A Method for Systematic Adaptation and Synchronization of Healthcare Processes

International organizations, as the World Health Organization (WHO) and national governments are constantly defining (or modifying) new healthcare protocols and procedures. Those changes have a significant impact, on one side, on the organizational concerns of a great number of healthcare institutions and centers, and on the other side, on their health information systems that need to be adapted according to the new (or modified) procedures. Administrative workflows are commonly defined by a high level entity and they must then be applied on different institutions ruled by this high level entity. Those workflows must then be adapted to the particular circumstances of each institution, complying with the general regulations of the process established at the top level. This problem, called Hierarchical Adaptation Problem, also implies establishing the methods to evolve together the high level regulation. Such methods must maintain the consistency among the different levels by means of the propagation of the changes to all the different adaptations of the original workflow. To solve this problem, this work introduces the Hierarchical Adaptation Method. A method based on ontologies to define the rules that must be satisfied by a generic workflow to be considered adaptable to different application cases and the rules that must be satisfied by its adapted versions. Moreover, it provides the operations to facilitate both adaptation of administrative workflows and propagation of changes

The Role of Nonlinear Dynamics in Quantitative Atomic Force Microscopy

Various methods of force measurement with the Atomic Force Microscope (AFM) are compared for their ability to accurately determine the tip-surface force from analysis of the nonlinear cantilever motion. It is explained how intermodulation, or the frequency mixing of multiple drive tones by the nonlinear tip-surface force, can be used to concentrate the nonlinear motion in a narrow band of frequency near the cantilevers fundamental resonance, where accuracy and sensitivity of force measurement are greatest. Two different methods for reconstructing tip-surface forces from intermodulation spectra are explained. The reconstruction of both conservative and dissipative tip-surface interactions from intermodulation spectra are demonstrated on simulated data.Comment: 25 pages (preprint, double space) 7 figure

A KK-monopole giant graviton in AdS_5 x Y_5

We construct a new giant graviton solution in AdS_5 x Y_5, with Y_5 a quasi-regular Sasaki-Einstein manifold, consisting on a Kaluza-Klein monopole wrapped around the Y_5 and with its Taub-NUT direction in AdS_5. We find that this configuration has minimal energy when put in the centre of AdS_5, where it behaves as a massless particle. When we take Y_5 to be S^5, we provide a microscopical description in terms of multiple gravitational waves expanding into the fuzzy S^5 defined as an S^1 bundle over the fuzzy CP^2. Finally we provide a possible field theory dual interpretation of the construction.Comment: 11 pages, published versio

Update on indications, complications, and outcomes of scleral contact lenses

Background: The role of scleral contact lenses (SCLs) has increasingly expanded since the first lens was fitted more than a century ago. While it was initially prescribed for the management of severely compromised corneas, the indications for modern SCL use have expanded to include less severe diseases. In this review, we aimed to provide an up-to-date overview of the current indications, complications, and outcomes for the various types of SCLs. Methods: In this narrative review, we thoroughly searched the PubMed/MEDLINE database for literature published from January 1980 to November 2021. Only relevant up-to-date English references were included. Furthermore, the figures in this manuscript were derived from our unit’s patient documentation. Results: Currently, SCLs can successfully be used to manage ocular surface diseases, visually rehabilitate irregular corneas, and correct irregular refractive errors. Although newer materials have yielded the same visual outcomes with fewer complications, these consequences still occur in approximately one-third of contact lens wearers, including difficulties in insertion and/or removal, discomfort or pain, and developing either halos, blurriness, or haze. Even though most of these complications are minor and can be easily treated, a good practice is essential to avoid sight-threatening complications such as microbial keratitis. Conclusions: SCLs are indispensable in ophthalmic clinics. The development of better-quality SCLs has increased the number of indications and improved the achievable visual rehabilitation. The future of developing improvements in SCL design, materials, and fit, and the expansion of their indication range is promising

The baryon vertex with magnetic flux

In this letter we generalise the baryon vertex configuration of AdS/CFT by adding a suitable instantonic magnetic field on its worldvolume, dissolving D-string charge. A careful analysis of the configuration shows that there is an upper bound on the number of dissolved strings. This should be a manifestation of the stringy exclusion principle. We provide a microscopical description of this configuration in terms of a dielectric effect for the dissolved strings.Comment: 17 pages, 2 figures. V2: reference added. V3: version to appear in JHE

Contact Lens-Associated Infectious Keratitis: Update on Diagnosis and Therapy

The focus of this chapter is to review the most recent advances in the diagnosis and treatment of contact-lens-related infectious keratitis, the most sight-threatening complication of contact lens wear. In the last decades, contact lenses technology has confronted several challenges, including the need for safer and more comfortable polymer materials. The development of high coefficient oxygen permeability (Dkt) and low-water content disposable contact lens translated into a significant improvement in ocular discomfort related to dry eye and allergic reactions, decreasing biofilm build-up on the external surface of the lens. Additionally, the emergence and boom-effect of corneal refractive surgery have also driven the development of better contact lens manufacturing. Despite these substantial technological advances, contact lens users continue to be at risk for developing corneal infections. We describe recent epidemiologic data, and advances in understanding the complex pathogenesis of the disease, including the clinical characteristics of the infectious process produced by bacteria, fungi, and protozoans. Finally, the recent development of diagnostic techniques and therapeutic regimens are discussed

