Responses of transplanted native tree species to invasive alien grass removals in an abandoned cattle pasture in the Lacandon region, Mexico

We tested the early performance of 16 native early-, mid-, and late-successional tree species in response to four intensities of grass removal in an abandoned cattle pasture dominated by the introduced, invasive African grass, Cynodon plectostachyus, within the Lacandon rainforest region, southeast Mexico. The increase in grass removals significantly improved the performance of many species, especially of early-and mid-successional species, while performance of late-successional species was relatively poor and did not differ significantly among treatments. Good site preparation and at least one additional grass removal four months after seedling transplant were found to be essential; additional grass removals led to improved significantly performance of saplings in most cases. In order to evaluate the potential of transplanting tree seedlings successfully in abandoned tropical pastures, we developed a "planting risk index", combining field performance measurements and plantation cost estimations. Our results showed a great potential for establishing restoration plantings with many early-and mid-successional species. Although planting risk of late-successional species was considered high, certain species showed some possibilities of acclimation after 18 months and should be considered in future plantation arrangements in view of their long-term contributions to biodiversity maintenance and also to human welfare through delivery of ecosystem services. Conducting a planting risk analysis can help avoid failure of restoration strategies involving simultaneous planting of early-, mid-, and late-successional tree species. This in turn will improve cost-effectiveness of initial interventions in large-scale, long-term restoration programs.

Prospective, multicenter validation of prediction scores for major bleeding in elderly patients with venous thromboembolism

The Outpatient Bleeding Risk Index (OBRI) and the Kuijer, RIETE and Kearon scores are clinical prognostic scores for bleeding in patients receiving oral anticoagulants for venous thromboembolism (VTE). We prospectively compared the performance of these scores in elderly patients with VTE.

Perilipin-1 in hemodialyzed patients: association with history of coronary heart disease and lipid profile

Perilipin-1 surrounds lipid droplets in both adipocytes and in atheroma plaque foam cells and controls access of lipases to the lipid core. In hemodialysis (HD) patients, dyslipidemia, malnutrition, inflammation and atherosclerosis are common. Thirty-six HD patients and 28 healthy volunteers were enrolled into the study. Ten HD patients suffered from coronary heart disease (CHD). Perilipin-1, triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), body mass index, albumin, geriatric nutritional risk index, normalized protein catabolic rate, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were measured. Perilipin-1 did not differ between HD patients and healthy volunteers. IL-6 and TNF-α were higher in HD patients. The evaluated nutritional markers and the markers of inflammation did not differ between HD patients with high perilipin-1 levels and HD patients with low perilipin-1 levels. Regarding the lipid profile, only HDL-C differed between HD patients with high perilipin-1 levels and HD patients with low perilipin-1 levels, and it was higher in the first subgroup. Perilipin-1 was significantly higher in HD patients without CHD. Perilipin-1 is detectable in the serum of HD patients and it is associated with increased HDL-C and decreased incidence of CHD.

Alterations of exhaled nitric oxide in pre-term infants with chronic lung disease

Animal models suggest that reduced nitric oxide (NO) synthase activity results in lower values of exhaled NO (eNO) present at birth in those individuals who are going to develop chronic lung disease of infancy (CLDI). Online tidal eNO was measured in 39 unsedated pre-term infants with CLDI (mean gestational age (GA) 27.3 weeks) in comparison with 23 healthy pre-term (31.6 weeks) and 127 term infants (39.9 weeks) at 44 weeks post-conceptional age, thus after the main inflammatory response. NO output (NO output (V'(NO)) = eNO x flow) was calculated to account for tidal- flow-related changes. Sex, maternal atopic disease and environmental factors (smoking, caffeine) were controlled for. The mean eNO was not different (14.9 ppb in all groups) but V'(NO) was lower in CLDI compared with healthy term infants (0.52 versus 0.63 nL x s(-1)). Values for healthy pre-term infants were between these two groups (0.58 nL x s(-1)). Within all pre-term infants (n = 62), V'(NO) was reduced in infants with low GA, high clinical risk index for babies scores and longer duration of oxygen therapy but not associated with post-natal factors, such as ventilation or corticosteroid treatment. After accounting for flow, the lower nitric oxide output in premature infants with chronic lung disease of infancy is consistent with the hypothesis of nitric oxide metabolism being involved in chronic lung disease of infancy.

