997 resultados para Intravenous regional perfusion


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ABSTRACT Amphibians are the most threatened vertebrate group according to the IUCN. Land-use and land cover change (LULCC) and climate change (CC) are two of the main factors related to declining amphibian populations. Given the vulnerability of threatened and rare species, the study of their response to these impacts is a conservation priority. The aim of this work was to analyze the combined impact of LULCC and CC on the regionally endemic species Melanophryniscus sanmartini Klappenbach, 1968. This species is currently categorized as near threatened by the IUCN, and previous studies suggest negative effects of projected changes in climate. Using maximum entropy methods we modeled the effects of CC on the current and mid-century distribution of M. sanmartini under two IPCC scenarios - A2 (severe) and B2 (moderate). The effects of LULCC were studied by superimposing the potential distribution with current land use, while future distribution models were evaluated under the scenario of maximum expansion of soybean and afforestation in Uruguay. The results suggest that M. sanmartini is distributed in eastern Uruguay and the south of Brazil, mainly related to hilly and grasslands systems. Currently more than 10% of this species' distribution is superimposed by agricultural crops and exotic forest plantations. Contrasting with a recent modelling study our models suggest an expansion of the distribution of M. sanmartini by mid-century under both climate scenarios. However, despite the rise in climatically suitable areas for the species in the future, LULCC projections indicate that the proportion of modified habitats will occupy up to 25% of the distribution of M. sanmartini. Future change in climate conditions could represent an opportunity for M. sanmartini, but management measures are needed to mitigate the effects of habitat modification in order to ensure its survival and allow the eventual expansion of its distribution.

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We use statistical techniques to quantify the effects of school attainment on individual wages, participation rates and employment probabilities in Spain, and to measure the contribution of education to labour productivity at the regional level. These estimates are then combined with data on private and public expenditure on education and with information on taxes and social benefits to construct measures of the private and social returns to schooling, to explore the effects of public policies on private incentives to invest in human capital, and to analyse the long-term effects of schooling on public finances. The results are used, together with estimates of the returns to alternative assets, to draw some tentative conclusions regarding the adequacy of the aggregate investment patterns observed in the regions of Spain, and to identify changes in the design of national and EU cohesion and growth policies that may help enhance their effectiveness.

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How should an equity-motivated policy-marker allocate public capital (infrastructure) across regions. Should it aim at reducing interregional differences in per capita output, or at maximizing total output? Such a normative question is examined in a model where the policy-marker is exclusively concerned about personal inequality and has access to two policy instruments. (i) a personal tax-transfer system (taxation is distortionary), and (ii) the regional allocation of public investment. I show that the case for public investment as a significant instrument for interpersonal redistribution is rather weak. In the most favorable case, when the tax code is constrained to be uniform across regions, it is optimal to distort the allocation of public investment in favor of the poor regions, but only to a limited extent. The reason is that poor individuals are relatively more sensitive to public trans fers, which are maximized by allocating public investment efficiently. If! the tax code can vary across regions then the optimal policy may involve an allocation of public investment distorted in favor of the rich regions.

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The objective of this paper is to investigate, in a methodologically consistent manner, the regional effects of public capital formation and the possible existence of regional spillover effects in Spain. The empirical results are based on VAR estimates at both the aggregate and regional levels using output, employment, and private capital, as well as different measures of public capital. Empirical results suggest that public capital affects output positively at the aggregate level as well as in all but one region. For most regions, the effects of public capital installed in the region itself are important but the spillover effects induced from public capital installed elsewhere are also very important. In fact, the spillover effects account for over half of the total effects of public capital formation in Spain. Furthermore, these spillover effects have a clear geographical pattern in that they tend to be more important in the peripheral regions of the country. We also find that relative to their share of the Spanish output, the biggest beneficiaries of public capital formation are the largest regions in the country. This suggests that public capital formation has contributed to concentration of output in these regions. Finally, in terms of the effects of public capital formation on the private inputs we find that both private capital and employment are affected positively at the aggregate level as well as for most of the regions. Nevertheless, the effects on private capital seem to be larger. Also, the spillover effects are very important for private capital but not for employment. This reflects a great degree of dynamism and mobility in the capital markets as opposed to the labor markets.

