A data generator for covid-19 patients’ care requirements inside hospitals

[EN] A Spanish version of the article is provided (see section before references). This paper presents the generation of a plausible data set related to the needs of COVID-19 patients with severe or critical symptoms. Possible illness’ stages were proposed within the context of medical knowledge as of January 2021. The parameters chosen in this data set were customized to fit the population data of the Valencia region (Spain) with approximately 2.5 million inhabitants. They were based on the evolution of the pandemic between September 2020 and March 2021, a period that included two complete waves of the pandemic. Contrary to expectation and despite the European and national transparency laws (BOE-A2013-12887, 2013; European Parliament and Council of the European Union, 2019), the actual COVID-19 pandemic-related data, at least in Spain, took considerable time to be updated and made available (usually a week or more). Moreover, some relevant data necessary to develop and validate hospital bed management models were not publicly accessible. This was either because these data were not collected, because public agencies failed to make them public (despite having them indexed in their databases), the data were processed within indicators and not shown as raw data, or they simply published the data in a format that was difficult to process (e.g., PDF image documents versus CSV tables). Despite the potential of hospital information systems, there were still data that were not adequately captured within these systems. Moreover, the data collected in a hospital depends on the strategies and practices specific to that hospital or health system. This limits the generalization of "real" data, and it encourages working with "realistic" or plausible data that are clean of interactions with local variables or decisions (Gunal, 2012; Marin-Garcia et al., 2020). Besides, one can parameterize the model and define the data structure that would be necessary to run the model without delaying till the real data become available. Conversely, plausible data sets can be generated from publicly available information and, later, when real data become available, the accuracy of the model can be evaluated (Garcia-Sabater and Maheut, 2021). This work opens lines of future research, both theoretical and practical. From a theoretical point of view, it would be interesting to develop machine learning tools that, by analyzing specific data samples in real hospitals, can identify the parameters necessary for the automatic prototyping of generators adapted to each hospital. Regarding the lines of research applied, it is evident that the formalism proposed for the generation of sound patients is not limited to patients affected by SARS-CoV-2 infection. The generation of heterogeneous patients can represent the needs of a specific population and serve as a basis for studying complex health service delivery systems.[ES] En este trabajo se presenta cómo se ha generado un conjunto de datos verosímiles relacionados con las necesidades de pacientes covid-19 con síntomas severe or critical. Se considerarán las etapas posibles con los conocimientos médicos a fecha de enero de 2021. Los parámetros elegidos en este data set están personalizados para adecuarse a los valores poblacionales de la región de Valencia (Spain), unos 2.5 Millones de habitantes y la evolución de la pandemia entre los meses de septiembre 2020 y marzo 2021, un periodo de tiempo que contemple dos olas completas de pandemia.En contra de lo que cabría esperar, a pesar de la ley de transparencia europea y nacional (BOE-A-2013-12887, 2013; Parlamento Europeo y del Consejo de la Unión Europea, 2019), los datos reales relacionados con la pandemia covid-19, al menos en España, tardan mucho en actualizarse y estar disponibles (normalmente una semana o más días). Además, algunos datos relevantes para trabajar los modelos de gestión de camas de hospital no están accesibles públicamente. Bien porque no se hayan recogido esos datos, o porque los organismos públicos no los ofrecen (a pesar de tenerlos indexados en sus bases de datos), o los ofrecen camuflados en indicadores procesados y no muestran los datos en bruto, o simplemente los publican en un formato de difícil reutilización (por ejemplo, en documentos PDF en lugar de en tablas CSV). A pesar de que los sistemas de información de los hospitales son bastante potentes, siguen existiendo datos que ni siquiera están recogidos adecuadamente en el sistema de información de salud.Por otra parte, los datos recogidos en un hospital dependen de las estrategias y practicas propias de ese hospital o sistema de salud. Este efecto limita la generalización de los datos “reales” y es necesario trabajar con datos “realistas” o verosímiles que están limpios de interacciones con variables o decisiones locales (Gunal, 2012; Marin-Garcia et al., 2020). Por un lado, se puede parametrizar el modelo y definir la estructura de datos que sería necesaria para ejecutar el modelo con datos reales. Por otro lado, se pueden generar conjuntos de datos verosímiles a partir de la información pública disponible y, posteriormente, cuando se disponga de los datos reales evaluar la bondad del modelo (Garcia-Sabater & Maheut, 2021).Marin-Garcia, JA.; Ruiz, A.; Julien, M.; Garcia-Sabater, JP. (2021). A data generator for covid-19 patients’ care requirements inside hospitals. WPOM-Working Papers on Operations Management. 12(1):76-115. https://doi.org/10.4995/wpom.1533276115121Alexander, G. L. (2007). The nurse-patient trajectory framework. Medinfo. MEDINFO, 12(Pt 2), 910- 914.Belciug, S., Bejinariu, S. I., & Costin, H. (2020). An artificial immune system approach for a multicompartment queuing model for improving medical resources and inpatient bed occupancy in pandemics. 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Protocol: Triple Diamond method for problem solving and design thinking. Rubric validation

