Prevalencia de microorganismos causales de infecciones postquirúrgicas en la cavidad abdominal en pacientes de la sala de cirugía del Hospital Escuela San Juan de Dios Estelí, enero a diciembre 2017

La infección del sitio quirúrgico es la principal causa de morbimortalidad postquirúrgica. Esto asociado a la creciente tendencia de las bacterias al desarrollo de resistencias a los antimicrobianos, que dificulta cada vez más el manejo de estos pacientes. Determinar la prevalencia de microorganismos causales de infecciones postquirúrgicas de la cavidad abdominal en pacientes de la sala de cirugía en el HESJD Estelí en el año 2017. Método: Se trata de un estudio descriptivo, cuantitativo, de corte transversal, retrospectivo, de muestreo polietápico. Universo: 720 pacientes postquirúrgicos. Población de estudio: 72 pacientes con infección del sitio quirúrgico. Muestra: 61 pacientes con un intervalo de confianza del 95% y un margen de error del 5%. Resultados: La edad predominante de pacientes que presentó infecciones fue de 45 a 54 años de edad 28%, seguido por el intervalo de edad de mayores de 65 años con el 21%. Del total de pacientes el 44% tenía patologías previas con una distribución Diabetes Mellitus tipo 2 (30%), Hipertensión arterial (26%). Las cirugías asociadas a mayor índice de infecciones del sitio quirúrgico fueron: Laparotomía exploratoria (61%) y apendicectomía (25%). Los agentes infectantes fueron Pseudomona aeruginosa (25%), Escherichia coli (20%), Kluyvera cryocrescens (11%). Las cepas aisladas fueron resistentes a Amoxicilina con Ácido clavulánico (100%), Ceftazidime (83%), Ceftriaxona (92%). Sensibilidad a Meropenem (89%), Imipenem (88%) y Piperacilina (83%). Conclusiones: Los pacientes entre 45 y 54 años (28%) y los mayores de 65 años (21%), son los pacientes que con mayor frecuencia presentaron infecciones del sitio quirúrgico. Laparotomía exploratoria predispone a infecciones del sitio quirúrgico. El patógeno infectante más encontrado es Pseudomona aeruginosa. Se encontró elevada resistencia a Amoxicilina con Ácido clavulánico, Ceftazidime y Ceftriaxona. Y alta sensibilidad al Meropenem, Imipenem y Piperacilina con tazobactam

Determinants of the Assimilation of Information Technologies in Human Resource Service Delivery in Canada and the United States of America

The use of Information Technology (IT) in the delivery of Human Resource (HR) services -a traditionally laborious, paper-intensive operation—is spearheading a revolution in the way personnel services are delivered. Based on a thorough review of practitioner and academic research literatures, this dissertation studies the determinants of assimilation for the following HR Information Technologies (HRITs): (1) HR functional applications; (2) Integrated HR software suites; (3) Interactive (or Automated) Voice Response systems; (4) HR intranets; (5) Employee Self-Service applications; (6) Manager Self-Service applications; (7) HR extranets; and (8) HR portals. The assimilation of HRITs is operationalized through a multidimensional variable, HR Technology Intensity (HRTI), that includes information on the assimilation stage of the technologies used in the firm, as well as on the penetration with which they are being used. Using a Diffusion of Innovations perspective, four sets of factors are hypothesized to influence HRTI: Environmental Factors (more specifically, Environmental Turbulence), Organizational Factors (Top Management Support and Uniqueness of HR Practices), User Department Factors (HR Innovation Climate, HR IT-Absorptive Capacity and HR-Technology Champion), and IS Department Factors (HR IS Resource Availability and HR-IS Relationship). The latter are theorized to mediate the relationship between the User Department factors and HRTI when the Locus of Responsibility for HR-Technology includes at least partially the IS function -a moderated mediation functional form (James & Brett, 1984). Data from 155 HR Executives from firms in Canada and the United States were collected using an Internet-based survey, yielding a response rate of 21.3%. No consequential differences were found among country sub-samples. Hierarchical regression analyses offered support for the hypotheses concerning the relationship between HRTI and Top Management Support (an Organizational Factor), and HR Innovation Climate (a User Department Factor). Moderated mediation analyses also substantiated the hypothesis linking HR Innovation Climate and HRTI by way of HR-IS Relationship when the Locus of Responsibility for HR-Technology includes the IS function. Finally, an alternate dependent variable (the Sum of Percentage Penetration of IT for HR) offers converging support for the analyses linking predictor and independent variables. Implications, limitations of this investigation, and suggestions for future research conclude this dissertation

Exploiting the MDM2-CK1 alpha Protein-Protein Interface to Develop Novel Biologics That Induce UBL-Kinase-Modification and Inhibit Cell Growth

Protein-protein interactions forming dominant signalling events are providing ever-growing platforms for the development of novel Biologic tools for controlling cell growth. Casein Kinase 1 α (CK1α) forms a genetic and physical interaction with the murine double minute chromosome 2 (MDM2) oncoprotein resulting in degradation of the p53 tumour suppressor. Pharmacological inhibition of CK1 increases p53 protein level and induces cell death, whilst small interfering RNA-mediated depletion of CK1α stabilizes p53 and induces growth arrest. We mapped the dominant protein-protein interface that stabilizes the MDM2 and CK1α complex in order to determine whether a peptide derived from the core CK1α-MDM2 interface form novel Biologics that can be used to probe the contribution of the CK1-MDM2 protein-protein interaction to p53 activation and cell viability. Overlapping peptides derived from CK1α were screened for dominant MDM2 binding sites using (i) ELISA with recombinant MDM2; (ii) cell lysate pull-down towards endogenous MDM2; (iii) MDM2-CK1α complex-based competition ELISA; and (iv) MDM2-mediated ubiquitination. One dominant peptide, peptide 35 was bioactive in all four assays and its transfection induced cell death/growth arrest in a p53-independent manner. Ectopic expression of flag-tagged peptide 35 induced a novel ubiquitin and NEDD8 modification of CK1α, providing one of the first examples whereby NEDDylation of a protein kinase can be induced. These data identify an MDM2 binding motif in CK1α which when isolated as a small peptide can (i) function as a dominant negative inhibitor of the CK1α-MDM2 interface, (ii) be used as a tool to study NEDDylation of CK1α, and (iii) reduce cell growth. Further, this approach provides a technological blueprint, complementing siRNA and chemical biology approaches, by exploiting protein-protein interactions in order to develop Biologics to manipulate novel types of signalling pathways such as cross-talk between NEDDylation, protein kinase signalling, and cell survival

