Campo de dirección. Método de las isoclinas, en la solución de ecuaciones diferenciales de primer orden

En la descripción del proceso de modelado se habla acerca de formular un modelo matemático de un problema del mundo real a través de un razonamiento intuitivo acerca del mismo o a partir de leyes físicas basadas en la evidencia proveniente de la experimentación. El modelo matemático a menudo toma la forma de una ecuación diferencial, es decir, una ecuación que contiene una función desconocida y algunas de sus derivadas

Trayectorias de un viaje por la investigación educativa desde el sentipensar de los maestros y maestras : experiencias en desarrollo del programa de pensamiento crítico

428 páginasEste libro reúne 19 experiencias que continúan el acompañamiento en la fundamentación, desarrollo y estructuración de estrategias de tipo pedagógico y didáctico dentro de la ruta sentipensante en el Nivel II: Experiencias en desarrollo. Igualmente, en estas experiencias se hace una ampliación de referentes, técnicas e instrumentos para recoger información de los 19 textos presentados. De tal manera, estas experiencias son fruto de este acompañamiento que ha realizado el Instituto para la Investigación Educativa y el Desarrollo Pedagógico IDEP, que servirán de base y referente para seguir aportando en la configuración y consolidación de comunidades de saber y práctica pedagógica, así como en la conformación de colectivos y redes de maestros y maestras

Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study

Background Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients’ preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings Between June 16, 2014, and April 29, 2015, data from 22803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj –4·4%, 95% CI –5·5 to –3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj –2·6%, 95% CI –3·9 to –1·4) and the administration of reversal agents (1·23, 1·07–1·41; –1·9%, –3·2 to –0·7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj –0·3%, 95% CI –2·4 to 1·5) nor extubation at a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; –0·4%, –3·5 to 2·2) was associated with better pulmonary outcomes. Interpretation We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications