Developing a system for advanced monitoring and intelligent drug administration in critical care units using ontologies

Selected paper of the 16th International Conference on Knowledge-Based and Intelligent Information & Engineering Systems, 2012 September 10-12, San Sebastian, Spain[Abstract] When a patient enters an intensive care unit (ICU), either after surgery or due to a serious clinical condition, his vital signs are continually changing, forcing the medical experts to make rapid and complex decisions, which frequently imply modifications on the dosage of drugs being administered. Life of patients at critical units depends largely on the wisdom of such decisions. However, the human factor is sometimes a source of mistakes that lead to incorrect or inaccurate actions. This work presents an expert system based on a domain ontology that acquires the vital parameters from the patient monitor, analyzes them and provides the expert with a recommendation regarding the treatment that should be administered. If the expert agrees, the system modifies the drug infusion rates being supplied at the infusion pumps in order to improve the patient's physiological status. The system is being developed at the IMEDIR Center (A Coruña, Spain) and it is being tested at the cardiac intensive care unit (CICU) of the Meixoeiro Hospital (Vigo, Spain), which is a specific type of ICU exclusively aimed to treat patients who have underwent heart surgery or that are affected by a serious coronary disorder.Instituto de Salud Carlos III; FIS-PI10/02180Programa Iberoamericano de Ciencia y Tecnología para el Desarrollo; ref. 209RT0366Galicia. Consellería de Cultura, Educación e Ordenación Universitaria; CN2012/217Galicia. Consellería de Cultura, Educación e Ordenación Universitaria; CN2011/034Galcia. Consellería de Cultura, Educación e Ordenación Universitaria; CN2012/21

CloudChain: A novel distribution model for digital products based on supply chain principles

Cloud computing is a popular outsourcing solution for organizations to support the information management during the life cycle of digital information goods. However, outsourcing management with a public provider results in a lack of control over digital products, which could produce incidents such as data unavailability during service outages, violations of confidentiality and/or legal issues. This paper presents a novel distribution model of digital products inspired by lean supply chain principles called CloudChain, which has been designed to support the information management during digital product lifecycle. This model enables connected networks of customers, partners and organizations to conduct the stages of digital product lifecycle as value chains. Virtual distribution channels are created over cloud resources for applications of organizations to deliver digital products to applications of partners through a seamless information flow. A configurable packing and logistic service was developed to ensure confidentiality and privacy in the product delivery by using encrypted packs. A chain management architecture enables organizations to keep tighter control over their value chains, distribution channels and digital products. CloudChain software instances were integrated to an information management system of a space agency. In an experimental evaluation CloudChain prototype was evaluated in a private cloud where the feasibility of applying supply chain principles to the delivery of digital products in terms of efficiency, flexibility and security was revealed.This work was partially funded by the sectorial fund of research, technological development and innovation in space activities of the Mexican National Council of Science and Technology (CONACYT) and the Mexican Space Agency (AEM), project No. 262891

Mutations related to Antiretroviral Resistance identified by ultra-deep sequencing in HIV-1 infected children under Structured Interruptions of HAART

Altres ajuts: CONACYT/GCPS/44519Although Structured Treatment Interruptions (STI) are currently not considered an alternative strategy for antiretroviral treatment, their true benefits and limitations have not been fully established. Some studies suggest the possibility of improving the quality of life of patients with this strategy; however, the information that has been obtained corresponds mostly to studies conducted in adults, with a lack of knowledge about its impact on children. Furthermore, mutations associated with antiretroviral resistance could be selected due to sub-therapeutic levels of HAART at each interruption period. Genotyping methods to determine the resistance profiles of the infecting viruses have become increasingly important for the management of patients under STI, thus low-abundance antiretroviral drug-resistant mutations (DRM's) at levels under limit of detection of conventional genotyping (<20% of quasispecies) could increase the risk of virologic failure. In this work, we analyzed the protease and reverse transcriptase regions of the pol gene by ultra-deep sequencing in pediatric patients under STI with the aim of determining the presence of high- and low-abundance DRM's in the viral rebounds generated by the STI. High-abundance mutations in protease and high- and low-abundance mutations in reverse transcriptase were detected but no one of these are directly associated with resistance to antiretroviral drugs. The results could suggest that the evaluated STI program is virologically safe, but strict and carefully planned studies, with greater numbers of patients and interruption/restart cycles, are still needed to evaluate the selection of DRM's during STI

