Cambios observados en las variables clínicas y paraclínicas en las primeras 48 horas de hospitalización en la Unidad de Cuidados Intensivos de pacientes con neumonía severa adquirida en la comunidad y su relación con la mortalidad

El pronóstico de la Neumonía Adquirida en la Comunidad Severa (NAC-S) depende de decisiones terapéuticas instauradas tempranamente. Los cambios fisiológicos ocurridos en las primeras horas pueden ser difíciles de detectar. No existe ningún modelo para la determinación temprana del éxito de la terapia instaurada en NAC-S. Metodología: Descripción de la totalidad de los pacientes con NAC-S hospitalizados en la Unidad de Cuidado Intensivo de la Fundación Cardioinfantil entre los años 2008 y 2012 haciendo comparaciones entre grupos (muertos vs. supervivientes) y entre momentos (0, 24 y 48 horas desde el ingreso a la UCI) y realizando regresión logística binaria. Resultados: Entre los pacientes que fallecieron la necesidad de soporte vasoactivo fue mayor en todos los momentos evaluados (sig=0.001), en la línea de base tuvieron mayores requerimientos de la Fracción Inspirada de O2 (mediana 0.55% vs. 0.50%, sig=0.011), a las 24 horas tuvieron pH (mediana 7.345 vs.7.370, sig=0.025) y tensión arterial diastólica (mediana 58.5mmHg vs.61.0mmHg, sig =0.049) menores, y a las 48 horas glicemia (mediana 157mg/dL vs.142mg/dL, sig =0.026) creatinina (mediana 1.1mg/dL vs.0.7mg/dL, sig =0.062) y nitrógeno ureico (mediana 35mg/dL vs. 22mg/dL, sig =0.003) mayores comparados con los pacientes que sobrevivieron. Entre los pacientes supervivientes hubo una disminución de la frecuencia cardiaca entre las 0 y 24 horas (mediana 97lpm vs. 86lpm, sig =0.000) y entre las 0 y las 48 horas (mediana 97lpm vs. 81lpm, sig=0.000) y una disminución de los neutrófilos entre las 0 y las 48 horas (mediana 9838 vs. 8617, sig=0.062). Conclusiones: Nuestros hallazgos sugieren la existencia de una secuencia de fenómenos fisiopatológicos que al ser reconocida temprana y claramente permitiría establecer un plan de reanimación más especifico y eficaz. Estas diferencias se pueden plantear en el contexto de un modelo mixto predictivo

La diplomacia cultural como herramienta para el mejoramiento de la relación económica de Colombia con Corea del Sur y Australia

Esta investigación se preocupa por dilucidar la función de la diplomacia cultural como herramienta para mejorar la relación económica de Colombia con Corea del Sur y Australia. Así, se analiza a la diplomacia cultural y lo que hace Colombia en esta materia en ambos países; así como el estado de la relación económica de Colombia en un periodo de ocho años con dichos países, y cómo las acciones culturales colombianas podrían llegar a mejorar dicha relación económica. De esta manera además del desarrollo conceptual de diplomacia cultural y los indicadores económicos, a saber; exportaciones; Inversión Extranjera Directa y turismo; se corrió un modelo de regresión lineal para saber si efectivamente hay relación entre ambas variables y una contribución final que consiste en una propuesta de generación de indicadores de gestión a utilizarse al momento de implementar la diplomacia cultural como herramienta en política exterior.

Natural resource windfalls and efficiency of local government expenditures: evidence from Peru

We study the role of natural resource windfalls in explaining the efficiency of public expenditures. Using a rich dataset of expenditures and public good provision for 1,836 municipalities in Peru for period 2001-2010, we estimate a non-monotonic relationship between the efficiency of public good provision and the level of natural resource transfers. Local governments that were extremely favored by the boom of mineral prices were more efficient in using fiscal windfalls whereas those benefited with modest transfers were more inefficient. These results can be explained by the increase in political competition associated with the boom. However, the fact that increases in efficiency were related to reductions in public good provision casts doubts about the beneficial effects of political competition in promoting efficiency.

