Uso de óxido nitroso en sedoanalgesia durante la infiltración de toxina botulínica en pacientes pediátricos afectos de parálisis cerebral y otras encefalopatías

El principal objetivo de este estudio consiste en determinar la efectividad y la seguridad del óxido nitroso utilizado como sedoanalgésico en un grupo de pacientes en edad pediátrica afectos de parálisis cerebral u otros trastornos del movimiento. Se han utilizado datos clínicos y del procedimiento recogidos entre los años 2009 y 2015 de 78 pacientes que se encuentran en seguimiento por la unidad de Neuropediatría del Hospital Universitario Río Hortega de Valladolid. Se recogió el número de infiltraciones de toxina botulínica por paciente y sesión, ofreciéndose sedación a todos los pacientes y en todos los procedimientos de infiltración. En los padres que rechazaron la medida no se administró sedación. El número de sesiones sin N2O con nivel de sedación 1 y 2 (inadecuada) fue de 48 frente a 26 con niveles 3 y 4 (adecuados), no siendo estadísticamente significativa la diferencia. En el grupo con N2O la diferencia entre niveles adecuados de sedoanalgesia (274 sesiones) frente a inadecuados (94 sesiones) fue significativa (p<0,05). Los efectos secundarios recogidos fueron leves. Se concluye que el uso de N2O como sedoanalgésico es tanto efectivo como seguro en estos pacientes.Grado en Medicin

Respuesta frente a las necesidades de la sociedad: Medicina de Precisión para hacer frente a la COVID-19.

Sesión 2.Elementos críticos en la implantación de la Medicina de Precisión.Medicina de Precisión en enfermedades infecciosas. Grupos de entidades coordinadas. Gestión de datos genómicos. Desarrollo de Sofware. Tiempo de respuesta para la secuenciación de genomas virales. Sistema Nacional de Vigilancia SARS-CoV-2 basado en secuenciación del genoma viral. Proyectos Fondo COVID19N

Diferencias de supervivencia y crecimiento en repoblaciones forestales entre plantas cultivadas en contenedor y a raíz desnuda

Planteamiento del problema: La degradación de las masas forestales en el mundo como consecuencia del cambio global, incrementa la necesidad de proyectos de restauración forestal. Para garantizar el éxito temprano de estos proyectos, es fundamental conseguir una elevada supervivencia post-plantación del material vegetal usado. El shock derivado del trasplante a campo es el principal estrés que experimentan las plantas inmediatamente después de su plantación. Dicho estrés está muy relacionado con la humedad del suelo en el momento de la plantación y puede condicionar durante años la supervivencia y crecimiento de las plantaciones forestales. La calidad del material vegetal y el tipo de planta, pueden ser cruciales para reducir el shock del trasplante. Los dos tipos fundamentales de planta que se usan en las plantaciones forestales a nivel mundial son la cultivada en contenedores y que, por tanto, tiene cepellón (planta en contenedor) y la cultivada directamente en el campo y que carece de cepellón (planta a raíz desnuda). No existe consenso sobre qué tipo de planta es más favorable en términos de supervivencia y crecimiento en campo, ni tampoco si las diferencias entre los tipos de planta pueden deberse a otras variables moduladoras como la aplicación de tratamientos de preparación del suelo o el clima. Objetivos: En este estudio, se ha realizado un meta-análisis para determinar si existen diferencias significativas en supervivencia y crecimiento en campo de las plantas en contenedor y las de raíz desnuda. Además, se ha analizado si existen otros factores que pueden modificar estas diferencias, tales como grupo taxonómico, el tipo de suelo (forestal o agrícola), la preparación del terreno, el control de la vegetación acompañante y la aridez. Finalmente, se llevó a cabo un conteo de votos, que incluyó un mayor número de estudios, para reforzar los resultados obtenidos en el meta-análisis. Resultados principales: Las plantas en contenedor presentaron una supervivencia en campo significativamente más alta que las plantas a raíz desnuda (p=0,0077). Esta diferencia también se observó en el crecimiento en altura, pero dependió del tamaño de las plantas y fue menor que la supervivencia. Así, la ventaja del contenedor se redujo cuanto mayor fue la edad y tamaño de las plantas a raíz desnuda, mientras que la ventaja se incrementó cuanto más grande fueron las plantas en contenedor. La ventaja de las plantas en contenedor se observó en las gimnospermas, pero no en las angiospermas, y con tratamientos de preparación del suelo. Tanto la aridez como el tipo de terreno y el control de la competencia no afectaron las diferencias de desarrollo de ambos tipos de planta. Conclusiones e implicaciones para la restauración: Este trabajo evidencia un fenómeno global en el que la planta en contenedor supera al cultivo a raíz desnuda en supervivencia en campo. Estos resultados permiten elaborar recomendaciones de uso importantes para el éxito temprano de futuros proyectos de restauración forestal y maximizar los beneficios ecológicos y socioeconómicos que producen.Background: The current degradation of forests due to global change makes active forest restoration a global priority. To ensure the success of forest restoration projects, early seedling outplanting survival is critical. The main stress that seedlings face after planting is the transplantation shock, which intensity depends on soil humidity. Transplantation shock can hinder the survival and growth of plantations for years, jeopardizing their success. The quality of plant material as well as stocktype, i.e. plants grown in containers forming plugs (container stock) and plants cultivated in the field that lack plugs (bare-root stock) can be crucial for reducing transplant shock. However, there is no consensus about what stocktype maximizes outplanting survival and growth, and whether stocktype performance is modulated by other variables such as soil preparation treatments or climate. Aims: In this study, we performed a meta-analysis to determine if stocktypes significantly differ in outplanting survival and growth. Moreover, we assessed whether taxonomic group (gymnosperm or angiosperm) and factors related to forest plantation such as land use (forest vs. cropland sites), soil preparation, weed control or aridity can modulate the outplanting performance of both stocktypes. Finally, a vote count analysis, which included a higher number of study cases than the meta-analysis was performed to supplement the meta-analysis results. Main results: Container stock had higher survival than bare-root stock (p=0,0077), while growth advantage of container stock was small and depended on seedling size. Thus, increase in seedling size and age of bare-root stock reduced the survival and growth advantage of container stock, while increase in seedling size of container stock enhanced the advantage of container stock. The higher performance of container stock over bare-root stock was observed in gymnosperms but not in angiosperms and with soil preparation treatments. Neither aridity nor the type of planting site (forest or cropland) or the control of competing vegetation influenced the advantage of container stock. Conclusions and practical implications: We evidence a global phenomenon in which container stock outperforms bare-root stock in survival under field conditions. These results can help to provide important guidelines for improving early performance of future forest restoration projects, which has ecological and economic benefits for the society.Máster Universitario en Restauración de Ecosistemas (M139

