Using population-based critical care data to evaluate trauma outcomes

Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved. Acknowledgements We would like to thank the Scottish Intensive Care Society Audit Group (SICSAG) for providing the data for this study. Mr Jan Jansen is in receipt of an NHS Research Scotland fellowship which includes salary funding.

Using population-based critical care data to evaluate trauma outcomes

Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved. Acknowledgements We would like to thank the Scottish Intensive Care Society Audit Group (SICSAG) for providing the data for this study. Mr Jan Jansen is in receipt of an NHS Research Scotland fellowship which includes salary funding.

Nanostructured Metal Oxide Coatings for Electrochemical Energy Conversion and Storage Electrodes

The realization of an energy future based on safe, clean, sustainable, and economically viable technologies is one of the grand challenges facing modern society. Electrochemical energy technologies underpin the potential success of this effort to divert energy sources away from fossil fuels, whether one considers alternative energy conversion strategies through photoelectrochemical (PEC) production of chemical fuels or fuel cells run with sustainable hydrogen, or energy storage strategies, such as in batteries and supercapacitors. This dissertation builds on recent advances in nanomaterials design, synthesis, and characterization to develop novel electrodes that can electrochemically convert and store energy.

Chapter 2 of this dissertation focuses on refining the properties of TiO2-based PEC water-splitting photoanodes used for the direct electrochemical conversion of solar energy into hydrogen fuel. The approach utilized atomic layer deposition (ALD); a growth process uniquely suited for the conformal and uniform deposition of thin films with angstrom-level thickness precision. ALD’s thickness control enabled a better understanding of how the effects of nitrogen doping via NH3 annealing treatments, used to reduce TiO2’s bandgap, can have a strong dependence on TiO2’s thickness and crystalline quality. In addition, it was found that some of the negative effects on the PEC performance typically associated with N-doped TiO2 could be mitigated if the NH3-annealing was directly preceded by an air-annealing step, especially for ultrathin (i.e., < 10 nm) TiO2 films. ALD was also used to conformally coat an ultraporous conductive fluorine-doped tin oxide nanoparticle (nanoFTO) scaffold with an ultrathin layer of TiO2. The integration of these ultrathin films and the oxide nanoparticles resulted in a heteronanostructure design with excellent PEC water oxidation photocurrents (0.7 mA/cm2 at 0 V vs. Ag/AgCl) and charge transfer efficiency.

In Chapter 3, two innovative nanoarchitectures were engineered in order to enhance the pseudocapacitive energy storage of next generation supercapacitor electrodes. The morphology and quantity of MnO2 electrodeposits was controlled by adjusting the density of graphene foliates on a novel graphenated carbon nanotube (g-CNT) scaffold. This control enabled the nanocomposite supercapacitor electrode to reach a capacitance of 640 F/g, under MnO2 specific mass loading conditions (2.3 mg/cm2) that are higher than previously reported. In the second engineered nanoarchitecture, the electrochemical energy storage properties of a transparent electrode based on a network of solution-processed Cu/Ni cores/shell nanowires (NWs) were activated by electrochemically converting the Ni metal shell into Ni(OH)2. Furthermore, an adjustment of the molar percentage of Ni plated onto the Cu NWs was found to result in a tradeoff between capacitance, transmittance, and stability of the resulting nickel hydroxide-based electrode. The nominal area capacitance and power performance results obtained for this Cu/Ni(OH)2 transparent electrode demonstrates that it has significant potential as a hybrid supercapacitor electrode for integration into cutting edge flexible and transparent electronic devices.

