Gel vs aceite mineral en el tratamiento del fotoenvejecimiento de manos con luz pulsada intensa

Introducción: En el tratamiento con Luz Pulsada Intensa (LPI) para el fotoenvejecimiento de las manos no se encuentran estudios que evidencien si existe alguna diferencia estadísticamente significativa en el grado de efectividad y seguridad al utilizar gel o aceite mineral como medios de acople. Objetivo: Determinar la efectividad y seguridad terapéutica en el uso de gel vs aceite mineral. Materiales y Métodos: Estudio observacional analítico de cohorte retrospectivo que involucró 29 pacientes. Realizado en tres fases; selección y recolección de las historias clínicas, evaluación fotográfica de registros pre tratamiento y pos tratamiento con determinación del grado de mejoría global en el fotoenvejecimiento de las manos por parte de tres evaluadores cegados, y análisis estadístico de los datos obtenidos por medio de las pruebas de Mann Whitney y Wilcoxon. Resultados: Se encontró mejoría dada por disminución en un grado del fotoenvejecimiento para los dos medios de acople con la misma significancia estadística. La percepción subjetiva mostró mejoría en todos los pacientes evaluados. La seguridad es similar en los dos grupos pero se evidenció mayor severidad en los efectos secundarios con el uso de aceite, con diferencias estadísticamente significativas en los efectos moderados y severos. Conclusión: La efectividad es la misma independiente del medio de acople que se use. La seguridad a pesar de evidenciar un perfil similar es mayor con el uso de gel en cuanto a la menor severidad de los efectos presentados. Se requieren más estudios de tipo ensayos clínicos controlados que permitan determinar una mayor evidencia.

Prevalencia de delirium en población adulta en cuidado intensivo.

Introducción: El delirium es un trastorno de conciencia de inicio agudo asociado a confusión o disfunción cognitiva, se puede presentar hasta en 42% de pacientes, de los cuales hasta el 80% ocurren en UCI. El delirium aumenta la estancia hospitalaria, el tiempo de ventilación mecánica y la morbimortalidad. Se pretendió evaluar la prevalencia de periodo de delirium en adultos que ingresaron a la UCI en un hospital de cuarto nivel durante 2012 y los factores asociados a su desarrollo. Metodología Se realizó un estudio transversal con corte analítico, se incluyeron pacientes hospitalizados en UCI médica y UCI quirúrgica. Se aplicó la escala de CAM-ICU y el Examen Mínimo del Estado Mental para evaluar el estado mental. Las asociaciones significativas se ajustaron con análisis multivariado. Resultados: Se incluyeron 110 pacientes, el promedio de estancia fue 5 días; la prevalencia de periodo de delirium fue de 19.9%, la mediana de edad fue 64.5 años. Se encontró una asociación estadísticamente significativa entre el delirium y la alteración cognitiva de base, depresión, administración de anticolinérgicos y sepsis (p< 0,05). Discusión Hasta la fecha este es el primer estudio en la institución. La asociación entre delirium en la UCI y sepsis, uso de anticolinérgicos, y alteración cognitiva de base son consistentes y comparables con factores de riesgo descritos en la literatura mundial.

Riesgo de accidentes biológicos en estudiantes de la salud: revisión de la literatura en los últimos 14 años.

