Nutrición parenteral e identificación de subpoblaciones con necesidades nutricionales similares

[email protected] disponibilidad de formulaciones parenterales normalizadas en relación a los aportes de nutrientes, plantea la problemática de su idoneidad en relación a las necesidades nutritivas de los pacientes. El objetivo de este trabajo es identificar subpoblaciones de pacientes con necesidades calórico-proteicas similares y valorar su adecuación a formulaciones normalizadas. Con este fin, se evaluaron, de forma prospectiva las necesidades calórico- proteicas de 100 pacientes adultos metabólicamente estables en tratamiento con nutrición parenteral total. Los aportes calóricos se estudiaron por Harris-Benedict (con corrección de Long) y los aportes proteicos se calcularon en función del grado de estrés. Las necesidades calórico-proteicas se analizaron mediante un análisis de cluster mediante el algoritmo de partición alrededor de los mediodes. Se consideró que cuando la formulación de nutrición parenteral contenía aportes equivalentes a ± 20% de las necesidades medias de cada subpoblación era adecuada para satisfacer los requerimientos calórico- proteicos de los pacientes. El porcentaje de pacientes, en función del número de subpoblaciones identificadas, que recibirían aportes adecuados a sus requerimientos se tomó como variable de estudio comparativo. En el caso de dos subpoblaciones, para la subpoblación 1 (N = 35), las necesidades de glucosa, lípidos y aminoácidos son: 275 (IC 95%: 265-285) g, 83 (IC 95%: 78- 88) g y 89 (IC 95%: 86-92) y para la subpoblación 2 (N = 65), 195 (IC 95%: 187-203) g, 58 (IC 95%: 56-61) g y 74 (IC 95%: 72-77) g, respectivamente. En el caso de tres subpoblaciones, estas mismas necesidades de nutrientes son para la subpoblación 1 (N = 19): 295 (IC 95%: 283- 306) g, 91 (IC 95%: 84-97) g y 91 (IC 95%: 86-95); para la subpoblación 2 (N = 45), 234 (IC 95%: 227-240) g, 67 (IC 95%: 64-70) g, y 84 (IC 95%: 82-86) g; y para la subpoblación 3 (N = 36): 172 (IC 95%: 165-179) g, 55 (IC 95%: 52-57) g y 68 (IC 95%: 64-71) g, respectivamente. La utilización de una, dos o tres formulaciones, que contengan aportes equivalentes a ± 20% de las necesidades medias de cada subpoblación, satisfacen los requerimientos de glucosa, lípidos y proteínas en el 45% (IC 95%: 36% a 55%), 74% (IC 95%: 65% a 83) y 82% (IC 95%: 74% a 89%) de los pacientes, respectivamente. En suma, el desarrollo de tres formulaciones normalizadas de nutrición parenteral permite satisfacer las necesidades nutricionales de al menos el 74% de los pacientes adultos metabólicamente estables subsidiarios de nutrición parenteral total.The aim of this study is to identify patients subpopulations with similar caloric and proteic needs (CPN) and developing and assessing the utility of standarized formulations of total parenteral nutrition (TPN) with equivalents supplies to the average patients needs of each identified subpopulation. CPN of one hundred metabolically stables adults patients in treatment with TPN were evaluated consecutively. Caloric supplies were calculated with the Harris-Benedict equation, with the Long corrections and proteics supplies were evaluated according to stress level. The identification of patients subpopulation according to the CPN was made through the cluster analysis with partitioning around mediods algorithm. We considered the formulation with equivalent supplies to the average needs of each subpopulation was adequated to the patients caloric-proteic requirements when their difference was lower than 20%. The percentage of patients who received adequated supplies were compared between the subpopulations identified. In case of two subpopulations, glucose, lipids and amino acid needs are: 275 (CI 95%: 265-285) g, 83 (CI 95%: 78-88) g and 89 (CI 95%: 86-92) g in subpopulation 1 (N = 35), and 195 (CI 95%: 187-203) g, 58 (CI 95%: 56-61) g and 74 (CI 95%: 72-77) g in subpopulation 2 (N = 65), respectively. In case of three subpopulations, in subpopulation 1 (N = 19), glucose, lipids and amino acid needs are: 295 (CI 95%: 283-306) g, 91 (CI 95%: 84-97) g and 91 (CI 95%: 86-95); 234 (CI 95%: 227-240) g, 67 (CI 95%: 64-70) g and 84 (CI 95%: 82-86) g to the subpopulation 2 (N = 45) and 172 (CI 95%: 165- 179) g, 55 (CI 95%: 52-57) g, and 68 (CI 95%: 64-71) g to the subpopulation 3 (N = 36) respectively. In general, caloric and proteic supplies are equal to the patients needs, but there was a tendendy to overfeeding in patients with lower CPN. The utilization of one, two or three formulations with equivalent supplies to the average needs of each subpopulation was adequated to the patients in the 45% (CI 95%: 36%-55%), 75% (CI 95%: 65%- 83%) and 82% (CI 95%: 74%-89%), respectively. Therefore, the development of three normalized formulations of total parenteral nutrition allows to satisfy the patients nutritional needs at least the 74% of the patients

