Hindsight judgement on ambiguous episodes of suspected infection in critically ill children: poor consensus amongst experts?

Few episodes of suspected infection observed in paediatric intensive care are classifiable without ambiguity by a priori defined criteria. Most require additional expert judgement. Recently, we observed a high variability in antibiotic prescription rates, not explained by the patients' clinical data or underlying diseases. We hypothesised that the disagreement of experts in adjudication of episodes of suspected infection could be one of the potential causes for this variability. During a 5-month period, we included all patients of a 19-bed multidisciplinary, tertiary, neonatal and paediatric intensive care unit, in whom infection was clinically suspected and antibiotics were prescribed (n=183). Three experts (two senior ICU physicians and a specialist in infectious diseases) were provided with all patient data, laboratory and microbiological findings. All experts classified episodes according to a priori defined criteria into: proven sepsis, probable sepsis (negative cultures), localised infection and no infection. Episodes of proven viral infection and incomplete data sets were excluded. Of the remaining 167 episodes, 48 were classifiable by a priori criteria (n=28 proven sepsis, n= 20 no infection). The three experts only achieved limited agreement beyond chance in the remaining 119 episodes (kappa = 0.32, and kappa = 0.19 amongst the ICU physicians). The kappa is a measure of the degree of agreement beyond what would be expected by chance alone, with 0 indicating the chance result and 1 indicating perfect agreement. Conclusion: agreement of specialists in hindsight adjudication of episodes of suspected infection is of questionable reliabilit

Material requirements for the adoption of unconventional silicon crystal and wafer growth techniques for high-efficiency solar cells

Silicon wafers comprise approximately 40% of crystalline silicon module cost, and represent an area of great technological innovation potential. Paradoxically, unconventional wafer-growth techniques have thus far failed to displace multicrystalline and Czochralski silicon, despite four decades of innovation. One of the shortcomings of most unconventional materials has been a persistent carrier lifetime deficit in comparison to established wafer technologies, which limits the device efficiency potential. In this perspective article, we review a defect-management framework that has proven successful in enabling millisecond lifetimes in kerfless and cast materials. Control of dislocations and slowly diffusing metal point defects during growth, coupled to effective control of fast-diffusing species during cell processing, is critical to enable high cell efficiencies. To accelerate the pace of novel wafer development, we discuss approaches to rapidly evaluate the device efficiency potential of unconventional wafers from injection-dependent lifetime measurements

Brownian dynamics computational model of protein diffusion in crowded media with dextran macromolecules as obstacles

The high concentration of macromolecules (i.e., macromolecular crowding) in cellular environments leads to large quantitative effects on the dynamic and equilibrium biological properties. These effects have been experimentally studied using inert macromolecules to mimic a realistic cellular medium. In this paper, two different experimental in vitro systems of diffusing proteins which use dextran macromolecules as obstacles are computationally analyzed. A new model for dextran macromolecules based on effective radii accounting for macromolecular compression induced by crowding is proposed. The obtained results for the diffusion coefficient and the anomalous diffusion exponent exhibit good qualitative and generally good quantitative agreement with experiments. Volume fraction and hydrodynamic interactions are found to be crucial to describe the diffusion coefficient decrease in crowded media. However, no significant influence of the hydrodynamic interactions in the anomalous diffusion exponent is found

Distilling a visual network of Retinitis Pigmentosa gene-protein interactions to uncover new disease candidates

BACKGROUND: Retinitis pigmentosa (RP) is a highly heterogeneous genetic visual disorder with more than 70 known causative genes, some of them shared with other non-syndromic retinal dystrophies (e.g. Leber congenital amaurosis, LCA). The identification of RP genes has increased steadily during the last decade, and the 30% of the cases that still remain unassigned will soon decrease after the advent of exome/genome sequencing. A considerable amount of genetic and functional data on single RD genes and mutations has been gathered, but a comprehensive view of the RP genes and their interacting partners is still very fragmentary. This is the main gap that needs to be filled in order to understand how mutations relate to progressive blinding disorders and devise effective therapies. METHODOLOGY: We have built an RP-specific network (RPGeNet) by merging data from different sources: high-throughput data from BioGRID and STRING databases, manually curated data for interactions retrieved from iHOP, as well as interactions filtered out by syntactical parsing from up-to-date abstracts and full-text papers related to the RP research field. The paths emerging when known RP genes were used as baits over the whole interactome have been analysed, and the minimal number of connections among the RP genes and their close neighbors were distilled in order to simplify the search space. CONCLUSIONS: In contrast to the analysis of single isolated genes, finding the networks linking disease genes renders powerful etiopathological insights. We here provide an interactive interface, RPGeNet, for the molecular biologist to explore the network centered on the non-syndromic and syndromic RP and LCA causative genes. By integrating tissue-specific expression levels and phenotypic data on top of that network, a more comprehensive biological view will highlight key molecular players of retinal degeneration and unveil new RP disease candidates

