Earth Observing System Covariance Realism Updates

This presentation will be given at the International Earth Science Constellation Mission Operations Working Group meetings June 13-15, 2017 to discuss the Earth Observing System Covariance Realism updates

One Way of Bringing Final Year Computer Science Student World to the World of Children with Cerebral Palsy: A Case Study

In this paper, a learning project is explained which is being carried out at the school of computer science at the University of Seville. The aim is that students receive knowledge of assistive technologies when in fact there is no this discipline in our curricula. So the best way, it is programming final studies projects in this field. We want to make the projects have a real application and can solve difficulties that children with Cerebral Palsy have in their daily activities in the school.Junta de Andalucía p08-TIC-363

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Trajectory Design Strategies from Geosynchronous Transfer Orbits to Lagrange Point Orbits in the Sun-Earth System

Over the past twenty years, ridesharing opportunities for smallsats, i.e., secondary payloads, has increased with the introduction of Evolved Expendable Launch Vehicle (EELV) Secondary Payload Adapter (ESPA) rings. However, the orbits available for these secondary payloads is limited to Low Earth Orbits (LEO) or Geostationary Orbits (GEO). By incorporating a propulsion system, propulsive ESPA rings offer the capability to transport a secondary payload, or a collection of payloads, to regions beyond GEO. In this investigation, the ridesharing scenario includes a secondary payload in a dropped-off Geosynchronous Transfer Orbit (GTO) and the region of interest is the vicinity near the Sun-Earth Lagrange points. However, mission design for secondary payloads faces certain challenges. A significant mission constraint for a secondary payload is the drop-off orbit orientation, as it is dependent on the primary mission. To address this mission constraint, strategies leveraging dynamical structures within the Circular Restricted Three-Body Problem (CRTBP) are implemented to construct efficient and flexible transfers from GTO to orbits near Sun-Earth Lagrange points. First, single-maneuver ballistic transfers are constructed from a range of GTO departure orientations. The ballistic transfer utilize trajectories within the stable manifold structure associated with periodic and quasi-periodic orbits near the Sun-Earth L1 and L2 points. Numerical differential corrections and continuation methods are leveraged to create families of ballistic transfers. A collection of direct ballistic transfers are generated that correspond to a region of GTO departure locations. Additional communications constraints, based on the Solar Exclusion Zone and the Earth’s penumbra shadow region, are included in the catalog of ballistic transfers. An integral-type path condition is derived and included throughout the differential corrections process to maintain transfers outside the required communications restrictions. The ballistic transfers computed in the CRTBP are easily transitioned to the higher-fidelity ephemeris model and validated, i.e., their geometries persist in the ephemeris model. To construct transfers to specific orbits near Sun-Earth L1 or L2, families of two-maneuver transfers are generated over a range of GTO departure locations. The two-maneuver transfers consist of a maneuver at the GTO departure location and a Deep Space Maneuver (DSM) along the trajectory. Families of two-maneuver transfers are created via a multiple-shooting differential corrections method and a continuation process. The generated families of transfers aid in the rapid generation of initial guesses for optimized transfer solutions over a range of GTO departure locations. Optimized multiple-maneuver transfers into halo and Lissajous orbits near Sun-Earth L1 and L2are included in this analysis in both the CRTBP model and the higher-fidelity ephemeris model. Furthermore, the two-maneuver transfer strategy employed in this analysis are easily extended to other Three-Body systems

Tiempos para pensar : investigación social y humanística hoy en Venezuela. Tomo I

En nuestros tiempos, hacer investigación en Ciencias Sociales y Humanidades e intentar aportar pensamiento crítico es un hacer personal y también una tarea colectiva que se gesta en el intercambio y en el encuentro, en el debate y en la puesta en común de visiones, análisis, puntos de partida y espacios que se recorren. Hay desafíos del nuevo tiempo que son desafíos de las sociedades, e interpelan a la producción de conocimiento social y humano, le proponen preguntas y encomiendas, exigen que responda a sus demandas éticas y epistémicas desde el Sur, piden que se construyan saberes alternativos, decoloniales, que expliquen, acompañen y prefiguren la emancipación. Este libro, que cuenta con dos tomos, encara este desafío con rigurosidad y espíritu crítico

Effectiveness of Ritonavir-Boosted Protease Inhibitor Monotherapy in Clinical Practice Even with Previous Virological Failures to Protease Inhibitor-Based Regimens.

