Propuesta de un plan estratégico para la autosostenibilidad de la Asociación Médicos por el Derecho a la Salud (MDS), El Salvador.

En esta investigación se ha diseñado una propuesta de un Plan Estratégico para la Autosostenibilidad de la Asociación Médicos por el Derecho a la Salud, MDS. El cual parte de un marco teórico de referencia acerca de las generalidades de las Asociaciones y Fundaciones en El Salvador, específicamente de la Asociación en estudio (MDS), así como de la teoría relacionada con el proceso administrativo de la planeación estratégica. Para conocer la situación actual de la Asociación se utilizaron fuentes de datos primarios (entrevistas, encuestas y la observación directa), también se utilizó la fuente de información de datos secundarios (documentos proporcionados por la Asociación y material bibliográfico); con el propósito de elaborar un diagnóstico económico, financiero y administrativo visualizando los recursos que poseen, los factores internos y externos que puedan afectar o beneficiar el funcionamiento eficiente y eficaz de la Asociación. Del proceso anterior se obtuvieron las siguientes conclusiones: La Asociación Médicos por el Derecho a la Salud MDS, actualmente no cuenta con un plan estratégico de autosostenibilidad para hacerle frente a los gastos de operación de la institución; la dependencia económica de la Asociación se compone en un 74% de donaciones restringidas y un 25% por donaciones no restringidas, lo cual indica que las estrategias actuales para la recaudación de fondos no han brindado los resultados esperados; MDS en la actualidad no cuenta con una estrategia para controlar los gastos fijos y variables, lo cual se ve reflejado en los gastos elevados en mantenimiento y reparación de vehículos en los dos últimos años, también mantienen un gasto excesivo en papelería de oficina, esto podría estar justificado a partir del crecimiento cuantitativo de la institución, sin embargo existen estrategias que podrían minimizar estos gastos; los inventarios de materiales y medicamentos son elevados, su rotación es lenta y en la razón rápida han mostrado una disminución sensible con relación a la razón circulante, indicando que los inventarios tienen una incidencia significativa en los activos provocando gastos. Partiendo de las conclusiones se plantean recomendaciones que se deben implementar para lograr un funcionamiento institucional fortalecido. También se presenta una propuesta de un plan estratégico, encaminado a la obtención de recursos los cuales contribuirán a cubrir los gastos administrativos de la institución y darle seguimiento a la ejecución de proyectos en las comunidades. Finalmente se muestra un sistema integrado de manuales el cual está constituido por: Manual de Bienvenida, de Organización, de Puestos, de Procedimientos y Controles Financieros, con el propósito que MDS, cuente con una herramienta técnica administrativa que le permita utilizar los recursos de forma más eficiente y alcanzar los objetivos institucionales.

Numerical simulation for the 3D seepage flow with fractional derivatives in porous media

In this paper, the numerical simulation of the 3D seepage flow with fractional derivatives in porous media is considered under two special cases: non-continued seepage flow in uniform media (NCSFUM) and continued seepage flow in non-uniform media (CSF-NUM). A fractional alternating direction implicit scheme (FADIS) for the NCSF-UM and a modified Douglas scheme (MDS) for the CSF-NUM are proposed. The stability, consistency and convergence of both FADIS and MDS in a bounded domain are discussed. A method for improving the speed of convergence by Richardson extrapolation for the MDS is also presented. Finally, numerical results are presented to support our theoretical analysis.

Falls in Parkinson's disease : kinematic evidence for impaired head and trunk control

Changes in stride characteristics and gait rhythmicity characterize gait in Parkinson's disease and are widely believed to contribute to falls in this population. However, few studies have examined gait in PD patients who fall. This study reports on the complexities of walking in PD patients who reported falling during a 12-month follow-up. Forty-nine patients clinically diagnosed with idiopathic PD and 34 controls had their gait assessed using three-dimensional motion analysis. Of the PD patients, 32 (65%) reported at least one fall during the follow-up compared with 17 (50%) controls. The results showed that PD patients had increased stride timing variability, reduced arm swing and walked with a more stooped posture than controls. Additionally, PD fallers took shorter strides, walked slower, spent more time in double-support, had poorer gait stability ratios and did not project their center of mass as far forward of their base of support when compared with controls. These stride changes were accompanied by a reduced range of angular motion for the hip and knee joints. Relative to walking velocity, PD fallers had increased mediolateral head motion compared with PD nonfallers and controls. Therefore, head motion could exceed “normal” limits, if patients increased their walking speed to match healthy individuals. This could be a limiting factor for improving gait in PD and emphasizes the importance of clinically assessing gait to facilitate the early identification of PD patients with a higher risk of falling.