Economic burden of surgical site infections at a European university hospital

OBJECTIVE: To quantify the economic burden of in-hospital surgical site infections (SSIs) at a European university hospital. DESIGN: Matched case-control study nested in a prospective observational cohort study. SETTING: Basel University Hospital in Switzerland, where an average of 28,000 surgical procedures are performed per year. METHODS: All in-hospital occurrences of SSI associated with surgeries performed between January 1, 2000, and December 31, 2001, by the visceral, vascular, and traumatology divisions at Basel University Hospital were prospectively recorded. Each case patient was matched to a control patient by age, procedure code, and National Nosocomial Infection Surveillance System risk index. The case-control pairs were analyzed for differences in cost of hospital care and in provision of specialized care. RESULTS: A total of 6,283 procedures were performed: 187 SSIs were detected in inpatients, 168 of whom were successfully matched with a control patient. For case patients, the mean additional hospital cost was SwF-19,638 (95% confidence interval [CI], SwF-8,492-SwF-30,784); the mean additional postoperative length of hospital stay was 16.8 days (95% CI, 13-20.6 days); and the mean additional in-hospital duration of antibiotic therapy was 7.4 days (95% CI, 5.1-9.6 days). Differences were primarily attributable to organ space SSIs (n = 76). CONCLUSIONS: In a European university hospital setting, SSIs are costly and constitute a heavy and potentially preventable burden on both patients and healthcare providers.

An examination of the Gonorrhea Cases & Places Study: An analysis of the Theory of Gender and Power, Situational/Environmental Variables Theory, and Sexual Script Theory as it relates to risky sexual behavior in African American adults

Objective. The purpose of the study is to provide a holistic depiction of behavioral & environmental factors contributing to risky sexual behaviors among predominantly high school educated, low-income African Americans residing in urban areas of Houston, TX utilizing the Theory of Gender and Power, Situational/Environmental Variables Theory, and Sexual Script Theory. Methods. A cross-sectional study was conducted via questionnaires among 215 Houston area residents, 149 were women and 66 were male. Measures used to assess behaviors of the population included a history of homelessness, use of crack/cocaine among several other illicit drugs, the type of sexual partner, age of participant, age of most recent sex partner, whether or not participants sought health care in the last 12 months, knowledge of partner's other sexual activities, symptoms of depression, and places where partner's were met. In an effort to determine risk of sexual encounters, a risk index employing the variables used to assess condom use was created categorizing sexual encounters as unsafe or safe. Results. Variables meeting the significance level of p<.15 for the bivariate analysis of each theory were entered into a binary logistic regression analysis. The block for each theory was significant, suggesting that the grouping assignments of each variable by theory were significantly associated with unsafe sexual behaviors. Within the regression analysis, variables such as sex for drugs/money, low income, and crack use demonstrated an effect size of ≥ ± 1, indicating that these variables had a significant effect on unsafe sexual behavioral practices. Conclusions. Variables assessing behavior and environment demonstrated a significant effect when categorized by relation to designated theories.

An examination of the Gonorrhea Cases & Places study: An analysis of the Theory of Gender and Power, Situational/Environmental Variables Theory, and Sexual Script Theory as it relates to risky sexual behavior in African American adults

Objective. The purpose of the study is to provide a holistic depiction of behavioral & environmental factors contributing to risky sexual behaviors among predominantly high school educated, low-income African Americans residing in urban areas of Houston, TX utilizing the Theory of Gender and Power, Situational/Environmental Variables Theory, and Sexual Script Theory. ^ Methods. A cross-sectional study was conducted via questionnaires among 215 Houston area residents, 149 were women and 66 were male. Measures used to assess behaviors of the population included a history of homelessness, use of crack/cocaine among several other illicit drugs, the type of sexual partner, age of participant, age of most recent sex partner, whether or not participants sought health care in the last 12 months, knowledge of partner's other sexual activities, symptoms of depression, and places where partner's were met. In an effort to determine risk of sexual encounters, a risk index employing the variables used to assess condom use was created categorizing sexual encounters as unsafe or safe. ^ Results. Variables meeting the significance level of p<.15 for the bivariate analysis of each theory were entered into a binary logistic regression analysis. The block for each theory was significant, suggesting that the grouping assignments of each variable by theory were significantly associated with unsafe sexual behaviors. Within the regression analysis, variables such as sex for drugs/money, low income, and crack use demonstrated an effect size of ≥±1, indicating that these variables had a significant effect on unsafe sexual behavioral practices. ^ Conclusions. Variables assessing behavior and environment demonstrated a significant effect when categorized by relation to designated theories. ^

