The Medicalization of End-of-Life Care: The Role of Health Professions Education

In the past 100 years, the advances in medical science and technology have shaped the health care delivery system in remarkable ways. The side effect of these advances has been a tendency to dehumanize the dying process, and consequently it has led to the rise of a specialty focused merely on bridging this gap in care. The public’s expectations of our legal, licensing, and medical education systems have also reflected this evolution in health care

Born-Oppenheimer and Renner-Teller coupled-channel quantum reaction dynamics of O(3P) + H2+(X2Σg+) collisions

We present Born-Oppenheimer (BO) and Renner-Teller (RT) time dependent quantum dynamics studies of the reactions O(3P) + H2+(X2Σg+) → OH+(X3Σ-) + H(2S) and OH(X2Π) + H+. We consider the OH2+ X˜2A″ and Ã2A′ electronic states that correlate with a linear 2Π species. The electronic angular momenta operators L and L2 are considered in nonadiabatic coupled-channel calculations, where the associated RT effects are due to diagonal VRT potentials that add up to the PESs and to off-diagonal CRTcouplings between the potential energy surfaces (PESs). Initial-state-resolved reaction probabilities PI, integral cross sections σI, and rate constants kI are obtained using recent ab initio PESs and couplings and the real wavepacket formalism. Because the PESs are strongly attractive, PI have no threshold energy and are large, σI decrease with collision energy, and kI depend little on the temperature. The X˜2A″ PES is up to three times more reactive than the Ã2A′ PES and H2+ rotational effects (j0 = 0, 1) are negligible. The diagonal VRT potentials are strongly repulsive at the collinearity and nearly halve all low-energy observables with respect to the BO ones. The off-diagonal CRTcouplings are important at low partial waves, where they mix the X˜2A″ and Ã2A′ states up to ∼20%. However, VRT effects predominate over the CRT ones that change at most by ∼19% the BO values of σI and kI. The reaction O(3P) + H2+(X2Σg+) → OH+(X3Σ-) + H(2S) is probably one of the most reactive atom + diatom collisions because its RT rate constant at room temperature is equal to 2.26 × 10-10 cm3 s-1. Within the BO approximation, the present results agree rather well with recent quasiclassical and centrifugal-sudden data using the sa me PESsThis work was supported by the Spanish Ministry of Science and Innovation (MICINN projects CTQ2011-27857-C02-01 and CONSOLIDER INGENIO 2010 under grant no. CSD2009-00038 entitled ‘‘Molecular Astrophysics: the Herschel and Alma era’’). Thanks are also given to the ‘‘Generalitat de Catalunya’’ (Autonomous Government of Catalonia; refs. 2014SGR 25, 2014SGR 1582 and XRQTC) for some help. We gratefully acknowledge H. Guo and D. Xie for the matrix elements of the electronic angular moment

Nanostructural differences in pectic polymers isolated from strawberry fruits with low expression levels of pectate lyase or polygalacturonase genes

Our research group has obtained transgenic strawberry plants expressing antisense sequences of either a pectate lyase (APEL lines) [1] or a polygalacturonase gene (APG lines) [2]. Both genes encode ripening-specific endo-pectinases with a common target, deesterified homogalacturonans, but each enzyme act by a different mechanism and pH range. Ripe fruits from both transgenic genotypes were significantly firmer than control, being APG fruits on average 25% firmer than APEL fruits. Cell wall analysis of both transgenic genotypes indicated that pectin fractions extracted with CDTA and sodium carbonate were significantly modified in transgenic fruits [2,3]. To gain insight in the role of these pectinases in pectin disassembly during ripening, CDTA and Na2CO3 pectins have been analyzed by atomic force microscopy (AFM). APEL and APG CDTA pectins had similar contour lengths but both were significantly longer than control. Similarly, APG carbonate chains were longer than control, showing APEL carbonate chains an intermediate length. Furthermore, transgenic pectins displayed a more complex branching pattern and a higher number of micellar aggregates, especially in the sodium carbonate fractions of APG samples. Acid hydrolysis of carbonate pectins reduced the number of micellar aggregates. AFM analyses confirm that the inhibition of both pectinases reduces pectin disassembly, and also suggest that each pectinase acts on specific pectin domains. Particularly, polygalacturonase silencing induces more significant pectin modifications, nicely correlated with the firmer phenotype of APG fruits, than the down-regulation of pectate lyase

