La Presión Intra-abdominal Influye Sobre los Limites de la Presión de la Vía Aérea Durante la Ventilación Protectora Pulmonar

Background: The Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have a impact on the respiratory system and the recommendations for mechanical ventilation of patients with IAH/ACS remain unclear. Our study characterize the influence of elevated intra-abdominal pressure (IAP) and positive end-expiratory pressure (PEEP) on airway plateau pressure (PPLAT) and bladder pressure (PBLAD). Methods: Nine (n=9) deeply anesthetized swine were mechanically ventilated via tracheostomy: volume-controlled mode at tidal volume = 10 ml/kg, frequency=15, Inspiratory:Expiratory ratio=1:2 and PEEP of 1 and 10 cmH2O (PEEP1 and PEEP10, respectively). A tracheostomy tube was place in the peritoneal cavity and different levels of IAP were applied utilizing a CPAP system. Measurements were performed during both PEEP1 and PEEP10. Results: PBLAD increased as experimental IAP rose. Minimal underestimation of IAP by PBLAD was observed. Applying PEEP10 did not significantly affect the correlation between experimental IAP and PBLAD. PBLAD (in cmH2O) was reflected by changes in PPLAT regardless of the PEEP.

Efectos y reacciones al fallo de la Corte Internacional de Justicia - CIJ en el diferendo de Nicaragua c. Colombia

El fallo de la CIJ respecto del diferendo de Nicaragua contra Colombia reconfiguró las fronteras en el Caribe colombiano y el mapa de la nación. La mala socialización del fallo a nivel nacional y departamental, genera un ambiente de negativismo sobre el panorama actual y a mediano y largo plazo. Este ambiente da paso a una serie de reacciones que influyen en el debate nacional con respecto a los efectos del fallo, dejando de lado elementos de fondo pertinentes para su mejor comprensión, asimilación y debate. El Estudio de Caso que se desarrolla a continuación pretende, en primer lugar, contextualizar el proceso histórico y jurídico que dan paso a la sentencia de la CIJ. En segundo lugar, hacer un examen riguroso de los efectos generados en Colombia. Finalmente, en tercer lugar, se desea aportar elementos de análisis que se centren en los efectos reales para Colombia y el archipiélago.

El desarrollo de la atención en estudiantes brasileños de la educación primaria y secundaria

El presente estudio tuvo como objetivo investigar eldesarrollo de la atención en estudiantes de la enseñanzaprimaria y secundaria de la ciudad de Natal (RN),Brasil. Participaron del estudio 561 sujetos, con edadesentre siete y catorce años, que fueron evaluados por elTest de Atención por Cancelación, con el propósito deinvestigar los mecanismos atencionales. En términosde la precisión y la velocidad en las tareas que evalúanla selectividad y alternancia, se constató que la curvade rendimiento de los participantes presentó un patrónascendente en función del nivel de escolaridad. Estavariable fue responsable por los contrastes estadísticamentesignificativos (p < 0.05) con respecto al desempeñode los participantes, lo cual sugiere que el patrónascendente constatado se encuentra apoyado en el nivelde escolaridad y en el desarrollo neurológico. En relacióncon la atención selectiva y alternada, se verificóun aumento significativo en el rendimiento en los tresprimeros grados de la enseñanza primaria. Con respectoa la atención selectiva, se observó estabilización delos resultados en los tres últimos años de la enseñanzasecundaria, lo que apunta al estabelecimiento de unameseta en el desarrollo de este mecanismo atencional.Por otro lado, en relación con la alternancia, no hubouna estabilización en el desempeño, y esto sugiere continuidaddel patrón ascendente, ya que en el grupo deedad en cuestión todavía están por ocurrir importantesprocesos de maduración y de desarrollo neurológico enla atención ejecutiva.

