Medición de la profundidad anestésica y memoria durante anestesia general mediante el cerebral state monitor (csm x06)

Este es un ensayo clínico controlado realizado en 327 pacientes ASA II, sometidas a cesárea, distribuidas aleatoriamente en dos grupos iguales para identificar las variaciones hemodinámicas y nivel metamérico, al aplicar Anestesia Intratecal con Lidocaína Isobárica al 2(AILI) comparada con Lidocaína Hiperbárica al 5(AILH), ambas a dosis de 80 mg. Resultados: la AILI, se mantuvo en determinadas metámeras sin sustancial variabilidad, comportamiento totalmente contrario a la AILH. Las diferencias estadísticas en la presión sistólica, diastólica, y frecuencia cardiaca, entre ambos tipos de anestesia no fueron significativas. La hipotensión se presentó en 32,9con AILI, y 54con AILH; siendo tratada con 2,26 mg (ñ 3.65) y 3,93 mg (ñ 4,26) de efedrina respectivamente. (p> 0.05). Con AILI se presentaron 4 casos de bloqueo raquídeo alto más dificultad respiratoria y, con AILH 3 casos, de los cuales solo 2 presentaron dificultad respiratoria. Conclusión: la AILI produce un bloqueo nervioso más predecible que la AILH. Los valores hemodinámicos y la incidencia de complicaciones, entre ambos anestésicos fueron semejantes

Nueva ruralidad. Temas emergentes, nuevos condicionantes y viejos problemas

Introducción Nos internamos en un nuevo siglo después de haber experimentado, durante la segunda mitad del anterior, grandes cambios en el entorno internacional y fundamentales transformaciones en las política y en las economías de los países de América Latina y el Caribe, sin haber podido resolver muchos de los problemas medulares que caracterizan nuestro estadio de desarrollo; entre ellos, las condiciones de iniquidad en las zonas rurales y los desequilibrios ambientales

A machine learning approach to measure and monitor physical activity in children to help fight overweight and obesity

Physical Activity is important for maintaining healthy lifestyles. Recommendations for physical activity levels are issued by most governments as part of public health measures. As such, reliable measurement of physical activity for regulatory purposes is vital. This has lead research to explore standards for achieving this using wearable technology and artificial neural networks that produce classifications for specific physical activity events. Applied from a very early age, the ubiquitous capture of physical activity data using mobile and wearable technology may help us to understand how we can combat childhood obesity and the impact that this has in later life. A supervised machine learning approach is adopted in this paper that utilizes data obtained from accelerometer sensors worn by children in free-living environments. The paper presents a set of activities and features suitable for measuring physical activity and evaluates the use of a Multilayer Perceptron neural network to classify physical activities by activity type. A rigorous reproducible data science methodology is presented for subsequent use in physical activity research. Our results show that it was possible to obtain an overall accuracy of 96 % with 95 % for sensitivity, 99 % for specificity and a kappa value of 94 % when three and four feature combinations were used.

Utility of the multi-component training distress scale to monitor swimmers during periods of training overload

The purpose of the present study was to determine the efficacy of the multi-component training distress scale (MTDS), in monitoring swimmers prior to national competition. Twenty-one national-level adolescent swimmers completed eight weeks of testing. Once a week participants completed an 8 × 50 m sprint test,
vertical jump test, sit-and-reach test, the MTDS and the
Recovery-Stress Questionnaire for Athletes (REST-Q). All testing
was incorporated into the swimmers’ normal training programme.
The REST-Q accounted for the following variances in performance:
flexibility (14.6%,p= 0.009), power output (17.7%,p= 0.003),swimming speed (15.5%,p
= 0.006) and swimming endurance(17.5%,p= 0.002). In comparison, the MTDS accounted for thefollowing variances in performance:
flexibility (12.1%, p= 0.095),power output (16.4%,p= 0.023), swimming speed (20.5%,p = 0.003) and swimming speed endurance (23.8%,p= 0.001).The findings of the current study suggest that both the REST-Q Sport and the MTDS have the capacity to predict performance on a range of fitness components associated with swimming.