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The purpose of this paper is to study the possible differences among countries as CO2 emitters and to examine the underlying causes of these differences. The starting point of the analysis is the Kaya identity, which allows us to break down per capita emissions in four components: an index of carbon intensity, transformation efficiency, energy intensity and social wealth. Through a cluster analysis we have identified five groups of countries with different behavior according to these four factors. One significant finding is that these groups are stable for the period analyzed. This suggests that a study based on these components can characterize quite accurately the polluting behavior of individual countries, that is to say, the classification found in the analysis could be used in other studies which look to study the behavior of countries in terms of CO2 emissions in homogeneous groups. In this sense, it supposes an advance over the traditional regional or rich-poor countries classifications .

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In this paper well-known summary inequality indexes are used to explore interregional income inequalities in Europe. In particular, we mainly employ Theils’population-weighted index because of its appealing properties. Two decomposition analysis are applied. First, regional inequalities are decomposed by regional subgroups (countries). Second, intertemporal inequality changes are separated into income and population changes. The main results can be summarized as follows. First, data confirm a reduction in crossregional inequality during 1982-97. Second, this reduction is basically due to real convergence among countries. Third, currently the greater part of European interregional disparities is within-country by nature, which introduce an important challenge for the European policy. Fourth, inequality changes are due mainly to income variations, population changes playing a minor role.

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The objective of this paper is to measure the impact of different kinds of knowledge and external economies on urban growth in an intraregional context. The main hypothesis is that knowledge leads to growth, and that this knowledge is related to the existence of agglomeration and network externalities in cities. We develop a three-tage methodology: first, we measure the amount and growth of knowledge in cities using the OCDE (2003) classification and employment data; second, we identify the spatial structure of the area of analysis (networks of cities); third, we combine the Glaeser - Henderson - De Lucio models with spatial econometric specifications in order to contrast the existence of spatially static (agglomeration) and spatially dynamic (network) external economies in an urban growth model. Results suggest that higher growth rates are associated to higher levels of technology and knowledge. The growth of the different kinds of knowledge is related to local and spatial factors (agglomeration and network externalities) and each knowledge intensity shows a particular response to these factors. These results have implications for policy design, since we can forecast and intervene on local knowledge development paths.

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A nivel mundial, en las últimas tres décadas, la inversión directa ha experimentado un desarrollo espectacular. Los datos de la UNCTAD muestran como, entre 1970 y 2005, los flujos de inversión emitida crecieron más de un quinientos por cien. A pesar que, para el conjunto del periodo estos incrementos inversión fueron continuados, hay que diferenciar cuatro etapas. Hasta principios de los ochenta, el volumen no era excesivamente elevado, pero las tasas de incremento mostraban una tendencia cada vez mayor en el desarrollo de la inversión a nivel mundial. Entre mediados de los ochenta y noventa, los flujos empezaron a crecer de forma más notable y sostenida. El boom inversor se produjo, sobretodo, a partir de los cuatro últimos años del siglo veinte, cuando la inversión creció a un ritmo espectacular; con tasas de incremento anual que en algunos años (como el de 1999) rozaron el sesenta por ciento. Tras el inicio del siglo XXI, la inversión directa se ralentizó. Entre los años 2001 y 2005 las salidas de capital disminuyeron y, aunque se mantuvieron en niveles ciertamente altos en comparación con el conjunto del periodo, fueron sensiblemente más bajos que los registrados a finales de la década de los noventa. El incremento general de este tipo de movimientos internacionales de capital, iniciado, sobretodo, a partir de la década de los ochenta y eclosionado a mediados de los noventa tuvo origen en un contexto de progresiva y paulatina liberalización de las relaciones económicas a nivel mundial; en transformaciones institucionales de gran calado en prácticamente todas las economías del mundo, y en un contexto de fuerte crecimiento económico impulsado, en gran parte, por el desarrollo tecnológico de la llamada "nueva economía".