Longitudinal investigation of wandering behavior in department of veterans affairs nursing home care units

Objectives To explore the extent of and factors associated with male residents who change wandering status post nursing home admission. Design Longitudinal design with secondary data analyses. Admissions over a 4-year period were examined using repeat assessments with the Minimum Data Set (MDS) to formulate a model understanding the development of wandering behavior. Setting One hundred thirty-four Veterans Administration (VA) nursing homes throughout the United States. Participants: Included 6673 residents admitted to VA nursing homes between October 2000 and October 2004. Measurements MDS variables (cognitive impairment, mood, behavior problems, activities of daily living and wandering) included ratings recorded at residents’ admission to the nursing home and a minimum of two other time points at quarterly intervals. Results The majority (86%) of the sample were classified as non wanderers at admission and most of these (94%) remained non wanderers until discharge or the end of the study. Fifty one per cent of the wanderers changed status to non wanderers with 6% of these residents fluctuating in status more than two times. Admission variables associated with an increased risk of changing status from non-wandering to wandering included older age, greater cognitive impairment, more socially inappropriate behavior, resisting care, easier distractibility, and needing less help with personal hygiene. Requiring assistance with locomotion and having three or more medical comorbidities were associated with a decreased chance of changing from non-wandering to wandering status. Conclusion A resident’s change from non-wandering to wandering status may reflect an undetected medical event that affects cognition, but spares mobility.

Multimedia search capabilities of Chinese language search engines

This paper reports results from a study exploring the multimedia search functionality of Chinese language search engines. Web searching in Chinese (Mandarin) is a growing research area and a technical challenge for popular commercial Web search engines. Few studies have been conducted on Chinese language search engines. We investigate two research questions: which Chinese language search engines provide multimedia searching, and what multimedia search functionalities are available in Chinese language Web search engines. Specifically, we examine each Web search engine's (1) features permitting Chinese language multimedia searches, (2) extent of search personalization and user control of multimedia search variables, and (3) the relationships between Web search engines and their features in the Chinese context. Key findings show that Chinese language Web search engines offer limited multimedia search functionality, and general search engines provide a wider range of features than specialized multimedia search engines. Study results have implications for Chinese Web users, Website designers and Web search engine developers. © 2009 Elsevier Ltd. All rights reserved.

Prediction of thermal expansion properties of carbon nanotubes using molecular dynamics simulations

The axial coefficients of thermal expansion (CTE) of various carbon nanotubes (CNTs), i.e., single-wall carbon nanotubes (SWCNTs), and some multi-wall carbon nanotubes (MWCNTs), were predicted using molecular dynamics (MDs) simulations. The effects of two parameters, i.e., temperature and the CNT diameter, on CTE were investigated extensively. For all SWCNTs and MWCNTs, the obtained results clearly revealed that within a wide low temperature range, their axial CTEs are negative. As the diameter of CNTs decreases, this temperature range for negative axial CTEs becomes narrow, and positive axial CTEs appear in high temperature range. It was found that the axial CTEs vary nonlinearly with the temperature, however, they decrease linearly as the CNT diameter increases. Moreover, within a wide temperature range, a set of empirical formulations was proposed for evaluating the axial CTEs of armchair and zigzag SWCNTs using the above two parameters. Finally, it was found that the absolute value of the negative axial CTE of any MWCNT is much smaller than those of its constituent SWCNTs, and the average value of the CTEs of its constituent SWCNTs. The present fundamental study is very important for understanding the thermal behaviors of CNTs in such as nanocomposite temperature sensors, or nanoelectronics devices using CNTs.