Conformal Spinning Quantum Particles in Complex Minkowski Space as Constrained Nonlinear Sigma Models in U(2,2) and Born's Reciprocity

We revise the use of 8-dimensional conformal, complex (Cartan) domains as a base for the construction of conformally invariant quantum (field) theory, either as phase or configuration spaces. We follow a gauge-invariant Lagrangian approach (of nonlinear sigma-model type) and use a generalized Dirac method for the quantization of constrained systems, which resembles in some aspects the standard approach to quantizing coadjoint orbits of a group G. Physical wave functions, Haar measures, orthonormal basis and reproducing (Bergman) kernels are explicitly calculated in and holomorphic picture in these Cartan domains for both scalar and spinning quantum particles. Similarities and differences with other results in the literature are also discussed and an extension of Schwinger's Master Theorem is commented in connection with closure relations. An adaptation of the Born's Reciprocity Principle (BRP) to the conformal relativity, the replacement of space-time by the 8-dimensional conformal domain at short distances and the existence of a maximal acceleration are also put forward.Comment: 33 pages, no figures, LaTe

Variability of early autumn planktonic assemblages in the strait of Gibraltar: a regionalization analysis

The Strait of Gibraltar (SG) is the only connection of the Mediterranean Sea with the global circulation. The SG is an outstanding marine region to explore physical-biological coupling of pelagic communities due to its hydrodynamic complexity, including strong tidal forcing and marked spatial gradients and fronts. The authors have unravelled the role of the fortnightly tidal scale (spring and neap tides) and local processes (upwelling and tidal-topographic mixing) that shape planktonic assemblages in the Strait. To do so, an oceanographic cruise was taken in early autumn 2008 with a high-resolution grid sampling and spring/neap tidal conditions. The planktonic features were captured using different automatic and semi-automatic techniques of plankton analyses (flow cytometry, FlowCAM, LOPC and Ecotaxa) that allowed covering a wide range of sizes of the community from pico- to mesoplankton. The SG was sectorized into two clusters based on the biogeochemical and main water column properties. Cluster 1 (CL1) covered shallow productive areas around Cape Trafalgar (CT). CL1 presented higher concentrations of chlorophyll and nutrients, and phytoplankton was mostly represented by Synechococcus and coastal diatoms while zooplankton had the highest percentage of meroplankton (31%). In contrast, cluster 2 (CL2) covered open ocean waters and presented more oligotrophic features, i.e. nitrogen-depleted waters with lower chlorophyll concentrations and a picoplankton community dominated by Prochlorococcus and holoplankton predominance in mesozooplankton. Under early autumn conditions with overall nutrient-depleted and stratified waters, the CT area emerges as an ecosystem where the constant tidal mixing and nutrients supply is coupled with an active production also being favored by high residence times and finally shaping a plankton community with unique features in the area.En prensa0,56

Simulating Turing Machines with Polarizationless P Systems with Active Membranes

We prove that every single-tape deterministic Turing machine working in t(n) t(n) time, for some function t:N→N t:N→N , can be simulated by a uniform family of polarizationless P systems with active membranes. Moreover, this is done without significant slowdown in the working time. Furthermore, if logt(n) log⁡t(n) is space constructible, then the members of the uniform family can be constructed by a family machine that uses O(logt(n)) O(log⁡t(n)) space.Ministerio de Economía y Competitividad TIN2012-3743

