Calorimetría indirecta versus Harris-Benedict para determinar gasto energético basal en pacientes ventilados

El inadecuado aporte nutricional en los pacientes con enfermedades criticas, ha llevado al desarrollo de complicaciones que incrementan la mortalidad y los costos de la atención en salud. Muchos factores están involucrados en el consumo de los nutrientes por el organismo, como: los traslados, las intervenciones quirúrgicas, el uso de vasopresores, la ventilación mecánica, entre otros. Si se presenta imprecisión en la de-terminación del gasto energético, puede conllevar a un sobre aporte alimenticio en el paciente el cual puede afectar la evolución y pronosti-co del individuo. Es de conocimiento universal que los costos en salud cada día se in-crementan, en especial cuando se presenta requerimiento del manejo de un paciente en la unidad de cuidados intensivos. Para predecir el gasto energético basal de los paciente en las UCI se cuentan con herramientas de evaluación sencillas, de fácil uso y económicas, como la ecuación de Harris-Benedict, o herramientas complejas y de difícil manejo como la Calorimetría Indirecta. El incremento en la demanda de servicios con mayor tecnología en el tratamiento de los pacientes, enfrenta al personal de salud para ser más crítico en el uso de la nueva tecnología, por tal motivo, se evaluó la presencia de correlación entre las ecuaciones de Harris-Benedict y Calorimetría Indirecta, encontrando que se presenta una buena correlación entre las ecuaciones, con un valor de Pearson de 0,700 y una p = 0.002. Por lo que se puede concluir que las ecuaciones pueden ser utilizadas para estimar el gasto energético basal de los pacientes en la UCI.

Nuevas tecnologías, nuevas formas de negocios: Smartphones y códigos QR en Chile

Hace varios años atrás el uso del celular era un bien que muy pocas personas tenían la oportunidad de adquirirlo. Por un lado esta adquisición era muy cara y además había muy poca oferta en el mercado. El uso de los celulares era estrictamente para llamadas urgentes y muy pocas personas podían tener este bien en sus manos. A medida que iban avanzando los años las personas generaban mas necesidades y las empresas hacían todo lo posible por satisfacer estas necesidades. Por esta misma razón las empresas empezaron a ir más allá que simplemente satisfacer estas necesidades. Por lo que empezaron a no solo crear un simple celular que sirviera para llamadas sino un celular que también incluyera cámara, video, mensajes de texto, mails, bluetooth, música, entre más funciones. Hoy en día un celular que no tenga este tipo de funciones es obsoleto y ahora las personas se vuelven cada vez más dependientes a un teléfono celular. Por eso es importante investigar si es verdaderamente importante y necesario tener toda la vida de las personas en el celular, si estas nuevas tecnologías son relevantes para la sustentabilidad de las empresas y también que beneficios trae la evolución de las nuevas tecnologías. En la actualidad se ha dado que para las personas es fundamental el uso de los smartphones, no solo en la vida personal sino también laboral. Por eso es relevante conocer qué tan importante es el Smartphone para las personas y también cómo se puede aprovechar esta tecnología. Para la sociedad en la que vivimos actualmente, estar en contacto con el mundo es fundamental y también ser parte de el, por lo que la aparición de estos smartphones ha permitido que ese acercamiento sea mas rápido y con mayor facilidad. En los últimos años, ha habido un boom en la oferta y demanda de este tipo de productos, en el cual las empresas han estado peleando por ofrecer tanto nuevos dispositivos y tecnologías, como también nuevos servicios en cuanto a conectividad y aplicaciones de estos.

Innovation In Games

In this lecture we look at how innovation in games has moved from the creation of new genres, to the incorporation of new technology, that has unlocked new ways to play games. In particular we look at casual and social games, motion controllers, virtual reality, augmented reality, location-based games, mixed reality, and alternate reality.