Crystallographic Oxide Phase Identification of Char Deposits Obtained from Space Shuttle Columbia Window Debris

Analyzing the remains of Space Shuttle Columbia has proven technically beneficial years after the vehicle breakup. This investigation focused on charred deposits on fragments of Columbia overhead windowpanes. Results were unexpected relative to the engineering understanding of material performance in a reentry environment. The TEM analysis demonstrated that the oxides of aluminum and titanium mixed with silicon oxides to preserve a history of thermal conditions to which portions of the vehicle were exposed. The presence of Ti during the beginning of the deposition process, along with the thermodynamic phase precipitation upon cool down, indicate that temperatures well above the Ti melt point were experienced. The stratified observations implied that additional exothermic reaction, expectedly metal combustion of a Ti structure, had to be present for oxide formation. Results are significant for aerospace vehicles where thermal protection system (TPS) breaches cause substructures to be in direct path with the reentry plasma.

Support vector machines framework for linear signal processing

This paper presents a support vector machines (SVM) framework to deal with linear signal processing (LSP) problems. The approach relies on three basic steps for model building: (1) identifying the suitable base of the Hilbert signal space in the model, (2) using a robust cost function, and (3) minimizing a constrained, regularized functional by means of the method of Lagrange multipliers. Recently, autoregressive moving average (ARMA) system identification and non-parametric spectral analysis have been formulated under this framework. The generalized, yet simple, formulation of SVM LSP problems is particularized here for three different issues: parametric spectral estimation, stability of Infinite Impulse Response filters using the gamma structure, and complex ARMA models for communication applications. The good performance shown on these different domains suggests that other signal processing problems can be stated from this SVM framework.Publicad

Environmental Awareness of the Young in a Rural Community in the Sierra Tarahumara, Chihuahua, Mexico

With the aim at exploring the environmental awareness of the young sector in a predominantly indigenous community, fifty structured street interviews were applied to young individuals, aged 14 to 21, attending schools at Turuachi, a distant undeveloped rural community in the Sierra Tarahumara, in the State of Chihuahua, Northern Mexico. The data were analyzed by the software SPSS® (Statistical Package for Social Sciences). Most of the interviewees showed a good knowledge of basic ecology concepts. However, their perception of environmental problems appeared to be more influenced by everyday experiences. Despite forest being a major natural resource in the area, the group studied viewed cropping as the main economic activity. The main environmental problem was garbage pollution followed by deforestation and drought. The Chi2 test showed that women had a stronger perception than men about the garbage issue (p<0.057) and a clear disposition (p<0.001) to participate in municipal cleaning campaigns. Nearly all the participants were willing to engage in activities to preserve environmental quality; community action and specific workshops were selected as viable organization alternatives. Key words: environmental education, community participation, environmental problems

Prevalence of colonizing bacteria and their association with primary bacteremias in hemodialysis of a university hospital

to be from 2.5 to 5.5 cases per 1,000 catheter-day. the clinical impact is relevant and increases the cost of the HD Unit. Methods: The present study is the irst of 2 phases. It was conducted from January to December of 2012, and included all patients and nurses who were in the HD Unit. The prevalence of Gramnegative bacilli (GNB) and methicillin-resistant Staphylococcus aureus (MrSA) colonizing the nasal passages and the skin is described. Also, phenotypic association was sought by genus, species and sensitivities between colonizing bacterial strains and blood cultures with GNB and MRSA. Results: the study included 70 patients and 10 nurses. the prevalence of nasal colonization in patients by GNB was 9% and 6% in the pericatheter, and no nursing GNB colonization was discovered. The prevalence of MRSA nasal colonization was 19% and 6% in the pericatheter for patients and in the nurses the nasal colonization was 50% and 10% in the hands. We identiied 29 cases of primary bacteremia. The primary bacteremia rate is 1.5 per 1,000 catheter-day or 0.4 episodes per patient per year. Conclusion: We demonstrated a high prevalence of MrSA colonization in patients and nurses in the HD Unit. No relationship was found between primary bacteremia by GNB and patients and nurses’ bacteria colonization by the phenotypic comparison

Academic freedom in Europe: time for a Magna Charta?

This paper is a preliminary attempt to establish a working definition of academic freedom for the European Union states. The paper details why such a definition is required for the European Union and then examines some of the difficulties of defining academic freedom. By drawing upon experience of the legal difficulties beset by the concept in the USA and building on previous analyses of constitutional and legislative protection for academic freedom, and of legal regulations concerning institutional governance and academic tenure, a working definition of academic freedom is then derived. The resultant definition which, it is suggested, could form the basis for a European Magna Charta Libertatis Academicae, goes beyond traditional discussions of academic freedom by specifying not only the rights inherent in the concept but also its accompanying duties, necessary limitations and safeguards. The paper concludes with proposals for how the definition might be tested and carried forward