Factores asociados a infección de fracturas abiertas de extremidades por accidentes de tránsito. Bogotá, 2012-2013

Los traumatismos por accidentes de tránsito, constituyen un problema de salud pública, a nivel mundial. Las lesiones más frecuentes son las fracturas de extremidades (84.3%). Las fracturas tienen un elevado riesgo de presentar infecciones, secuelas e incapacidades permanentes. Objetivo : Determinar si los factores asociados con la patología (lugar de fractura, clasificación de fractura, comorbilidades del paciente) y/o los factores relacionados con la atención médica (uso de profilaxis antibiótica diferente al protocolo institucional, tiempo prolongado para remisión, demoras en manejo quirúrgico) se asocian a mayor probabilidad de presentar infección de fracturas abiertas, en población mayor a 15 años, atendidos por accidente de tránsito, en una clínica de Bogotá de tercer nivel especializada en atención de SOAT, durante el período Octubre de 2012 a Octubre de 2013. Metodología: Estudio de casos y controles no apareado, relación 1:3, conformado por 43 casos (fracturas abiertas infectadas) y 129 controles (fracturas abiertas no infectadas). Resultados: La edad media de los casos fue de 39.42 +/- 16.82 años (med=36 años) y la edad media de los controles fue de 33.15 +/- 11.78 años (med=30 años). El 83.7% de los casos y el 78.3% de los controles corresponden al sexo masculino. Predominaron los accidentes en motocicleta en el 81.4% de los casos y el 86% de los controles. En el análisis bivariado se encuentra que la edad mayor a 50 años (p=0.042), una clasificación de la fractura grado IIIB o IIIC (p=0.02), cumplimiento del protocolo antibiótico institucional según el grado de fractura (p=0.014) y un tiempo mayor a 24 horas desde el momento del accidente al centro especializado en trauma (p=0.035) se asociaron significativamente con infección de la fractura abierta. En el análisis multivariado se encuentra únicamente que la clasificación de la fractura grado IIIB o IIIC se asocia con infección de la fractura OR 2.6 IC95% (1.187 – 5.781) (p=0.017). La duración de hospitalización fue mayor en los casos (32.37+/- 22.92 días, med=26 días) que en los controles (8.81 +/- 7.52 días, med=6 días) (p<0.001). El promedio de lavados quirúrgicos fue mayor en los casos (4.85±4.1, med=4.0) que en el grupo control (1.94±1.26, med=2) (p<0.001). Conclusiones: La infección posterior a una fractura abierta, implica costos elevados de atención con hospitalizaciones prolongadas y mayor frecuencia de intervenciones quirúrgicas como se evidencia en el presente estudio. Se debe fortalecer el sistema de remisión y contra remisión para acortar los tiempos de inicio de manejo especializado de los pacientes con fracturas abiertas. Se debe incentivar dentro de las instituciones, el cumplimiento de protocolos de profilaxis antibiótica según el grado de la fractura para disminuir el riesgo de complicación infecciosa.

Soluções sólidas vs. dispersões sólidas: impacto dos parâmetros de formulação

Filmes matriciais foram preparados com fármacos com diferentes solubilidades aquosas (tartarato de metoprolol, ibuprofeno e diclofenac Na) e diferentes polímeros (etilcelulose, Eudragit RS e Eudragit RL). Foram obtidas soluções sólidas (fármaco dissolvido) e dispersões sólidas (fármaco disperso). A libertação dos fármacos foi estudada em função do tipo de fármaco, doseamento, tipo e quantidade de aditivo e do tipo de polímero. A libertação dos fármacos não foi de acordo com a sua solubilidade aquosa, mas sim com o estado físico do fármaco na matriz. O incremento do conteúdo do fármaco na matriz aumentou a velocidade de libertação monotonicamente para a solução sólida. Em contraste, com a dispersão sólida, o aumento da dosagem de fármaco não originou quase nenhum efeito até 30 %, registando-se apenas, posteriormente, um acréscimo na sua velocidade. A inclusão de aditivos hidrofílicos aumentou principalmente a fase inicial do perfil de libertação do fármaco e não produziu efeito no plateau. Por outro lado, polietilenoglicol 1500 diminuiu a libertação de diclofenac Na devido ao aprisionamento do fármaco nos seus domínios. O efeito do tipo de polímero na libertação de ibuprofeno esteve relacionado com a partição do fármaco com o polímero. No caso do tartarato de metoprolol, a libertação foi muito mais rápida do da matriz de Eudragit RS do que de EC, devido à formação de uma mistura amorfa.

