Pulsioximetría de pacientes en hemodiálisis, de la unidad de terapia renal – fundación cardioinfantil, análisis para establecer recomendaciones

Introducción. En Colombia, el 80% de los pacientes con enfermedad renal crónica en hemodiálisis tienen fístula arteriovenosa periférica (FAV) que asegura el flujo de sangre durante la hemodiálisis (1), la variabilidad en el flujo de sangre en el brazo de la FAV hacia la parte distal, puede afectar la lectura de la oximetría de pulso (SpO2) (2), llevando a la toma de decisiones equivocadas por el personal de salud. El objetivo de este estudio es aclarar si existe diferencia entre la SpO2 del brazo de la FAV y el brazo contralateral. Materiales y métodos. Se realizó un estudio de correlación entre los valores de SpO2 del brazo con FAV contra el brazo sin FAV, de 40 pacientes que asistieron a hemodiálisis. La recolección de los datos se llevó a cabo, con un formato que incluyó el resultado de la pulsioximetria y variables asociadas, antes, durante y después de la hemodiálisis. Se comparó la mediana de los deltas de las diferencias con pruebas estadísticas T Student – Mann Whitney, aceptando un valor significativo de p < 0,05. Resultados. No se encontraron diferencias estadísticamente significativas de la SpO2 entre el brazo con FAV y el brazo sin FAV, antes, durante y después de la diálisis, sin embargo si se apreció una correlación positiva estadísticamente significativa. Conclusiones. Se encontró correlación positiva estadísticamente significativa, donde no hubo diferencias en el resultado la pulsioximetría entre el brazo con FAV y brazo sin FAV, por lo tanto es válido tomar la pulsioximetría en cualquiera de los brazos.

Endocarditis infecciosa por Staphylococcus Aureus Meticilino sensible y resistente en la Fundación Cardioinfantil – Instituto de Cardiología

Introducción y objetivos: La endocarditis infecciosa (EI) es una enfermedad grave producida por diversos gérmenes que afectan las válvulas cardiacas y el tejido endomiocárdico. El objetivo fue describir las características epidemiológicas, clínicas, ecocardiográficas y microbiológicas de la endocarditis infecciosa por Staphylococcus aureus (S. aureus) meticilino sensible y resistente de la Fundación Cardioinfantil – Instituto de Cardiología (FCI-IC) en el periodo de tiempo 2010- 2015. Métodos: Cohorte retrospectiva de casos de EI por S. aureus en la FCIIC para el período 2010-2015. Se realizó descripción de las variables generales de la población a estudio utilizando medidas de tendencia central y dispersión. Análisis de desenlaces teniendo cuenta la concentración inhibitoria mínima de vancomicina. Resultados: En el estudio se presentaron 27 casos de EI, con una mayor proporción de pacientes de sexo masculino, con hipertensión, diabetes y hemodiálisis. La fiebre fue la manifestación más frecuente seguida de fenómenos vasculares. La válvula más comprometida fue la mitral, principalmente nativa. Discusión: La presentación clínica de los pacientes con EI por S. aureus es aguda por lo que la fiebre es la principal manifestación clínica presentada, lo anterior favorece un rápido diagnóstico clínico. De las cepas de S. aureus causante de EI no se encontró gérmenes con sensibilidad intermedia ni resistente a la vancomicina según criterios establecidos por CLSI. Se encontró mayor proporción de pacientes con un valor de CMI para vancomicina mayor a 0,5μg/ml lo cual es importante dado que podemos estar enfrentándonos a cepas hetero VISA (hVISA).

Signal processing of microstructure profiles: integrating turbulent spatial scales in aquatic ecological modeling

The main objective of this thesis was the integration of microstructure information in synoptic descriptors of turbulence, that reflects the mixing processes. Turbulent patches are intermittent in space and time, but they represent the dominant process for mixing. In this work, the properties of turbulent patches were considered the potential input for integrating the physical microscale measurements. The development of a method for integrating the properties of the turbulent patches required solving three main questions: a) how can we detect the turbulent patches from he microstructure measurements?; b) which are the most relevant properties of the turbulent patches?; and ) once an interval of time has been selected, what kind of synoptic parameters could better reflect the occurrence and properties of the turbulent patches? The answers to these questions were the final specific objectives of this thesis.

