Incidence of bacteremia associated with central venous catheter and prevalence of different risk factors for it in the Central Military Hospital (Homic) between 2013 to 2015.

La Bacteriemia asociada a la inserción de catéter venoso central (BAICVC) es una de las complicaciones que hoy en día son motivo de preocupación en los centros hospitalarios dado el impacto en mortalidad que este tiene. Realizamos un estudio de cohortes retrospectivo, seleccionando historias clínicas del periodo 2013-2015. Para el estudio se seleccionaron mediante aleatorización simple, 500 historias clínicas del HOMIC de pacientes quienes se encontraron hospitalizados en los servicios de urgencias, hospitalización general, Unidades de Cuidados Intensivos y salas de cirugía, registrando las diferentes variables modificables y no modificables que se asocian como factores de riesgo para la infección asociada a CVC. Se analizaron 439 historias clínicas, encontrándose una prevalencia de bacteriemia asociado al CVC del 7.3%; Se encontró una diferencia significativa entre la bacteriemia asociada a CVC al portar catéter monolumen 3.1%, trilumen 5.1%, bilumen 9.8%, (p= 0.001), también con el uso concomitante de tratamiento antibiótico (5.9% vs 13.4% bacteriemia asociado a CVC en quienes recibieron antibiótico vs quienes no lo recibieron, p= 0.018); la nutrición parenteral mostro una diferencia significativa en rango gris (11.3% vs 6% BAICVC en pacientes que recibieron nutrición parenteral vs quienes no la recibieron, p= 0.067 ). No se encontró una diferencia significativa (p=>0.05) con los siguientes factores de riesgo: edad, sexo, cuando el diagnóstico principal fué médico o quirúrgico, sitio anatómico de inserción, lugar donde se realizó el procedimiento de inserción del CVC; tampoco con comorbilidades tales como diabetes mellitus, VIH, Enfermedades Autoinmunes, Cáncer o Enfermedad Renal (aguda o crónica). Las BAICVC tampoco se asociaron al uso concomitante de vasopresor, terapia biológica, corticoides sistémicos; quimioterapia; no se documentaron bacteriemias relacionadas a CVC en los 14 pacientes con algún tipo de Hepatopatía incluidos en el estudio. La prevalencia de BAICVC en nuestra población es del 7.3%, el germen más prevalente fue S epidermidis; se encontró una correlación estadísticamente significativa con el numero de dias de permanencia del catéter, asi como del número de curaciones realizadas al mismo y el número de lúmenes del CVC, con una incidencia aumentada en los Catéteres centrales bilumen. Hay una tendencia no estadísticamente significativa a la asociación entre nutrición parenteral total (NPT) e BAICVC. Se deben realizar estudios que analicen los factores que determinan el comportamiento del control/descontrol de las comorbilidades en el paciente y su asociación con BAICVC; Los programas como Clínica de catéter evitan la progresión de BAICVC, por ende, se deben fomentar y fortalecer.The bacteremia associated with the insertion of central venous catheter (BAICVC) is one of the complications that today are of concern in hospitals in mortality given the impact that this has. We conducted a retrospective cohort study, selecting medical records of 2013-2015. For the study were selected by simple randomization, 500 medical records of Homic of patients who met hospitalized in the emergency department, general hospitalization, intensive care units and operating rooms, recording the different modifiable and non-modifiable variables associated as risk factors for infection associated with CVC. 439 medical records were analyzed, finding a prevalence of bacteremia associated with CVC 7.3%; a significant difference between bacteremia associated with CVC to carry catheter monolumen 3.1%, trilumen 5.1%, bilumen 9.8% (p = 0.001), also with concomitant use of antibiotic treatment (5.9% vs 13.4% bacteremia associated with CVC it ​​found in those receiving antibiotic vs those who did not receive, p = 0.018); parenteral nutrition showed a significant difference in gray range (11.3% vs 6% BAICVC in patients receiving parenteral nutrition vs. those who did not, p = 0.067). A significant difference (p = <0.05) with the following risk factors not found: age, sex, when the main diagnosis was medical or surgical, anatomical insertion site, where the CVC insertion procedure was performed; not with comorbidities such as diabetes mellitus, HIV, autoimmune diseases, cancer or kidney disease (acute or chronic). The BAICVC were not associated with concomitant use of vasopressor, biological therapy, systemic corticosteroids; chemotherapy; CVC not related bacteremia in 14 patients with some form of liver disease included in the study were documented. BAICVC prevalence in our population is 7.3%, the most prevalent germ was S epidermidis; A statistically significant correlation with the number of days spent catheter as well as the number of cures performed the same and the number of lumens CVC, with an increased incidence in the central Catheters bilumen found. There is a no statistically significant association between total parenteral nutrition (TPN) and BAICVC trend. Studies should be conducted to analyze the factors that determine the behavior of the control / lack of control of comorbidities in the patient and its association with BAICVC; Programs like catheter Clinic prevent progression BAICVC therefore should be encouraged and strengthened

