Gastric Perforation and Phlegmon Formation by Foreign Body Ingestion

This is a case report of foreign body ingestion in a suicide attempt resulting in gastric perforation and phlegmon formation during a subsequent 6 month period that eventually required surgical intervention. The patient had a prolonged course because she did not report a history of foreign body ingestion and the initial evaluating physicians had no suspicion about possible foreign body ingestion and may have missed important findings on physical examination. Gastric perforation by a foreign object  may have a slow course rather than presenting acute abdomen. The realization of a proper physical examination in the emergency department is key to an accurate diagnosis

Efecto de la comunicación del Banco de la República sobre la curva de rendimientos

Analizamos el efecto, sobre la curva de rendimientos, de la comunicación del Banco de la República mediante dos tipos de documentos, las minutas de las reuniones de política monetaria y los informes de política monetaria (anteriormente informes sobre inflación) durante el periodo 2011-II a 2018-IV. Extraemos información numérica de los fan charts publicados en los informes de política monetaria e información narrativa –usando Latent Dirichlet Allocation, una herramienta de lingüística computacional- tanto de las minutas como de los informes. Mediante la metodología de estudio de eventos analizamos el impacto sobre cuatro diferentes tasas: spot a un año, forward a 3 años, forward a 5 años y forward a 5 años, dentro de 5 años. No encontramos evidencia de que la información numérica tenga algún efecto sobre estas tasas. Con respecto a las variables narrativas encontramos que (i) para los informes de política, hay un efecto significativo solo sobre dos de las tasas (spot a un año y forward a 5 años) y (ii) para las minutas hay un efecto significativo sobre las cuatro tasas. Creemos que estos resultados pueden explicarse por el rezago de publicación que tenía el informe de política monetaria durante el periodo analizado.We analyze the effect on the yield curve of Banco de la Republica’s communication through two specific outlets, the minutes of the monetary policy meetings and the inflation reports during the period 2011-Q2 to 2018-Q4. We extract numeric information from the inflation reports’ fan charts, and narrative information -using Latent Dirichlet Allocation, a computational linguistics tool- from the text of both outlets. We use an event-study approach to analyze the impact on four specific maturities: one-year spot, three-year forward, five-year forward and five-year ahead five-year forward rates. We find no evidence that numeric information has any effect on market yields. Regarding narrative variables we find that (i) for the inflation report, there is a significant effect on just two yields (one-year spot and five-year forward), and (ii) for the minute, there is a significant effect on all yields. We believe that these results may be explained by the publication lag of the inflation report during the period of analysis.Efecto de la comunicación del Banco de la República sobre la curva de rendimientos Enfoque El documento analiza el efecto de la comunicación del Banco de la República (BR) sobre las tasas de interés de mercado a diferentes plazos. En particular, se estudian dos tipos de documentos publicados por el BR: las Minutas de las reuniones de política monetaria de la Junta Directiva y los Informes de Política Monetaria (anteriormente Informes sobre Inflación). Se analizan dos tipos de información: numérica y narrativa. Esta última se extrae usando Latent Dirichlet Allocation (LDA), una herramienta de análisis de texto mediante la cual se identifican los principales temas tratados en los documentos, su importancia y los cambios de la misma para cada tema a través del tiempo. El análisis del efecto de la comunicación se hace mediante el método estadístico de estudio de eventos, el cual supone que los cambios que se observan en las tasas de interés, el día que se publica una minuta o un informe de política, reflejan la reacción del mercado a la entrega de la información contenida en esos documentos. Contribución Aunque algunos trabajos previos han estudiado el efecto de la comunicación del BR sobre las tasas de interés, este documento es, en nuestro conocimiento, el primero en usar la herramienta LDA para ese propósito y también, el primero en incluir para este análisis el informe de política monetaria. Tanto las minutas como los informes de política son herramientas fundamentales en la comunicación del BR, y el análisis del impacto de su publicación sobre el mercado es relevante para el estudio y evaluación de las estrategias de comunicación del banco central. Resultados No encontramos evidencia de que la información numérica tenga algún efecto sobre las tasas de mercado. Con respecto a la información narrativa, no hay evidencia robusta de que aquella procedente del informe de política tenga efecto sobre las tasas, mientras que sí la hay para el caso de la que está contenida en las minutas. Consideramos que estos resultados pueden explicarse por el rezago de publicación que tenía el informe de política monetaria durante el periodo analizado. Frase destacada: Tanto las minutas como los informes de política son herramientas fundamentales en la comunicación del BR, y el análisis del impacto de su publicación sobre el mercado es relevante para el estudio y evaluación de las estrategias de comunicación del banco central