Validation of the SenseWear Mini activity monitor in 5-12-year-old children

OBJECTIVES: This study aimed to validate SenseWear Mini software algorithm versions 2.2 (SW2.2) and 5.2 (SW5.2) for estimating energy expenditure (EE) in children. DESIGN: Laboratory-based validation study. METHODS: 57 children aged 5-12 y completed a protocol involving 15 semi-structured sedentary (SED), light-intensity (LPA), and moderate- to vigorous-intensity (MVPA) physical activities. EE was estimated using portable indirect calorimetry (IC). The accuracy of EE estimates (kcal·min(-1)) from SW2.2 and SW5.2 were examined at the group level and individual level using the mean absolute percentage error (MAPE), Bland-Altman plots and equivalence testing. RESULTS: MAPE values were lower for SW5.2 (30.1±10.7%) than for SW2.2 (44.0±6.2%). Although mean differences for SW5.2 were smaller than for SW2.2 during SED (-0.23±0.22 vs. -0.61±0.20kcal·min(-1)), LPA (-0.69±0.76 vs. -1.07±0.46kcal·min(-1)) and MVPA (-2.22±1.15 vs. -2.57±1.15kcal·min(-1)), limits of agreement did not decrease for the updated algorithms. For all activities, SW2.2 and SW5.2 were not equivalent to IC (p>0.05). Errors increased with increasing intensity. CONCLUSION: The current SenseWear Mini algorithms SW5.2 underestimated EE. The overall improved accuracy for SW5.2 was not accompanied with improved accuracy at the individual level and EE estimates were not equivalent to IC.

Il sistema Trauma Tracker - individuazione e analisi di parametri vitali acquisiti da monitor multiparametrico.

Lo scopo della presente tesi è lo studio e la progettazione di un sistema Hands-Free applicato in ambito Healthcare, volto ad aiutare il personale sanitario nello svolgimento delle mansioni lavorative. Il progetto, denominato Trauma Tracker, ha avuto origine grazie alla collaborazione con medici ed infermieri dell'ospedale Maurizio Bufalini di Cesena. In particolare, il sistema in prodotto si prende carico della compilazione del report finale contenente tutte le operazioni svolte sui pazienti nell'ambito del Pronto Soccorso, riducendo così notevolmente le possibilità di errori dovuti a fattori umani. Durante le fasi di sviluppo e progettazione sono state aggiunte ulteriori funzionalità al sistema, fino a farlo diventare vero e proprio oggetto incantato, in grado di esibire proprietà finora inimmaginabili in questo campo di applicazione. Trauma Tracker, almeno in queste prime fasi, non si propone come uno strumento immediatamente utilizzabile sul campo e pronto ad affiancare i medici, poiché necessiterebbe subito di qualità come robustezza ed affidabilità a livelli estremamente elevati. Per questo motivo il progetto è stato trattato come un "Proof of Concept", ossia un prototipo che ha lo scopo di dimostrare la fattibilità di tale sistema nella realtà, e di verificarne l'utilità una volta applicato in uno scenario concreto. L'argomento trattato ha quindi una grande importanza, poiché getta le basi di una tecnologia che un giorno potrà aiutare medici ed infermieri a svolgere al meglio l'impegnativo compito di salvare vite. In questa tesi, è stato approfondito in particolare il sottosistema utilizzato per il riconoscimento dei parametri vitali dal monitor multi-parametrico posto nei diversi reparti ospedalieri. Esso ha richiesto lunghe fasi di implementazione e collaudo per ottenere dei risultati soddisfacenti, che alla fine sono stati raggiunti.

