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Sample records for cart mortalidad hospitalaria

  1. Aproximación a la metodología basada en árboles de decisión (CART: Mortalidad hospitalaria del infarto agudo de miocardio Approach to the methodology of classification and regression trees

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    Javier Trujillano

    2008-02-01

    Full Text Available Objetivo: : Realizar una aproximación a la metodología de árboles de decisión tipo CART (Classification and Regression Trees desarrollando un modelo para calcular la probabilidad de muerte hospitalaria en infarto agudo de miocardio (IAM. Método: Se utiliza el conjunto mínimo básico de datos al alta hospitalaria (CMBD de Andalucía, Cataluña, Madrid y País Vasco de los años 2001 y 2002, que incluye los casos con IAM como diagnóstico principal. Los 33.203 pacientes se dividen aleatoriamente (70 y 30 % en grupo de desarrollo (GD = 23.277 y grupo de validación (GV = 9.926. Como CART se utiliza un modelo inductivo basado en el algoritmo de Breiman, con análisis de sensibilidad mediante el índice de Gini y sistema de validación cruzada. Se compara con un modelo de regresión logística (RL y una red neuronal artificial (RNA (multilayer perceptron. Los modelos desarrollados se contrastan en el GV y sus propiedades se comparan con el área bajo la curva ROC (ABC (intervalo de confianza del 95%. Resultados: En el GD el CART con ABC = 0,85 (0,86-0,88, RL 0,87 (0,86-0,88 y RNA 0,85 (0,85-0,86. En el GV el CART con ABC = 0,85 (0,85-0,88, RL 0,86 (0,85-0,88 y RNA 0,84 (0,83-0,86. Conclusiones: Los 3 modelos obtienen resultados similares en su capacidad de discriminación. El modelo CART ofrece como ventaja su simplicidad de uso y de interpretación, ya que las reglas de decisión que generan pueden aplicarse sin necesidad de procesos matemáticos.Objective: To provide an overview of decision trees based on CART (Classification and Regression Trees methodology. As an example, we developed a CART model intended to estimate the probability of intrahospital death from acute myocardial infarction (AMI. Method: We employed the minimum data set (MDS of Andalusia, Catalonia, Madrid and the Basque Country (2001-2002, which included 33,203 patients with a diagnosis of AMI. The 33,203 patients were randomly divided (70% and 30% into the development (DS

  2. Atención prenatal y mortalidad materna hospitalaria en Tijuana, Baja California

    OpenAIRE

    Gonzaga-Soriano, María Rode; Zonana-Nacach, Abraham; Anzaldo-Campos, María Cecilia; Olazarán-Gutiérrez, Asbeidi

    2014-01-01

    Objetivo. Describir la atención médica prenatal recibida en mujeres con mortalidad materna hospitalaria en el IMSS durante 2005-2012 en Tijuana, Baja California, México. Material y métodos. La información se obtuvo de los archivos de los Comités de Mortalidad Materna y revisión del expediente. Resultados. Hubo 44 muertes maternas (MM). Treinta (68%) asistieron a atención prenatal (AP), el promedio de citas fue de 3.8 y 18 (41%) tuvieron una AP adecuada (≥ 5 citas). Seis (14%) mujeres no sabía...

  3. Mortalidad hospitalaria en pacientes cirróticos en un hospital de tercer nivel

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    R. Zubieta-Rodríguez

    2017-07-01

    Conclusiones: La mortalidad hospitalaria en pacientes cirróticos es elevada, siendo la sepsis y el sangrado los 2 eventos precipitantes de insuficiencia hepática crónica agudizada y muerte. Un puntaje MELD alto, leucocitos elevados y albúmina baja están relacionados con un pobre desenlace durante la hospitalización. Es necesaria la adecuación de medidas de salud pública encaminadas a la prevención, diagnóstico temprano y oportuno de esta enfermedad, para evitar el desarrollo de complicaciones y mejorar el pronóstico en pacientes cirróticos.

  4. Mortalidad materna en Guatemala: diferencias entre muerte hospitalaria y no hospitalaria Maternal mortality in Guatemala: differences between hospital and non-hospital deaths

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    Ana Marina Tzul

    2006-06-01

    Full Text Available OBJETIVO: Estimar la asociación entre características obstétricas, sociodemográficas y factores de riesgo relacionados con la mortalidad materna hospitalaria y no hospitalaria en Guatemala durante el año 2000 MATERIAL Y MÉTODOS: Se realizó un estudio epidemiológico transversal con 649 casos de muertes maternas (MM ocurridas en la República de Guatemala durante el año 2000, en el que se compararon las características de las muertes maternas hospitalarias y no hospitalarias RESULTADOS: De 649 MM registradas, 270 (41.6% se clasificaron como MM hospitalarias y 379 (58.4% como MM no hospitalarias. La mayor proporción de muertes ocurrió en mujeres mayores de 35 años de edad (29.28%, indígenas (65.49%, casadas o unidas (87.83%, con ocupación no remunerada (94.78%, sin educación (66.56%. El riesgo de MM no hospitalaria fue mayor en mujeres del grupo indígena (RM= 3.4; IC95% 2.8-5.3, con ocupación no remunerada (RM= 8.95; IC95% 1.7-46.4, bajo nivel escolar (RM= 1.96; IC95% 1.0-3.8, y hemorragia como causa básica de muerte (RM= 4.28; IC95% 2.3-7.9 CONCLUSIONES: De los 679 casos de MM ocurridas en Guatemala en el año 2000, 58% correspondió a MM no hospitalarias, lo que puede estar relacionado con el hecho de que una alta proporción de la población habita en áreas rurales o de alta marginalidad, además de aspectos culturales (mayoría indígena que dificultan la accesibilidad a los servicios de salud. Los resultados presentados pueden servir de orientación para determinar estrategias de intervención que prevengan la mortalidad materna en los ámbitos hospitalario y extrahospitalario, en Guatemala.OBJECTIVE:To estimate the association between obstetric and socio-demographic characteristics and risk factors related to intra- and extra-hospital maternal mortality in Guatemala during the year 2000 MATERIALS AND METHODS: A cross-sectional epidemiologic study was carried out in 649 maternal mortality (MM cases that occurred in

  5. Aplicación de las redes neuronales artificiales para la estratificación de riesgo de mortalidad hospitalaria

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    Trujillano J.

