Efectividad de ligadura con banda y clipaje en el manejo endoscópico de hemorragia diverticular colónica en el Hospital Víctor Lazarte Echegaray

La hemorragia digestiva baja tiene como etiología más frecuente la diverticulosis colónica. La hemorragia diverticular de colon constituye una emergencia gastroenterológica muy frecuente que requiere cuidado hospitalario, el cual consiste en brindarle al paciente tratamiento médico farmacológico, transfusional y también endoscópico. La terapia endoscópica que suele realizarse en el manejo de hemorragia diverticular colónica consiste en la colocación de clips hemostáticos y la ligadura con banda elástica. Sin embargo, en nuestro país, región y ciudad hay carencia de evidencia científica acerca de cuál método es el idóneo en este tipo de problema médico digestivo. Es así que, el presente estudio de investigación busca determinar la mejor opción terapéutica endoscópica en pacientes con diagnóstico de hemorragia diverticular colónica del servicio de Gastroenterología del Hospital Víctor Lazarte Echegaray de la ciudad de Trujillo, comparando la efectividad en el manejo hemostático endoscópico de pacientes con diagnóstico de hemorragia diverticular de colon sometidos a ligadura con banda elástica y clipaje endoscópico. La muestra del presente estudio estará conformada por 80 pacientes con diagnóstico de hemorragia diverticular colónica sometidos a colonoscopía diagnóstica y posteriormente colonoscopía terapéutica. La eficacia del tratamiento será evaluada mediante la ausencia signos de resangrado tales como hematoquecia y/o rectorragia en las 48 horas posteriores al procedimiento terapéutico mediante examen físico. Se empleará el diseño de cohortes de tipo retrospectivo en el periodo de estudio enero 2020 - diciembre 2021Tesis de segunda especialida

Anesthetic Management of Patients with Post COVID-19 Syndrome: A Quality Improvement Project

Background: Millions of people have been infected with the novel Coronavirus 2019, creating a global pandemic. Despite the high mortality rate of this viral infection, millions of people have recovered, and are now presenting for surgical procedures with a history of COVID-19 infection. Residual effects of COVID-19 infection have been observed for several after diagnosis and are referred to as post COVID-19 syndrome. Post COVID-19 sequela can alter multisystem physiological processes that may alter anesthetic care throughout the perioperative period. Objectives: The purpose of this quality improvement project is to improve anesthesia provider knowledge on the management of patients who have post COVID-19 syndrome. Methods: The primary methodology of the proposed quality improvement project is to administer an educational intervention to anesthesia providers which discusses the management of patients undergoing elective surgery and have a history of COVID-19 infection. Pre- and post- assessment surveys will be used to measure the effectiveness of the educational intervention. Results: Overall, there was an improvement in anesthesia provider knowledge following the educational intervention. Participants also answered they would “always” or “often” consider additional pre-operative testing compared to “sometimes” prior to the educational intervention

Notch Sensitivity Study in U-notched Polymers Built by Additive Manufacturing (AM)

Onyx ® is a new material composed of Polyamide 6 reinforced with short carbon fiber, used in the novel additive manufacturing composites technique. This paper aims to present the axial fatigue performance of this material with and without U-notches. The experimentally determined S-N fatigue curve was obtained under axial load with a load inversion ratio, R = 0.1, and compared to fatigue performance of U-notched samples ranging from 0.25 to 2 mm radius. In addition, the stress concentration factor was compared for static and alternative loading to obtain the notch sensitivity in terms of the U-notch radius, showing that there is indeed a difference in stress concentration between them. The advantage of the approach is that it permits using commonly used dimensioning methods for this AM material

