Automatización de puestos de trabajo de accionamientos eléctricos

This work shows two automated production systems in the electric drives laboratory at the university of Camagüey, to become laboratories sets, geared to the needs of modern industry. Production systems were electrically coupled to a PLC, so you can regulate speed and working regime using frequency converters. Finally the paper presents the possibility to interact with a SCADA which monitors the system in real time using a personal computer automation of different tasks that correspond to simulations of real technical problems. In addition, we developed a manual that allows the use of automated laboratory system in a manner which ensures blended teaching present and future.En el presente trabajo se muestra como fueron automatizados dos sistemas productivos existentes en el laboratorio de accionamiento eléctrico de la universidad de Camagüey para que se convirtieran en puestos de laboratorios acordes a las necesidades de la industria moderna. Los sistemas productivos fueron acoplados eléctricamente a un PLC, con esto, se les puede regular la velocidad y el régimen de trabajo con ayuda de convertidores de frecuencia. Por último el trabajo presenta la posibilidad de interactuar con un SCADA que supervisa en tiempo real con ayuda de una computadora personal diferentes tareas de automatización que se corresponden con simulaciones de problemas técnicos reales. Además se desarrolló un manual que permite la utilización del sistema de laboratorio automatizado de manera semipresencial lo que garantiza la docencia presente y futura

No Apparent Influence of Nonadherence on Tacrolimus Intrapatient Variability in Stable Kidney Transplant Recipients

Background: High intrapatient variability (IPV) in tacrolimus exposure has been associated with an increased risk of graft rejection and graft loss. It has been suggested that medication nonadherence has high impact on IPV. The objective of this study is to assess the relationship between tacrolimus IPV and medication nonadherence in stable kidney transplant recipients. Methods: This study was conducted within the Reducing Renal Function Deterioration trial (Netherlands Trial Register: NTR7256), which included stable kidney transplant recipients. Nonadherence was assessed quantitatively by electronic monitoring (EM) and qualitatively using the composite adherence score (CAS) consisting of patient self-reporting (Immunosuppressant Therapy Adherence Scale), a physician report, and the tacrolimus trough concentrations (C-0). IPV in tacrolimus C(0)and area under the concentration-time curves (AUCs) was evaluated at 5 and 3 sampling instances, respectively. Results: Data of 64 kidney transplant recipients (43 males, 21 females; mean age 53.6 years), mean time post-transplantation 5.4 years, were collected. Mean missed tacrolimus intake was 7% (0.3%-13.4%) based on EM, missing one intake every 2 weeks. Based on the CAS, 68.9% of the patients were categorized as nonadherent. The mean IPV was 17.9% (4.4%-65.3%) and 20.2% (2.5%-51.6%) for tacrolimus C(0)and AUCs, respectively. The nonadherence data displayed a nonparametric distribution, with nonadherence scores mostly in the lower ranges. There was no significant difference in the mean IPV between adherent and nonadherent patients. There were no differences in EM, CAS, physician report, or time-in-therapeutic range, but patients with a low AUC IPV showed a slightly higher Immunosuppressant Therapy Adherence Scale score than those with a high AUC IPV (P= 0.035). Conclusions: There was no apparent relationship between IPV and nonadherence in this motivated kidney transplant recipient population, with one missed tacrolimus dose every 2 weeks.Clinical Pharmacy and ToxicologyNephrolog

Medication non-adherence after kidney transplantation: A critical appraisal and systematic review