    2003-01-01

    Full Text Available Objetivo: Comparar la capacidad de predicción de mortalidad hospitalaria de una red neuronal artificial (RNA con el Acute Physiology and Chronic Health Evaluation II (APACHE II y la regresión logística (RL, y comparar la asignación de probabilidades entre los distintos modelos. Método: Se recogen de forma prospectiva las variables necesarias para el cálculo del APACHE II. Disponemos de 1.146 pacientes asignándose aleatoriamente (70 y 30% al grupo de Desarrollo (800 y al de Validación (346. Con las mismas variables se genera un modelo de RL y de RNA (perceptrón de 3 capas entrenado por algoritmo de backpropagation con remuestreo bootstrap y con 9 nodos en la capa oculta en el grupo de desarrollo. Se comparan los tres modelos en función de los criterios de discriminación con el área bajo la curva ROC (ABC [IC del 95%] y de calibración con el test de Hosmer-Lemeshow C (HLC. Las diferencias entre las probabilidades se valoran con el test de Bland-Altman. Resultados: En el grupo de validación, el APACHE II con ABC de 0,79 (0,75-0,84 y HLC de 11 (p = 0,329; modelo RL, ABC de 0,81 (0,76-0,85 y HLC de 29 (p = 0,0001, y en RNA, ABC de 0,82 (0,77-0,86 y HLC de 10 (p = 0,404. Los pacientes con mayores diferencias en la asignación de probabilidad entre RL y RN (8% del total son pacientes con problemas neurológicos. Los peores resultados se obtienen en los pacientes traumáticos (ABC inferior a 0,75 en todos los modelos. En los pacientes respiratorios, la RNA alcanza los mejores resultados (ABC = 0,87 [0,78-0,91]. Conclusiones: Una RNA es capaz de estratificar el riesgo de mortalidad hospitalaria utilizando las variables del sistema APACHE II. La RNA consigue mejores resultados frente a RL, sin alcanzar significación, ya que no trabaja con restricciones lineales ni de independencia de variables, con una diferente asignación de probabilidad individual entre los modelos.

  6. Morbilidad, Mortalidad,Indice Ocupacional y Estadía Hospitalaria en Servicios de Enfermedades Diarreicas Agudas

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    Enrique González Corona

    1999-09-01

    Full Text Available Se realizó un estudio retrospectivo y descriptivo de la morbilidad, mortalidad, estadía e índice ocupacional del Servicio de Enfermedades Diarreicas Agudas del Hospital Infantil Sur de Santiago de Cuba, a fin de evaluar su evolución en 23 años (1972-1994. Se observó un incremento de la morbilidad hasta 1984 y luego un descenso progresivo hasta la actualidad. La mortalidad disminuyó progresivamente hasta la ausencia de fallecimientos en los últimos 4 años. El índice ocupacional se mantuvo cerca del 70 % en los momentos en que el Servicio contó con 120 y 60 camas, respectivamente, y se redujo aproximadamente al 50 % a partir de 1992, cuando la dotación de camas se limitó a 30. La estadía, que era alrededor de 9 días al principio del período, resultó ser de 4 en el último trienio. Se considera que la evolución positiva de tales indicadores se debe a una mejor calidad en el tratamiento de estas enfermedades, y se relacionan algunos de los elementos que lo han hehco posible.A retrospective and descriotive study of morbidity, mortality, stay length and bed occupancy rate was conducted at the Service of Acute Diarrheal Diseases of the South Pediatric Hospital, in Santiago de Cuba, in order to evaluate its evolution in a period of 23 years (1972-1994. An increase of morbidity was observed until 1984 and then a progressive decrease up to now. There was a gradual reduction of mortality and no deaths have been reported during the last 4 years. The bed occupancy rate was at about 70 % when the Service had 120 and 60 beds, respectively, and there was a reduction of nearly 50 % when the number of bed was limited to 30. Stay length that was approximately 9 days at the beginning of the period proved to be 4 in the last 3 years. It is considered that the positive evolution of these indicators is the result of a better quality in the treatment of these diseases. Some of the elements that made it possible are mentioned here.

  7. Una propuesta para medir la calidad de la atención hospitalaria usando información sobre mortalidad A proposal for quality assessment through mortality data