Serial clustering of extratropical cyclones

The clustering in time (seriality) of extratropical cyclones is responsible for large cumulative insured losses in western Europe, though surprisingly little scientific attention has been given to this important property. This study investigates and quantifies the seriality of extratropical cyclones in the Northern Hemisphere using a point-process approach. A possible mechanism for serial clustering is the time-varying effect of the large-scale flow on individual cyclone tracks. Another mechanism is the generation by one parent cyclone of one or more offspring through secondary cyclogenesis. A long cyclone-track database was constructed for extended October March winters from 1950 to 2003 using 6-h analyses of 850-mb relative vorticity derived from the NCEP NCAR reanalysis. A dispersion statistic based on the varianceto- mean ratio of monthly cyclone counts was used as a measure of clustering. It reveals extensive regions of statistically significant clustering in the European exit region of the North Atlantic storm track and over the central North Pacific. Monthly cyclone counts were regressed on time-varying teleconnection indices with a log-linear Poisson model. Five independent teleconnection patterns were found to be significant factors over Europe: the North Atlantic Oscillation (NAO), the east Atlantic pattern, the Scandinavian pattern, the east Atlantic western Russian pattern, and the polar Eurasian pattern. The NAO alone is not sufficient for explaining the variability of cyclone counts in the North Atlantic region and western Europe. Rate dependence on time-varying teleconnection indices accounts for the variability in monthly cyclone counts, and a cluster process did not need to be invoked.

Ecological and life-history traits predict bee species responses to environmental disturbances

The ability to predict the responses of ecological communities and individual species to human-induced environmental change remains a key issue for ecologists and conservation managers alike. Responses are often variable among species within groups making general predictions difficult. One option is to include ecological trait information that might help to disentangle patterns of response and also provide greater understanding of how particular traits link whole clades to their environment. Although this ‘‘trait-guild” approach has been used for single disturbances, the importance of particular traits on general responses to multiple disturbances has not been explored. We used a mixed model analysis of 19 data sets from throughout the world to test the effect of ecological and life-history traits on the responses of bee species to different types of anthropogenic environmental change. These changes included habitat loss, fragmentation, agricultural intensification, pesticides and fire. Individual traits significantly affected bee species responses to different disturbances and several traits were broadly predictive among multiple disturbances. The location of nests – above vs. below ground – significantly affected response to habitat loss, agricultural intensification, tillage regime (within agriculture) and fire. Species that nested above ground were on average more negatively affected by isolation from natural habitat and intensive agricultural land use than were species nesting below ground. In contrast below-ground-nesting species were more negatively affected by tilling than were above-ground nesters. The response of different nesting guilds to fire depended on the time since the burn. Social bee species were more strongly affected by isolation from natural habitat and pesticides than were solitary bee species. Surprisingly, body size did not consistently affect species responses, despite its importance in determining many aspects of individuals’ interaction with their environment. Although synergistic interactions among traits remain to be explored, individual traits can be useful in predicting and understanding responses of related species to global change.

Farming systems methodology for efficient resource management at the farm level: a review from an Indian perspective

Farming systems research is a multi-disciplinary holistic approach to solve the problems of small farms. Small and marginal farmers are the core of the Indian rural economy Constituting 0.80 of the total farming community but possessing only 0.36 of the total operational land. The declining trend of per capita land availability poses a serious challenge to the sustainability and profitability of farming. Under such conditions, it is appropriate to integrate land-based enterprises such as dairy, fishery, poultry, duckery, apiary, field and horticultural cropping within the farm, with the objective of generating adequate income and employment for these small and marginal farmers Under a set of farm constraints and varying levels of resource availability and Opportunity. The integration of different farm enterprises can be achieved with the help of a linear programming model. For the current review, integrated farming systems models were developed, by Way Of illustration, for the marginal, small, medium and large farms of eastern India using linear programming. Risk analyses were carried out for different levels of income and enterprise combinations. The fishery enterprise was shown to be less risk-prone whereas the crop enterprise involved greater risk. In general, the degree of risk increased with the increasing level of income. With increase in farm income and risk level, the resource use efficiency increased. Medium and large farms proved to be more profitable than small and marginal farms with higher level of resource use efficiency and return per Indian rupee (Rs) invested. Among the different enterprises of integrated farming systems, a chain of interaction and resource flow was observed. In order to make fanning profitable and improve resource use efficiency at the farm level, the synergy among interacting components of farming systems should be exploited. In the process of technology generation, transfer and other developmental efforts at the farm level (contrary to the discipline and commodity-based approaches which have a tendency to be piecemeal and in isolation), it is desirable to place a whole-farm scenario before the farmers to enhance their farm income, thereby motivating them towards more efficient and sustainable fanning.