Introducción: Todos los trabajadores del área de la salud están en riesgo de padecer un accidente biológico. No obstante los estudiantes de estas aéreas, pueden presentar más riesgo porque apenas están en formación y no tienen la práctica o experiencia suficiente. Existen varios artículos que han estudiado la incidencia y prevalencia de accidentes biológicos en los trabajadores del área de la salud, Sin embargo, sobre esta problemática de la población estudiantil del área de la salud, se encuentra menos literatura. Por lo tanto con esta revisión sistemática se busca analizar y actualizar este tema. Métodos: Se realizó una revisión de la literatura científica de artículos publicados en los últimos 14 años, en relación con la prevalencia de accidentes biológicos en estudiantes de medicina, odontología, enfermería y residentes del área de la salud a nivel mundial. Se llevó a cabo la búsqueda en la base de datos de Pubmed, encontrando un total de 100 artículos, escritos en inglés, francés, español o portugués. Resultados: Las prevalencias encontradas sobre accidentes biológicos en estudiantes fueron las siguientes: en países europeos a nivel de enfermería los valores oscilan entre 10.2 % a 32%, en medicina fueron del 16%-58.8%, y en odontología del 21 %. En países asiáticos, se encontró que en enfermería el porcentaje varía de 49%-96 %, en medicina van del 35% -68%, y en odontología varia de 68.a 75.4%. En Norte América, en medicina las cifras fluctúan alrededor del 11-72.7 % y en odontología giran alrededor del 19.1%. Finalmente respecto a Suramérica la prevalencia fue de 31.2 a 46.7% en medicina, y del 40% en enfermería. Conclusiones: Por lo anterior se pudo concluir que, la prevalencia de accidentes biológicos en los estudiantes del área de la salud es elevada y varía según el continente en el que se encuentren.

Multimodel assessment of water scarcity under climate change

Water scarcity severely impairs food security and economic prosperity in many countries today. Expected future population changes will, in many countries as well as globally, increase the pressure on available water resources. On the supply side, renewable water resources will be affected by projected changes in precipitation patterns, temperature, and other climate variables. Here we use a large ensemble of global hydrological models (GHMs) forced by five global climate models and the latest greenhouse-gas concentration scenarios (Representative Concentration Pathways) to synthesize the current knowledge about climate change impacts on water resources. We show that climate change is likely to exacerbate regional and global water scarcity considerably. In particular, the ensemble average projects that a global warming of 2 degrees C above present (approximately 2.7 degrees C above preindustrial) will confront an additional approximate 15% of the global population with a severe decrease in water resources and will increase the number of people living under absolute water scarcity (< 500 m(3) per capita per year) by another 40% (according to some models, more than 100%) compared with the effect of population growth alone. For some indicators of moderate impacts, the steepest increase is seen between the present day and 2 degrees C, whereas indicators of very severe impacts increase unabated beyond 2 degrees C. At the same time, the study highlights large uncertainties associated with these estimates, with both global climate models and GHMs contributing to the spread. GHM uncertainty is particularly dominant in many regions affected by declining water resources, suggesting a high potential for improved water resource projections through hydrological model development.

First look at changes in flood hazard in the inter-sectoral impact model intercomparison project ensemble

Climate change due to anthropogenic greenhouse gas emissions is expected to increase the frequency and intensity of precipitation events, which is likely to affect the probability of flooding into the future. In this paper we use river flow simulations from nine global hydrology and land surface models to explore uncertainties in the potential impacts of climate change on flood hazard at global scale. As an indicator of flood hazard we looked at changes in the 30-y return level of 5-d average peak flows under representative concentration pathway RCP8.5 at the end of this century. Not everywhere does climate change result in an increase in flood hazard: decreases in the magnitude and frequency of the 30-y return level of river flow occur at roughly one-third (20-45%) of the global land grid points, particularly in areas where the hydro-graph is dominated by the snowmelt flood peak in spring. In most model experiments, however, an increase in flooding frequency was found in more than half of the grid points. The current 30-y flood peak is projected to occur in more than 1 in 5 y across 5-30% of land grid points. The large-scale patterns of change are remarkably consistent among impact models and even the driving climate models, but at local scale and in individual river basins there can be disagreement even on the sign of change, indicating large modeling uncertainty which needs to be taken into account in local adaptation studies.

