A decision support system for elective surgery scheduling under uncertain durations

The operation room (OR) is one of the most expensive material resources in hospitals. Additionally, the demand for surgical service is increasing due to the aging population, while the number of surgical interventions performed is stagnated because of budget reasons. In this context, the importance of improving the efficiency of the surgical service is accentuated. The main objective of this work is to propose and to evaluate a Decision Support System (DSS) for helping medical staff in the automatic scheduling of elective patients, improving the efficiency of medical teams'' work. First, the scheduling criteria are fixed and then the scheduling problem of elective patients is approached by a mathematical programming model. A heuristic algorithm is proposed and included in the DSS. Moreover, other different features are implemented in a software tool with a friendly user interface, called CIPLAN. Considering realistic data, a simulation comparison of the scheduling obtained using the approach presented in this paper and other similar approaches in the bibliography is shown and analyzed. On the other hand, a case study considering real data provided by the Orthopedic Surgical Department (OSD) of the "Lozano Blesa" hospital in Zaragoza (HCU) is proposed. The simulation results show that the approach presented here obtains similar occupation rates and similar confidence levels of not exceeding the available time than approaches in the bibliography. However, from the point of view of respecting the order of the patients in the waiting list, the approach in this paper obtains scheduling much more ordered. In the case of the Orthopedic Surgical Department of the "Lozano Blesa" hospital in Zaragoza, the occupation rate may be increased by 2.83%, which represents a saving of 110, 000 euros per year. Moreover, medical doctors (who use this tool) consider CIPLAN as an intuitive, rapid and efficient software solution that can make easier the corresponding task

Tortugas marinas en aguas argentinas

Con la ayuda de los sensores remotos y los sistemas de posicionamiento geográfico, los científicos están descubriendo varias facetas sobre las vida de las tortugas marinas. Se describe el método para realizar el siguimiento satelital, sus migraciones, y se dan las características de las especies de tortugas marinas encontradas en aguas costeras de la Argentina. Este trabajo de divulgación científica hace hincapié en la importancia de su conservación, según la Unión Internacional para la Conservación de la Naturaleza, éstas se encuentran en peligro o en peligro crítico de extinción en todo el mundo. Se incluyen al final otras lecturas sugeridas sobre el tema

Pan-Atlantic analysis of the overlap of a highly migratory species, the leatherback turtle, with pelagic longline fisheries

Large oceanic migrants play important roles in ecosystems, yet many species are of conservation concern as a result of anthropogenic threats, of which incidental capture by fisheries is frequently identified. The last large populations of the leatherback turtle, Dermochelys coriacea, occur in the Atlantic Ocean, but interactions with industrial fisheries could jeopardize recent positive population trends, making bycatch mitigation a priority. Here, we perform the first pan-Atlantic analysis of spatio-temporal distribution of the leatherback turtle and ascertain overlap with longline fishing effort. Data suggest that the Atlantic probably consists of two regional management units: northern and southern (the latter including turtles breeding in South Africa). Although turtles and fisheries show highly diverse distributions, we highlight nine areas of high susceptibility to potential bycatch (four in the northern Atlantic and five in the southern/equatorial Atlantic) that are worthy of further targeted investigation and mitigation. These are reinforced by reports of leatherback bycatch at eight of these sites. International collaborative efforts are needed, especially from nations hosting regions where susceptibility to bycatch is likely to be high within their exclusive economic zone (northern Atlantic: Cape Verde, Gambia, Guinea Bissau, Mauritania, Senegal, Spain, USA and Western Sahara; southern Atlantic: Angola, Brazil, Namibia and UK) and from nations fishing in these high-susceptibility areas, including those located in international waters

Survival of several Rhizobium/Bradyrhizobium strains on different inoculant formulations and inoculated seeds

