Evaluation Of A Novel Method Of Real Time Computer Assisted Spine Surgery

In this paper the effectiveness of a novel method of computer assisted pedicle screw insertion was studied using testing of hypothesis procedure with a sample size of 48. Pattern recognition based on geometric features of markers on the drill has been performed on real time optical video obtained from orthogonally placed CCD cameras. The study reveals the exactness of the calculated position of the drill using navigation based on CT image of the vertebra and real time optical video of the drill. The significance value is 0.424 at 95% confidence level which indicates good precision with a standard mean error of only 0.00724. The virtual vision method is less hazardous to both patient and the surgeon

Factores asociados a infección por Acinetobacter baumannii en una Unidad de Cuidados Intensivos en Bogotá D.C.

INTRODUCCIÓN: Acinetobacter baumannii es un cocobacilo gram negativo, oportunista, de baja virulencia. En los últimos años, se ha convertido en responsable del aumento de la incidencia de infecciones en las Unidades de Cuidado Intensivo (UCI), que se caracterizan por multiresistencia a antibióticos de amplio espectro. METODOLOGÍA: Estudio de Casos y Controles Pareado, razón 1:4, en tres cohortes de brotes por A. baumannii 2006-2010 de un Hospital Universitario. Como medida de asociación se calculó el Odd Ratio con una confiabilidad del 95%, utilizando regresión logística condicional. RESULTADOS: Se identificaron 3 brotes en el periodo 2006-2010, de los cuales se obtuvo una muestra de 14 casos y 56 controles. En el análisis multivariado se encontró asociación estadísticamente significativa entre la infección/colonización por A. baumannii y el presentar algún estado de inmunosupresión (OR=15.45; IC95%=1.12-212.44) y el tener catéter venoso central en un tiempo superior a diez días (OR=13.74; IC95%=1.25-151.44). No se encontró asociación estadísticamente significativa entre infección/colonización y mortalidad. De 14 casos, 13 presentaron aislamientos de multiresistentes, 9 son de origen respiratorio, 2 hemocultivos y 3 de origen abdominal. La mortalidad en los casos no está asociada a procesos de inmunosupresión, bacteremias e infecciones/colonizaciones respiratorias. CONCLUSIONES: La infección/colonización por A. baumannii se asoció a estado de inmunosupresión del paciente y el tener catéter venoso central por más de 10 días, que se correlaciona con la intervención invasiva, frecuente en las Unidades de Cuidados Intensivos. No fue posible establecer diferenciación clara entre infección y colonización, y su asociación con la mortalidad de los pacientes.

Estudio de correlación entre la PaO2/FiO2 y la SO2/FiO2 en niños en ventilación mecánica de la Fundación Cardioinfantil en Bogotá entre Abril y Junio de 2011

Objetivos: Determinar si existe correlación entre las variables SaFiO2 y PaFiO2 de pacientes con patología respiratoria aguda en la unidad de Cuidado Intensivo Pediátrico, en la Fundación Cardioinfantil en la ciudad de Bogotá D.C. Materiales y métodos: Se analizaron las variables cuantitativas con medidas de tendencia central como la media y medidas de dispersión como la desviación estándar. Se utilizó un nivel de confiabilidad del 95% y un poder estimado 80%, para prueba de hipótesis de una proporción. Se realizó un análisis de correlación para medir la fuerza de la relación entre las variables PaO2/FiO2 y SO2/FiO2 a través del coeficiente de correlación. Resultados: Se incluyeron 12 pacientes y se tomaron un total de 65 registros de SO2/FiO2 y PaO2/FiO2 encontrando que existe relación positiva entre las variables SaO2/FIO2 y PaO2/FIO2, la cual es variable dependiendo de la fracción inspirada de oxigeno con el cual se encuentre el paciente. De acuerdo a las observaciones realizadas, la variable SaO2/FIO2 está moderadamente correlacionada (r = 0,602) con la PaO2/FIO2, cuando la FIO2 está entre 0.35 y 0.55; un grado de correlación aceptable (r = 0,319) cuando la FIO2 está entre 0.60 – 0.80 y 0.81 – 1 (r = 0,318). Conclusiones: Los métodos no invasivos en la evaluación de la oxigenación podrían ser una alternativa para el seguimiento clínico en niños con lesión pulmonar aguda o síndrome de dificultad respiratorio agudo. Se requiere de estudios analíticos que brinden una mejor evidencia científica que pueda ser extrapolable a la población infantil objeto de este estudio.