Hospital district viability and Medicaid /market changes

Hospital districts (HD) that serve the uninsured and the needy face new challenges with the implementation of Medicaid managed. The potential loss of Medicaid patients and revenues may affect the ability to cost-shift and subsequently decrease the ability of the HD to meet its legal obligation of providing care for the uninsured. ^ To investigate HD viability in the current market, the aims of this study were to: (1) describe HD's environment, (2) document the HDs strategic response, (3) document changes in the HD's performance (patient volume) and financial status, and (4) determine whether relationships or trends exist between HD strategy, performance and financial status. ^ To achieve these aims, three Texas HDs (Fort Worth, Lubbock, and San Antonio) were selected to be evaluated. For each HD four types of strategic responses were documented and evaluated for change. In addition, the ability of each HD to sustain operations was evaluated by documenting performance and financial status changes (patient volume and financial ratios). A pre-post case study design method was used in which the Medicaid managed care “rollout'” date, at each site, was the central date. First, a descriptive analysis was performed which documented the environment, strategy, financial status, and patient volume of each hospital district. Second, to compare hospital districts, each hospital district was: (i) classified by a risk index, (ii) classified by its strategic response profile, and (iii) given a performance score based upon pre-post changes in patient volume and financial indicators. ^ Results indicated that all three HDs operate in a high risk environment compared to the rest of the nation. Two HDs chose the “Status Quo” response whereas one HD chose the “Competitive Proactive” response. Medicaid patient volume decreased in two of three HDs whereas indigent patient volume increased in two of the three (an indication of increasing financial risk). Total patient revenues for all HDs increased over the study period; however, the rate of increase slowed for all three after the Medicaid rollout date. All HDs experienced a decline in financial status between pre-post periods with the greatest decline observed in the HD that saw the greatest increase in indigent patient volume. ^ The pre-post case study format used and the lack of control study sites do not allow for assignment of causality. However, the results suggest possible adverse effects of Medicaid managed care and the need for a larger study, based on a stronger evaluation research design. ^

Metodología de evaluación de la seguridad vial en intersecciones basada en el análisis cuantitativo de conflictos entre vehículos