The effect of a variety factors on the survival of several rhizobia strains on inoculants and inoculated seeds has been evaluated. Since the rhizobia strains showed different cell-density-evolution patterns on peat-based inoculants and on inoculated seeds, several inoculant formulations with highly effective Rhizobium/ Bradyrhizobium strains (for Lupinus, Hedysarum, Phaseolus and Glycine max. ) were monitored under the following storage conditions: (a) the inoculants were kept refrigerated (at 4°C), or (b) at room temperature (25°C). The effect of water content (30–50%, w/w) in the inoculants as well as that of several seed-coating adhesives were also investigated. Alternative carriers including perlite and vermiculite were tested. For all of the strains, survival on sterile peat-based inoculants was higher than on the corresponding unsterile peat formulation; for the latter, refrigerated storage conditions are recommended to ensure high bacterial densities. The water content of the inoculants had a differential effect on strain survival depending on the sterility of the peat, such that a high water content was more detrimental when unsterilized peat was employed. The best adherent for rhizobia survival was a gum arabic/water solution. Perlite was as effective as peat in maintaining a high population of rhizobia, at least for 6 months of storage

Polyfunctional T cell responses in children in early stages of chronic Trypanosoma cruzi infection contrast with monofunctional responses of long-term infected adults

Background: Adults with chronic Trypanosoma cruzi exhibit a poorly functional T cell compartment, characterized by monofunctional (IFN-γ-only secreting) parasite-specific T cells and increased levels of terminally differentiated T cells. It is possible that persistent infection and/or sustained exposure to parasites antigens may lead to a progressive loss of function of the immune T cells. Methodology/Principal Findings: To test this hypothesis, the quality and magnitude of T. cruzi-specific T cell responses were evaluated in T. cruzi-infected children and compared with long-term T. cruzi-infected adults with no evidence of heart failure. The phenotype of CD4+ T cells was also assessed in T. cruzi-infected children and uninfected controls. Simultaneous secretion of IFN-γ and IL-2 measured by ELISPOT assays in response to T. cruzi antigens was prevalent among T. cruzi-infected children. Flow cytometric analysis of co-expression profiles of CD4+ T cells with the ability to produce IFN-γ, TNF-α, or to express the co-stimulatory molecule CD154 in response to T. cruzi showed polyfunctional T cell responses in most T. cruzi-infected children. Monofunctional T cell responses and an absence of CD4+TNF-α+-secreting T cells were observed in T. cruzi-infected adults. A relatively high degree of activation and differentiation of CD4+ T cells was evident in T. cruzi-infected children. Conclusions/Significance: Our observations are compatible with our initial hypothesis that persistent T. cruzi infection promotes eventual exhaustion of immune system, which might contribute to disease progression in long-term infected subjects.Fil: Albareda, María Cecilia. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud. Instituto Nacional de Parasitología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal de Agudos "Eva Perón"; ArgentinaFil: de Rissio, Ana María. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud. Instituto Nacional de Parasitología; ArgentinaFil: Tomas, Gonzalo. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud. Instituto Nacional de Parasitología; ArgentinaFil: Serjan, Alicia. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos "Juan A. Fernández"; ArgentinaFil: Alvarez, María Gabriela. Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal de Agudos "Eva Perón"; ArgentinaFil: Viotti, Rodolfo Jorge. Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal de Agudos "Eva Perón"; ArgentinaFil: Fichera, Laura Edith. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud. Instituto Nacional de Parasitología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Esteva, Mónica Inés. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud. Instituto Nacional de Parasitología; ArgentinaFil: Potente, Daniel Fernando. Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal de Agudos "Eva Perón"; ArgentinaFil: Armenti, Alejandro. Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal de Agudos "Eva Perón"; ArgentinaFil: Tarleton, Rick L.. University of Georgia; Estados UnidosFil: Laucella, Susana Adriana. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud. Instituto Nacional de Parasitología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Many-particle Hamiltonian for open systems with full Coulomb interaction: Application to classical and quantum time-dependent simulations of nanoscale electron devices

Premi a l'excel·lència investigadora. Àmbit de les Ciències Tecnològiques i Enginyeries. 2010A many-particle Hamiltonian for a set of particles with Coulomb interaction inside an open system is described without any perturbative or mean-field approximation. The boundary conditions of the Hamiltonian on the borders of the open system [in the real three-dimensional (3D) space representation] are discussed in detail to include the Coulomb interaction between particles inside and outside of the open system. The many-particle Hamiltonian provides the same electrostatic description obtained from the image-charge method, but it has the fundamental advantage that it can be directly implemented into realistic (classical or quantum) electron device simulators via a 3D Poisson solver. Classically, the solution of this many-particle Hamiltonian is obtained via a coupled system of Newton-type equations with a different electric field for each particle. The quantum-mechanical solution of this many-particle Hamiltonian is achieved using the quantum (Bohm) trajectory algorithm [X. Oriols, Phys. Rev. Lett. 98, 066803 (2007)]. The computational viability of the many-particle algorithms to build powerful nanoscale device simulators is explicitly demonstrated for a (classical) double-gate field-effect transistor and a (quantum) resonant tunneling diode. The numerical results are compared with those computed from time-dependent mean-field algorithms showing important quantitative differences