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    Esteban Puentes-Rosas

    2011-01-01

    Full Text Available OBJETIVO. Presentar la Razón Estandarizada de Mortalidad Intrahospitalaria (REMI como alternativa para medir la calidad de atención hospitalaria en México. MATERIAL Y MÉTODOS. Las fuentes de información fueron los registros de egresos hospitalarios del Instituto Mexicano del Seguro Social (IMSS, del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE y de la Secretaría de Salud en 2008. Mediante regresión logística se estimó la probabilidad de muerte intrahospitalaria controlando por sexo, edad, días de estancia y diagnóstico. La REMI es el resultado de dividir las muertes observadas entre la suma de las probabilidades estimadas para cada hospital. RESULTADOS. La REMI más baja correspondió a los hospitales del ISSSTE. Por entidad, los servicios con mejores resultados fueron los del ISSSTE en Veracruz, y los que tuvieron peor desempeño fueron los de la SS en Nayarit. CONCLUSIÓN. Los resultados obtenidos sugieren que la REMI puede constituirse como una alternativa adecuada para monitorear el desempeño de los hospitales en términos de la mortalidad observada.OBJECTIVE. To introduce the Hospital Standardized Mortality Ratio (HSMR as an alternative to assess the quality of hospital care in Mexico. MATERIAL AND METHODS. Data-sets of public hospital discharges were used as source of information. The analyses were based in a logistic model to estimate the risk of hospital death adjusting by sex, age, length of stay and main diagnosis. The HSMR is estimated dividing the observed deaths by the addition of the risk for each discharge by hospital. RESULTS. The ISSSTE had the lowest HSMR. At state level, the best figure was obtained by the hospitals of the ISSSTE in Veracruz, while the worst performance corresponds to hospitals of the SS in Nayarit. CONCLUSION. Our results suggest that this indicator can be used as a suitable alternative to evaluate the performance of hospitals in terms of mortality.

  8. Preditores de mortalidade hospitalar em pacientes com embolia pulmonar estáveis hemodinamicamente Predictores de mortalidad hospitalaria en pacientes con embolia pulmonar estables hemodinámicamente Predictors of hospital mortality in hemodynamically stable patients with pulmonary embolism

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    André Volschan

    2009-08-01

    Full Text Available FUNDAMENTO: A embolia pulmonar apresenta alta mortalidade em pacientes com hipotensão arterial ou choque circulatório. Entretanto, em pacientes hemodinamicamente estáveis, a associação de algumas variáveis clínicas com a mortalidade ainda não está claramente estabelecida. OBJETIVOS: Derivar um modelo de estratificação do risco de mortalidade intra-hospitalar em pacientes com embolia pulmonar hemodinamicamente estáveis. MÉTODOS: Estudo de coorte multicêntrico prospectivo de 582 pacientes consecutivos que foram admitidos em unidades de emergência ou de terapia intensiva, com suspeita clínica de embolia pulmonar, e que tiveram o diagnóstico confirmado por meio de um ou mais dos seguintes exames: arteriografia pulmonar, angiotomografia computadorizada helicoidal, angioressonância magnética, ecodopplercardiograma, cintilografia pulmonar ou duplex-scan venoso. Os dados sobre características demográficas, comorbidades e manifestações clínicas foram coletados e incluídos em uma análise de regressão logística para compor o modelo de predição. RESULTADOS: A mortalidade global foi de 14,1%. Foram identificadas como variáveis independentes de risco de óbito: idade > 65 anos; repouso no leito > 72h; cor pulmonale crônico; taquicardia sinusal e taquipnéia. Após a estratificação por faixas de risco, observaram-se mortalidades de 5,4%, 17,8% e 31,3%, respectivamente nos subgrupos de baixo, moderado e alto riscos. O modelo mostrou sensibilidade de 65,5% e especificidade de 80%, com uma área sob a curva de 0,77. CONCLUSÃO: Em pacientes hemodinamicamente estáveis com embolia pulmonar, a idade > 65 anos, o repouso no leito > 72h, o cor pulmonale crônico, a taquicardia sinusal e a taquipnéia foram preditores independentes da mortalidade intra-hospitalar. Entretanto o modelo de predição necessita ser validado em outras populações para sua incorporação à prática clínica.FUNDAMENTO: La embolia pulmonar presenta alta

  9. Asociación entre factores socioeconómicos y mortalidad intrahospitalaria por accidente cerebrovascular isquémico en una cohorte hospitalaria de Colombia, 2003-2006

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    Federico Arturo Silva

    2013-06-01

    Full Text Available OBJETIVO: Determinar si existe asociación entre las condiciones socioeconómicas y la mortalidad intrahospitalaria (MIH por accidente cerebrovascular (ACV isquémico en una muestra de población colombiana e identificar la cadena de eventos que determinan esa asociación. MÉTODOS: Estudio prospectivo de una cohorte hospitalaria de pacientes con ACV isquémico registrados en cuatro instituciones clínicas de referencia colombianas -ubicadas en Floridablanca, Bucaramanga, Bogotá y Medellín- entre febrero de 2003 y diciembre de 2006. Mediante análisis jerárquico se evaluaron las variables socioeconómicas agrupadas en tres niveles para determinar su relación con la MIH por ACV isquémico en un modelo de riesgos proporcionales de Cox. RESULTADOS: En los 253 pacientes incluidos, la MIH fue de 9,4 %. En el análisis por niveles, la mortalidad estuvo inversamente asociada con el nivel educacional (estudios superiores a primaria, los ingresos mensuales (≥ salario mínimo y la vinculación al régimen contributivo. En el análisis jerárquico, al combinar los 3 niveles, solo la asociación inversa con la afiliación al régimen contributivo mantuvo su significación estadística (RR 0,35; IC95%: 0,13-0,96; P = 0,04. CONCLUSIONES: Los resultados indican que en Colombia, el estar afilado al régimen contributivo de salud es un factor protector independiente contra la MIH tras un ACV isquémico. La secuencia educación-ingresos-acceso a servicios de salud constituye una vía de explicación de la relación entre las condiciones socioeconómicas y el desenlace clínico de estos eventos. Se deben diseñar estrategias para mitigar las diferencias en la calidad y la distribución de los servicios de salud en la población colombiana.