Analysis of the calving pattern of herds in small-scale dairy systems in central Mexico

This study sets out to find the best calving pattern for small-scale dairy systems in Michoacan State, central Mexico. Two models were built. First, a linear programming model was constructed to optimize calving pattern and herd structure according to metabolizable energy availability. Second, a Markov chain model was built to investigate three reproductive scenarios (good, average and poor) in order to suggest factors that maintain the calving pattern given by the linear programming model. Though it was not possible to maintain the optimal linear programming pattern, the Markov chain model suggested adopting different reproduction strategies according to period of the year that the cow is expected to calve. Comparing different scenarios, the Markov model indicated the effect of calving interval on calving pattern and herd structure.

A likelihood ratio appropach to family-based association studies with covariates

We introduce a procedure for association based analysis of nuclear families that allows for dichotomous and more general measurements of phenotype and inclusion of covariate information. Standard generalized linear models are used to relate phenotype and its predictors. Our test procedure, based on the likelihood ratio, unifies the estimation of all parameters through the likelihood itself and yields maximum likelihood estimates of the genetic relative risk and interaction parameters. Our method has advantages in modelling the covariate and gene-covariate interaction terms over recently proposed conditional score tests that include covariate information via a two-stage modelling approach. We apply our method in a study of human systemic lupus erythematosus and the C-reactive protein that includes sex as a covariate.

Statistical modeling suggests that antiandrogens in effluents from wastewater treatment works contribute to widespread sexual disruption in fish living in English rivers.

BACKGROUND: The widespread occurrence of feminized male fish downstream of some wastewater treatment works has led to substantial interest from ecologists and public health professionals. This concern stems from the view that the effects observed have a parallel in humans, and that both phenomena are caused by exposure to mixtures of contaminants that interfere with reproductive development. The evidence for a "wildlife-human connection" is, however, weak: Testicular dysgenesis syndrome, seen in human males, is most easily reproduced in rodent models by exposure to mixtures of antiandrogenic chemicals. In contrast, the accepted explanation for feminization of wild male fish is that it results mainly from exposure to steroidal estrogens originating primarily from human excretion. OBJECTIVES: We sought to further explore the hypothesis that endocrine disruption in fish is multi-causal, resulting from exposure to mixtures of chemicals with both estrogenic and antiandrogenic properties. METHODS: We used hierarchical generalized linear and generalized additive statistical modeling to explore the associations between modeled concentrations and activities of estrogenic and antiandrogenic chemicals in 30 U.K. rivers and feminized responses seen in wild fish living in these rivers. RESULTS: In addition to the estrogenic substances, antiandrogenic activity was prevalent in almost all treated sewage effluents tested. Further, the results of the modeling demonstrated that feminizing effects in wild fish could be best modeled as a function of their predicted exposure to both anti-androgens and estrogens or to antiandrogens alone. CONCLUSION: The results provide a strong argument for a multicausal etiology of widespread feminization of wild fish in U.K. rivers involving contributions from both steroidal estrogens and xeno-estrogens and from other (as yet unknown) contaminants with antiandrogenic properties. These results may add farther credence to the hypothesis that endocrine-disrupting effects seen in wild fish and in humans are caused by similar combinations of endocrine-disrupting chemical cocktails.

When are ant-attractant devices a worthwhile investment? Vicia faba extrafloral nectaries and Lasius niger ants

Most studies aiming to determine the beneficial effect of ants on plants simply consider the effects of the presence or exclusion of ants on plant yield. This approach is often inadequate, however, as ants interact with both non-tended herbivores and tended Homoptera. Moreover, the interaction with these groups of organisms is dependent on ant density, and these functional relationships are likely to be non-linear. A model is presented here that segregates plant herbivores into two categories depending on the sign of their numerical response to ants (myrmecophiles increase with ants, non-tended herbivores decline). The changes in these two components of herbivores with increasing ant density and the resulting implications for ant-plant mutualisms are considered. It emerges that a wide range of ant densities needs to be considered as the interaction sign (mutualism or parasitism) and strength is likely to change with ant density. The model is used to interpret the results of an experimental study that varied levels of Aphis fabae infestation and Lasius niger ant attendance on Vicia faba bean plants. Increasing ant density consistently reduced plant fitness and thus, in this location, the interaction between the ants and the plant can be considered parasitic. In the Vicia faba system, these costs of ants are unlikely to be offset by other beneficial agents (e.g., parasitoids), which also visit extrafloral nectaries.