Pan-Atlantic analysis of the overlap of a highly migratory species, the leatherback turtle, with pelagic longline fisheries

This is the final version of the article. Available from the publisher via the DOI in this record.Large oceanic migrants play important roles in ecosystems, yet many species are of conservation concern as a result of anthropogenic threats, of which incidental capture by fisheries is frequently identified. The last large populations of the leatherback turtle, Dermochelys coriacea, occur in the Atlantic Ocean, but interactions with industrial fisheries could jeopardize recent positive population trends, making bycatch mitigation a priority. Here, we perform the first pan-Atlantic analysis of spatio-temporal distribution of the leatherback turtle and ascertain overlap with longline fishing effort. Data suggest that the Atlantic probably consists of two regional management units: northern and southern (the latter including turtles breeding in South Africa). Although turtles and fisheries show highly diverse distributions, we highlight nine areas of high susceptibility to potential bycatch (four in the northern Atlantic and five in the southern/equatorial Atlantic) that are worthy of further targeted investigation and mitigation. These are reinforced by reports of leatherback bycatch at eight of these sites. International collaborative efforts are needed, especially from nations hosting regions where susceptibility to bycatch is likely to be high within their exclusive economic zone (northern Atlantic: Cape Verde, Gambia, Guinea Bissau, Mauritania, Senegal, Spain, USA and Western Sahara; southern Atlantic: Angola, Brazil, Namibia and UK) and from nations fishing in these high-susceptibility areas, including those located in international waters.Work in Gabon was financially supported by the Large Pelagics Research Center through National Oceanographic and Atmospheric Agency award no. NA04NMF4550391, the UK Defra Darwin Initiative, the Shellshock Campaign (European Association for Zoos and Aquaria) and the UK Natural Environment Research Council. Sea turtle monitoring programmes in Gabon were financially supported by the Wildlife Conservation Society and by the Gabon Sea Turtle Partnership with funding from the Marine Turtle Conservation Fund (United States Fish and Wildlife Service, US Department of the Interior). Four of the satellite tags were deployed in Canadian waters by M. James (Dalhousie University) and the Canadian Sea Turtle Network, with the funding support of Canadian Sea Turtle Network leatherback field research provided by R. A. Myers, the Canadian Wildlife Federation, Environment Canada and WWF-Canada. Work in French Guiana was financially supported by CNES, DEAL and the European Union.This study results from the collaborative effort of 10 data providers, which have satellite-tracked leatherback turtles in the Atlantic Ocean since 1995, through their voluntary participation in the Trans-Atlantic Leatherback Conservation Initiative (TALCIN), a WWF-led initiative. We thank C. Drews (WWF-International) and Jean-Yves Georges (IPHC-CNRS) for having initiated this project. Significant contributions were made by A. Fonseca and M. L. Felix and the WWF Guianas office in fostering this project to secure its continuation. We thank those involved in the sea turtle restoration plan in French Guiana (DEAL, ONCFS, Kulalasi NGO, Kwata, the Reserve Naturelle de l'Amana, Chiefs of Awala and Yalimapo), Yvon Le Maho (IPHC-CNRS) for having initiated the leatherback tracking programme in French Guiana, colleagues from the Regional Program for Sea Turtles Research and Conservation of Argentina–PRICTMA, Aquamarina and Fundación Mundo Marino, the onboard scientific observers from PNOFA-DINARA, the crew and owner of the F/V Torres del Paine, the artisanal fishermen from Kiyú, San José, Uruguay, D. del Bene (PROFAUMA), Z. Di Rienzo and colleagues from Karumbé, the University of Pisa for initiating the satellite tagging programmes in South Africa, and the South African Department of Environmental Affairs for continuing the work in cooperation with Dr Nel from the Nelson Mandela Metropolitan University, Port Elizabeth and Ezemvelo KZN Wildlife. We thank M. L. Felix for her efforts in the deployment of satellite tags in Suriname and the Nature Conservation Division Suriname for facilitating these research efforts. P.M. thanks C. Palma for his help in dealing with ICCAT's database, C. Ere, as well as the GIS training and support received from SCGIS and the ESRI Conservation Program, which allowed processing of fishing-effort data. We thank J. Parezo for her careful reading of the manuscript. All authors designed the study and contributed data; S.F, M.S.C., P.M. and M.J.W. compiled the data; S.F., M.A.N. and A.L. coordinated and supervised the project; S.F., M.J.W., P.M. and B.J.G. led the data analysis and interpretation with contributions from all authors; the manuscript was developed by S.F. and M.J.W. as lead authors, with contributions from all authors

