Sobrecarga del cuidador principal en la Unidad de Ortogeriatría del Hospital "San José" de Teruel

La familia es quien suministra la mayor parte de los cuidados necesarios, pasando a ser una población clínicamente vulnerable por la posible sobrecarga que conlleva dicha labor. El objetivo principal de nuestro estudio es evaluar el índice de sobrecarga del cuidador principal así como el nivel de dependencia de los pacientes cuidados y ,como objetivos secundarios, definir las características de los pacientes, así como las de sus respectivos cuidadores principales. Estudio transversal descriptivo, en 31 pacientes y sus respectivos cuidadores. Se analizaron variables sociodemográficas tanto del paciente como del cuidador. La sobrecarga del cuidador se evaluó mediante la Escala de Sobrecarga de Zarit y el nivel de dependencia del paciente con el Índice de Barthel. Como resultados de nuestro estudio se obtuvo una media de edad de los pacientes fue 81,87años. El 71% eran mujeres que procedían del medio rural (64,5%). El 48,4% presentaron dependencia leve en el momento del alta. El 67,7% de los cuidadores principales fueron mujeres con una media de edad de 58,38 años, casadas el 76,7% de los casos y cuyo vínculo más frecuente era hija (54,5%). El 74,2% no presentaron ninguna sobrecarga

Pattern Recognition Techniques Implementation on Data from In-Line Inspection (ILI)

PresentationOnshore pipeline failure caused by corrosion represents about 16% of the overall number of incidents during the period from 2004 to 2011 according to databases such as CONCAWE and PHMSA. In-Line Inspection (ILI) is one of the available inspection techniques used to determine overall pipeline status, highlighted because it establishes a clear perspective of inner and outer condition of the pipe against the failure modes and wall thickness. Furthermore, it supports measures to prevent risk based on standards such as ASMEB31G or API579-1/ASME FFS-1. However, this approximation could represent a conservative assessment of the pipeline status, taking into account the uncertainty associated with ILI inspection tools such as MFL and UT. Several researches have been conducted to analyze available inspection techniques attempting to reduce noise generated by their inspection tools, and determine procedures in order to establish correct metal loss detection, excelling pattern recognition analysis and reliability concepts. Therefore this work seeks to transform a set of data obtained from two ILI runs, into useful information to support decision making in risk analysis based on pattern recognition techniques and reliability concepts, in order to obtain base failure frequencies for prior analysis from individual and grouped flaws. Moreover, growth corrosion and remaining life models supported on the standards mentioned above were evaluated using a pressure failure criteria. As a result it was obtained that the failure probability of the grouped flaws increases 10% in comparison with the corresponding flaws evaluated individually

p-facility Huff location problem on networks

The p-facility Huff location problem aims at locating facilities on a competitive environment so as to maximize the market share. While it has been deeply studied in the field of continuous location, in this paper we study the p-facility Huff location problem on networks formulated as a Mixed Integer Nonlinear Programming problem that can be solved by a branch-and-bound algorithm. We propose two approaches for the initialization and division of subproblems, the first one based on the straightforward idea of enumerating every possible combination of p edges of the network as possible locations, and the second one defining sophisticated data structures that exploit the structure of the combinatorial and continuous part of the problem. Bounding rules are designed using DC (difference of convex) and Interval Analysis tools. In our computational study we compare the two approaches on a battery of 21 networks and show that both of them can handle problems for p ≤ 4 in reasonable computing time.Ministerio de Economía y CompetitividadJunta de AndalucíaHungarian National Research, Development and Innovation OfficeInformation and Communication Technologies COS

Modeling of pipeline corrosion degradation mechanism with a Lévy Process based on ILI (In-Line) inspections