Studying Recommender Systems to Enhance Distributed Computing Schedulers

Distributed Computing frameworks belong to a class of programming models that allow developers to

launch workloads on large clusters of machines. Due to the dramatic increase in the volume of

data gathered by ubiquitous computing devices, data analytic workloads have become a common

case among distributed computing applications, making Data Science an entire field of

Computer Science. We argue that Data Scientist's concern lays in three main components: a dataset,

a sequence of operations they wish to apply on this dataset, and some constraint they may have

related to their work (performances, QoS, budget, etc). However, it is actually extremely

difficult, without domain expertise, to perform data science. One need to select the right amount

and type of resources, pick up a framework, and configure it. Also, users are often running their

application in shared environments, ruled by schedulers expecting them to specify precisely their resource

needs. Inherent to the distributed and concurrent nature of the cited frameworks, monitoring and

profiling are hard, high dimensional problems that block users from making the right

configuration choices and determining the right amount of resources they need. Paradoxically, the

system is gathering a large amount of monitoring data at runtime, which remains unused.

In the ideal abstraction we envision for data scientists, the system is adaptive, able to exploit

monitoring data to learn about workloads, and process user requests into a tailored execution

context. In this work, we study different techniques that have been used to make steps toward

such system awareness, and explore a new way to do so by implementing machine learning

techniques to recommend a specific subset of system configurations for Apache Spark applications.

Furthermore, we present an in depth study of Apache Spark executors configuration, which highlight

the complexity in choosing the best one for a given workload.

An Exploration of the challenges associated with software logging in large systems

Over the past few years, logging has evolved from from simple printf statements to more complex and widely used logging libraries. Today logging information is used to support various development activities such as fixing bugs, analyzing the results of load tests, monitoring performance and transferring knowledge. Recent research has examined how to improve logging practices by informing developers what to log and where to log. Furthermore, the strong dependence on logging has led to the development of logging libraries that have reduced the intricacies of logging, which has resulted in an abundance of log information. Two recent challenges have emerged as modern software systems start to treat logging as a core aspect of their software. In particular, 1) infrastructural challenges have emerged due to the plethora of logging libraries available today and 2) processing challenges have emerged due to the large number of log processing tools that ingest logs and produce useful information from them. In this thesis, we explore these two challenges. We first explore the infrastructural challenges that arise due to the plethora of logging libraries available today. As systems evolve, their logging infrastructure has to evolve (commonly this is done by migrating to new logging libraries). We explore logging library migrations within Apache Software Foundation (ASF) projects. We i find that close to 14% of the pro jects within the ASF migrate their logging libraries at least once. For processing challenges, we explore the different factors which can affect the likelihood of a logging statement changing in the future in four open source systems namely ActiveMQ, Camel, Cloudstack and Liferay. Such changes are likely to negatively impact the log processing tools that must be updated to accommodate such changes. We find that 20%-45% of the logging statements within the four systems are changed at least once. We construct random forest classifiers and Cox models to determine the likelihood of both just-introduced and long-lived logging statements changing in the future. We find that file ownership, developer experience, log density and SLOC are important factors in determining the stability of logging statements.

Intervención cognitivo-conductual para el control de ansiedad ante la biopsia insicional en pacientes con cáncer de mama

Oncological patients are submitted to invasive exams in order to obtain an accurate diagnosis; these procedures may cause maladaptative reactions (fear, anxiety and pain). Particularly in breast cancer, the most common diagnose technique is the incisional biopsy. Most of the patients are unaware about the procedure and for that reason they may focus their thoughts on possible events such as pain, bleeding, the anesthesia, or the later surgical wound care. Anxiety and pain may provoke physiological, behavioral and emotional complications, and because of this reason, the Behavioral Medicine trained psychologist takes an active role before and after the biopsy. The aim of this study was to evaluate the effect of a cognitive-behavioral program to reduce anxiety in women submitted to incisional biopsy for the first time. There were 10 participants from the Hospital Juárez de México, Oncology service; all of them were treated as external patients. The intervention program focused in psycho-education and passive relaxation training using videos, tape-recorded instructions and pamphlets. Anxiety measures were performed using the IDARE-State inventory, and a visual-analogue scale of anxiety (EEF-A), and the measurement of blood pressure and heart rate). Data were analyzed both intrasubject and intersubject using the Wilcoxon test (p≤0.05). The results show a reduction in anxiety (as in punctuation as in ranges) besides, a reduction in the EEF-A.

