Neuropatía auditiva y cribados neonatales

In the 2010 CODEPEH Recommendations, the discovery of all hearing loss is advised regardless of its etiology and severity. Auditory neuropathy can go unnoticed in programs based on the use of otoemissions as the first level of screening. However, there are very specific cases that can present this pathology and this allows its discovery provided that adequate criteria are followed in the programs based on otoemissions, as has been done in all of them. This work, in addition to describing this pathology in its etiological, pathophysiological, clinical, diagnostic and therapeutic aspects, specifies those antecedents that make us suspect, not only auditory neuropathy, but also retrocochlear lesions that, due to their own location, would not be detected by otoemissions. It is children who spend more than 5 days in PICU, those with toxoplasmosis, those who have had hyperbilirubinemia with exchange transfusion, and those with a family history of neurological processes, especially those with a history of Otof Gene disorders, who need to complete screening with auditory evoked potentials.En las Recomendaciones de la CODEPEH 2010, se aconseja el descubrimiento de todas las hipoacusias independientemente de su etiología y severidad. La neuropatía auditiva puede pasar desapercibida en los programas basados en el uso de otoemisiones como primer nivel del cribado. Sin embargo son casos muy concretos los que pueden presentar esta patología y ello permite su descubrimiento siempre que se sigan unos criterios adecuados en los programas basados en las otoemisiones, como se viene haciendo en todos ellos. Este trabajo, además de describir esta patología en sus aspectos etiológico, fisiopatológico, clínico, diagnóstico y terapéutico, concreta aquellos antecedentes que hacen sospechar, no solo la neuropatía auditiva, también las lesiones retrococleares que por su propia localización no serían detectadas por las otoemisiones. Son los niños que pasan más de 5 días en UCIP, los que tienen toxoplasmosis, los que han tenido hiperbilirrubinemia con exanguinotransfusión y los que tienen antecedentes familiares de procesos neurológicos, especialmente aquellos con antecedentes de trastornos del Gen Otof, los que necesitan completar el cribado con potenciales evocados auditivos

Estudio de daños por Impactos en líneas de confección de fruta (manzana)

Frutas y hortalizas estan llegando al consumidor con magulladuras y podredumbres. El origen de estas se encuentra sobre todo en los golpes y rozaduras producidos durante su clasificacion y confeccion en las centrales. Las loneas utilizadoas para estas operaciones son autenticas desconocidas para sus responsabels y con frecuencia los daños que en ellas se producen escapan a su control. Para mejorar estos problemas el Laboratorio de Propiedades Fisicas de la E.T.S.I. Agronomode de MAdrid cuenta con un sistema de deteccion de daños y propuesta de soluciones mediante el uso de frutos electronicos

Exergy as a measure of sustainable retrofitting of buildings

This study presents a novel optimization methodology for choosing optimal building retrofitting strategies based on the concept of exergy analysis. The study demonstrates that the building exergy analysis may open new opportunities in the design of an optimal retrofit solution despite being a theoretical approach based on the high performance of a Carnot reverse cycle. This exergy-based solution is different from the one selected through traditional efficient retrofits where minimizing energy consumption is the primary selection criteria. The new solution connects the building with the reference environment, which acts as “an unlimited sink or unlimited sources of energy”, and it adapts the building to maximize the intake of energy resources from the reference environment. The building hosting the School of Architecture at the University of Navarra has been chosen as the case study building. The unique architectural appearance and bespoke architectural characteristics of the building limit the choices of retrofitting solutions; therefore, retrofitting solutions on the façade, roof, roof skylight and windows are considered in multi-objective optimization using the jEPlus package. It is remarkable that different retrofitting solutions have been obtained for energy-driven and exergy-driven optimization, respectively. Considering the local contexts and all possible reference environments for the building, three “unlimited sinks or unlimited sources of energy” are selected for the case study building to explore exergy-driven optimization: the external air, the ground in the surrounding area and the nearby river. The evidence shows that no matter which reference environment is chosen, an identical envelope retrofitting solution has been obtaine