The impact of moist processes on the African easterly jet-African easterly wave system

The African Easterly Jet-Easterly Wave (AEJ-AEW) system was explored in an idealised model. Prescribed zonally symmetric surface temperature and moisture profiles determine the AEJ which becomes established through meridional contrasts in dry and moist convection.As in previous studies, a realistic AEJ developed with only dry convection. Including moist processes, increased its development rate, but reduced its speed and meridional extent. AEWs grew through barotropic-baroclinic conversions. Negative meridional potential vorticity (PV) gradients arose in the zonally symmetric state through the intrusion of the low-PV Saharan boundary layer. Since moist processes strengthened this significantly through diabatically generated PV in the Intertropical Convergence Zone, moist AEWs were three times stronger. Larger barotropic conversions and faster AEJ development increased the moist wave growth-rate. Jet-level and northerly low-level amplitudes grew, but in the moist case the low-level amplitudes weakened as the AEW interacted with convection, consistent with their absence from observations during the peak monsoon. Striking dependencies between the AEJ, AEW and rainfall existed. Two time-scales governed their evolution, depending on the transfer coefficients: (1) the AEJ's replenishment rate influenced by heat fluxes, and (2) the wave growth-rate, by damping, and the slower jet development rate.Moist AEWs were characterized by intermittent growth/decay, with growth preceded by increased mean rainfall and later, weakening AEJs. These dependencies established an internal 8-10-day variability, consistent with intra-seasonal observations of 9-day rainy sequences. This internal variability offers an alternative explanation to the previously proposed external forcing and a new view of the moist AEW life cycle. Copyright © 2009 Royal Meteorological Society

Spatial covariation of Azotobacter abundance and soil properties: A case study using the wavelet transform

The soil microflora is very heterogeneous in its spatial distribution. The origins of this heterogeneity and its significance for soil function are not well understood. A problem for understanding spatial variation better is the assumption of statistical stationarity that is made in most of the statistical methods used to assess it. These assumptions are made explicit in geostatistical methods that have been increasingly used by soil biologists in recent years. Geostatistical methods are powerful, particularly for local prediction, but they require the assumption that the variability of a property of interest is spatially uniform, which is not always plausible given what is known about the complexity of the soil microflora and the soil environment. We have used the wavelet transform, a relatively new innovation in mathematical analysis, to investigate the spatial variation of abundance of Azotobacter in the soil of a typical agricultural landscape. The wavelet transform entails no assumptions of stationarity and is well suited to the analysis of variables that show intermittent or transient features at different spatial scales. In this study, we computed cross-variograms of Azotobacter abundance with the pH, water content and loss on ignition of the soil. These revealed scale-dependent covariation in all cases. The wavelet transform also showed that the correlation of Azotobacter abundance with all three soil properties depended on spatial scale, the correlation generally increased with spatial scale and was only significantly different from zero at some scales. However, the wavelet analysis also allowed us to show how the correlation changed across the landscape. For example, at one scale Azotobacter abundance was strongly correlated with pH in part of the transect, and not with soil water content, but this was reversed elsewhere on the transect. The results show how scale-dependent variation of potentially limiting environmental factors can induce a complex spatial pattern of abundance in a soil organism. The geostatistical methods that we used here make assumptions that are not consistent with the spatial changes in the covariation of these properties that our wavelet analysis has shown. This suggests that the wavelet transform is a powerful tool for future investigation of the spatial structure and function of soil biota. (c) 2006 Elsevier Ltd. All rights reserved.

Spatangoid-produced ichnofabrics (Bateig Limestone, Miocene, Spain) and the preservation of spatangoid trace fossils

A spatangoid-produced ichnofabric is described from the Miocene Bateig Limestone, SE Spain. This ichnofabric is characterized by the dominant presence of large meniscate burrows (Bichordites) produced by irregular echinoids. This constitutes an unusual mode of occurrence for spatangoid bioturbation, as their traces are most typically preserved in bases and tops of sandstone event beds. In fact, despite their important role as burrowers in modern settings (that can be extended back to the Early Cretaceous based on their body fossil record), spatangoid trace fossils (Scolicia and Bichordites) are comparatively rare. Several factors play an important role in their preservation: mechanism of burrowing, sediment characteristics, early diagenesis and presence/absence of deep-tier burrowers. Spatangoid-produced ichnofabrics, such as those from the Bateig Limestone, characterize depositional settings with intermittent deposition of event beds where there is an absence of deeper-tier bioturbation. (C) 2008 Elsevier B.V. All rights reserved

