Ejercicio y resultados clínicos en pacientes con enfermedad de Parkinson: una revisión sistemática y metaanálisis

Antecedentes. La enfermedad de Parkinson (EP) es la segunda enfermedad neurodegenerativa más común en el mundo, la cual afecta el componente físico, psicológico y social de los individuos que la padecen. Numerosos estudios han abordado los beneficios de diferentes programas de ejercicio, llegando a ser una estrategia no-farmacológica efectiva para aminorar el deterioro funcional de los pacientes con EP. Objetivo. Determinar los efectos de las diferentes modalidades de ejercicio físico en los principales desenlaces clínicos en pacientes con EP. Métodos. Se consultaron las bases de datos MEDLINE, EMBASE, Scopus, CENTRAL y PEDro desde febrero de 1990 hasta febrero de 2014 para identificar Ensayos Clínicos Aleatorizados (ECA) publicados. Además, se examinaron las listas de referencias de otras revisiones y de estudios identificados. La extracción de datos se realizó por dos autores independientes. Se empleó un modelo de efectos aleatorios en presencia de heterogeneidad estadística (I2>50%). El sesgo de publicación fue evaluado mediante el gráfico de embudo. Resultados: Un total de 18 estudios fueron incluidos. Se encontraron diferencias estadísticamente significativas en las intervenciones con ejercicio y las siguientes medidas de resultado, severidad de los síntomas motores (MDS-UPDRS) DME 1.44, IC 95% [-2.09 a -0.78] (p<0.001) I2= 87,9% y el equilibrio DME 0,52 IC 95% [0,30 a 0,74] (p<0.001) I2= 85,6%. En el análisis de subgrupos en la modalidad de ejercicio aeróbico, en MDS-UPDRS DME -1,28, IC 95% [-1,98 a -0,59] (p<0.001), 3 calidad de vida DME -1,91 IC 95% [-2,76 a -1,07] (p<0.001), equilibrio DME 0,54 IC 95% [0,31 a 0,77] (p<0.001), 10-m WT DME 0,15 IC 95% [0,06 a 0,25] (p<0.001) y Vo2 máximo DME -1,09 IC 95% [-1,31 a -0,88] (p=0.001), 6MWT DME 40,46 IC 95% [11,28 a 69,65] (p=0.007). Conclusiones: El ejercicio aeróbico produjo mejoras significativas en MDS UPDRS, equilibrio, calidad de vida, 10-m WT y y Vo2 máximo; mientras que el ejercicio combinado mejoró la fuerza.

Regulatory governance in the latinamerican telecommunications sector

Empezando con Chile a comienzos de 1980, los países de América Latina han profundizado la reforma a las telecomunicaciones para crear un entorno regulatorio que incentive la inversión privada, en particular la inversión extranjera. En este artículo, trabajo las tendencias regulatorias en el sector telecomunicaciones de 24 países latinoamericanos y del caribe durante el período 1980-1997 y construyo un índice basado en : autonomía, rendición de cuentas, claridad de las funciones y objetivos, transparencia y participación, y el tipo de mandato legal que crea el ente regulador. El índice muestra que, en promedio, la mayoría de los países llevaron a cabo fuertes reformas regulatorias en la dirección sugerida por expertos e investigadores. El índice también se correlación bien con varias variables políticas, de riesgo, económicas y de telecomunicaciones.

Las prácticas de recursos humanos y su incidencia en el bienestar laboral de los empleados

El objetivo del presente trabajo es formular, mediante una profunda revisión documental, bibliográfica y empírica, una fundamentación teórica sobre si existe o no incidencia de las prácticas de recursos humanos sobre el bienestar laboral de los empleados, y el que grado en que esta se presenta sobre aspecto como el engagement y la satisfacción laboral. Se realizó la revisión de múltiples estudios empíricos que aportaran evidencia sobre la relación que se presenta entre las principales prácticas de recursos humanos – provisión de personal, formación y desarrollo, promoción de personal, evaluación de desempeño, compensación y pago, y balance trabajo-familia – y el bienestar laboral, representado en el engagement y satisfacción en el trabajo de los empleados. Los resultados de este trabajo indican la existencia de una relación e incidencia de las prácticas de recursos humanos, el bienestar laboral, el engagement y la satisfacción laboral. De igual forma se encontró que estas relaciones son principalmente de carácter positivo, lo cual indica que las organizaciones que desarrollan este tipo de prácticas en su interior, fomentan tanto el desarrollo y la presencia de bienestar laboral en sus empleados, como su perdurabilidad.

Does uncertainty cause inertia in decision making? An experimental study of the role of regret aversion and indecisiveness

Previous research has shown that often there is clear inertia in individual decision making---that is, a tendency for decision makers to choose a status quo option. I conduct a laboratory experiment to investigate two potential determinants of inertia in uncertain environments: (i) regret aversion and (ii) ambiguity-driven indecisiveness. I use a between-subjects design with varying conditions to identify the effects of these two mechanisms on choice behavior. In each condition, participants choose between two simple real gambles, one of which is the status quo option. I find that inertia is quite large and that both mechanisms are equally important.

Evidence for a reversal with age in the pattern of near-wall blood flow around aortic branches

The changes that occur with age in the distribution of atherosclerotic lesions around arterial branch points challenge accepted theories relating disease to haemodynamic stresses. We investigated whether flow near branch points changes with age in a way that can account for the different lesion distributions. Flow around 20 branches from immature and mature aortas was investigated by examining the length:width ratio and orientation of endothelial nuclei; these properties depend on the magnitude and direction of near-wall flows, respectively. There were significant changes in the pattern of nuclear shape with age, consistent with a reversal in the pattern of shear around branches. In control regions away from branches, there were no such changes. The role of haemodynamic stresses in atherogenesis may require re-evaluation in the light of these results. (C) 2003 Elsevier Ireland Ltd. All rights reserved.

