An application of chance-constrained model predictive control to inventory management in hospitalary pharmacy

Trabajo presentado a la 53rd IEEE Conference on Decision and Control (CDC 2014), celebrada del 15 al 17 de diciembre en Los Angeles, California (US).-- et al.Inventory management is one of the main tasks that the pharmacy department has to carry out in a hospital. It is a complex problem that requires to establish a tradeoff between different and contradictory optimization criteria. The complexity of the problem is increased due to the constraints that naturally arise in this type of applications. In this paper, which corresponds to preliminary works performed to implement advanced control techniques for pharmacy management in two Spanish hospitals, we propose and assess chance-constrained model predictive control (CC-MPC) as a mean to relieve this issue.The authors would like to acknowledge Junta de Andalucía (Pharmacon-trol Project, P12-TIC-2400), for funding this work.Peer Reviewe

Combined therapies of antithrombotics and antioxidants delay in silico brain tumor progression

Glioblastoma multiforme, the most frequent type of primary brain tumor, is a rapidly evolving and spatially heterogeneous high-grade astrocytoma that presents areas of necrosis, hypercellularity and microvascular hyperplasia. The aberrant vasculature leads to hypoxic areas and results in an increase of the oxidative stress selecting for more invasive tumor cell phenotypes. In our study we assay in silico different therapeutic approaches which combine antithrombotics, antioxidants and standard radiotherapy. To do so, we have developed a biocomputational model of glioblastoma multiforme that incorporates the spatio-temporal interplay among two glioma cell phenotypes corresponding to oxygenated and hypoxic cells, a necrotic core and the local vasculature whose response evolves with tumor progression. Our numerical simulations predict that suitable combinations of antithrombotics and antioxidants may diminish, in a synergetic way, oxidative stress and the subsequent hypoxic response. This novel therapeutical strategy, with potentially low or no toxicity, might reduce tumor invasion and further sensitize glioblastoma multiforme to conventional radiotherapy or other cytotoxic agents, hopefully increasing median patient overall survival time.Comment: 8 figure

Quality of life associated with treatment adherence in patients with type 2 diabetes: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Despite certain contradictions, an association has been identified between adherence to drug treatment and the quality of life in patients with type 2 diabetes. The contradictions observed emphasize the importance of using different methods to measure treatment adherence, or the association of psychological precursors of adherence with quality of life. For this reason, we have used an indirect method to measure adherence (pill count), as well as two adherence behaviour precursors (attitude and knowledge), to assess the association between adherence and the quality of life in type 2 diabetes patients.</p> <p>Methods</p> <p>A cross-sectional comparative study on a random sample of 238 type 2 diabetic patients was carried out over one year in four family medicine units of the Mexican Institute of Social Security (IMSS) in Aguascalientes, Mexico. Treatment adherence was measured using the indirect method of pill count to assess adherence behaviour, obtaining information at two home visits. In the first we recorded the medicine prescribed and in the second, we counted the medicine remaining to determine the proportion of the medicine taken. We also assessed two adherence behaviour precursors: the patients' knowledge regarding their medical prescription measured through a structured questionnaire; and attitudes to treatment adherence using a Likert scale. Quality of life was measured through the WHOQOL-100 (the WHO Quality of Life questionnaire). Information concerning both knowledge and attitude was obtained through interviews with the patients. A multiple linear regression model was constructed to establish the relationship between each quality of life domain and the variables related to adherence, controlling for covariates.</p> <p>Results</p> <p>There was no association between quality of life and treatment adherence behaviour. However, the combination of strong knowledge and a positive attitude was associated with five of the six quality of life domains.</p> <p>Conclusion</p> <p>The results suggest that it is important to explore psychological precursors of treatment adherence behaviour in type 2 diabetic patients. Indeed, we consider that it will be useful to carry out interventions that change negative attitudes towards treatment adherence and that promote medical prescription knowledge, which may help to improve the quality of life of such patients.</p

Sustainable Orientation of Management Capability and Innovative Performance: The Mediating Effect of Knowledge Management