Implementation of learning by doing methods in the graphical engineering field

Regarding the different options to approaches with excessively theoretical contents that are applied in teaching, there are several innovative learning strategies for active students’ involvement. According to (1) most of the business look for professional profiles in which applicants not only have an academic background but also good personal skills, such as initiative, undertaking, communication skills, commercial vision, and so on. This paper presents the experiments that aim to achieve the objectives and catching skills by the Learning by doing technique (2), through a contextualization of the subject “Container and Packaging” in the Industrial Design Degree. Moreover, a close relation between university and business is achieved. In this way students acquire the requirements demanded by the company. A particularization of an industrial design methodology proposed by the Technological Institute of Packaging, Transport and Logistics (ITENE, Valencia) has been implemented for the design of packaging and packaging (4). Besides using this method, students take on a project-based learning (PBL) work under the role of company. Then, they realize the redesign of the container of a manufactured product close to his residence province, i.e. Ron Montero Winery, Granada. This practice will not only look for improving the student's ability to research and solve problems, but also to manage the professional and personal relationships that occur within each work group. These situations are necessary in the training process since they will be to be fought daily in their future professional life.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tec

Contabilidad de gestión : herramientas que contribuyen al fortalecimiento de la planeación, el control y la toma de decisiones en las microempresas. Caso aplicado Esmomag S.A.S.

Las microempresas son de gran importancia en la economía, ya que son determinantes en la generación de riqueza y empleo, impulsando el desarrollo del país, por esto su importancia. Por ende, es importante incorporar o mejorar los procesos de gestión en las microempresas; desde la contabilidad de gestión, existen algunas herramientas que permiten contrarrestar las adversidades que se presentan en las organizaciones. Por tal razón, la pregunta orientadora es ¿Cuáles son las herramientas de la contabilidad de gestión que pueden ser utilizadas para fortalecer los procesos de planeación, control y toma de decisiones, caso aplicado en la empresa ESMOMAG S.A.S de la ciudad de Buga?. Para desarrollar la pregunta se abordó el tipo de investigación exploratoria de corte descriptivo y el método de investigación cualitativo, lo cual permitió hacer deducciones partiendo de datos particulares a generales. La técnica de recolección que se utilizó fue indagación documental y trabajo de campo. De acuerdo con lo anterior, se evidencia cómo la contabilidad de gestión presenta herramientas que contribuyen al correcto funcionamiento y perdurabilidad de las microempresas, pues realiza un aporte a los procesos de planeación, control y toma de decisiones. La microempresa ESMOMAG S.A.S en particular, y las microempresas en general, independientemente del sector al que pertenezcan, al emplear estas herramientas de la contabilidad de gestión puede obtener un mayor conocimiento de su entorno tanto externo como interno, lo cual permite realizar una proyección, accediendo a la mejora continua, por ende, fortaleciendo la gestión empresarial y su perdurabilidad en el mercado.PregradoCONTADOR(A) PÚBLIC

Social engagement within the facility increased life expectancy in nursing home residents [preprint]

