Challenges in secondary prevention of cardiovascular diseases: A review of the current practice

With the changing demography of populations and increasing prevalence of co-morbidity, frail patients and more complex cardiac conditions, the modern medicine is facing novel challenges leading to rapid innovation where evidence and experiences are lacking. This scenario is also evident in cardiovascular disease prevention, which continuously needs to accommodate its ever changing strategies, settings, and goals. The present paper summarises actual challenges of secondary prevention, and discusses how this intervention should not only be effective but also efficient. By this way the paper tries to bridge the gaps between research and real-world findings and thereby may find ways to improve standard care.

The PREDICTS database: a global database of how local terrestrial biodiversity responds to human impacts

Biodiversity continues to decline in the face of increasing anthropogenic pressures such as habitat destruction, exploitation, pollution and introduction of alien species. Existing global databases of species' threat status or population time series are dominated by charismatic species. The collation of datasets with broad taxonomic and biogeographic extents, and that support computation of a range of biodiversity indicators, is necessary to enable better understanding of historical declines and to project - and avert - future declines. We describe and assess a new database of more than 1.6 million samples from 78 countries representing over 28,000 species, collated from existing spatial comparisons of local-scale biodiversity exposed to different intensities and types of anthropogenic pressures, from terrestrial sites around the world. The database contains measurements taken in 208 (of 814) ecoregions, 13 (of 14) biomes, 25 (of 35) biodiversity hotspots and 16 (of 17) megadiverse countries. The database contains more than 1% of the total number of all species described, and more than 1% of the described species within many taxonomic groups - including flowering plants, gymnosperms, birds, mammals, reptiles, amphibians, beetles, lepidopterans and hymenopterans. The dataset, which is still being added to, is therefore already considerably larger and more representative than those used by previous quantitative models of biodiversity trends and responses. The database is being assembled as part of the PREDICTS project (Projecting Responses of Ecological Diversity In Changing Terrestrial Systems - http://www.predicts.org.uk). We make site-level summary data available alongside this article. The full database will be publicly available in 2015.

High-affinity phosphate/arsenate transport in white lupin (Lupinus albus) is relatively insensitive to phosphate status

The development of proteoid roots under phosphorus deficiency by white lupin (Lupinus albus) may result in increased arsenate uptake, as arsenate is a phosphate analogue. This, together with its high biomass production, rapid growth and ability to survive in soils with low phosphate and nitrogen contents, low pH and high metal contents make them an interesting species to investigate with respect to revegetation, and possibly also for long-term phytoremediation, of arsenic contaminated soils. Kinetic parameters for arsenate uptake for P-deficient and P-sufficient plants, as well as for proteoid and nonproteoid roots were obtained. Down-regulation of arsenate uptake by phosphate, as well as phosphate/arsenate competition for P-deficient and P-sufficient plants was studied. Arsenate uptake was reduced by phosphate, but small differences were found between P-deficient and P-sufficient plants. Arsenate uptake by proteoid roots was higher than for nonproteoid roots of P-deficient plants, with higher V_max and similar K_m values. Down-regulation of the high affinity phosphate/arsenate uptake system by phosphate does take place but seems to be slower than in other plants. This study suggests that the low sensitivity of the phosphate/arsenate uptake system to regulation by phosphate may be related to the adaptations of white lupin to low P available environments. Such adaptation are absent in plants unable to develop proteoid roots.

Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries

Importance Limited information exists about the epidemiology, recognition, management, and outcomes of patients with the acute respiratory distress syndrome (ARDS).

Objectives To evaluate intensive care unit (ICU) incidence and outcome of ARDS and to assess clinician recognition, ventilation management, and use of adjuncts—for example prone positioning—in routine clinical practice for patients fulfilling the ARDS Berlin Definition.

Design, Setting, and Participants The Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) was an international, multicenter, prospective cohort study of patients undergoing invasive or noninvasive ventilation, conducted during 4 consecutive weeks in the winter of 2014 in a convenience sample of 459 ICUs from 50 countries across 5 continents.

Exposures Acute respiratory distress syndrome.