Phosphorus dynamics in the ditch system of a restored peat wetland

The restoration of wetlands as bird habitats often involves the maintenance of a fluctuating water regime by careful, localised ditch water management using pumps and sluices. However, there is evidence in the literature to Suggest that alternate flood/drainage cycles can accelerate nutrient cycling and transport within the soil and, therefore, pose a threat to water quality through the process of eutrophication. This study focused on the dynamics and losses of soil P in a recently re-wetted, eutrophic fen peat developed on alluvium ill South west England. During the 2-year Study (2001 and 2002), soil water tensiometry revealed that the field water table (fluctuating annually between +20 and 60 cm relative to ground level) was extensively influenced across most of the 8.4 ha field site by the management of the adjacent ditch water levels. This conservation-led, prescribed water balance was facilitated by the high hydraulic conductivity (1.1 x 10(-s) ms(-1)) of the lower (70-140 cm), degraded layer of peat. However, only during a 7-day period of water table drawdown by intermittent pump drainage, approximately 45 g ha(-1) of dissolved reactive P (DRP) entered the pumped ditch from the field via this degraded layer. Summer rainfall events >35 mm d(-1) also coincided with significant peaks ill ditch water P concentration (up to 200 mu g L-1 DRP). Even larger peaks (Up to 700 mu g L-1 DRP) Occurred With the annual onset of autumn reflooding. These episodic P loss events pose a serious potential threat to biological water quality. (C) 2009 Elsevier B.V. All rights reserved.

Wetland restoration within agricultural watersheds: Balancing water quality protection with habitat conservation

Peat wetlands that have been restored from agricultural Land have the potential to act as Long term sources of phosphorus (P) and, therefore have to potenital to accelerate freshwater eutrophication. During a two-year study the water table in a eutrophic fen peat that was managed by pump drainage fluctuated annually between +20 cm and -60 cm relative to ground Level. This precise management was facilitated by the high hydraulic conductivity (K) of the humified peat (1.1 x 10(-5) m s(-1)) below around 60 cm depth. However, during one week of intermittent pumping, as much as 50 g ha(-1) dissolved P entered the pumped ditch. Summer. rainfall events and autumn reflooding also triggered P losses. The P Losses were attributed to the low P sorption capacity (217 mg kg(-1)) of the saturated peat below 60 cm, combined with its high K and the reductive dissolution of Fe bound P.

Environmental control for layers

Light patterns have less effect on numbers of eggs laid by current stocks than on those of forty years ago, but the principles have not changed. Ovarian activity is stimulated by increasing photoperiods and suppressed by decreasing photoperiods. The light pattern used during rearing can still have large effects on age at 50% lay, even for modern stocks. Early sexual maturity maximises egg numbers but gives smaller eggs. Late maturity maximises egg size at the expense of numbers. The relationship between egg output (g/hen d) and age at first egg is curvilinear, with maximum yield occurring in flocks maturing in about the centre of their potential range. Fancy patterns of increasing daylength after maturity are probably not justified. A flock held on a constant 14h day will lay as many eggs as one given step up lighting. Intermittent lighting saves about 5% of feed consumption with no loss of output, provided that the feed has adequate amino acid content to allow for the reduced feed intake. Producers with light-proof laying houses should be taking advantage of intermittent lighting. The recommended light intensity for laying houses is still 10 lx, although the physiological threshold for response to changes in photoperiod is closer to 2 lx. Very dim (0.05 lx) light filtering into blacked out houses will not stimulate the hypothalamic receptors responsible for photo-sexual responses, but may affect the bird's biological clock, which can alter its response to a constant short photoperiod. Feed intake shows a curvilinear dependence on environmental temperature. At temperatures below the panting threshold, performance can be maintained by adjusting the feed so as to maintain an adequate intake of critical amino acids. Above the panting threshold, the hen is unable to take in enough energy to maintain normal output. There is no dietary modification which can effectively offset this problem. Diurnally cycling temperatures result in feed intake and egg production equivalent to that observed under a constant temperature equal to the mean of the cycle. When the poultry house is cooler at night than by day, it helps to provide light so that the birds can feed during the cooler part of the cycle.