Simulation of monsoon disturbances in the LMD GCM

The monsoon depressions that form over India during the summer are analyzed using simulations from the Laboratoire de Meteorologie Dynamique general circulation model. This type of synoptic system often occurs with a frequency of one to two per month and can produce a strong Indian rainfall. Two kinds of analyses are conducted in this study. The first one is a subjective analysis based on the evolution of the precipitation rate and the pattern of the sea level pressure. The second one is an objective analysis performed using the TRACK program, which identifies and tracks the minima in the sea level pressure anomaly held and computes the statistics for the distribution of systems. The analysis of a 9-yr control run, which simulates strong precipitation rates over the foothills of the Himalayas and over southern India but weak rates over central India, shows that the number of disturbances is coo low and that they almost never occur during August, when break conditions prevail. The generated disturbances more often move north, toward the foothills of the Himalayas. Another analysis is performed to study the effect of the Tibetan Plateau elevation on these disturbances with a 9-yr run carried out with a Tibetan Plateau at 50% of its current height. It is shown that this later integration simulates more frequent monsoon disturbances, which move rather northwestward, in agreement with the current observations. The comparison between the two runs shows that the June-July-August rainfall difference is in large part due to changes in the occurrence of the monsoon disturbances.

Impact of Tibetan Orography and Heating on the Summer Flow over Asia

The influence on the summer flow over Asia of both the orographic and thermal forcing of the Tibetan Plateau is investigated using a sequence of idealised experiments with a global primitive equation model. The zonally averaged flow is prescribed and both realistic and idealised orography and heating are used. There is some similarity between the responses to the two forcings when applied separately. The upper tropospheric Tibetan anticyclone is predominantly forced by the heating but also weakly by the orography. Below this, both forcings tend to give air descending in an equatorward anticyclonic circulation down the isentropes to the west and rising in a similar poleward circulation to the east. However the heating-only response has a strong ascending southwesterly flow that is guided around the south and south-east of the orography when it is included. On the northern side, the westerly flow over the orography gives ascent on the upslope and descent on the downslope. It is found that heating over the Plateau leads to a potential vorticity (PV) minimum and that if it is sufficiently strong the flow is unstable, producing a quasi-biweekly oscillation. During this oscillation the Tibetan anticyclone changes between a single centre over the southwestern side of the Plateau and a split/double structure with centres over China and the Middle East. These characteristics are similar to observed variability in the region. Associated with this quasi-biweekly oscillation are significant variations in the strength of the ascent over the Plateau and the Rossby wave pattern over the North Pacific. The origin of the variability is instability associated with the zonally extended potential vorticity PV minimum on a θ-surface, as proposed by Hsu and Plumb (2000). This minimum is due to the tendency to reduce the PV above the heating over the Plateau and to advection by the consequent anticyclone of high PV around from the east and low PV to the west. The deep convection to the south and southeast of the Plateau tends to suppress the quasi-biweekly oscillation because the low PV produced above it acts to reduce the meridional PV gradient reversal. The occurrence of the oscillation depends on the relative magnitude of the heating in the two regions.

Significance of cross correlations in the stress relaxation of polymer melts

According to linear response theory, all relaxation functions in the linear regime can be obtained using time correlation functions calculated under equilibrium. In this paper, we demonstrate that the cross correlations make a significant contribution to the partial stress relaxation functions in polymer melts. We present two illustrations in the context of polymer rheology using (1) Brownian dynamics simulations of a single chain model for entangled polymers, the slip-spring model, and (2) molecular dynamics simulations of a multichain model. Using the single chain model, we analyze the contribution of the confining potential to the stress relaxation and the plateau modulus. Although the idea is illustrated with a particular model, it applies to any single chain model that uses a potential to confine the motion of the chains. This leads us to question some of the assumptions behind the tube theory, especially the meaning of the entanglement molecular weight obtained from the plateau modulus. To shed some light on this issue, we study the contribution of the nonbonded excluded-volume interactions to the stress relaxation using the multichain model. The proportionality of the bonded/nonbonded contributions to the total stress relaxation (after a density dependent "colloidal" relaxation time) provides some insight into the success of the tube theory in spite of using questionable assumptions. The proportionality indicates that the shape of the relaxation spectrum can indeed be reproduced using the tube theory and the problem is reduced to that of finding the correct prefactor. (c) 2007 American Institute of Physics

