Factores asociados a insuficiencia renal postoperatoria en cirugía de revascularización miocárdica

Introducción: La insuficiencia renal postoperatoria (IRP) es una complicación de alta prevalencia y de importancia en la cirugía cardiaca. Se estima que más del 30% de los pacientes sometidos a cirugía cardiaca desarrollan IRP clínicamente importante. Una estrategia razonable a realizar es la identificación de factores de riesgo modificables para intervenir sobre ellos. Objetivos: Determinar cuáles de los antecedentes clínicos del paciente y factores relacionados con el procedimiento quirúrgico se asocian a la aparición de IRP en pacientes sometidos a cirugía de –revascularización miocárdica (RVM). Métodos: Estudio de casos y controles. Casos fueron pacientes sometidos a cirugía de revascularización miocárdica electiva que presentaron insuficiencia renal postoperatoria durante el postoperatorio inmediato hasta el egreso. Controles pacientes sometidos a cirugía de revascularización miocárdica electiva que no presentaron insuficiencia renal postoperatoria durante el postoperatorio inmediato hasta el egreso. Estudio realizado entre enero de 2005 y diciembre de 2013. Se realizó un modelo de regresión logística para determinar los factores asociados a insuficiencia renal posoperatoria. Las asociaciones se expresan en OR con sus respectivos intervalos de confianza. Resultados: Edad avanzada OR 1.03 IC 95% (1.01-1.04), presencia preoperatoria de diabetes mellitus OR 1.8 IC 95% (1.9-3.4), enfermedad pulmonar OR 1.3 IC 95% (1.1-1.6), dislipidemia OR 3.5 IC 95% (1.7-7.1), insuficiencia cardiaca OR 2.7 IC 95% (1.1-6.7) y mayor tiempo de perfusión OR 1.02 IC 95% (1.01-1.03) se asociaron a mayor riesgo de IRP. Mayor hematocrito OR 0.86 IC95% (0.82-0.91) y mayor fracción de eyección OR 0.94 IC 95% (0.92-0.96) se asociaron disminuyendo el riesgo de IRP. Conclusiones: En pacientes sometidos a RVM los factores asociados a la presentación de IRP fueron comorbilidades que se asocian a daño renal progresivo dentro y fuera del contexto de la cirugía. Esto implica que las estrategias para minimizar este evento estarán enfocadas a identificar tempranamente los pacientes y realizar una adecuada nefroprotección.

Cuando creces, yo crezco contigo”: La configuración de áreas de protección ambiental y de subjetividades en el Humedal de Córdoba y la vereda El Verjón Bajo

La configuración de lugares como áreas de protección ambiental puede ser vista como un proceso técnico y objetivo, en el que se crean políticas públicas que definen prácticas adecuadas e inadecuadas en el lugar. Pero esta configuración es un proceso histórico y negociado. Este se construye en contante diálogo entre diferentes actores que se preocupan por definir qué es la naturaleza y el cuidado ambiental, y las percepciones que individuos que habitan en o cerca a estos lugares construyen en su diario vivir. Es así como la configuración socioambiental de lugares como áreas de protección ocurre por transformaciones en la forma de percibir un lugar, la relaciones con este y sobre todo, prácticas y relaciones que se traducen en formas de negociar nociones de naturaleza y cuidado ambiental. Esta negociación tiene grandes implicaciones en los individuos, particularmente en su subjetividad. Es decir, en hechos como la forma de nombrarlo, caminarlo, observar las especies, iniciar proyectos de agricultura orgánica, cambiar prácticas productivas, el cerramiento de zonas para proteger las fuentes de agua o zonas de vegetación. También sobre su subjetividad, la manera como se sienten frente al lugar, como juzgan sus acciones y las de otros y cómo construyen objetivos personales con respecto a la idea de cuidado ambiental.

