Determining Staffing Levels for Contingency Contract Administration Support

The purpose of this thesis is to investigate different manpower models used by CONUS contracting offices which may be of use in determining CCAS team personnel requirements. In this research effort I intend to answer the following question: \u27which of the most commonly employed CONUS manning model methodologies offers the best practical solution to the problem of staffing a contingency contracting operation?\u2

Character template estimation from document images and their transcriptions

Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 1995.Includes bibliographical references (p. 124-126).by Mauricio Lomelin Stoupignan.M.S

Modelo de articulación entre los proyectos educativos institucionales en educación básica y media que propenden por la conservación del patrimonio turístico en el municipio de salado blanco del departamento del Huila.

Esta proyecto obedece a la oportunidad de implementar dentro de los procesos de formación académicos de las Instituciones Educativas del Municipio de Saladoblanco; actividades que articulen el patrimonio turístico existente con los Planes Educativos Institucionales (PEI) de tal manera que manteniendo los lineamientos nacionales estandarizados por la Ley 115 de 1994 que son consolidados en los planes de estudio de la Institución Educativa La Cabaña y Misael Pastrana Borrero permitan formar una cultura turística en los estudiantes las cuales potencializarán al Municipio como uno de los destinos turísticos en el mediano plazo. El Municipio de Saladoblanco dentro del Plan de Desarrollo “Unidos es Mejor” 2016- 2019, trae los lineamientos básicos para el fomento del desarrollo turístico con criterio de sostenibilidad y competitividad. Es pertinente que en el proceso de actualización del Esquema de Ordenamiento Territorial se incorpore el turismo como un uso productivo del suelo para el desarrollo de actividades de contacto con la naturaleza, aventura, salud y bienestar, como también el desarrollo de actividades culturales, entre ellos la construcción de escenarios arqueológicos que motiven la llegada de turistas de origen nacional e internacional. Todo este proceso y la implementación del mismo requiere de una verdadera cultura turística que solo podrá alcanzar su éxito si se construye desde la base; niños, niñas y adolescentes del Jardín del Huila.This project is due to the opportunity to implement within the academic formation processes of the Educational Institutions of the Municipality of Saladoblanco; activities that articulate the existing tourism heritage with the Institutional Educational Plans (PEI) in such a way that maintaining the national guidelines standardized by Law 115 of 1994 that are consolidated in the study plans of the Educational Institution La Cabaña and Misael Pastrana Borrero allow to form a tourist culture in the students which will empower the Municipality as one of the tourist destinations in the medium term. The Municipality of Saladoblanco within the Development Plan "United is Better" 2016-2019, brings the basic guidelines for the promotion of tourism development with criteria of sustainability and competitiveness. It is pertinent that in the process of updating the Territorial Ordinance Scheme, tourism is incorporated as a productive use of land for the development of activities of contact with nature, adventure, health and well-being, as well as the development of cultural activities, among them the construction of archaeological sites that motivate the arrival of tourists of national and international origin. All this process and the implementation of it requires a true tourist culture that can only be successful if it is built from the base; children and adolescents of the Garden of Huila

Descripción del comportamiento de la política fiscal del Municipio de Tuluá del año 2003 al 2008

PregradoCONTADOR(A) PÚBLIC

Por Iuan Iacome Lomelin sobre la merced que tiene suplicado le haga su Magestad de concederle revista en el pleito que trata con los herederos de Francisco Serra [Texto impreso]

El texto alude repetidas veces al año 1627 como año pasadoInicial grab. xilSign. : A-E

1358-P: Point of Care OGTT for the Screening of Gestational Diabetes: A Feasible Proposal for Low-Resource Settings

Due to the ubiquity of risk factors associated with gestational diabetes (GDM) in Mexican women and the low availability of the Oral Glucose Tolerance Test (OGTT), we compared the efficacy of two point of care (POC) models for GDM detection against the plasmatic 2hr OGTT-75gr in primary health care clinics in Mexico. We evaluated 328 pregnant women without previous diabetes diagnosis from a prospective cohort study “Cuido mi embarazo”; all of them were tested with the gold standard plasmatic 2hr OGTT-75gr for the diagnosis of GDM based on the ADA 2019 criteria. Simultaneously, we measured with a glucometer (ACCU-CHEK instant®) the glucose concentration either by capillary whole blood (172 measures) or from venous whole blood (156 measures). We evaluated the diagnostic accuracy by calculating the sensitivity, specificity, and ROC curve of each of the glucometer test results compared to the plasmatic test. For the first model, POC venous OGTT, the incidence of GDM was 41.66% compared to 7.05% of the plasmatic test. The ROC area under the curve for GDM prediction was 0.81 (95% CI 0.77-0.85), with a sensitivity of 100% and specificity of 62.8%. The low specificity is dependent on the fasting venous value of 64% since it was compared to 95% and 97% specificity of the 1hr and 2hr values, respectively. The second model, POC capillary OGTT, had an incidence of GDM of 30.23% compared to 8.13% of the plasmatic test. It had lower sensitivity (78.57%) and higher specificity (74.1%) compared to the first model, having an overall 0.76 (95% CI 0.65-0.88) ROC area under the curve for GDM prediction. We propose POC venous OGTT as a feasible diagnostic alternative for low resource settings where laboratory infrastructure is not available. Its positive bias could be beneficial since the treatment and control of early cases is related to better health outcomes for the moms and their babies. Further analysis is needed to improve GDM, POC screening interventions. Disclosure H. Gallardo: None. J. Lomelin-Gascon: Other Relationship; Self; Lilly Global Health Partnership. L.A. Martinez: Other Relationship; Self; Lilly Global Health Partnership. A. Montoya: None. E. Reyes-Muñoz: None. R.C. Tapia-Conyer: None. Funding Eli Lilly and Company </jats:sec