Linear viscoelasticity from molecular dynamics simulation of entangled polymers

The linear viscoelastic (LVE) spectrum is one of the primary fingerprints of polymer solutions and melts, carrying information about most relaxation processes in the system. Many single chain theories and models start with predicting the LVE spectrum to validate their assumptions. However, until now, no reliable linear stress relaxation data were available from simulations of multichain systems. In this work, we propose a new efficient way to calculate a wide variety of correlation functions and mean-square displacements during simulations without significant additional CPU cost. Using this method, we calculate stress−stress autocorrelation functions for a simple bead−spring model of polymer melt for a wide range of chain lengths, densities, temperatures, and chain stiffnesses. The obtained stress−stress autocorrelation functions were compared with the single chain slip−spring model in order to obtain entanglement related parameters, such as the plateau modulus or the molecular weight between entanglements. Then, the dependence of the plateau modulus on the packing length is discussed. We have also identified three different contributions to the stress relaxation:  bond length relaxation, colloidal and polymeric. Their dependence on the density and the temperature is demonstrated for short unentangled systems without inertia.

Evaluating the efficacy of planktonic foraminifer calcite and 18O data for sea surface temperature reconstruction for the Late Miocene

This study examines the efficacy of published δ18O data from the calcite of Late Miocene surface dwelling planktonic foraminifer shells, for sea surface temperature estimates for the pre-Quaternary. The data are from 33 Late Miocene (Messinian) marine sites from a modern latitudinal gradient of 64°N to 48°S. They give estimates of SSTs in the tropics/subtropics (to 30°N and S) that are mostly cooler than present. Possible causes of this temperature discrepancy are ecological factors (e.g. calcification of shells at levels below the ocean mixed layer), taphonomic effects (e.g. diagenesis or dissolution), inaccurate estimation of Late Miocene seawater oxygen isotope composition, or a real Late Miocene cool climate. The scale of apparent cooling in the tropics suggests that the SST signal of the foraminifer calcite has been reset, at least in part, by early diagenetic calcite with higher δ18O, formed in the foraminifer shells in cool sea bottom pore waters, probably coupled with the effects of calcite formed below the mixed layer during the life of the foraminifera. This hypothesis is supported by the markedly cooler SST estimates from low latitudes—in some cases more than 9 °C cooler than present—where the gradients of temperature and the δ18O composition of seawater between sea surface and sea bottom are most marked, and where ocean surface stratification is high. At higher latitudes, particularly N and S of 30°, the temperature signal is still cooler, though maximum temperature estimates overlap with modern SSTs N and S of 40°. Comparison of SST estimates for the Late Miocene from alkenone unsaturation analysis from the eastern tropical Atlantic at Ocean Drilling Program (ODP) Site 958—which suggest a warmer sea surface by 2–4 °C, with estimates from oxygen isotopes at Deep Sea Drilling Project (DSDP) Site 366 and ODP Site 959, indicating cooler than present SSTs, also suggest a significant impact on the δ18O signal. Nevertheless, much of the original SST variation is clearly preserved in the primary calcite formed in the mixed layer, and records secular and temporal oceanographic changes at the sea surface, such as movement of the Antarctic Polar Front in the Southern Ocean. Cooler SSTs in the tropics and sub-tropics are also consistent with the Late Miocene latitude reduction in the coral reef belt and with interrupted reef growth on the Queensland Plateau of eastern Australia, though it is not possible to quantify absolute SSTs with the existing oxygen isotope data. Reconstruction of an accurate global SST dataset for Neogene time-slices from the existing published DSDP/ODP isotope data, for use in general circulation models, may require a detailed re-assessment of taphonomy at many sites.