El modo tradicional de estimar el nivel de seguridad vial es el registro de accidentes de tráfico, sin embargo son altamente variables, aleatorios y necesitan un periodo de registro de al menos 3 años. Existen metodologías preventivas en las cuales no es necesario que ocurra un accidente para determinar el nivel de seguridad de una intersección, como lo es la técnica de los conflictos de tráfico, que introduce las mediciones alternativas de seguridad como cuantificadoras del riesgo de accidente. El objetivo general de la tesis es establecer una metodología que permita clasificar el riesgo en intersecciones interurbanas, en función del análisis de conflictos entre vehículos, realizado mediante las variables alternativas o indirectas de seguridad vial. La metodología para el análisis y evaluación temprana de la seguridad en una intersección, estará basada en dos medidas alternativas de seguridad: el tiempo hasta la colisión y el tiempo posterior a la invasión de la trayectoria. El desarrollo experimental se realizó mediante estudios de campo, para la parte exploratoria de la investigación, se seleccionaron 3 intersecciones interurbanas en forma de T donde se obtuvieron las variables que caracterizan los conflictos entre vehículos; luego mediante técnicas de análisis multivariante, se obtuvo los modelos de clasificación del riesgo cualitativo y cuantitativo. Para la homologación y el estudio final de concordancia entre el índice propuesto y el modelo de clasificación, se desarrollaron nuevos estudios de campo en 6 intersecciones interurbanas en forma de T. El índice de riesgo obtenido resulta una herramienta muy útil para realizar evaluaciones rápidas conducentes a estimar la peligrosidad de una intersección en T, debido a lo simple y económico que resulta obtener los registros de datos en campo, por medio de una rápida capacitación a operarios; la elaboración del informe de resultados debe ser por un especialista. Los índices de riesgo obtenidos muestran que las variables originales más influyentes son las mediciones de tiempo. Se pudo determinar que los valores más altos del índice de riesgo están relacionados a un mayor riesgo de que un conflicto termine en accidente. Dentro de este índice, la única variable cuyo aporte es proporcionalmente directo es la velocidad de aproximación, lo que concuerda con lo que sucede en un conflicto, pues una velocidad excesiva se manifiesta como un claro factor de riesgo ya que potencia todos los fallos humanos en la conducción. Una de las principales aportaciones de esta tesis doctoral a la ingeniería de carreteras, es la posibilidad de aplicación de la metodología por parte de administraciones de carreteras locales, las cuales muchas veces cuentan con recursos de inversión limitados para efectuar estudios preventivos, sobretodo en países en vías de desarrollo. La evaluación del riesgo de una intersección luego de una mejora en cuanto a infraestructura y/o dispositivos de control de tráfico, al igual que un análisis antes – después, pero sin realizar una comparación mediante la ocurrencia de accidentes, sino que por medio de la técnica de conflictos de tráfico, se puede convertir en una aplicación directa y económica. Además, se pudo comprobar que el análisis de componentes principales utilizado en la creación del índice de riesgo de la intersección, es una herramienta útil para resumir todo el conjunto de mediciones que son posibles de obtener con la técnica de conflictos de tráfico y que permiten el diagnóstico del riesgo de accidentalidad en una intersección. En cuanto a la metodología para la homologación de los modelos, se pudo establecer la validez y confiabilidad al conjunto de respuestas entregadas por los observadores en el registro de datos en campo, ya que los resultados de la validación establecen que la medición de concordancia de las respuestas entregadas por los modelos y lo observado, son significativas y sugieren una alta coincidencia entre ellos. ABSTRACT The traditional way of estimating road safety level is the record of occurrence of traffic accidents; however, they are highly variable, random, and require a recording period of at least three years. There are preventive methods which do not need an accident to determine the road safety level of an intersection, such as traffic conflict technique, which introduces surrogate safety measures as parameters for the evaluation of accident risks. The general objective of the thesis is to establish a methodology that will allow the classification of risk at interurban intersections as a function of the analysis of conflicts between vehicles performed by means of surrogate road safety variables. The proposal of a methodology for the analysis and early evaluation of safety at an intersection will be based on two surrogate safety measures: the time to collision and the post encroachment time. On the other hand, the experimental development has taken place by means of field studies in which the exploratory part of the investigation selected three interurban T-intersections where the application of the traffic conflict technique gave variables that characterize the conflicts between vehicles; then, using multivariate analysis techniques, the models for the classification of qualitative and quantitative risk were obtained. With the models new field studies were carried out at six interurban Tintersections with the purpose of developing the homologation and the final study of the agreement between the proposed index and the classification model. The risk index obtained is a very useful tool for making rapid evaluations to estimate the hazard of a T-intersection, as well as for getting simply and economically the field data records after a fast training of the workers and then preparing the report of results by a specialist. The risk indices obtained show that the most influential original variables are the measurements of time. It was determined that the highest risk index values are related with greater risk of a conflict resulting in an accident. Within this index, the only variable whose contribution is proportionally direct is the approach speed, in agreement with what happens in a conflict, because excessive speed appears as a clear risk factor at an intersection because it intensifies all the human driving faults. One of the main contributions of this doctoral thesis to road engineering is the possibility of applying the methodology by local road administrations, which very often have limited investment resources to carry out these kinds of preventive studies, particularly in developing countries. The evaluation of the risk at an intersection after an improvement in terms of infrastructure and/or traffic control devices, the same as a before/after analysis, without comparison of accident occurrence but by means of the traffic conflict technique, can become a direct and economical application. It is also shown that main components analysis used for producing the risk index of the intersection is a useful tool for summarizing the whole set of measurements that can be obtained with the traffic conflict technique and allow diagnosing accident risk at an intersection. As to the methodology for the homologation of the models, the validity and reliability of the set of responses delivered by the observers recording the field data could be established, because the results of the validation show that agreement between the observations and the responses delivered by the models is significant and highly coincident.