La diversificación curricular. Posibilidades para una planificación alternativa

One of the most decisive facts in the educational development of our country in the last few years, developed by LOGSE, has undoubtedly been the extension of basic education to ten years for all children. This has allowed that all students can obtain their Secondary Educational Certificate, although in certain instances after the necessary cunicular measures. With this aim, LOGSE establishes curricular diversification for certain students older than 16, so that they can get the secondary stage objectives and its co!Tesponding certificate by means of different contents, a different methodology and different subjects. Our intention in this article is to analyse certain conditions for the general development of diversification syllabuses, taking into account the difficulties of the educational centres and the teachers' prospect facing the educational mnovation processes. In this sense, we have a look into the actual reality of diversification programmes in secondly schools in the Region of Murcia, emphasising the structural elements that support theit· deve-lopment. Finally, the point of view the students following this type of prograrmnes is also analysedUn hecho decisivo en el desarrollo educativo de nuestro pais en los últimos años, ha sido, sin duda, la extensión a diez años de la enseñanza básica para todos Este hecho, desarrollado por la L.O.G.S.E. ha propiciado que todos los alumnos obtengan, de ser posible, y con las medidas curriculares necesarias, el título de graduado en Educación Secundaria. Con este fin, la LOGSE establece, para alumnos y alumnas mayores de 16 años, diversificaciones del currículo, para que los objetivos de la etapa secundaria y el título correspondiente, sean conseguidos, a través de una metodología, contenidos y áreas diferentes. En este artículo pretendemos analizar determinadas condiciones para el desarrollo general de los programas de diversificación, tomando en cuenta las dificultades de los centros y las perspectivas del profesorado ante los consecuentes procesos de innovación educativa. En ese sentido, revisamos las realidades más concretas, de los programas de diversificación en los institutos de secundaria de la Región de Murcia, poniendo énfasis en los elementos estructurales que apoyan su desarrollo. Finalmente se aborda de modo puntual un aspecto poco considerado: la visión de los alumnos sujetos del programa

Macromolecular crowding upon in-vivo-like enzyme-kinetics: effect of enzyme-obstacle size ratio

In the present work, the volume exclusion phenomenon, also known as macromolecular crowding, has been applied to the field of enzyme kinetics. It has been approached by adding polymeric obstacles in the media of different enzymatic reactions. The concentration and size of these obstacles have been changed systematically in order to obtain kinetic information about each reaction. Results indicate that the performance of a certain enzyme always depends on the amount of excluded volume. However, only large, oligomeric proteins display an obstacle size-dependent behavior. Besides, crowding can hinder diffusion to the extent of being capable of shifting reaction control from activation to diffusion

Efecto de diferentes tipos de cosecha sobre la calidad tecnológica de la fibra de algodón en cultivos de alta densidad

Desde la introducción en la Argentina de los sistemas de producción de algodón en surcos estrechos la superficie de cosecha con plataformas recolectoras de tipo stripper ha aumentado y se han desarrollado variados sistemas. El objetivo del presente trabajo fue evaluar la calidad tecnológica de la fibra en algodones conducidos bajo sistema de surcos estrechos y recolectados bajos diferentes sistemas stripper y su comparación con el sistema picker. A partir del desmote de cada unidad experimental se individualizaron los fardos de fibras producidos y se analizaron por (HVI), obteniéndose valores de Longitud, Resistencia, Uniformidad, Micronaire, Elongación, y color a través de Rd y +b, con estos datos se construyeron tablas de frecuencias según los intervalos de clasificación para cada parámetro de calidad. El análisis de la distribución de frecuencias de los parámetros más significativos que determinan la calidad de la fibra de algodón permitieron detectar mínimos cambios en las distribuciones y estos no modificaron el intervalo de clase con mayor frecuencia, lo que no implicaría cambios en la calidad tecnológica de la fibra cosechada con distintos sistemas de cosecha stripper en relación con la cosecha picker. Los cambios en la distribución fueron mayores cuando el ensayo se realizó en condiciones de secano debido a un menor control de la fructificación del cultivo por lo que pone de relevancia el manejo de este en los sistemas que se cosecharan con sistemas stripper.Cotton fiber characteristics are influenced by the genetic and environmental factors, such as management, climate maturation, and significantly by harvesting conditions. The objective of this study was to analyze the variables of cotton fiber characteristics depending on the, picker, and stripper harvest systems, in narrow row cotton system. The experiments are conducted for five seasons in Argentina. The two first season in watering crop a de the tree last at rainfall. The cotton samples, taken from the stored basket of harvesters, were derived by mechanical systems harvesting. The analysis of the frequency distribution of the most significant parameters that determine the quality of the cotton fiber allowed to detect minimum changes in the distributions and these did not modify the class interval more frequently, which would not imply changes in the technological quality of the fiber harvested with different systems of harvesting stripper in relation to the picker. The changes in the distribution were greater when the test was carried out in rainfed conditions due to a lower control of the fruiting of the crop, which makes the management of the crop relevant in systems that were harvested with stripper systemsEEA Las BreñasFil: Tarrago, Jose Ramon. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Las Breñas; Argentina. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias; ArgentinaFil: Colli, Sergio Leonardo. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Las Breñas; Argentina. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias; ArgentinaFil: Nadal, Nelson Jose. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Las Breñas; ArgentinaFil: Gimenez, L. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias; Argentin

