Design and Development of a Remote Station for Real-time Monitoring of Urban Flooding

This paper presents the design and development of urban flood monitoring stations that use pressure sensor to determine flooding levels. GPRS and SMS were used to communicate data from the remote stations to a server located at a data center. A web-based visualization tool has been developed to allow access to data in real-time. Based on experiments, the sensor measurements have a difference of 0.872cm to 3.067cm with actual values. The higher differences tend to be associated with higher water levels while lower differences were noted for lower water levels. With further experimentation, these differences can be used as correction factors to get to a more accurate reading, specially for purposes of R&D or modeling, though for issuance of warnings to the public, these differences are small enough especially since warnings are mostly based on qualitative descriptions such as knee-deep or waist deep flood level. Image capture was also experimented on and is envisioned to be incorporated with the station to provide a means to verify water level by providing a visual reference. Likewise, the image capture device will serve as a redundant sensor that can also determine flood levels thru image processing. Currently, two prototypes are deployed along Espana Avenue, an area known for flooding. Data from the stations show the typical behavior of flood water but currently, there is no reliable means to verify the accuracy of sensor readings, until the image capture device is installed. The data are viewable thru a web-based visualization tool

Relación entre parámetros bioquímicos y contenido de óxido nítrico en sangre

Dado que el 80% de las defunciones causadas por problemas de salud se debe a enfermedades crónicas no transmisibles (ECNT), tales como diabetes (3%), accidentes cerebrovasculares (33%) y cáncer (20%), entre otras, es importante implementar medidas preventivas para disminuir estas cifras y mejorar la calidad de vida poblacional. Por ello, el objetivo del presente trabajo fue determinar la relación entre análisis bioquímicos tradicionales y contenido de óxido nítrico en sangre, como parámetro de oxidación a nivel celular. La población estuvo representada por 103 hombres y mujeres, de 18 a 65 años, que acudieron a las instalaciones de la UMaza para realizarse los estudios. Se analizaron 103 sueros obtenidos por venopunción en pacientes con ayunos de 12 horas y se procesaron para la determinación de glucosa, colesterol, HDL colesterol, LDL colesterol y triglicéridos. Además, se obtuvo muestra para la valoración de hemoglobina y hematocrito, y contenido de óxido nítrico en sangre a través de la técnica del óxido nítrico

LA GESTIÓN POR COMPETENCIAS: UN MODELO PARA LA GESTIÓN DE RECURSOS HUMANOS EN LAS ORGANIZACIONES SANITARIAS.

The management for competences constitutes a model of participation and an adaptable stimulus to the career of the health professional. It is an integral model of management of the human resources that contributes, detecting, acquiring, promoting and developing the competences that give an extra value to the organization and for this reason this model is unique in this field of management. It proposes a management style in which the human factor is a priority and every person must contribute with their best skills to the organization. The aims we have proposed are to extend a new model of direction in the health organization, make the readers aware of the importance and impact of the management for competences and contribute with a global and integral vision knowing the specific tools of the management of human resources for competences. The model we are presenting in this paper is considered as one of the most appropriate for the current period. It is a way to fight the daily challenges in such a way that it makes it possible to train the intellectual capital of institutions and organizations. In general most of the companies and especially health organizations do not invest enough in the development of their teams, for reasons like the lack of systematized strategies for the evaluation of performance, or the unawareness of the importance of training the intellectual capital as a key factor.La gestión por competencias constituye un modelo de participación y estímulo adaptable a la carrera profesional del profesional sanitario. Es un modelo integral de gestión de los recursos humanos que contribuye a tal fin, detectando, adquiriendo, potenciando y desarrollando las competencias que dan valor añadido a la organización y que le diferencia en su sector. Propone un estilo de dirección donde prima el factor humano, en el que cada persona debe aportar sus mejores cualidades a la organización. Extender un nuevo modelo de dirección en la organización sanitaria, sensibilizar a los lectores sobre la importancia y la repercusión de la gestión por competencias y aportar una visión global e integral conociendo las herramientas específicas de la gestión de recursos humanos por competencias, son los objetivos que nos hemos planteado. El modelo que presentamos, se viene posicionando como uno de los más adecuados para los nuevos tiempos. Se trata de una manera de lidiar con lo cotidiano, de tal manera que posibilita la formación del capital intelectual de una institución u organización. La mayoría de las empresas en general y de las organizaciones sanitarias en particular, invierten de forma muy tímida en el desarrollo de sus equipos, por motivos que varían desde la inexistencia de estrategias sistematizadas de evaluación de desempeño, hasta el desconocimiento de la importancia de la formación de un capital intelectual como factor diferencial