  10. Cancer incidence, hospital morbidity, and mortality in young adults in Brazil Incidencia, morbilidad hospitalaria y mortalidad por cáncer en adultos jóvenes en Brasil Incidência, morbidade hospitalar e mortalidade por câncer em adultos jovens no Brasil

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    Rosalina Jorge Koifman

    2013-05-01

    Full Text Available There are still relatively few studies in the world on cancer incidence and mortality in young adults. The current study aimed to explore cancer distribution in young adults in Brazil. A descriptive study was conducted on cancer incidence (selected State capitals, hospital morbidity, and mortality (Brazil and selected capitals in the 20-24-year age strata in 2000-2002, and trends in cancer mortality rates in Brazil in 1980-2008 in the same population. Testicular cancer was the principal anatomical site in young adult males; in young adult women, the main sites were thyroid, uterine cervix, and Hodgkin disease. Brain cancer was the principal cause of death from cancer in both sexes, and time trends in mortality showed an increase in mortality from brain cancer in men and from lymphocytic leukemia in both sexes. As a whole, the results show an epidemiological pattern of cancer in young adults with regional distribution characteristics.En el mundo todavía son relativamente pocos los estudios sobre la incidencia y mortalidad por cáncer en adultos jóvenes. El objetivo fue explorar la distribución de cáncer en adultos jóvenes en Brasil. Se realizó un estudio descriptivo de la incidencia (capitales seleccionadas, de la morbilidad hospitalaria y de la mortalidad (Brasil y capitales seleccionadas por cáncer a los 20-24 años, en el período de 2000-2002, y de la evolución de las tasas de mortalidad por cáncer en Brasil en el período de 1980-2008, en la misma población. El cáncer de testículo fue la principal localización anatómica en hombres, y las neoplasias de la glándula tiroides, del cuello de útero y la enfermedad de Hodgkin en las mujeres. El cáncer de encéfalo fue la principal causa de muerte por cáncer en ambos sexos y la tendencia temporal de la mortalidad muestra un aumento en la mortalidad por cáncer de encéfalo en hombres y por la leucemia linfoide en ambos sexos. En conjunto, los resultados presentados retratan un padr

  11. Hiponatremias hospitalarias

    OpenAIRE

    Sánchez de la Nieta García, María Dolores

    2011-01-01

    INTRODUCCIÓN La hiponatremia constituye la principal alteración hidroelectrolítica en el medio hospitalario, aunque habitualmente pasa desaparecida probablemente por cursar mayoritariamente de forma asintomática, por su aparente baja mortalidad o por la insuficiente comprensión de sus génesis y tratamiento por facultativos no nefrológos. Al revisar la literatura reciente, cada vez son más los estudios que analizan las hiponatremias y su incidencia. Actualmente se reconoce como un trastorno co...

  12. Aplicación de las redes neuronales artificiales para la estratificación de riesgo de mortalidad hospitalaria Application of artificial neural networks for risk stratification of hospital mortality

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    J. Trujillano

    2003-12-01

    Full Text Available Objetivo: Comparar la capacidad de predicción de mortalidad hospitalaria de una red neuronal artificial (RNA con el Acute Physiology and Chronic Health Evaluation II (APACHE II y la regresión logística (RL, y comparar la asignación de probabilidades entre los distintos modelos. Método: Se recogen de forma prospectiva las variables necesarias para el cálculo del APACHE II. Disponemos de 1.146 pacientes asignándose aleatoriamente (70 y 30% al grupo de Desarrollo (800 y al de Validación (346. Con las mismas variables se genera un modelo de RL y de RNA (perceptrón de 3 capas entrenado por algoritmo de backpropagation con remuestreo bootstrap y con 9 nodos en la capa oculta en el grupo de desarrollo. Se comparan los tres modelos en función de los criterios de discriminación con el área bajo la curva ROC (ABC [IC del 95%] y de calibración con el test de Hosmer-Lemeshow C (HLC. Las diferencias entre las probabilidades se valoran con el test de Bland-Altman. Resultados: En el grupo de validación, el APACHE II con ABC de 0,79 (0,75-0,84 y HLC de 11 (p = 0,329; modelo RL, ABC de 0,81 (0,76-0,85 y HLC de 29 (p = 0,0001, y en RNA, ABC de 0,82 (0,77-0,86 y HLC de 10 (p = 0,404. Los pacientes con mayores diferencias en la asignación de probabilidad entre RL y RN (8% del total son pacientes con problemas neurológicos. Los peores resultados se obtienen en los pacientes traumáticos (ABC inferior a 0,75 en todos los modelos. En los pacientes respiratorios, la RNA alcanza los mejores resultados (ABC = 0,87 [0,78-0,91]. Conclusiones: Una RNA es capaz de estratificar el riesgo de mortalidad hospitalaria utilizando las variables del sistema APACHE II. La RNA consigue mejores resultados frente a RL, sin alcanzar significación, ya que no trabaja con restricciones lineales ni de independencia de variables, con una diferente asignación de probabilidad individual entre los modelos.Objective: To compare the ability of an artificial neural network (ANN to

  13. Mortalidad intrahospitalaria por accidente cerebrovascular

    OpenAIRE

    Federico Rodríguez Lucci; Virginia Pujol Lereis; Sebastián Ameriso; Guillermo Povedano; María F. Díaz; Alejandro Hlavnicka; Néstor A. Wainsztein; Sebastián F. Ameriso

    2013-01-01

    La mortalidad global por accidente cerebrovascular (ACV) ha disminuido en las últimas tres décadas, probablemente debido a un mejor control de los factores de riesgo vascular. La mortalidad hospitalaria por ACV ha sido tradicionalmente estimada entre 6 y 14% en la mayoría de las series comunicadas. Sin embargo, los datos de ensayos clínicos recientes sugieren que esta cifra sería sustancialmente menor. Se revisaron datos de pacientes internados con diagnóstico de ACV del Banco de Datos de Str...

