Riesgo cardiovascular en pacientes nonagenarios: Prescripción potencialmente inapropiada de medicamentos en nonagenarios.

La población mundial está envejeciendo progresivamente en los últimos años y las enfermedades cardiovasculares (ECV) se han situado como la primera causa de muerte, su mejor conocimiento es trascendente. Algunos fármacos no disponen hoy de evidencia científica de ser beneficiosos en pacientes muy ancianos como las estatinas, otros se prescriben en exceso como los IBP sin aparente justificación. Personas y métodos: realizamos un estudio en pacientes de más de 90 años para conocer sus características, por medio de una encuesta llevada a cabo por cuatro estudiantes de la Facultad de Medicina de Valladolid, analizando cada uno diferentes aspectos. Cada alumno realizó unas 20 encuestas a pacientes de más de 90 años ingresados en el Hospital Universitario Río Hortega (HURH). Objetivos: analizamos la prescripción de fármacos, centrándonos en IBP y en estatinas. Intentamos averiguar si existen diferencias entre pacientes tratados y no tratados con estos fármacos y valoramos la prescripción inadecuada de los mismos. Resultados: de los 82 pacientes entrevistados, 2/3 estaban en tratamiento con IBP y 1 de cada 8 en tratamiento con estatinas. La mayoría de los factores asociados al mayor consumo de IBP no justifican su consumo (sexo masculino, vivir en residencia de ancianos, baja escolarización y una dependencia para una o más AIVD). Tampoco los factores asociados al tratamiento con estatinas son coherentes aparentemente (ser varón, vivir en domicilio familiar); en ambos casos solo padecer una elevada comorbilidad parece asociarse a su consumo. Conclusión: los pacientes nonagenarios que hemos estudiado sufren una prescripción inapropiada de medicamentos, que no solo carece de evidencias de utilidad, sino que además podría ser no beneficioso para ellos y supone un sobrecoste para la sociedad

Partial orderings for hesitant fuzzy sets

New partial orderings =o=o, =p=p and =H=H are defined, studied and compared on the set HH of finite subsets of the unit interval with special emphasis on the last one. Since comparing two sets of the same cardinality is a simple issue, the idea for comparing two sets A and B of different cardinalities n and m respectively using =H=H is repeating their elements in order to obtain two series with the same length. If lcm(n,m)lcm(n,m) is the least common multiple of n and m we can repeat every element of A lcm(n,m)/mlcm(n,m)/m times and every element of B lcm(n,m)/nlcm(n,m)/n times to obtain such series and compare them (Definition 2.2). (H,=H)(H,=H) is a bounded partially ordered set but not a lattice. Nevertheless, it will be shown that some interesting subsets of (H,=H)(H,=H) have a lattice structure. Moreover in the set BB of finite bags or multisets (i.e. allowing repetition of objects) of the unit interval a preorder =B=B can be defined in a similar way as =H=H in HH and considering the quotient set View the MathML sourceB¿=B/~ of BB by the equivalence relation ~ defined by A~BA~B when A=BBA=BB and B=BAB=BA, View the MathML source(B¿,=B) is a lattice and (H,=H)(H,=H) can be naturally embedded into it.Peer ReviewedPostprint (author's final draft

El uso de la distancia interpersonal en el comportamiento motor de boxeadores de diferente nivel deportivo