[EN] There is a set of tools that we can use to improve the results of each of the phases that continuous improvement projects must go through (8D, PDCA, DMAIC, Double diamond, etc.). These methods use divergent techniques, which help generate multiple alternatives, and convergent techniques that help analyze and filter the generated options. However, the tools used in all those frameworks are often very similar. Our goal, in this research, is to develop a comprehensive model that allows it to be used both for problem-solving and for taking advantage of opportunities. This protocol defines the main terms related to our research, makes a framework proposal, proposes a rubric that identifies observable milestones at each stage of the model and proposes the action plan to validate this rubric and the model in a given context. The action plan will be implemented in a future research.Marin-Garcia, JA.; Garcia-Sabater, JJ.; Garcia-Sabater, JP.; Maheut, J. (2020). Protocol: Triple Diamond method for problem solving and design thinking. Rubric validation. WPOM-Working Papers on Operations Management. 11(2):49-68. https://doi.org/10.4995/wpom.v11i2.14776OJS496811

A Triple-A supply chain measurement model: validation and analysis

"This article is (c) Emerald Group Publishing and permission has been granted for this version to appear here https://doi.org/10.1108/IJPDLM-06-2018-0233. Emerald does not grant permission for this article to be further copied/distributed or hosted elsewhere without the express permission from Emerald Group Publishing Limited"[EN] Purpose The purpose of this paper is to establish definitions and dimensions of Triple-A supply chain (SC) variables based on a literature review and to validate a Triple-A SC measurement model using a worldwide multiple informant sample. Design/methodology/approach Following a literature review, Triple-A SC variables (agility, alignment and adaptability) are conceptualized and a list of possible items is created for their measurement. An international 309 plant sample is used to validate the convergent and criterion validities of the composites proposed to measure Triple-A SC. Findings Contributions to the literature: clarification of Triple-A SC variable concepts; identification of key dimensions of Triple-A SC variables; development of a validated Triple-A SC measurement scale for future empirical research and industrial applications. Research limitations/implications A rigorously validated instrument is needed to measure Triple-A SC variables and enable researchers to credibly test theories regarding causal links between capabilities, practices and performance. Practical implications Proposal of a scale for use by managers of different functions to analyze Triple-A SC deployment in the company. Originality/value The only Triple-A SC scale used in the previous literature has serious limitations: scales were not taken from an extended literature review; data were collected from single respondents in a single country. This is the first validated Triple-A SC measurement model to overcome these limitations.This study has been conducted within the frameworks of the following projects: 'Accion especial SGUIT-2015 (SBAPA2015-06) HPM-(Project 2015/148 U.S.)-Junta de Andalucia (Spain); PAIDI Excellence Project P08-SEJ-0384-Junta de Andalucia (Spain); and DPI2009-11148-Spanish National Program of Industrial Design and Production.Marin-Garcia, JA.; Alfalla-Luque, R.; Machuca, JA. (2018). A Triple-A supply chain measurement model: validation and analysis. International Journal of Physical Distribution and Logistics Management. 48(10):976-994. https://doi.org/10.1108/IJPDLM-06-2018-0233S9769944810Agarwal, A., Shankar, R., & Tiwari, M. K. (2007). Modeling agility of supply chain. Industrial Marketing Management, 36(4), 443-457. doi:10.1016/j.indmarman.2005.12.004Alfalla-Luque, R., & Medina-López, C. (2009). Supply Chain Management: Unheard of in the 1970s, core to today’s company. 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Alpine forbs rely on different photoprotective strategies during spring snowmelt