A platform for supporting micro-collaborations in a diverse device environment

Collaborative software is usually thought of as providing audio-video conferencing services, application/desktop sharing, and access to large content repositories. However mobile device usage is characterized by users carrying out short and intermittent tasks sometimes referred to as 'micro-tasking'. Micro-collaborations are not well supported by traditional groupware systems and the work in this paper seeks out to address this. Mico is a system that provides a set of application level peer-to-peer services for the ad-hoc formation and facilitation of collaborative groups across a diverse mobile device domain. The system builds on the Java ME bindings of the JXTA P2P protocols, and is designed with an approach to use the lowest common denominators that are required for collaboration between varying degrees of mobile device capability. To demonstrate how our platform facilitates application development, we built an exemplary set of demonstration applications and include code examples here to illustrate the ease and speed afforded when developing collaborative software with Mico.

Diversification of a large genus in a continental biodiversity hotspot: temporal and spatial origin of Muraltia (Polygalaceae) in the Cape of South Africa

Phylogenetic relationships in the largely South African genus Muraltia (Polygalaceae) are assessed based on DNA sequence data (nuclear ribosomal ITS, plastid atpB-rbcL spacer, trnL intron, and trnL-F spacer) for 73 of the 117 currently recognized species in the genus. The previously recognised subgenus Muraltia is monophyletic, but the South African endemic genus Nylandtia is embedded in Muraltia subgenus Psiloclada. Subgenus Muraltia is found to be sister to subgenus Psiloclada. Estimates show the beginning of diversification of the two subgenera in the early Miocene (Psiloclada, 19.3+/-3.4 Ma; Muraltia, 21.0+/-3.5 Ma) pre-dating the establishment of the Benguela current (intermittent in the middle to late Oligocene and markedly intensifying in the late Miocene), and summer-dry climate in the Cape region. However, the later increase in species numbers is contemporaneous with these climatic phenomena. Results of dispersal-vicariance analyses indicate that major clades in Muraltia diversified from the southwestern and northwestern Cape, where most of the species are found today.

Test performance indicators from a single soccer specific fitness test differentiate between highly trained and recreationally active soccer players

Aim. The aim of this study was to investigate whether a single soccer specific fitness test (SSFT) could differentiate between highly trained and recreationally active soccer players in selected test performance indicators. Methods. Subjects: 13 Academy Scholars (AS) from a professional soccer club and 10 Recreational Players (RP) agreed to participate in this study. Test 1-(V)over dotO(2) max was estimated from a progressive shuttle run test to exhaustion. Test 2-The SSFT was controlled by an automated procedure and alternated between walking, sprinting, jogging and cruise running speeds. Three activity blocks (1A, 2A and 3A) were separated by 3 min rest periods in which blood lactate samples were drawn. The 3 blocks of activity (Part A) were followed by 10 min of exercise at speeds alternating between jogging and cruise running (Part B). Results. Estimated (V)over dotO(2) max did not significantly differ between groups, although a trend for a higher aerobic capacity was evident in AS (p<0.09). Exercising heart rates did not differ between AS and RP, however, recovery heart rates taken from the 3 min rest periods were significantly lower in AS compared with RP following blocks 1A (124.65 b(.)min(-1) +/-7.73 and 133.98 b(.)min(-1) +/-6.63), (p<0.05) and 3A (129.91 b.min(-1) +/-10.21 and 138.85 b.min(-1) +/-8.70), (p<0.01). Blood lactate concentrations were significantly elevated in AS in comparison to RP following blocks 2A (6.91 mmol(.)l(-1) +/-2.67 and 4.74 mmol(.)l(-1) +/-1.28) and 3A (7.18 mmol(.)l(-1) +/-2.97 and 4.88 mmol(.)l(-1) +/-1.50), (p<0.05). AS sustained significantly faster average sprint times in block 3A compared with RP (3.18 sec +/-0.12 and 3.31 sec +/-0.12), (p<0.05). Conclusion. The results of this study show that highly trained soccer players are able to sustain, and more quickly recover from, high intensity intermittent exercise.