Conjunto de datos disponible en: http://hdl.handle.net/20.500.12105/11202 y Artículo final en: https://repisalud.isciii.es/handle/20.500.12105/11382Social engagement (SE) has been consistently shown to improve survival among community- dwelling older people, but the evidence in nursing home residents is inconclusive and prone to short-term reverse causation and confounding by major health determinants. A representative cohort of 382 nursing home residents in Madrid without severe physical and cognitive impairments at baseline was followed up for 10-year all-cause mortality. Standardized cumulative mortality curves for residents with low/null, moderate, and high levels of SE at baseline were estimated using Kaplan-Meier methods and spline-based survival models with inverse probability of exposure weights conditional on baseline sociodemographic characteristics, facility features, comorbidity, and disability. Standardized 5-year mortality risks and median survival times were compared across levels of SE. The baseline prevalences of low/null, moderate, and high SE were 36.0%, 44.2%, and 19.8%, respectively. A total of 268 residents died during 2,305 person-years of follow-up. Compared with residents with low/null SE at baseline, the standardized differences (95% confidence intervals) in 5-year mortality risk were −2.3% (−14.6% to 10.0%) for moderately engaged residents and −18.4% (−33.8% to −2.9%) for highly engaged residents. The median survival time increased by 0.4 (−1.4 to 2.2) and 3.0 (0.8 to 5.2) years, respectively. Residents with high SE within the nursing home had substantially lower mortality risk and longer median survival than residents with similar health determinants but low/null SE. The development of intervention programs, aimed at increasing SE among nursing home residents, could improve their long-term survival with an inherent gain in quality of life.This work was supported by the Institute of Health Carlos III (Grant PI15CIII00037). The funding agencies had no role in study design, data analysis, interpretation of results, manuscript preparation, or in the decision to submit this manuscript for publicationN

Improving classification based on physical surface tension-neural net for the prediction of psychosocial-risk level in public school teachers

Background. Psychosocial risks, also present in educational processes, are stress factors particularly critical in state-schools, affecting the efficacy, stress, and job satisfaction of the teachers. This study proposes an intelligent algorithm to improve the prediction of psychosocial risk, as a tool for the generation of health and risk prevention assistance programs.Methods. The proposed approach, Physical Surface Tension-Neural Net (PST-NN), applied the theory of superficial tension in liquids to an artificial neural network (ANN), in order to model four risk levels (low, medium, high and very high psychosocial risk). The model was trained and tested using the results of tests for measurement of the psychosocial risk levels of 5,443 teachers. Psychosocial, and also physiological and musculoskeletal symptoms, factors were included as inputs of the model. The classification efficiency of the PST-NN approach was evaluated by using the sensitivity, specificity, accuracy and ROC curve metrics, and compared against other techniques as the Decision Tree model, Naive Bayes, ANN, Support Vector Machines, Robust Linear Regression and the Logistic Regression Model.Results. The modification of the ANN model, by the adaptation of a layer that includes concepts related to the theory of physical surface tension, improved the separation of the subjects according to the risk level group, as a function of the mass and perimeter outputs. Indeed, the PST-NN model showed better performance to classify psychosocial risk level on state-school teachers than the linear, probabilistic and logistic models included in this study, obtaining an average accuracy value of 97.31%.Conclusions. The introduction of physical models, such as the physical surface tension, can improve the classification performance of ANN. Particularly, the PST-NN model can be used to predict and classify psychosocial risk levels among state-school teachers at work. This model could help to early identification of psychosocial risk and to the development of programThe authors received financial support from the "Convocatoria Nacional para el Apoyo al Desarrollo de Tesis de Posgrado o de Trabajos Finales de Especialidades en el area de la Salud de la Universidad Nacional de Colombia 2017-2018'' via Resolution 21 of december 2017 from Vicerectoria of Investigaciones, who selected the proposal research: "Sistema de clasificacion basado en tecnicas inteligentes para identificar el grado de riesgo psicosocial en docentes de educacion basica primaria y secundaria en colegios publicos de Colombia'', with identification number Hermes 40976 and Quipu code 201010016754. The authors also received financial support from the "Universidad de San Buenaventura-Cali-Facultad de Ingenieria-Nuevas tecnologias trabajo y gestion''. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Diseño y construcción de un prototipo de ladrillo a base de celulosa vegetal (cartón) y cemento para el municipio de Girardot