Hacia los territorios inteligentes frente a incendios forestales

To face the growing impact of large wildfires in the last few decades, a conceptual framework and an operational tool for participative territorial planning allowing risk mitigation are presented. We advocate for a preventive (rather than reactive) approach relying of land uses that reduce fuel load in a cost-effective way (wood harvesting, livestock husbandry, intercropping and agroforestry). “Productive fuel breaks” are proposed as preventive infrastructures aimed at avoiding fire spread in strategic locations. In addition, these infrastructures may trigger entrepreneurship in the scarcely populated areas where large fires occur.Ante el creciente impacto de los grandes incendios en las últimas décadas, se presenta el marco conceptual y una nueva herramienta para la planificación participativa del territorio que ayude a mitigar el problema. Se aboga por un enfoque basado en la prevención de los incendios (no sólo en la reacción que supone la extinción) apoyado en los usos del territorio capaces de extraer vegetación potencialmente combustible de forma rentable (explotaciones madereras, ganaderas, agrícolas y mixtas). Se proponen los “cortafuegos productivos” como infraestructura preventiva básica diseñada estratégicamente para evitar la propagación del fuego y capaz al mismo tiempo de dinamizar los territorios rurales despoblados que favorecen los incendios catastróficos

Diseño hidráulico de una planta de potabilización de agua en la Vereda de San Antonio de Anapoima

Trabajo de InvestigaciónEn el proyecto se plantea una solución enfocada a mejorar la calidad de vida de la comunidad. Se ve la necesidad de la construcción de una Planta de Potabilización con todos los parámetros que indica la norma utilizada en este caso las RAS2000. Se comienza analizar el nivel de complejidad y un estudio en el agua con la que se va a abastecer la planta, seguido de esto se analiza cuáles son los mecanismos necesarios en el proceso de tratamiento para que arroje unos resultados positivos y dar por terminada esta necesidad sufrida por la población.GLOSARIO RESUMEN INTRODUCCIÓN 1. GENERALIDADES 2. CARACTERIZACIÓN DE LA VEREDA SAN ANTONIO 3. PLANTAS DE POTABILIZACIÓN 4. DISEÑO A IMPLEMENTAR 5. OTRA ALTERNATIVA DE SISTEMAS DE POBAILIZACION 6. COSTOS DE LA PTAP 7. CONCLUSIONES 8. RECOMENDACIONES 9. BIBLIOGRAFIA 10. ANEXOSPregradoIngeniero Civi

Diabetic Macular Edema: From Old Concepts to New Therapeutic Avenues

Diabetic macular edema (DME) is an important cause of blindness in the working population and is currently challenging to treat. Current interventions include focal laser or intravitreal injections. This article outlines a new treatment protocol based on the concept that peripheral ischemia is the introduction to angiogenesis, that will ultimately gather its momentum at the fovea. Performing extreme peripheral light laser panretinal photocoagulation (PRP) back to the equator reduces excessive expression of the vascular endothelial growth factor (VEGF) in the eye. Subsequently, this decreases VEGF-induced DME and provides long-term protection for the development of neovascularization. Initial exacerbation of DME often accompanies PRP, Therefore; first injections of anti-VEGF agents (with or without dexamethasone implant) can forestall worsening of DME preventing loss of vision. However, on the other hand, applying peripheral PRP and intraocular injections can induce posterior vitreous detachment (PVD). This could help release vitreomacular adhesions (VMA) and vitreomacular traction (VMT), decreasing DME severity and improving response to intravitreal injections. The current approach works by laser ablation of the peripheral retina that should stop the drive for VEGF release; moreover, laser ablation should produce secondary, accidental and beneficial PVD. This approach precludes focal laser therapy and paves the path for prolonged anti-VEGF therapy