El objetivo del estudio fue comparar el comportamiento motor (i.e., tiempo de reacción y precisión en la respuesta) en una muestra reducida de boxeadores de diferente nivel deportivo (n = 4 avanzados y n = 4 noveles) durante la percepción de series de 10 acciones de ataque del oponente a diferentes distancias (i.e., corta, media, larga), tanto en situación real (3D) como video-proyectada (2D). La probabilidad de aparición de unas acciones u otras del oponente fue manipulada en función de su distancia de separación al participante. Los participantes debían de reaccionar rápida y precisamente, ejecutando una esquiva adecuada al ataque del oponente. Se utilizó una cámara de alta velocidad para analizar el comportamiento motor. Los resultados mostraron que los boxeadores avanzados reaccionaron antes que los noveles en la distancia corta y larga, siendo más precisos en todas las distancias. Cuando se incluyó la dimensionalidad en el análisis, el grupo de mayor nivel fue más rápido en las tres distancias (2D) y más preciso (2D y 3D). Por todo ello, los boxeadores avanzados usaron la distancia interpersonal como información situacional para mejorar su comportamiento defensivo frente a los oponentes.The aim of this study was to compare the motor performance (i.e., reaction time and response accuracy) of a reduced boxers sample with different sport levels (n = 4 advanced and n = 4 novices) during the perception of sequences of 10 trials containing opponents' attacks at different distances (i.e., short, medium, long), both in field (3D) and laboratory-based scenarios (2D). The likelihood of the opponent' actions was manipulated according to the participant's distance. The participants had to react quickly and accurately, performing a proper dodge to the opponent's hits. A high-speed camera was used to analyze motor behavior. The results showed that the advanced group reacted faster than the novices in the short and long distances, being more accurate at all distances. When the dimensionality was included into the analysis, the group of higher level was faster (2D) and more accurate (2D and 3D) at the three distances. Therefore, the advanced boxers used the interpersonal distance as contextual information to improve the defensive behavior against the opponents.O objetivo do estudo foi comparar o comportamento motor (i.e., tempo de reação e precisão em resposta) em uma pequena amostra de pugilistas nível esporte diferente (n = 4 avançado n = 4 iniciante) durante a percepção de série de 10 ações atacar o adversário em diferentes distâncias (ou seja, de curto, médio, longo), ambos real (3D) situação projetada-video (2D). A probabilidade de uma ação ou outro adversário foi manipulado em função da sua distância um do outro participante. Os participantes devem reagir rapidamente e evasivo oponente ataque running precisamente adequada. Um câmera de alta velocidade foi utilizado para analisar o comportamento do motor. Os resultados mostraram que pugilistas avançados reagiram antes novato no curta e longa distância, mais precisamente em todas as distâncias. Quando a dimensionalidade foi incluído na análise, o grupo de maior nível foi mais rápido em todas as três distâncias (2D) e mais preciso (2D e 3D). Portanto, pugilistas avançados utilizado a distância interpessoal como informação situacional para melhorar o seu comportamento defensivo contra os oponentes

Functional supramolecular tetrathiafulvalene-based films with mixed valences states

Tetrathiafulvalene molecules substituted with a carboxylic acid group (TTFCOOH) were bound as redox-active moieties into a poly(4-vinyl pyridine) (P4VP) skeleton through non-covalent interactions (hydrogen bonds). The aspect of the resulting P4VP-TTFCOOH films showed a uniform and smooth morphology. Moreover, the redox function of TTFCOOH in P4VP-TTFCOOH was demonstrated using tetrachloroauric acid, iron(III) perchlorate and iodine vapors as doping agents. The oxidized states of TTFCOOH as well as the mixed valance state TTFCOOH0-TTFCOOH+• were generated in a controlled manner in solid state, resulting in an organic film capable of charge transport. The charge transport along the organic donor molecules hydrogen bonded to the polymer matrix was demonstrated employing Electrostatic Force Microscopy (EFM)Postprint (author's final draft

Transitive Closure of Interval-valued Relations

This paper introduces some concepts of intervalvalued fuzzy relations and some of their properties: reflexivity, symmetry, T-transitivity, composition and locally reflexivity. It is also introduced the concept of T-transitive closure for an interval-valued fuzzy relation. An algorithm to compute the T-transitive closure of finite interval-valued relations, some properties and some examples are given.Peer ReviewedPostprint (published version

An algorithm to compute the transitive closure, a transitive approximation and a transitive opening of a fuzzy proximity

A method to compute the transitive closure, a transitive opening and a transitive approximation of a reflexive and symmetric fuzzy relation is given. Other previous methods in literature compute just the transitive closure, some transitive approximations or some transitive openings. The proposed algorithm computes the three different similarities that approximate a proximity for the computational cost of computing just one. The shape of the binary partition tree for the three output similarities are the same.Peer ReviewedPostprint (published version