NGC 6705 a young α\alpha-enhanced Open Cluster from OCCASO data

The stellar [$\alpha$/Fe] abundance is sometimes used as a proxy for stellar age, following standard chemical evolution models for the Galaxy, as seen by different observational results. In this work we show that the Open Cluster NGC6705/M11 has a significant $\alpha$-enhancement [$\alpha$/Fe]$>0.1$ dex, despite its young age ($\sim$300 Myr), challenging the current paradigm. We use high resolution (R$>65,000$) high signal-to-noise ($\sim$70) spectra of 8 Red Clump stars, acquired within the OCCASO survey. We determine very accurate chemical abundances of several $\alpha$ elements, using an equivalent width methodology (Si, Ca and Ti), and spectral synthesis fits (Mg and O). We obtain [Si/Fe]=$0.13\pm0.05$, [Mg/Fe]=$0.14\pm0.07$, [O/Fe]=$0.17\pm0.07$, [Ca/Fe]=$0.06\pm0.05$ and [Ti/Fe]=$0.03\pm0.03$. Our results place these cluster within the group of young [$\alpha$/Fe]-enhanced field stars recently found by several authors in the literature. The ages of our stars have an uncertainty of around 50 Myr, much more precise than for field stars. By integrating the cluster's orbit in several non-axisymmetric Galactic potentials, we establish the M11's most likely birth radius to lie between 6.8-7.5 kpc from the Galactic center, not far from its current position. With the robust Open Cluster age scale, our results prove that a moderate [$\alpha$/Fe]-enhancement is no guarantee for a star to be old, and that not all $\alpha$-enhanced stars can be explained with an evolved blue straggler scenario. Based on our orbit calculations, we further argue against a Galactic bar origin of M11.Comment: 10 pages, 6 figures, accepted in A&

Estabilidad de patatas chips fritas en aceites vegetales de distinto grado de insaturación. Efecto del palmitato de ascorbilo durante el almacenamiento

Four vegetable oils with different polyunsaturated/saturated fatty acid ratio (P/S): 5.2 for sunflower oil, 3.,4 for canola rapeseed oil, 0.4 for a blend of palm oleic and canola rapeseed oil (80:20), and 0.3 for palm olein were assayed for stability of crisps fried in these oils during storage at 60º C. The action of ascorbyl palmitate with special attention to its synergistic effect on the natural antioxidants was also tested. by addition to the fried potatoes. The evolution of the oxidative stability was measured through peroxide value, quantitation of tocopherols and tocotrienols, and induction time (IT) by means of Rancimat. Oil degradation during frying was very low as both polar compound percentages and natural antioxidant had similar levels to those present in refined oils. Evolution of analytical parameters during storage results indicated that oil unsaturation degree or P/S had a much more importance on stability of the product than had the content and type of natural antioxidants and the addition of AP. Nevertheless, addition of AP to the fried potatoes had a significant effect resulting in higher retention of natural antioxidants, higher IT and lower PV at any storage timeSe estudia la evolución de la oxidación a 60º C en patatas fritas con cuatro aceites vegetales de distinta relación ácidos grasos poliinsaturados/saturados (P/S): 5,4 para el aceite de girasol, 3,4 para el aceite de canola, 0,4 para una mezcla de oleína de palma (80 %) y aceite de canola (20 %) y 0,3 para la oleína de palma. Se estudia igualmente la influencia de la adición de palmitato de ascorbilo (AP) durante la conservación del producto frito con especial atención a su efecto sinergista sobre los antioxidantes naturales. La evolución de la oxidación en lotes de patatas, con y sin adición de AP, se determinó mediante las siguientes determinaciones analíticas: índice de peróxidos (PV), cuantificación de tocoferoles y tocotrienoles, y periodos de inducción (IT) en Rancimat. La degradación de los aceites durante el proceso de fritura fue muy baja puesto que los niveles de compuestos polares y de antioxidantes naturales fueron similares a los encontrados en aceites refinados. La evolución de los índices analíticos durante el almacenamiento mostraron la importancia primordial del grado de insaturación del aceite por encima de la cantidad y tipo de antioxidantes y de la adición de AP. Sin embargo, la adición de AP a las patatas fritas tuvo un claro efecto sinergista traducido en menores PV y mayores cantidades de antioxidantes naturales e IT para cualquier tiempo de almacenamiento