El documental històric com a reflexió sobre l’ús i abús de la memòria

Aquest article estudia el documental històric amb la intenció de confrontar alguna de les controvèrsies que han sorgit sobre la idea de la reconstrucció històrica en el camp del cinema i de la televisió. El primer punt plantejat consisteix en l’actualització de la idea proposada per Marc Ferro de que cada pel•lícula és un document de mentalitats, partint de dues idees bàsiques: primer, que el cinema, a més de ser un document, té una història com a producte artístic i segon, que la documentació del passat ha de dur-se a terme sense caure en el que Tzevan Todorov diu els abusos de la memòria. El segon punt té a veure amb el problema de com la història és modificada donada la percepció que tenim de ella des d’un punt particular al present. Finalment, entra en el tema de la ètica amb la intenció de fer front al problema de les limitacions de l’acte de mostrar en un moment històric particular en que aquesta mostra ha estat transformada en una forma de banalització

Ús de problemàtiques ètiques per l'ensenyança del codi deontològic de la psicologia: una sessió il·lustrativa

El present treball exposa el contingut i procediment d’una sessió emmarcada en un taller–seminari sobre ètica aplicada als àmbits professionals de la psicologia. L’objectiu de la mateixa és introduir als estudiants en els fonaments del Codi Deontològic, així com la reflexió d’alguns dels articles que aquest conté. El mètode expositiu consisteix en presentar i discutir tres situacions, èticament problemàtiques, a partir de les quals s’il·lustra el contingut normatiu de diferents articles que regulen l’exercici professional en l’àmbit de la psicologia

Using the variogram to explore imagery of two different spatial resolutions

The resolution of remotely sensed data is becoming increasingly fine, and there are now many sources of data with a pixel size of 1 m x 1 m. This produces huge amounts of data that have to be stored, processed and transmitted. For environmental applications this resolution possibly provides far more data than are needed: data overload. This poses the question: how much is too much? We have explored two resolutions of data-20 in pixel SPOT data and I in pixel Computerized Airborne Multispectral Imaging System (CAMIS) data from Fort A. P. Hill (Virginia, USA), using the variogram of geostatistics. For both we used the normalized difference vegetation index (NDVI). Three scales of spatial variation were identified in both the SPOT and 1 in data: there was some overlap at the intermediate spatial scales of about 150 in and of 500 m-600 in. We subsampled the I in data and scales of variation of about 30 in and of 300 in were identified consistently until the separation between pixel centroids was 15 in (or 1 in 225pixels). At this stage, spatial scales of about 100m and 600m were described, which suggested that only now was there a real difference in the amount of spatial information available from an environmental perspective. These latter were similar spatial scales to those identified from the SPOT image. We have also analysed I in CAMIS data from Fort Story (Virginia, USA) for comparison and the outcome is similar.:From these analyses it seems that a pixel size of 20m is adequate for many environmental applications, and that if more detail is required the higher resolution data could be sub-sampled to a 10m separation between pixel centroids without any serious loss of information. This reduces significantly the amount of data that needs to be stored, transmitted and analysed and has important implications for data compression.

A maternal influence on the conditioning to plant cues of Aphidius colemani Viereck, parasitizing the aphid Myzus persicae Sulzer

The offspring of parasitoids, Aphidius colemani Viereck, reared on Brussels sprouts and emerging from Myzus persicae Sulzer on a fully defined artificial diet, show no preferences in a four-way olfactometer, either for the odour of the diet, the odour of Brussels sprouts, or the odour of two other crucifers (cabbage and Chinese cabbage). A similar lack of odour preferences is shown when the host aphids are exposed for parasitization (for 48 h) on cabbage, Chinese cabbage or wheat. However, if parasitization occurs on Brussels sprouts, a weak but statistically highly significant response to Brussels sprout odour is observed. Although as many as 30-35% of the parasitoids show no response to any odour, another 35% respond positively to the odour of Brussels sprout compared with responses to the odours of cabbage, Chinese cabbage or wheat of only approximately 10%. An analagous result is obtained when the parent parasitoids are reared on cabbage. In this case, significant positive responses of their offspring to cabbage odour occur only if the 48-h parasitization has occurred also on cabbage. However, with parasitoids from Brussels sprouts parasitizing the aphids for 48 h also on Brussels sprouts, the offspring subsequently emerging from pupae excised from the mummies show no preference for Brussels sprout odour. Thus, although the Brussels sprout cue had been experienced early in the development of the parasitoids, they only become conditioned to it when emerging from the mummy. Both male and female parasitoids respond very similarly in all experiments. It is proposed that the chemical cue (probably glucosinolates in these experiments) is most likely in the silk surrounding the parasitoid pupa, and that the mother may leave the chemical in or around the egg at oviposition, inducing chemical defences in her offspring to the secondary plant compounds that the offspring are likely to encounter.

