Estudio tafonómico de los macrovertebrados de yacimientos delPleistocenoMedio.

Sin resume

Joint route selection and split level management for 5G C-RAN

This work tackles the problem faced by network/infrastructure providers of jointly selecting routing and functional split level to satisfy requests from virtual mobile network operators (vMNOs). We build a novel system model that brings together all the involved elements and features, embracing split levels defined by the 3GPP and packet switch fronthaul network. To our best knowledge, this is the first work that provides a solution for multiple vMNO requests considering the two aforementioned sub-problems (i.e. split selection and routing). We use the model defined to formulate an optimization problem, which is characterized by the exponential size of its search space. We propose two heuristic approaches to address this problem: (1) a greedy scheme, and (2) an evolutionary algorithm, which is also improved with a specialized initialization. We conduct extensive experiments to assess the performance and behavior of the proposed methods, over varying network instances. When possible, we also perform comparisons with respect to the optimal solution and a well-known commercial solver. Our results indicate that the proposed techniques represent appropriate trade-offs between solution quality and execution time, and can serve complementary goals: the quality of the results yielded by our evolutionary method are better, but at the cost of longer execution times; in contrast, our greedy algorithm offers a reasonably appropriate performance, with an execution time that is notably lower. Our experiments show that it is possible to produce near-optimal results to the above complex problem through computationally efficient algorithmic solutions.This paper has been partially supported by the Secretary of Public Education of Mexico (SEP) and Cinvestav through research grant 262, and the National Council of Research and Technology (CONACYT) through grant ERANetLACFONCICYT No. 272278. Luis Diez and Ramon Agüero acknowledge the funding by the Spanish Government (Ministerio de Economía y Competitividad, Fondo Europeo de Desarrollo Regional, MINECO-FEDER) by means of the project FIERCE: Future Internet Enabled Resilient smart CitiEs (RTI2018-093475-AI00)

TP86 154. ¿Es útil el sistema de asistencia oxigenador de membrana extracorpórea en el tromboembolismo pulmonar masivo?

IntroducciónEn España, en series de autopsias se ha descubierto que la causa de muerte es un tromboembolismo pulmonar (TEP) en un 2,6%. La aparición de esta enfermedad está claramente aumentada en los pacientes oncológicos. En ocasiones las medidas clásicas del tratamiento del TEP no surgen efecto y el paciente puede fallecer; en estos casos está indicada la implantación de una asistencia cardiorrespiratoria.Material y métodosPaciente de 35 años con quimioterapia por un seminoma. Ingresa por disnea y dolor torácico con mala evolución. Se traslada a unidad de coronarias donde se diagnostica de un TEP bilateral masivo y disfunción importante ventricular derecha presentando dos episodios de parada cardiorrespiratoria. Tras las maniobras de resucitación se implanta oxigenador de membrana extracorpórea (ECMO) venoarterial que se mantiene 5 días, mientras tanto se hepariniza al paciente completamente.ResultadosEl paciente es extubado y dado de alta a los 21 días. Tras un seguimiento de 20 meses el paciente permanece vivo.ConclusiónEl sistema ECMO venoarterial es muy útil en pacientes con TEP, ya que realiza dos funciones: descargar el corazón derecho y oxigenar al paciente. Podemos heparinizar al paciente para revertir el cuadro, ya que las incisiones a nivel femoral son fácilmente controladas

Impact of a COVID-19 Outbreak in an Elderly Care Home after Primary Vaccination

[EN] Elderly care home residents are particularly vulnerable to COVID-19 due to immunesenescence, pre-existing medical conditions, and the risk of transmission from staff and visitors. This study aimed to describe the outcomes of a COVID-19 outbreak in a long-term care facility for elderly persons following the initial vaccination. A single-center, retrospective, observational design was used to analyze the variables associated with hospitalization and death rate by logistic regression. Adjusted odds ratios (aOR) and their 95% confidence intervals (CI) were calculated. Sixty-eight residents received the first dose of the COVID-19 vaccine. Despite being negative six days after vaccination, the performance of a second test 4 days later revealed 51 positives (75.0%) among residents and 18 among workers (56.3%). A total of 65 of the 68 residents (95.58%) had positive results with symptoms, whereas 34.9% required hospitalization, and 25.8% died. The best-fitting model to explain the distribution of cases reflects three points at the time of infection.. The time from vaccination to symptom onset explains the hospitalization and mortality rates since a day elapsed halves the risk of hospitalization (aOR = 0.57; CI = 0.38−0.75) and the risk of death by a quarter (aOR = 0.74; CI = 0.63−0.88). Nursing homes present an elevated risk of transmission and severity of SARS-CoV-2 infection. Although vaccination reduces the risk of hospitalization and death, extreme prevention and control measures are essential in these institutions despite the high vaccination coverage.S