Diseño de un modelo de riesgo integral de incendios forestales mediante técnicas multicriterio y su automatización en sistemas de información geográfica : una aplicación en la Comunidad Valenciana

Los incendios forestales son la principal causa de mortalidad de árboles en la Europa mediterránea y constituyen la amenaza más seria para los ecosistemas forestales españoles. En la Comunidad Valenciana, diariamente se despliega cerca de un centenar de vehículos de vigilancia, cuya distribución se apoya, fundamentalmente, en un índice de riesgo de incendios calculado en función de las condiciones meteorológicas. La tesis se centra en el diseño y validación de un nuevo índice de riesgo integrado de incendios, especialmente adaptado a la región mediterránea y que facilite el proceso de toma de decisiones en la distribución diaria de los medios de vigilancia contra incendios forestales. El índice adopta el enfoque de riesgo integrado introducido en la última década y que incluye dos componentes de riesgo: el peligro de ignición y la vulnerabilidad. El primero representa la probabilidad de que se inicie un fuego y el peligro potencial para que se propague, mientras que la vulnerabilidad tiene en cuenta las características del territorio y los efectos potenciales del fuego sobre el mismo. Para el cálculo del peligro potencial se han identificado indicadores relativos a los agentes naturales y humanos causantes de incendios, la ocurrencia histórica y el estado de los combustibles, extremo muy relacionado con la meteorología y las especies. En cuanto a la vulnerabilidad se han empleado indicadores representativos de los efectos potenciales del incendio (comportamiento del fuego, infraestructuras de defensa), como de las características del terreno (valor, capacidad de regeneración…). Todos estos indicadores constituyen una estructura jerárquica en la que, siguiendo las recomendaciones de la Comisión europea para índices de riesgo de incendios, se han incluido indicadores representativos del riesgo a corto plazo y a largo plazo. El cálculo del valor final del índice se ha llevado a cabo mediante la progresiva agregación de los componentes que forman cada uno de los niveles de la estructura jerárquica del índice y su integración final. Puesto que las técnicas de decisión multicriterio están especialmente orientadas a tratar con problemas basados en estructuras jerárquicas, se ha aplicado el método TOPSIS para obtener la integración final del modelo. Se ha introducido en el modelo la opinión de los expertos, mediante la ponderación de cada uno de los componentes del índice. Se ha utilizado el método AHP, para obtener las ponderaciones de cada experto y su integración en un único peso por cada indicador. Para la validación del índice se han empleado los modelos de Ecuaciones de Estimación Generalizadas, que tienen en cuenta posibles respuestas correlacionadas. Para llevarla a cabo se emplearon los datos de oficiales de incendios ocurridos durante el período 1994 al 2003, referenciados a una cuadrícula de 10x10 km empleando la ocurrencia de incendios y su superficie, como variables dependientes. Los resultados de la validación muestran un buen funcionamiento del subíndice de peligro de ocurrencia con un alto grado de correlación entre el subíndice y la ocurrencia, un buen ajuste del modelo logístico y un buen poder discriminante. Por su parte, el subíndice de vulnerabilidad no ha presentado una correlación significativa entre sus valores y la superficie de los incendios, lo que no descarta su validez, ya que algunos de sus componentes tienen un carácter subjetivo, independiente de la superficie incendiada. En general el índice presenta un buen funcionamiento para la distribución de los medios de vigilancia en función del peligro de inicio. No obstante, se identifican y discuten nuevas líneas de investigación que podrían conducir a una mejora del ajuste global del índice. En concreto se plantea la necesidad de estudiar más profundamente la aparente correlación que existe en la provincia de Valencia entre la superficie forestal que ocupa cada cuadrícula de 10 km del territorio y su riesgo de incendios y que parece que a menor superficie forestal, mayor riesgo de incendio. Otros aspectos a investigar son la sensibilidad de los pesos de cada componente o la introducción de factores relativos a los medios potenciales de extinción en el subíndice de vulnerabilidad. Summary Forest fires are the main cause of tree mortality in Mediterranean Europe and the most serious threat to the Spanisf forest. In the Spanish autonomous region of Valencia, forest administration deploys a mobile fleet of 100 surveillance vehicles in forest land whose allocation is based on meteorological index of wildlandfire risk. This thesis is focused on the design and validation of a new Integrated Wildland Fire Risk Index proposed to efficient allocation of vehicles and specially adapted to the Mediterranean conditions. Following the approaches of integrated risk developed last decade, the index includes two risk components: Wildland Fire Danger and Vulnerability. The former represents the probability a fire ignites and the potential hazard of fire propagation or spread danger, while vulnerability accounts for characteristics of the land and potential effects of fire. To calculate the Wildland Fire Danger, indicators of ignition and spread danger have been identified, including human and natural occurrence agents, fuel conditions, historical occurrence and spread rate. Regarding vulnerability se han empleado indicadores representativos de los efectos potenciales del incendio (comportamiento del fuego, infraestructurasd de defensa), como de las características del terreno (valor, capacidad de regeneración…). These indicators make up the hierarchical structure for the index, which, following the criteria of the European Commission both short and long-term indicators have been included. Integration consists of the progressive aggregation of the components that make up every level in risk the index and, after that, the integration of these levels to obtain a unique value for the index. As Munticriteria methods are oriented to deal with hierarchically structured problems and with situations in which conflicting goals prevail, TOPSIS method is used in the integration of components. Multicriteria methods were also used to incorporate expert opinion in weighting of indicators and to carry out the aggregation process into the final index. The Analytic Hierarchy Process method was used to aggregate experts' opinions on each component into a single value. Generalized Estimation Equations, which account for possible correlated responses, were used to validate the index. Historical records of daily occurrence for the period from 1994 to 2003, referred to a 10x10-km-grid cell, as well as the extent of the fires were the dependant variables. The results of validation showed good Wildland Fire Danger component performance, with high correlation degree between Danger and occurrence, a good fit of the logistic model used and a good discrimination power. The vulnerability component has not showed a significant correlation between their values and surface fires, which does not mean the index is not valid, because of the subjective character of some of its components, independent of the surface of the fires. Overall, the index could be used to optimize the preventing resources allocation. Nevertheless, new researching lines are identified and discussed to improve the overall performance of the index. More specifically the need of study the inverse relationship between the value of the wildfire Fire Danger component and the forested surface of each 10 - km cell is set out. Other points to be researched are the sensitivity of the index component´s weight and the possibility of taking into account indicators related to fire fighting resources to make up the vulnerability component.