International audienceIn pipelines, one of the primary testing procedures used to identify the e↵ects and evolution of corrosion over time is through In-Line Inspections (ILI). ILI inspections provide detailed information regarding the inner and outer pipeline condition based on the remaining wall thickness. Based on this information, di↵erent approaches have been proposed to predict the degradation extent of the defects detected. However, these predictions are subject of uncertainties due to the inspection tool and the degradation process that poses some challenges for assessing an entire pipeline within the timespan between two inspections. To address this problem, ILI data was used to formulate a degradation model for steel-pipe degradation based on a Mixed Lévy Process. The model combines a Gamma and Compound Poisson Processes aimed for a better description of the degradation reported by the ILI data. The model seeks to estimate corrosion lifetime distribution and the mean time to failure (MTTF) more accurately. The model was tested on an actual segment of an oil pipeline, and the results have been used to support a preventive maintenance program

Crater formation by the rupture of underground natural gas pipelines: a probabilistic-based model

Parallel and crossing pipelines are frequently implemented due to land-use restrictions and their ease of operation and maintenance. Given the proximity of these pipelines and the hazardousness of the substances they transport, an eventual Loss of Containment (LOC) in a parallel/crossing corridor can lead to a domino effect that should be considered in Quantitative Risk Analysis (QRA). For underground pipelines, this LOC is accompanied by a formation of a crater, which can uncover adjacent pipelines triggering a domino effect scenario to take place. This paper aims to develop a model to predict feasible crater dimensions (i.e., width and depth) from a LOC in underground natural gas pipelines using operational and structural parameters. For this purpose, a recent review of 57 underground natural gas pipeline accidents were considered in a probability-based approach once data was processed. This approach initially predicts the Width-to-Depth crater ratio (WD) using a multivariate regression. Then feasible crater dimensions were determined using the regression prediction interval and the width-depth joint probability function, which is approximated with a Gaussian copula. This approach proposes a worst, mean and less severe scenarios to support decision-making processes regarding parallel or crossing underground natural gas pipelines with a LOC. Besides the identification of domino effect scenarios, this information can be used to support pipeline segmentation for risk analysis or even to support Right-of-Way (ROW) definition during pipeline installation.Peer ReviewedPostprint (author's final draft

Analysis of crater formation in buried NG pipelines: A survey based on past accidents and evaluation of domino effect

The formation of a crater by the abrupt and catastrophic rupture of a high-pressure pipeline can be highly relevant, especially when the crater uncovers other pipelines, which could undergo a domino effect with a significant increase of the consequences on people or on the environment. However, this scenario has been only partially studied in the literature. To assess the influence of the pipeline parameters on the dimensions of the resulting crater, a statistical analysis of accidental ruptures of buried natural gas pipelines that have involved the formation of a crater was carried out. Mathematical expressions are proposed to describe the proportionality relationships found, which can be very useful to support adequate separation distances in the design and construction of parallel corridors of pipelines after appropriate escalating effects are considered. Finally, detailed event trees were developed to calculate the probability of occurrence of the final outcomes, as well as the identified domino sequences, based on a qualitative and quantitative analysis of the data. The study of these accident scenarios, based on actual cases, represents a useful and needed advance in risk analysis of natural gas transportation through pipelinesPostprint (author's final draft

Andean bear (Tremarctos ornatus) population density and relative abundance at the buffer zone of the Chingaza National Natural Park, cordillera oriental of the Colombian Andes