Caracterización del drenaje de aguas lluvias de la plataforma interior del aeropuerto El Dorado

Saneamiento de comunidadesEn este documento se presenta la caracterización de la red del sistema de Alcantarillado Pluvial de la Plataforma Interior del Aeropuerto El Dorado de la Ciudad de Bogotá, Colombia, en términos del desempeño y la capacidad del mismo, para hacer frente a caudales máximos de diseño y evitar inundaciones por fenómenos de presurización. En este sentido, a partir de la identificación de las condiciones de la red en términos de diseño hidráulico, se reconocieron algunas razones que posiblemente puedan ser detonantes frente a fenómenos de inundación. Para tal fin, se realizó una comprobación de diseño a partir de una hoja de cálculo y una simulación de los segmentos de la red de alcantarillado que contaban con información completa mediante el software EPA-SWMM. De esta forma se identificaron algunos problemas de funcionamiento relacionados con cambios en la topología de las redes existentes por el acople de las nuevas obras de drenaje en la plataforma.Trabajo de GradoINTRODUCCIÓN 2 MARCOS DE REFERENCIA 3 METODOLOGÍA 4 DESCRIPCION DE LA RED DE ALCANTARILLADO PLUVIAL 5 ANALISIS DE LA TORMENTA REGISTRADA EL DÍA 20 DE ABRIL DE 2017 6 ESTIMACION DE CAUDALES DE DISEÑO 7 MODELACIÓN DEL COMPORTAMIENTO HIDRÁULICO DE LA RED 8 CONCLUSIONES Y RECOMENDACIONES 9 BIBLIOGRAFÍA 10 APENDICESEspecializaciónEspecialista en Recursos Hídrico

Comparación de dos técnicas para la determinación de carbono orgánico del suelo, en le LAFQA Departamento de Química, UNAN-Managua, Septiembre-Diciembre,2015

Se determina la concentración de carbono orgánico del suelo mediante las técnicas: volumétrica (V) y colorimétrica (C), las cuales están basadas en el método de combustión húmeda de Walkley & Black, y se determina parámetros de eficiencia mediante contrastes estadísticos. La técnica (V) determina una concentración de 11.40 ± 2.00 g/kg con precisión de 7.44% y exactitud de 27.61% en un MRC, en cambio la técnica (C) determina una concentración de 8.37 ± 1.54 g/kg con precisión de 9.14% y exactitud de 6.31% para el MRC. Sin embargo la determinación colorimétrica presenta una mejor precisión de 1.88% en la muestra PLANTEL en comparación a la precisión volumétrica de 7.43%, la precisión colorimétrica mejora debido al aumento del número de réplicas. La técnica colorimétrica presenta mejor precisión y exactitud con respecto a la técnica volumétrica e incertidumbres muy cercanas es por eso que la determinación colorimétrica resulta ser más eficiente para la determinación de carbono orgánico del suelo. Se recomienda utilizar la técnica colorimétrica debido a que proporciona datos más exactos y más precisos. Palabras clave: Carbono Orgánico, Volumetría, Colorimetría, Precisión, Exactitud, Incertidumbr

State-to-state reaction probabilities using bond coordinates: application to the Li+HF(v,j) collision

A time-dependent method to evaluate state-to-state reaction probabilities is presented. For demonstration purposes, the method is applied to Li+HF(v=0, 1, j=0, J=0) reactive collisions using the global potential energy surfaces (GPES). This accuracy of the method is very good when compared with recent time-independent hyperspherical calculations in this system.This work has been supported by DGICYT (Ministerio de Educación y Ciencia, Spain) under Grant Nos. PB97-0027 and PB95-0071, and by the European TMR network Contract No. ERBFMRXCT96-0088. M. L. also thanks the Comunidad Autónoma de Madrid for a Grant. We also want to acknowledge DGICYT and CIEMAT for the use of a CRAY-J90.Peer Reviewe