The Betic Ophiolites and the Mesozoic Evolution of the Western Tethys

The Betic Ophiolites consist of numerous tectonic slices, metric to kilometric in size, of eclogitized mafic and ultramafic rocks associated to oceanic metasediments, deriving from the Betic oceanic domain. The outcrop of these ophiolites is aligned along 250 km in the Mulhacen Complex of the Nevado-Filabride Domain, located at the center-eastern zone of the Betic Cordillera (SE Spain). According to petrological/geochemical inferences and SHRIMP (Sensitive High Resolution Ion Micro-Probe) dating of igneous zircons, the Betic oceanic lithosphere originated along an ultra-slow mid-ocean ridge, after rifting, thinning and breakup of the preexisting continental crust. The Betic oceanic sector, located at the westernmost end of the Tethys Ocean, developed from the Lower to Middle Jurassic (185-170 Ma), just at the beginning of the Pangaea break-up between the Iberia-European and the Africa-Adrian plates. Subsequently, the oceanic spreading migrated northeastward to form the Ligurian and Alpine Tethys oceans, from 165 to 140 Ma. Breakup and oceanization isolated continental remnants, known as the Mesomediterranean Terrane, which were deformed and affected by the Upper Cretaceous-Paleocene Eo-Alpine high-pressure metamorphic event, due to the intra-oceanic subduction of the Jurassic oceanic lithosphere and the related continental margins. This process was followed by the partial exhumation of the subducted oceanic rocks onto their continental margins, forming the Betic and Alpine Ophiolites. Subsequently, along the Upper Oligocene and Miocene, the deformed and metamorphosed Mesomediterranean Terrane was dismembered into different continental blocks collectively known as AlKaPeCa microplate (Alboran, Kabylian, Peloritan and Calabrian). In particular, the Alboran block was displaced toward the SW to occupy its current setting between the Iberian and African plates, due to the Neogene opening of the Algero-Provencal Basin. During this translation, the different domains of the Alboran microplate, forming the Internal Zones of the Betic and Rifean Cordilleras, collided with the External Zones representing the Iberian and African margins and, together with them, underwent the later alpine deformation and metamorphism, characterized by local differences of P-T (Pressure-Temperature) conditions. These Neogene metamorphic processes, known as Meso-Alpine and Neo-Alpine events, developed in the Nevado-Filabride Domain under Ab-Ep amphibolite and greenschists facies conditions, respectively, causing retrogradation and intensive deformation of the Eo-Alpine eclogites.This research was funded by Project CGL2009-12369 of the Spanish Ministry of Science and Innovation, co-financed with FEDER funds, and by Research Group RNM 333 of Junta de Andalucía (Spain)

Alimentación de los lenguados Cyclopsetta querna y Syacium latifrons en la costa de Jalisco y Colima, México

Flatfish are important components of shrimp fisheries bycatch. The purpose of this study was to analyze feeding habits of Cyclopsetta querna and Syacium latifrons, with the aim of expanding the biological knowledge of these species. Specimens were collected in seven sampling stations with shrimp trawl nets. Stomachs of 196 individuals of C. querna and 313 of S. latifrons were analyzed. The trophic spectrum of C. querna consisted of 12 food components, while 24 were recorded for S. latifrons. The main prey for C. querna were fish, while for S. latifrons it was crustaceans, such as stomatopods. A slight ontogenetic trophic variation was observed in C. querna, not so in S. latifrons; however, no differences were observed considering only the diet by sex. Diversity analyses of the food spectrum were less than 0.5 for both species. It is considered that in both species feeding is given mainly by the seasonal availability of resources and by the ability to capture prey. On the other hand, the coexistence of these species in the same area is due to the difference in the preferential consumption of prey hence reducing the competition for food.Los lenguados forman un componente importante como fauna de acompañamiento del camarón. El objetivo del presente trabajo consistió en analizar la alimentación de Cyclopseta querna y Syacium latifrons, con el fin de ampliar el conocimiento biológico de estas especies. Los ejemplares se colectaron en siete estaciones de muestreo con redes de arrastre de camarón. Se analizaron los estómagos de 196 individuos de C. querna y 313 de S. latifrons. El espectro trófico de C. querna estuvo constituido por 12 componentes alimentarios, mientras que para S. latifrons se registraron 24. Las presas principales de C. querna fueron los peces, mientras que para S. latifrons fueron los crustáceos, como por ejemplo, estomatópodos. Se observó una ligera variación ontogénica en la dieta de C. querna, no así en S. latifrons; sin embargo, en la dieta por sexos no se observaron diferencias. Los análisis de diversidad del espectro alimentario fueron menores de 0,5 para ambas especies. Se considera que en ambas especies la alimentación se da principalmente por la disponibilidad de recursos en las estaciones del año y por la capacidad de captura de presas. Por otra parte, la coexistencia de estas especies en una misma zona se da por diferencias en el consumo preferencial de sus presas al disminuir la competencia por alimento