Influence of time on the plant availability of Cd, Ni and Zn after sewage sludge has been applied to soils

A pot experiment was conducted to test the hypothesis that decomposition of organic matter in sewage sludge and the consequent formation of dissolved organic compounds (DOC) would lead to an increase in the bioavailability of the heavy metals. Two Brown Earth soils, one with clayey loam texture (CL) and the other a loamy sand (LS) were mixed with sewage sludge at rates equivalent to 0, 10 and 50 1 dry sludge ha(-1) and the pots were sown with ryegrass (Lolium perenne L.). The organic matter content and heavy metal availability assessed with soil extractions with 0.05 M CaCl2 were monitored over a residual time of two years, while plant uptake over one year, after addition of the sludge. It was found that the concentrations of Cd and Ni in both the ryegrass and the soil extracts increased slightly but significantly during the first year. In most cases, this increase was most evident especially at the higher sludge application rate (50 t ha(-1)). However, in the second year metal availability reached a plateau. Zinc concentrations in the ryegrass did not show an increase but the CaCl2 extracts increased during the first year. In contrast, organic matter content decreased rapidly in the first months of the first year and much more slowly in the second (total decrease of 16%). The concentrations of DOC increased significantly in the more organic rich CL soil in the course of two years. The pattern followed by the decomposition of organic matter with time and the production of DOC may provide at least a partial explanation for trend towards increased metal availability.

Edaphic influences on plant community adaptation in the Chiquibul forest of Belize

Edaphic variables figure significantly in plant community adaptations in tropical ecosystems but are often difficult to resolve because of the confounding influence of climate. Within the Chiquibul forest of Belize, large areas of Ultisols and Inceptisols occur juxtaposed within a larger zone of similar climate, permitting unambiguous assessment of edaphic contributions to forest composition. Wet chemical analyses, X-ray diffraction and X-ray fluorescence spectroscopy were employed to derive chemical (pH, exchangeable cations, CEC, total and organic C, total trace elements) and physical (texture, mineralogy) properties of four granite-derived Ustults from the Mountain Pine Ridge plateau and four limestone-derived Ustepts from the San Pastor region. The soils of these two regions support two distinct forests, each possessing a species composition reflecting the many contrasting physicochemical properties of the underlying soil. Within the Mountain Pine Ridge forest, species abundance and diversity is constrained by nutrient deficiencies and water-holding limitations imposed by the coarse textured, highly weathered Ultisols. As a consequence, the forest is highly adapted to seasonal drought, frequent fires and the significant input of atmospherically derived nutrients. The nutrient-rich Inceptisols of the San Pastor region, conversely, support an abundant and diverse evergreen forest, dominated by Sabal mauritiiformis, Cryosophila stauracantha and Manilkara spp. Moreover, the deep, fine textured soils in the depressions of the karstic San Pastor landscape collect and retain during the wet season much available water, thereby serving as refugia during particularly long periods of severe drought. To the extent that the soils of the Chiquibul region promote and maintain forest diversity, they also confer redundancy and resilience to these same forests and, to the broader ecosystem, of which they are a central part. (C) 2005 Elsevier B.V. All rights reserved.

Evaluating the efficacy of planktonic foraminifer calcite and 18O data for sea surface temperature reconstruction for the Late Miocene

This study examines the efficacy of published δ18O data from the calcite of Late Miocene surface dwelling planktonic foraminifer shells, for sea surface temperature estimates for the pre-Quaternary. The data are from 33 Late Miocene (Messinian) marine sites from a modern latitudinal gradient of 64°N to 48°S. They give estimates of SSTs in the tropics/subtropics (to 30°N and S) that are mostly cooler than present. Possible causes of this temperature discrepancy are ecological factors (e.g. calcification of shells at levels below the ocean mixed layer), taphonomic effects (e.g. diagenesis or dissolution), inaccurate estimation of Late Miocene seawater oxygen isotope composition, or a real Late Miocene cool climate. The scale of apparent cooling in the tropics suggests that the SST signal of the foraminifer calcite has been reset, at least in part, by early diagenetic calcite with higher δ18O, formed in the foraminifer shells in cool sea bottom pore waters, probably coupled with the effects of calcite formed below the mixed layer during the life of the foraminifera. This hypothesis is supported by the markedly cooler SST estimates from low latitudes—in some cases more than 9 °C cooler than present—where the gradients of temperature and the δ18O composition of seawater between sea surface and sea bottom are most marked, and where ocean surface stratification is high. At higher latitudes, particularly N and S of 30°, the temperature signal is still cooler, though maximum temperature estimates overlap with modern SSTs N and S of 40°. Comparison of SST estimates for the Late Miocene from alkenone unsaturation analysis from the eastern tropical Atlantic at Ocean Drilling Program (ODP) Site 958—which suggest a warmer sea surface by 2–4 °C, with estimates from oxygen isotopes at Deep Sea Drilling Project (DSDP) Site 366 and ODP Site 959, indicating cooler than present SSTs, also suggest a significant impact on the δ18O signal. Nevertheless, much of the original SST variation is clearly preserved in the primary calcite formed in the mixed layer, and records secular and temporal oceanographic changes at the sea surface, such as movement of the Antarctic Polar Front in the Southern Ocean. Cooler SSTs in the tropics and sub-tropics are also consistent with the Late Miocene latitude reduction in the coral reef belt and with interrupted reef growth on the Queensland Plateau of eastern Australia, though it is not possible to quantify absolute SSTs with the existing oxygen isotope data. Reconstruction of an accurate global SST dataset for Neogene time-slices from the existing published DSDP/ODP isotope data, for use in general circulation models, may require a detailed re-assessment of taphonomy at many sites.