Medication non-adherence is one of the most important causes for shortened graft survival subsequently leading to a reduction in kidney graft survival results. Our aim was to provide an overview of its prevalence, risk factors, diagnostic methods and interventions to improve adherence in kidney transplant recipients. Therefore, we systematically searched the databases PubMed, COCHRANE Library, Web of Science and EMBASE for studies addressing "medication adherence", "compliance", "adherence", "kidney transplantation" and "life style factors". We identified 96 studies that satisfied our inclusion criteria. A problematic lack of a uniformly accepted definition for non-adherence was found, consequently leading to a wide range in non-adherence prevalence (36-55%). Using one uniformly accepted non-adherence definition should therefore be encouraged. A wide range in diagnostic methods makes it difficult to accurately detect non-adherence. Heterogeneous results of intervention studies make it difficult to select the best adherence enhancing method, challenging the battle against medication non-adherence. Literature suggests a combination of personalized interventions, based on patient-specific non-adherent behavior, to be most successful in improvement of adherence. High quality diagnostic methods and multidisciplinary, personalized interventions with focus on relevant clinical outcome are essential in overcoming medication non-adherence in kidney transplant recipients. (C) 2019 Elsevier Inc. All rights reserved.Nephrolog

Therapeutic drug monitoring of tacrolimus and mycophenolic acid in outpatient renal transplant recipients using a volumetric dried blood spot sampling device

Nephrolog

Factors associated with COVID-19 length of hospitalization and mortality during four epidemic waves, March 2020–November 2021, Suriname

Objectives. To determine the sociodemographic risk factors associated with coronavirus disease 2019 (COVID-19) mortality in Suriname. Methods. This was a retrospective cohort study. All registered deaths from COVID-19 in Suriname (n=1112) between March 13, 2020 and November 11, 2021 were included. Data were collected from medical records and included demographic variables and hospitalization duration of patients who died. Descriptive statistics, chi-squared tests, ANOVA models, and logistic regression analyses were used to determine associations between sociodemographic variables, length of hospitalization, and mortality during four epidemic waves. Results. The case fatality rate over the study period was 22 per 1 000 population. The first epidemic wave was from July to August 2020, the second from December 2020 to January 2021, the third from May to June 2021, and the fourth from August to September 2021. Significant differences were found in the number of deaths and hospitalization duration by wave (p<0.001). Patients were more likely to have a longer hospitalization during the first (OR 1.66; 95% CI: 0.98, 2.82) and third waves (OR 2.37; 95% CI: 1.71, 3.28) compared with the fourth wave. Significant differences in mortality were also seen between ethnicities by wave (p=0.010). Compared with the mixed and other group, people of Creole ethnicity (OR 2.7; 95% CI: 1.33, 5.29) and Tribal people (OR 2.8; 95% CI: 1.12, 7.02) were more likely to die during the fourth wave than the third wave. Conclusions. Tailored interventions are needed for males, people of Creole descent, Tribal and Indigenous peoples, and people older than 65 years

Influence of prenatal exposure to mercury, perceived stress, and depression on birth outcomes in suriname: Results from the mekitamara study

Prenatal exposure to mercury, stress, and depression may have adverse effects on birth outcomes. Little is known on the influence of chemical and non-chemical stressors on birth outcomes in the country of Suriname. We assessed the influence of prenatal exposure to mercury, perceived stress, and depression on adverse birth outcomes in 1143 pregnant Surinamese women who participated in the Caribbean Consortium for Research in Environmental and Occupational Health-MeKiTamara prospective cohort study. Associations between mercury (≥1.1 µg/g hair, USEPA action level/top versus bottom quartile), probable depression (Edinburgh Depression Scale ≥12), high perceived stress (Cohen’s Perceived Stress Scale ≥20), and adverse birth outcomes (low birthweight (<2500 g), preterm birth (<37 completed weeks of gestation), and low Apgar score (<7 at 5 min)) were assessed using bivariate and multivariate logistic regressions. Prevalence of elevated mercury levels, high perceived stress, and probable depression were 37.5%, 27.2%, and 22.4%, respectively. Mercury exposure was significantly associated with preterm birth in the overall study cohort (OR 2.47; 95% CI 1.05–5.83) and perceived stress with a low Apgar score (OR 9.73; 95% CI 2.03–46.70). Depression was not associated with any birth outcomes. These findings can inform policy-and practice-oriented solutions to improve maternal and child health in Suriname