Climate Change and Transregional Convergence: Carbon Markets in North Amer ica

National policies in North America have not been drafted properly to address the problem of climate change, following the impasse of international negotiations. Facing this scenario, new alternatives emerge with the leadership and participation of new actors. Local governments in North America, especially of British Columbia, Ontario and Quebec, have been developing strategies to face climate change and emissions reduction in parallel to the national efforts and the global governance strategies. These local governments have developed a transregional approach that has resulted in the creation of regional institutions such as the Western Climate Initiative, the Regional Greenhouse GasInitiative and the Midwestern GreenhouseGas Reduction Accord.Their main goal is to establish regional carbon markets to mitigate and adapt to climate change impacts in a cost-effective way. In spite of these efforts, these initiatives have faced the overlapping problem among them and with national and globalstrategies. The goal of this research is to explore how these carbon markets have developed convergence policies. Convergence among these markets is expressed in their offset system and in secondary markets.

Hacia un nuevo vínculo de las relaciones entre la Unión Europea y la Comunidad Andina: los referentes de gobernanza y la visión europea de seguridad respecto a América Latina

Teniendo en cuenta que la U.E. ha desarrollado una visión de seguridad respecto a Latinoamérica de carácter civil y cooperativa, mas no militar, y que la noción que en gran medida hoy explica la estructura de interacción comunitaria es la gobernanza, el objetivo del presente trabajo es desarrollar un primer acercamiento al estudio de la UE como referente de seguridad y de gobernanza para la Comunidad Andina.En esa medida, se analizará el caso en dos niveles de análisis, uno internacional, donde se ubica la UE como referente de seguridad (relaciones entre la UE y América Latina), y otro subregional, donde estaría la UE como referente de gobernanza (modelo de integración propiamente dicho), se tratará de identificar algunos elementos que dentro del contexto de seguridad hemisférica y subregional puedan conducir a pensar que la propuesta de tomar a la UE como referente, en cuanto a su definición de seguridad y sus modelos de funcionamiento, resultaría viable. En este sentido, de manera propositiva, se recomendarán algunas orientaciones generales, con el fin de proponer una nueva forma de pensar la seguridad andina, que además de que integre la variable no militar, también incorpore la participación de nuevos actores securitarios.-----Taking account that the European Unions (EU) security vision of Latin America has a civilian and cooperative character, and not a military and defensive nature, and considering also that the notion which explains the structure of community interactions is the Governance, the objective of this paper is to develop a first approach to the study of the EU as a security and Governance referent.This approach develops two levels of analysis. The first one is the international level, where the EU is a security referent for Latin America and the second one, is the subregional level, where EU could be a Governance referent through the integration model. For such purpose this article identifies some hemispheric and subregional elements that show that the EU could be a model of security and governance for Latin America. Finally I recommend some general orientations to build a new way of thinking the Andian Security in order to incorporate not only the military dimension, but to integrate, as possible, the participation of new actors and other perspectives into a more security comprehensive notion.

Análisis ecocardiográfico de la función sistólica del ventrículo izquierdo por médicos no cardiólogos con un dispositivo de bolsillo

Se realizó un estudio transversal, se incluyeron 3 residentes no cardiólogos y se les dio formación básica en ecocardiografía (horas teóricas 22, horas prácticas 65), con recomendaciones de la Sociedad Americana de Ecocardiografia y aportes del aprendizaje basado en problemas, con el desarrollo de competencia técnicas y diagnósticas necesarias, se realizó el análisis de concordancia entre residentes y ecocardiografistas expertos, se recolectaron 122 pacientes hospitalizados que cumplieran con los criterios de inclusión y exclusión, se les realizo un ecocardiograma convencional por el experto y una valoración ecocardiográfica por el residente, se evaluó la ventana acústica, contractilidad, función del ventrículo izquierdo y derrame pericárdico. La hipótesis planteada fue obtener una concordancia moderada. Resultados: Se analizó la concordancia entre observadores para la contractilidad miocárdica (Kappa: 0,57 p=0,000), función sistólica del ventrículo izquierdo (Kappa 0,54 p=0.000) siendo esta moderada por estar entre 0,40 – 0,60 y con una alta significancia estadística, para la calidad de la ventana acústica (Kappa: 0,22 p= 0.000) y presencia de derrame pericárdico (Kappa: 0,26 p= 0.000) se encontró una escasa concordancia ubicándose entre 0,20 – 0,40. Se estableció una sensibilidad de 90%, especificidad de 67%, un valor predictivo positivo de 80% y un valor predictivo negativo de 85% para el diagnóstico de disfunción sistólica del ventrículo izquierdo realizado por los residentes.