The literature suggests that innovation allows organizations to reach a desirable level of sustainability. There is evidence to support the role of knowledge management (KM) as well as management capability (MC) in producing a sustainable approach at organizations. Furthermore, organizations commonly achieve sustainable practices through corporate social responsibility (CSR). In particular, the health sector is increasingly implementing CSR strategies, although with a narrow understanding of the factors to success. Hence, trends lead to asymmetric growth between organizations. This study aims to examine the mediating role of KM in the relationship between MC and innovative performance (IP) in 331 Health Provider Institutions (HPIs). The research reflective model was assessed through Partial Least Squares Structural Equation Modeling (PLS-SEM). According to the results, MC has a positive effect on IP, MC has a positive effect on KM, and KM has a positive effect on IP. Likewise, KM significantly mediates the relationship between MC and IP. Our findings support the importance of KM in addressing MCs in HPIs as it enables innovative practices to address CSR goals to achieve a sustainable impact. Moreover, this study contributes by expanding KM to contexts that are not usually studied, such as health in a South American country

Multidimensional emotional disorders inventory: Reliability and validity in a Spanish clinical sample

Background. The categorical approach to diagnosing mental disorders has been criticized for a number of reasons (e.g., high rates of comorbidity; larger number of diagnostic categories and combination). Diverse alternatives have been proposed using a hybrid or totally dimensional perspective. Despite the evidence supporting use of the Multidimensional Emotional Disorders Inventory (MEDI) for assessing the transdiagnostic dimensions of Emotional Disorders using a dimensional-categorical hybrid approach, no data exist on Spanish clinical samples. The present study explores the validity and reliability of the 49-item MEDI in a clinical sample and provides data for its use. Methods. A total of 280 outpatients with emotional disorders attended in different Spanish public Mental Health Units in Spain filled out all questionnaires during the assessment phase and the MEDI again one week after. The instruments used evaluate four main constructs: personality, mood, anxiety and avoidance. Results. The nine original factors were confirmed and showed adequate reliability (α: 0.66–0.91) and stability (r = 0.76–0.87). No differences in mean scores by sex were presented in any subscale (p ≥ .07). The MEDI subscales correlated significantly with the scales of each of the selected constructs (0.45 < r < 0.76). Limitations. The main limitations of this study were the limited sample size and not being able to count on MEDI scores post-transdiagnostic intervention. Conclusions. The MEDI demonstrates adequate reliability and validity. It allows to assess diverse symptoms efficiently, thus being of interest for clinical studies and practice

Identification of non-tuberculous mycobacteria isolated from opossum (Didelphis virginiana) lymph nodes and characterisation of lesions

The aim of this study was to investigate the presence of NTM in the lymph nodes of opossums (D. virginiana) and to characterise the microscopic changes in affected tissue. Retropharyngeal and tracheobronchial lymph nodes were collected postmortem from 18 opossums in the state of Colima, Mexico in 2013. The lymph nodes were also cultured for mycobacterial organisms and processed for histopathological examination. Bacteriological cultures yielded 5/18X100 (28%) isolates of NTM, which were subsequently identified as M. terrae, M. szulgai, M. gastri and M. asiaticum. Microscopic examination of the affected nodes revealed a necrotic granulomatous lymphadenitis (3/60%) composed of histiocytes, epithelioid cells and giant cells with intralesional alcoholresistant acid bacteria. An association between the sex of the opossum and the presence of NTM was observed. To our knowledge, this is the first report of NTM isolation in opossums with granulomatous lymphadenitis in Mexico

Cartilage tissue engineering: adult human mesenchymal stromal cells and collagen biomaterials

Abstract presentado en el 2014 World Congress on Osteoarthritis: Promoting Clinical and Basic Research in Osteoarthriti

Low thermal conductivity in La-filled cobalt antimonide skutterudites with an inhomogeneous filling factor prepared under high-pressure conditions

La-filled skutterudites LaxCo4Sb12 (x : 0.25 and 0.5) have been synthesized and sintered in one step under high-pressure conditions at 3.5 GPa in a piston-cylinder hydrostatic press. The structural properties of the reaction products were characterized by synchrotron X-ray powder diffraction, clearly showing an uneven filling factor of the skutterudite phases, confirmed by transmission electron microscopy. The non-homogeneous distribution of La filling atoms is adequate to produce a significant decrease in lattice thermal conductivity, mainly due to strain field scattering of high-energy phonons. Furthermore, the lanthanum filler primarily acts as an Einstein-like vibrational mode having a strong impact on the phonon scattering. Extra-low thermal conductivity values of 2.39 W/mK and 1.30 W/mK are measured for La0.25Co4Sb12 and La0.5Co4Sb12 nominal compositions at 780 K, respectively. Besides this, lanthanum atoms have contributed to increase the charge carrier concentration in the samples. In the case of La0.25Co4Sb12, there is an enhancement of the power factor and an improvement of the thermoelectric properties