Prediction of glucose excursions under uncertain parameters and food intake in intensive insulin therapy for type 1 diabetes mellitus

Considering the difficulty in the insulin dosage selection and the problem of hyper- and hypoglycaemia episodes in type 1 diabetes, dosage-aid systems appear as tremendously helpful for these patients. A model-based approach to this problem must unavoidably consider uncertainty sources such as the large intra-patient variability and food intake. This work addresses the prediction of glycaemia for a given insulin therapy face to parametric and input uncertainty, by means of modal interval analysis. As result, a band containing all possible glucose excursions suffered by the patient for the given uncertainty is obtained. From it, a safer prediction of possible hyper- and hypoglycaemia episodes can be calculated

Frecuencia de situaciones inseguras seg��n el registro de una cl��nica privada de tercer nivel de Bogot��

Introducci��n: La seguridad del paciente es una prioridad en la atenci��n en salud a nivel mundial, conllevando a que las instituciones empleen estrategias para fomentar su cultura, dentro de ellas el registro de situaciones inseguras. Objetivo: Determinar frecuencia de registro de situaciones inseguras asociadas a la atenci��n de salud en una cl��nica privada de tercer nivel de Bogot��, durante el periodo mayo a noviembre de 2013. M��todo: Estudio descriptivo, realizado a partir de una base de datos secundaria de registros diligenciados por el personal de la cl��nica. Resultados: se reportaron 379 situaciones inseguras, incidentes (52%), eventos adversos (36%) y riesgos (12%). La situaci��n insegura m��s reportada seg��n el tipo fue uso seguro de medicamentos y dispositivos m��dicos (36,93%). Por servicio el que m��s report�� fue hospitalizaci��n (47%) y urgencias (21%), el cargo que m��s report�� por enfermer��a (72,5%). Conclusi��n: La implementaci��n de estrategias orientadas a estimular el reporte favorece la identificaci��n de fallas en el proceso de atenci��n disminuyendo la frecuencia de eventos adversos. Siendo este un primer paso en el programa de seguridad del paciente.

Factores de riesgo para morbilidad materna extrema en gestantes

Introducci��n: La morbilidad materna extrema es un t��rmino usado para definir cualquier condici��n obst��trica severa que amenaza la vida y requiere una intervenci��n m��dica urgente con el fin de prevenir la probable muerte materna. Con el presente estudio se pretendi�� evaluar los factores de riesgo para morbilidad materna extrema en las gestantes del Hospital Universitario Mayor. Metodolog��a Se realiz�� un estudio de casos y controles, comparando pacientes con MME y sin MME en una relaci��n de 1:1. Se realiz�� un muestreo aleatorio simple teniendo en cuenta 95% de la poblaci��n apareadas por diagn��stico de ingreso. Resultados Se incluyeron un total de 110 pacientes (55 en cada grupo). Ambas poblaciones fueron comprables. Ser de estrato socioecon��mico bajo (p 0,000), haber tenido 2 o menos partos (p 0,000), ser tipo de sangre negativo (p0.000) realizar entre 0-3 controles prenatales (p 0,000), tener antecedente de preeclampsia (p 0,000), hipotiroidismo (p 0,000), o trastorno bipolar (p 0,000), son factores de riesgo significativos para presentar MME. Entre los factores protectores est��n tener m��s de tres partos OR 0,60 (IC95%: 0,17-0,82, p=0,00) y 7 o m��s controles prenatales OR 0,23 (IC95%: 0,09-0,55, p=0,000). Resultados concordantes con la literatura Discusi��n: Es importante dar a conocer los resultados del presente estudio para promover las campa��as de prevenci��n primaria, secundaria y terciaria con el fin de evitar las altas complicaciones que se pueden presentar en las mujeres en edad f��rtil de nuestra poblaci��n.

Aproximaci��n a un modelo metodol��gico orientado a los procesos de gesti��n de conocimiento generadores de valor en organizaciones del sector salud en Colombia

En las organizaciones del sector salud en Colombia, se realizan procedimientos que a pesar de ser hom��logos entre ellos, no se discriminan ocasionando que no siempre se escoja el que genere mejores resultados, no solo desde el punto de vista m��dico sino tambi��n de la direcci��n que se ejerce en las organizaciones la cual debe estar en funci��n de optimizar cualquiera de los procesos propios de la actividad, en este caso, en busca de generaci��n de valor usando como v��a la apropiada GC, ��ste documento est�� orientado a demostrar que la GC aporta herramientas que permiten desarrollar la aproximaci��n a un modelo metodol��gico que procura facilitar la elecci��n de procedimientos en salud si se toman los costos asociados como criterios relevantes del an��lisis, se seleccionaron como instrumento de demostraci��n a los procesos denominados Traqueostom��a Quir��rgica y Traqueostom��a Percut��nea la intensi��n de desarrollar una aproximaci��n a un modelo metodol��gico orientado a los procesos de gesti��n de conocimiento generadores de valor en organizaciones del sector salud en Colombia.