Hydrological droughts in the 21st century, hotspots and uncertainties from a global multimodel ensemble experiment

Increasing concentrations of greenhouse gases in the atmosphere are expected to modify the global water cycle with significant consequences for terrestrial hydrology. We assess the impact of climate change on hydrological droughts in a multimodel experiment including seven global impact models (GIMs) driven by bias-corrected climate from five global climate models under four representative concentration pathways (RCPs). Drought severity is defined as the fraction of land under drought conditions. Results show a likely increase in the global severity of hydrological drought at the end of the 21st century, with systematically greater increases for RCPs describing stronger radiative forcings. Under RCP8.5, droughts exceeding 40% of analyzed land area are projected by nearly half of the simulations. This increase in drought severity has a strong signal-to-noise ratio at the global scale, and Southern Europe, the Middle East, the Southeast United States, Chile, and South West Australia are identified as possible hotspots for future water security issues. The uncertainty due to GIMs is greater than that from global climate models, particularly if including a GIM that accounts for the dynamic response of plants to CO2 and climate, as this model simulates little or no increase in drought frequency. Our study demonstrates that different representations of terrestrial water-cycle processes in GIMs are responsible for a much larger uncertainty in the response of hydrological drought to climate change than previously thought. When assessing the impact of climate change on hydrology, it is therefore critical to consider a diverse range of GIMs to better capture the uncertainty.

Comparing projections of future changes in runoff from hydrological and biome models in ISI-MIP

Future changes in runoff can have important implications for water resources and flooding. In this study, runoff projections from ISI-MIP (Inter-sectoral Impact Model Inter-comparison Project) simulations forced with HadGEM2-ES bias-corrected climate data under the Representative Concentration Pathway 8.5 have been analysed for differences between impact models. Projections of change from a baseline period (1981-2010) to the future (2070-2099) from 12 impacts models which contributed to the hydrological and biomes sectors of ISI-MIP were studied. The biome models differed from the hydrological models by the inclusion of CO2 impacts and most also included a dynamic vegetation distribution. The biome and hydrological models agreed on the sign of runoff change for most regions of the world. However, in West Africa, the hydrological models projected drying, and the biome models a moistening. The biome models tended to produce larger increases and smaller decreases in regionally averaged runoff than the hydrological models, although there is large inter-model spread. The timing of runoff change was similar, but there were differences in magnitude, particularly at peak runoff. The impact of vegetation distribution change was much smaller than the projected change over time, while elevated CO2 had an effect as large as the magnitude of change over time projected by some models in some regions. The effect of CO2 on runoff was not consistent across the models, with two models showing increases and two decreases. There was also more spread in projections from the runs with elevated CO2 than with constant CO2. The biome models which gave increased runoff from elevated CO2 were also those which differed most from the hydrological models. Spatially, regions with most difference between model types tended to be projected to have most effect from elevated CO2, and seasonal differences were also similar, so elevated CO2 can partly explain the differences between hydrological and biome model runoff change projections. Therefore, this shows that a range of impact models should be considered to give the full range of uncertainty in impacts studies.

Twentieth-century global-mean sea-level rise: is the whole greater than the sum of the parts?

Confidence in projections of global-mean sea level rise (GMSLR) depends on an ability to account for GMSLR during the twentieth century. There are contributions from ocean thermal expansion, mass loss from glaciers and ice sheets, groundwater extraction, and reservoir impoundment. Progress has been made toward solving the “enigma” of twentieth-century GMSLR, which is that the observed GMSLR has previously been found to exceed the sum of estimated contributions, especially for the earlier decades. The authors propose the following: thermal expansion simulated by climate models may previously have been underestimated because of their not including volcanic forcing in their control state; the rate of glacier mass loss was larger than previously estimated and was not smaller in the first half than in the second half of the century; the Greenland ice sheet could have made a positive contribution throughout the century; and groundwater depletion and reservoir impoundment, which are of opposite sign, may have been approximately equal in magnitude. It is possible to reconstruct the time series of GMSLR from the quantified contributions, apart from a constant residual term, which is small enough to be explained as a long-term contribution from the Antarctic ice sheet. The reconstructions account for the observation that the rate of GMSLR was not much larger during the last 50 years than during the twentieth century as a whole, despite the increasing anthropogenic forcing. Semiempirical methods for projecting GMSLR depend on the existence of a relationship between global climate change and the rate of GMSLR, but the implication of the authors' closure of the budget is that such a relationship is weak or absent during the twentieth century.