The effect of wheat straw residue on the emergence and early growth of sugar beet (Beta vulgaris) and oilseed rape (Brassica napus)

The management of straw residue can be a concern in non-inversion tillage systems where straw tends to be incorporated at shallow depths or left on the soil surface. This can lead to poor crop establishment because straw residue can impede or hinder crop emergence and growth. Small container-based experiments were undertaken using varying amounts of wheat straw residue either incorporated or placed oil the soil surface. The effects on (lays to seedling emergence, percentage emergence, seedling dry-weight and soil temperature using sugar beet and oilseed rape were investigated because these crops often follow wheat in a cropping sequence. The position of the straw residue was found to be the primary factor in reducing crop emergence and growth. Increasing the amount of straw residue (from 3.3 t ha(-1) to 6.7 t ha(-1)) did not show any consistent trends in reducing crop emergence or growth. However, in some instances, results indicated that an interaction between the position and the amount of straw residue Occurred particularly when the straw and seed was placed on the soil surface. Straw placed on the soil surface significantly reduced mean day-time soil temperature by approximately 2.5 degrees C compared to no residue. When the seed and straw was placed on the soil Surface a lack of seed-to-soil contact caused a reduction in emergence by approximately 30% because of the restriction in available moisture that limited the ability for seed imbibition. This trend was reversed when the seed was placed in the soil, but with straw residue still on the soil surface, because the surface straw was likely to reduce moisture evaporation and improved seed-to-soil contact that led to rapid emergence. In general, when straw was mixed in or placed on the soil surface along with the seed, sugar beet and oilseed rape emergence and early growth biomass was significantly restricted by approximately 50% compared to no residue. The consequences of placing seed with or near to straw residue have been shown to cause a restriction in crop establishment. In both oilseed tape and sugar beet, this could lead to a reduction in final crop densities, poor, uneven growth and potentially lower yields that could lower financial margins. Therefore, if farmers are planning to use non-inversion tillage methods for crop establishment, the management and removal of straw residue from near or above the seed is considered important for successful crop establishment. (C) 2008 Elsevier B.V. All rights reserved.

Solving surface structures from normal incidence X-ray standing wave data

A program is provided to determine structural parameters of atoms in or adsorbed on surfaces by refinement of atomistic models towards experimentally determined data generated by the normal incidence X-ray standing wave (NIXSW) technique. The method employs a combination of Differential Evolution Genetic Algorithms and Steepest Descent Line Minimisations to provide a fast, reliable and user friendly tool for experimentalists to interpret complex multidimensional NIXSW data sets.

‘Superteachers’, saints and solitaires: an investigation into advanced skills teachers of drama

This paper reports on a survey conducted in 2010 among ASTs who identified themselves as being specialists in, or having responsibility for, the subject of drama. The survey endeavoured to explore the professional backgrounds and experiences of these ASTs and gain insights into what they enjoyed about the role. It was especially concerned to address the following questions: 1. What general skills do ASTs in drama think they need to possess? 2. What subject specific knowledge and skills do they feel are needed to satisfy the demands of their role? In addition, insights were sought into what training and support had been afforded them, how they regarded themselves and were regarded by others in the role.

Fermentable carbohydrate alters hypothalamic neuronal activity and protects against the obesogenic environment

Obesity has become a major global health problem. Recently, attention has focused on the benefits of fermentable carbohydrates on modulating metabolism. Here, we take a system approach to investigate the physiological effects of supplementation with oligofructose-enriched inulin (In). We hypothesize that supplementation with this fermentable carbohydrate will not only lead to changes in body weight and composition, but also to modulation in neuronal activation in the hypothalamus. Male C57BL/6 mice were maintained on a normal chow diet (control) or a high fat (HF) diet supplemented with either oligofructose-enriched In or corn starch (Cs) for 9 weeks. Compared to HF+Cs diet, In supplementation led to significant reduction in average daily weight gain (mean ± s.e.m.: 0.19 ± 0.01 g vs. 0.26 ± 0.02 g, P < 0.01), total body adiposity (24.9 ± 1.2% vs. 30.7 ± 1.4%, P < 0.01), and lowered liver fat content (11.7 ± 1.7% vs. 23.8 ± 3.4%, P < 0.01). Significant changes were also observed in fecal bacterial distribution, with increases in both Bifidobacteria and Lactobacillius and a significant increase in short chain fatty acids (SCFA). Using manganese-enhanced MRI (MEMRI), we observed a significant increase in neuronal activation within the arcuate nucleus (ARC) of animals that received In supplementation compared to those fed HF+Cs diet. In conclusion, we have demonstrated for the first time, in the same animal, a wide range of beneficial metabolic effects following supplementation of a HF diet with oligofructose-enriched In, as well as significant changes in hypothalamic neuronal activity.