RPGeNet v2 .0: expanding the universe of retinal disease gene interactions network

RPGeNet offers researchers a user-friendly queriable tool to visualize the interactome network of visual disorder genes, thus enabling the identification of new potential causative genes and the assignment of novel candidates to specific retinal or cellular pathways. This can be highly relevant for clinical applications as retinal dystrophies affect 1:3000 people worldwide, and the causative genes are still unknown for 30% of the patients. RPGeNet is a refined interaction network interface that limits its skeleton network to the shortest paths between each and every known causative gene of inherited syndromic and non-syndromic retinal dystrophies. RPGeNet integrates interaction information from STRING, BioGRID and PPaxe, along with retina-specific expression data and associated genetic variants, over a Cytoscape.js web interface. For the new version, RPGeNet v2.0, the database engine was migrated to Neo4j graph database manager, which speeds up the initial queries and can handle whole interactome data for new ways to query the network. Further, user facilities have been introduced as the capability of saving and restoring a researcher customized network layout or as novel features to facilitate navigation and data projection on the network explorer interface. Responsiveness has been further improved by transferring some functionality to the client side

Improvement of diabetic retinopathy screening of diabetic patients seen at the Internal Medicine Clinic​​

Diabetic retinopathy (DR) is a leading cause of vision loss globally. The International Diabetes Federation (IDF) estimated the global population with diabetes to be 463 million in 2019 and 700 million in 2045. Retinopathy is a highly specific neurovascular complication of both type 1 and types 2 diabetes, and the prevalence strongly correlates to both the duration of diabetes and the level of glycemic control. Regular follow-up with early detection and treatment of vision-threatening retinopathy enables the prevention of up to 98% of visual loss due to diabetic retinopathy

Lavado de activos y paraísos financieros

El lavado de dinero forma parte de una problemática dinámica y compleja a nivel mundial, dado a su impacto desfavorable sobre el gobierno, la economía y la sociedad; representando, asimismo, un una amenaza para la seguridad de los estados. Se busca analizar las principales cuestiones relacionadas al lavado de dinero, sus consecuencias a nivel mundial, su vinculación con los paraísos financieros y el rol del contador público nacional en su detección. El presente trabajo consiste en un análisis descriptivo. A partir de datos obtenidos de normativa nacional e internacional, buscando profundizar el rol del contador público nacional, en lo pertinente a la detección, al lavado de activos de origen delictivo y sus correspondientes sanciones previstas en la legislación argentina, considerando la necesidad de adecuar y/o actualizar dicha legislación con respecto a los avances en el tema a nivel mundial y contemplando las nuevas metodologías que se utilizan día a día en territorio nacional; para finalmente mostrar algunas conclusiones con el objeto de aportar elementos que sean de utilidad para la reflexión sobre esta problemática.Fil: Casco, Sergio Alejandro. Universidad Nacional de Cuyo. Facultad de Ciencias Económicas.Fil: La Fata, Franco Lucas. Universidad Nacional de Cuyo. Facultad de Ciencias Económicas.Fil: Nadal, Mauricio Daniel. Universidad Nacional de Cuyo. Facultad de Ciencias Económicas.Fil: Romero, Rocío María . Universidad Nacional de Cuyo. Facultad de Ciencias Económicas