Ránula del neonato en el suelo de la boca. Reporte de un caso

Introducción: el mucocele y la ránula son quistes de retención mucosa, localizados en la cavidad oral donde se localizan glándulas salivales menores. Presentación del caso: recién nacido a término de buen peso, masculino, segundo gemelar producto de una cesárea. En el examen físico del nacimiento se observa  una tumoración azulada en el piso de la boca, que dificultaba la alimentación del bebé, pero no ocasionaba dificultad respiratoria. Según  evolución clínica, a los 5 días de vida la madre notó disminución espontánea del aumento de volumen de la base de la lengua, aunque aún persistían los problemas en la alimentación. Se diagnostica ránula sublingual congénita que evoluciona favorablemente. Después de una valoración multidisciplinaria es egresado con seguimiento por su condición de alto riesgo. Actualmente saludable, con buen desarrollo psicomotor y sin recidivas. Conclusiones: la importancia del tema que se presenta es que se describe una presentación rara de ránula sublingual congénita del suelo de la boca en un recién nacido que evolucionó espontáneamente sin comprometer la salud del niño ni requerir intervención quirúrgica

Therapeutic alternatives for the prevention of intra peritoneal adhesions

Intestinal adhesions are bands of fibrous tissue created by the intimate contact of two injured surface tissues; these appear in 93% of the patient undergoing intra-abdominal or gastrointestinal surgery. The comorbidities associated with the formation of adhesions have an impact on quality care offered to patients, leading to an increase in healthcare. Goals of this study was to perform a review that includes different therapeutic alternatives in basic and clinical research to prevent the formation of postoperative abdominal peritoneal adhesions. A bibliographic search was conducted in different databases including Pub med, Medline, Cochrane, science direct, from the years 2000 to 2018 using the keywords: gastrointestinal adhesions, small bowel obstruction, prophylaxis, treatment. Only experimental and clinical articles were selected. The development of peritoneal adhesions in most of the experimental studies occurred with cecal abrasion, studying the effect of biodegradable materials, drugs and gels such as mXG Hydrogel. Nanofiber membranes, agents created with recombinant technology such as periostin antisense oligonucleotide and aerosol applications such as polysaccharide 4DryField PH, are positioned to replace in the future the actual limited mechanical barriers application commonly used in abdominal surgery such as seprafilm and interceed. There are several anti-adhesion agents in experimental phase with different mechanism of action that could be used in the short term to prevent the formation of post-surgical intestinal adhesions. The inclusion of gastrointestinal surgeons in basic research is increasing and necessary with multidisciplinary collaboration. It is expected in short term the study and development of a greater number of materials to minimize tissue trauma and decrease the formation of post-surgical adhesions

Una perspectiva multidisciplinaria

Derivado de la necesidad de fomentar la investigación multidisciplinaria, la Facultad de Economía de la Universidad Autónoma del Estado de México llevó a cabo los días 8 y 9 de septiembre de 2016, el VIII Coloquio de Investigación intitulado “Desarrollo económico, regional y sustentable”. En este magno evento se presentaron 36 ponencias agrupadas en cinco mesas de trabajo: sectores productivos, crecimiento económico y mercado de trabajo; tecnología, innovación y organizaciones; desigualdad regional, pobreza y migración; economía financiera e internacional; y medio ambiente y sociedad. Del material expuesto en el VIII Coloquio, se eligieron 16 investigaciones, mismas que integran este libro. Los estudios presentados en cada uno de los subsiguientes capítulos fueron seleccionados de acuerdo a un proceso de rigurosidad científica, siendo sometidos a dictamen por pares ciegos a partir de la integración de un Comité Académico de expertos. Lo anterior con la finalidad de proporcionar al lector un material de investigación de calidad y solidez científica respecto a temas de trascendencia vinculados con los sectores productivos, la innovación, las organizaciones, la responsabilidad social, la desigualdad, la educación y el medioambiente.Consecuencia de la apertura de los mercados y los preceptos competitivos dictados por la globalización, se manifiesta la necesidad de vincular los diversos saberes provenientes de las ciencias naturales y sociales, con el fin de complementar el conocimiento y generar nuevas formas de visualizar el entorno. A raíz de ello, la investigación multidisciplinaria asume un papel cada vez más importante en los círculos académicos, empresariales y gubernamentales. En este marco, entra en desuso la visualización del individuo como un sujeto atomístico desvinculado del medio ambiente que le rodea. El objetivo de este libro es otorgar una visión multidisciplinaria al estudio de temas económicos incorporando visiones teóricas y empíricas procedentes de las ciencias sociales y naturales. La obra está compuesta por 16 capítulos agrupados en cuatro secciones. La primera parte, conglomera cinco capítulos en torno a los tópicos sectores productivos y crecimiento económico.Facultad de Economía. Universidad Autónoma del Estado de Méxic