Sistema de control borroso en lazo cerrado para terapias con insulina en diabetes tipo I

La diabetes mellitus es un trastorno del metabolismo de los carbohidratos producido por la insuficiente o nula producción de insulina o la reducida sensibilidad a esta hormona. Es una enfermedad crónica con una mayor prevalencia en los países desarrollados debido principalmente a la obesidad, la vida sedentaria y disfunciones en el sistema endocrino relacionado con el páncreas. La diabetes Tipo 1 es una enfermedad autoinmune en la que son destruidas las células beta del páncreas, que producen la insulina, y es necesaria la administración de insulina exógena. Un enfermo de diabetes Tipo 1 debe seguir una terapia con insulina administrada por la vía subcutánea que debe estar adaptada a sus necesidades metabólicas y a sus hábitos de vida, esta terapia intenta imitar el perfil insulínico de un páncreas no patológico. La tecnología actual permite abordar el desarrollo del denominado “páncreas endocrino artificial”, que aportaría precisión, eficacia y seguridad para los pacientes, en cuanto a la normalización del control glucémico y reducción del riesgo de hipoglucemias. Permitiría que el paciente no estuviera tan pendiente de su enfermedad. El páncreas artificial consta de un sensor continuo de glucosa, una bomba de infusión de insulina y un algoritmo de control, que calcula la insulina a infusionar usando la glucosa como información principal. Este trabajo presenta un método de control en lazo semi-cerrado mediante un sistema borroso experto basado en reglas. La regulación borrosa se fundamenta en la ambigüedad del lenguaje del ser humano. Esta incertidumbre sirve para la formación de una serie de reglas que representan el pensamiento humano, pero a la vez es el sistema que controla un proceso, en este caso el sistema glucorregulatorio. Este proyecto está enfocado en el diseño de un controlador borroso que haciendo uso de variables como la glucosa, insulina y dieta, sea capaz de restaurar la función endocrina del páncreas de forma tecnológica. La validación del algoritmo se ha realizado principalmente mediante experimentos en simulación utilizando una población de pacientes sintéticos, evaluando los resultados con estadísticos de primer orden y algunos más específicos como el índice de riesgo de Kovatchev, para después comparar estos resultados con los obtenidos por otros métodos de control anteriores. Los resultados demuestran que el control borroso (FBPC) mejora el control glucémico con respecto a un sistema predictivo experto basado en reglas booleanas (pBRES). El FBPC consigue reducir siempre la glucosa máxima y aumentar la mínima respecto del pBRES pero es en terapias desajustadas, donde el FBPC es especialmente robusto, hace descender la glucosa máxima 8,64 mg/dl, el uso de insulina es 3,92 UI menor, aumenta la glucosa mínima 3,32 mg/dl y lleva al rango de glucosa 80 – 110 mg/dl 15,33 muestras más. Por lo tanto se puede concluir que el FBPC realiza un mejor control glucémico que el controlador pBRES haciéndole especialmente efectivo, robusto y seguro en condiciones de desajustes de terapia basal y con gran capacidad de mejora futura. SUMMARY The diabetes mellitus is a metabolic disorder caused by a poor or null insulin secretion or a reduced sensibility to insulin. Diabetes is a chronic disease with a higher prevalence in the industrialized countries, mainly due to obesity, the sedentary life and endocrine disfunctions connected with the pancreas. Type 1 diabetes is a self-immune disease where the beta cells of the pancreas, which are the responsible of secreting insulin, are damaged. Hence, it is necessary an exogenous delivery of insulin. The Type 1 diabetic patient has to follow a therapy with subcutaneous insulin administration which should be adjusted to his/her metabolic needs and life style. This therapy tries to mimic the insulin profile of a non-pathological pancreas. Current technology lets the development of the so-called endocrine artificial pancreas that would provide accuracy, efficiency and safety to patients, in regards to the glycemic control normalization and reduction of the risk of hypoglycemic. In addition, it would help the patient not to be so concerned about his disease. The artificial pancreas has a continuous glucose sensor, an insulin infusion pump and a control algorithm, that