Using idealized snow forcing to test teleconnections with the Indian summer monsoon in the Hadley Centre GCM

Anomalous heavy snow during winter or spring has long been regarded as a possible precursor of deficient Indian monsoon rainfall during the subsequent summer. However previous work in this field is inconclusive, in terms of the mechanism that communicates snow anomalies to the monsoon summer, and even the region from which snow has the most impact. In this study we explore these issues in coupled and atmosphere-only versions of the Hadley Centre model. A 1050-year control integration of the HadCM3 coupled model, which well represents the seasonal cycle of snow cover over the Eurasian continent, is analysed and shows evidence for weakened monsoons being preceded by strong snow forcing (in the absence of ENSO) over either the Himalaya/Tibetan Plateau or north/west Eurasia regions. However, empirical orthogonal function (EOF) analysis of springtime interannual variability in snow depth shows the leading mode to have opposite signs between these two regions, suggesting that competing mechanisms may be possible. To determine the dominant region, ensemble integrations are carried out using HadAM3, the atmospheric component of HadCM3, and a variety of anomalous snow forcing initial conditions obtained from the control integration of the coupled model. Forcings are applied during spring in separate experiments over the Himalaya/Tibetan Plateau and north/west Eurasia regions, in conjunction with climatological SSTs in order to avoid the direct effects of ENSO. With the aid of idealized forcing conditions in sensitivity tests, we demonstrate that forcing from the Himalaya region is dominant in this model via a Blanford-type mechanism involving reduced surface sensible heat and longwave fluxes, reduced heating of the troposphere over the Tibetan Plateau and consequently a reduced meridional tropospheric temperature gradient which weakens the monsoon during early summer. Snow albedo is shown to be key to the mechanism, explaining around 50% of the perturbation in sensible heating over the Tibetan Plateau, and accounting for the majority of cooling through the troposphere.

The zonal asymmetry of the Southern Hemisphere storm-track

Atmospheric general circulation model experiments have been performed to investigate how the significant zonal asymmetry in the Southern Hemisphere (SH) winter storm track is forced by sea surface temperature (SST) and orography. An experiment with zonally symmetric tropical SSTs expands the SH upper-tropospheric storm track poleward and eastward and destroys its spiral structure. Diagnosis suggests that these aspects of the observed storm track result from Rossby wave propagation from a wave source in the Indian Ocean region associated with the monsoon there. The lower-tropospheric storm track is not sensitive to this forcing. However, an experiment with zonally symmetric midlatitude SSTs exhibits a marked reduction in the magnitude of the maximum intensity of the lower-tropospheric storm track associated with reduced SST gradients in the western Indian Ocean. Experiments without the elevation of the South African Plateau or the Andes show reductions in the intensity of the major storm track downstream of them due to reduced cyclogenesis associated with the topography. These results suggest that the zonal asymmetry of the SH winter storm track is mainly established by stationary waves excited by zonal asymmetry in tropical SST in the upper troposphere and by local SST gradients in the lower troposphere, and that it is modified through cyclogenesis associated with the topography of South Africa and South America.