Proponer un mampuesto a base de cemento y celulosa de origen vegetal (cartón) que cumpla con la normatividad colombiana para el municipio de Girardot.Cuidar del medio ambiente se ha convertido en una necesidad en el área de la construcción, pues el mundo actual exige una concientización que permita desarrollar mayores prácticas sostenibles en pro de la supervivencia del planeta y los seres humanos. Adicionalmente, existen numerosos estudios de investigación en el ámbito estudiantil orientados a la puesta en práctica de nuevos recursos que permitan mejorar o cambiar los conceptos técnicos y teóricos de los recursos que se extraen de la explotación ambiental adquiridos de afluentes y canteras. Por esta razón,surge la presente investigación en la que se busca diseñar y construir un prototipo de ladrillo a base de celulosa vegetal (cartón) y cemento, que cumpla con la normativa colombiana para generar una alternativa constructiva en el municipio de Girardot. Para ello, se estableció el estudio actual como una investigación experimental, enmarcada en un enfoque mixto y, por lo tanto, para cumplir con los objetivos propuestosse llevó a cabo una serie de diseños experimentales y ensayos de laboratorio, buscando formular una óptima dosificación de mezcla en la cualse logró determinar que el prototipo numero 3 compuesto por un 75% de cartón y un 25% de cemento más aditivos, es el más adecuado para ser una variación del ladrillo de arcilla tradicional.Caring for the environment has become a necessity in the area of construction since today's world demands an awareness that allows the development of more sustainable practices for the survival of the planet and human beings. Additionally, there are numerous research studies in the student environment oriented to the implementation of new resources that allow improving or changing the technical and theoretical concepts of the resources that are extracted from the environmental exploitation acquired from tributaries and quarries. For this reason, the present investigation arises in which it is sought to design and build a prototype of brick based on vegetable cellulose (cardboard) and cement, which complies with the Colombian regulations to generate a constructive alternative in the municipality of Girardot. For this purpose, the current study was established as experimental research, framed in a mixed approach and, therefore, to meet the proposed objectives, a series of experimental designs and laboratory tests were carried out, seeking to formulate an optimal mixture dosage in which it was determined that the prototype number 3, composed of 75% cardboard and 25% cement plus additives, is the most suitable to be a variation of the traditional clay brick

Diseño y construcción de un prototipo de ladrillo a base de celulosa vegetal (cartón) y cemento para el municipio de Girardot