Surface based hypothesis verification in intensity images using geometric and appearance data

In this paper we discuss current work concerning Appearance-based and CAD-based vision; two opposing vision strategies. CAD-based vision is geometry based, reliant on having complete object centred models. Appearance-based vision builds view dependent models from training images. Existing CAD-based vision systems that work with intensity images have all used one and zero dimensional features, for example lines, arcs, points and corners. We describe a system we have developed for combining these two strategies. Geometric models are extracted from a commercial CAD library of industry standard parts. Surface appearance characteristics are then learnt automatically by observing actual object instances. This information is combined with geometric information and is used in hypothesis evaluation. This augmented description improves the systems robustness to texture, specularities and other artifacts which are hard to model with geometry alone, whilst maintaining the advantages of a geometric description.

Perspex machine X: software development

The Perspex Machine arose from the unification of computation with geometry. We now report significant redevelopment of both a partial C compiler that generates perspex programs and of a Graphical User Interface (GUI). The compiler is constructed with standard compiler-generator tools and produces both an explicit parse tree for C and an Abstract Syntax Tree (AST) that is better suited to code generation. The GUI uses a hash table and a simpler software architecture to achieve an order of magnitude speed up in processing and, consequently, an order of magnitude increase in the number of perspexes that can be manipulated in real time (now 6,000). Two perspex-machine simulators are provided, one using trans-floating-point arithmetic and the other using transrational arithmetic. All of the software described here is available on the world wide web. The compiler generates code in the neural model of the perspex. At each branch point it uses a jumper to return control to the main fibre. This has the effect of pruning out an exponentially increasing number of branching fibres, thereby greatly increasing the efficiency of perspex programs as measured by the number of neurons required to implement an algorithm. The jumpers are placed at unit distance from the main fibre and form a geometrical structure analogous to a myelin sheath in a biological neuron. Both the perspex jumper-sheath and the biological myelin-sheath share the computational function of preventing cross-over of signals to neurons that lie close to an axon. This is an example of convergence driven by similar geometrical and computational constraints in perspex and biological neurons.

Global retrieval of ATSR cloud parameters and evaluation (GRAPE): dataset assessment

The Along-Track Scanning Radiometers (ATSRs) provide a long time-series of measurements suitable for the retrieval of cloud properties. This work evaluates the freely-available Global Retrieval of ATSR Cloud Parameters and Evaluation (GRAPE) dataset (version 3) created from the ATSR-2 (1995�2003) and Advanced ATSR (AATSR; 2002 onwards) records. Users are recommended to consider only retrievals flagged as high-quality, where there is a good consistency between the measurements and the retrieved state (corresponding to about 60% of converged retrievals over sea, and more than 80% over land). Cloud properties are found to be generally free of any significant spurious trends relating to satellite zenith angle. Estimates of the random error on retrieved cloud properties are suggested to be generally appropriate for optically-thick clouds, and up to a factor of two too small for optically-thin cases. The correspondence between ATSR-2 and AATSR cloud properties is high, but a relative calibration difference between the sensors of order 5�10% at 660 nm and 870 nm limits the potential of the current version of the dataset for trend analysis. As ATSR-2 is thought to have the better absolute calibration, the discussion focusses on this portion of the record. Cloud-top heights from GRAPE compare well to ground-based data at four sites, particularly for shallow clouds. Clouds forming in boundary-layer inversions are typically around 1 km too high in GRAPE due to poorly-resolved inversions in the modelled temperature profiles used. Global cloud fields are compared to satellite products derived from the Moderate Resolution Imaging Spectroradiometer (MODIS), Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) measurements, and a climatology of liquid water content derived from satellite microwave radiometers. In all cases the main reasons for differences are linked to differing sensitivity to, and treatment of, multi-layer cloud systems. The correlation coefficient between GRAPE and the two MODIS products considered is generally high (greater than 0.7 for most cloud properties), except for liquid and ice cloud effective radius, which also show biases between the datasets. For liquid clouds, part of the difference is linked to choice of wavelengths used in the retrieval. Total cloud cover is slightly lower in GRAPE (0.64) than the CALIOP dataset (0.66). GRAPE underestimates liquid cloud water path relative to microwave radiometers by up to 100 g m�2 near the Equator and overestimates by around 50 g m�2 in the storm tracks. Finally, potential future improvements to the algorithm are outlined.

The GRAPE aerosol retrieval algorithm

The aerosol component of the Oxford-Rutherford Aerosol and Cloud (ORAC) combined cloud and aerosol retrieval scheme is described and the theoretical performance of the algorithm is analysed. ORAC is an optimal estimation retrieval scheme for deriving cloud and aerosol properties from measurements made by imaging satellite radiometers and, when applied to cloud free radiances, provides estimates of aerosol optical depth at a wavelength of 550 nm, aerosol effective radius and surface reflectance at 550 nm. The aerosol retrieval component of ORAC has several incarnations – this paper addresses the version which operates in conjunction with the cloud retrieval component of ORAC (described by Watts et al., 1998), as applied in producing the Global Retrieval of ATSR Cloud Parameters and Evaluation (GRAPE) data-set.