Between Herbals et alia: Intertextuality in Medieval English Herbals

This study reports a corpus-based study of medieval English herbals, which are texts conveying information on medicinal plants. Herbals belong to the medieval medical register. The study charts intertextual parallels within the medieval genre, and between herbals and other contemporary medical texts. It seeks to answer questions where and how herbal texts are linked to each other, and to other medical writing. The theoretical framework of the study draws on intertextuality and genre studies, manuscript studies, corpus linguistics, and multi-dimensional text analysis. The method combines qualitative and quantitative analyses of textual material from three historical special-language corpora of Middle and Early Modern English, one of which was compiled for the purposes of this study. The text material contains over 800,000 words of medical texts. The time span of the material is from c. 1330 to 1550. Text material is retrieved from the corpora by using plant name lists as search criteria. The raw data is filtered through qualitative analysis which produces input for the quantitative analysis, multi-dimensional scaling (MDS). In MDS, the textual space that parallel text passages form is observed, and the observations are explained by a qualitative analysis. This study concentrates on evidence of material and structural intertextuality. The analysis shows patterns of affinity between the texts of the herbal genre, and between herbals and other texts in the medical register. Herbals are most closely linked with recipe collections and regimens of health: they comprise over 95 per cent of the intertextual links between herbals and other medical writing. Links to surgical texts, or to specialised medical texts are very few. This can be explained by the history of the herbal genre: as herbals carry information on medical ingredients, herbs, they are relevant for genres that are related to pharmacological therapy. Conversely, herbals draw material from recipe collections in order to illustrate the medicinal properties of the herbs they describe. The study points out the close relationship between medical recipes and recipe-like passages in herbals (recipe paraphrases). The examples of recipe paraphrases show that they may have been perceived as indirect instruction. Keywords: medieval herbals, early English medicine, corpus linguistics, intertextuality, manuscript studies

Tuotantotekniikan ja säilytysajan vaikutus kasvihuonekurkkujen ja -tomaattien aistittavaan laatuun.

Finland has moved from growing vegetables by natural light to year-round greenhouse production using artificial lighting. Determination of sensory effects on greenhouse-grown vegetables is important as sensory evaluation provides information which chemical methods can not. It can tell us about the quality of samples which affects the consumers' behaviour. There are different opinions on how the quality of vegetables should be determined. The consumers are dissatisfied with the quality of vegetables and fruits, although the variety of products is larger than ever. The aim of this study was to find out how artificial lighting contributes to the sensory quality of greenhouse tomatoes and cucumbers compared to traditional natural lighting, and how storage affects the sensory attributes of the samples. In this study there were two sets of tomatoes and two sets of cucumbers, representing two different harvest seasons. Sensory evaluation involved two steps. The first step was to sort the samples and the second step was to generate a profile using descriptive analysis. Sorting was found to give some approximate information on differences between tomato and cucumber samples. MDS-maps dimensions were presented by age and lighting technique. The reliability of sorting results was quite good. The quality of the natural products was inconsistent. Production technology had more of an effect on cucumber samples than tomato samples. Natural light cucumbers were, for example sweeter and softer than artificial light cucumbers. Age had an especially large effect on cucumber appearance characteristics. There were less differences between tomato samples than cucumber samples. Production technology had less of an effect on tomato samples than age, e.g. hardness decreased during storage. In this study, it was found that artificial lighting has little effect on the sensory quality of Finnish greenhouse tomatoes compared with tomatoes grown under natural light.

Molecular Modelling of Estrogen-Producing Enzymes CYP450 Aromatase and 17beta-Hydroxysteroid Dehydrogenase Type 1

