Visión de la calidad y el riesgo en instituciones de salud con programas de formación médica en Colombia

Este tuvo como objetivo describir la tendencia que tuvieron los resultados de los indicadores de calidad técnica y gerencia del riesgo: infecciones intrahospitalarias, mortalidad hospitalaria y reingreso hospitalario desde el año 2006 al 2010 y establecer si existieron diferencias entre las Instituciones de salud, con y sin convenios docente asistenciales tanto públicas y privadas de 11 ciudades de Colombia. Este estudio encontró que posterior a la promulgación de la ley 30 de 1992, el número de programas de medicina se incrementó considerablemente en la última década. Esta situación llevó a considerar dos cosas: primero que el número de Instituciones de práctica en el país puede ser insuficiente ante la gran cantidad de nuevos estudiantes de medicina, con algún grado de hacinamiento en los sitios de práctica y segundo que esa situación puede tener algún efecto sobre la calidad de la atención y el resultado de los indicadores medidos. Se evidenciaron importantes deficiencias técnicas en el reporte obligatorio de la información por parte de los hospitales, donde solo un 10% de ellas cumplieron con el reporte completo de los indicadores desde el año 2006; encontrando que se registra solamente un 65% del total de la información que debería estar publicada. En cuanto al análisis estadístico de los datos, se utilizó el chi cuadrado de tendencias, que no arrojó diferencias estadísticamente significativas de los indicadores en los periodos analizados entre las instituciones con y sin convenios docentes; pero sí evidenció diferencias entre la suma de mínimos cuadrados de dos de los indicadores.

Distribución hiperbólica generalizada: una aplicación en la selección de portafolios y en la cuantificación de medidas de riesgo de mercado

En este trabajo se implementa una metodología para incluir momentos de orden superior en la selección de portafolios, haciendo uso de la Distribución Hiperbólica Generalizada, para posteriormente hacer un análisis comparativo frente al modelo de Markowitz.

Efectividad y seguridad de la quetiapina en la disminución de los síntomas depresivos, en pacientes con esquizofrenia

Introducción: La depresión se presenta frecuentemente en pacientes con esquizofrenia, en las diferentes fases de esta y, dada su similitud con diferentes síntomas propios de la esquizofrenia, su identificación resulta difícil. El objetivo del presente estudio es determinar la efectividad y seguridad de la Quetiapina en la disminución de síntomas depresivos comparada con otros antipsicóticos de segunda generación en pacientes con esquizofrenia. Metodología: se realizó una revisión sistemática de la literatura en 6 bases de datos de acuerdo con la metodología PRISMA, que incluyó estudios de efectividad y seguridad de la Quetiapina (Seroquel®) en pacientes con esquizofrenia y depresión. Los desenlaces fueron medidos mediante escalas para depresión, tasas de suicidio y efectos adversos. Resultados: Se incluyeron dos estudios. El estudio de Di Fiorino en 2014, reportó efectividad de Quetiapina en el tratamiento de pacientes psicóticos con depresión con una diferencia de las reducciones de mínimos cuadrados de la escala CDSS de 2.2 IC 95% (0.8 -3.7) frente a risperidona, y de 3.3 (p<0.0001) en la escala HAM-D frente a risperidona. Los efectos adversos presentados con quetiapina fueron: somnolencia, boca seca, hipotensión. No se reportaron muertes por quetiapina. Discusión: La quetiapina demostró ser efectiva y segura en el manejo de los síntomas depresivos en pacientes con esquizofrenia frente a risperidona al valorar la población con escala CDSS. No fueron reportados desenlaces de suicidio en ninguno de los estudios. La calidad de la evidencia es moderada con sesgos metodológicos importantes. Es necesaria la realización de más estudios clínicos aleatorizados y con cegamiento y estudios de metaanálisis en población homogénea

El modelo TAM y la enseñanza superior : una investigación del efecto moderador del sexo.

Monográfico con el título: 'El reto de la educación de mujeres y varones'. Resumen basado en el de la publicación

Pose and Structure Recovery using Active Models

A new formulation of a pose refinement technique using ``active'' models is described. An error term derived from the detection of image derivatives close to an initial object hypothesis is linearised and solved by least squares. The method is particularly well suited to problems involving external geometrical constraints (such as the ground-plane constraint). We show that the method is able to recover both the pose of a rigid model, and the structure of a deformable model. We report an initial assessment of the performance and cost of pose and structure recovery using the active model in comparison with our previously reported ``passive'' model-based techniques in the context of traffic surveillance. The new method is more stable, and requires fewer iterations, especially when the number of free parameters increases, but shows somewhat poorer convergence.