Persistent Aortic Stiffness and Left Ventricular Hypertrophy in Children of Diabetic Mothers

Publisher Copyright: © 2020 Canadian Cardiovascular SocietyBackground: Fetuses of diabetic mothers develop left ventricular (LV) hypertrophy and are at increased long-term risk of cardiovascular disease. In our previous longitudinal study from midgestation to late infancy we showed persistence of LV hypertrophy and increased aortic stiffness compared with infants of healthy mothers, the latter of which correlated with third trimester maternal hemoglobin A1c. In the present study, we reexamined the same cohort in early childhood to determine if these cardiovascular abnormalities persisted. Methods: Height, weight, and right arm blood pressure were recorded. A full functional and structural echocardiogram was performed with offline analysis of LV posterior wall and interventricular septal diastolic thickness (IVSd), systolic and diastolic function, and aortic pulse wave velocity. Vascular reactivity was assessed using digital thermal monitoring. Participants also completed a physical activity questionnaire. Results: Twenty-five children of diabetic mothers (CDMs) and 20 children from healthy pregnancies (mean age, 5.6 ± 1.7 and 5.3 ± 1.3 years, respectively; P = not significant) were assessed. Compared with controls, IVSd z score was increased in CDMs (1.2 ± 0.6 vs 0.5 ± 0.3, respectively; P = 0.006), with one-fifth having a z score of more than +2.0. Aortic pulse wave velocity was increased in CDMs (3.2 ± 0.6 m/s vs 2.2 ± 0.4 m/s; P = 0.001), and correlated with IVSd z score (R2 = 0.81; P = 0.001) and third trimester maternal A1c (R2 = 0.65; P < 0.0001). Body surface area, height, weight, blood pressure, vascular reactivity, and physical activity scores did not differ between groups. Our longitudinal analysis showed that individuals with greater IVSd, and aortic stiffness in utero, early and late infancy also tended to have greater measures in early childhood (P < 0.001 and P < 0.0001, respectively). Conclusions: CDMs show persistently increased interventricular septal thickness and aortic stiffness in early childhood.Peer reviewe

Intrauterine exposure to chronic hypoxia in the rat leads to progressive diastolic function and increased aortic stiffness from early postnatal developmental stages

Aim We sought to explore whether fetal hypoxia exposure, an insult of placental insufficiency, is associated with left ventricular dysfunction and increased aortic stiffness at early postnatal ages. Methods Pregnant Sprague Dawley rats were exposed to hypoxic conditions (11.5% FiO2) from embryonic day E15‐21 or normoxic conditions (controls). After delivery, left ventricular function and aortic pulse wave velocity (measure of aortic stiffness) were assessed longitudinally by echocardiography from day 1 through week 8. A mixed ANOVA with repeated measures was performed to compare findings between groups across time. Myocardial hematoxylin and eosin and picro‐sirius staining were performed to evaluate myocyte nuclear shape and collagen fiber characteristics, respectively. Results Systolic function parameters transiently increased following hypoxia exposure primarily at week 2 (p \u3c .008). In contrast, diastolic dysfunction progressed following fetal hypoxia exposure beginning weeks 1–2 with lower early inflow Doppler velocities, and less of an increase in early to late inflow velocity ratios and annular and septal E’/A’ tissue velocities compared to controls (p \u3c .008). As further evidence of altered diastolic function, isovolumetric relaxation time was significantly shorter relative to the cardiac cycle following hypoxia exposure from week 1 onward (p \u3c .008). Aortic stiffness was greater following hypoxia from day 1 through week 8 (p \u3c .008, except week 4). Hypoxia exposure was also associated with altered nuclear shape at week 2 and increased collagen fiber thickness at week 4. Conclusion Chronic fetal hypoxia is associated with progressive LV diastolic dysfunction, which corresponds with changes in nuclear shape and collagen fiber thickness, and increased aortic stiffness from early postnatal stages

Maternal and cord blood hemoglobin as determinants of placental weight: A cross-sectional study

Background: Both high and low placental weights are associated with adverse pregnancy outcomes. Maternal hemoglobin levels can influence placental weight, but the evidence is conflicting. Since maternal hemoglobin does not invariably correlate with fetal/neonatal blood hemoglobin levels, we sought to determine whether cord blood hemoglobin or maternal hemoglobin status more closely associates with placental weight in women undergoing elective cesarean section at term. Methods: This was a cross-sectional study conducted at the Royal Alexandra Hospital, Edmonton, Canada, involving 202 women with term singleton pregnancies undergoing elective cesarean section. Maternal blood and mixed cord blood hemoglobin levels were analyzed using a HemoCue Hb201+ system. Birth weight, placental weight, one-and five-minute APGAR scores, American Society of Anesthesiologists physical state classification, maternal age, and maternal height were also recorded. Relationships between maternal and cord blood hemoglobin levels with placental weight, birth weight, and birth weight to placental weight ratio were the main outcome measures. Results: A total of 182 subjects were included in the analysis. Regression analysis showed that cord blood hemoglobin, but not maternal hemoglobin, was inversely related with placental weight (β = −2.4, p = 0.001) and positively related with the birth weight to placental weight ratio (β = 0.015, p = 0.001 and p = 0.63, respectively). Conclusions: Our findings suggest that measuring cord blood hemoglobin levels, rather than maternal hemoglobin levels, may provide important diagnostic information about in utero fetal adaptation to suboptimal placental function and neonatal health