The Andean bear (Tremarctos ornatus) population density and relative abundance within the Chingaza Massif were assessed between September 2015 and May 2016. One hundred seventeen (117) camera traps were installed at 9 grids: 13 cameras per grid, each camera separated 750 m from the other; the sampling effort was 17,057 days-trap. Two thousand seven hundred eighty-four (2,784) native fauna records were obtained, 1,456 corresponding to mammals, 183 records for Andean bear specimens, 158 of them independent bear records (at least one hour between records), and 106 effective-independent bear records (also permitting individual recognition). Fifty-seven (57) Andean bear individuals were identified according to key external morphological features. Sixteen (16) adults were recaptured (12 males and 4 females), with a maximum mean distance of 27.22 km. Bears population density was 2.9 bears per 100 km². Based on this density and the buffer area of the sampling grids, we estimated an overall number of 122 bears in 4,215.15 km². The estimated density is the first for the species in Colombia and the lowest regarding previous reports from other countries. Thus, it is necessary to better understand how integral habitat quality and the anthropic impacts on habitat quality, availability, and connectivity may affect the Andean bear population densities in Colombia, as a useful tool for assessing populations` state and focus future conservation actions.Fil: Rodríguez, Daniel. Protección y Conservación del Oso Andino (fundación Wii); ColombiaFil: Reyes, Adriana. Protección y Conservación del Oso Andino (fundación Wii); ColombiaFil: Quiñones Guerrero, Andres. Protección y Conservación del Oso Andino (fundación Wii); ColombiaFil: Poveda Gómez, Fidel Ernesto. Corporación Manaba (manaba); ColombiaFil: Castillo-Navarro, Yeimy. Protección y Conservación del Oso Andino (fundación Wii); ColombiaFil: Duque, Robinson. Empresa de Acueducto y Alcantarillado de Bogotá E.s.p.; ColombiaFil: Reyes Amaya, Nicolás Rafael. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico - Tucumán. Unidad Ejecutora Lillo; Argentin

La Gran Moral. MacIntyre y el carácter integrador de la filosofía perenne

En el mundo académico contemporáneo han venido tomando fuerza, desde hace varias décadas, los temas de la interdisciplinariedad y la transdisciplinariedad, como respuesta de un sector de la comunidad científica a los problemas de la especialización y a la desconexión entre las ciencias. Como todo elemento o aspecto de la realidad, este tema requiere de una debida fundamentación filosófica que se encuentra en el pensamiento clásico. En el presente artículo se intenta mostrar la relación entre la tradición de la filosofía perenne y este fundamento, atendiendo, sobre todo, a la importancia de la mirada holística del fenómeno ético y pretendiendo sustentar que el diálogo entre las ciencias sólo es posible rescatando el paradigma metafísico, legado por los griegos a la civilización occidental y defendido por MacIntyre en su libro "Ethics in the Conflicts of Modernity. An Essay on Desire, Practical Reasoning, and Narrative" (University of Cambridge, 2016)

Clinical Heterogeneity of Pulmonary Arterial Hypertension Associated With Variants in TBX4

Background: The knowledge of hereditary predisposition has changed our understanding of Pulmonary Arterial Hypertension. Genetic testing has been widely extended and the application of Pulmonary Arterial Hypertension specific gene panels has allowed its inclusion in the diagnostic workup and increase the diagnostic ratio compared to the traditional sequencing techniques. This is particularly important in the differential diagnosis between Pulmonary Arterial Hypertension and Pulmonary Venoocclusive Disease. Methods: Since November 2011, genetic testing is offered to all patients with idiopathic, hereditable and associated forms of Pulmonary Arterial Hypertension or Pulmonary Venoocclusive Disease included in the Spanish Registry of Pulmonary Arterial Hypertension. Herein, we present the clinical phenotype and prognosis of all Pulmonary Arterial Hypertension patients with disease-associated variants in TBX4. Results: Out of 579 adults and 45 children, we found in eight patients from seven families, disease-causing associated variants in TBX4. All adult patients had a moderate-severe reduction in diffusion capacity. However, we observed a wide spectrum of clinical presentations, including Pulmonary Venoocclusive Disease suspicion, interstitial lung disease, pulmonary vascular abnormalities and congenital heart disease. Conclusions: Genetic testing is now essential for a correct diagnosis work-up in Pulmonary Arterial Hypertension. TBX4-associated Pulmonary Arterial Hypertension has marked clinical heterogeneity. In this regard, a genetic study is extremely useful to obtain an accurate diagnosis and provide appropriate management.This project was founded by Project "Bases Gene´tico Moleculares de la Medicina de Precisio´n en la Hipertensio´n Arterial Pulmonar". Funder: Instituto Carlos III. Ministerio de Economı´a y Competitividad. https://www.isciii.es/Paginas/Inicio.aspx Award number: PI 18/01233 Grant Recipient: P E-