Influence of transhumance on the leonese dialectalism of the province of Salamanca

[ES] El efecto de la trashumancia ha sido muy importante para el mantenimiento de los rasgos dialectales en la actual provincia de Salamanca. Los viajes periódicos de los pastores, desde la montaña de León a las sierras del sur de esta provincia, supusieron un efecto continuador en el habla desde los primeros tiempos de los asentamientos medievales de colonos. Estos rasgos siguieron bastante presentes hasta la llegada de las comunicaciones de masas.[EN] The effect of transhumance has been very important for the maintenance of dialectal traits in the current province of Salamanca. The periodic journeys of the shepherds, from the mountains of León to the mountains south of Salamanca, had a continuing effect on speech since the early days of the medieval colonist settlements. These traits remained quite present until the advent of mass communications

La Influencia de la trashumancia en el dialectalismo leonés de la provincia de Salamanca

El efecto de la trashumancia ha sido muy importante para el mantenimiento de los rasgos dialectales en la actual provincia de Salamanca. Los viajes periódicos de los pastores, desde la montaña de León a las sierras del sur de esta provincia, supusieron un efecto continuador en el habla desde los primeros tiempos de los asentamientos medievales de colonos. Estos rasgos siguieron bastante presentes hasta la llegada de las comunicaciones de masas

BMI and low bone mass in an elderly male nursing home population

Little is known about osteoporosis in institutionalized older adults. Risk factors such as low body mass index (BMI) have been investigated in female populations, but remain understudied in men. The objective of this study was to examine characteristics of older men residing in a nursing home who received bone mineral density evaluations. 57 male Miami Veterans Affairs Medical Center (VAMC) nursing home residents were screened for osteoporosis using a peripheral dual X-ray (pDXA) technique. T-scores were categorized into three groups: normal (0 > -1); osteopenic (-1 to -2.49); osteoporotic (< -2.5). Average age was 76.2 years (standard deviation = 11.5; range: 48-100). T-scores indicated that 37.3% of the population was normal, 35.6% osteopenic, and 27.1% osteoporotic. 35.6% of patients had normal BMIs, 3.4% were underweight, 47.5% were overweight, and 13.6% were considered obese. There was a high prevalence of overweight and obese individuals (61.1%) in the osteopenic and osteoporotic groups. As expected, there was a high prevalence of low bone mass in our population (62%). However, overweight and obese men were more likely to have osteoporosis and osteopenia, contrary to literature and clinical knowledge. This finding may be partially explained by the prevalence of sedentary lifestyle and relative lack of weight-bearing activity in this group of men

Potential energy surfaces for singlet and triplet states of the LiH2+ system and quasi-classical trajectory cross sections for H + LiH+ and H+ + LiH

A new set of six accurate ab initio potential energy surfaces (PESs) is presentedfor the first three singlet and triplet states of LiH2+ (1,21A', 11A'', 1,23A', 13A'' states,where four of them are investigated for the first time), which have allowed new detailedstudies gaining a global view on this interesting system. These states are relevant for thestudy of the most important reactions of the lithium chemistry in the early universe.More than 45000 energy points were calculated using the multi-reference configurationinteraction level of theory using explicitly correlated methods (ic-MRCI-F12), and theresults obtained for each individual electronic state were fitted to an analytical function.Using quasiclassical trajectories and considering the initial diatomic fragment in theground rovibrational state, we have determined the integral cross sections for the H +LiH+(X2+, C2) and H+ + LiH(X1+, B1) reactions. In these calculations all availablereaction channels were considered: the chemically most important H or H+transfer/abstraction as well as atom exchange and collision induced dissociation for upto 1.0 eV of collision energ