Estado del arte del proyecto

Cuatro elementos estructuran esta investigación: la acupuntura urbana como marco estratégico, el diseño participativo como mecanismo, el espacio público como objeto y las ciudades del Caribe Colombiano como contexto. La acupuntura urbana resulta de una conceptualización de fundamentos procedentes de la cultura oriental, su utilización en la producción urbana alude a un modelo de trabajo en la ciudad basado en intervenciones de pequeño formato capaces de catapultar el desarrollo urbano en el contexto en el que emergen, de manera progresiva, articulándose como sistema urbano en red para el conjunto de la ciudad. Abordamos la participación ciudadana como mecanismo fundamental en el hacer ciudad, particularmente, en la emergencia del espacio público como estructurante de las dinámicas comunitarias y generador de condiciones de calidad de vida urbana. En este sentido, relacionar los procesos de acupuntura urbana con dinámicas participativas en la producción de espacio público, nos ubica en un marco estratégico de trabajo concreto, en una tipología de proyecto y en una escala urbana centrada en lo local. La propuesta está encaminada a una indagación que permita establecer un modelo de actuación urbana para el Caribe Colombiano, basado en estrategias de acupuntura urbana. El proyecto apunta a la búsqueda de sistema multicriterio de diseño, proyección y gestión del espacio público, basado en la implementación de estrategias de acupuntura urbana estrechamente relacionadas con esquemas participativos. Un instrumento que, pretende ser un soporte para la mejora de las prácticas de diseño urbano, desde la dimensión proyectual y social, permitiendo incorporar diversos elementos y criterios para el diseño, materialización y gestión del espacio público teniendo como caso de estudio la ciudad de Barranquilla

Performance evaluation of SiPM detectors for PET imaging in the presence of magnetic fields

Proceeding of: 2008 IEEE Nuclear Science Symposium Conference Record (NSS '08), Dresden, Germany, 19-25 Oct. 2008The multi-pixel photon counter (MPPC) or silicon photo-multiplier (SiPM), recently introduced as a solid-state photodetector, consists of an array of Geiger-mode photodiodes(microcells). is a promising device for PET thanks to its potential for high photon detection efficiency (PDE) and immunity to high magnetic fields. is also very easy to use, with simple electronic read-out, high gain and small size. In this work we evaluate the performance of three 1 x 1 mm2 and one 6 x 6 mm2 (2 x 2 array) SiPMs offered by Hamamatsu for their use in PET. We examine the dependence of the energy resolution and the gain of these devices on the thermal and reverse bias when coupled to LYSO scintillator crystals. We find that the 400 and 1600 microcells models and the 2 x 2 array are suitable for small size crystals, like those employed in high resolution small animal scanners. The good performance of these devices up to 7 Tesla has also been confirmed.This work was supported in part by the MEC (FPA2007-07393), CDTEAM (CENIT-Ingenio 2010) Ministerio de Industria, Spain, UCM (Grupos UCM: 910059), CPAN (ConsoliderIngenio 2010) CSPD-2007-00042 projects, and the RECAVA-RETIC network

Estado del arte del proyecto

Desde la implementación hace más de tres años del modelo de "proyecto integral" en la facultad de Arquitectura de la Universidad de la Costa CUC, se ha venido recopilando una gran cantidad de información urbanística y del tejido social de diferentes territorios de la geografía caribe; lo que nos sugiere para su real aprovechamiento, la creación de una metodología de organización y sistematización que facilite su uso y divulgación. Es por esto que nace la iniciativa de construir una ambiciosa base de datos a nivel de paisaje urbano sobre la región, cuyo énfasis inicial esté centrado en el Área Metropolitana de Barranquilla (puede llegar a ser colaborativa, interactiva y en tiempo real alojada en un espacio web); que recoja, Inventaríe, catalogue, jerarquice, mapee y proponga nuevas líneas de exploración, sobre todos los elementos singulares que hacen parte del imaginario ciudadano o mapa mental de la estructura urbana y se constituya sobre el tiempo en un referente iconográfico: “marco conceptual” de su memoria colectiva; así como también en una ventana para debatir propuestas de ordenación y transformación urbana; estableciéndose paralelamente como una fuente informativa desde donde se puedan concebir y diseñar lugares emblemáticos, posibles itinerarios, grandes artefactos urbanos, espacios públicos domésticos, áreas susceptibles de acupuntura urbana, entre otras más visiones del urbanismo contemporáneo adaptadas a las realidades vernáculas; o simplemente construir una compilación donde se puedan nutrir las actuales y futuras generaciones de arquitectos, urbanista, paisajistas y otros profesionales afines que intervienen cotidianamente sobre los complejos ecosistemas urbanos de nuestra extensa región caribe

Cost-minimization analysis in the treatment of spasticity in children with cerebral palsy with botulinum toxin type A: an observational, longitudinal, retrospective study

