Análisis del modelo de atención de una aseguradora estadounidense para identificar oportunidades de mejoramiento que se puedan adaptar al sistema de salud colombiano

Teniendo en cuenta las dificultades que ha presentado el Sistema de Salud colombiano caracterizado por la corrupción, las barreras administrativas para el acceso a los servicios de salud y la falta de una estructura administrativa, que le permita desarrollar mecanismos para ser eficiente en la prestación de servicios de salud, entre otros (Pantoja, 2011) (Colprensa, 2011) (Ruíz Gómez, 2012); el presente proyecto de investigación busca determinar los factores clave de éxito de una aseguradora Estadounidense y que se podrían adaptar al Sistema de Salud colombiano. Para lograr el propósito de este proyecto, se realizó una búsqueda de artículos donde se describieran los factores claves de éxito del modelo de aseguramiento y prestación de la aseguradora Kaiser Permanente, con el fin de analizar si dichos factores se pueden implementar de acuerdo al marco normativo en el que se desarrolla el sistema de salud colombiano. De acuerdo al análisis de la información y a la revisión de la normatividad que modela el Sistema de Salud colombiano, se pudo determinar que el Sistema General de Seguridad Social en Salud (SGSSS) cuenta con los mecanismos normativos que le permiten adoptar e implementar los factores claves de éxito que caracterizan el modelo de aseguramiento y prestación de servicios de Kaiser Permanente; por otra parte, es necesario tener en cuenta que en el modelo colombiano se permite la integración vertical sólo en un 40% , lo que no se ha estudiado es si este modelo de integración es beneficioso o no, a la hora de buscar la eficiencia en la prestación en salud, ya que el modelo Kaiser se caracteriza por aplicar una integración vertical del 100%, característica que le permite, por la evidencia encontrada, ser eficiente en la atención de sus usuarios.

Effect of small, acid-soluble proteins on spore resistance and germination under a combination of pressure and heat treatment

To find the range of pressure required for effective high-pressure inactivation of bacterial spores and to investigate the role of alpha/beta-type small, acid-soluble proteins (SASP) in spores under pressure treatment, mild heat was combined with pressure (room temperature to 65 degrees C and 100 to 500 MPa) and applied to wild-type and SASP-alpha(-/)beta(-) Bacillus subtilis spores. On the one hand, more than 4 log units of wild-type spores were reduced after pressurization at 100 to 500 MPa and 65 degrees C, On the other hand, the number of surviving mutant spores decreased by 2 log units at 100 MPa and by more than 5 log units at 500 MPa. At 500 MPa and 65 degrees C, both wild-type and mutant spore survivor counts were reduced by 5 log units. Interestingly, pressures of 100, 200, and 300 MPa at 65 degrees C inactivated wild-type SASP-alpha(+)/beta(+) spores more than mutant SASP-alpha(-)/beta(-) spores, and this was attributed to less pressure-induced germination in SASP-alpha(-)/beta(-) spores than in wild-type SASP-alpha(+)/beta(+) spores. However, there was no difference in the pressure resistance between SASP-alpha(+)/beta(+) and SASP-alpha(-)/beta(-) spores at 100 MPa and ambient temperature (approximately 22 degrees C) for 30 min. A combination of high pressure and high temperature is very effective for inducing spore germination, and then inactivation of the germinated spore occurs because of the heat treatment. This study showed that alpha/beta-type SASP play a role in spore inactivation by increasing spore germination under 100 to 300 MPa at high temperature.

Effect of heat treatment on the antioxidant activity, color, and free phenolic acid profile of malt

Green malt was kilned at 95 degrees C following two regimens: a standard regimen (SKR) and a rapid regimen (RKR). Both resulting malts were treated further in a tray dryer heated to 120 degrees C, as was green malt previously dried to 65 degrees C (TDR). Each regimen was monitored by determining the color, antioxidant activity (by both ABTS(center dot+) and FRAP methods), and polyphenolic profile. SKR and RKR malts exhibited decreased L* and increased b* values above approximately 80 degrees C. TDR malts changed significantly less, and color did not develop until 110 degrees C, implying that different chemical reactions lead to color in those malts. Antioxidant activity increased progressively with each regimen, although with TDR malts this became significant only at 110-120 degrees C. The RKR malt ABTS(center dot+) values were higher than those of the SKR malt. The main phenolics, that is, ferulic, p-coumaric, and vanillic acids, were monitored throughout heating. Ferulic acid levels increased upon heating to 80 degrees C for SKR and to 70 degrees C for RKR, with subsequent decreases. However, the levels for TDR malts did not increase significantly. The increase in free phenolics early in kilning could be due to enzymatic release of bound phenolics and/or easier extractability due to changes in the matrix. The differences between the kilning regimens used suggest that further modification of the regimens could lead to greater release of bound phenolics with consequent beneficial effects on flavor stability in beer and, more generally, on human health.