  14. 135. Mediastinitis postoperatoria: factores de riesgo, supervivencia y estancia hospitalaria

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    L. Riesco de la Vega

    2010-01-01

    Conclusiones: La incidencia de mediastinitis en nuestra población de pacientes es de un 2,2%. Edad, EPOC, obesidad, uso de arteria mamaria y reintervención son factores de riesgo independientes de esta complicación. La mediastinitis es una complicación grave, con una alta mortalidad (25,4%, y que conlleva una prolongación de la estancia en UCI y hospitalaria, con el consecuente consumo de recursos sanitarios.

  15. Mortalidad intrahospitalaria por accidente cerebrovascular

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    Federico Rodríguez Lucci

    2013-08-01

    Full Text Available La mortalidad global por accidente cerebrovascular (ACV ha disminuido en las últimas tres décadas, probablemente debido a un mejor control de los factores de riesgo vascular. La mortalidad hospitalaria por ACV ha sido tradicionalmente estimada entre 6 y 14% en la mayoría de las series comunicadas. Sin embargo, los datos de ensayos clínicos recientes sugieren que esta cifra sería sustancialmente menor. Se revisaron datos de pacientes internados con diagnóstico de ACV del Banco de Datos de Stroke de FLENI y los registros institucionales de mortalidad entre los años 2000 y 2010. Los subtipos de ACV isquémicos se clasificaron según criterios TOAST y los ACV hemorrágicos en hematomas intrapanquimatosos, hemorragias subaracnoideas aneurismáticas, malformaciones arteriovenosas y otros hematomas intraparenquimatosos. Se analizaron 1514 pacientes, 1079 (71% con ACV isquémico (grandes vasos 39%, cardioembólicos 27%, lacunares 9%, etiología indeterminada 14%, otras etiologías 11% y 435 (29% con ACV hemorrágico (intraparenquimatosos 27%, hemorragia subaracnoidea 30%, malformaciones arteriovenosas 25% y otros hematomas espontáneos 18%. Se registraron 38 muertes intrahospitalarias (17 ACV isquémicos y 21 ACV hemorrágicos, representando una mortalidad global del 2.5% (1.7% en ACV isquémicos y 4.8% en ACV hemorrágicos. No se registraron muertes asociadas al uso de fibrinolíticos endovenosos. La mortalidad intrahospitalaria en pacientes con ACV isquémico y hemorrágico en nuestro centro fue baja. El manejo en un centro dedicado a las enfermedades neurológicas y el enfoque multidisciplinario por personal médico y no médico entrenado en el cuidado de la enfermedad cerebrovascular podrían explicar, al menos en parte, estos resultados.

  16. Prevalencia y factores asociados a desnutrición hospitalaria en un hospital general: Perú, 2012

    OpenAIRE

    L. E. Veramendi-Espinoza; J. H. Zafra-Tanaka; O. Salazar-Saavedra; J. E. Basilio-Flores; E. Millones-Sánchez; G. A. Pérez-Casquino; L. M. Quispe-Moore; M. E. Tapia-Vicente; D. I. Ticona-Rebagliati; N. B. Asato; L. Quispe-Calderón; H. J. Ruiz García; A. Chia-Gil; D. E. Rey-Rodríguez; B. T. Surichaqui

    2013-01-01

    Introducción: La desnutrición hospitalaria es un problema prevalente que genera mayor morbi-mortalidad, peor respuesta al tratamiento, mayor estancia y costo hospitalario. Objetivos: Determinar la prevalencia y factores asociados a desnutrición hospitalaria en un hospital general peruano. Métodos: Estudio analítico transversal de 211 pacientes en servicios de Medicina y Cirugía. Se analizó variables demográficas, clínicas e indicadores antropométricos. El análisis multivariado fue de regresió...

  17. Escala de riesgo Aristóteles como factor predictor de mortalidad en el cierre quirúrgico de persistencia de ductus arterioso en prematuros

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    Antonio Jimenez-Aceituna

    2017-07-01

    Conclusiones: La mortalidad asociada al cierre quirúrgico del ductus persistente depende más del estado de prematuridad que de la cirugía, siendo la escala Aristóteles el factor más útil para determinar el grado de prematuridad y predecir la mortalidad hospitalaria. Los prematuros con 15 o más puntos en esta escala tuvieron una mayor mortalidad, para los que se propone un manejo conservador.

  18. Aplicación de variables bioquímicas y antropométricas en la predicción de la desnutrición hospitalaria

    OpenAIRE

    Herrera Castro, Patricia

    2016-01-01

    [ES]La desnutrición es la causa más frecuente de aumento de la morbi-mortalidad y uno de los principales problemas de salud en el mundo. Afecta de forma particular a un grupo de pacientes, los hospitalizados, donde la incapacidad de ingesta y la enfermedad son comunes. Esta entidad propia es denominada desnutrición hospitalaria (DH). La Desnutrición Hospitalaria está bien reconocida y documentada en la literatura mundial. A pesar de ser la enfermedad más prevalente en los hospitales,...

  19. Service Cart For Engines

    Science.gov (United States)

    Ng, Gim Shek

    1995-01-01

    Cart supports rear-mounted air-cooled engine from Volkswagen or Porsche automobile. One person removes, repairs, tests, and reinstalls engine of car, van, or home-built airplane. Consists of framework of wood, steel, and aluminum components supported by four wheels. Engine lifted from vehicle by hydraulic jack and gently lowered onto waiting cart. Jack removed from under engine. Rear of vehicle raised just enough that engine can be rolled out from under it. Cart easily supports 200-lb engine. Also used to hold transmission. With removable sheet-metal top, cart used as portable seat.