Liderazgo y clima organizacional en el profesional de enfermería del Hospital II “Luis Negreíros Vega”, año 2016

El presente trabajo de investigación tiene como objetivo general, determinar la relación entre el Liderazgo y el Clima Organizacional en el profesional de enfermería del Hospital Luís Negreíros Vega. Callao, 2015. La metodología utilizada es no experimental, hipotético deductivo, de tipo aplicada, diseño descriptivo correlacional. Con una muestra de 150 profesionales de enfermería de los diversos servicios del hospital. Se aplicó el cuestionario de liderazgo para la variable 1 y clima organizacional para la variable 2. A través del uso del instrumento validado por expertos, se midió la confiabilidad del mismo, grupo muestral, los resultados de la prueba de confiabilidad del alfa de Cronbach fue de 0,99 para la variable liderazgo, y 0,897 para Clima Organizacional. Se elaboró el análisis descriptivo y prueba de hipótesis cuyos resultados se evidencian a través de tablas y gráficos. Se utilizó el estadístico coeficiente de correlación Rho Spearman para la prueba de hipótesis. Se determinó que el Liderazgo y el Clima Organizacional no se relacionan significativamente en el profesional de enfermería del Hospital Luís Negreíros Vega – Callao, 2015. Los datos fueron analizados empleando el coeficiente de correlación de Rho Spearman en el cual los resultados arrojan un valor r=,055 con una significancia p=, 504, afirmando así que no existe una relación entre el liderazgo y el clima organizacional en el profesional de enfermería del Hospital Luis Negreíros Vega, Callao 2015 Por lo que tanto se concluye que no existe correlación entre el liderazgo y el clima organizacional

Quality of bus services performance: benefits of real time passenger information systems

One of the main problems in urban areas is the steady growth in car ownership and traffic levels. Therefore, the challenge of sustainability is focused on a shift of the demand for mobility from cars to collective means of transport. For this purpose, buses are a key element of the public transport systems. In this respect Real Time Passenger Information (RTPI) systems help people change their travel behaviour towards more sustainable transport modes. This paper provides an assessment methodology which evaluates how RTPI systems improve the quality of bus services performance in two European cities, Madrid and Bremerhaven. In the case of Madrid, bus punctuality has increased by 3%. Regarding the travellers perception, Madrid raised its quality of service by 6% while Bremerhaven increased by 13%. On the other hand, the users¿ perception of Public Transport (PT) image increased by 14%

Real time passenger information systems and quality of bus services

One of the main problems in urban areas is the steady growth in car ownership and traffic levels. Therefore, the challenge of sustainability is focused on a shift of the demand for mobility from cars to collective means of transport. For this end, buses are a key element of the public transport systems. In this respect Real Time Passenger Information (RTPI) systems help citizens change their travel behaviour towards more sustainable transport modes. This paper provides an assessment methodology which evaluates how RTPI systems improve the quality of bus services in two European cities, Madrid and Bremerhaven. In the case of Madrid, bus punctuality has increased by 3%. Regarding the travellers perception, Madrid raised its quality of service by 6% while Bremerhaven increased by 13%. On the other hand, the users ́ perception of Public Transport (PT) image increased by 14%