Strengthening the link between climate, hydrological and species distribution modeling to assess the impacts of climate change on freshwater biodiversity

To understand the resilience of aquatic ecosystems to environmental change, it is important to determine how multiple, related environmental factors, such as near-surface air temperature and river flow, will change during the next century. This study develops a novel methodology that combines statistical downscaling and fish species distribution modeling, to enhance the understanding of how global climate changes (modeled by global climate models at coarse-resolution) may affect local riverine fish diversity. The novelty of this work is the downscaling framework developed to provide suitable future projections of fish habitat descriptors, focusing particularly on the hydrology which has been rarely considered in previous studies. The proposed modeling framework was developed and tested in a major European system, the Adour-Garonne river basin (SW France, 116,000 km(2)), which covers distinct hydrological and thermal regions from the Pyrenees to the Atlantic coast. The simulations suggest that, by 2100, the mean annual stream flow is projected to decrease by approximately 15% and temperature to increase by approximately 1.2 °C, on average. As consequence, the majority of cool- and warm-water fish species is projected to expand their geographical range within the basin while the few cold-water species will experience a reduction in their distribution. The limitations and potential benefits of the proposed modeling approach are discussed. Copyright © 2012 Elsevier B.V. All rights reserved.

Ethanol elicits and potentiates nociceptor responses via the vanilloid receptor-1

The vanilloid receptor-1 (VR1) is a heat-gated ion channel that is responsible for the burning sensation elicited by capsaicin. A similar sensation is reported by patients with esophagitis when they consume alcoholic beverages or are administered alcohol by injection as a medical treatment. We report here that ethanol activates primary sensory neurons, resulting in neuropeptide release or plasma extravasation in the esophagus, spinal cord or skin. Sensory neurons from trigeminal or dorsal root ganglia as well as VR1-expressing HEK293 cells responded to ethanol in a concentration-dependent and capsazepine-sensitive fashion. Ethanol potentiated the response of VR1 to capsaicin, protons and heat and lowered the threshold for heat activation of VR1 from approximately 42 degrees C to approximately 34 degrees C. This provides a likely mechanistic explanation for the ethanol-induced sensory responses that occur at body temperature and for the sensitivity of inflamed tissues to ethanol, such as might be found in esophagitis, neuralgia or wounds.

Enhanced thermal properties and morphology of ion-exchanged polypyrrole films

The thermal stability of electrochemically prepared polypyrrole (PPy) films with p-toluenesulfonate (pTS) or perchlorate (ClO₄⁻) counterion (PPy/pTS and PPy/ClO₄⁻) is improved by simple treatment with aqueous sulfuric acid, sodium sulfate or sodium bisulfate. The degree of stabilization achieved depends on the solution, temperature and duration of treatment. Although the mechanism for improved stability is not yet clear, it is apparent that the level of ion exchange and the original polymer microstructure are important. A model for the conductivity decay as a function of thickness has been proposed. The early stages of ion exchange are not symmetrical, and diffusion is facilitated at the electrode side of the film. Furthermore, X-ray diffraction shows no evidence of morphological change after treatment of PPy/pTS (43 μm), but in PPy/pTS (12 μm) and PPy/ClO₄⁻ (41 μm) films an additional peak is indicative of more ordered structure following treatment. The glass transition temperature, T_g, of PPy/pTS and PPy/ClO₄⁻ films obtained by modulated differential scanning calorimetry is approximately 155°C.