  20. State of the cart.

    Science.gov (United States)

    Bernstein, C; Weiss, S; Lorenzini, B

    1994-03-15

    Food on wheels: it's here, there and everywhere. But while some operations rev up cart expansion plans, others have shifted into low gear. Here's an update on that '90s phenomenon: mobile merchandising.

  1. Jeux de cartes

    Directory of Open Access Journals (Sweden)

    Priscilla DE ROO

    1988-03-01

    Full Text Available Le dessinateur Cabu illustre par la carte deux étapes récentes de l'État de la France: les rapports entre eux (État et institutions et nous (les Français et leur territoire avant et après la cohabitation.

  2. Jeux de cartes

    Directory of Open Access Journals (Sweden)

    Pierre GENTELLE

    1986-09-01

    Full Text Available Dans la grande tradition de la science-fiction et des lieux imaginaires traduits ici en «jeux» de cartes, l'auteur bouleverse quelques localisations au prix de mouvements tectoniques imprévus et en prévoit quelques conséquences.

  3. Controlling errors in unidosis carts

    Directory of Open Access Journals (Sweden)

    Inmaculada Díaz Fernández

    2010-01-01

    Full Text Available Objective: To identify errors in the unidosis system carts. Method: For two months, the Pharmacy Service controlled medication either returned or missing from the unidosis carts both in the pharmacy and in the wards. Results: Uncorrected unidosis carts show a 0.9% of medication errors (264 versus 0.6% (154 which appeared in unidosis carts previously revised. In carts not revised, the error is 70.83% and mainly caused when setting up unidosis carts. The rest are due to a lack of stock or unavailability (21.6%, errors in the transcription of medical orders (6.81% or that the boxes had not been emptied previously (0.76%. The errors found in the units correspond to errors in the transcription of the treatment (3.46%, non-receipt of the unidosis copy (23.14%, the patient did not take the medication (14.36%or was discharged without medication (12.77%, was not provided by nurses (14.09%, was withdrawn from the stocks of the unit (14.62%, and errors of the pharmacy service (17.56% . Conclusions: It is concluded the need to redress unidosis carts and a computerized prescription system to avoid errors in transcription.Discussion: A high percentage of medication errors is caused by human error. If unidosis carts are overlooked before sent to hospitalization units, the error diminishes to 0.3%.

  4. Fan Cart: The Next Generation

    Science.gov (United States)

    Lamore, Brian

    2016-01-01

    For years the fan cart has provided physics students with an excellent resource for exploring fundamental mechanics concepts such as acceleration, Newton's laws, impulse, momentum, work-energy, and energy conversions. "The Physics Teacher" has even seen some excellent do-it-yourself (DIY) fan carts and activities. If you are interested…

  5. A la Carte Community

    DEFF Research Database (Denmark)

    Gundelach, Peter; Brincker, Benedikte

    2010-01-01

    and shows that there are high levels of virtual as well as face-to-face interaction among the members. The participants feel that they belong to the community and many also feel that they are recognised as part of the community. However, the members do not share common values neither in relation to software......The exchange of open source software is a phenomenon that is becoming in- creasingly significant to IT users. This article presents the results of a study of the TYPO3 community, a community related to an open source CMS software. The article explores the community, identity and values of TYPO3...... pro- duction nor generally. Instead, they stress that you are free to choose your own values. Against this background, the authors introduce the notion of an ‘a la carte community', i.e. a community where individuals pick and choose their degree of participation and integra- tion into the community...

  6. FMIT alignment cart

    International Nuclear Information System (INIS)

    Potter, R.C.; Dauelsberg, L.B.; Clark, D.C.; Grieggs, R.J.

    1981-01-01

    The Fusion Materials Irradiation Test (FMIT) Facility alignment cart must perform several functions. It must serve as a fixture to receive the drift-tube girder assembly when it is removed from the linac tank. It must transport the girder assembly from the linac vault to the area where alignment or disassembly is to take place. It must serve as a disassembly fixture to hold the girder while individual drift tubes are removed for repair. It must align the drift tube bores in a straight line parallel to the girder, using an optical system. These functions must be performed without violating any clearances found within the building. The bore tubes of the drift tubes will be irradiated, and shielding will be included in the system for easier maintenance

  7. La redistribution des cartes.

    Directory of Open Access Journals (Sweden)

    Muriel Berthou Crestey

    2009-11-01

    Full Text Available Redessinée par Jacques Rancière, la carte du sensible acquiert une dimension interactive, formant un réseau de connexions organisé sans hiérarchie préétablie. Fondée sur le principe de l’horizontalité et de l’égalité, elle déplace les limites pour offrir un terrain propice à l’émancipation, permettant un cadrage inédit, un regard neuf. Chaque place assignée est désormais ouverte et vacante. Il n’y a plus de chemin tracé. Toute nouvelle configuration est possible et ...

  8. Engineering CAR-T cells.

    Science.gov (United States)

    Zhang, Cheng; Liu, Jun; Zhong, Jiang F; Zhang, Xi

    2017-01-01

    Chimeric antigen receptor redirected T cells (CAR-T cells) have achieved inspiring outcomes in patients with B cell malignancies, and are now being investigated in other hematologic malignancies and solid tumors. CAR-T cells are generated by the T cells from patients' or donors' blood. After the T cells are expanded and genetically modified, they are reinfused into the patients. However, many challenges still need to be resolved in order for this technology to gain widespread adoption. In this review, we first discuss the structure and evolution of chimeric antigen receptors. We then report on the tools used for production of CAR-T cells. Finally, we address the challenges posed by CAR-T cells.