Identificaci��n de factores de riesgo asociados a fatiga en personal de enfermer��a en una cl��nica del sector privado de la ciudad de Bogot��, Colombia

La fatiga asociada a la carga de trabajo impuesta en trabajadores del sector salud es un factor directamente relacionado con el nivel de desempe��o del trabajador y por lo tanto de la seguridad del paciente. El objetivo del presente estudio es realizar una evaluaci��n multidimensional de la fatiga laboral percibida del personal de enfermer��a de una Instituci��n Prestadora de Servicios de Salud (IPS) de IV nivel la ciudad de Bogot��. Para la valoraci��n de fatiga se aplic�� la versi��n en espa��ol del Inventario Sueco de Fatiga Ocupacional (SOFI-S) acompa��ado de preguntas abstra��das de la bater��a de riesgo psicosocial del Ministerio de la Protecci��n Social y un cuestionario demogr��fico. Se encuestaron 60 enfermeras (3,3% hombres, 96,7% mujeres). Los principales factores asociados a la generaci��n de fatiga son las horas de sue��o, el turno y las actividades del hogar. La agrupaci��n factorial genera 4 dimensiones de fatiga y no 5 como com��nmente se agrupa el cuestionario SOFI.

Plan de negocios Lunette Atelier

Lunette Atelier, desde Septiembre de 2014 se dedica a la venta de gafas de sol por Facebook, cuenta con 5.000 seguidores y 2.000 en Instagram, actualmente est�� en el proceso de registro de marca en la C��mara de Comercio de Bogot��. El objetivo de este plan de empresa es hacer una l��nea de negocio: venta de vestidos de ba��o 100% personalizables por medio de una p��gina web. La necesidad de la mayor��a de las mujeres de hoy en d��a a la hora de irse a vacaciones y lucir sus vestidos de ba��o es verse bien, sentirse c��modas, seguras y ��nicas. Es por esto que la empresa quiere satisfacer esta necesidad, ofreciendo un portafolio de productos variado para que sus clientas puedan elegir la mejor opci��n para su cuerpo, la que las haga sentir m��s seguras, no importa la talla que sea, el color que quiera o el dise��o que le quede mejor, Lunette Atelier ofrece productos exclusivos y ��nicos para todas la mujeres. Nuestro valor agregado, ofrecemos una experiencia de compra ��nica por medio del dise��o de cada una de las prendas a la medida y al gusto de cada cliente. Todas nuestras piezas son confeccionadas con las mejores materias primas del mercado, aparte de esto son exclusivas e importadas. La mayor��a de nuestros productos est��n hechos de microfibras lo que hace que las prendas sean c��modas y el��sticas para que a la hora de usarlas el cliente se sienta lo m��s confortable posible.

Plan de negocios Plastic Industrial

Plastic Industrial SAS es un intraemprendimiento el cual va ligado con Americana de Accesorios ACES LTDA, siendo esta una empresa industrial familiar que lleva mas de 25 a��os en el mercado, centrada en el sector de autopartes, encargada de producir accesorios en pl��stico a trav��s de inyectoras especializadas. El producto en el cual nos especializamos es Security Road, un producto basado en el kit de carretera ya existente en el mercado pero con ciertas caracter��sticas diferenciadoras que ayudaran a que las mujeres siendo tan independientes en esta ��poca, se sientan identificadas con este producto y m��s all�� de esto adquieran un sentido de pertenencia no solo con su veh��culo y con su seguridad sino tambi��n con la de las personas que la rodean. Fabricaremos un kit de carretera el cual con caracter��sticas de dise��o y funcionales har��n de este un producto m��s seguro y diferente. El dise��o que tiene hace que para las mujeres sea mucho m��s sencillo de armar.