Breast cancer is the most common cancer in women in the western countries. Approximately two-thirds of breast cancer tumours are hormone dependent, requiring estrogens to grow. Estrogens are formed in the human body via a multistep route starting from cholesterol. The final steps in the biosynthesis include the CYP450 aromatase enzyme, converting the male hormones androgens (preferred substrate androstenedione ASD) into estrogens(estrone E1), and the 17beta-HSD1 enzyme, converting the biologically less active E1 into the active hormone 17beta-hydroxyestradiol E2. E2 is bound to the nuclear estrogen receptors causing a cascade of biochemical reactions leading to cell proliferation in normal tissue, and to tumour growth in cancer tissue. Aromatase and 17beta-HSD1 are expressed in or near the breast tumour, locally providing the tissue with estrogens. One approach in treating hormone dependent breast tumours is to block the local estrogen production by inhibiting these two enzymes. Aromatase inhibitors are already on the market in treating breast cancer, despite the lack of an experimentally solved structure. The structure of 17beta-HSD1, on the other hand, has been solved, but no commercial drugs have emerged from the drug discovery projects reported in the literature. Computer-assisted molecular modelling is an invaluable tool in modern drug design projects. Modelling techniques can be used to generate a model of the target protein and to design novel inhibitors for them even if the target protein structure is unknown. Molecular modelling has applications in predicting the activities of theoretical inhibitors and in finding possible active inhibitors from a compound database. Inhibitor binding at atomic level can also be studied with molecular modelling. To clarify the interactions between the aromatase enzyme and its substrate and inhibitors, we generated a homology model based on a mammalian CYP450 enzyme, rabbit progesterone 21-hydroxylase CYP2C5. The model was carefully validated using molecular dynamics simulations (MDS) with and without the natural substrate ASD. Binding orientation of the inhibitors was based on the hypothesis that the inhibitors coordinate to the heme iron, and were studied using MDS. The inhibitors were dietary phytoestrogens, which have been shown to reduce the risk for breast cancer. To further validate the model, the interactions of a commercial breast cancer drug were studied with MDS and ligand–protein docking. In the case of 17beta-HSD1, a 3D QSAR model was generated on the basis of MDS of an enzyme complex with active inhibitor and ligand–protein docking, employing a compound library synthesised in our laboratory. Furthermore, four pharmacophore hypotheses with and without a bound substrate or an inhibitor were developed and used in screening a commercial database of drug-like compounds. The homology model of aromatase showed stable behaviour in MDS and was capable of explaining most of the results from mutagenesis studies. We were able to identify the active site residues contributing to the inhibitor binding, and explain differences in coordination geometry corresponding to the inhibitory activity. Interactions between the inhibitors and aromatase were in agreement with the mutagenesis studies reported for aromatase. Simulations of 17beta-HSD1 with inhibitors revealed an inhibitor binding mode with hydrogen bond interactions previously not reported, and a hydrophobic pocket capable of accommodating a bulky side chain. Pharmacophore hypothesis generation, followed by virtual screening, was able to identify several compounds that can be used in lead compound generation. The visualisation of the interaction fields from the QSAR model and the pharmacophores provided us with novel ideas for inhibitor development in our drug discovery project.

Comprehending adverbs of doubt and certainty in health communication: A multidimensional scaling approach

This research explored the feasibility of using multidimensional scaling (MDS) analysis in novel combination with other techniques to study comprehension of epistemic adverbs expressing doubt and certainty (e.g., evidently, obviously, probably) as they relate to health communication in clinical settings. In Study 1, Australian English speakers performed a dissimilarity-rating task with sentence pairs containing the target stimuli, presented as "doctors' opinions". Ratings were analyzed using a combination of cultural consensus analysis (factor analysis across participants), weighted-data classical-MDS, and cluster analysis. Analyses revealed strong within-community consistency for a 3-dimensional semantic space solution that took into account individual differences, strong statistical acceptability of the MDS results in terms of stress and explained variance, and semantic configurations that were interpretable in terms of linguistic analyses of the target adverbs. The results confirmed the feasibility of using MDS in this context. Study 2 replicated the results with Canadian English speakers on the same task. Semantic analyses and stress decomposition analysis were performed on the Australian and Canadian data sets, revealing similarities and differences between the two groups. Overall, the results support using MDS to study comprehension of words critical for health communication, including in future studies, for example, second language speaking patients and/or practitioners. More broadly, the results indicate that the techniques described should be promising for comprehension studies in many communicative domains, in both clinical settings and beyond, and including those targeting other aspects of language and focusing on comparisons across different speech communities.