rRNA probes used to quantify the effects of glycomacropeptide and alpha-lactalbumin supplementation on the predominant groups of intestinal bacteria of infant rhesus monkeys challenged with enteropathogenic Escherichia coli

Objectives: Certain milk factors may help to promote the growth of a host-friendly colonic microflora (e.g. bifidobacteria, lactobacilli) and explain why breast-fed infants experience fewer and milder intestinal infections than those who are formula-fed. The effects of supplementation of formula with two such milk factors was investigated in this study. Materials and Methods: Infant rhesus macaques were breastfed, fed control formula, or formula supplemented with glycomacropeptide (GMP) or alpha-lactalburnin (alpha-LA) from birth to 5 months of age. Blood was drawn monthly and rectal swabs were collected weekly. At 4.5 months of age, 10(8) colonyforming units of enteropathogenic E.coli O127, strain 2349/68 (EPEC) was given orally and the response to infection assessed. The bacteriology of rectal swabs pre- and post-infection was determined by culture independent fluorescence in situ hybridization. Results: Post-challenge, breast-fed infants and infants fed alpha-LA-supplemented formula had no diarrhea, whilst those infants fed GMP-supplemented formula had intermittent diarrhea. In infants fed control formula the diarrhea was acute. Conclusions: Supplementation of infant formula with appropriate milk proteins may be useful for improving the infant's ability to resist acute infection caused by E.coli.

Using continuous ground-based radar and lidar measurements for evaluating the representation of clouds in four operational models

The ability of four operational weather forecast models [ECMWF, Action de Recherche Petite Echelle Grande Echelle model (ARPEGE), Regional Atmospheric Climate Model (RACMO), and Met Office] to generate a cloud at the right location and time (the cloud frequency of occurrence) is assessed in the present paper using a two-year time series of observations collected by profiling ground-based active remote sensors (cloud radar and lidar) located at three different sites in western Europe (Cabauw. Netherlands; Chilbolton, United Kingdom; and Palaiseau, France). Particular attention is given to potential biases that may arise from instrumentation differences (especially sensitivity) from one site to another and intermittent sampling. In a second step the statistical properties of the cloud variables involved in most advanced cloud schemes of numerical weather forecast models (ice water content and cloud fraction) are characterized and compared with their counterparts in the models. The two years of observations are first considered as a whole in order to evaluate the accuracy of the statistical representation of the cloud variables in each model. It is shown that all models tend to produce too many high-level clouds, with too-high cloud fraction and ice water content. The midlevel and low-level cloud occurrence is also generally overestimated, with too-low cloud fraction but a correct ice water content. The dataset is then divided into seasons to evaluate the potential of the models to generate different cloud situations in response to different large-scale forcings. Strong variations in cloud occurrence are found in the observations from one season to the same season the following year as well as in the seasonal cycle. Overall, the model biases observed using the whole dataset are still found at seasonal scale, but the models generally manage to well reproduce the observed seasonal variations in cloud occurrence. Overall, models do not generate the same cloud fraction distributions and these distributions do not agree with the observations. Another general conclusion is that the use of continuous ground-based radar and lidar observations is definitely a powerful tool for evaluating model cloud schemes and for a responsive assessment of the benefit achieved by changing or tuning a model cloud

Demand response experience in Europe: policies, programmes and implementation

Over the last few years, load growth, increases in intermittent generation, declining technology costs and increasing recognition of the importance of customer behaviour in energy markets have brought about a change in the focus of Demand Response (DR) in Europe. The long standing programmes involving large industries, through interruptible tariffs and time of day pricing, have been increasingly complemented by programmes aimed at commercial and residential customer groups. Developments in DR vary substantially across Europe reflecting national conditions and triggered by different sets of policies, programmes and implementation schemes. This paper examines experiences within European countries as well as at European Union (EU) level, with the aim of understanding which factors have facilitated or impeded advances in DR. It describes initiatives, studies and policies of various European countries, with in-depth case studies of the UK, Italy and Spain. It is concluded that while business programmes, technical and economic potentials vary across Europe, there are common reasons as to why coordinated DR policies have been slow to emerge. This is because of the limited knowledge on DR energy saving capacities; high cost estimates for DR technologies and infrastructures; and policies focused on creating the conditions for liberalising the EU energy markets.