Main Outcomes and Measures The primary outcome was ICU incidence of ARDS. Secondary outcomes included assessment of clinician recognition of ARDS, the application of ventilatory management, the use of adjunctive interventions in routine clinical practice, and clinical outcomes from ARDS.

Results Of 29 144 patients admitted to participating ICUs, 3022 (10.4%) fulfilled ARDS criteria. Of these, 2377 patients developed ARDS in the first 48 hours and whose respiratory failure was managed with invasive mechanical ventilation. The period prevalence of mild ARDS was 30.0% (95% CI, 28.2%-31.9%); of moderate ARDS, 46.6% (95% CI, 44.5%-48.6%); and of severe ARDS, 23.4% (95% CI, 21.7%-25.2%). ARDS represented 0.42 cases per ICU bed over 4 weeks and represented 10.4% (95% CI, 10.0%-10.7%) of ICU admissions and 23.4% of patients requiring mechanical ventilation. Clinical recognition of ARDS ranged from 51.3% (95% CI, 47.5%-55.0%) in mild to 78.5% (95% CI, 74.8%-81.8%) in severe ARDS. Less than two-thirds of patients with ARDS received a tidal volume 8 of mL/kg or less of predicted body weight. Plateau pressure was measured in 40.1% (95% CI, 38.2-42.1), whereas 82.6% (95% CI, 81.0%-84.1%) received a positive end-expository pressure (PEEP) of less than 12 cm H2O. Prone positioning was used in 16.3% (95% CI, 13.7%-19.2%) of patients with severe ARDS. Clinician recognition of ARDS was associated with higher PEEP, greater use of neuromuscular blockade, and prone positioning. Hospital mortality was 34.9% (95% CI, 31.4%-38.5%) for those with mild, 40.3% (95% CI, 37.4%-43.3%) for those with moderate, and 46.1% (95% CI, 41.9%-50.4%) for those with severe ARDS.

Conclusions and Relevance Among ICUs in 50 countries, the period prevalence of ARDS was 10.4% of ICU admissions. This syndrome appeared to be underrecognized and undertreated and associated with a high mortality rate. These findings indicate the potential for improvement in the management of patients with ARDS.

The PREDICTS database: a global database of how local terrestrial biodiversity responds to human impacts

Biodiversity continues to decline in the face of increasing anthropogenic pressures such as habitat destruction, exploitation, pollution and introduction of alien species. Existing global databases of species’ threat status or population time series are dominated by charismatic species. The collation of datasets with broad taxonomic and biogeographic extents, and that support computation of a range of biodiversity indicators, is necessary to enable better understanding of historical declines and to project – and avert – future declines. We describe and assess a new database of more than 1.6 million samples from 78 countries representing over 28,000 species, collated from existing spatial comparisons of local-scale biodiversity exposed to different intensities and types of anthropogenic pressures, from terrestrial sites around the world. The database contains measurements taken in 208 (of 814) ecoregions, 13 (of 14) biomes, 25 (of 35) biodiversity hotspots and 16 (of 17) megadiverse countries. The database contains more than 1% of the total number of all species described, and more than 1% of the described species within many taxonomic groups – including flowering plants, gymnosperms, birds, mammals, reptiles, amphibians, beetles, lepidopterans and hymenopterans. The dataset, which is still being added to, is therefore already considerably larger and more representative than those used by previous quantitative models of biodiversity trends and responses. The database is being assembled as part of the PREDICTS project (Projecting Responses of Ecological Diversity In Changing Terrestrial Systems – www.predicts.org.uk). We make site-level summary data available alongside this article. The full database will be publicly available in 2015.