NAIRA III

NAIRA III uses computational intelligence techniques to extract metadata, create databases, help species tagging and automatically classify captured species into trap camera images. This performs the image processing in seven steps: the first step consists in extracting the metadata related to the information corresponding to the precise moment of the photographic capture, such as date, time and geographical coordinates (when the camera records this information), and the information that is printed in the photo frame such as the moon phase, temperature or camera code (Figure 1). The extracted data is organized in a spreadsheet in Microsoft Excel format, which has been built following the Darwin Core format standards.NAIRA III utiliza técnicas de inteligencia computacional para extraer metadatos, crear bases de datos, ayudar al etiquetado de especies y clasificar&nbsp; utomáticamente las especies capturadas en imágenes de cámaras trampa. Esta realiza el procesamiento de imágenes en siete pasos: el primer paso consiste en la extracción de los metadatos relacionados con la información correspondiente al momento preciso de la captura fotográfica, como fecha, hora y coordenadas geográficas (cuando la cámara registra esta información), y la información que se encuentra impresa en el marco de la fotografía como la fase lunar, temperatura o código de la cámara (Figura 1). Los datos extraídos son organizados en una hoja de cálculo en formato de Microsoft Excel, que ha sido construida siguiendo los estándares del formato Darwin Core

"Paper in Screen" Prototyping a Rapid Technique to Anticipate the Mobile User Experience

Prototyping is generally acknowledged as an effective method for generating cost-effective, preliminary designs of various products including web and mobile user interfaces. Out of the existing types of prototyping, paper prototyping is known for being the most cost-effective of them all, as well as the most constrained for the realistic user experience elements it can render. High-Fidelity prototypes on the other hand offer a richer experience to the user, at the high cost of developing sophisticated software/hardware-based demonstrations. Although both of these types of prototypes continue to be widely and successfully used in product and interface design, there is no evidence of a cost-effective technique that would elicit user’s feedback which as rich as high-fidelity prototypes but without implementation effort. This study proposes an innovative prototyping technique called “Paper in Screen” (Bolchini, Pulido, Faiola, 2009) which enables designers to cheaply and rapidly prototype a mobile application in its key components (interface design and mobile device integration) without the need for implementing a high-fidelity prototype. A study was performed with 10 user experience professionals to evaluate their perception of the technique’s effectiveness, from which a number of benefits and drawbacks of the “Paper in Screen” were learned. The obtained results point to areas of future research in mobile prototyping

Diagnóstico molecular de plagas de la dehesa y protocolos de gestión para facilitar su control biológico por el ganado

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Completeness of a Normed Space via Strong p-Cesàro Summability

In this paper we will characterize the completeness and barrelledness of a normed space through the strong p-Cesàro summability of series. A new characterization of weakly unconditionally Cauchy series and unconditionally convergent series through the strong p-Cesàro summability is obtained

Targeted policy proposals for managing spontaneous forest expansion in the Mediterranean

Recent forest expansion in Euro‐Mediterranean countries predominantly results from secondary succession in abandoned farmland, rather than from artificial afforestation. This major forest transition involves the delivery of both ecosystem services and disservices, which must be balanced through new land‐use planning and policy approaches. Ecosystem services arising from this expansion of forests include increased carbon sequestration, water infiltration, provision of forest products, soil retention, and forest coalescence. Nevertheless, ecosystem disservices such as reductions in water yield, landscape homogenisation, increased wildfire risk, and/or the loss of high nature value managed habitats caution against generalisation of the benefits of such expansion. Most EU funds related to forests are being allocated to conservation, restoration, or fire prevention and extinction efforts, whereas sustainable forest management and the maintenance of multifunctional agro‐silvo‐pastoral mosaics are hampered by the lack of financial incentives and by environmental regulations. Policy implications. We advocate for more‐targeted policies based on landscape planning that favours multifunctionality while reducing environmental and economic uncertainties and maximizing the ecosystem service/disservice ratio. The following recommendations follow from this approach: (1) a climate‐smart policy favouring fire‐resistant landscapes and enhancing value chains that stimulate active forest management; (2) the adoption of a territorial perspective, beyond forest and farm‐based measures and payments, that relies on management actions and minimizes socio‐ecological tensions; (3) re‐focusing CAP Pillar II grants from afforestation and forest protection measures to sustainable forest management; (4) transforming the CAP direct payments to support multifunctional farming systems (e.g. agroforestry); (5) a more balanced inclusion of different land uses in the Natura 2000 network and intensification of the support for High Nature Value farming in less‐favoured areas.info:eu-repo/semantics/acceptedVersio