Say yes

Proponer matrimonio no es cualquier cosa, por lo cual la manera en la que se entrega el anillo es un momento que nunca se olvida y tiene que ser perfecto. Es a partir de esto que en los ��ltimos a��os, se ha venido fortaleciendo una tendencia en la que las propuestas de matrimonio se han tornado mucho m��s creativas, llamativas y ostentosas, por lo cual cada vez m��s personas buscan de una manera creativa proponer matrimonio a su pareja, sin embargo aunque esta tendencia est�� en auge en otros pa��ses, en Colombia la gente no se esfuerza para proponer matrimonio de una forma creativa Say Yes es una empresa del sector de servicios ubicada en Bogot�� que se encarga de crear, desarrollar y planear las propuestas de matrimonio so��adas para las parejas. La empresa nace de la idea de 3 j��venes emprendedores que lo que se quieren lograr con este proyecto es brindarle a la comunidad una forma f��cil y segura de planear y desarrollar su propuesta de matrimonio, creando y uni��ndose a las tendencias mundiales que hay hoy en d��a, ayudando a elaborar, planear y tener ��xito en la propuesta de matrimonio so��ada para la pareja. Para la conformaci��n de la compa����a se debe hacer una inversi��n de alrededor de 28 millones, la cual se espera recuperar en un plazo de cuatro a��os con una tasa de interna retorno del 5,37% y en adelante generar ganancias, adicionalmente se espera lograr alcanzar el punto de equilibrio para finales del segundo a��o de funcionamiento.

Prediction of postprandial blood glucose under intra-patient variability and uncertainty and its use in the design of insulin dosing strategies for type 1 diabetic patients

In this thesis I propose a novel method to estimate the dose and injection-to-meal time for low-risk intensive insulin therapy. This dosage-aid system uses an optimization algorithm to determine the insulin dose and injection-to-meal time that minimizes the risk of postprandial hyper- and hypoglycaemia in type 1 diabetic patients. To this end, the algorithm applies a methodology that quantifies the risk of experiencing different grades of hypo- or hyperglycaemia in the postprandial state induced by insulin therapy according to an individual patient���s parameters. This methodology is based on modal interval analysis (MIA). Applying MIA, the postprandial glucose level is predicted with consideration of intra-patient variability and other sources of uncertainty. A worst-case approach is then used to calculate the risk index. In this way, a safer prediction of possible hyper- and hypoglycaemic episodes induced by the insulin therapy tested can be calculated in terms of these uncertainties.

Reac����es imunol��gicas associadas aos anti-inflamat��rios n��o-ester��ides

As reac����es de hipersensibilidade relacionadas com os anti-inflamat��rios n��o-ester��ides (AINEs) s��o muito comuns na popula����o, sendo consideradas como a segunda causa para o aparecimento deste tipo de reac����es. Os AINEs podem desencadear reac����es de hipersensibilidade al��rgicas (imediatas e tardias) e reac����es n��o al��rgicas. Clinicamente, esta hipersensibilidade pode ser manifestada a n��vel respirat��rio, cut��neo e sist��mico. O diagn��stico, in vivo (testes cut��neos e testes de provoca����o oral, nasal e de inala����o) ou teste in vitro (BAT, CAST, ASPIteste e TTL), �� um passo importante para prevenir o aparecimento de novas reac����es e encontrar uma terap��utica alternativa para o paciente. Quando o paciente apresenta hipersensibilidade a um ��nico AINE pode ser prescrito um AINE de outra fam��lia. Enquanto que se a hipersensibilidade for cruzada �� mais seguro optar-se pelos inibidores selectivos da COX-2.

Feeding–Danger Trade-Offs Underlie Stopover Site Selection by Migrants

To migrate successfully, birds need to store adequate fat reserves to fuel each leg of the journey. Migrants acquire their fuel reserves at stopover sites; this often entails exposure to predators. Therefore, the safety attributes of sites may be as important as the feeding opportunities. Furthermore, site choice might depend on fuel load, with lean birds more willing to accept danger to obtain good feeding. Here, we evaluate the factors underlying stopover-site usage by migrant Western Sandpipers (Calidris mauri) on a landscape scale. We measured the food and danger attributes of 17 potential stopover sites in the Strait of Georgia and Puget Sound region. We used logistic regression models to test whether food, safety, or both were best able to predict usage of these sites by Western Sandpipers. Eight of the 17 sites were used by sandpipers on migration. Generally, sites that were high in food and safety were used, whereas sites that were low in food and safety were not. However, dangerous sites were used if there was ample food abundance, and sites with low food abundance were used if they were safe. The model including both food and safety best-predicted site usage by sandpipers. Furthermore, lean sandpipers used the most dangerous sites, whereas heavier birds (which do not need to risk feeding in dangerous locations) used safer sites. This study demonstrates that both food and danger attributes are considered by migrant birds when selecting stopover sites, thus both these attributes should be considered to prioritize and manage stopover sites for conservation.