Snowmelt in alpine ecosystems brings ample water, and together with above-freezing temperatures, initiates plant growth. In this scenario, rapid activation of photosynthesis is essential for a successful life-history strategy. But, strong solar radiation in late spring enhances the risk of photodamage, particularly before photosynthesis is fully functional. We compared the photoprotective strategy of five alpine forbs: one geophyte not particularly specialised in subnival life (Crocus albiflorus) and four wintergreens differing in their degree of adaptation to subnival life, from least to most specialised: Gentiana acaulis, Geum montanum, Homogyne alpina and Soldanella alpina. We used distance to the edge of snow patches as a proxy to study time-dependent changes after melting. We postulated that the photoprotective response of snowbed specialists would be stronger than of more-generalist alpine meadow species. F-v/F-m was relatively low across wintergreens and even lower in the geophyte C. albiflorus. This species also had the largest xanthophyll-cycle pool and lowest tocopherol and flavonoid glycoside contents. After snow melting, all the species progressively activated ETR, but particularly the intermediate snowbed species G. acaulis and G. montanum. The photoprotective responses after snowmelt were idiosyncratic: G. montanum rapidly accumulated xanthophyll-cycle pigments, tocopherol and flavonoid glycosides; while S. alpina showed the largest increase in plastochromanol-8 and chlorophyll contents and the greatest changes in optical properties. Climate warming scenarios might shift the snowmelt date and consequently alter the effectiveness of photoprotection mechanisms, potentially changing the fitness outcome of the different strategies adopted by alpine forbs.Peer reviewe

Potential Production of Ethanol by Saccharomyces cerevisiae Immobilized and Coimmobilized with Zymomonas mobilis: Alternative for the Reuse of a Waste Organic

Fermentation technologies have been developed to improve the production of ethanol and an alternative is the immobilization technology, which offers the possibility of efficiently incorporating symbiotic bacteria in the same matrix. This study analyzes the potential use of immobilized and coinmobilized systems on beads of calcium alginate for ethanol production used mango waste (Mangifera indica) by Zymomonas mobilis and Saccharomyces cerevisiae compared with free cells culture and evaluate the effect of glucose concentration on productivity in coimmobilized system using a Chemostat reactor Ommi Culture Plus. For free cell culture, the productivity was higher for Z. mobilis (5.76 g L-1 h-1) than for S. cerevisiae (5.29 g L-1 h-1); while in coimmobilized culture, a higher productivity was obtained (8.80 g L-1 h-1) with respect to immobilized cultures (8.45 g L-1 h-1 - 8.70 g L-1 h-1). The conversion of glucose to ethanol for coimmobilized system was higher (6.91 mol ethanol) with 50 g L-1 of glucose compared to 200 g L-1 of glucose (5.82 mol ethanol); suggesting the immobilized and coimmobilized cultures compared with free cells offer an opportunity for the reuse of organic residues and high alcohol production

Atresia anal en el perro y el gato

Ponencia en el XXXI CONGRESO NACIONAL DE LA ASOCIACIÓN MEXICANA DE MÉDICOS VETERINARIOS ESPECIALISTAS EN PEQUEÑAS ESPECIES, A.C.La atresia anal es una patología poco frecuente con una prevalencia del 0.13% y del 1.6% para el caso de los perros y de los gatos menores de un año de edad respectivamente, atendidos en nuestro centro hospitalario. En el presente documento se expone la experiencia en el diagnóstico y manejo de tres pacientes con atresia anal, realizamos una revisión de las teorías de los mecanismos fisiopatológicos involucrados en el desarrollo embrionario, y con base en esos criterios, sugerimos la mejor clasificación del tipo de atresia anal partiendo del análisis de las propuestas existentes y su relación con los conceptos actuales de la anatomía embriológica

Electrohysterography in the diagnosis of preterm birth: a review

This is an author-created, un-copyedited versíon of an article published in Physiological Measurement. IOP Publishing Ltd is not responsíble for any errors or omissíons in this versíon of the manuscript or any versíon derived from it. The Versíon of Record is available online at http://doi.org/10.1088/1361-6579/aaad56.[EN] Preterm birth (PTB) is one of the most common and serious complications in pregnancy. About 15 million preterm neonates are born every year, with ratios of 10-15% of total births. In industrialized countries, preterm delivery is responsible for 70% of mortality and 75% of morbidity in the neonatal period. Diagnostic means for its timely risk assessment are lacking and the underlying physiological mechanisms are unclear. Surface recording of the uterine myoelectrical activity (electrohysterogram, EHG) has emerged as a better uterine dynamics monitoring technique than traditional surface pressure recordings and provides information on the condition of uterine muscle in different obstetrical scenarios with emphasis on predicting preterm deliveries. Objective: A comprehensive review of the literature was performed on studies related to the use of the electrohysterogram in the PTB context. Approach: This review presents and discusses the results according to the different types of parameter (temporal and spectral, non-linear and bivariate) used for EHG characterization. Main results: Electrohysterogram analysis reveals that the uterine electrophysiological changes that precede spontaneous preterm labor are associated with contractions of more intensity, higher frequency content, faster and more organized propagated activity and stronger coupling of different uterine areas. Temporal, spectral, non-linear and bivariate EHG analyses therefore provide useful and complementary information. Classificatory techniques of different types and varying complexity have been developed to diagnose PTB. The information derived from these different types of EHG parameters, either individually or in combination, is able to provide more accurate predictions of PTB than current clinical methods. However, in order to extend EHG to clinical applications, the recording set-up should be simplified, be less intrusive and more robust-and signal analysis should be automated without requiring much supervision and yield physiologically interpretable results. Significance: This review provides a general background to PTB and describes how EHG can be used to better understand its underlying physiological mechanisms and improve its prediction. The findings will help future research workers to decide the most appropriate EHG features to be used in their analyses and facilitate future clinical EHG applications in order to improve PTB prediction.This work was supported by the Spanish Ministry of Economy and Competitiveness and the European Regional Development Fund under grant DPI2015-68397-R.Garcia-Casado, J.; Ye Lin, Y.; Prats-Boluda, G.; Mas-Cabo, J.; Alberola Rubio, J.; Perales Marin, AJ. (2018). Electrohysterography in the diagnosis of preterm birth: a review. Physiological Measurement. 39(2). https://doi.org/10.1088/1361-6579/aaad56S39