Energy.

Se analiza cómo las actuales tecnologías están transformando el mundo del futuro, destacando los principios científicos que hay detrás de ellas y el impacto que estas nuevas ideas tendrán en nuestros estilos de vida y el medio ambiente.

Optimal management of natural resources. Accounting for heterogeneity

Dynamic optimization methods have become increasingly important over the last years in economics. Within the dynamic optimization techniques employed, optimal control has emerged as the most powerful tool for the theoretical economic analysis. However, there is the need to advance further and take account that many dynamic economic processes are, in addition, dependent on some other parameter different than time. One can think of relaxing the assumption of a representative (homogeneous) agent in macro- and micro-economic applications allowing for heterogeneity among the agents. For instance, the optimal adaptation and diffusion of a new technology over time, may depend on the age of the person that adopted the new technology. Therefore, the economic models must take account of heterogeneity conditions within the dynamic framework. This thesis intends to accomplish two goals. The first goal is to analyze and revise existing environmental policies that focus on defining the optimal management of natural resources over time, by taking account of the heterogeneity of environmental conditions. Thus, the thesis makes a policy orientated contribution in the field of environmental policy by defining the necessary changes to transform an environmental policy based on the assumption of homogeneity into an environmental policy which takes account of heterogeneity. As a result the newly defined environmental policy will be more efficient and likely also politically more acceptable since it is tailored more specifically to the heterogeneous environmental conditions. Additionally to its policy orientated contribution, this thesis aims making a methodological contribution by applying a new optimization technique for solving problems where the control variables depend on two or more arguments --- the so-called two-stage solution approach ---, and by applying a numerical method --- the Escalator Boxcar Train Method --- for solving distributed optimal control problems, i.e., problems where the state variables, in addition to the control variables, depend on two or more arguments. Chapter 2 presents a theoretical framework to determine optimal resource allocation over time for the production of a good by heterogeneous producers, who generate a stock externalit and derives government policies to modify the behavior of competitive producers in order to achieve optimality. Chapter 3 illustrates the method in a more specific context, and integrates the aspects of quality and time, presenting a theoretical model that allows to determine the socially optimal outcome over time and space for the problem of waterlogging in irrigated agricultural production. Chapter 4 of this thesis concentrates on forestry resources and analyses the optimal selective-logging regime of a size-distributed forest.

SME’s Alliance Dynamics in the Mobile Marketing Industry

This paper presents a case study of the two similar sized, new, technology-based firms acting as alliance partners in the Mobile commerce industry. The analysis describes how the alliance dynamics in our case study relate to seminal research in the field of business alliance formation. Contrary to the established predictions we find that the negative influence on alliance performance described as a consequence of the dissolved routinized alliance pattern by seminal authors is not present. At the same time, the case study shows that internalization of complementary assets does not by necessity result in dissolution of the business alliance as argued from a resource and competence based perspective.

Generation of candidate human influenza vaccine strains in cell culture: rehearsing the European response to an H7N1 pandemic threat

Background: Although H5N1 avian influenza viruses pose the most obvious imminent pandemic threat, there have been several recent zoonotic incidents involving transmission of H7 viruses to humans. Vaccines are the primary public health defense against pandemics, but reliance on embryonated chickens eggs to propagate vaccine and logistic problems posed by the use of new technology may slow our ability to respond rapidly in a pandemic situation. Objectives: We sought to generate an H7 candidate vaccine virus suitable for administration to humans whose generation and amplification avoided the use of eggs. Methods: We generated a suitable H7 vaccine virus by reverse genetics. This virus, known as RD3, comprises the internal genes of A/Puerto Rico/8/34 with surface antigens of the highly pathogenic avian strain A/Chicken/Italy/13474/99 (H7N1). The multi-basic amino acid site in the HA gene, associated with high pathogenicity in chickens, was removed. Results: The HA modification did not alter the antigenicity of the virus and the resultant single basic motif was stably retained following several passages in Vero and PER. C6 cells. RD3 was attenuated for growth in embryonated eggs, chickens, and ferrets. RD3 induced an antibody response in infected animals reactive against both the homologous virus and other H7 influenza viruses associated with recent infection by H7 viruses in humans. Conclusions: This is the first report of a candidate H7 vaccine virus for use in humans generated by reverse genetics and propagated entirely in mammalian tissue culture. The vaccine has potential use against a wide range of H7 strains.