Presión arterial en preescolares de la localidad de Usaquén en Bogotá

Introducción: La hipertensión arterial es un problema de salud pública tanto en países industrializados como en vía de desarrollo. Su prevalencia en la infancia viene en aumento por lo que es relevante determinarla en niños preescolares a nivel local. Objetivo: Determinar la prevalencia de hipertensión arterial en niños de tres a cinco años de una cohorte de 14 hogares infantiles del ICBF de la localidad de Usaquén en Bogotá. Materiales y métodos: Se realizó un estudio de corte transversal analítico, utilizando la base de datos de un ensayo aleatorizado y controlado del año 200913, y se evaluaron las cifras de tensión arterial de acuerdo a sexo, edad, talla y su correlación con el IMC con un nivel de confianza del 95% y precisión del 1%. Se calcularon las medias, desviaciones estándar, percentiles y prevalencia. Resultados: Se obtuvo una muestra de 1035 casos, encontrándose una prevalencia de 4,5% de HTA sistólica, 10,4% de diastólica, ambas en estadio I; teniendo en cuenta tanto sistólica como diastólica, fue de 11,6% en estadio I. Se determinaron los valores de presión arterial sistólica y diastólica en cuartiles de acuerdo a edad, sexo y talla. El coeficiente de correlación entre el IMC y los niveles de presión arterial sistólica y diastólica fueron de 0.0992 y 0.0362 respectivamente. Conclusión: La prevalencia de HTA general fue de 11,6%, predominando la diastólica en estadio I en niños preescolares. No se encontró correlación entre el IMC y las cifras de tensión arterial sistólica y diastólica.

Accidentes de trabajo y enfermedades laborales de los mineros de socavón en Boyacá, Cundinamarca y Norte de Santander

RESUMEN. Introducción: la minería a cielo abierto y la subterránea, presentan altas cifras de lesiones asociadas a esta industria a nivel internacional. Países como Australia, algunos de Europa y Estados Unidos tienen avances en seguridad minera, tanto en lesiones fatales como no mortales; sin embargo, otros países no muestran el mismo desarrollo, ejemplo de ello son algunos países de África, China y países de Suramérica. Colombia, muestra un paupérrimo avance en seguridad minera, agravado por ausencia de registros de calidad para establecer políticas en salud y seguridad minera. Objetivo: describir los accidentes de trabajo (AT) y enfermedades laborales (EL) de dichos trabajadores y sus relaciones con tiempo de exposición y oficio. Metodología: estudio transversal con 476 trabajadores del el sector de minería. Se indago sobre los AT y EL de los mineros de socavón en los departamentos de Boyacá, Cundinamarca y Norte de Santander. Se realizó análisis estadístico con medidas de tendencia central y dispersión, estimación de prevalencia de AT y EL y pruebas de asociación Chi-cuadrado para identificar factores relacionados con las variables. Para las estimaciones de parámetros se empleó un nivel de confianza del 95% y las pruebas de asociación un nivel α de 0,05. Resultados: La edad en años de los trabajadores varió entre 20 y 76 años con una media general de 43 ± 10. La antigüedad laboral en años varió entre 10 y 57 años con una media general de 19,3±9,1. Los trabajadores con mayor promedio de antigüedad laboral fueron los de Cundinamarca (valor_p< 0.000). La incidencia de AT fue de 52,3%, IC (95% 47,7% – 56,9%) en los tres departamentos, siendo mayor en Boyacá. Las regiones anatómicas más comprometidas fueron miembros inferiores 32,2%, miembros superiores 26,9%, la cabeza y espalda con 9,9% respectivamente. La enfermedad laboral que más se diagnosticó, fue hernia de disco. Conclusiones: Este estudio muestra la magnitud del problema de la accidentalidad observada en los tres departamentos; la distribución de los accidentes en el sector minero, según la región anatómica, el tipo de lesión y su agente causal, esto será insumo para ayudar a la elaboración de políticas públicas, a nivel empresarial, de las Administradoras de Riesgos Laborales (ARL) y otros actores del Sistema de gestión de la Seguridad y Salud en el Trabajo (SGSST). Palabras clave: minería, exposición profesional, accidentes de trabajo, enfermedad laboral, Colombia.