Three-phase DC/AC power converter with power quality optimization

Introduction— The DC/AC power conversion systems currently used in multiple applications such as alternative energy sources involve power quality problems due to voltage regulations and distortions such as those caused by harmonic distortion. Objective— Develop a power converter prototype that, through a multi-objective genetic algorithm, allows optimizing the energy quality of three-phase inversion systems through the use of multilevel converters. Methodology— The prototype to be used in the power conversion is defined, the output voltage is modeled mathematically, the optimization multi-objective genetic algorithms are developed, the prototype is implemented and its operation is validated. Results— The algorithm developed and implemented in the developed prototype mitigates power quality phenomena associated with short and long duration variations such as swell, sag, undervoltage and overvoltage, avoids the presence of voltage fluctuations and presents a lower harmonic content in all 1% cases. Conclusions— The implemented prototype allows optimizing the power quality of three-phase power supply systems through the use of multilevel inverters, avoiding the presence of power quality phenomena.Introducción— Los sistemas de conversión DC/AC utilizados actualmente en múltiples aplicaciones como las fuentes alternativas de energía involucra problemas de la calidad de la energía debido regulaciones de tensión y deformaciones como las causadas por la distorsión armónica. Objetivo— Desarrollar un prototipo que a través de un algoritmo genético multiobjetivo permita optimizar la calidad de la energía de los sistemas de inversión trifásicos a través del uso de convertidores multinivel. Metodología— Se define el prototipo a utilizar en la conversión de potencia, se modela matemáticamente la tensión de salida, se desarrollan los algoritmos genéticos multiobjetivo de optimización, se implementa el prototipo y se valida su funcionamiento. Resultados— El algoritmo desarrollado e implementado en el prototipo desarrollado mitiga los fenómenos de calidad de la energía asociados a las variaciones de corta y larga duración como swell, sag, undervoltaje y overvoltaje, evita la presencia de fluctuaciones de tensión y presenta un contenido armónico menor en todos los casos del 1% Conclusiones— El prototipo implementado optimizar la calidad de la energía de los sistemas trifásicos de suministro de energía a través del uso de un inversor multinivel, evitando la presencia de fenómenos de calidad de la energía.&nbsp

Advanced Biomedical Laboratory (ABL) Synergy with Communication, Robotics, and IoT

This paper proposes a framework for integrating IoT and automation in a biomedical laboratory to improve safety, optimize processes, and enhance students\u27 learning experience. The framework incorporates a centralized control unit and distributed subsystems to control equipment and machinery and includes autonomous robotics and intelligent monitoring systems. The paper presents the results of undergraduate students\u27 work on automating various biomedical processes, including developing an Intelligent Autonomous Monitoring (IAM) device. IAM utilizes machine learning algorithms to identify outliers in processes and safety hazards. Moreover, IAM autonomously detects and localizes biomedical tools and equipment. Results show the feasibility of delivering real-time results for localizing specific tools necessary within a biomedical laboratory. This framework offers a systemic approach toward process automation, aiding researchers in developing new equipment and automating existing processes. Furthermore, it assists students in gaining a fundamental understanding of the theory behind biomedical principles while providing a repeatable experimental environment through more accurate data and event collection

On-line method for optimal tuning of PID controllers using standard OPC interface

Introduction− The controlled PID is the most widely used mathematical algorithm as a regulatory control strategy in industrial environments. The applications are varied; however, its answer depends on the proper calculation of its three parameters: the proportional, the derivative, and the integral. Analytical tuning and experimental methods solve the problem, but new tuning possibilities are now enabled within the digital and process integration context. Objective− Automatically and remotely obtain the optimal parameters of the PID controller, taking advantage of an online connection via the OPC communication protocol to analyze the transient response of the system. Methodology− The study is carried out in three main phases; it begins with a PD3 SMAR thermal process with connection via OPC; in this phase, the mathematical model of the process is built analytically based on fundamental laws. In the second phase, using an analytical tuning method, the PID control architecture is created on which the online experimentation is carried out. In the third phase, the genetic algorithms for automatic tuning are implemented, extracting performance measures from the PID controller through the transient response of the process and optimally determining the values for the proportional, derivative, and integral parameters. Results− The automatic tuning method was tested with two properly instrumented industrial processes. The potential for application can be seen due to its good result and because it does not require specific mathematical knowledge compared to conventional tuning methods. Conclusions− The automatic tuning method can be used remotely to calculate the optimal parameters of a PID controller. The parameters are calculated from the transient response and the definition of design criteria adaptable to any need for control, response, and process

Incidencia de la gestión de cobranza y recaudación del impuesto predial en la Municipalidad Distrital de Calzada, periodo 2018.

