Patient Blood Management in Cesarean Section

Worldwide, every minute a woman dies due to complications during pregnancy, obstetric hemorrhage being the leading cause. However, most of these deaths are preventable with prompt recognition and management. The main objective of its management in the initial phase of resuscitation is to aggressively optimize macro and microhemodynamic parameters by ensuring effective resuscitation. Patient blood management (PBM) consists in the timely application of evidence-based medical and surgical procedures aimed at maintaining hemoglobin concentration, optimizing hemostasis and minimizing blood loss to improve patient outcome, all of these based in three pillars: endogenous erythropoiesis, platelet and coagulation factors function and physiological reserve of anemia. PBM consider various strategies to reach the main goal, including transfusional, non-transfusional and surgical measures. At preoperative period the prevention and treatment of anemia is the corner stone of the PBM guideline. Once at the operating room the fluid management, uterotonic and pro-coagulant drugs, fibrinogen and blood products transfusion play a key role and surgical techniques have to be done if the patient life is threatened. Manage postpartum anemia by appropriate iron administration. Optimize the patient’s physiological response to anemia, treat infections and maximize oxygen delivery to minimize transfusions if they are not strictly necessary

Strengthening Supersalud is a priority to guarantee the fundamental right to health

El fortalecimiento técnico de la Superintendencia Nacional de Salud (SuperSalud), ente de inspección, vigilancia y control del Sistema General de Seguridad Social en Salud de Colombia, es necesario. Para tal fin, se propone el uso eficiente de los sistemas de información, que permita la toma de decisiones en política pública y que garantice el derecho fundamental de la salud.The technical strengthening of the National Superintendence of Health, an inspection, surveil-lance and control entity of the General System of Social Security in Health of Colombia, is nec-essary. For this, the efficient implementation of information systems will allow decision-making in public policy that guarantees the fundamental right to health.https://orcid.org/0000-0003-4579-6033Revista Nacional - IndexadaN

La ciudad como experiencia de conocimiento: Nuevas metodologías de aprendizaje, iniciación de la investigación y extensión universitaria a partir de la historia urbana

Depto. de GeografíaDepto. de Historia Moderna y ContemporáneaDepto. de Historia del ArteFac. de Geografía e HistoriaFALSEsubmitte

Desafíos actuales de la educación superior

El presente libro corresponde al trabajo investigativo realizado por sus autores frente a los desafíos que enfrenta y enfrentará la educación en tiempos actuales (provisional)

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis

Search for narrow resonances in dilepton mass spectra in proton-proton collisions at root s=13 TeV and combination with 8 TeV data

Peer reviewe

Search for top squark pair production in pp collisions at root s=13 TeV using single lepton events

Peer reviewe

Impacts of the Tropical Pacific/Indian Oceans on the Seasonal Cycle of the West African Monsoon

The current consensus is that drought has developed in the Sahel during the second half of the twentieth century as a result of remote effects of oceanic anomalies amplified by local land–atmosphere interactions. This paper focuses on the impacts of oceanic anomalies upon West African climate and specifically aims to identify those from SST anomalies in the Pacific/Indian Oceans during spring and summer seasons, when they were significant. Idealized sensitivity experiments are performed with four atmospheric general circulation models (AGCMs). The prescribed SST patterns used in the AGCMs are based on the leading mode of covariability between SST anomalies over the Pacific/Indian Oceans and summer rainfall over West Africa. The results show that such oceanic anomalies in the Pacific/Indian Ocean lead to a northward shift of an anomalous dry belt from the Gulf of Guinea to the Sahel as the season advances. In the Sahel, the magnitude of rainfall anomalies is comparable to that obtained by other authors using SST anomalies confined to the proximity of the Atlantic Ocean. The mechanism connecting the Pacific/Indian SST anomalies with West African rainfall has a strong seasonal cycle. In spring (May and June), anomalous subsidence develops over both the Maritime Continent and the equatorial Atlantic in response to the enhanced equatorial heating. Precipitation increases over continental West Africa in association with stronger zonal convergence of moisture. In addition, precipitation decreases over the Gulf of Guinea. During the monsoon peak (July and August), the SST anomalies move westward over the equatorial Pacific and the two regions where subsidence occurred earlier in the seasons merge over West Africa. The monsoon weakens and rainfall decreases over the Sahel, especially in August.Peer reviewe