Proponer un mampuesto a base de cemento y celulosa de origen vegetal (cartón) que cumpla con la normatividad colombiana para el municipio de Girardot.Cuidar del medio ambiente se ha convertido en una necesidad en el área de la construcción, pues el mundo actual exige una concientización que permita desarrollar mayores prácticas sostenibles en pro de la supervivencia del planeta y los seres humanos. Adicionalmente, existen numerosos estudios de investigación en el ámbito estudiantil orientados a la puesta en práctica de nuevos recursos que permitan mejorar o cambiar los conceptos técnicos y teóricos de los recursos que se extraen de la explotación ambiental adquiridos de afluentes y canteras. Por esta razón,surge la presente investigación en la que se busca diseñar y construir un prototipo de ladrillo a base de celulosa vegetal (cartón) y cemento, que cumpla con la normativa colombiana para generar una alternativa constructiva en el municipio de Girardot. Para ello, se estableció el estudio actual como una investigación experimental, enmarcada en un enfoque mixto y, por lo tanto, para cumplir con los objetivos propuestosse llevó a cabo una serie de diseños experimentales y ensayos de laboratorio, buscando formular una óptima dosificación de mezcla en la cualse logró determinar que el prototipo numero 3 compuesto por un 75% de cartón y un 25% de cemento más aditivos, es el más adecuado para ser una variación del ladrillo de arcilla tradicional.Caring for the environment has become a necessity in the area of construction since today's world demands an awareness that allows the development of more sustainable practices for the survival of the planet and human beings. Additionally, there are numerous research studies in the student environment oriented to the implementation of new resources that allow improving or changing the technical and theoretical concepts of the resources that are extracted from the environmental exploitation acquired from tributaries and quarries. For this reason, the present investigation arises in which it is sought to design and build a prototype of brick based on vegetable cellulose (cardboard) and cement, which complies with the Colombian regulations to generate a constructive alternative in the municipality of Girardot. For this purpose, the current study was established as experimental research, framed in a mixed approach and, therefore, to meet the proposed objectives, a series of experimental designs and laboratory tests were carried out, seeking to formulate an optimal mixture dosage in which it was determined that the prototype number 3, composed of 75% cardboard and 25% cement plus additives, is the most suitable to be a variation of the traditional clay brick

High site fidelity and restricted ranging patterns in southern Australian bottlenose dolphins

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Information on site fidelity and ranging patterns of wild animals is critical to understand how they use their environment and guide conservation and management strategies. Delphinids show a wide variety of site fidelity and ranging patterns. Between September 2013 and October 2015, we used boat‐based surveys, photographic identification, biopsy sampling, clustering analysis, and geographic information systems to determine the site‐fidelity patterns and representative ranges of southern Australian bottlenose dolphins (Tursiops cf. australis) inhabiting the inner area of Coffin Bay, a highly productive inverse estuary located within Thorny Passage Marine Park, South Australia. Agglomerative hierarchical clustering (AHC) of individuals’ site‐fidelity index and sighting rates indicated that the majority of dolphins within the inner area of Coffin Bay are “regular residents” (n = 125), followed by “occasional residents” (n = 28), and “occasional visitors” (n = 26). The low standard distance deviation indicated that resident dolphins remained close to their main center of use (range = 0.7–4.7 km, X ± SD = 2.3 ± 0.9 km). Representative ranges of resident dolphins were small (range = 3.9–33.5 km2, X ± SD = 15.2 ± 6.8 km2), with no significant differences between males and females (Kruskal–Wallis, χ2 = 0.426, p = .808). The representative range of 56% of the resident dolphins was restricted to a particular bay within the study area. The strong site fidelity and restricted ranging patterns among individuals could be linked to the high population density of this species in the inner area of Coffin Bay, coupled with differences in social structure and feeding habits. Our results emphasize the importance of productive habitats as a major factor driving site fidelity and restricted movement patterns in highly mobile marine mammals and the high conservation value of the inner area of Coffin Bay for southern Australian bottlenose dolphins

Land use change in a Mediterranean metropolitan region and its periphery: Assessment of conservation policies through CORINE land cover data and Markov models

Sustainable territorial management requires reliable assessment of the impact of conservation policies on landscape structure and dynamics. Euro-Mediterranean regions present a remarkable biodiversity which is linked in part to traditional land use practices and which is currently threatened by global change. The effectiveness of one-decade conservation policies against land use changes was examined in Central Spain (Madrid Autonomous Community). A Markov model of landscape dynamics was parameterized with CORINE Land Cover information and transition matrices were obtained. The methods were applied in both protected and unprotected areas to examine whether the intensity and direction of key land use changes —urbanisation, agricultural intensification and land abandonment— differed significantly depending on the protection status of those areas. Protected areas experienced slower rates of agricultural intensification processes and faster rates of land abandonment, with respect to those which occurred in unprotected areas. It illustrates how simple mathematical tools and models —parameterized with available data— can provide to managers and policy makers useful indicators for conservation policy assessment and identification of land use transitions