35 research outputs found
Medidas cautelares en los procesos de alimentos en Colombia estudio de su imposición prevalente a cargo de los Jueces de familia por tratarse de derechos alimentarios de los menores en el marco del decreto expedido en la emergencia sanitaria
El propósito de la actual indagación, recae en examinar la función de las cautelas en los procesos de alimentos en Colombia, en pro de los derechos de niños, niñas y adolescentes. Todo a partir de la expedición del decreto de emergencia sanitaria. Para alcanzar este objetivo este trabajo se apoya en el enfoque cualitativo de investigación con un alcance exploratorio y explicativo. Además, con fundamento en los métodos de investigación hermenéutico crÃtico y holÃstico, y a través de las técnicas de revisión documental de doctrina y jurisprudencia nacional y extranjera.Universidad Libre- Facultad de Derecho- Especializacion en Derecho Procesa
¿Qué indica o designa tener derechos?
Para entender el significado de la adjudicación de derechos por parte de un individuo en la sociedad es necesario hacer un análisis sobre el origen de los derechos humanos y el estado de derecho moderno, este último es el encargado de volver exclusivas las funciones y normas estatales para aplicarlas sobre un territorio determinado el cual es dependiente del estado; en éste fenómeno se destaca el cambio de politicidad a estatalidad y de juridicidad a positividad, también, algunos ejemplos recientes de estados modernos pueden ser la Unión Soviética en el siglo XX y la nación judÃa hasta la creación del estado de Israel en 1948
Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial
Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie
Canagliflozin and Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus and Chronic Kidney Disease in Primary and Secondary Cardiovascular Prevention Groups
Background: Canagliflozin reduces the risk of kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, but effects on specific cardiovascular outcomes are uncertain, as are effects in people without previous cardiovascular disease (primary prevention). Methods: In CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation), 4401 participants with type 2 diabetes mellitus and chronic kidney disease were randomly assigned to canagliflozin or placebo on a background of optimized standard of care. Results: Primary prevention participants (n=2181, 49.6%) were younger (61 versus 65 years), were more often female (37% versus 31%), and had shorter duration of diabetes mellitus (15 years versus 16 years) compared with secondary prevention participants (n=2220, 50.4%). Canagliflozin reduced the risk of major cardiovascular events overall (hazard ratio [HR], 0.80 [95% CI, 0.67-0.95]; P=0.01), with consistent reductions in both the primary (HR, 0.68 [95% CI, 0.49-0.94]) and secondary (HR, 0.85 [95% CI, 0.69-1.06]) prevention groups (P for interaction=0.25). Effects were also similar for the components of the composite including cardiovascular death (HR, 0.78 [95% CI, 0.61-1.00]), nonfatal myocardial infarction (HR, 0.81 [95% CI, 0.59-1.10]), and nonfatal stroke (HR, 0.80 [95% CI, 0.56-1.15]). The risk of the primary composite renal outcome and the composite of cardiovascular death or hospitalization for heart failure were also consistently reduced in both the primary and secondary prevention groups (P for interaction >0.5 for each outcome). Conclusions: Canagliflozin significantly reduced major cardiovascular events and kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, including in participants who did not have previous cardiovascular disease
Canagliflozin and renal outcomes in type 2 diabetes and nephropathy
BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years
Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial
Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials.
Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure.
Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen.
Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049
Arquitectura software de soporte tecnológico de un modelo de negocios de adiestramiento y cuidado estético de mascotas caninas soportadas en tecnologÃas web
Tesis (Ingeniero de Sistemas).--Universidad de Cartagena. Facultad de Ciencias E IngenierÃas. Programa de IngenierÃa de Sistemas, 2018El presente estudio tiene por objeto diseñar una arquitectura software, que de soporte tecnológico a un modelo de negocios dirigido al adiestramiento y cuidado estético de mascotas caninas, soportadas en tecnologÃas web
Uniform stability of nonlinear time-varying impulsive systems with eventually uniformly bounded impulse frequency
We provide novel sufficient conditions for stability of nonlinear and time-varying impulsive systems. These conditions generalize, extend, and strengthen many existing results. Different types of input-to-state stability (ISS), as well as zero-input global uniform asymptotic stability (0-GUAS), are covered by employing a two-measure framework and considering stability of both weak (decay depends only on elapsed time) and strong (decay depends on elapsed time and the number of impulses) flavors. By contrast to many existing results, the stability state bounds imposed are uniform with respect to initial time and also with respect to classes of impulse-time sequences where the impulse frequency is eventually uniformly bounded. We show that the considered classes of impulse-time sequences are substantially broader than other previously considered classes, such as those having fixed or (reverse) average dwell times, or impulse frequency achieving uniform convergence to a limit (superior or inferior). Moreover, our sufficient conditions are stronger, less conservative and more widely applicable than many existing results.Fil: Mancilla Aguilar, Jose Luis. Instituto Tecnológico de Buenos Aires; ArgentinaFil: Haimovich, Hernan. Consejo Nacional de Investigaciones CientÃficas y Técnicas. Centro CientÃfico Tecnológico Conicet - Rosario. Centro Internacional Franco Argentino de Ciencias de la Información y de Sistemas. Universidad Nacional de Rosario. Centro Internacional Franco Argentino de Ciencias de la Información y de Sistemas; ArgentinaFil: Feketa, Petro. Christian Albrechts Universitat Zu Kiel.; Alemani
Color and Contrast Enhancement by Controlled Piecewise Affine Histogram Equalization
This paper presents a simple contrast enhancement algorithm based on histogram equalization (HE). The proposed algorithm performs a piecewise affine transform of the intensity levels of a digital image such that the new cumulative distribution function will be approximately uniform (as with HE), but where the stretching of the range is locally controlled to avoid brutal noise enhancement. We call this algorithm Piecewise Affine Equalization (PAE). Several experiments show that, in general, the new algorithm improves HE results
Academic performance and social networks of adolescents in a caribbean city in Colombia
Abstract Background Social factors and networks of friends can influence an adolescent’s behavior, including academic performance (AP) in school. This study aimed to analyze the relationship between AP and adolescents’ social networks in a Caribbean city in Colombia. Methods A cross-sectional study was carried out with 806 schoolchildren from 12 to 17 years old of both sexes (52.7% girls), selected by multi-stage sampling from schools in the rural and urban areas of the city of MonterÃa, Colombia. The AP was obtained from the school records; the sociodemographic variables included the location of the school (rural or urban), family structure, family functioning (Apgar score), and family affluence scale. Social network variables included social activity, popularity, reciprocity, homophily, friends’ academic performance, network size, network density, cluster of friends, and centrality. Results The AP was inversely associated with the Apgar score in boys. No associations of AP with the school location, family structure, family affluence scale, and age were observed. In social network variables, AP was positively associated with popularity and friends’ academic performance in girls and boys, and negatively associated with homophily in boys. Conclusions AP was associated with social network variables. These results could help implement interventions to improve adolescents’ social environment and AP