Radical Conservatism

In 1938, Yugoslav sculptor Oscar Nemon arrived in Britain, having fled the Nazi invasion of Brussels, where he was living with Magritte. He was part of the European avant-garde that came to the UK as a refugee. Shortly thereafter, Nemon proposed a bold architectural plan to construct a temple of universal ethics in London and was in correspondence over this with central figures in Britain. After the war, he became know for his portrayal of figures like Churchil, culminating in a bust of Margaret Thatcher that is currently at the Tory HQ. Shown at Castlefield Gallery in 2013-2014, Radical Conservatism was an exhibition that explored the space between these two moments and asked whether these two terms are really antithetical. In the British context in particular, where the European avant-garde never really took hold, a kind of reactionary modernism has always defined a culture wary of revolution. But today more than ever, with the left increasingly holding on to the past of the welfare state as an ideal, and the right quietly revolutionising our world through neoliberal reforms, the paradigms of radicalism and conservatism need to be redefined. Can conservatism be seen as a radical position in itself? If art is defined by a movement towards the new - could 'holding on to the past' stubbornly be seen as a critical position, now that neo-liberalism has forced a far more radical shift in politics than the left has managed in a long time? Curated by Pil and Galia Kollectiv, featuring work by Chris Evans, IRWIN, Pil and Galia Kollectiv, Joseph Lewis, Patrick Moran, Oscar Nemon and Public Movement and a symposium with contributions from Professor Alun Rowlands and Robert Garnett.

Differentiation between Neotropical rainforest, dry forest and savannah ecosystems by their modern pollen spectra and implications for the fossil pollen record

Accurate differentiation between tropical forest and savannah ecosystems in the fossil pollen record is hampered by the combination of: i) poor taxonomic resolution in pollen identification, and ii) the high species diversity of many lowland tropical families, i.e. with many different growth forms living in numerous environmental settings. These barriers to interpreting the fossil record hinder our understanding of the past distributions of different Neotropical ecosystems and consequently cloud our knowledge of past climatic, biodiversity and carbon storage patterns. Modern pollen studies facilitate an improved understanding of how ecosystems are represented by the pollen their plants produce and therefore aid interpretation of fossil pollen records. To understand how to differentiate ecosystems palynologically, it is essential that a consistent sampling method is used across ecosystems. However, to date, modern pollen studies from tropical South America have employed a variety of methodologies (e.g. pollen traps, moss polsters, soil samples). In this paper, we present the first modern pollen study from the Neotropics to examine the modern pollen rain from moist evergreen tropical forest (METF), semi-deciduous dry tropical forest (SDTF) and wooded savannah (cerradão) using a consistent sampling methodology (pollen traps). Pollen rain was sampled annually in September for the years 1999–2001 from within permanent vegetation study plots in, or near, the Noel Kempff Mercado National Park (NKMNP), Bolivia. Comparison of the modern pollen rain within these plots with detailed floristic inventories allowed estimates of the relative pollen productivity and dispersal for individual taxa to be made (% pollen/% vegetation or ‘p/v’). The applicability of these data to interpreting fossil records from lake sediments was then explored by comparison with pollen assemblages obtained from five lake surface samples.

Primary evolving networks and the comparative analysis of robust and fragile structures

In this paper we consider the structure of dynamically evolving networks modelling information and activity moving across a large set of vertices. We adopt the communicability concept that generalizes that of centrality which is defined for static networks. We define the primary network structure within the whole as comprising of the most influential vertices (both as senders and receivers of dynamically sequenced activity). We present a methodology based on successive vertex knockouts, up to a very small fraction of the whole primary network,that can characterize the nature of the primary network as being either relatively robust and lattice-like (with redundancies built in) or relatively fragile and tree-like (with sensitivities and few redundancies). We apply these ideas to the analysis of evolving networks derived from fMRI scans of resting human brains. We show that the estimation of performance parameters via the structure tests of the corresponding primary networks is subject to less variability than that observed across a very large population of such scans. Hence the differences within the population are significant.