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis

Differential cross section measurements for the production of a W boson in association with jets in proton–proton collisions at √s = 7 TeV

Measurements are reported of differential cross sections for the production of a W boson, which decays into a muon and a neutrino, in association with jets, as a function of several variables, including the transverse momenta (pT) and pseudorapidities of the four leading jets, the scalar sum of jet transverse momenta (HT), and the difference in azimuthal angle between the directions of each jet and the muon. The data sample of pp collisions at a centre-of-mass energy of 7 TeV was collected with the CMS detector at the LHC and corresponds to an integrated luminosity of 5.0 fb[superscript −1]. The measured cross sections are compared to predictions from Monte Carlo generators, MadGraph + pythia and sherpa, and to next-to-leading-order calculations from BlackHat + sherpa. The differential cross sections are found to be in agreement with the predictions, apart from the pT distributions of the leading jets at high pT values, the distributions of the HT at high-HT and low jet multiplicity, and the distribution of the difference in azimuthal angle between the leading jet and the muon at low values.United States. Dept. of EnergyNational Science Foundation (U.S.)Alfred P. Sloan Foundatio

Juxtaposing BTE and ATE – on the role of the European insurance industry in funding civil litigation

One of the ways in which legal services are financed, and indeed shaped, is through private insurance arrangement. Two contrasting types of legal expenses insurance contracts (LEI) seem to dominate in Europe: before the event (BTE) and after the event (ATE) legal expenses insurance. Notwithstanding institutional differences between different legal systems, BTE and ATE insurance arrangements may be instrumental if government policy is geared towards strengthening a market-oriented system of financing access to justice for individuals and business. At the same time, emphasizing the role of a private industry as a keeper of the gates to justice raises issues of accountability and transparency, not readily reconcilable with demands of competition. Moreover, multiple actors (clients, lawyers, courts, insurers) are involved, causing behavioural dynamics which are not easily predicted or influenced. Against this background, this paper looks into BTE and ATE arrangements by analysing the particularities of BTE and ATE arrangements currently available in some European jurisdictions and by painting a picture of their respective markets and legal contexts. This allows for some reflection on the performance of BTE and ATE providers as both financiers and keepers. Two issues emerge from the analysis that are worthy of some further reflection. Firstly, there is the problematic long-term sustainability of some ATE products. Secondly, the challenges faced by policymakers that would like to nudge consumers into voluntarily taking out BTE LEI

Search for stop and higgsino production using diphoton Higgs boson decays

Results are presented of a search for a "natural" supersymmetry scenario with gauge mediated symmetry breaking. It is assumed that only the supersymmetric partners of the top-quark (stop) and the Higgs boson (higgsino) are accessible. Events are examined in which there are two photons forming a Higgs boson candidate, and at least two b-quark jets. In 19.7 inverse femtobarns of proton-proton collision data at sqrt(s) = 8 TeV, recorded in the CMS experiment, no evidence of a signal is found and lower limits at the 95% confidence level are set, excluding the stop mass below 360 to 410 GeV, depending on the higgsino mass