Significado de la anemia en las diferentes etapas de la vida

Overview: Anemia is very common in primary care consultations and pediatrics, and IDA is the cause of 50% of all cases of anemia. Methodology: Literature review and documentary descriptive analysis of the pathogenesis of iron-deficiency anemia, the basic diagnostic tests to study IDA and the significance of such using a specific time period in the documentary search and inclusion criteria that takes into account factors that are analyzed in the study: Ideas about the metabolism of iron. Ideas about hematopoiesis. Laboratory diagnosis and classification of anemia. Clinical features of iron deficiency anemia. Causes of iron deficiency. Results and conclusion: The staged documentary study covers the publications on the pathogenesis of iron deficiency anemia, the basic diagnostic tests to study the IDA and the significance of such, and it shows how important this data is for professional nursing in the area of primary care and pediatrics, to identify it and act accordingly.Resumen: La anemia presenta una elevada prevalencia en las consultas de atención primaria y pediatría, y la ADH representa el 50% de todos los casos de anemia. Metodología: Revisión bibliográfica y análisis descriptivo documental sobre etiopatogenia de la anemia ferropénica, las pruebas diagnósticas básicas para el estudio de la ADH  y su significado, utilizando una temporalidad determinada en la búsqueda documental y criterios de inclusión atendiendo a las dimensiones que se analizan en el estudio: Nociones acerca del metabolismo del hierro. Nociones acerca de la hematopoyesis. Diagnóstico por el laboratorio y clasificación de las anemias. Clínica de la anemia ferropénica. Causas de la deficiencia de hierro. Resultados y conclusión: EL estudio documental efectuado nos presenta la existencia de publicaciones con contenidos sobre etiopatogenia de la anemia ferropénica, las pruebas diagnósticas básicas para el estudio de la ADH  y su significado, evidenciando la importancia de este contenido para el profesional de enfermería en el área de la atención primaria y pediatría

Optical Enhancement of Exoskeleton-Based Estimation of Glenohumeral Angles

In Robot-Assisted Rehabilitation (RAR) the accurate estimation of the patient limb joint angles is critical for assessing therapy efficacy. In RAR, the use of classic motion capture systems (MOCAPs) (e.g., optical and electromagnetic) to estimate the Glenohumeral (GH) joint angles is hindered by the exoskeleton body, which causes occlusions and magnetic disturbances. Moreover, the exoskeleton posture does not accurately reflect limb posture, as their kinematic models differ. To address the said limitations in posture estimation, we propose installing the cameras of an optical marker-based MOCAP in the rehabilitation exoskeleton. Then, the GH joint angles are estimated by combining the estimated marker poses and exoskeleton Forward Kinematics. Such hybrid system prevents problems related to marker occlusions, reduced camera detection volume, and imprecise joint angle estimation due to the kinematic mismatch of the patient and exoskeleton models. This paper presents the formulation, simulation, and accuracy quantification of the proposed method with simulated human movements. In addition, a sensitivity analysis of the method accuracy to marker position estimation errors, due to system calibration errors and marker drifts, has been carried out. The results show that, even with significant errors in the marker position estimation, method accuracy is adequate for RAR

Cutting the cylinder into squares: The square form factor

In this article we present a method for constructing two-point functions in the spirit of the hexagon proposal, which leads us to propose a "square form factor". Since cutting the square gives us two squares, we can write a consistency condition that heavily constrains such form factors. In particular, we are able to use this constraint to reconstruct the Gaudin through the forest expansion of the determinant appearing in its definition. We also use this procedure to compute the norm of off-shell Bethe states for some simple cases.Comment: 34 pages, 10 figure

Thermal optimization of a dual pressure goswami cycle for low grade thermal sources