Familial hypercholesterolaemia: A study of 36 cases with a phenotype of homozygous familiar hypercholesterolaemia

La hipercolesterolemia familiar homocigótica (HFHo) se caracteriza por niveles muy elevados de cLDL y por enfermedad aterosclerótica temprana. Aunque la frecuencia es baja (1/300.000), las complicaciones son muy severas y pueden ser evitadas. Encontrar y tratar esta población de manera temprana podría reducir la mortalidad. Se describen 36 casos en Colombia, en donde se calcula que haya entre 160 y 200 casos. Resultados Un total de 36 pacientes con fenotipo sugestivo de HFHo fueron identificados y tratados en un período de observación de cuatro años. La media de edad fue 27 años (24 mujeres). 34 pacientes tuvieron un puntaje según la Red de Clínicas de Lípidos de Holanda (RCLH) mayor de 8 (diagnóstico definitivo) y los restantes 2 tenían puntaje equivalente a diagnóstico probable. Un cuarto de los casos procedían de la costa norte colombiana. En las pruebas genéticas, 14 fueron homocigóticos verdaderos para mutación del gen que codifica para el receptor de LDL (LDLR), 12 heterocigóticos compuestos, 2 heterocigóticos dobles y uno autosómico recesivo (LDLRAP1); 5 pacientes fueron heterocigóticos simples (LDLR) y 2 pacientes no autorizaron la prueba. En los homocigóticos verdaderos, la variante más frecuente encontrada fue la c.11G>A. 14 pacientes cursaron con enfermedad coronaria, 9 con estenosis carotídea, 8 con estenosis aórtica y 2 tuvieron ataques cerebrovasculares (ACV). 34 pacientes recibían estatinas (24 rosuvastatina), 30 recibían ezetimibe, 2 recibían evolocumab y 20 recibían lomitapide (dosis promedio 12,7mg). Ninguno recibió aféresis de cLDL. Los medicamentos, en general, fueron bien tolerados y la reducción promedio de cLDL con la terapia fue de 533,7mg/dl a 245,1mg/dl (54%). Conclusiones Todos los pacientes recibieron tratamiento hipolipemiante y se encontraron alteraciones genéticas diagnósticas en todos aquellos que autorizaron el examen. Los niveles elevados de cLDL conllevan tanto riesgo que el tratamiento debe establecerse aún sin conocer el diagnóstico genético.Homozygous familial hypercholesterolemia (HoFH) is characterized for very high levels of cLDL and early cardiovascular disease. Although incidence is low (1/300 000), complications are very severe and can be avoided. Finding and treating this population promptly could reduce mortality. We describe 36 cases in Colombia, where 160 to 200 cases are expected. Results 36 patients with phenotype of HoHF were identified and treated in a follow-up of 4 years. The mean age was 27 years (24 women). 34 of them had at least 8 points in the FH Dutch Lipid Clinic Criteria (definitive diagnosis) and two had probable diagnosis. A quarter of the cases came from the Colombian North Coast. In molecular tests, 14 were true homozygous for LDLR, 12 were compound heterozygous for LDLR, 2 double heterozygous and one was autosomal recessive; 5 were heterozygous and 2 patients did not authorized genetic test. In true homozygous subjects, the most frequent variant was c.11G>A. 14 patients had coronary disease, 9 carotid stenosis, 8 aortic stenosis and 2 had stroke. 34 patients were on statins (25 rosuvastatin), 30 were receiving ezetimibe, 2 were receiving a PSCK9 inhibitor (evolocumab) and 20 were on lomitapide with mean doses of 12.7mg. None received lipoprotein apheresis. Medications were very well tolerated. Changes in cLDL after therapy was from 533.7 mg/dL to 245 mg/dL, (54%). Conclusions Treatment was started in all patients. We found genetic mutations in all patients with genetic tests. The high levels of cLDL mean such a high risk that treatment must be started promptly, even without a genetic test