calculates the insulin infusion using the glucose as main information. This project presents a method of control in semi-closed-loop, through an expert fuzzy system based on rules. The fuzzy regulation is based on the human language ambiguity. This uncertainty serves for construction of some rules that represent the human language besides it is the system that controls a process, in this case the glucoregulatory system. This project is focus on the design of a fuzzy controller that, using variables like glucose insulin and diet, will be able to restore the pancreas endocrine function with technology. The algorithm assessment has mainly been done through experiments in simulation using a population of synthetic patients, evaluating the results with first order statistical parameters and some other more specific such as the Kovatchev risk index, to compare later these results with the ones obtained in others previous methods of control. The results demonstrate that the fuzzy control (FBPC) improves the glycemic control connected with a predictive expert system based on Booleans rules (pBRES). The FBPC is always able to reduce the maximum level of glucose and increase the minimum level as compared with pBRES but it is in unadjusted therapies where FBPC is especially strong, it manages to decrease the maximum level of glucose and insulin used by 8,64 mg/dl and 3,92 UI respectively, also increases the value of minimum glucose by 3,32 mg/dl, getting 15,33 samples more inside the 80-110 mg/dl glucose rank. Therefore we can conclude that FBPC achieves a better glycemic control than the controller pBRES doing it especially effective, robust and safe in conditions of mismatch basal therapy and with a great capacity for future improvements.

Avaliação da radioatividade natural em tintas de uso comercial no Brasil

A radioatividade natural presente em solos, rochas e materiais de construção, devida ao 40K e às séries radioativas do 232Th e 238U é a principal contribuição à exposição externa aos seres humanos. Neste trabalho, determinou-se as concentrações de atividade de 226Ra (da série do 238U), 232Th e 40K presentes em 50 amostras de tintas látex de cor branca comercializadas no Brasil, especificamente, 15 do tipo econômico, 15 do tipo standard, 20 do tipo premium e em uma amostra de dióxido de titânio. As amostras foram seladas e armazenadas por um período mínimo de 30 dias para se alcançar o equilíbrio radioativo secular nas séries do 238U e do 232Th e medidas pela técnica analítica de espectrometria gama de alta resolução. As concentrações de atividade foram calculadas utilizando-se as médias ponderadas pelas incertezas do 214Pb e 214Bi para o 226Ra e médias ponderadas pelas incertezas do 228Ac, 212Pb e 212Bi para o 232Th. A concentração de atividade do 40K foi determinada pela sua transição única de 1460,8 keV. Fatores de autoatenuação gama foram calculados e utilizados para correção da concentração de atividade das amostras com densidade maior que 1,0 g.cm-3. Os índices radiológicos equivalente em rádio (Raeq), índice de concentração de atividade (Iγ), índice de risco à exposição gama interna (Hin), o índice de risco à exposição gama externa (Hex) e a taxa de dose (D) e dose efetiva anual (Def) foram calculados a partir das concentrações de atividade do 226Ra, 232Th e 40K. As concentrações de atividade de 226Ra das tintas variaram entre valores abaixo da atividade mínima detectável e 38,7 Bq.kg-1, as de 232Th variaram entre valores abaixo da atividade mínima detectável e 101,2 Bq.kg-1 e as de 40K variaram entre valores abaixo da atividade mínima detectável e 256 Bq.kg-1. O Raeq variou entre 1,41 Bq.kg-1 e 203 Bq.kg-1, o Iγ variou entre 0,0047 e 0,720, o Hin variou entre 0,0076 e 0,653 e o Hex variou entre 0,0038 e 0,549. A taxa de dose variou de 0,170 nGy.h-1 a 21,3 nGy.h-1 e a dose efetiva anual variou entre 0,83 μSv.a-1 e 104,2 μSv.a-1. Estes resultados mostram que as concentrações de atividades das tintas utilizadas neste estudo estão abaixo dos limites recomendados por Hassan et al. para Raeq (370 Bq.kg-1), pela Comissão Européia para o Iγ (limite de 2 para materiais superficiais) e pela Organização para Cooperação Econômica e Desenvolvimento para Hin e para Hex (ambos com limite de 1), para todas as 50 amostras estudadas, mostrando assim a segurança destas tintas com relação a proteção radiológica.