Temperature conditions during 'cold' sheet metal stamping

This paper investigates the friction and deformation-induced heating that occurs during the stamping of high strength sheet steels, under room temperature conditions. A thermo-mechanical finite element model of a typical plane strain stamping process was developed to understand the temperature conditions experienced within the die and blank material; and this was validated against experimental measurements. A high level of correlation was achieved between the finite element model and experimental data for a range of operating conditions and parameters. The model showed that the heat generated during realistic production conditions can result in high temperatures of up to 108 °C and 181 °C in the blank and die materials, respectively, for what was traditionally expected to be 'cold' forming conditions. It was identified that frictional heating was primarily responsible for the peak temperatures at the die surface, whilst the peak blank temperatures were caused by a combination of frictional and deformation induced heating. The results provide new insights into the local conditions within the blank and die, and are of direct relevance to sheet formability and tool wear performance during industrial stamping processes. © 2014 Elsevier B.V. All rights reserved.

Composição química e digestibilidade da vagem de algarobeira (prosopis juliflora, (sw) dc) submetida a diferentes tratamentos térmicos

The ground pods of mesquite (GPM) was submitted to different thermal treatments for two hours after wanted temperature stabilization, for making of the treatments: A = ground pods of mesquite without heat treatment (approximately 30 degrees C); B = The ground pods of mesquite treated at 60 degrees C; C = The ground pods of mesquite treated at 80 degrees C; D = The ground pods of mesquite treated at 100 degrees C and E = The ground pods of mesquite treated at 120 degrees C. Soon after, samples were collected for accomplishment for chemical analyses and in vitro digestibility. A completely randomized design with three replications was utilized. The DM, CP, NFE, CF, ADF, celluloses, lignin, ash and CE values, did not were affected (P>0.05) by temperature. It was observed a quadratic effect (P<0.01) on the contents of EE, decreasing linear effect (P<0.01) on the CC and increasing linear effect on the NDF (P<0.01) and Hemicellulose (P<0.05) contents. The in vitro dry matter digestibility and the in vitro organic matter digestibility were not affected (P>0.05) by temperature. on the other hand the in vitro protein digestibility level, showed a quadratic effect (P<0.05), decreasing after 54 degrees C.

Female reproductive system of the sugarcane spittlebug Mahanarva fimbriolata (Auchenorrhyncha): Vitellogenesis dynamics and protein quantification

The present study aimed describing the ovaries of the sugarcane spittlebug Mahanarva fimbriolata which are meroistic telotrophic with nurse cells and oocytes located in the tropharium. SEM revealed paired ovaries located dorsolaterally around the intestine, and oocytes exhibiting shapes ranging from round (less developed) to elliptic (more developed), suggesting a simultaneous, although, asynchronous development. Based on histological data we classified the oocytes in stages from I to V. Stage I oocytes exhibit follicular epithelium with cubic and/or prismatic cells, fine cytoplasmic granules. Stage II oocytes present intercellular spaces in the follicular epithelium due to the incorporation of yolk elements from the hemolymph. Small granules are present in the periphery of oocytes while larger granules are observed in the center. Stage III oocytes are larger and intercellular spaces in the follicular epithelium are evident, as well as the interface between follicular epithelium and oocyte. Yolk granules of different sizes are present in the cytoplasm. During this stage, chorion deposition initiates. Stage IV oocytes exhibit squamous follicular cells and larger intercellular spaces when compared to those observed in the previous stage. The oocyte cytoplasm present granular and viscous yolk, the latter is the result of the breakdown of granules. Stage V oocytes exhibit a follicular epithelium almost completely degenerated, smaller quantities of granular yolk and large amounts of viscous yolk. Based on our findings we established the sequence of yolk deposition in M. fimbriolata oocyte as follows: proteins and lipids, which are first produced by endogenous processes in stages I and II oocytes. Exogenous incorporation begins in stage III. In stages I and II oocytes, lipids are also produced by follicular epithelial cells. The third element to be deposited is polysaccharides, mainly found as complexes. Therefore, the yolk present in the oocytes of this species consists of glycolipoproteins. Molecular weights of proteins present in M. fimbriolata oocytes ranged from 10 to 92 KDa, differently from vitellogenin, the most common protein present in insect oocytes, weighing approximately 180 KDa. (c) 2006 Elsevier Ltd. All rights reserved.