Implementing innovation in construction: Contexts, relative boundedness and actor-network theory

Theoretical understanding of the implementation and use of innovations within construction contexts is discussed and developed. It is argued that both the rhetoric of the 'improvement agenda' within construction and theories of innovation fail to account for the complex contexts and disparate perspectives which characterize construction work. To address this, the concept of relative boundedness is offered. Relatively unbounded innovation is characterized by a lack of a coherent central driving force or mediator with the ability to reconcile potential conflicts and overcome resistance to implementation. This is a situation not exclusive to, but certainly indicative of, much construction project work. Drawing on empirical material from the implementation of new design and coordination technologies on a large construction project, the concept is developed, concentrating on the negotiations and translations implementation mobilized. An actor-network theory (ANT) approach is adopted, which emphasizes the roles that both human actors and non-human agents play in the performance and outcomes of these interactions. Three aspects of how relative boundedness is constituted and affected are described; through the robustness of existing practices and expectations, through the delegation of interests on to technological artefacts and through the mobilization of actors and artefacts to constrain and limit the scope of negotiations over new technology implementation.

ENABLE: a wrist worn device with integrated accessible services to support old people living independently and safely at home

This RTD project, 2007-2009, is partly funded by the European Commission, in Framework Programme 6. It aims to assist elderly people for living well, independently and at case. ENABLE will provide a number of services for elderly people based on the new technology provided by mobile phones. The project is developing a Wrist unit with both integrated and external sensors, and with a radio frequency link to a mobile phone. Dedicated ENABLE software running on the wrist unit and mobile phone makes these services fully accessible for the elderly users. This paper outlines the fundamental motivation and the approach which currently is undertaken in order to collect the more detailed user needs and requirements. The general architecture and the design of the ENABLE system are outlined.

Directed search with real options

While search is normally modelled by economists purely in terms of decisions over making observations, this paper models it as a process in which information is gained through feedback from innovatory product launches. The information gained can then be used to decide whether to exercise real options. In the model the initial decisions involve a product design and the scale of production capacity. There are then real options to change these factors based on what is learned. The case of launching product variants in parallel is also considered. Under ‘true’ uncertainty, the model can be seen in terms of heuristic decision-making based on subjective beliefs with limited foresight. Search costs, the values of the real options, beliefs, and the cost of capital are all shown to be significant in determining the search path.

IT implementation in the construction organization

Organizational issues are inhibiting the implementation and strategic use of information technologies (IT) in the construction sector. This paper focuses on these issues and explores processes by which emerging technologies can be introduced into construction organizations. The paper is based on a case study, conducted in a major house building company that was implementing a virtual reality (VR) system for internal design review in the regional offices. Interviews were conducted with different members of the organization to explore the introduction process and the use of the system. The case study findings provide insight into the process of change, the constraints that inhibit IT implementation and the relationship between new technology and work patterns within construction organizations. They suggest that (1) user-developer communications are critical for the successful implementation of non-diffused innovations in the construction industry; and (2) successful uptake of IT requires both strategic decision-making by top management and decision-making by technical managers.

Implementation of VR systems: a comparison between the early adoption of CAD and current uptake of VR

Use of new technologies, such as virtual reality (VR), is important to corporations, yet understanding of their successful implementation is insuf. ciently developed. In this paper a case study is used to analyse the introduction of VR use in a British housebuilding company. Although the implementation was not successful in the manner initially anticipated, the study provides insight into the process of change, the constraints that inhibit implementation and the relationship between new technology and work organization. Comparison is made with the early use of CAD and similarities and differences between empirical . ndings of the case study and the previous literature are discussed.