Circula : revue d'idéologies linguistiques, no 1, La médiatisation des idéologies linguistiques : tradition et continuité dans la presse écrite

Le numéro 1 (printemps 2015) contient : partie 1 : Les idéologies linguistiques dans la tradition de la presse périodique. Partie 2 : Enjeux sociaux et politiques des questions de langue et de norme

Hollywood and world cinema influences: tracing intertextuality in the works of two contemporary filmmakers from Francophone Africa; Mahamat Saleh Haroun and Abderrahmane Sissako

Don’t tell me the moon is shining; show me the glint of light on broken glass Anton Chekhov Representations of Africa in cinema are almost as old as cinema itself and date back to Hollywood’s silent era. Most early examples feature the continent as a mere exotic backdrop and include The Sheik (Melford 1921), soon followed, in 1926, by George Fitzmaurice’s Son of the Sheik starring Rudolph Valentino. The next decade brought Van Dyke’s Tarzan movies, Robert Stevenson’s King Solomon’s Mines (1937), and, on the European side, Duvivier’s Pépé le Moko (1936). For representations of Francophone Africa by Africans themselves, the viewing public more or less had to wait, however, until decolonisation in the 1960s (with, for example, Sembene Ousmane’s Borom Sarret and La Noire de…, both released in 1966 and, in 1968, Mandabi). Since then Francophone African cinema has come a long way and has diversified into various strands. Between Borom Sarret and Mahamat-Saleh Haroun’s 2006 Daratt, Saison sèche - or the same director’s Un homme qui crie, almost half a century has elapsed. Over this period, films inevitably have addressed a spectrum of visual, ideological and political tropes. They range from unadorned depictions of the newly independent states and their societies to highly aestheticised productions, not to mention surreal and poetic visions as displayed for instance in Djibril Diop Mambéty’s Touki Bouki (1973). Most of the early films send an overt socio-political message which is a clear and explicit denunciation of a corrupt state of affairs (Souleymane Cissé’s Baara, 1977). They aim to trigger strong emotional and political responses from the viewer, in unambiguous support for the film-maker’s stand. Sembene himself declared: “I consider cinema a means of political action” (Murphy 2000: 221). Similarly, the Mauritanian director Med Hondo wishes to “take up this technical medium and to make it a mouthpiece on behalf of [his] fellow Africans and Arabs” (Jeffries 2002: 11). All this echoes the claims of the Fédération Panafricaine des Cinéastes (FEPACI, founded in 1969), an organisation “dedicated to the liberation of Africa”. In sharp contrast to the incipient momentum given Francophonie by Bourguiba, the Nigerien Hamani Diori and the Senegalese Senghor, who invoked a worldwide communauté organique francophone, FEPACI called for “the creation of an aesthetics of disalienation… [using] didactic... forms to denounce the alienation of countries that were politically independent but culturally and economically dependent on the West” (Diawara 1996: 40). Sembene’s Xala (1974) became the blueprint for this, to this day the best-known vein of Francophone African cinema. Thus considered, this pedigree seems a million miles from mainstream global cinema with its overriding mission to entertain. A question therefore arises: to what extent can a cinema that sprang from such beginnings be seen to interface in any meaningful way with a global film industry that, overwhelmingly and for a century, has indeed entertained the world – with Hollywood at its centre?

Robótica móvel: sistema de condução autónoma

Dissertação para obtenção do grau de Mestre em Engenharia Electrotécnica Ramo Automação e Electrónica Industrial

Conferencia "Desarrollo de las capacidades humanas y competitivas"

El Foro de Presidentes se enfoca en la innovación y la sostenibilidad de las empresas de la mano de un Gobierno Corporativo. Conferencista: Doctor Sergio Arango, Consultor Estratégico, Doctor Jorge Esteban Giraldo, Director General Región Latinoamérica Centro GRUPO BIMBO

Relación del control metabólico del paciente con diabetes y el ausentismo laboral

Tesis (Maestría en Salud Pública con Especialidad en Medicina del Trabajo) UANL

Importancia de las actividades no descritas en los profesio nales de la salud [por] Estéban Gilberto Ramos Peña

Tesis (Maestría en Salud Pública, con Especialidad en Salud en el Trabajo) U.A.N.L.

Desarrollo de un modelo para medición de barreras que afectan a la productividad

Tesis (Maestro en Ciencias de la Administración con Especialidad en Investigación de Operaciones) UANL, 1997

Los costos como herramienta de mejora contínua

Tesis (Maestría en Contaduría Pública con Especialidad en Finanzas) U.A.N.L.

La institución afianzadora y las garantías de recuperación en el sistema jurídico mexicano

[Tesis] (Maestría en Derecho Mercantil) U.A.N.L.