Catheter-related bloodstream infections: predictive factors for Gram-negative bacteria aetiology and 30 day mortality in a multicentre prospective cohort

PROBAC REIPI/GEIH-SEIMC/SAEI.[Background] Catheter-related bloodstream infections (CRBSIs) increase morbidity and mortality, prolong hospitalization and generate considerable medical costs. Recent guidelines for CRBSI recommend empirical therapy against Gram-positive bacteria (GPB) and restrict coverage for Gram-negative bacteria (GNB) only to specific circumstances.[Objectives]To investigate predictors of GNB aetiology in CRBSI and to assess the predictors of outcome in patients with CRBSI.[Methods] Patients with CRBSI were selected from the PROBAC cohort, a prospective, observational, multicentre national cohort study including patients with bloodstream infections consecutively admitted to 26 Spanish hospitals in a 6 month period (October 2016–March 2017). Outcome variables were GNB aetiology and 30 day mortality. Adjusted analyses were performed by logistic regression.[Results] Six hundred and thirty-one episodes of CRBSI were included in the study. Risk factors independently related to GNB aetiology were central venous catheter (CVC) [OR 1.60 (95% CI: 1.05–2.44), P = 0.028], sepsis/septic shock [OR: 1.76 (95% CI: 1.11–2.80), P = 0.016], antibiotic therapy in the previous 30 days [OR: 1.56 (95% CI: 1.02–2.36), P = 0.037], neutropenia <500/μL [OR: 2.01 (95% CI: 1.04–3.87), P = 0.037] and peripheral vascular disease [OR: 2.04 (95% CI: 1.13–3.68), P = 0.018]. GNB were not associated with increased mortality in adjusted analysis, while removal of catheter [OR: 0.24 (95% CI: 0.09–0.61), P = 0.002] and adequate empirical treatment [OR: 0.37 (95% CI: 0.18–0.77), P = 0.008] were strong protective factors.[Conclusions] Our study reinforces the recommendation that empirical coverage should cover GNB in patients presenting with sepsis/septic shock and in neutropenic patients. Catheter removal and adequate empirical treatment were both protective factors against mortality in patients with CRBSI.This study was funded by Plan Nacional de I+D+i 2013–2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, through the following grants: Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0001; RD16/0016/0007; RD16/0016/0008; RD16/0016/0012), co-financed by European Development Regional Fund ‘A way to achieve Europe’, Operative Program Intelligent Growth 2014–2020, and PI16/01432. F. Caló enjoyed an ESCMID Observership grant at Hospital Universitario Virgen Macarena to develop this research

La relación entre Curso de articulación o propedéutico y rendimiento de los alumnos en la Cátedra de Introducción a la Teoría Contable de la Facultad de Ciencias Económicas de la Universidad Nacional de Entre Ríos

