuring their retail property to defray potential risks. Originality/value – The paper examines shopping centre online marketing models for the first time in detail, and will be of value to retail occupiers, owners and other stakeholders of shopping centres.

Application of dried blood spots to determine vitamin D status in a large nutritional study with unsupervised sampling: the Food4Me project

An efficient and robust method to measure vitamin D (25-hydroxy vitamin D3 (25(OH)D3) and 25-hydroxy vitamin D2 in dried blood spots (DBS) has been developed and applied in the pan-European multi-centre, internet-based, personalised nutrition intervention study Food4Me. The method includes calibration with blood containing endogenous 25(OH)D3, spotted as DBS and corrected for haematocrit content. The methodology was validated following international standards. The performance characteristics did not reach those of the current gold standard liquid chromatography-MS/MS in plasma for all parameters, but were found to be very suitable for status-level determination under field conditions. DBS sample quality was very high, and 3778 measurements of 25(OH)D3 were obtained from 1465 participants. The study centre and the season within the study centre were very good predictors of 25(OH)D3 levels (P<0·001 for each case). Seasonal effects were modelled by fitting a sine function with a minimum 25(OH)D3 level on 20 January and a maximum on 21 July. The seasonal amplitude varied from centre to centre. The largest difference between winter and summer levels was found in Germany and the smallest in Poland. The model was cross-validated to determine the consistency of the predictions and the performance of the DBS method. The Pearson's correlation between the measured values and the predicted values was r 0·65, and the sd of their differences was 21·2 nmol/l. This includes the analytical variation and the biological variation within subjects. Overall, DBS obtained by unsupervised sampling of the participants at home was a viable methodology for obtaining vitamin D status information in a large nutritional study.

Reproducibility of the online Food4Me food-frequency questionnaire for estimating dietary intakes across Europe

Background: Accurate dietary assessment is key to understanding nutrition-related outcomes and is essential for estimating dietary change in nutrition-based interventions. Objective: The objective of this study was to assess the pan-European reproducibility of the Food4Me food-frequency questionnaire (FFQ) in assessing the habitual diet of adults. Methods: Participantsfromthe Food4Me study, a 6-mo,Internet-based, randomizedcontrolled trial of personalized nutrition conducted in the United Kingdom, Ireland, Spain, Netherlands, Germany, Greece, and Poland were included. Screening and baseline data (both collected before commencement of the intervention) were used in the present analyses, and participants were includedonly iftheycompleted FFQs at screeningand at baselinewithin a 1-mo timeframebeforethe commencement oftheintervention. Sociodemographic (e.g., sex andcountry) andlifestyle[e.g.,bodymass index(BMI,inkg/m2)and physical activity] characteristics were collected. Linear regression, correlation coefficients, concordance (percentage) in quartile classification, and Bland-Altman plots for daily intakes were used to assess reproducibility. Results: In total, 567 participants (59% female), with a mean 6 SD age of 38.7 6 13.4 y and BMI of 25.4 6 4.8, completed bothFFQswithin 1 mo(mean 6 SD: 19.26 6.2d).Exact plus adjacent classification oftotal energy intakeinparticipants was highest in Ireland (94%) and lowest in Poland (81%). Spearman correlation coefficients (r) in total energy intake between FFQs ranged from 0.50 for obese participants to 0.68 and 0.60 in normal-weight and overweight participants, respectively. Bland-Altman plots showed a mean difference between FFQs of 210 kcal/d, with the agreement deteriorating as energy intakes increased. There was little variation in reproducibility of total energy intakes between sex and age groups. Conclusions: The online Food4Me FFQ was shown to be reproducible across 7 European countries when administered within a 1-mo period to a large number of participants. The results support the utility of the online Food4Me FFQ as a reproducible tool across multiple European populations. This trial was registered at clinicaltrials.gov as NCT01530139.