Pulling Back the Veil: The Characterization and Habitability of Enshrouded Worlds

Thesis (Ph.D.)--University of Washington, 2016-08

Proprioception in ankle sprain from exercises and bandages

Ankle sprains are the most common injuries in sports, usually causing damage to the lateral ligaments. Recurrence has as usual result permanent instability, and thus loss of proprioception. This fact, together with residual symptoms, is what is known as chronic ankle instability, CAI, or FAI, if it is functional. This problem tries to be solved by improving musculoskeletal stability and proprioception by the application of bandages and performing exercises. The aim of this study has been to review articles (meta-analisis, systematic reviews and revisions) published in 2009-2015 in PubMed, Medline, ENFISPO and BUCea, using keywords such as “sprain instability”, “sprain proprioception”, “chronic ankle instability”. Evidence affirms that there does exist decreased proprioception in patients who suffer from CAI. Rehabilitation exercise regimen is indicated as a treatment because it generates a subjective improvement reported by the patient, and the application of bandages works like a sprain prevention method limiting the range of motion, reducing joint instability and increasing confidence during exercise. As podiatrists we should recommend proprioception exercises to all athletes in a preventive way, and those with CAI or FAI, as a rehabilitation programme, together with the application of bandages. However, further studies should be generated focusing on ways of improving proprioception, and on the exercise patterns that provide the maximum benefit.

Lies and Camouflage

Collaborative installation of painting and sculpture with Denise de Cordova. Both artists use a female subject as a recurring metaphor – as cipher, ghost, or nom de plume, and both employ intricately decorated surfaces to allude to ambiguities inherent in using material to speak of ideas.

Proposta de modelo de recomendação de conteúdo baseado em arquivos de legendas de filmes e séries

A crescente complexidade dos objetos armazenados e o grande volume de dados exigem modelos de recuperação e recomendação cada vez mais sofisticados. O objetivo deste trabalho é propor um modelo de recomendação de conteúdo baseado em arquivos de  legendas de filmes e séries. Utilizando a ferramenta Apache Lucene, para recuperação da informação, e a ferramenta OGMA, para análise de textos, foi possível propor, para o modelo, três etapas distintas: uma pesquisa utilizando palavra-chave, a classificação de filmes e séries por gênero e a identificação de títulos similares. Também é apresentado uma adaptação ao modelo para identificar em cada título um sentimento, denominado análise de sentimentos. Como resultado ressaltamos que a pesquisa por palavras-chave gerourecomendações surpreendentes, já que proporcionam ao usuário liberdade de pesquisa dentro de um conteúdo específico. Já a classificação por gênero apresentou índice de 73% de acerto em comparação com os gêneros apresentados pelo site IMDb, facilitando a recomendação de conteúdo. A análise de sentimentos demonstrou recomendações com coesão, determinando títulos apropriados para cada sentimento. Por último, a identificação de títulos similares, apresentou resultados primários, trazendo apenas filmes e séries com a mesma temática, sem apresentar nenhum resultado em comum com o site IMDb. Concluiu-se que apesar da enorme dificuldade de ser assertivo na recuperação da informação, existevantagens em se utilizar os arquivos de legendas para ajudar na composição dos sistemas de recomendação.

Do simple ventilation and gas exchange measurements predict early successful weaning from respiratory support in unselected general intensive care patients?