Biosynthesis of Salmonella enterica [NiFe]-hydrogenase-5 : probing the roles of system-specific accessory proteins

A subset of bacterial [NiFe]-hydrogenases have been shown to be capable of activating dihydrogen-catalysis under aerobic conditions; however, it remains relatively unclear how the assembly and activation of these enzymes is carried out in the presence of air. Acquiring this knowledge is important if a generic method for achieving production of O2-resistant [NiFe]-hydrogenases within heterologous hosts is to be developed. Salmonella enterica serovar Typhimurium synthesizes the [NiFe]-hydrogenase-5 (Hyd-5) enzyme under aerobic conditions. As well as structural genes, the Hyd-5 operon also contains several accessory genes that are predicted to be involved in different stages of biosynthesis of the enzyme. In this work, deletions in the hydF, hydG, and hydH genes have been constructed. The hydF gene encodes a protein related to Ralstonia eutropha HoxO, which is known to interact with the small subunit of a [NiFe]-hydrogenase. HydG is predicted to be a fusion of the R. eutropha HoxQ and HoxR proteins, both of which have been implicated in the biosynthesis of an O2-tolerant hydrogenase, and HydH is a homologue of R. eutropha HoxV, which is a scaffold for [NiFe] cofactor assembly. It is shown here that HydG and HydH play essential roles in Hyd-5 biosynthesis. Hyd-5 can be isolated and characterized from a ΔhydF strain, indicating that HydF may not play the same vital role as the orthologous HoxO. This study, therefore, emphasises differences that can be observed when comparing the function of hydrogenase maturases in different biological systems

Inhibitory Receptors Are Expressed by Trypanosoma cruzi-Specific Effector T Cells and in Hearts of Subjects with Chronic Chagas Disease

We had formerly demonstrated that subjects chronically infected with Trypanosoma cruzi show impaired T cell responses closely linked with a process of T cell exhaustion. Recently, the expression of several inhibitory receptors has been associated with T cell dysfunction and exhaustion. In this study, we have examined the expression of the cytotoxic T lymphocyte antigen 4 (CTLA-4) and the leukocyte immunoglobulin like receptor 1 (LIR-1) by peripheral T. cruzi antigen-responsive IFN-gamma (IFN-γ)-producing and total T cells from chronically T. cruzi-infected subjects with different clinical forms of the disease. CTAL-4 expression was also evaluated in heart tissue sections from subjects with severe myocarditis. The majority of IFN-γ-producing CD4+ T cells responsive to a parasite lysate preparation were found to express CTLA-4 but considerably lower frequencies express LIR-1, irrespective of the clinical status of the donor. Conversely, few IFN-γ-producing T cells responsive to tetanus and diphtheria toxoids expressed CTLA-4 and LIR-1. Polyclonal stimulation with anti-CD3 antibodies induced higher frequencies of CD4+CTAL-4+ T cells in patients with severe heart disease than in asymptomatic subjects. Ligation of CTLA-4 and LIR-1 with their agonistic antibodies, in vitro, reduces IFN-γ production. Conversely, CTLA-4 blockade did not improved IFN-γ production in response to T. cruzi antigens. Subjects with chronic T. cruzi infection had increased numbers of CD4+LIR-1+ among total peripheral blood mononuclear cells, relative to uninfected individuals and these numbers decreased after treatment with benznidazole. CTLA-4 was also expressed by CD3+ T lymphocytes infiltrating heart tissues from chronically infected subjects with severe myocarditis. These findings support the conclusion that persistent infection with T. cruzi leads to the upregulation of inhibitory receptors which could alter parasite specific T cell responses in the chronic phase of Chagas disease