The relationship between diffuse spectral reflectance of the soil and its cation exchange capacity is scale-dependent

Diffuse reflectance spectroscopy (DRS) is increasingly being used to predict numerous soil physical, chemical and biochemical properties. However, soil properties and processes vary at different scales and, as a result, relationships between soil properties often depend on scale. In this paper we report on how the relationship between one such property, cation exchange capacity (CEC), and the DRS of the soil depends on spatial scale. We show this by means of a nested analysis of covariance of soils sampled on a balanced nested design in a 16 km × 16 km area in eastern England. We used principal components analysis on the DRS to obtain a reduced number of variables while retaining key variation. The first principal component accounted for 99.8% of the total variance, the second for 0.14%. Nested analysis of the variation in the CEC and the two principal components showed that the substantial variance components are at the > 2000-m scale. This is probably the result of differences in soil composition due to parent material. We then developed a model to predict CEC from the DRS and used partial least squares (PLS) regression do to so. Leave-one-out cross-validation results suggested a reasonable predictive capability (R2 = 0.71 and RMSE = 0.048 molc kg− 1). However, the results from the independent validation were not as good, with R2 = 0.27, RMSE = 0.056 molc kg− 1 and an overall correlation of 0.52. This would indicate that DRS may not be useful for predictions of CEC. When we applied the analysis of covariance between predicted and observed we found significant scale-dependent correlations at scales of 50 and 500 m (0.82 and 0.73 respectively). DRS measurements can therefore be useful to predict CEC if predictions are required, for example, at the field scale (50 m). This study illustrates that the relationship between DRS and soil properties is scale-dependent and that this scale dependency has important consequences for prediction of soil properties from DRS data

An application of the GLUE methodology for estimating the parameters of the INCA-N model

The conceptual and parameter uncertainty of the semi-distributed INCA-N (Integrated Nutrients in Catchments-Nitrogen) model was studied using the GLUE (Generalized Likelihood Uncertainty Estimation) methodology combined with quantitative experimental knowledge, the concept known as 'soft data'. Cumulative inorganic N leaching, annual plant N uptake and annual mineralization proved to be useful soft data to constrain the parameter space. The INCA-N model was able to simulate the seasonal and inter-annual variations in the stream-water nitrate concentrations, although the lowest concentrations during the growing season were not reproduced. This suggested that there were some retention processes or losses either in peatland/wetland areas or in the river which were not included in the INCA-N model. The results of the study suggested that soft data was a way to reduce parameter equifinality, and that the calibration and testing of distributed hydrological and nutrient leaching models should be based both on runoff and/or nutrient concentration data and the qualitative knowledge of experimentalist. (c) 2006 Elsevier B.V. All rights reserved.

Harmonic force fields from scaled SCF calculations: Program ASYM40

We report an extended version of our normal coordinate program ASYM40, which may be used to transform Cartesian force constants from ab initio calculations to a force field in nonredundant internal (symmetry) coordinates. When experimental data are available, scale factors for the theoretical force field may then be optimized by least-squares refinement. The alternative of refining an empirical force field to fit a wide variety of data, as with the previous version ASYM20, has been retained. We compare the results of least-squares refinement of the full harmonic force field with least-squares refinement of only the scale factors for an SCF calculated force field and conclude that the latter approach may be useful for large molecules where more sophisticated calculations are impractical. The refinement of scale factors for a theoretical force field is also useful when there are only limited spectroscopic data. The program will accept ab initio calculated force fields from any program that presents Cartesian force constants as output. The program is available through Quantum Chemistry Program Exchange.