Regeneration ecology and woody species diversity in the remnant natural forest at Wondo Genet, Ethiopia – Potential for landscape restoration

Regeneration ecology, diversity of native woody species and its potential for landscape restoration was studied in the remnant natural forest at the College of Forestry and Natural Resources at Wondo Genet, Ethiopia. The type of forest is Afromontane rainforest , with many valuable tree species like Aningeria adolfi-friederici, and it is an important provider of ecological, social and economical services for the population that lives in this area. The study contains two parts, natural regeneration studies (at the natural forest) and interviews with farmers in the nearby village of the remnant patch. The objective of the first part was to investigate the floristic composition, densitiy and regeneration profiles of native woody species in the forest, paying special attention to woody species that are considered the most relevant (socio-economic). The second part provided information on woody species preferred by the farmers and on multiple uses of the adjacent natural forest, it also provided information and analysed perceptions on forest degradation. Systematic plot sampling was used in the forest inventory. Twenty square plots of 20 x 20 m were assessed, with 38 identified woody species (the total number of species was 45), representing 26 families. Of these species 61% were trees, 13% shrubs, 11% lianas and 16% species that could have both life forms. An analysis of natural regeneration of five important tree species in the natural forest showed that Aningeria adolfi-friederici had the best regeneration results. An analysis of population structure (as determined by height classes) of two commercially important woody species in the forest, Aningeria adolfi-friederici and Podocarpus falcatus, showed a marked difference: Aningeria had a typical “reversed J” frequency distribution, while Podocarpus showed very low values in all height classes. Multi dimensional scaling (MDS) was used to map the sample plots according to their similarity in species composition, using the Sørensen quantitative index, coupled with indicator species analysis .Three groups were identified with respective indicator species: Group 1 – Adhatoda schimperiana, Group 2 – Olea hochstetteri , Group 3 – Acacia senegal and Aningeria adolfi-friederici. Thirty questionnaire interviews were conducted with farmers in the village of Gotu Onoma that use the nearby remant forest patch. Their tree preferences were exotic species such as Eucalyptus globulus for construction and fuelwood and Grevillea robusta for shade and fertility. Considering forest land degradation farmers were aware of the problem and suggested that the governmental institutions address the problem by planting more Eucalyptus globulus. The natural forest seemed to have moderate levels of disturbance and it was still floristically diverse. However, the low rate of natural regeneration of Podocarpus falcatus suggested that this species is threatened and must be a priority in conservation actions. Plantations and agroforestry seem to be possible solutions for rehabilitation of the surrounding degraded lands, thereby decreasing the existent pressure in the remnant natural forest.

Quantum Error Correction via Codes over GF(2)

It is well known that n-length stabilizer quantum error correcting codes (QECCs) can be obtained via n-length classical error correction codes (CECCs) over GF(4), that are additive and self-orthogonal with respect to the trace Hermitian inner product. But, most of the CECCs have been studied with respect to the Euclidean inner product. In this paper, it is shown that n-length stabilizer QECCs can be constructed via 371 length linear CECCs over GF(2) that are self-orthogonal with respect to the Euclidean inner product. This facilitates usage of the widely studied self-orthogonal CECCs to construct stabilizer QECCs. Moreover, classical, binary, self-orthogonal cyclic codes have been used to obtain stabilizer QECCs with guaranteed quantum error correcting capability. This is facilitated by the fact that (i) self-orthogonal, binary cyclic codes are easily identified using transform approach and (ii) for such codes lower bounds on the minimum Hamming distance are known. Several explicit codes are constructed including two pure MDS QECCs.

Ecology of the swampy relic forests of Kathalekan from central Western Ghats, India

Introduction of agriculture three millennia ago in Peninsular India’s Western Ghats altered substantially ancient tropical forests. Early agricultural communities, nevertheless, strived to attain symbiotic harmony with nature as evident from prevalence of numerous sacred groves, patches of primeval forests sheltering biodiversity and hydrology. Groves enhanced heterogeneity of landscapes involving elements of successional forests and savannas favouring rich wildlife. A 2.25 km2 area of relic forest was studied at Kathalekan in Central Western Ghats. Interspersed with streams studded with Myristica swamps and blended sparingly with shifting cultivation fallows, Kathalekan is a prominent northernmost relic of southern Western Ghat vegetation. Trees like Syzygium travancoricum (Critically Endangered), Myristica magnifica (Endangered) and Gymnacranthera canarica (Vulnerable) and recently reported Semecarpus kathalekanensis, are exclusive to stream/swamp forest (SSF). SSF and non-stream/swamp forest (NSSF) were studied using 18 transects covering 3.6 ha. Dipterocarpaceae, its members seldom transgressing tropical rain forests, dominate SSF (21% of trees) and NSSF (27%). The ancient Myristicaceae ranks high in tree population (19% in SSF and 8% in NSSF). Shannon-Weiner diversity for trees is higher (>3) in six NSSF transects compared to SSF (<3). Higher tree endemism (45%), total endemic tree population (71%) and significantly higher above ground biomass (349 t/ha) cum carbon sequestration potential (131 t/ha) characterizes SSF. Faunal richness is evident from amphibians (35 species - 26 endemics, 11 in IUCN Red List). This study emphasizes the need for bringing to light more of relic forests for their biodiversity, carbon sequestration and hydrology. The lives of marginal farmers and forest tribes can be uplifted through partnership in carbon credits, by involving them in mitigating global climatic change through conservation and restoration of high biomass watershed forests.