  9. Mortalidad infantil en Cuba 1959-1999

    Directory of Open Access Journals (Sweden)

    Raúl Riverón Corteguera

    2001-09-01

    Full Text Available De 1959 a 1999, con los datos estadísticos disponibles, la mortalidad infantil en Cuba disminuyó en 81,3 %, la mortalidad neonatal precoz se redujo el 73,4 %, la mortalidad neonatal tardía el 83,6 % y la posneonatal en 86,0 %. Las reducciones obtenidas en el período se distribuyeron uniformemente entre todas las provincias, aunque la mayor disminución se produjo en las provincias centrales y occidentales. Los rubros que más disminuyeron sus tasas fueron: enteritis y otras enfermedades diarreicas, infecciones respiratorias agudas, afecciones perinatales en general y las meningitis, aunque todas las causas reducen la mortalidad en el período. La natalidad descendió el 51,3 %, la fecundidad lo hizo en 30 %, el crecimiento demográfico bruto de la población disminuyó el 59,8 %, el parto institucional aumentó en 65,9 %, el bajo peso al nacer descendió el 36,9 %, la mortalidad perinatal se redujo el 67,2 %, los nacidos vivos disminuyeron el 21,1 % y la supervivencia infantil a los 5 años aumentó el 3,8 %. Esto ha sido posible debido principalmente a la decisión política de priorizar el sector de la salud y muy especialmente la salud maternoinfantil adoptada por nuestro Estado a principios de la década de los 60, lo que permitió alcanzar avances en la organización, calidad de la atención y una amplia cobertura de los servicios de salud. También fueron elementos importantes, el mejoramiento del nivel de vida y de la educación alcanzados por la población, las mejoras logradas en la situación sanitaria y epidemiológica, la distribución equitativa de los alimentos que prioriza a la madre y al niño. Un elemento fundamental en la última década ha sido el desarrollo del "médico de la familia" en la atención primaria y el mejoramiento de la atención hospitalaria. Por otra parte han contribuido de manera notable el establecimiento del Programa Nacional de Atención Maternoinfantil, que abarca las inmunizaciones, el control de las

  10. Toward dialysis "a la carte".

    Science.gov (United States)

    Funck-Brentano, J L

    1987-12-01

    From the very beginning, the artificial kidney postponed the death of patients with end-stage renal failure. For years, owing to the performance of the machine, the patient was obliged to follow a severe diet in order to maintain good humoral and circulatory status. Now technological improvements allow "dialysis à la carte," whereby each individual achieves a better clinical status. The next step will be automation of the procedure to improve its security, mainly for dialysis performed at home.

  11. [Regulatory assessment of the "Nutrición Hospitalaria" journal].

    Science.gov (United States)

    Iglesias Vázquez, E; Culebras, J M; García de Lorenzo, A

    2000-01-01

    A study is carried out to determine the degree of compliance by the journal entitled "Nutrición Hospitalaria" with the international standards issued by the ISO (International Standards Organization) by means of the application of a survey questionnaire drawn up in accordance with the guidelines published by national and international standards organizations. In total, 161 parameters are considered. Together with the general aspects of the publication, an analysis is made of its specific sections, decisive in the establishment of its level of compliance. After the analysis carried out, it was seen that the general standardization mean was 64% and the real average was 76.82%. At the same time, the necessary recommendations are given to improve these standardization levels and improve the editorial quality of "Nutrición Hospitalaria".

  12. Factores de riesgo asociados a mortalidad en infecciones relacionadas con la atención en salud en un hospital universitario de tercer nivel en Colombia

    Directory of Open Access Journals (Sweden)

    Christian José Pallares

    2014-04-01

    Full Text Available Introducción. Las infecciones hospitalarias son una amenaza para la salud pública. A pesar de los esfuerzos para contenerlas, su incidencia sigue siendo grande y genera altos costos en la atención en salud. Objetivo. Determinar los factores asociados a mortalidad en pacientes con diagnóstico de infecciones hospitalarias en nuestra institución. Materiales y métodos. Se llevó a cabo un estudio prospectivo de cohortes entre enero y diciembre del 2011 por medio de la observación de 1.015 pacientes con diagnóstico de infección de acuerdo a los criterios del sistema de vigilancia hospitalaria sugeridos por los Centers for Disease Control and Prevention (CDC. Se excluyó a quienes no tenían cultivo microbiológico de la infección o habían tenido reingresos hospitalarios en menos de un año. Se evaluaron variables sociodemográficas y clínicas, perfiles de resistencia microbiológica y uso de antibióticos. La variable de desenlace fue la muerte. Se realizó un análisis de supervivencia para cada variable, estableciendo significación estadística con la prueba de log-rank, así como un análisis multivariado mediante regresión de Cox. Se consideraron significativos los valores de p menores de 0,05. Resultados. El promedio de edad fue de 43 años (57 % hombres y 43 % mujeres; 53 % de los pacientes tuvo diagnóstico clínico y 47 %, quirúrgico; 54 % de las infecciones se presentó en la herida quirúrgica y 62 % de ellas se asociaron a microorganismos Gram negativos. La mortalidad durante el seguimiento fue de 24,4 %. En el análisis multivariado se encontró asociación con mortalidad para las variables de estancia en cuidado intensivo (hazard ratio (HR=1,51; IC95% 1,13-2,01, uso inapropiado de antibióticos (HR=3,05; IC95% 2,34-3,98 y uso de antibiótico genérico o copia (HR=1,91; IC IC95% 1,43-2,55. Conclusiones. El empleo de moléculas genéricas y el uso inadecuado de antibióticos en pacientes con infecciones hospitalarias son

  13. Efecto del tratamiento antibiótico inicial adecuado sobre la mortalidad en pacientes en estado crítico con bacteriemia por Pseudomonas aeruginosa