OBJECTIVE: Cost-minimization analysis of onabotulinumtoxinA and abobotulinumtoxinA, taking into account the real dose administered to children with spasticity associated with dynamic equinus foot deformity due to cerebral palsy. METHOD: A single centre, observational, longitudinal, and retrospective study which included spastic paediatric patients aged 2-to-18-years and treated with onabotulinumtoxinA or abobotulinumtoxinA from December 1995 to October 2012, in the Paediatric Neurology Unit of a first-level Spanish hospital. A longitudinal analysis of spasticity severity was made to confirm the similar efficacy of both treatments. Cost minimization was analyzed using the dose administered and the direct costs (pharmacological and medical visits costs) from the perspective of the National Health System (in euros from 2016). RESULTS: We analyzed 895 patients with paediatric spasticity: 543 were treated only with onabotulinumtoxinA, 292 only with abobotulinumtoxinA, and 60 with both treatments. The mean doses administered were 5.44 U/kg (SD = 2.17) for onabotulinumtoxinA, and 14.73 U/kg (5.26) for abobotulinumto xinA. The total annual direct cost (pharmacological and medical visits) was ¿ 839.56 for onabotulinumtoxinA and ¿ 631.23 for abobotulinumtoxinA, which represents a difference of ¿ 208.34 per year in favour of treatment with abobotulinumtoxinA. CONCLUSIONS: It has been demonstrated that in real clinical practice, the cost per patient and year for treatment of paediatric spasticity was lower when abobotulinumtoxinA was used

Estado del arte del proyecto

La Arquitectura, el espacio público y el arte público del barrio El Prado, ese patrimonio reconocible en Barranquilla, serán, piezas de un gran y particular museo. Un museo vivo. El trazado de un barrio Centenario, con anchos andenes y antejardines, el verde de los parques, la riqueza estilística de las grandes casas, hoy reconvertidas en nuevos usos, evidencia la historia y la memoria de uno de los barrios más importantes de la formación de las ciudades latinoamericanas de principios del siglo XX, con la emergencia de los modelos higienistas de hacer ciudad y los criterios de ciudad jardín. Es vivo, porque sus gentes así lo hacen. Por ello es un museo particular

PREDICT identifies precipitating events associated with the clinical course of acutely decompensated cirrhosis

Background & Aims: Acute decompensation (AD) of cirrhosis may present without acute-on-chronic liver failure (ACLF) (ADNo ACLF), or with ACLF (AD-ACLF), defined by organ failure(s). Herein, we aimed to analyze and characterize the precipitants leading to both of these AD phenotypes. Methods: The multicenter, prospective, observational PREDICT study (NCT03056612) included 1,273 non-electively hospitalized patients with AD (No ACLF = 1,071; ACLF = 202). Medical history, clinical data and laboratory data were collected at enrolment and during 90-day follow-up, with particular attention given to the following characteristics of precipitants: induction of organ dysfunction or failure, systemic inflammation, chronology, intensity, and relationship to outcome. Results: Among various clinical events, 4 distinct events were precipitants consistently related to AD: proven bacterial infections, severe alcoholic hepatitis, gastrointestinal bleeding with shock and toxic encephalopathy. Among patients with precipitants in the AD-No ACLF cohort and the AD-ACLF cohort (38% and 71%, respectively), almost all (96% and 97%, respectively) showed proven bacterial infection and severe alcoholic hepatitis, either alone or in combination with other events. Survival was similar in patients with proven bacterial infections or severe alcoholic hepatitis in both AD phenotypes. The number of precipitants was associated with significantly increased 90day mortality and was paralleled by increasing levels of surrogates for systemic inflammation. Importantly, adequate first-line antibiotic treatment of proven bacterial infections was associated with a lower ACLF development rate and lower 90-day mortality. Conclusions: This study identified precipitants that are significantly associated with a distinct clinical course and prognosis in patients with AD. Specific preventive and therapeutic strategies targeting these events may improve outcomes in patients with decompensated cirrhosis. Lay summary: Acute decompensation (AD) of cirrhosis is characterized by a rapid deterioration in patient health. Herein, we aimed to analyze the precipitating events that cause AD in patients with cirrhosis. Proven bacterial infections and severe alcoholic hepatitis, either alone or in combination, accounted for almost all (96-97%) cases of AD and acute-on-chronic liver failure. Whilst the type of precipitant was not associated with mortality, the number of precipitant(s) was. This study identified precipitants that are significantly associated with a distinct clinical course and prognosis of patients with AD. Specific preventive and therapeutic strategies targeting these events may improve patient outcomes. (c) 2020 European Association for the Study of the Liver. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology

Background & Aims: Acute decompensation (AD) of cirrhosis is defined as the acute development of ascites, gastrointestinal hemorrhage, hepatic encephalopathy, infection or any combination thereof, requiring hospitalization. The presence of organ failure(s) in patients with AD defines acute-on-chronic liver failure (ACLF). The PREDICT study is a European, prospective, observational study, designed to characterize the clinical course of AD and to identify predictors of ACLF. Methods: A total of 1,071 patients with AD were enrolled. We collected detailed pre-specified information on the 3-month period prior to enrollment, and clinical and laboratory data at enrollment. Patients were then closely followed up for 3 months. Outcomes (liver transplantation and death) at 1 year were also recorded. Results: Three groups of patients were identified. Pre-ACLF patients (n = 218) developed ACLF and had 3-month and 1-year mortality rates of 53.7% and 67.4%, respectively. Unstable decompensated cirrhosis (UDC) patients (n = 233) required ≥1 readmission but did not develop ACLF and had mortality rates of 21.0% and 35.6%, respectively. Stable decompensated cirrhosis (SDC) patients (n = 620) were not readmitted, did not develop ACLF and had a 1-year mortality rate of only 9.5%. The 3 groups differed significantly regarding the grade and course of systemic inflammation (high-grade at enrollment with aggravation during follow-up in pre-ACLF; low-grade at enrollment with subsequent steady-course in UDC; and low-grade at enrollment with subsequent improvement in SDC) and the prevalence of surrogates of severe portal hypertension throughout the study (high in UDC vs. low in pre-ACLF and SDC). Conclusions: Acute decompensation without ACLF is a heterogeneous condition with 3 different clinical courses and 2 major pathophysiological mechanisms: systemic inflammation and portal hypertension. Predicting the development of ACLF remains a major future challenge. ClinicalTrials.gov number: NCT03056612. Lay summary: Herein, we describe, for the first time, 3 different clinical courses of acute decompensation (AD) of cirrhosis after hospital admission. The first clinical course includes patients who develop acute-on-chronic liver failure (ACLF) and have a high short-term risk of death – termed pre-ACLF. The second clinical course (unstable decompensated cirrhosis) includes patients requiring frequent hospitalizations unrelated to ACLF and is associated with a lower mortality risk than pre-ACLF. Finally, the third clinical course (stable decompensated cirrhosis), includes two-thirds of all patients admitted to hospital with AD – patients in this group rarely require hospital admission and have a much lower 1-year mortality risk

Design and implementation of a mobile platform that allows promoting the trade of artisan products made by Colombian farmers

La venta y comercialización de productos artesanales y el interés de las personas por comprarlos ha crecido exponencialmente durante el pasar de los años, lo cual crea oportunidades para innovar de la mano de las tecnologías actuales y así ofrecer soluciones a distintas problemáticas que se presentan a nivel social y comercial. En el sector artesanal colombiano hemos identificado una oportunidad de innovación, ya que es evidente la falta de tecnología en la que se apoya este sector comercial del país. Es por esta razón que nuestro proyecto está enfocado a la implementación de tecnologías recientes para la innovación del estilo de vida comercial de los artesanos colombianos. Además, también involucra el beneficio a los consumidores finales, ya que tendrán la oportunidad de comunicarse, personalizar, negociar, comprar en cantidad y tener el contacto directo de aquella persona que le está brindando el servicio. Nuestra solución consta del diseño y la implementación de una aplicación móvil que permita impulsar el comercio de productos artesanales colombianos. Dentro del territorio colombiano, durante décadas se han venido desarrollando grupos de artesanos de todas partes del país, desde grupos indígenas hasta campesinos locales que se han dedicado al cultivo del campo, o bien han sido víctimas del desplazamiento forzado. Esta población en específico, vende sus productos artesanales mayoritariamente a personas que sirven de revendedores, ya que éstos no tienen la comunicación o las posibilidades de envío para hacerle llegar sus productos a consumidores locales. Ésta problemática de la falta de comunicación, contiene efectos negativos como lo son la devaluación de sus productos debido a que no reciben lo que deberían por su trabajo. Otra consecuencia es la alta posibilidad de la falsificación de sus productos e incluso la importación de productos provenientes de China que pretenden ser el reemplazo de los productos originales que fabrican los artesanos.The sale and commercialization of artisan products and the interest of people to buy them has grown exponentially over the years, which creates opportunities to innovate hand in hand with current technologies and thus offer solutions to different problems that arise at the level social and commercial. In the Colombian artisan sector we have identified an opportunity for innovation, since the lack of technology on which this commercial sector of the country relies is evident. It is for this reason that our project is focused on the implementation of recent technologies for the innovation of the commercial lifestyle of Colombian artisans. In addition, it also involves the benefit to end consumers, since they will have the opportunity to communicate, personalize, negotiate, buy in quantity and have direct contact with the person who is providing the service. Our solution consists of the design and implementation of a mobile application that allows promoting the trade of Colombian artisan products. Within Colombian territory, for decades groups of artisans from all over the country have been developing, from indigenous groups to local peasants who have dedicated themselves to farming, or have been victims of forced displacement. This specific population sells its artisan products mainly to people who serve as resellers, since they do not have the communication or the shipping possibilities to get their products to local consumers. This problem of lack of communication, contains negative effects such as the devaluation of their products because they do not receive what they should for their work. Another consequence is the high possibility of counterfeiting of their products and even the importation of products from China that claim to be the replacement of the original products manufactured by artisans