66 research outputs found

    Diseño de un controlador de intensidad luminosa para una máquina de insolación

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    This paper presents a design for a insolation machine controller used in curing processes. This development began conducting a thorough prior review to the actual insolation machine and the procedures to be carried out in the printing laboratory, in order to understand the process of curing, assessing the possibilities for improving the equipment in use. The proposed controller design is a PID, which was made with matlab simulation tools, giving priority to the exposure time in the process of curing which must be the same for any type of fabric or mesh frame. This will allow the insolation machine does not require to be operated by highly qualified and competent staff in this art.El presente documento muestra el diseño de un controlador para una máquina de insolación usada en procesos de fotocurado. Para ello se inició el desarrollo realizando una revisión previa minuciosa a la máquina de insolación existente, y a los procedimientos que se deben llevar a cabo en el laboratorio de estampados, con el fin de comprender el proceso de fotocurado, evaluando las posibilidades de mejora de los equipos en uso. El diseño propuesto para el controlador es un PI, el cual se realizó con herramientas de simulación de Matlab, dando prioridad al tiempo de exposición en el proceso de fotocurado el cual debe ser el mismo para cualquier tipo de tela o malla del bastidor, lo cual permite que la máquina de insolación no requiera ser operada por personal altamente calificado o competente en este arte

    Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

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    This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

    Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

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    BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

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

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    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

    Estudios de Caso sobre Ciencias Agropecuarias y Rurales en el siglo XXI.

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    Libro científico sobre estudios de casos en el medio agropecuario y ruralCon el advenimiento del siglo XXI y el avance de los procesos de globalización, el medio rural presenta diversos cambios económicos, sociales, políticos y culturales. Lo anterior significa que el campo es un objeto de estudio altamente dinámico, complejo e inasible. las ciencias agropecuarias y rurales, en la actualidad, requieren de un abordaje sistémico e interdisciplinario que den cuenta de la heterogeneidad de situaciones y contextos que enfrenta el campo mexicano. La presente obra agrupa 18 estudios de caso, que capturan algunas fotografías de las diversas problemáticas de la ruralidad mexicana, con lo cual se pretende dar cuenta tanto de los objetivos de estudio como de la perspectiva teórico metodológico desde que estos son abordados. lo anterior tiene que ver con el hecho de que las ciencias agropecuarias y rurales manifiestan un alto grado de observación empírica, motivo por el que los estudios de caso se convierten en la perspectiva metodológica idónea que permite ir y venir de la realidad a la teoría y viceversa para la construcción de objetos de estudio. En este volumen se aborda una gran diversidad de casos, que sintetizan la heterogeneidad de enfoques y perspectivas mediante las cuales los fenómenos agropecuarios y rurales han sido abordados en el Instituto de Ciencias Agropecuarias y Rurales de la Universidad Autónoma del Estado de México, en los últimos 30 años

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    Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

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    Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

    Diseño de un controlador de intensidad luminosa para una máquina de insolación

    Get PDF
    This paper presents a design for a insolation machine controller used in curing processes. This development began conducting a thorough prior review to the actual insolation machine and the procedures to be carried out in the printing laboratory, in order to understand the process of curing, assessing the possibilities for improving the equipment in use. The proposed controller design is a PID, which was made with matlab simulation tools, giving priority to the exposure time in the process of curing which must be the same for any type of fabric or mesh frame. This will allow the insolation machine does not require to be operated by highly qualified and competent staff in this art.El presente documento muestra el diseño de un controlador para una máquina de insolación usada en procesos de fotocurado. Para ello se inició el desarrollo realizando una revisión previa minuciosa a la máquina de insolación existente, y a los procedimientos que se deben llevar a cabo en el laboratorio de estampados, con el fin de comprender el proceso de fotocurado, evaluando las posibilidades de mejora de los equipos en uso. El diseño propuesto para el controlador es un PI, el cual se realizó con herramientas de simulación de Matlab, dando prioridad al tiempo de exposición en el proceso de fotocurado el cual debe ser el mismo para cualquier tipo de tela o malla del bastidor, lo cual permite que la máquina de insolación no requiera ser operada por personal altamente calificado o competente en este arte

    Learning Structure from Data and its Application to Ozone Prediction

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    . In this paper we propose an algorithm for structure learning in predictive expert systems based on a probabilistic network representation. The idea is to have the "simplest" structure (minimum number of links) with acceptable predictive capability. The algorithm starts by building a tree structure based on measuring mutual information between pairs of variables, and then it adds links as necessary to obtain certain predictive performance. We have applied this method for ozone prediction in M'exico City, where the ozone level is used as a global indicator for the air quality in different parts of the city. It is important to predict the ozone level a day, or at least several hours in advance, to reduce the health hazards and industrial losses that occur when the ozone reaches emergency levels. We obtained as a first approximation a tree-structured dependency model for predicting ozone in one part of the city. We observe that even with only three parameters, its estimations are accepta..

    Supply Chain Management y logistica en la empresa El Campesino Palacio del Cristal

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    El trabajo se desarrolló con el fin de brindar una visión clara frente a las diversas temáticas que se abordaran en el curso y bajo condiciones representativas causantes de los principales aspectos que se relacionan con El Supply Chain Management y Logística, específicamente en la empresa El Campesino Palacio del CristalThe work was developed in order to provide a clear vision in front of the diverse Topics that will be addressed in the course and under representative conditions that cause the main aspects related to Supply Chain Management and Logistics, specifically in the company El Campesino Palacio del Crista
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