Fractal structures in nonlinear plasma physics

Fractal structures appear in many situations related to the dynamics of conservative as well as dissipative dynamical systems, being a manifestation of chaotic behaviour. In open area-preserving discrete dynamical systems we can find fractal structures in the form of fractal boundaries, associated to escape basins, and even possessing the more general property of Wada. Such systems appear in certain applications in plasma physics, like the magnetic field line behaviour in tokamaks with ergodic limiters. The main purpose of this paper is to show how such fractal structures have observable consequences in terms of the transport properties in the plasma edge of tokamaks, some of which have been experimentally verified. We emphasize the role of the fractal structures in the understanding of mesoscale phenomena in plasmas, such as electromagnetic turbulence.

Longitudinal scaling property of the charge balance function in Au plus Au collisions at root s(NN)=200 GeV

We present measurements of the charge balance function, from the charged particles, for diverse pseudorapidity and transverse momentum ranges in Au + Au collisions at root S(NN) = 200 GeV using the STAR detector at RHIC. We observe that the balance function is boost-invariant within the pseudorapidity coverage vertical bar-1.3, 1.3 vertical bar. The balance function properly scaled by the width of the observed pseudorapidity window does not depend on the position or size of the pseudorapidity window. This scaling property also holds for particles in different transverse momentum ranges. In addition, we find that the width of the balance function decreases monotonically with increasing transverse momentum for all centrality classes. (c) 2010 Elsevier B.V. All rights reserved.

Observation of an Antimatter Hypernucleus

Nuclear collisions recreate conditions in the universe microseconds after the Big Bang. Only a very small fraction of the emitted fragments are light nuclei, but these states are of fundamental interest. We report the observation of antihypertritons-comprising an antiproton, an antineutron, and an antilambda hyperon-produced by colliding gold nuclei at high energy. Our analysis yields 70 +/- 17 antihypertritons (3/Lambda(H) over bar) and 157 +/- 30 hypertritons ((3)(Lambda)H). The measured yields of (3)(Lambda)H (3/Lambda(H) over bar) and (3)He ((3)(He) over bar) are similar, suggesting an equilibrium in coordinate and momentum space populations of up, down, and strange quarks and antiquarks, unlike the pattern observed at lower collision energies. The production and properties of antinuclei, and of nuclei containing strange quarks, have implications spanning nuclear and particle physics, astrophysics, and cosmology.

System size dependence of associated yields in hadron-triggered jets STAR Collaboration

We present results on the system size dependence of high transverse momentum di-hadron correlations at root s(NN) = 200 GeV as measured by STAR at RHIC. Measurements in d + Au, Cu + Cu and Au + Au collisions reveal similar jet-like near-side correlation yields (correlations at small angular separation Delta phi similar to 0, Delta eta similar to 0) for all systems and centralities. Previous measurements have shown Chat the away-side (Delta phi similar to pi) yield is suppressed in heavy-ion collisions. We present measurements of the away-side Suppression as a function of transverse momentum and centrality in Cu + Cu and Au + Au collisions. The suppression is found to be similar in Cu + Cu and An + An collisions at a similar number of participants. The results are compared to theoretical calculations based on the patron quenching model and the modified fragmentation model. The observed differences between data and theory indicate that the correlated yields presented here will further constrain dynamic energy loss models and provide information about the dynamic density profile in heavy-ion collisions. (C) 2009 Elsevier B.V. All rights reserved.