Efficient urban interchanges: the City-HUB model

Multimodal trips are increasing in metropolitan areas, making public transport less attractive. There is a need for integration in order to achieve effective seamless mobility. One dimension of integration is to reduce the disruption of transfer among modes and interchanges appear as the best solution when big number of travellers has to transfer. The City-HUB 7FP project has developed a three years research for deploying new interchanges and improving existing ones. It starts by identifying two groups of dimensions that define Interchange key features. The first dimension is related to Physical&Size, including passenger demand, modes of transport, services and facilities and location in the city. The second dimension is related to Local Impacts such as developing of new activities –housing, offices, nearby shopping-, jobs creation and its connection with the local Development Plan. The combination of the elements of the two dimensions define the following key features: building design, stakeholders’ involvement and the type of business model. The findings are based on interviews to practitioners undertaken in 26 selected interchanges in 9 European countries. According to these key features, the interchange should organize the space among three different zones: access-egress zone; facilities zone; and arrival-departure-transfer zone. The first one is where links to the local area and access to transport modes are focused. The last one caters for intermodal transfers. Travel information and intermodal services are spread across both zones as well as the facilities and retailing. Users’ perceptions should be collected to improve interchange efficiency. To that end a travellers’ attitudinal survey has been carried out in interchanges in 5 European cities. From the user point of view the most important factors identified in the surveys are safety and security, transfer conditions, emergency situation, information, design, services&facilities, environmental quality and comfort of waiting time. All these elements define the interchange from two different perspectives: “as a transport node” and “as a place”. The first one is related to the functionality as a node of the transport network; the second includes all the features for make the transfer experience more attractive and efficient. The project has identified a number of recommendations for developing urban transport interchanges. Some of them refers to users, other to operators and the third part deals with local impacts, governance issues and business models. All these findings have served to develop an integrated concept of interchange: City-HUB mode

Urban transport interchanges: Importance-Performance analysis for evaluating perceived quality

As the world becomes more urbanised, public transport in cities must seek to provide viable alternatives to individual car transport. At an urban level, interchanges in public transport networks provide easy transfers between and within different transport modes and facilitate seamless travel. This study proposes a methodological framework with which to identify the factors that travellers view as key elements of an urban transport interchange. An attitudinal survey was undertaken in order to collect information about users? needs and perceptions in the Moncloa interchange in Madrid, Spain. The results obtained from an Importance-Performance Analysis (IPA) show that aspects related to the signposting of different facilities and transport services, the internal design of the interchange and the surrounding area, and safety and security are the greatest strengths of the interchange

Energy- and environmentally efficient road management: The case of the Spanish motorway network

Transport is responsible for 41% of CO2 emissions in Spain, and around 65% of that figure is due to road traffic. Tolled motorways are currently managed according to economic criteria: minimizing operational costs and maximizing revenues from tolls. Within this framework, this paper develops a new methodology for managing motorways based on a target of maximum energy efficiency. It includes technological and demand-driven policies, which are applied to two case studies. Various conclusions emerge from this study. One is, that the use of intelligent payment systems is recommended; and another, is that the most sustainable policy would involve defining the most efficient strategy for each motorway section, including the maximum use of its capacity, the toll level which attracts the most vehicles, and the optimum speed limit for each type of vehicle

Decarbonization of toll plazas: impact assessment of toll collection system management

Transport climate change impacts have become a worldwide concern. The use of Intelligent Transport Systems (ITS) could contribute to a more effective use of resources in toll road networks. Management of toll plazas is central to the reduction of greenhouse gas (GHG) emissions, as it is there that bottlenecks and congestion occur. This study focuses on management strategies aimed at reducing climate change impacts of toll plazas by managing toll collection systems. These strategies are based on the use of different collection system technologies – Electronic Toll Collection (ETC) and Open Road Tolling (ORT) – and on queue management. The carbon footprint of various toll plazas is determined by a proposed integrated methodology which estimates the carbon dioxide (CO2) emissions of the different operational stages at toll plazas (deceleration, service time, acceleration, and queuing) for the different toll collection systems. To validate the methodology, two main-line toll plazas of a Spanish toll highway were evaluated. The findings reveal that the application of new technologies to toll collection systems is an effective management strategy from an environmental point of view. The case studies revealed that ORT systems lead to savings of up to 70% of CO2 emissions at toll plazas, while ETC systems save 20% comparing to the manual ones. Furthermore, queue management can offer a 16% emissions savings when queue time is reduced by 116 seconds. The integrated methodology provides an efficient environmental management tool for toll plazas. The use of new technologies is the future of the decarbonization of toll plazas