Desenvolvimento de um método in vivo para melhor compreender a pele do obeso

O impacto da obesidade na fisiopatologia da pele humana parece relacionar-se com diversas dermatoses, resultado da alteração da sua fisiologia normal, incluindo alterações na função barreira e na função de “envelope”. Contudo, a informação disponível é ainda escassa devido às diversas complexidades do tema. Este trabalho pretende contribuir para a definição de uma metodologia de abordagem experimental para estudar, de forma objectiva, as alterações funcionais que caracterizam a pele obesa. O presente estudo, transversal, incluiu 28 voluntárias, do sexo feminino, saudáveis, com idade média 23±5 anos de idade, após consentimento informado. Foi realizada uma única medição de caracterização das diversas funções cutâneas obtidas por meios não invasivos em condições controladas. As variáveis consideradas relevantes foram, a hidratação (superficial e profunda) a função de barreira e o comportamento biomecânico, medidos em 4 áreas anatómicas distintas. Através do SPSS (v 20.0) realizámos uma análise estatística univariada com cálculo de medidas de tendência central e de dispersão. Recorremos aos testes de Pearson e de Spearman, para as variáveis que seguiam, ou não, uma distribuição normal, respectivamente, adoptando um grau de confiança de 95% . Os resultados permitem propor uma metodologia para o estudo da pele, aplicável ao doente obeso, incluindo a escolha das áreas anatómicas e das variáveis adequadas ao objetivo pretendido.

Explorando modelos in vivo para caracterizar a microcirculação periférica : um estudo piloto

Nos últimos anos, a circulação cutânea surgiu como uma janela interessante para analisar a função microcirculatória e os mecanismos de disfunção. Tecnologias não-invasivas, incluindo a Fluxometria por Laser Doppler (FLD), gasimetria transcutânea e a Perda Transepidérmica de Água (PTEA), ajudaram a considerar a circulação cutânea como um modelo de translação útil na doença vascular. Neste estudo procurou-se avaliar o perfil de resposta de um grupo de indivíduos jovens saudáveis ​​(n = 8), de ambos os sexos (24,5 ± 0,8 anos de idade) a três manobras de condicionamento da perfusão no membro inferior - A: elevação da perna enquanto sentado, B: elevação da perna enquanto em decúbito dorsal; C: oclusão supra-sistólica com um torniquete. As técnicas de medição incluiram FLD, pressões parciais transcutâneas (tc) pO2 e pCO2 por gasimetria e PTEA por evaporimetria. Foram aplicados testes de estatística descritiva e não paramétrica, sendo adotado um nível de confiança de 95%. As tcpO2 e tcpCO2 alteraram-se significativamente durante as manobras. Foi registado um perfil de evolução recíproca para FLD e PTEA em A e C, o que pode sugerir que, sob as condições experimentais as condições de perfusão local podem influenciar a função epidérmica "barreira". Os modelos propostos parecem ser adequados para caracterizar a microcirculação periférica in vivo, o que justifica estudos de desenvolvimento posteriores.

The frequency and dynamics of stratospheric sudden warmings in the 21st century

Changes to stratospheric sudden warmings (SSWs) over the coming century, as predicted by the Geophysical Fluid Dynamics Laboratory (GFDL) chemistry climate model [Atmospheric Model With Transport and Chemistry (AMTRAC)], are investigated in detail. Two sets of integrations, each a three-member ensemble, are analyzed. The first set is driven with observed climate forcings between 1960 and 2004; the second is driven with climate forcings from a coupled model run, including trace gas concentrations representing a midrange estimate of future anthropogenic emissions between 1990 and 2099. A small positive trend in the frequency of SSWs is found. This trend, amounting to 1 event/decade over a century, is statistically significant at the 90% confidence level and is consistent over the two sets of model integrations. Comparison of the model SSW climatology between the late 20th and 21st centuries shows that the increase is largest toward the end of the winter season. In contrast, the dynamical properties are not significantly altered in the coming century, despite the increase in SSW frequency. Owing to the intrinsic complexity of our model, the direct cause of the predicted trend in SSW frequency remains an open question.