La investigación titulada “Incidencia de la gestión de cobranza y recaudación del impuesto predial en la Municipalidad Distrital de Calzada, periodo 2018”, investigación aplicada; nivel descriptivo – correlacional, con diseño no experimental; aplicando la técnica de cuestionario y análisis documental; y teniendo como población los trabajadores de la Municipalidad Distrital de Calzada, referida a la gestión de cobranza y su correlato con la recaudación del impuesto predial de la Municipalidad Distrital de Calzada, periodo 2018; se Concluye que, la gestión de cobranza incide significativamente en la recaudación del impuesto predial en la Municipalidad Distrital de Calzada, periodo 2018; la gestión de cobranza, incide significativamente en la recaudación del impuesto en predios urbanos y rústicos; se pudo establecer que los empleados encomendados en el trabajo de recaudación no realizan adecuadamente su labor, el cual repercute directamente en los resultados en función a la inscripción en el registro de contribuyentes, identificación de los contribuyentes omisos y morosos; además de una débil acción de cobranza.The research entitled "Incidence of the collection management and collection of property tax in the District Municipality of Calzada, period 2018", is an applied research with descriptive - correlational level, non-experimental design. The technique of questionnaire and documentary analysis was applied; and the population consisted of the workers of the District Municipality of Calzada, referred to the collection management and its correlation with the collection of property tax in the District Municipality of Calzada, period 2018. It is concluded that the collection management has a significant impact on the collection of property tax in the District Municipality of Calzada, period 2018; the collection management has a significant impact on the collection of the tax in urban and rustic properties. It could be established that the employees entrusted with the collection work do not perform their work properly, which has a direct impact on the results in terms of registration in the taxpayer registry, identification of defaulting and delinquent taxpayers, as well as a weak collection action

Projected changes in the season of hot days in the Middle East and North Africa

Financiado para publicación en acceso aberto: Universidade de Vigo/CISUGThe present study analyses changes in the timing and duration of the hot days season over the Middle East and North Africa region from 1970 to 2099 using model simulations of 11 regional models from the Coordinated Regional Climate Downscaling Experiment under the RCP8.5 scenario. In general, a non-symmetrical lengthening of the hot days season is projected, with a tendency to extend more into spring than into autumn. By the end of the century and the RCP8.5 scenario, Western Africa and the Persian Gulf display a hot days season starting 60 days earlier than in the historical period (1970–1999) (May vs. July, respectively). Southernmost latitudes are the most affected by a later retreat of the hot days season, of up to 60 days with respect to the historical period (October vs. August). The length of the extreme season is projected to increase between 100 and 120 days for the southernmost latitudes and the Persian Gulf resulting in nearly four more months with hot days conditions.Comisión Europea | Ref. INTERREG‐POCTEP 2014‐2020Comisión Europea | Ref. 0034‐RISC_ML_6_EXunta de Galicia | Ref. ED431C 2017/6

Redesign of the System for the Dispensing and Control of Medicines in Clínica Oftalmológica del Caribe.

El proyecto aplicado empresarial busca proponer soluciones innovadoras para el control de inventarios, la dispensación y el monitoreo del uso del medicamento en cada paciente de la Clínica Oftalmológica del Caribe. El desarrollo del proyecto, propone aplicar herramientas administrativas y gerenciales para el control y dispensación de medicamentos, buscando mejorar de los niveles de inventarios, evitar sobrecostos, pérdidas y posibles ineficiencias que impactan en el resultado financiero de la Clínica.The applied business project seeks to resolve the weaknesses in the control of inventories, dispensing and monitoring the use of medications in each patient of the Clínica Oftalmológica del Caribe. The development of the project proposes to apply administrative and managerial tools for the control and dispensing of medicines, thereby seeking to improve inventory levels, avoid cost overruns, losses and possible inefficiencies that impact the financial result of the Clinic