Journal Article;BACKGROUND AND OBJECTIVE Significant controversy still exists about ritonavir-boosted protease inhibitor monotherapy (mtPI/rtv) as a simplification strategy that is used up to now to treat patients that have not experienced previous virological failure (VF) while on protease inhibitor (PI) -based regimens. We have evaluated the effectiveness of two mtPI/rtv regimens in an actual clinical practice setting, including patients that had experienced previous VF with PI-based regimens. METHODS This retrospective study analyzed 1060 HIV-infected patients with undetectable viremia that were switched to lopinavir/ritonavir or darunavir/ritonavir monotherapy. In cases in which the patient had previously experienced VF while on a PI-based regimen, the lack of major HIV protease resistance mutations to lopinavir or darunavir, respectively, was mandatory. The primary endpoint of this study was the percentage of participants with virological suppression after 96 weeks according to intention-to-treat analysis (non-complete/missing = failure). RESULTS A total of 1060 patients were analyzed, including 205 with previous VF while on PI-based regimens, 90 of whom were on complex therapies due to extensive resistance. The rates of treatment effectiveness (intention-to-treat analysis) and virological efficacy (on-treatment analysis) at week 96 were 79.3% (CI95, 76.8-81.8) and 91.5% (CI95, 89.6-93.4), respectively. No relationships were found between VF and earlier VF while on PI-based regimens, the presence of major or minor protease resistance mutations, the previous time on viral suppression, CD4+ T-cell nadir, and HCV-coinfection. Genotypic resistance tests were available in 49 out of the 74 patients with VFs and only four patients presented new major protease resistance mutations. CONCLUSION Switching to mtPI/rtv achieves sustained virological control in most patients, even in those with previous VF on PI-based regimens as long as no major resistance mutations are present for the administered drug.Ye

Data from: Effectiveness of ritonavir-boosted protease inhibitor monotherapy in clinical practice even with previous virological failures to protease inhibitor-based regimens

Background and objective: Significant controversy still exists about ritonavir-boosted protease inhibitor monotherapy (mtPI/rtv) as a simplification strategy that is used up to now to treat patients that have not experienced previous virological failure (VF) while on protease inhibitor (PI)-based regimens. We have evaluated the effectiveness of two mtPI/rtv regimens in an actual clinical practice setting, including patients that had experienced previous VF with PI-based regimens. Methods: This retrospective study analyzed 1060 HIV-infected patients with undetectable viremia that were switched to lopinavir/ritonavir or darunavir/ritonavir monotherapy. In cases in which the patient had previously experienced VF while on a PI-based regimen, the lack of major HIV protease resistance mutations to lopinavir or darunavir, respectively, was mandatory. The primary endpoint of this study was the percentage of participants with virological suppression after 96 weeks according to intention-to-treat analysis (non-complete/missing= failure). Results: A total of 1060 patients were analyzed, including 205 with previous VF while on PI-based regimens, 90 of whom were on complex therapies due to extensive resistance. The rates of treatment effectiveness (intention-to-treat analysis) and virological efficacy (on-treatment analysis) at week 96 were 79.3% (CI95, 76.8?81.8) and 91.5% (CI95, 89.6-93.4), respectively. No relationships were found between VF and earlier VF while on PI-based regimens, the presence of major or minor protease resistance mutations, the previous time on viral suppression, CD4+ T-cell nadir, and HCV-coinfection. Genotypic resistance tests were available in 49 out of the 74 patients with VFs and only four patients presented new major protease resistance mutations. Conclusion: Switching to mtPI/rtv achieves sustained virological control in most patients, even in those with previous VF on PI-based regimens as long as no major resistance mutations are present for the administered drug

Transparencia, combate a la corrupción y gobierno abierto : la experiencia en México