Lagrangian validation of numerical drifter trajectories using drifting buoys: Application to the Agulhas system

The skill of numerical Lagrangian drifter trajectories in three numerical models is assessed by comparing these numerically obtained paths to the trajectories of drifting buoys in the real ocean. The skill assessment is performed using the two-sample Kolmogorov–Smirnov statistical test. To demonstrate the assessment procedure, it is applied to three different models of the Agulhas region. The test can either be performed using crossing positions of one-dimensional sections in order to test model performance in specific locations, or using the total two-dimensional data set of trajectories. The test yields four quantities: a binary decision of model skill, a confidence level which can be used as a measure of goodness-of-fit of the model, a test statistic which can be used to determine the sensitivity of the confidence level, and cumulative distribution functions that aid in the qualitative analysis. The ordering of models by their confidence levels is the same as the ordering based on the qualitative analysis, which suggests that the method is suited for model validation. Only one of the three models, a 1/10° two-way nested regional ocean model, might have skill in the Agulhas region. The other two models, a 1/2° global model and a 1/8° assimilative model, might have skill only on some sections in the region

Recent changes in solar outputs and the global mean surface temperature. III. Analysis of contributions to global mean air surface temperature rise

A multivariate fit to the variation in global mean surface air temperature anomaly over the past half century is presented. The fit procedure allows for the effect of response time on the waveform, amplitude and lag of each radiative forcing input, and each is allowed to have its own time constant. It is shown that the contribution of solar variability to the temperature trend since 1987 is small and downward; the best estimate is -1.3% and the 2sigma confidence level sets the uncertainty range of -0.7 to -1.9%. The result is the same if one quantifies the solar variation using galactic cosmic ray fluxes (for which the analysis can be extended back to 1953) or the most accurate total solar irradiance data composite. The rise in the global mean air surface temperatures is predominantly associated with a linear increase that represents the combined effects of changes in anthropogenic well-mixed greenhouse gases and aerosols, although, in recent decades, there is also a considerable contribution by a relative lack of major volcanic eruptions. The best estimate is that the anthropogenic factors contribute 75% of the rise since 1987, with an uncertainty range (set by the 2sigma confidence level using an AR(1) noise model) of 49–160%; thus, the uncertainty is large, but we can state that at least half of the temperature trend comes from the linear term and that this term could explain the entire rise. The results are consistent with the intergovernmental panel on climate change (IPCC) estimates of the changes in radiative forcing (given for 1961–1995) and are here combined with those estimates to find the response times, equilibrium climate sensitivities and pertinent heat capacities (i.e. the depth into the oceans to which a given radiative forcing variation penetrates) of the quasi-periodic (decadal-scale) input forcing variations. As shown by previous studies, the decadal-scale variations do not penetrate as deeply into the oceans as the longer term drifts and have shorter response times. Hence, conclusions about the response to century-scale forcing changes (and hence the associated equilibrium climate sensitivity and the temperature rise commitment) cannot be made from studies of the response to shorter period forcing changes.

Liquid ultraviolet matrix-assisted laser desorption/ionization - mass spectrometry for automated proteomic analysis

We have combined several key sample preparation steps for the use of a liquid matrix system to provide high analytical sensitivity in automated ultraviolet -- matrix-assisted laser desorption/ionisation -- mass spectrometry (UV-MALDI-MS). This new sample preparation protocol employs a matrix-mixture which is based on the glycerol matrix-mixture described by Sze et al. The low-femtomole sensitivity that is achievable with this new preparation protocol enables proteomic analysis of protein digests comparable to solid-state matrix systems. For automated data acquisition and analysis, the MALDI performance of this liquid matrix surpasses the conventional solid-state MALDI matrices. Besides the inherent general advantages of liquid samples for automated sample preparation and data acquisition the use of the presented liquid matrix significantly reduces the extent of unspecific ion signals in peptide mass fingerprints compared to typically used solid matrices, such as 2,5-dihydroxybenzoic acid (DHB) or alpha-cyano-hydroxycinnamic acid (CHCA). In particular, matrix and low-mass ion signals and ion signals resulting from cation adduct formation are dramatically reduced. Consequently, the confidence level of protein identification by peptide mass mapping of in-solution and in-gel digests is generally higher.