Comparison of non-invasive electrohysterographic recording techniques for monitoring uterine dynamics

Non-invasive recording of uterine myoelectric activity (electrohysterogram, EHG) could provide an alternative to monitoring uterine dynamics by systems based on tocodynamometer (TOCO). Laplacian recording of bioelectric signals has been shown to give better spatial resolution and less interference than mono and bipolar surface recordings. The aim of this work was to study the signal quality obtaines from monopolar, bipolar and Laplacian techniques in EHG recordings, as well as to assess their ability to detect uterine contractions. Twenty-two recording sessions were carried out on singleton pregnant women during the active phase of labour. In each session the following simultaneous recordings were obtained: internal uterine pressure (IUP), external tension of abdominal wall (TOCO) and EHG signals (5 monopolar and 4 bipolar recordings, 1 discrete aproximation to the Laplacian of the potential and 2 estimates of the Laplacian from two active annular electrodes). The results obtained show that EHG is able to detect a higher number of uterine contractions than TOCO. Laplacian recordings give improved signal quality over monopolar and bipolar techniques, reduce maternal cardiac interference and improve the signal-to-noise ratio. The optimal position for recording EHG was found to be the uterine median axis and the lower centre-right umbilical zone.Research partly supported by the Spanish Ministerio de Ciencia y Tecnologia (TEC2010-16945) and the Universitat Politecnica de Valencia (PAID 2009/10-2298). The translation of this paper was funded by the Universitat Politecnica de Valencia, Spain.Alberola Rubio, J.; Prats Boluda, G.; Ye Lin, Y.; Valero, J.; Perales Marin, AJ.; Garcia Casado, FJ. (2013). Comparison of non-invasive electrohysterographic recording techniques for monitoring uterine dynamics. Medical Engineering and Physics. 35(12):1736-1743. https://doi.org/10.1016/j.medengphy.2013.07.008S17361743351

Pathology of cattle experimentally intoxicated with ground Ricinus communis seeds

Five Aberdeen Angus calves were inoculated intra-ruminally with ground seeds of Ricinus communis at doses of 1, 1.5, 2 or 3 gr per kg of body weight, or with saline solution (control), respectively. Grossly, all intoxicated animals showed hemorrhages in abdominal serosas, epicardium, endocardium, spleen, pre-stomachs, abomasum, and small and large intestine, and diffuse edema of the ruminal mucosa. Microscopically, in all animals inoculated with R. communis seeds, the main feature was the presence of pyknotic and karyorrhectic nuclei in the endothelium of central nervous system, hepatic, ruminal, intestinal, glomerular and alveolar capillaries, and in lymphoid cells of multiple organs. Apoptosis, confirmed by activated caspase-3 immunohistochemistry, was observed in these cells. No gross or microscopic lesions were observed in the control animal. The results of this study suggest that apoptosis is the main mechanism of cell death in cattle intoxicated with R. communis seeds.EEA BalcarceFil: Marin, Raúl. Universidad Nacional de Jujuy; Argentina.Fil: Schild, Carlos. Instituto Nacional de Investigación Agropecuaria (INIA); Uruguay.Fil: García, Juan. Universidad de la República. Centro Universitario de la Región del Este; Uruguay.Fil: Cantón, Germán. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina.Fil: Micheloud, Juan. INTA, Estación Experimental Agropecuaria Salta; Argentina.Fil: Morrell, Eleonora. INTA, Estación Experimental Agropecuaria Balcarce; Argentina.Fil: Uzal, Francisco. Universidad de California; Estados Unidos