La transparencia en México ha tenido un sinuoso camino, para garantizar que las instituciones y los funcionarios públicos den a conocer la información sobre sus actividades de interés para los ciudadanos. En ese sentido, las organizaciones de la sociedad civil como el Colectivo por Municipios Transparentes (CIMTRA), académicos y universidades son un espacio de discusión que busca impulsar y promover este derecho consagrado en la Constitución. Además, para garantizar la rendición de cuentas se ha estimulado el combate a la corrupción y doctrinas políticas como el gobierno abierto, que promulgan la colaboración y participación ciudadana a fin de hacer accesible la información de las organizaciones e instituciones públicas. Ese importante análisis, innovador y actual, formulado por especialistas e investigadores sobre los alcances y limitaciones de estos temas es abordado en esta obra, para mover a la reflexión y análisis críticos y, sobre todo, para impulsar acciones a favor de políticas públicas que mejoren la función sustantiva del gobierno: garantizar a los ciudadanos bienestar.11Presentación Felipe José Hevia de Jara 15Introducción José Antonio Meyer Rodríguez José Luis Estrada Rodríguez José Ojeda Bustamante 17Capítulo I Calidad de la democracia para la fiscalización, control y seguimiento de los recursos públicos José Luis Estrada Rodríguez Lorenzo Antonio Portilla Vásquez 35Capítulo II Deliberación pública y participación ciudadana, primordial sustento para el Gobierno Abierto y la rendición de cuentas José Antonio Meyer Rodríguez Jorge Luis Castillo Durán Alejandra Rodríguez Estrada 47Capítulo III Midiendo al Gobierno Abierto en México: los portales estatales de transparencia durante el periodo 2015-2016 Rodrigo Sandoval Almazán 67Capítulo IV Transparencia y contraloría social en la generación de Gobierno Abierto en el ámbito subnacional María Gabriela Martínez Tiburcio 87Capítulo V Discurso presidencial y corrupción en México. Una aproximación desde el Análisis Crítico del Discurso Carlos Enrique Ahuactzin Martínez Jorge Luis Castillo Durán Bárbara Torres Romero 113 Capítulo VI Retos y sensibilización hacia la transparencia en la Ciudad de México Dulce Maribel Corona Rojas María Luisa Rubio González Víctor Alejandro Villegas Corona 129 Capítulo VII Partidos Políticos en México: los Intocables de la transparencia y rendición de cuentas Hugo Sánchez Gudiño 149 Capítulo VIII Gobierno Abierto en el contexto subnacional José de Jesús Sosa López 169 Capítulo IX Capacidades institucionales para la transparencia presupuestal en la frontera norte de México Ramón Fernández Mejía 189 Capítulo X Comprender y transparentar a la legislatura en Puebla: una agenda ciudadana José Luis Mendoza Tablero 201 Capítulo XI Práctica exitosa en la implementación y ejecución del modelo de Gobierno Abierto: caso Zacatecas Norma Julieta del Río Venegas 223 Capítulo XII La educación cívica como condición para la transparencia y rendición de cuentas Rafael Caballero Álvarez Alma Verónica Méndez Pacheco 243 Capítulo XIII Transparencia y sujetos obligados: análisis de los juicios presentados al IAIP de Tlaxcala (2015-2016) María Magdalena Sam Bautista 267 Capítulo XIV Hacia una nueva agenda de transparencia, acceso a la información y rendición de cuentas en el ámbito local en México Ricardo Joel Jiménez González 299 Capítulo XV Gobierno Abierto: retos y avances en Veracruz Yolli García Alvarez Angélica Mendieta Ramírez 321 Capítulo XVI Análisis sobre los indicadores de impunidad y corrupción en Puebla Juan Antonio Le Clercq Ortega 339 Capítulo XVII Las ampliaciones de la Unión Europea hacia Europa del Este, impacto político en transparencia y gobernanza Pedro Manuel Rodríguez Suárez 361 Capítulo XVIII El Sistema Nacional Anticorrupción en México: análisis de sus alcances y limitaciones Jairo Garzón Montaño 385 Capítulo XIX Gobierno de opacidad vs Gobierno Abierto: comité local de Gobierno Abierto subnacional José Ojeda Bustamante Yadira del Carmen Rosales Ruiz Georgina Alducin González 405 Sobre los autore