Vibrational energy levels of water

Several quartic force fields and a full sextic anharmonic force field for H,O have been determined from high-quality ab initio calculations, the highest at the aug-cc-pVQZ CCSD(T) level of theory. These force fields have been used to determine vibrational excited state band origins up to 15 000 cm - ’ above the zero-point level, using both a perturbation-resonancea pproach and a variational approach. An optimisedq uartic force field hasb eeno btained by least squares refinement of our best ab initio results to fit the observed overtone levels of 5 symmetrically substituted isotopomers of water (Hi60, Hi70, HisO, D,O, and T,O) with an rms error of less than 10 cm-‘, using the perturbation-resonancem odel for the vibrational calculation. Predicatel east squaresr efinement was usedt o provide a loose constraint of the refined force field to the ab initio results. The results obtained prove the viability of the perturbation-resonancem odel for usei n larger molecular systemsa nd also highlight someo f its weaknesse

Anharmonic force field of acetylene

The harmonic and anharmonic force field of acetylene has been determined in a least-squares calculation from recently determined data on the spectroscopic constants of various isotopic species (including the vibrational l-doubling constant). A general quadratic and cubic force field was used, but a constrained quartic force field containing only 8 of the 23 possible quartic constants. The results are discussed and compared with earlier work.

Vibration–rotation variational calculations: precise results on HCN up to 25 000 cm−1

Variation calculations of the vibration–rotation energy levels of many isotopomers of HCN are reported, for J=0, 1, and 2, extending up to approximately 8 quanta of each of the stretching vibrations and 14 quanta of the bending mode. The force field, which is represented as a polynomial expansion in Morse coordinates for the bond stretches and even powers of the angle bend, has been refined by least squares to fit simultaneously all observed data on the Σ and Π state vibrational energies, and the Σ state rotational constants, for both HCN and DCN. The observed vibrational energies are fitted to roughly ±0.5 cm−1, and the rotational constants to roughly ±0.0001 cm−1. The force field has been used to predict the vibration rotation spectra of many isotopomers of HCN up to 25 000 cm−1. The results are consistent with the axis‐switching assignments of some weak overtone bands reported recently by Jonas, Yang, and Wodtke, and they also fit and provide the assignment for recent observations by Romanini and Lehmann of very weak absorption bands above 20 000 cm−1.

The anharmonic force field of HCN and HCP

The quadratic, cubic, and quartic force field of HCN has been calculated by a least squares refinement to fit the most recent observed data on the vibration-rotation constants of HCN, DCN and H13CN. All of the observed parameters are fitted within their standard errors of observation. The corresponding parameters for other isotopic species are calculated. For HCP and DCP the more limited data available have been fitted to an anharmonic force field using constraints based on comparison with HCN. Using this force field the zero-point rotational constants B0 have been corrected to obtain the equilibrium constants Be, and hence the equilibrium structure has been determined to be re(CH) = 1•0692(7)A, and re(CP) = 1•5398(2)A.

Vibration-rotation spectra and the harmonic force field of HOCl

Vibration-rotation spectra of HOCl have been measured at a resolution of 0.05 cm−1 to determine vibration rotation constants, and 35–37 Cl isotope shifts in the vibration frequencies. The spectrum of DOCl has also been recorded, and a preliminary analysis for the band origins has been made. The vibrational frequency data and centrifugal distortion constants have been used to determine the harmonic force field in a least-squares refinement; the force field obtained also gives a good fit to data on the vibrational contributions to the inertial defect. The equilibrium rotational constants of HOCl have been obtained, and an equilibrium structure has been estimated.

Nitrous acid: vibrational frequency shifts due to 15N substitution, and the harmonic force field

Vibration rotation spectra of HO15 NO and DO15 NO have been measured at a resolution of 0•04 cm-1 to determine the isotopic shifts in the vibrational band origins. These have been used together with recently determined data on the vibrational band origins, Coriolis constants, and centrifugal distorition constants, to determine the harmonic force field of both cis and trans nitrous acid in least squares refinement calculations. The results are discussed in relation to recent ab initio calculations, the inertia defects, and the torsional potential function.

C---H local modes in cyclobutene, part I: FTIR studies, 600 to 10000 cm–1

The vibrational structure of C---H stretching states in gas-phase cyclobutene was studied using FTIR spectroscopy in the range 700–9000 cm−1. The structure was modelled using two effective vibrational Hamiltonians, one for each type of C---H bond present, consisting of local mode basis functions subject to coupling with symmetrically equivalent bonds and to Fermi resonances with suitable low frequency vibrations. Best-fit model parameters were determined using least-squares routines and the model predictions are compared to the observed band positions and intensities. Some discussion is given of the relevance of the observed couplings to intramolecular vibrational redistribution (IVR) which results in the observation of statistical behaviour in cyclobutene isomerization induced by excitation of C---H stretching overtones in the visible region.