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Background: Inadequate intraoperative cerebral perfusion has been suggested as a possible cause of postoperative cognitive dysfunction (POCD). Methods: We investigated 35 patients aged 65 or older undergoing elective major non-cardiac surgery under standardized general anaesthesia (thiopental, sevoflurane, fentanyl, atracurium). Intraoperative cerebral perfusion was monitored with transcranial Doppler, and near-infrared spectroscopy (NIRS). Arterial blood pressure was monitored continuously with a Finapres device. Mx, an index allowing continuous monitoring of cerebrovascular autoregulation based on the changes in mean arterial blood pressure (MAP) and cerebral blood flow velocity was calculated. Mx >0.5 was defined as disturbed cerebrovascular autoregulation. Cognitive function was measured preoperatively and 7 days postoperatively using the CERAD-NAB Plus test battery. A postoperative decline >1 z-score in at least two of the tested domains was defined as POCD. Data are shown as mean } SD. Results: Mean age was 75 } 7 yrs. Sixteen patients (46%) developed POCD. These patients were older (77 } 8 vs 73 } 7 yrs), had lower MAP (77 } 12 vs 81 } 11 mm Hg), lower cerebral tissue oxygenation indices measured by NIRS (66.8 } 6.0 vs 68.6 } 4.3%) and less efficient cerebrovascular autoregulation (Mx 0.54 } 0.17 and 0.44 } 0.22) than patients without POCD. Disturbed intraoperative cerebrovascular autoregulation was found more often (56 vs 37%) in patients with POCD. However, none of these differences reached statistical significance. Conclusions: Our data show a trend towards subtle changes in intraoperative cerebral perfusion in elderly patients who develop POCD. However, a cause effect relationship must not be assumed and a greater number of patients needs to be investigated patients. However, more patients need to be investigated to confirm and characterize these differences.

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This paper presents estimates of the contribution of infrastructure investment to the growth of output and employment in Spain and its regions and investigates the impact of this factor on the process of regional convergence in income per capita during the period 1965-2004.

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BACKGROUND: To date, there is no quality assurance program that correlates patient outcome to perfusion service provided during cardiopulmonary bypass (CPB). A score was devised, incorporating objective parameters that would reflect the likelihood to influence patient outcome. The purpose was to create a new method for evaluating the quality of care the perfusionist provides during CPB procedures and to deduce whether it predicts patient morbidity and mortality. METHODS: We analysed 295 consecutive elective patients. We chose 10 parameters: fluid balance, blood transfused, Hct, ACT, PaO2, PaCO2, pH, BE, potassium and CPB time. Distribution analysis was performed using the Shapiro-Wilcoxon test. This made up the PerfSCORE and we tried to find a correlation to mortality rate, patient stay in the ICU and length of mechanical ventilation. Univariate analysis (UA) using linear regression was established for each parameter. Statistical significance was established when p < 0.05. Multivariate analysis (MA) was performed with the same parameters. RESULTS: The mean age was 63.8 +/- 12.6 years with 70% males. There were 180 CABG, 88 valves, and 27 combined CABG/valve procedures. The PerfSCORE of 6.6 +/- 2.4 (0-20), mortality of 2.7% (8/295), CPB time 100 +/- 41 min (19-313), ICU stay 52 +/- 62 hrs (7-564) and mechanical ventilation of 10.5 +/- 14.8 hrs (0-564) was calculated. CPB time, fluid balance, PaO2, PerfSCORE and blood transfused were significantly correlated to mortality (UA, p < 0.05). Also, CPB time, blood transfused and PaO2 were parameters predicting mortality (MA, p < 0.01). Only pH was significantly correlated for predicting ICU stay (UA). Ultrafiltration (UF) and CPB time were significantly correlated (UA, p < 0.01) while UF (p < 0.05) was the only parameter predicting mechanical ventilation duration (MA). CONCLUSIONS: CPB time, blood transfused and PaO2 are independent risk factors of mortality. Fluid balance, blood transfusion, PaO2, PerfSCORE and CPB time are independent parameters for predicting morbidity. PerfSCORE is a quality of perfusion measure that objectively quantifies perfusion performance.

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El trabajo analiza los procesos de gestación y evolución del orden regional de Asia oriental en materia de seguridad, así como la estructura normativa del mismo. En estos procesos las iniciativas bilaterales de los Estados tradicionalmente han jugado un papel determinante. Las últimas dos décadas, no obstante, han sido testigo del creciente peso de otros actores no estatales en el marco del llamado second track y del impulso de iniciativas multilaterales. En cuanto a la estructura de este orden, por otra parte, ésta se compone de unos principios y normas constitucionales y de unas instituciones fundamentales que delimitan un orden diferente de y compatible con el orden internacional actual.