Fascitis necrosante genital

Las infecciones bacterianas de la piel y partes blandas constituyen una patología frecuente como consulta en los servicios de urgencias. Los cuadros más frecuente son las celulitis, que tienen un buen pronóstico, pero ocasionalmente se ven infecciones más profundas que afectan a tejido celular subcutáneo, fascia y músculo. En este caso el diagnóstico y tratamiento precoces son fundamentales para el pronóstico del paciente. Describimos un caso de Gangrena de Fournier que a pesar del un diagnóstico y tratamiento precoces en el servicio de urgencias, produjo la muerte del paciente. 

The Epistemological Foundations of Artificial Agents

Lacey, N. J., Lee, M. H. (2003). The Epistemological Foundations of Artificial Agents. Minds and Machines, 13, 339-365.

The topological behaviour of 3D null points in the Sun's corona

Brown D. S. and Priest E. R. 2001, The topological behaviour of 3D null points in the Sun's corona, Astronomy and Astrophysics, 367, 339-346

Computational Intelligence and Feature Selection : Rough and Fuzzy Approaches

Computational Intelligence and Feature Selection provides a high level audience with both the background and fundamental ideas behind feature selection with an emphasis on those techniques based on rough and fuzzy sets, including their hybridizations. It introduces set theory, fuzzy set theory, rough set theory, and fuzzy-rough set theory, and illustrates the power and efficacy of the feature selections described through the use of real-world applications and worked examples. Program files implementing major algorithms covered, together with the necessary instructions and datasets, are available on the Web.

Effects of prior warm-up regime on severe-intensity cycling performance

Burnley, M, Doust, J and Jones, A (2005) Effects of Prior Warm-up Regime on Severe-Intensity Cycling Performance. Medicine and Science in Sports and Exercise, 37 (5). pp. 838-845. ISSN 1530-0315 RAE2008

A probabilistic index for completely positive maps and an application

Gohm, Rolf, (2003) 'A probabilistic index for completely positive maps and an application', Journal of Operator Theory 54(2) pp.339-361 RAE2008

Lámparas de diseño contemporáneo de intenso colorido, piezas en cobre y muestra pirotécnica.

7 fotografías a color.

Supporting therapist engagement in evidence based practice: Developing a continuing education programme through participatory action research

Therapists find it challenging to integrate research evidence into their clinical decision-making because it may involve modifying their existing practices. Although continuing education (CE) programmes for evidence-based practice (EBP) have employed various approaches to increase individual practitioner’s knowledge and skills, these have been shown to have little impact in changing customary behaviours. To date, there has been little attempt to actively engage therapists as collaborators in developing educational processes concerning EBP. The researcher collaborated with seven clinical therapists (one occupational therapist, four physiotherapists and two speech and language therapists) enrolled in a new post-qualification Implementing Evidence in Therapy Practice (IETP) MSc module to monitor and adapt the learning programme over ten weeks. The participating therapists actively engaged in participatory action research (PAR) iterative cycles of reflecting→ planning→ acting→ observing→ reflecting with the researcher. Mixed methods were used to evaluate the IETP module and its influence on therapists’ subsequent engagement in EBP activities. Data were gathered immediately on completion of the module and five months later. Immediate post-module findings revealed four components as being important to the therapists: 1) characteristics of the learning environment; 2) acquisition of relevant EBP skills; 3) nature of the learning process; and 4) acquiring confidence. The two themes and sub-themes which emerged from individual interviews conducted five months post-module expanded on the four components already identified. Theme 1: Experiencing the learning (sub-themes: module organisation; learning is relational; improving the module); and theme 2: Enacting the learning through a new way of being (sub-themes: criticality and reflection; self agency; modelling EBP behaviours; positioning self in an EB work culture). The therapists’ perspectives had by then shifted from that of a learner to that of a clinician constructing a new sense of self as an evidence-based practitioner. Findings from this study underline the importance of the process of socially constructed knowledge and of empowering learners through collaboratively designed continuing education programmes. In the student-driven learning environment, therapists chose repetitive skill-building and authentic problem-solving activities which reflected the complexity of the environments to which they were expected to transfer their learning. These findings have implications for educators designing EBP continuing education programmes, during which students develop professional ways of being.

Why walkers slip: shine is not a reliable cue for slippery ground.

In a series of four studies, we investigated the visual cues that walkers use to predict slippery ground surfaces and tested whether visual information is reliable for specifying low-friction conditions. In Study 1, 91% of participants surveyed responded that they would use shine to identify upcoming slippery ground. Studies 2-4 confirmed participants' reliance on shine to predict slip. Participants viewed ground surfaces varying in gloss, paint color, and viewing distance under indoor and outdoor lighting conditions. Shine and slip ratings and functional walking judgments were related to surface gloss level and to surface coefficient of friction (COF). However, judgments were strongly affected by surface color, viewing distance, and lighting conditions--extraneous factors that do not change the surface COF. Results suggest that, although walkers rely on shine to predict slippery ground, shine is not a reliable visual cue for friction. Poor visual information for friction may underlie the high prevalence of friction-related slips and falls.

Platelet Counts, Acute Kidney Injury, and Mortality after Coronary Artery Bypass Grafting Surgery.

BACKGROUND: Cardiac surgery requiring cardiopulmonary bypass is associated with platelet activation. Because platelets are increasingly recognized as important effectors of ischemia and end-organ inflammatory injury, the authors explored whether postoperative nadir platelet counts are associated with acute kidney injury (AKI) and mortality after coronary artery bypass grafting (CABG) surgery. METHODS: The authors evaluated 4,217 adult patients who underwent CABG surgery. Postoperative nadir platelet counts were defined as the lowest in-hospital values and were used as a continuous predictor of postoperative AKI and mortality. Nadir values in the lowest 10th percentile were also used as a categorical predictor. Multivariable logistic regression and Cox proportional hazard models examined the association between postoperative platelet counts, postoperative AKI, and mortality. RESULTS: The median postoperative nadir platelet count was 121 × 10/l. The incidence of postoperative AKI was 54%, including 9.5% (215 patients) and 3.4% (76 patients) who experienced stages II and III AKI, respectively. For every 30 × 10/l decrease in platelet counts, the risk for postoperative AKI increased by 14% (adjusted odds ratio, 1.14; 95% CI, 1.09 to 1.20; P < 0.0001). Patients with platelet counts in the lowest 10th percentile were three times more likely to progress to a higher severity of postoperative AKI (adjusted proportional odds ratio, 3.04; 95% CI, 2.26 to 4.07; P < 0.0001) and had associated increased risk for mortality immediately after surgery (adjusted hazard ratio, 5.46; 95% CI, 3.79 to 7.89; P < 0.0001). CONCLUSION: The authors found a significant association between postoperative nadir platelet counts and AKI and short-term mortality after CABG surgery.