On the structure and dynamics of Indian monsoon depressions

ERA-Interim reanalysis data from the past 35 years have been used with a newly-developed feature tracking algorithm to identify Indian monsoon depressions originating in or near the Bay of Bengal. These were then rotated, centralised and combined to give a fully three-dimensional 106-depression composite structure – a considerably larger sample than any previous detailed study on monsoon depressions and their structure. Many known features of depression structure are confirmed, particularly the existence of a maximum to the southwest of the centre in rainfall and other fields, and a westward axial tilt in others. Additionally, the depressions are found to have significant asymmetry due to the presence of the Himalayas; a bimodal mid-tropospheric potential vorticity core; a separation into thermally cold- (~–1.5K) and neutral- (~0K) cores near the surface with distinct properties; and that the centre has very large CAPE and very small CIN. Variability as a function of background state has also been explored, with land/coast/sea, diurnal, ENSO, active/break and Indian Ocean Dipole contrasts considered. Depressions are found to be markedly stronger during the active phase of the monsoon, as well as during La Niña. Depressions on land are shown to be more intense and more tightly constrained to the central axis. A detailed schematic diagram of a vertical cross-section through a composite depression is also presented, showing its inherent asymmetric structure.

Implementation and role of device management Solutions to the end users

This research is based on consumer complaints with respect to recently purchased consumer electronics. This research document will investigate the instances of development and device management as a tool used to aid consumer and manage consumer’s mobile products in order to resolve issues in or before the consumers is aware one exists. The problem at the present time is that mobile devices are becoming very advanced pieces of technology, and not all manufacturers and network providers have kept up the support element of End users. As such, the subject of the research is to investigate how device management could possibly be used as a method to promote research and development of mobile devices, and provide a better experience for the consumer. The wireless world is becoming increasingly complex as revenue opportunities are driven by new and innovative data services. We can no longer expect the customer to have the knowledge or ability to configure their own device. Device Management platforms can address the challenges of device configuration and support through new enabling technologies. Leveraging these technologies will allow a network operator to reduce the cost of subscriber ownership, drive increased ARPU (Average Revenue per User) by removing barriers to adoption, reduce churn by improving the customer experience and increase customer loyalty. DM technologies provide a flexible and powerful management method but are managing the same device features that have historically been configured manually through call centers or by the end user making changes directly on the device. For this reason DM technologies must be treated as part of a wider support solution. The traditional requirement for discovery, fault finding, troubleshooting and diagnosis are still as relevant with DM as they are in the current human support environment yet the current generation of solutions do little to address this problem. In the deployment of an effective Device Management solution the network operator must consider the integration of the DM platform, interfacing with many areas of the business, supported by knowledge of the relationship between devices, applications, solutions and services maintained on an ongoing basis. Complementing the DM solution with published device information, setup guides, training material and web based tools will ensure the quality of the customer experience, ensuring that problems are completely resolved, driving data usage by focusing customer education on the use of the wireless service In this way device management becomes a tool used both internally within the network or device vendor and by the customer themselves, with each user empowered to effectively manage the device without any prior knowledge or experience, confident that changes they apply will be relevant, accurate, stable and compatible. The value offered by an effective DM solution with an expert knowledge service will become a significant differentiator for the network operator in an ever competitive wireless market. This research document is intended to highlight some of the issues the industry faces as device management technologies become more prevalent, and offers some potential solutions to simplify the increasingly complex task of managing devices on the network, where device management can be used as a tool to aid customer relations and manage customer’s mobile products in order to resolve issues before the user is aware one exists. The research is broken down into the following, Customer Relationship Management, Device management, the role of knowledge with the DM, Companies that have successfully implemented device management, and the future of device management and CRM. And it also consists of questionnaires aimed at technical support agents and mobile device users. Interview was carried out with CRM managers within support centre to further the evidence gathered. To conclude, the document is to consider the advantages and disadvantages of device management and attempt to determine the influence it will have over customer support centre, and what methods could be used to implement it.