Guía de educación sanitaria para pacientes con oxigenoterapia domiciliaria y ventilación mecánica no invasiva.

Las enfermedades del aparato respiratorio constituyen un problema de salud pública a nivel mundial por las altas tasas de morbilidad y mortalidad, absorbiendo una gran cantidad de recursos destinados a salud. Se define como oxigenoterapia el uso terapéutico del oxígeno y consiste en su administración a concentraciones mayores de las que se encuentran en el aire ambiente, con la intención de tratar o prevenir las manifestaciones de la hipoxia. Esta medida terapéutica ha demostrado aumentar la supervivencia en los enfermos con insuficiencia respiratoria. La aplicación de la terapéutica con oxígeno tiene las mismas exigencias de vigilancia que cualquier otro fármaco, haciendo imprescindible un correcto uso para obtener un tratamiento eficaz. La elección de la fuente de oxígeno se debe realizar por criterios técnicos, de comodidad, coste y de adaptabilidad para el paciente. La alta prevalencia de las patologías respiratorias en la sociedad hace que se considere prioritaria la elaboración de una guía educativa capaz de homogenizar un mínimo de aspectos básicos y de conocimientos, imprescindibles para el manejo de la oxigenoterapia en el domicilio, asegurándose así un tratamiento propio y eficaz de la enfermedad.Grado en Enfermerí

Reputation systems and secure communication in vehicular networks

A thorough review of the state of the art will reveal that most VANET applications rely on Public Key Infrastructure (PKI), which uses user certificates managed by a Certification Authority (CA) to handle security. By doing so, they constrain the ad-hoc nature of the VANET imposing a frequent connection to the CA to retrieve the Certificate Revocation List (CRL) and requiring some degree of roadside infrastructure to achieve that connection. Other solutions propose the usage of group signatures where users organize in groups and elect a group manager. The group manager will need to ensure that group members do not misbehave, i.e., do not spread false information, and if they do punish them, evict them from the group and report them to the CA; thus suffering from the same CRL retrieval problem. In this thesis we present a fourfold contribution to improve security in VANETs. First and foremost, Chains of Trust describes a reputation system where users disseminate Points of Interest (POIs) information over the network while their privacy remains protected. It uses asymmetric cryptography and users are responsible for the generation of their own pair of public and private keys. There is no central entity which stores the information users input into the system; instead, that information is kept distributed among the vehicles that make up the network. On top of that, this system requires no roadside infrastructure. Precisely, our main objective with Chains of Trust was to show that just by relying on people¿s driving habits and the sporadic nature of their encounters with other drivers a successful reputation system could be built. The second contribution of this thesis is the application simulator poiSim. Many¿s the time a new VANET application is presented and its authors back their findings using simulation results from renowned networks simulators like ns-2. The major issue with network simulators is that they were not designed with that purpose in mind and handling simulations with hundreds of nodes requires a massive processing power. As a result, authors run small simulations (between 50 and 100 nodes) with vehicles that move randomly in a squared area instead of using real maps, which rend unrealistic results. We show that by building tailored application simulators we can obtain more realistic results. The application simulator poiSim processes a realistic mobility trace produced by a Multi-agent Microscopic Traffic Simulator developed at ETH Zurich, which accurately describes the mobility patterns of 259,977 vehicles over regional maps of Switzerland for 24 hours. This simulation runs on a desktop PC and lasts approximately 120 minutes. In our third contribution we took Chains of Trust one step further in the protection of user privacy to develop Anonymous Chains of Trust. In this system users can temporarily exchange their identity with other users they trust, thus making it impossible for an attacker to know in all certainty who input a particular piece of information into the system. To the best of our knowledge, this is the first time this technique has been used in a reputation system. Finally, in our last contribution we explore a different form of communication for VANETs. The vast majority of VANET applications rely on the IEEE 802.11p/Wireless Access in Vehicular Environments (WAVE) standard or some other form of radio communication. This poses a security risk if we consider how vulnerable radio transmission is to intentional jamming and natural interferences: an attacker could easily block all radio communication in a certain area if his transmitter is powerful enough. Visual Light Communication (VLC), on the other hand, is resilient to jamming over a wide area because it relies on visible light to transmit information and ,unlike WAVE, it has no scalability problems. In this thesis we show that VLC is a secure and valuable form of communication in VANETs

Adrenomedullin in pancreatic carcinoma. a case-control study of 22 patients

Pancreatic carcinoma is a leading cause of cancer-related death. Reduction of the diagnostic delay is mandatory. Adrenomedullin (AM) is overexpressed in pancreatic cancer. A case-control study including 12 patients with pathological diagnosis of pancreatic carcinoma and 10 healthy controls was conducted at our Institution. Blood samples were obtained at the time of hospitalization and post-operatively for cases. Controls’ samples were obtained from healthy volunteers. AM was measured by using enzyme immunoassay method. AM showed significant increase in pancreatic carcinoma patients vs controls (4.51 ng/ml vs 1.91 ng/ml, p value = 0.04) regardless of tumor stage, differentiation, resecability/unresecability, diabetes. A cut-off of 1.75 ng/ml reaches a sensibility of 83% and a specificity of 70% (p value = 0.0147; CL 95%; AUC 0.767). The increase of AM didn’t correlate with the increase of other common tumor markers (CA 19-9 and CEA), nor direct bilirubin. These data confirm the utility of studying the role of AM in pancreatic cancer, in order to achieve an early diagnosis in high risk populations

Follow-up after curative resection for gastric cancer. Is it time to tailor it?