Using alcohol unit-marked glasses enhances capacity to monitor intake:evidence from a mixed-method intervention trial

AIMS: In the UK, people tend to have poor knowledge of government guidelines for alcohol use, and lack the motivation and skills required to use them to monitor their drinking. The study aim was to determine whether using glasses marked with such guidelines would improve knowledge and attitudes, increase frequency of counting units and lower alcohol intake. METHODS: A total of 450 adults in the UK participated in an intervention vs control study with 1-month follow-up. The intervention group was encouraged to use glasses supplied by the researchers that indicated the unit content of drinks of different strengths and volumes, and stated the intake guidelines. Data were collected online. A further more in-depth interview with 13 intervention group participants enquired into their experiences of using the glasses. RESULTS: Analyses adjusted for baseline variables showed that the intervention improved the following: knowledge of unit-based guidelines, ability to estimate the unit content of drinks, attitudes toward the guidelines and frequency of counting unit intake. However, there was no significant difference in alcohol consumption between the groups at follow-up. Interviews suggested that the glasses encouraged people to think about their drinking and to discuss alcohol with other people. The design of the glasses was not appealing to all, and their initial impact did not always persist. CONCLUSION: Use of unit-marked glasses led to changes in people's reported use of unit-based guidelines to monitor their drinking but, in the short term, no change in consumption. Qualitative data suggested that the glasses could have an impact at the individual level (on knowledge and attitudes) and at a broader level (by prompting discussion of alcohol use).

Selección de temas de actualidad en cardiología clínica, cardiología geriátrica e insuficiencia cardiaca y trasplante 2015

SIN FINANCIACIÓN

A transformation-based multivariate chart to monitor process dispersion

Multivariate monitoring techniques such as multivariate control charts are used to control the processes that contain more than one correlated characteristic. Although the majority of previous researches are focused on controlling only the mean vector of multivariate processes, little work has been performed to monitor the covariance matrix. In this research, a new method is presented to detect possible shifts in the covariance matrix of multivariate processes. The basis of the proposed method is to eliminate the correlation structure between the quality characteristics by transformation technique and then use an S chart for each variable. The performance of the proposed method is then compared to the ones from other existing methods and a real case is presented.

Monitor objectivity with important clients: evidence from auditor opinions around the world

We examine whether monitors are likely to compromise their monitoring objectivity in the face of economically important clients in international business settings. In the context of external auditing and assurance services, we measure monitor objectivity by whether auditors are more (or less) likely to issue to their important clients modified audit opinions, that is, audit opinions provided to outside investors about the firm that demotes explicit areas of concern. Using a large cross-country sample, we document that auditors are more likely to issue modified opinions to their economically important clients relative to other clients. Furthermore, we find that this association is stronger (1) for Big N auditors, (2) for multinational audit clients, and (3) in countries with stronger legal regimes. These results suggest that monitors prioritize the protection of their reputation over lucrative economic relationships, and such information certification function is more pronounced for international auditors, multinational client firms, and in strong legal regimes.

Temas críticos para la competitividad y la calidad de vida de Bogotá y la región

Gestión del conocimiento

South Carolina general fund revenue monitor October fiscal year 2016-17

This document is a summary of revenues from various sources in the state as well as giving expected revenues, based on income, corporation and other taxes received,