Center of mass energy and system-size dependence of photon production at forward rapidity at RHIC

We present the multiplicity and pseudorapidity distributions of photons produced in Au + Au and Cu + Cu collisions at root(s)NN = 62.4 and 200 GeV. The photons are measured in the region -3.7 < eta < -2.3 using the photon Multiplicity detector in the STAR experiment at RHIC. The number of photons produced per average number of participating nucleon pairs increases with the beam energy and is independent of (lie collision centrality. For collisions with similar average numbers of participating nucleons the photon multiplicities are observed to be similar for An + Au and Cu + Cu collisions at a given beam energy. The ratios of the number of charged particles to photons in the measured pseudorapidity range are found to be 1.4 +/- 0.1 and 1.2 +/- 0.1 for root(s)NN = 62.4 and 200 GeV, respectively. The energy dependence of this ratio could reflect varying contributions from baryons to charged particles, while mesons are the dominant contributors to photon production in the given kinematic region. The photon pseudorapidity distributions normalized by average number of participating nucleon pairs, when plotted as a function of eta-Y(beam), are found to follow a longitudinal scaling independent of centrality and colliding ion species at both beam energies. (C) 2009 Elsevier B.V. All rights reserved.

Observation of the antimatter helium-4 nucleus

High-energy nuclear collisions create an energy density similar to that of the Universe microseconds after the Big Bang(1); in both cases, matter and antimatter are formed with comparable abundance. However, the relatively short-lived expansion in nuclear collisions allows antimatter to decouple quickly from matter, and avoid annihilation. Thus, a high-energy accelerator of heavy nuclei provides an efficient means of producing and studying antimatter. The antimatter helium-4 nucleus ((4)(He) over bar), also known as the anti-alpha ((alpha) over bar), consists of two antiprotons and two antineutrons (baryon number B = -4). It has not been observed previously, although the alpha-particle was identified a century ago by Rutherford and is present in cosmic radiation at the ten per cent level(2). Antimatter nuclei with B -1 have been observed only as rare products of interactions at particle accelerators, where the rate of antinucleus production in high-energy collisions decreases by a factor of about 1,000 with each additional antinucleon(3-5). Here we report the observation of (4)<(He) over bar, the heaviest observed antinucleus to date. In total, 18 (4)(He) over bar counts were detected at the STAR experiment at the Relativistic Heavy Ion Collider (RHIC; ref. 6) in 10(9) recorded gold-on-gold (Au+Au) collisions at centre-of-mass energies of 200 GeV and 62 GeV per nucleon-nucleon pair. The yield is consistent with expectations from thermodynamic(7) and coalescent nucleosynthesis(8) models, providing an indication of the production rate of even heavier antimatter nuclei and a benchmark for possible future observations of (4)(He) over bar in cosmic radiation.

Energy and system size dependence of phi meson production in Cu plus Cu and Au plus Au collisions

We study the beam-energy and system-size dependence of phi meson production (using the hadronic decay mode phi -> K(+) K(-)) by comparing the new results from Cu + Cu collisions and previously reported Au + Au collisions at root s(NN) = 62.4 and 200 GeV measured in the STAR experiment at RHIC. Data presented in this Letter are from mid-rapidity (vertical bar y vertical bar < 0.5) for 0.4 < p(T) < 5 GeV/c. At a given beam energy, the transverse momentum distributions for phi mesons are observed to be similar in yield and shape for Cu + Cu and Au + Au colliding systems with similar average numbers of participating nucleons. The phi meson yields in nucleus-nucleus collisions, normalized by the average number of participating nucleons, are found to be enhanced relative to those from p + p collisions. The enhancement for phi mesons lies between strange hadrons having net strangeness = 1 (K(-) and <(A)over bar>) and net strangeness = 2 (Xi). The enhancement for phi mesons is observed to be higher at root s(NN) = 200 GeV compared to 62.4 GeV. These observations for the produced phi(s (s) over bar) mesons clearly suggest that, at these collision energies, the source of enhancement of strange hadrons is related to the formation of a dense partonic medium in high energy nucleus-nucleus collisions and cannot be alone due to canonical suppression of their production in smaller systems. (C) 2009 Elsevier B.V. All rights reserved.