Facebook & Blackboard: comparison of learner perspectives

Different systems, different purposes ��� but how do they compare as learning environments? We undertook a survey of students at the University, asking whether they learned from their use of the systems, whether they made contact with other students through them, and how often they used them. Although it was a small scale survey, the results are quite enlightening and quite surprising. Blackboard is populated with learning material, has all the students on a module signed up to it, a safe environment (in terms of Acceptable Use and some degree of staff monitoring) and provides privacy within the learning group (plus lecturer and relevant support staff). Facebook, on the other hand, has no learning material, only some of the students using the system, and on the face of it, it has the opportunity for slips in privacy and potential bullying because the Acceptable Use policy is more lax than an institutional one, and breaches must be dealt with on an exception basis, when reported. So why do more students find people on their courses through Facebook than Blackboard? And why are up to 50% of students reporting that they have learned from using Facebook? Interviews indicate that students in subjects which use seminars are using Facebook to facilitate working groups ��� they can set up private groups which give them privacy to discuss ideas in an environment which perceived as safer than Blackboard can provide. No staff interference, unless they choose to invite them in, and the opportunity to select who in the class can engage. The other striking finding is the difference in use between the genders. Males are using blackboard more frequently than females, whilst the reverse is true for Facebook. Interviews suggest that this may have something to do with needing to access lecture notes��� Overall, though, it appears that there is little relationship between the time spent engaging with Blackboard and reports that students have learned from it. Because Blackboard is our central repository for notes, any contact is likely to result in some learning. Facebook, however, shows a clear relationship between frequency of use and perception of learning ��� and our students post frequently to Facebook. Whilst much of this is probably trivia and social chit chat, the educational elements of it are, de facto, contructivist in nature. Further questions need to be answered - Is the reason the students learn from Facebook because they are creating content which others will see and comment on? Is it because they can engage in a dialogue, without the risk of interruption by others?

Future innovations in anti-platelet therapies

Platelets have long been recognized to be of central importance in haemostasis, but their participation in pathological conditions such as thrombosis, atherosclerosis and inflammation is now also well established. The platelet has therefore become a key target in therapies to combat cardiovascular disease. Anti-platelet therapies are used widely, but current approaches lack efficacy in a proportion of patients, and are associated with side effects including problem bleeding. In the last decade, substantial progress has been made in understanding the regulation of platelet function, including the characterization of new ligands, platelet-specific receptors and cell signalling pathways. It is anticipated this progress will impact positively on the future innovations towards more effective and safer anti-platelet agents. In this review, the mechanisms of platelet regulation and current anti-platelet therapies are introduced, and strong, and some more speculative, potential candidate target molecules for future anti-platelet drug development are discussed.

Selective catalytic oxidation of alkylaromatic molecules by nanosize water droplets containing Co2+ species in supercritical carbon dioxide fluid

Stabilized nano-sized water droplet carrying water-soluble Co2+ species is employed as a new catalyst system for the oxidation of the alkyl aromatics in the presence of a fluorinated surfactant. This stable system contains no labile C-H structure and can facilitate excellent mixing of catalytic Co(II)/NaBr species, hydrocarbon substrates and oxygen in supercritical carbon dioxide fluid, which is demonstrated to be an excellent alternative solvent system to acetic acid or nitric acid for air oxidation of a number of alkyl aromatic hydrocarbons using Co(II) species at mild conditions. As a result, potential advantages of this 'greener' catalytic method including safer operation, easier separation and purification, higher catalytic activity with selectivity and without using corrosive or oxidation unstable solvent are therefore envisaged.

Consistently inconsistent: commercially available starch-based Dysphagia products

Individuals with dysphagia may be prescribed thickened fluids to promote a safer and more successful swallow. Starch-based thickening agents are often employed; however, these exhibit great variation in consistency. The aim of this study was to compare viscosity and the rheological profile parameters complex (G*), viscous (G���), and elastic modulus (G���) over a range of physiological shear rates. UK commercially available dysphagia products at ���custard��� consistency were examined. Commercially available starch-based dysphagia products were prepared according to manufacturers��� instructions; the viscosity and rheological parameters were tested on a CVOR Rheometer. At a measured shear rate of 50 s���1, all products fell within the viscosity limits defined according to the National Dysphagia Diet Task Force guidelines. However, at lower shear rates, large variations in viscosity were observed. Rheological parameters G*, G���, and G��� also demonstrated considerable differences in both overall strength and rheological behavior between different batches of the same product and different product types. The large range in consistency and changes in the overall structure of the starch-based products over a range of physiological shear rates show that patients could be receiving fluids with very different characteristics from that advised. This could have detrimental effects on their ability to swallow.