Predicamento de seguridad yemení

Con el inicio del periodo Post-Guerra Fría el Sistema Internacional comienza a experimentar un incremento en el fortalecimiento de su componente social; la Sociedad de Estados alcanza un mayor nivel de homogenización, el estado, unidad predominante de esta, comienzan atravesar una serie de transformaciones que obedecerán a una serie de cambios y continuidades respecto al periodo anterior. Desde la perspectiva del Realismo Subalterno de las Relaciones Internacionales se destacan el proceso de construcción de estado e inserción al sistema como las variables que determinan el sentimiento de inseguridad experimentado por las elites estatales del Tercer Mundo; procesos que en el contexto de un nuevo y turbulento periodo en el sistema, tomara algunas características particulares que darán un sentido especifico al sentimiento de inseguridad y las acciones a través de las cuales las elites buscan disminuirlo. La dimensión externa del sentimiento de inseguridad, el nuevo papel que toma la resistencia popular como factor determinante del sentimiento de inseguridad y de la cooperación, así como del conflicto, entre los miembros de la Sociedad Internacional, la inserción como promotor de estrategias de construcción de Estado, son alguno de los temas puntuales, que desde la perspectiva subalterna, parecen salir a flote tras el análisis del sistema en lo que se ha considerado como el periodo Post-Guerra Fría. En este sentido Yemen, se muestra como un caso adecuado no solo para poner a prueba las postulados de la teoría subalterna, veinte años después de su obra más prominente (The third world security Predicament), escrita por M. Ayoob, sino como un caso pertinente que permite acercarse más a la comprensión del papel del Tercer Mundo al interior de la Sociedad Internacional de Estados.

Análisis de la relación entre la gestión del riesgo y la vulnerabilidad. Caso de estudio: Brisas del Volador, Ciudad Bolívar

Este estudio analiza la relación entre la gestión del riesgo y la vulnerabilidad en el barrio Brisas del Volador, ubicado en Ciudad Bolívar, Bogotá. Se explicó el cambio en el enfoque de estudio y manejo de los desastres a partir de la consolidación de términos relacionados a procesos sociales, como lo son la vulnerabilidad y el riesgo. Así mismo, se describieron los cambios que se han establecido en la forma de abordar el riesgo en Colombia, tanto a nivel nacional como distrital. La investigación reveló la forma como se ha generado la vulnerabilidad a partir de la intersección de distintos procesos en un asentamiento informal y como se materializan diferentes elementos para conformar la vulnerabilidad global. A partir de esto, se recopilaron las acciones implementadas en la zona de estudio desde la gestión del riesgo, se clasificaron en cada uno de los tres procesos: conocimiento, reducción o manejo del desastre y posteriormente se estudiaron. Con base en esto, se analizaron las medidas que tuvieron una incidencia en la reducción de la vulnerabilidad y los resultados que generaron.

Recensão a "O Jardineiro do Cacuaco: temas antropológicos"

Existirão certamente mais jardins que jardineiros e, definitivamente, mais lugares da Antropologia que Antropólogos. No panorama português, Francisco Martins Ramos é o Antropólogo ao Sul. Docente universitário por mais de 30 anos na Universidade de Évora (Portugal), aí percorreu todas as etapas da carreira académica, de Assistente Estagiário a Professor Catedrático e a ela continua ligado como Professor Emérito, título que lhe foi atribuído em 2010. O Jardineiro do Cacuaco é o nono livro do Autor. Trata-se de uma obra eminentemente académica, orientada para estudantes de Antropologia mas, sobretudo para os seus alunos, antigos e actuais, que certamente gostarão de (re)encontrar em formato de livro textos de cariz antropológico, alguns inéditos, outros já publicados e agora actualizados. Ao todo, e para além das palavras prévias e de um Prefácio docemente intitulado “Os Exercícios de Francisco Ramos ou a Ternura da Memória”, da autoria de Jorge Gaspar, a obra é composta por dezoito textos tematicamente diferenciados e de estrutura, dimensão e estilo narrativo variável, a que se junta um pequeno conto, o qual, aliás, dá o nome ao volume. No livro que agora vem à estampa pelas Edições Colibri, Francisco Martins Ramos reúne alguns dos já clássicos lugares da Antropologia, revê e acrescenta outros e a todos dá profundidade. Da superfície para o fundo, este é um livro de e sobre lugares: geográficos, académicos, simbólicos e, também, afectivos. E em todos esses lugares a Antropologia respira; é não apenas o substantivo mas também o verbo que o autor habilmente conjuga da sociedade vila-velhense ao mundo globalizado, como aliás tinha já insignemente demonstrado em De Monsaraz a Melbourne: Reflexões Antropológicas numa Era Global (Edições Colibri, 2012).