Purification, crystallization and preliminary X-ray diffraction analysis of a class P-III metalloproteinase (BmMP-III) from the venom of Bothrops moojeni

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Circular, elliptic and oval billiards in a gravitational field

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Novel polymer electrolytes based on gelatin and ionic liquids

This study describes the results of the characterization of polymer electrolytes using gelatin matrix doped with europium triflate and/or different ionic liquids. Samples of solvent-free electrolytes were prepared and characterized by ionic conductivity measurements, thermal analysis, electrochemical stability, X-ray diffraction (XRD), scanning electron microscopy (SEM) and photoluminescence spectroscopy. Electrolyte samples are thermally stable up to approximately 220 degrees C. All the materials synthesized are totally amorphous. The room temperature conductivity maximum of this electrolyte system is based on ionic liquid 1-ethyl-3-methylimidazolium acetate, (C(2)mim)(OAc) (1.18 x 10(-4) S cm(-1) at 30 degrees C). The electrochemical stability domain of all samples is about 2.0 V versus Li/Li+. This new series of materials represents a promising alternative in polymer electrolytes research field. The preliminary studies carried out with electrochromic devices (ECDs) incorporating optimized compositions have confirmed that these materials may perform as satisfactory multifunctional component layers in the field of "smart windows". This new materials, will open a land of promising applications in many areas: optics, energy, medicine for example as membranes and separation devices, ECD-based devices, sensors, etc. (C) 2012 Elsevier B.V. All rights reserved.

Measurement of flow harmonics with multi-particle cumulants in Pb+Pb collisions at √sNN=2.76 TeV with the ATLAS detector

ATLAS measurements of the azimuthal anisotropy in lead–lead collisions at √sNN = 2.76 TeV are shown using a dataset of approximately 7μb−1 collected at the LHC in 2010. The measurements are performed for charged particles with transversemomenta 0.5 < pT < 20 GeV and in the pseudorapidity range |η| < 2.5. The anisotropy is characterized by the Fourier coefficients, vn, of the charged-particle azimuthal angle distribution for n = 2–4. The Fourier coefficients are evaluated using multi-particle cumulants calculated with the generating function method. Results on the transverse momentum, pseudorapidity and centrality dependence of the vn coefficients are presented. The elliptic flow, v2, is obtained from the two-, four-, six- and eight-particle cumulants while higher-order coefficients, v3 and v4, are determined with two- and four-particle cumulants. Flow harmonics vn measured with four-particle cumulants are significantly reduced compared to the measurement involving two-particle cumulants. A comparison to vn measurements obtained using different analysis methods and previously reported by the LHC experiments is also shown. Results of measurements of flow fluctuations evaluated with multiparticle cumulants are shown as a function of transverse momentum and the collision centrality. Models of the initial spatial geometry and its fluctuations fail to describe the flow fluctuations measurements.

Geochemistry of Atlantis Massif serpentinites

The Lost City hydrothermal system at the southern Atlantis Massif (Mid-Atlantic Ridge, 30°N) provides a natural laboratory for studying serpentinization processes, the temporal evolution of ultramafic-hosted hydrothermal systems, and alteration conditions during formation and emplacement of an oceanic core complex. Here we present B, O, and Sr isotope data to investigate fluid/rock interaction and mass transfer during detachment faulting and exhumation of lithospheric sequences within the Atlantis Massif. Our data indicate that extensive serpentinization was a seawater-dominated process that occurred predominately at temperatures of 150-250 °C and at high integrated W/R ratios that led to a marked boron enrichment (34-91 ppm). Boron removal from seawater during serpentinization is positively correlated with changes in d11B (11-16 per mil) but shows no correlation with O-isotope composition. Modeling indicates that B concentrations and isotope values of the serpentinites are controlled by transient temperature-pH conditions. In contrast to prior studies, we conclude that low-temperature marine weathering processes are insignificant for boron geochemistry of the Atlantis Massif serpentinites. Talc- and amphibole-rich fault rocks formed within a zone of detachment faulting at temperatures of approximately 270-350 °C and at low W/R ratios. Talc formation in ultramafic domains in the massif was subsequent to an early stage of serpentinization and was controlled by the access of Si-rich fluids derived through seawater-gabbro interactions. Replacement of serpentine by talc resulted in boron loss and significant lowering of d11B values (9-10 per mil), which we model as the product of progressive extraction of boron. Our study provides new constraints on the boron geochemical cycle at oceanic spreading ridges and suggests that serpentinization associated with ultramafic-hosted hydrothermal systems may have important implications for the behavior of boron in subduction zone settings.