El Proyecto de Investigación denominado “La relación entre Curso de articulación o propedéutico y rendimiento de los alumnos en la Cátedra de Introducción a la Teoría Contable de la Facultad de Ciencias Económicas de la Universidad Nacional de Entre Ríos”, basado en las Cohortes 2010-2011, 2011-2012 y 2012-2013, tiene como objetivo realizar el seguimiento de los resultados en exámenes parciales y finales realizados por los alumnos de la Cátedra de Introducción a la Teoría Contable, luego de haber cursado y aprobado el Curso de Articulación o Propedéutico, respectivamente en forma obligatoria para poder acceder al cursado de la cátedra mencionada. La inquietud de relacionar el curso de articulación o propedéutico con el rendimiento en la cátedra, se origina en tratar de establecer si existen diferencias en los resultados de las evaluaciones, según se haya participado o no de los cursos mencionados, considerando una instancia propicia para realizar el estudio el inicio del ciclo lectivo 2011, en que se establece la obligatoriedad de esas instancias.El proyecto de articulación está destinado a los alumnos aspirantes a ingresar a la Facultad de Ciencias Económicas, con el propósito de desarrollar contenidos teóricos y prácticos acordes con los criterios adoptado por la cátedra de “Introducción a la Teoría Contable”. Con él se pretende lograr dos objetivos: por un lado, nivelar el conocimiento de los alumnos formados en la materia contable y, por otro lado, servir de curso introductorio para aquellos alumnos no formados en dicha materia.El presente informe expone el análisis descriptivo de los datos de los ingresantes 2010, 2011, 2012 y 2013 como así también estudia posibles relaciones entre la obligatoriedad implementada en el curso de articulación o propedéutico a partir del año 2011 y el rendimiento observado en la asignatura Introducción a la Teoría Contabl

Quasiexperimental intervention study protocol to optimise the use of new antibiotics in Spain: the NEW_SAFE project

Introduction Ceftaroline, tedizolid, dalbavancin, ceftazidime-avibactam and ceftolozane-tazobactam are novel antibiotics used to treat infections caused by multidrug-resistant pathogens (MDR). Their use should be supervised and monitored as part of an antimicrobial stewardship programme (ASP). Appropriate use of the new antibiotics will be improved by including consensual indications for their use in local antibiotic guidelines, together with educational interventions providing advice to prescribers to ensure that the recommendations are clearly understood. Methods and analysis This study will be implemented in two phases. First, a preliminary historical cohort (2017-2019) of patients from 13 Andalusian hospitals treated with novel antibiotics will be analysed. Second, a quasiexperimental intervention study will be developed with an interrupted time-series analysis (2020-2021). The intervention will consist of an educational interview between prescribers and ASP leaders at each hospital to reinforce the proper use of novel antibiotics. The educational intervention will be based on a consensus guideline designed and disseminated by leaders after the retrospective cohort data have been analysed. The outcomes will be acceptance of the intervention and appropriateness of prescription. Incidence of infection and colonisation with MDR organisms as well as incidence ofClostridioides difficileinfection will also be analysed. Changes in prescription quality between periods and the safety profile of the antibiotics in terms of mortality rate and readmissions will also be measured. Ethics and dissemination Ethical approval will be obtained from the Andalusian Coordinating Institutional Review Board. The study is being conducted in compliance with the protocol and regulatory requirements consistent with International Council of Harmonisation E6 Good Clinical Practice and the ethical principles of the latest version of the Declaration of Helsinki. The results will be published in peer-reviewed journals and disseminated at national and international conferences

Quasiexperimental intervention study protocol to optimise the use of new antibiotics in Spain: the NEW_SAFE project