Lo tangible e intangible del diseño

1 archivo PDF (366 páginas)"El Departamento de Evaluación del Diseño, en el Tiempo de la División de Ciencias y Artes para el Diseño de la Universidad Autónoma Metropolitana, Azcapotzalco, publica este libro colectivo, donde se aborda la discusión y el análisis sobre "Lo tangible e intangible del diseño". Este libro tiene como finalidad el profundizar en distintas posiciones teóricas, metodológicas y empíricas, donde un grupo interdisciplinario de profesores investigadores del Departamento de Evaluación, desde la arquitectura, los estudios urbanos, la educación, la historia, la semiótica, el diseño de la comunicación gráfica y el industrial; buscan convergencias y discuten divergencias que puedan generar servir como referentes intelectuales y teóricos, en el diseño. Este libro es resultado del Cuarto Coloquio Departamental: Lo tangible e Intangible del Diseño. Evaluación de Objetos, Espacios, Mensajes, realizado durante el mes de septiembre del año 2004, el cual se constituyó como un espacio para el intercambio de experiencias académicas y profesionales, desde una perspectiva interdisciplinaria, centrada en la reflexión y la discusión sobre la manera de cómo se puede analizar, definir y evaluar, lo tangible y lo intangible en el diseño"

Responsabilidad social empresarial : decisiones, reflexiones y casos de estudio

Esta obra es resultado del esfuerzo conjunto realizado por miembros de la Asociación Latinoamericana de Casos (ALAC), el Centro Internacional de Casos del Tecnológico de Monterrey (México) y la Universidad del Norte (Colombia). Contiene una selección de trabajos que versan sobre la problemática de la responsabilidad social empresarial en América Latina, la visión de la cultura y el devenir histórico acerca de este tema y una serie de casos que, sin lugar a dudas, se constituyen en un aporte significativo a los procesos de enseñanza-aprendizaje respecto a la ética empresarial y la responsabilidad social

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Genomic Ancestry, CYP2D6, CYP2C9, and CYP2C19 Among Latin Americans

We present the distribution of CYP2D6, CYP2C9, and CYP2C19 variants and predicted phenotypes in 33 native and admixed populations from Ibero-America (n > 6,000) in the context of genetic ancestry (n = 3,387). Continental ancestries are the major determinants of frequencies of the increased-activity allele CYP2C19*17 and CYP2C19 gUMs (negatively associated with Native American ancestry), decreased-activity alleles CYP2D6*41 and CYP2C9*2 (positively associated with European ancestry), and decreased-activity alleles CYP2D6*17 and CYP2D6*29 (positively associated with African ancestry). For the rare alleles, CYP2C9*2 and CYPC19*17, European admixture accounts for their presence in Native American populations, but rare alleles CYP2D6*5 (null-activity), CYP2D6-multiplication alleles (increased activity), and CYP2C9*3 (decreased-activity) were present in the pre-Columbian Americas. The study of a broad spectrum of Native American populations from different ethno-linguistic groups show how autochthonous diversity shaped the distribution of pharmaco-alleles and give insights on the prevalence of clinically relevant phenotypes associated with drugs, such as paroxetine, tamoxifen, warfarin, and clopidogrel

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Probabilistic Assessment of a Design Truck Model and Live Load Factor from WIM data for Mexican Highway Bridge Design

This study is focused on the statistical characterization of live load effects on bridges using weigh-in-motion (WIM) data from a Mexican highway. A truck load model that is simpler than the design truck model implemented in the current Mexican requirements is suggested for design. The statistics are employed in target-reliability based calibration/verification of load factors in Mexican bridge design. Suggestions that could be useful for the Canadian bridge engineering practice are included.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Fine structural organization of a non-reticulate plant cell nucleus An ultracytochemical and immunocytochemical study

We studied the fine structural organization of the meristematic nucleus in roots of Lycopersicon esculentum (tomato) using ultracytochemical and immunocytochemical approaches. The nucleus has a non-reticulate (i.e. low DNA content) structure whose supramolecular organization differs in some respects from that in reticulate nuclei, principally in the organization of the chromocentres associated with the nuclear envelope, with which centromeric structures appear to be associated. The main difference at the nucleolar level is found in the fibrillar centres, which have a low amount of DNA labelling and in which inclusions of condensed chromatin are present only very rarely. The distribution of nucleolar DNA amongst the nucleolar compartments is similar to that in reticulate nucleoli as demonstrated using an anti-DNA monoclonal antibody. Tomato nuclei have nucleolus-associated bodies or karyosomes, like other plant species with a low DNA content and non-reticulate nuclear organization. The nuclear ribonucleoprotein structures in the inter- and perichromatin region