Características cineantropométricas en jugadores de baloncesto adolescentes

Introducción: El baloncesto presenta una gran heterogeneidad antropométrica entre jugadores en relación a la posición de juego. El base suele ser el más bajo del equipo pero también el más rápido. El escolta suele ser similar al base, más bajo, rápido y ágil que el resto. El alero es de una altura intermedia entre los jugadores interiores y exteriores, combina la altura con la velocidad, y el pívot tiene un rol más físico, es el más alto y con mayor masa muscular. El objetivo del estudio es describir el perfil cineantropométrico del equipo cadete masculino del Valencia Basket Club. Material y Métodos: Se han evaluado 20 jugadores de baloncesto cadete masculino (15,35±0,59años). Un antropometrista nivel I tomó las medidas según la metodología de la Society for the Advancement of Kinanthropometry (ISAK). Se calculó la composición corporal según el consenso de cineantropometría del Grupo Español de Cineantropometría (GREC), el somatotipo según Heath-Carter, e índices adiposo-musculares. Resultados: Se observaron diferencias en los valores de peso, talla, pliegues cutáneos y composición corporal, de las variables estudiadas de la muestra total y por posición de juego, siendo los valores menores los de la posición base y mayores en los pívots. Se estableció una tendencia creciente de estos parámetros en el siguiente orden: base, escolta, alero y pívot. Conclusiones: El somatotipo global del jugador de baloncesto cadete del Valencia Basket Club es ectomorfo balanceado. Conocer el perfil cineantropométrico puede beneficiar la elaboración de planes de entrenamiento y nutrición, así como reflejar la evolución y dirigirla hacia las características ligadas al rendimiento óptimo.

Factors Affecting Jaguar and Puma Predation on Livestock in Costa Rica

The wild cats and the livestock farmers are part of the space conflict in the rural areas in Latin America. In this sense, this conflict causes a discomfort among the livestock producers due to the loss of animals and, consequently, it also causes a negative reaction towards the wild cats leading such reaction into the elimination of the wild cats per se. Although, there have been some initiatives have tried to approach such conflict by recommending mitigation and prevention measurements to the producers, these measurements are undertaken without coordination. For this reason, the following project presents a planning tool that can ease the coordination processes undertaken for the solving of the conflict between human beings and wild cats.

Surgical Site Infection in a University Hospital in Northeast Brazil

We examined prevention of surgical site infection (SSI) in a tertiary teaching hospital in northeast Brazil, from January 1994 to December 2003. The survey included 5,742 patients subjected to thoracic, urologic, vascular and general surgery. The criteria for diagnosing SSI were those of the Centers for Disease Control, USA, and the variables of the National Nosocomial Infection Surveillance risk index were used. Data analysis revealed that anesthetic risk scores, wound class and duration of surgery were significantly associated with SSI. A total of 296 SSIs were detected among the 5,742 patients (5.1%). The overall incidence of SSI was 8.8% in 1994; it decreased to 3.3% in 2003. In conclusion, the use of educational strategies, based on guidelines for SSI prevention reduced SSI incidence. Appropriate management of preoperative, intraoperative, and postoperative incision care, and a surveillance system based on international criteria, were useful in reducing SSI rates in our hospital