This paper presents a theoretical investigation of a new configuration of the combined power andcoolingcycleknownastheGoswamicycle. Thenewconfigurationconsistsoftwoturbinesoperating at two different working pressures with a low-heat source temperature, below 150 °C. A comprehensive analysis was conducted to determine the effect of key operation parameters such as ammonia mass fraction at the absorber outlet and boiler-rectifier, on the power output, cooling capacity, effective first efficiency, and effective exergy efficiency, while the performance of the dual-pressure configuration was compared with the original single pressure cycle. In addition, a Pareto optimization with a genetic algorithmwasconductedtoobtainthebestpowerandcoolingoutputcombinationstomaximizeeffective first law efficiency. Results showed that the new dual-pressure configuration generated more power than the single pressure cycle, by producing up to 327.8 kW, while the single pressure cycle produced up to 110.8 kW at a 150 °C boiler temperature. However, the results also showed that it reduced the cooling output as there was less mass flow rate in the refrigeration unit. Optimization results showed that optimum effective first law efficiency ranged between 9.1% and 13.7%. The maximum effective first law efficiency at the lowest net power (32 kW) and cooling (0.38 kW) outputs was also shown. On the other hand, it presented 13.6% effective first law efficiency when the net power output was 100 kW and the cooling capacity was 0.38 kW

Integrating curriculum-based dynamic assessment in computerized adaptive testing: Development and predictive validity of the EDPL-BAI battery on reading competence

In recent decades, there have been significant changes in the conceptualization of reading as well as in the perception of how this activity should be assessed. Interest in the analysis of reading processes has led to the emergence of new explanatory models based primarily on the contributions of cognitive psychology. In parallel, there have been notable advances in measurement procedures, especially in models based on Item Response Theory (IRT), as well as in the capacity and performance of specific software programs that allow data to be managed and analyzed. These changes have contributed significantly to the rise of testing procedures such as computerized adaptive tests (CATs), whose fundamental characteristic is that the sequence of items presented in the tests is adapted to the level of competence that the subject manifests. Likewise, the incorporation of elements of dynamic assessment (DA) as the prompts are gradually offered allows for obtaining information about the type and degree of support required to optimize the subject’s performance. In this sense, the confluence of contributions from DA and CATs offers a new possibility for approaching the assessment of learning processes. In this article, we present a longitudinal research developed in two phases, through which a computerized dynamic adaptive assessment battery of reading processes (EDPL-BAI) was configured. The research frame involved 1,831 students (46% girls) from 13 public schools in three regions of Chile. The purpose of this study was to analyze the differential contribution on reading competence of dynamic scores obtained in a subsample composed of 324 (47% girls) students from third to sixth grade after the implementation of a set of adaptive dynamic tests of morpho-syntactic processes. The results achieved in the structural equation modeling indicate a good global fit. Individual relationships show a significant contribution of calibrated score that reflects estimated knowledge level on reading competence, as well as dynamic scores based on the assigned value of graduated prompts required by the students. These results showed significant predictive values on reading competence and incremental validity in relation to predictions made by static criterion tests

Dynamic computerized-adaptive assessment of reading processes: Incremental validity on text comprehension

This study explores the predictive and incremental validity of the Dynamic Computerized Adaptive Reading Processes Assessment Device (EDPL-BAI). This battery has 38 tasks organized in 6 modules to assess different processes related to reading comprehension (e.g. phoneme-grapheme association, executive functions, metacognitive processes). Method: A total of 1336 Chilean students from 3rd to 6th grade (45% females) from 12 public urban and rural schools participated in a longitudinal study consisting of three assessment cycles. On the first cycle, the students were assessed with a standardized reading comprehension test (CL-PT), the Raven Progressive Matrices Test (PMR), and the complete poll of items were calibrated in a non-dynamic version of EDPL-BAI. On the second cycle, seven months after, a sub sample of 1068 students were administered the adaptive and dynamic version of the EDPL-BAI (graduated prompts were displayed after wrong responses), while the remainder 268 students were assessed with the non-dynamic version of EDPL-BAI, and for all the students a pre and post-test (using selected items from EDPL-BAI), CL-PT and PMR were administered. Finally, at the third cycle, four month after, the non-dynamic version of EDPL-BAI and CL-PT were administered to the complete sample. Results and Conclusions: Multiple CFAs were conducted to determine the factorial structure of the EDPL-BAI, and a final model of 6 factors was retained. Predictive and incremental validity of the EDPL-BAI was explored with SEM analysis. The dynamic and non-dynamic versions of the EDPL-BAI were good predictors of reading comprehension. The dynamic version showed incremental validity over the non-dynamic version. Furthermore, graduated prompts predicted reading comprehension performanc

The self-regulatory German health care system between growing competition and state hierarchy

This article focuses on the changing role of the state in financing, providing and regulating health care services under the German health care system from 1970-2000. While a reduced role of the state can be observed in terms of financing, our analysis of service provision indicates inconsistent developments. Monetary resource flow analyses indicate a decrease in private service provision as a percentage of total health expenditure, but when analysing the development of health employment we see a growth in “private” health care personnel. The most important changes, however, have taken place in terms of regulation. Since the early 1990s, the traditionally self-regulatory German health care system has simultaneously faced growing competition and state hierarchy

Inverse kinematics for upper limb compound movement estimation in exoskeleton-assisted rehabilitation

Robot-Assisted Rehabilitation (RAR) is relevant for treating patients affected by nervous system injuries (e.g., stroke and spinal cord injury) -- The accurate estimation of the joint angles of the patient limbs in RAR is critical to assess the patient improvement -- The economical prevalent method to estimate the patient posture in Exoskeleton-based RAR is to approximate the limb joint angles with the ones of the Exoskeleton -- This approximation is rough since their kinematic structures differ -- Motion capture systems (MOCAPs) can improve the estimations, at the expenses of a considerable overload of the therapy setup -- Alternatively, the Extended Inverse Kinematics Posture Estimation (EIKPE) computational method models the limb and Exoskeleton as differing parallel kinematic chains -- EIKPE has been tested with single DOFmovements of the wrist and elbow joints -- This paper presents the assessment of EIKPEwith elbow-shoulder compoundmovements (i.e., object prehension) -- Ground-truth for estimation assessment is obtained from an optical MOCAP (not intended for the treatment stage) -- The assessment shows EIKPE rendering a good numerical approximation of the actual posture during the compoundmovement execution, especially for the shoulder joint angles -- This work opens the horizon for clinical studies with patient groups, Exoskeleton models, and movements types -

Concordance study between conventional cytology and flow cytometry for identifying neoplastic infiltration of the cerebrospinal fluid in patients with acute leukemia

Introducción: la leucemia aguda es el cáncer más frecuente en la infancia. Las manifestaciones clínicas son sistémicas y la infiltración al sistema nervioso central es infrecuente e impacta su tratamiento y pronóstico. Se han implementado diferentes técnicas como citometría de flujo (CMF) y citometría covencional (CC) para mejorar la eficiencia en el diagnóstico de blastos en el líquido cefalorraquídeo (LCR). Métodos: estudio retrospectivo de concordancia entre la CMF y CC para determinar la presencia de blastos en el LCR en pacientes pediátricos con diagnóstico de leucemia aguda. Resultados: se analizaron 111 muestras de 34 pacientes, de los cuales solo 6 eran de bajo riesgo (17,6 %). De las 111 muestras, solo en 37 se reportaron empleando CC y CMF. La concordancia entre las dos técnicas fue satisfactoria cuando las dos pruebas eran negativas kappa (0,80 a 0,96). Conclusiones: el diagnóstico de infiltración al sistema nervioso central se debe optimizar, y en la actualidad contamos con dos técnicas de características operativas diferentes. A pesar de que la CMF se reporta como un método más sensible, tiene mayores costos y con el trabajo solo se demuestra buena concordancia con la CC cuando es negativa; por lo anterior, se requieren más estudios para determinar si se debe cambiar a la citología que en la actualidad es el patrón de referencia.Artículo original163-170Introduction: Acute leukemia is the most com-mon childhood cancer. The clinical manifes-tations are systemic and infiltration to central nervous system is uncommon and impact on the treatment and prognosis. It has been implemen-ted different techniques as CMF and CC, in order to improve efficiency in diagnosing CSF blasts. Methods: Retrospective study of agreement bet-ween the CPM and CC to determine the presence of blasts in the CSF in pediatric patients with a diagnosis of acute leukemia. Results: 111 sam-ples from 34 patients, of whom only 6 were low risk (17.6%) were analyzed. Of the 111 samples found, only 37 concurrent CC and CPM report. The agreement between the 2 techniques was satisfactory when the 2 tests were negative ka-ppa (0.80 to 0.96). Conclusions: The diagnosis of CNS infiltration should be optimized; and to-day we have 2 techniques of different operating characteristics. Although the CPM is reported as a more sensitive method has higher costs and work only good agreement was shown by the CC when it is negative, the above further studies are needed to determine whether should switch to the cytology is currently the gold standard