Genomic alterations in Myeloproliferative Neoplasms and Myelodysplastic Syndromes

Myeloproliferative neoplasms (MPN) and myelodysplastic syndromes (MDS) are a heterogeneous group of clonal hematopoietic disorders whose etiology and molecular pathogenesis are poorly understood. During the past decade, enormous developments in microarray technology and bioinformatics methods have made it possible to mine novel molecular alterations in a large number of malignancies, including MPN and MDS, which has facilitated the detection of new prognostic, predictive and therapeutic biomarkers for disease stratification. By applying novel microarray techniques, we profiled copy number alterations and microRNA (miRNA) expression changes in bone marrow aspirate and blood samples. In addition, we set up and validated an miRNA expression test for bone marrow core biopsies in order to utilize the large archive material available in many laboratories. We also tested JAK2 mutation status and compare it with the in vitro growth pattern of hematologic progenitors cells. In the study focusing on 100 MPN cases, we detected a Janus kinase 2 (JAK2) mutation in 71 cases. We observed spontaneous erythroid colony growth in all mutation-positive cases in addition to nine mutation negative cases. Interestingly, seven JAK2V167F negative ET cases showed spontaneous megakaryocyte colony formation, one case of which also harbored a myeloproliferative leukemia virus oncogene (MPL) mutation. We studied copy number alterations in 35 MPN and 37 MDS cases by using oligonucleotide-based array comparative hybridization (array CGH). Only one essential thrombocythemia (ET) case presented copy number alterations in chromosomes 1q and 13q. In contrast, MDS cases were characterized by numerous novel cryptic chromosomal aberrations with the most common copy number losses at 5q21.3q33.1 and 7q22.1q33, while the most common copy number gain was trisomy 8. As for the study of the bone marrow core biopsy samples, we showed that even though these samples were embedded in paraffin and underwent decalcification, they were reliable sources of miRNA and suitable for array expression analysis. Further, when studying the miRNA expression profiles of the 19 MDS cases, we found that, compared to controls, two miRNAs (one human Epstein-Barr virus (miR-BART13) miRNA and one human (has-miR-671-5p) miRNA) were downregulated, whereas two other miRNAs (hsa-miR-720 and hsa-miR-21) were upregulated. However, we could find no correlation between copy number alterations and microRNA expression when integrating these two data. This thesis brings to light new information about genomic changes implicated in the development of MPN and MDS, and also underlines the power of applying genome-wide array screening techniques in neoplasias. Rapid advances in molecular techniques and the integration of different genomic data will enable the discovery of the biological contexts of many complex disorders, including myeloid neoplasias.

Explicit codes uniformly reducing repair bandwidth in distributed storage

A distributed storage setting is considered where a file of size B is to be stored across n storage nodes. A data collector should be able to reconstruct the entire data by downloading the symbols stored in any k nodes. When a node fails, it is replaced by a new node by downloading data from some of the existing nodes. The amount of download is termed as repair bandwidth. One way to implement such a system is to store one fragment of an (n, k) MDS code in each node, in which case the repair bandwidth is B. Since repair of a failed node consumes network bandwidth, codes reducing repair bandwidth are of great interest. Most of the recent work in this area focuses on reducing the repair bandwidth of a set of k nodes which store the data in uncoded form, while the reduction in the repair bandwidth of the remaining nodes is only marginal. In this paper, we present an explicit code which reduces the repair bandwidth for all the nodes to approximately B/2. To the best of our knowledge, this is the first explicit code which reduces the repair bandwidth of all the nodes for all feasible values of the system parameters.