Liquid ultraviolet matrix-assisted laser desorption/ionization mass spectrometry for automated proteomic analysis

We have combined several key sample preparation steps for the use of a liquid matrix system to provide high analytical sensitivity in automated ultraviolet - matrix-assisted laser desorption/ ionisation - mass spectrometry (UV-MALDI-MS). This new sample preparation protocol employs a matrix-mixture which is based on the glycerol matrix-mixture described by Sze et al. U. Am. Soc. Mass Spectrom. 1998, 9, 166-174). The low-ferntomole sensitivity that is achievable with this new preparation protocol enables proteomic analysis of protein digests comparable to solid-state matrix systems. For automated data acquisition and analysis, the MALDI performance of this liquid matrix surpasses the conventional solid-state MALDI matrices. Besides the inherent general advantages of liquid samples for automated sample preparation and data acquisition the use of the presented liquid matrix significantly reduces the extent of unspecific ion signals in peptide mass fingerprints compared to typically used solid matrices, such as 2,5-dihydrox-ybenzoic acid (DHB) or alpha-cyano-hydroxycinnamic acid (CHCA). In particular, matrix and lowmass ion signals and ion signals resulting from cation adduct formation are dramatically reduced. Consequently, the confidence level of protein identification by peptide mass mapping of in-solution and in-gel digests is generally higher.

Observed changes in top-of-the-atmosphere radiation and upper-ocean heating consistent within uncertainty

Global climate change results from a small yet persistent imbalance between the amount of sunlight absorbed by Earth and the thermal radiation emitted back to space. An apparent inconsistency has been diagnosed between interannual variations in the net radiation imbalance inferred from satellite measurements and upper-ocean heating rate from in situ measurements, and this inconsistency has been interpreted as ‘missing energy’ in the system. Here we present a revised analysis of net radiation at the top of the atmosphere from satellite data, and we estimate ocean heat content, based on three independent sources. We find that the difference between the heat balance at the top of the atmosphere and upper-ocean heat content change is not statistically significant when accounting for observational uncertainties in ocean measurements, given transitions in instrumentation and sampling. Furthermore, variability in Earth’s energy imbalance relating to El Niño-Southern Oscillation is found to be consistent within observational uncertainties among the satellite measurements, a reanalysis model simulation and one of the ocean heat content records. We combine satellite data with ocean measurements to depths of 1,800 m, and show that between January 2001 and December 2010, Earth has been steadily accumulating energy at a rate of 0.50±0.43 Wm−2 (uncertainties at the 90% confidence level). We conclude that energy storage is continuing to increase in the sub-surface ocean.

On the statistical modeling of persistence in total ozone anomalies

Geophysical time series sometimes exhibit serial correlations that are stronger than can be captured by the commonly used first‐order autoregressive model. In this study we demonstrate that a power law statistical model serves as a useful upper bound for the persistence of total ozone anomalies on monthly to interannual timescales. Such a model is usually characterized by the Hurst exponent. We show that the estimation of the Hurst exponent in time series of total ozone is sensitive to various choices made in the statistical analysis, especially whether and how the deterministic (including periodic) signals are filtered from the time series, and the frequency range over which the estimation is made. In particular, care must be taken to ensure that the estimate of the Hurst exponent accurately represents the low‐frequency limit of the spectrum, which is the part that is relevant to long‐term correlations and the uncertainty of estimated trends. Otherwise, spurious results can be obtained. Based on this analysis, and using an updated equivalent effective stratospheric chlorine (EESC) function, we predict that an increase in total ozone attributable to EESC should be detectable at the 95% confidence level by 2015 at the latest in southern midlatitudes, and by 2020–2025 at the latest over 30°–45°N, with the time to detection increasing rapidly with latitude north of this range.

Evaluation of a photosynthesis-based biogenic isoprene emission scheme in JULES and simulation of isoprene emissions under present-day climate conditions

We have incorporated a semi-mechanistic isoprene emission module into the JULES land-surface scheme, as a first step towards a modelling tool that can be applied for studies of vegetation – atmospheric chemistry interactions, including chemistry-climate feedbacks. Here, we evaluate the coupled model against local above-canopy isoprene emission flux measurements from six flux tower sites as well as satellite-derived estimates of isoprene emission over tropical South America and east and south Asia. The model simulates diurnal variability well: correlation coefficients are significant (at the 95 % level) for all flux tower sites. The model reproduces day-to-day variability with significant correlations (at the 95 % confidence level) at four of the six flux tower sites. At the UMBS site, a complete set of seasonal observations is available for two years (2000 and 2002). The model reproduces the seasonal pattern of emission during 2002, but does less well in the year 2000. The model overestimates observed emissions at all sites, which is partially because it does not include isoprene loss through the canopy. Comparison with the satellite-derived isoprene-emission estimates suggests that the model simulates the main spatial patterns, seasonal and inter-annual variability over tropical regions. The model yields a global annual isoprene emission of 535 ± 9 TgC yr−1 during the 1990s, 78 % of which from forested areas.