Matproblem och personlighet

The purpose of this study was to examine by means of Eysenck Personality Inventory (EPI), the relationship between Neuroticism, and self-rated eating problems. Altogether 105 respondents, mean aged 42,3 years, including 11 men and 94 women, participated by answering an Internet-based questionnaire comprising three different sections. Neuroticism correlated with self-rated eating problems (r=,468, p<0,01). By means of multiple regression analysis it was indicated that both Neuroticism (p<.001) and Body Mass Index (BMI) (p<.001) contributed significantly to the prediction of self-rated eating problems (multiple correlation (ß=.594). The study indicated that the personality only partly explained the variation of eating problems. The result was discussed in terms of significance of biological factors stressing changes in 5-HT levels triggering eating problems.

The concept of e-service from a social interaction perspective

Today’s e-services are complex phenomenon consisting of several different e-services linked together. The e-services are provided by IT systems and presented to customers through user interfaces. Within web design research criteria are laid out for the design of good user interfaces, but one problem is that these analyses are performed without a service focus. This lack of service focus can result in the designed user interfaces providing indistinct service concepts, especially where several e-services are intertwined with each other.In order to design IT system interfaces, we have to be clear about which e-services are provided by the IT system and how these e-services are related to each other. This paper presents a framework for the analysis of user interfaces in terms of focused e-service, service environment and two types of intertwined e-services; related e-services and interrelating e-services. The analyses are exemplified by an Internet based e-marketplace. The paper discusses how the framework can be combined with ordinary web design criteria and how it can be used for e-service development.

Förutsättningar för distanskommunikation mellan reklambyråer och kunder : En intervju- och enkätundersökning

Små reklambyråer har, i skuggan av den ekonomiska krisen, fått konkurrens om sina kunder av större reklambyråer och tryckerier. En lösning kan vara att skapa relationer till företag utanför närområdet. Internetbaserade verktyg för distanskommunikation skulle i sådana fall kunna erbjuda ett bra komplement till det fysiska mötet. Distanskommunikation är effektivt eftersom det bland annat ger minskad tidsåtgång för möten och minskade resekostnader. Denna typ av kommunikation kan dock innebära större risk för missförstånd, och färre tillfällen att bygga en personlig relation till kunden. Användningen av internetbaserade verktyg för att kommunicera på distans förväntas dock bli allt vanligare i framtiden, i takt med att utbudet av kommunikationsverktyg ökar. Huvudmålet med denna studie har därför varit att undersöka förutsättningarna för distanskommunikation mellan reklambyrå och kund. Syftet har varit att ta reda på hur för- och nackdelar med distanskommunikation värderas av respektive parter, samt vilket kommunikationssätt som de anser lämpar sig bäst vid olika arbetssteg. Detta undersöktes genom enkätundersökning till utvalda företag samt intervjuer med fyra mindre reklambyråer i Dalarna. Studiens resultat, visade tydligt att det personliga mötet är mycket viktigt, och att det inte kan ersättas av någon form av distanskommunikation. Däremot ansåg både företag och reklambyråer att verktyg för distanskommunikation kan användas vid arbetsmöten.

Han, hon, höna? : En kvantitativ studie om attityder till det könsneutrala personliga pronomenet hen

Språk både reflekterar och påverkar vår världssyn. Hur mottas då försök från gräsrotsnivå att introducera ett könsneutralt pronomen i ett språk som speglar den i samhället rådande könsdikotomin? Syftet med denna uppsats är att utifrån Hirdmans och Butlers respektive genusteorier undersöka vilken inställning användare på ett stort svenskt internetforum har till det könsneutrala personliga pronomenet hen. Undersökningen genomfördes med hjälp av en internetbaserad enkät som besvarades av cirka 150 personer. För att analysera svaren till de slutna frågorna tog vi hjälp av statistikprogrammet SPSS och för att bearbeta de öppna frågorna har vi använt oss av en tematisk analys. Resultatet visar på starkt polariserade åsikter runt hen, där ungefär lika många personer är för som emot ordet. Bland dem som är emot användandet av hen uppfattar de flesta att syftet med ordet är att skapa ett könslöst samhälle, medan hen-förespråkarna ser det som ett komplement till hon och han. Vi har även kunnat se att det finns ett visst samband mellan individens attityd till hen och dennes syn på kön och genus, vilket bekräftar vår hypotes om att det finns en sådan korrelation.