Bayesian decision procedures for binary and continuous bivariate dose-escalation studies

In this paper, Bayesian decision procedures are developed for dose-escalation studies based on binary measures of undesirable events and continuous measures of therapeutic benefit. The methods generalize earlier approaches where undesirable events and therapeutic benefit are both binary. A logistic regression model is used to model the binary responses, while a linear regression model is used to model the continuous responses. Prior distributions for the unknown model parameters are suggested. A gain function is discussed and an optional safety constraint is included. Copyright (C) 2006 John Wiley & Sons, Ltd.

Evaluation of milk urea nitrogen as a diagnostic of protein feeding

An evaluation of milk urea nitrogen (MUN) as a diagnostic of protein feeding in dairy cows was performed using mean treatment data (n = 306) from 50 production trials conducted in Finland (n = 48) and Sweden (n = 2). Data were used to assess the effects of diet composition and certain animal characteristics on MUN and to derive relationships between MUN and the efficiency of N utilization for milk production and urinary N excretion. Relationships were developed using regression analysis based on either models of fixed factors or using mixed models that account for between-experiment variations. Dietary crude protein (CP) content was the best single predictor of MUN and accounted for proportionately 0.778 of total variance [ MUN (mg/dL) = -14.2 + 0.17 x dietary CP content (g/kg dry matter)]. The proportion of variation explained by this relationship increased to 0.952 when a mixed model including the random effects of study was used, but both the intercept and slope remained unchanged. Use of rumen degradable CP concentration in excess of predicted requirements, or the ratio of dietary CP to metabolizable energy as single predictors, did not explain more of the variation in MUN (R-2 = 0.767 or 0.778, respectively) than dietary CP content. Inclusion of other dietary factors with dietary CP content in bivariate models resulted in only marginally better predictions of MUN (R-2 = 0.785 to 0.804). Closer relationships existed between MUN and dietary factors when nutrients (CP to metabolizable energy) were expressed as concentrations in the diet, rather than absolute intakes. Furthermore, both MUN and MUN secretion (g/d) provided more accurate predictions of urinary N excretion (R-2 = 0.787 and 0.835, respectively) than measurements of the efficiency of N utilization for milk production (R-2 = 0.769). It is concluded that dietary CP content is the most important nutritional factor influencing MUN, and that measurements of MUN can be utilized as a diagnostic of protein feeding in the dairy cow and used to predict urinary N excretion.

Dynamic integrated system optimization and parameter estimation for discrete time optimal control of nonlinear systems

An algorithm for solving nonlinear discrete time optimal control problems with model-reality differences is presented. The technique uses Dynamic Integrated System Optimization and Parameter Estimation (DISOPE), which achieves the correct optimal solution in spite of deficiencies in the mathematical model employed in the optimization procedure. A version of the algorithm with a linear-quadratic model-based problem, implemented in the C+ + programming language, is developed and applied to illustrative simulation examples. An analysis of the optimality and convergence properties of the algorithm is also presented.

A new approach for the solution of the optimal set-point tracking problem for nonlinear systems

In this paper, a discrete time dynamic integrated system optimisation and parameter estimation algorithm is applied to the solution of the nonlinear tracking optimal control problem. A version of the algorithm with a linear-quadratic model-based problem is developed and implemented in software. The algorithm implemented is tested with simulation examples.

Optimal control of nonlinear differential algebraic equation systems

A novel iterative procedure is described for solving nonlinear optimal control problems subject to differential algebraic equations. The procedure iterates on an integrated modified linear quadratic model based problem with parameter updating in such a manner that the correct solution of the original non-linear problem is achieved. The resulting algorithm has a particular advantage in that the solution is achieved without the need to solve the differential algebraic equations . Convergence aspects are discussed and a simulation example is described which illustrates the performance of the technique. 1. Introduction When modelling industrial processes often the resulting equations consist of coupled differential and algebraic equations (DAEs). In many situations these equations are nonlinear and cannot readily be directly reduced to ordinary differential equations.