There is still no consensus on the follow-up frequency and regimen after curative resection for gastric cancer. Moreover, controversy exists regarding the utility of follow-up in improving survival, and the recommendations of experts and societies vary considerably. The main reason to establish surveillance programs is to diagnose tumor recurrence or metachronous cancers early and to thereby provide prompt treatment and prolong survival. In the setting of gastric malignancies, other reasons have been put forth: (1) the detection of adverse effects of a previous surgery, such as malnutrition or digestive sequelae; (2) the collection of data; and (3) the identification of psychological and/or social problems and provision of appropriate support to the patients. No randomized controlled trials on the role of follow-up after curative resection of gastric carcinoma have been published. Herein, the primary retrospective series and systematic reviews on this subject are analyzed and discussed. Furthermore, the guidelines from international and national scientific societies are discussed. Follow-up is recommended by the majority of institutions; however, there is no real evidence that follow-up can improve long-term survival rates. Several studies have demonstrated that it is possible to stratify patients submitted to curative gastrectomy into different classes according to the risk of recurrence. Furthermore, promising studies have identified several molecular markers that are related to the risk of relapse and to prognosis. Based on these premises, a promising strategy will be to tailor follow-up in relation to the patient and tumor characteristics, molecular marker status, and individual risk of recurrence

Conformis No

Treballs Finals de Grau de Belles arts. Facultat de Belles Arts. Universitat de Barcelona, Curs: 2017-2018, Tutor: Dalmau Sivila, Jordi[spa] Los temas tratados en este proyecto se nutren de una necesidad imperiosa de exteriorizar una incomodidad interna y personal frente a la conformidad y pasividad de nuestra sociedad. Un pensamiento individual, pero, a la vez, colectivo si hablamos de una comunidad. Años atrás, recién llegada de Bioquímica a Bellas Artes, sintiéndome en la piel de la oveja negra, forastera en el entorno y dado que mis proyectos no me realizaban, creía que no tenía nada que compartir, sólo era una máquina de creación hueca y marchita. ¿Querría hacer eso toda la vida? Evidentemente que no. Tras corregir el error que fue intentar buscar “mi arte” fuera de “mí”, topé con mis propios problemas, el trabajo. Once años inmersa en el mundo laboral, donde sin intención artística, había hecho performance para denunciar problemáticas, creado carteles e identificadores de protesta para conflictos internos, etc., y seguía buscando lo QUÉ quería transmitir con el arte. “¡Siempre te quejas, chica!” Qué razón tenéis. No me gusta esta situación laboral, no me gusta este gobierno corrupto falto de moral y de juicio (aunque de jueces van bien cubiertos...), no me gustan las injusticias, no lassoporto, ¿por qué no reclamamos? ¿Cuándo se pasó de activo a pasivo? “ConformisNo”, es un estado de ánimo y es la falta de ello, del no salto, un intento frustrado de salir de la zona de confort y visualizar lo que no me satisface sobre mí misma y sobre mi entorno. Mi intención es hacer del Artivismo una forma de vida, por lo que las instalaciones realizadas, no son una meta ni un objetivo finalizado (pese a que sí cumplen una finalidad como obra terminada), sino que, a mi forma de ver, son los primeros pasos del sendero que, al fin, se traza cada vez menos abrupto y moldeado según mis convicciones. El ciclo consta de cinco obras independientes pero atadas por el trasfondo del NO a la conformidad con que se acepta todo, una pequeña sacudida al espectador con la esperanza de la creación de un ligero empoderamiento del mismo.[eng] The issues that we are talking about in this project are nourished by an imperative need to externalize an internal and personal discomfort against of the conformity and passivity of our society. An individual thought but, at the same time, collective if we are talking about a community. A few years ago, recently arrived from Biochemistry to Arts, feeling like a black sheep, foreigner in this new place and since my projects didn’t realize me, I thought that there’s nothing to share with anyone, I was only a creative machine empty and withered. Would I want to do this all my life? Obviously not. After correcting the mistake that was trying to find “my art” out of “me”, I ran into my own problems, my job. Eleven years immersed in work issues, where without artistically intention, I made performances to report problems, I created posters and protest identifiers for internal conflicts, etc., and I still looking for WHAT I wanted to show with art.“Girl, you always complain!” You are right. I don’t like the professional work, I don’t like the corrupt government without moral and judgment right, I don’t like the unfair situations, I can’t stand them, why we don’t com-plain? When we crossed the line from the active to passive? “ConformisNo” is a state of mind and is the lack of it, no risks, a frustrated attempt to leave the comfort zone and visualize what doesn’t satisfy me about myself and my social environment. My intention is take the Artivism and transform it in a way of life, that’s why installations aren’t a goal or a finalized objective (although there are finished with a purpose), but, to my eyes, there are the first steps of the path that, finally, is traced step by step less rocky and more matching to my convictions.The cycle is about five independent works but tied by the background of the NO of the conformity that we accept everything, a small shake to the spectator with the hope of creating a slight empowerment in them