Background. The value of respiratory variables as weaning predictors in the intensive care unit (ICU) is controversial. We evaluated the ability of tidal volume (Vtexp), respiratory rate ( f ), minute volume (MVexp), rapid shallow breathing index ( f/Vt), inspired–expired oxygen concentration difference [(I–E)O2], and end-tidal carbon dioxide concentration (PE′CO2) at the end of a weaning trial to predict early weaning outcomes. Methods. Seventy-three patients who required .24 h of mechanical ventilation were studied. A controlled pressure support weaning trial was undertaken until 5 cm H2O continuous positive airway pressure or predefined criteria were reached. The ability of data from the last 5 min of the trial to predict whether a predefined endpoint indicating discontinuation of ventilator support within the next 24 h was evaluated. Results. Pre-test probability for achieving the outcome was 44% in the cohort (n¼32). Non-achievers were older, had higher APACHE II and organ failure scores before the trial, and higher baseline arterial H+ concentrations. The Vt, MV, f, and f/Vt had no predictive power using a range of cut-off values or from receiver operating characteristic (ROC) analysis. The [I–E]O2 and PE′CO2 had weak discriminatory power [areaunder the ROC curve: [I–E]O2 0.64 (P¼0.03); PE′CO2 0.63 (P¼0.05)]. Using best cut-off values for [I–E]O2 of 5.6% and PE′CO2 of 5.1 kPa, positive and negative likelihood ratios were 2 and 0.5, respectively, which only changed the pre- to post-test probability by about 20%. Conclusions. In unselected ICU patients, respiratory variables predict early weaning from mechanical ventilation poorly.

RCOS: Real time context sharing across a fleet of smart mobile devices

Today, biodiversity is endangered by the currently applied intensive farming methods imposed on food producers by intermediate actors (e.g.: retailers). The lack of a direct communication technology between the food producer and the consumer creates dependency on the intermediate actors for both producers and the consumers. A tool allowing producers to directly and efficiently market produce that meets customer demands could greatly reduce the dependency enforced by intermediate actors. To this end, in this thesis, we propose, develop, implement and validate a Real Time Context Sharing (RCOS) system. RCOS takes advantage of the widely used publish/subscribe paradigm to exchange messages between producers and consumers, directly, according to their interest and context. Current systems follow a topic-based model or a content-based model. With RCOS, we propose a context-awareness approach into the matching process of publish/subscribe paradigm. Finally, as a proof of concept, we extend the Apache ActiveMQ Artemis software and create a client prototype. We evaluate our proof of concept for larger scale deployment.

Investigación de rasgos temperamentales de los estudiantes de medicina de Cuenca, tomo I

Doctor en Medicina y Cirugía

El Señorío de Chillón. De Bernardo de Cabrera a Sancho de Alburquerque

El presente artículo se refiere a la evolución que experimentó la villa de Chillón en los decenios centrales del siglo XIV. Chillón, perteneciente al término de Córdoba, fue señorío de relevantes personajes de la época. Entre 1344 y 1350, perteneció a Bernardo de Cabrera, privado de Pedro IV de Aragón. Posteriormente, pasó a poder de Juan Alfonso de Alburquerque, que desempeñó la misma función en la Corte del rey Pedro de Castilla. Reintegrada posteriormente a la jurisdicción de Córdoba, fue entregada por Enrique II a su hermano don Sancho, que no logró vencer la oposición de la ciudad y no llegó realmente a posesionarse de la villa, la cual terminó por vender a Diego Fernández de Córdoba, alguacil mayor de Córdoba, en 1370.

Gestión de recursos de una unidad de rescate en montaña

Este Trabajo de Fin de Grado va enfocado al desarrollo de un sistema eficaz para gestionar los recursos que componen una Unidad de Rescate en Montaña (URM). Estos recursos son tanto los medios humanos como los materiales, los primeros son los rescatadores, los segundos el material especializado que se emplea en las maniobras de rescate. Mantener información actualizada del estado del material es básico para garantizar la seguridad de las intervenciones de este tipo de unidad. Además saber qué cantidad, tipo y ubicación de dicho material, es básico documentar el empleo de este facilita la trazabilidad de su uso cumpliendo la normativa vigente que regula el trabajo en altura. Como modelo de forma de trabajo de una URM se tomará la perteneciente al Consorcio Provincial de Bomberos de Málaga (CPB Málaga). El sistema desarrollado es una aplicación web que bajo entorno Java Enterprise Edition (Java 2EE) que se ejecutará en un servidor Apache Tomcat y empleará una base de datos en MySql para almacenar la información, de esta forma se facilita el acceso distribuido de la gestión a los diferentes usuarios y el mantenimiento del sistema al estar todo centralizado, además de las ventajas que da un sistema desarrollado en Java que puede ser desplegado con independencia del sistema operativo empleado.