Standardised description of health and social care:A systematic review of use of the ESMS/DESDE (European Service Mapping Schedule/Description and Evaluation of Services and DirectoriEs)

Background: Evidence-informed planning and interpretation of research results both require standardised description of local care delivery context. Such context analysis descriptions should be comparable across regions and countries to allow benchmarking and organizational learning, and for research findings to be interpreted in context. The European Service Mapping Schedule (ESMS) is a classification of adult mental health services that was later adapted for the assessment of health and social systems research (Description and Evaluation of Services and DirectoriEs - DESDE). The aim of the study was to review the diffusion and use of the ESMS/DESDE system in health and social care and its impact in health policy and decision-making. Method: We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (1997–2018). Results: Out of 155 papers mentioning ESMS/DESDE, 71 have used it for service research and planning. The classification has been translated into eight languages and has been used by seven international research networks. Since 2000, it has originated 11 instruments for health system research with extensive analysis of their metric properties. The ESMS/DESDE coding system has been used in 585 catchment areas in 34 countries for description of services delivery at local, regional and national levels. Conclusions: The ESMS/DESDE system provides a common terminology, a classification of care services, and a set of tools allowing a variety of aims to be addressed in healthcare and health systems research. It facilitates comparisons across and within countries for evidence-informed plannin

Facile synthesis of low band gap ZnO Microstructures

Abstract In this work a simple chemical route was employed to synthesize ZnO microparticles by precipitation from aqueous solution of ZnCl2 as precursor, NaOH as oxidizing and sodium dodecyl sulfate (SDS) as surfactant. Samples of ZnO microparticles were analyzed by scanning electron microscopy (SEM), FTIR spectroscopy, Raman spectroscopy, X-Ray diffraction, UV/Vis-NIR diffusereflectance,highresolutiontransmissionelectronmicroscopy(HR-TEM),andN2 adsorption-desorption.Itwasobserved from SEM analysis that ZnO microparticles with morphologies resembling six-blade impeller with diameters in the range of 500 nm to 1 m, and sheet-like (approximately 200 nm×300 nm) were obtained through this technique. X-Ray diffraction and Raman analyses confirmed the obtaining of hexagonal wurtzite ZnO crystal structure. The calculated band gap energy was 3.19 eV, which is slightly lower than the average value reported in the literature. Specific BET area of ZnO microparticles was 26.5 m2/g. Keywords: ZnO, microstructures, band gap energy, SEM, morphology. Resumen En este trabajo se empleó un a ruta química sencilla para sintetizar micropartículas de ZnO mediante precipitación en solución acuosa de ZnCl2 como precursor, NaOH como oxidante y dodecil sulfato de sodio (SDS) como tensoactivo. Las muestras de ZnO fueron analizadas mediante microscopía de barrido electrónico (SEM), espectroscopía de FTIR, espectroscopía Raman, difracción de rayos-X, reflectancia difusa de UV/Vis-NIR, microscopía de transmisión de electrones de alta resolución (HRTEM), y mediante adsorción-desorción de N2. Se observó mediante análisis de SEM que mediante esta técnica se obtienen micropartículas de ZnO con morfologías similares a impulsores de seis-aspas con diámetros entre 500 nm y 1 m, morfologías tipo-hojas(deaproximadamente200nm×300nm).Losanálisisdedifracciónderayos-XydeRamanconfirmaronlaobtención de ZnO con estructura cristalina wurtzita hexagonal. La energía de band gap calculada fue de 3.19 eV, la cual es ligeramente menor que el valor promedio reportado en la literatura. El área superficial BET de las nanopartículas de ZnO fue de 26.5 m2/g Palabras clave: ZnO, microestructuras, energía de band gap, SEM, morfología