Serum Free Light Chains Removal by HFR Hemodiafiltration in Patients with Multiple Myeloma and Acute Kidney Injury. a Case Series

Background/Aims: Multiple myeloma (MM) represents 10% of all haematologic malignancies. Renal involvement occurs in 50% of MM patients; of them, 12-20% have acute kidney injury (AKI), with 10% needing dialysis at presentation. While hemodialysis (HD) has no effect upon circulating and tissue levels of monoclonal proteins, novel apheretic techniques aim at removing the paraproteins responsible for glomerular / tubular deposition disease. High cut-off HD (HCO-HD) combined with chemotherapy affords a sustained reduction of serum free light chains (FLC) levels. One alternative technology is haemodiafiltration with ultrafiltrate regeneration by adsorption on resin (HFR–SUPRA), employing a “super high-flux” membrane (polyphenylene S-HF, with a nominal cut-off of 42 kD). Aim of our pilot study was to analyze the effectiveness of HFR-SUPRA in reducing the burden of FLC, while minimizing albumin loss and hastening recovery of renal function in 6 subjects with MM complicated by AKI. Methods: Six HD-dependent patients with MM were treated with 5 consecutive sessions of HFR-SUPRA on a Bellco® monitor, while simultaneously initiating chemotherapy. Levels of albumin and FLC were assessed, calculating the rates of reduction. Renal outcome, HD withdrawal and clinical follow-up or death were recorded. Results: All patients showed a significant reduction of FLC, whereas serum albumin concentration remained unchanged. In three, HD was withdrawn, switching to a chemotherapy alone regimen. The other patients remained HD-dependent and died shortly thereafter for cardiovascular complications. Conclusion: Our study suggests that HFR-SUPRA provides a rapid and effective reduction in serum FLC in patients with MM and AKI

Art education at the museum : a study of the educational sectors of the Art Gallery and de Museum of Modern Art in São Paulo, Brazil

Orientador: Maria de Fatima Morethy CoutoDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de ArtesResumo: O presente trabalho apresenta um panorama das ações do setor educativo da Pinacoteca do Estado e do Museu de Arte Moderna de São Paulo. Os documentos históricos das instituições pesquisadas e as concepções teóricas de propostas do ensino da arte em instituições museológicas, nos diferentes períodos históricos, constituíram a base da pesquisa. Foram analisadas as parcerias, projetos e propostas efetivadas pelos setores educativos das instituições pesquisadas. A pesquisadora, valendo-se de sua experiência profissional acompanhou projetos de parceria entre as instituições pesquisadas e escolas públicas estaduais, o que possibilitou observar, verificar e considerar os pontos didáticos favoráveis e desfavoráveis ao público, a partir das ações oferecidas pelos setores educativos dos museus estudados.Abstract: This paper presents an overview of the actions of the education sector Pinacoteca of the State and the Modern Art Museum of São Paulo. The historical documents of the institutions surveyed and the proposed theoretical concepts of teaching art in museological institutions in different historical periods, formed the basis of the research. We analyzed the partnerships, projects and proposals for effective educational sectors of the institutions surveyed. The researcher, drawing on his professional experience is monitored projects in partnership between the institutions surveyed and state public schools, which allowed observe, verify and consider the teaching points favorable and unfavorable to the public from the shares offered by the educational sectors of museums studied.MestradoArtes VisuaisMestre em Arte

Campamento educativo en el medio natural

Este campamento es una herramienta educativa, en este caso destinado a los niños de 5º y 6º de primaria de un centro. Lo que queremos conseguir con él es que los alumnos salgan de su entorno de confort y empiecen a estar en contacto con la naturaleza, trabajando de una forma lúdica todas las asignaturas, dando realmente importancia a la educación física. En este trabajo nos pararemos a analizar qué son las actividades físicas en el medio natural y qué beneficios psicológicos, motrices, académicos y sociales nos aportan. También veremos qué son los campamentos y qué tipos existen. Disfrutaremos del proceso de creación, observaremos cómo elegimos el curso, el porqué de la ubicación del campamento, además de ver qué metodología usamos para poder conseguir los objetivos y competencias e inculcar los valores que trasmite el campamento, y planificaremos el día a día del campamento para que sea una experiencia única.Grado en Educación Primari

La dote en Roma y en el Derecho civil español: estudio comparativo

En torno a la dote giran la totalidad de las relaciones patrimoniales en Roma, convirtiéndose así, el sistema dotal, en el régimen característico, no sólo de Roma, sino también de las sociedades premodernas. De importancia internacional y permaneciendo presente en nuestro Derecho español hasta 1981, año en que desaparece mediante la Ley 13 de mayo 1981, se mantiene aún en algún que otro país y, en el caso nuestro, sigue latente en Derechos forales como el de Cataluña.Grado en Derech