Cavernous sinus metastasis from oropharyngeal squamous cell carcinoma

Metastasis to the cavernous sinus from head and neck cancer is uncommon and has been previously reported by a few authors. It is usually a late manifestation of the primary tumor and may be the first evidence of a widespread dissemination of the disease. Main clinical findings are those related with involvement of cranial nerves III to VI as they pass through the cavernous sinus. Although diagnosis may be difficult, the appearance of clinical and radiological findings of cavernous sinus involvement in a context of head and neck cancer must alert us about an intracranial metastatic infiltration. In most cases treatment is palliative with radiotherapy and/or chemotherapy. The prognosis of this entity is poor, with survival of a few months. We present the case of cavernous sinus metastasis from oropharyngeal squamous cell carcinoma and review the literature about the clinical presentation and management of this rare entity

Transpose return relation method for designing low noise oscillators

In this paper, a new linear method for optimizing compact low noise oscillators for RF/MW applications will be presented. The first part of this paper makes an overview of Leeson's model. It is pointed out, and it is demonstrates that the phase noise is always the same inside the oscillator loop. It is presented a general phase noise optimization method for reference plane oscillators. The new method uses Transpose Return Relations (RRT) as true loop gain functions for obtaining the optimum values of the elements of the oscillator, whatever scheme it has. With this method, oscillator topologies that have been designed and optimized using negative resistance, negative conductance or reflection coefficient methods, until now, can be studied like a loop gain method. Subsequently, the main disadvantage of Leeson's model is overcome, and now it is not only valid for loop gain methods, but it is valid for any oscillator topology. The last section of this paper lists the steps to be performed to use this method for proper phase noise optimization during the linear design process and before the final non-linear optimization. The power of the proposed RRT method is shown with its use for optimizing a common oscillator, which is later simulated using Harmonic Balance (HB) and manufactured. Then, the comparison of the linear, HB and measurements of the phase noise are compared

Gestão estratégica e Inovação empresarial: Referências conceituais /

Universidad Autónoma del Carib

The use of the interpersonal distance in the motor behavior of boxers with different sport level

El objetivo de este estudio fue comparar el rendimiento motor (es decir, el tiempo de reacción y la precisión de la respuesta) de una muestra reducida de boxeadores con diferentes niveles deportivos (n = 4 avanzados y n = 4 novatos) durante la percepción de secuencias de 10 ensayos que contienen oponentes y ataques a diferentes distancias (es decir, corto, medio, largo), tanto en el campo (3D) como en escenarios basados en laboratorio (2D). La probabilidad de las acciones del oponente fue manipulada de acuerdo con la distancia del participante. Los participantes tuvieron que reaccionar de forma rápida y precisa, realizando una evasión adecuada a los golpes del oponente. Se utilizó una cámara de alta velocidad para analizar el comportamiento del motor. Los resultados mostraron que el grupo avanzado reaccionó más rápido que los novatos en las distancias cortas y largas, siendo más preciso en todas las distancias. Cuando se incluyó la dimensionalidad en el análisis, el grupo de nivel superior fue más rápido (2D) y más preciso (2D y 3D) en las tres distancias. Por lo tanto, los boxeadores avanzados utilizaron la distancia interpersonal como información contextual para mejorar el comportamiento defensivo contra los oponentes.The aim of this study was to compare the motor performance (i.e., reaction time and response accuracy) of a reduced boxers sample with different sport levels (n = 4 advanced and n = 4 novices) during the perception of sequences of 10 trials containing opponents´ attacks at different distances (i.e., short, medium, long), both in field (3D) and laboratory-based scenarios (2D). The likelihood of the opponent´ actions was manipulated according to the participant´s distance. The participants had to react quickly and accurately, performing a proper dodge to the opponent´s hits. A high-speed camera was used to analyze motor behavior. The results showed that the advanced group reacted faster than the novices in the short and long distances, being more accurate at all distances. When the dimensionality was included into the analysis, the group of higher level was faster (2D) and more accurate (2D and 3D) at the three distances. Therefore, the advanced boxers used the interpersonal distance as contextual information to improve the defensive behavior against the opponents.• Gobierno de Extremadura y Fondo Europeo de Desarrollo Regional. AyudapeerReviewe