[Introduction] Ceftaroline, tedizolid, dalbavancin, ceftazidime-avibactam and ceftolozane-tazobactam are novel antibiotics used to treat infections caused by multidrug-resistant pathogens (MDR). Their use should be supervised and monitored as part of an antimicrobial stewardship programme (ASP). Appropriate use of the new antibiotics will be improved by including consensual indications for their use in local antibiotic guidelines, together with educational interventions providing advice to prescribers to ensure that the recommendations are clearly understood.[Methods and analysis] This study will be implemented in two phases. First, a preliminary historical cohort (2017–2019) of patients from 13 Andalusian hospitals treated with novel antibiotics will be analysed. Second, a quasiexperimental intervention study will be developed with an interrupted time-series analysis (2020–2021). The intervention will consist of an educational interview between prescribers and ASP leaders at each hospital to reinforce the proper use of novel antibiotics. The educational intervention will be based on a consensus guideline designed and disseminated by leaders after the retrospective cohort data have been analysed. The outcomes will be acceptance of the intervention and appropriateness of prescription. Incidence of infection and colonisation with MDR organisms as well as incidence of Clostridioides difficile infection will also be analysed. Changes in prescription quality between periods and the safety profile of the antibiotics in terms of mortality rate and readmissions will also be measured.[Ethics and dissemination] Ethical approval will be obtained from the Andalusian Coordinating Institutional Review Board. The study is being conducted in compliance with the protocol and regulatory requirements consistent with International Council of Harmonisation E6 Good Clinical Practice and the ethical principles of the latest version of the Declaration of Helsinki. The results will be published in peer-reviewed journals and disseminated at national and international conferences.[Trial registration number] NCT03941951; Pre-results.The study is funded by the Consejería de Salud, Junta de Andalucía, grant PI-0077-2018. The investigators also receive funds for research from the Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0001) through the Plan Nacional de I+D+ i 2013‐2016, cofinanced by European Development Regional Fund “A way to achieve Europe”, Operative program Intelligent Growth 2014‐2020

Antimicrobial use and microbiological testing in district general hospital ICUs of the Veneto region of north-east Italy

International - predominantly American - studies undertaken in the ICUs of teaching centres show that inadequate antibiotic therapy increases mortality and length of stay. We sought to ascertain whether this also pertains to smaller ICUs in the Veneto region of north-east Italy. To the best of our knowledge, this is the first such survey in the Veneto area or in Italy as a whole. A retrospective, observational study was performed across five general-hospital ICUs to examine appropriateness of microbiological sampling, empirical antibiotic adequacy, and outcomes. Among 911 patients (mean age, 65.8 years ± 16.2 SD; median ICU stay, 17.0 days [IQR, 8.0–29.0]), 757 (83.1 %) were given empirical antibiotics. Treatment adequacy could be fully assessed in only 212 patients (28.0 %), who received empirical treatment and who had a relevant clinical sample collected at the initiation of this antibiotic (T0). Many other patients only had delayed microbiological investigation of their infections between day 1 and day 10 of therapy. Mortality was significantly higher among the 34.9 % of patients receiving inadequate treatment (48.6 % vs 18.80 %; p < 0.001). Only 32.5 % of combination regimens comprised a broad-spectrum Gram-negative β-lactam plus an anti-MRSA agent, and many combinations were irrational. Inadequate treatment was frequent and was strongly associated with mortality; moreover, there was delayed microbiological investigation of many infections, precluding appropriate treatment modification and de-escalation. Improvements in these aspects and in antibiotic stewardship are being sought

Ten Issues for Updating in Community-Acquired Pneumonia: An Expert Review

Community-acquired pneumonia represents the third-highest cause of mortality in industrialized countries and the first due to infection. Although guidelines for the approach to this infection model are widely implemented in international health schemes, information continually emerges that generates controversy or requires updating its management. This paper reviews the most important issues in the approach to this process, such as an aetiologic update using new molecular platforms or imaging techniques, including the diagnostic stewardship in different clinical settings. It also reviews both the Intensive Care Unit admission criteria and those of clinical stability to discharge. An update in antibiotic, in oxygen, or steroidal therapy is presented. It also analyzes the management out-of-hospital in CAP requiring hospitalization, the main factors for readmission, and an approach to therapeutic failure or rescue. Finally, the main strategies for prevention and vaccination in both immunocompetent and immunocompromised hosts are reviewed

Influence of Food and lifestyle in Oxidative Stress

Las enfermedades crónicas no transmisibles (ECNT) han sido identificadas por la Organización Mundial de la Salud (OMS) como las causales de cáncer, diabetes, enfermedades cardiovasculares y respiratorias crónicas. Los cuatro factores de riesgo más importantes de las ECNT son los hábitos alimentarios inadecuados, el uso de tabaco, el sedentarismo y el abuso de alcohol, todos ellos determinantes sociales evitables y prevenibles. Las ECNT son la primera causa de muerte en Argentina al igual que en el resto del mundo