    Directory of Open Access Journals (Sweden)

    Andrés Leonardo González

    2014-04-01

    Full Text Available Introducción. La bacteriemia es una de las infecciones hospitalarias de mayor mortalidad, especialmente en las unidades de cuidados intensivos, donde es más frecuente. Pseudomonas aeruginosa es uno de los causantes de bacteriemia más agresivos. Objetivo. Evaluar la asociación entre el tratamiento antibiótico inicial y la mortalidad hospitalaria en estos pacientes. Materiales y métodos. Se trata de un estudio de cohorte retrospectivo multicéntrico realizado entre 2005 y 2008. Se consideró tratamiento adecuado aquel iniciado en las primeras 48 horas del diagnóstico que incluyera, al menos, una dosis de antibiótico intravenoso al que P. aeruginosa fuera sensible y hubiera sido suministrado en la dosis y frecuencia recomendadas. El desenlace principal fue la mortalidad hospitalaria en un lapso de 30 días. Se hizo pareo según grado de exposición usando índices de propensión y, posteriormente, análisis paramétrico de supervivencia. Resultados. Se incluyeron 164 pacientes. La mediana de edad y la clasificación del APACHE II (Acute Physiology and Chronic Health Evaluation II fue de 56 y 13, respectivamente. Se identificó la fuente de la bacteriemia en 68,3 % de los casos, y la más frecuente fue el tracto respiratorio; 44 % de los pacientes recibió tratamiento inadecuado, y la resistencia bacteriana fue la principal variable asociada. La proporción de incidencia de sepsis grave, choque séptico, falla orgánica múltiple y muerte en el lapso de 30 días fue de 67,7, 50, 41,5 y 43,9 %, respectivamente. El tratamiento adecuado se asoció a una prolongación del tiempo hasta el evento (razón de tiempo ajustada, 2,95, IC95%, 1,63 a 5,33. Conclusión. El tratamiento antibiótico inicial adecuado es un factor protector contra la mortalidad hospitalaria en pacientes con bacteriemia por P. aeruginosa.

  14. Estructura hospitalaria y su relación con la sobrevida de pacientes pediátricos con leucemia linfoblástica aguda

    OpenAIRE

    Miranda-Lora, América Liliana; Klünder-Klünder, Miguel; Ruíz-Cano, Jenifer; Reyes-López, Alfonso; Dorantes-Acosta, Elisa; Zapata-Tarrés, Marta; Manuell-Lee, Gabriel; Garduño-Espinosa, Juan; Muñoz-Hernández, Onofre

    2012-01-01

    Introducción. Se han identificado características de las unidades médicas que pueden considerarse como estándares ideales para la atención de pacientes pediátricos con cáncer. La implementación de estos estándares ha mejorado la sobrevida de los pacientes. Como parte de la evaluación de la calidad de la atención que reciben los niños con leucemia linfoblástica aguda afiliados al Seguro Popular, se analizó la relación entre la estructura de las unidades médicas y la mortalidad hospitalaria. Mé...

  15. Des cartes dans la classe…

    Directory of Open Access Journals (Sweden)

    R. Gimeno

    1990-09-01

    Full Text Available La majorité des enseignants qui veulent faire des cartes — et les faire réaliser aux élèves — pour répondre aux exigences des instructions officielles, doivent surmonter leur manque de compétences en cartographie et en didactique ainsi que les difficultés propres aux logiciels de cartographie encore peu performants. Ces compétences et la réflexion qui les accompagne sont pourtant accessibles aux enfants de l’école élémentaire…

  16. Rolling Friction on a Wheeled Laboratory Cart

    Science.gov (United States)

    Mungan, Carl E.

    2012-01-01

    A simple model is developed that predicts the coefficient of rolling friction for an undriven laboratory cart on a track that is approximately independent of the mass loaded onto the cart and of the angle of inclination of the track. The model includes both deformation of the wheels/track and frictional torque at the axles/bearings. The concept of…

  17. Mortalidade infantil em duas coortes de base populacional no Sul do Brasil: tendências e diferenciais

    Directory of Open Access Journals (Sweden)

    Menezes Ana M. B.

    1996-01-01

    Full Text Available Estudou-se a tendência temporal da mortalidade infantil através de dois estudos de coorte realizados em Pelotas, Rio Grande do Sul, em 1982 e 1993. Ambas coortes incluíram todos os nascimentos hospitalares e óbitos verificados através de visitas regulares aos hospitais, cartórios e cemitérios. As informações sobre a causa de morte foram obtidas através de entrevistas com pediatras, revisão do prontuário, necrópsias e entrevista com os pais das crianças. O coeficiente de mortalidade infantil caiu de 36,4 por mil nascidos vivos para 21,1 na década. As principais causas de mortalidade infantil em 1993 foram as perinatais, malformações congênitas, diarréia e infecções respiratórias. Crianças com baixo peso ao nascer apresentaram mortalidade 12 vezes maior do que crianças com peso adequado, e crianças pré-termo, duas vezes mais do que crianças com retardo de crescimento intra-uterino. Crianças de famílias com renda baixa (um salário mínimo apresentaram mortalidade sete vezes superior àquelas com renda alta (10 salários mínimos. A mortalidade de crianças de baixo peso ao nascer e alta renda familiar decresceu em 67%, contra apenas 36% para as de baixa renda. Conclui-se que, mesmo com uma queda expressiva da mortalidade infantil na década, persistem importantes desigualdades sociais.

  18. Análise da mortalidade e das internações por doenças cardiovasculares em Niterói, entre 1998 e 2007 Análisis de la mortalidad y de las hospitalizaciones por enfermedades cardiovasculares en Niterói, entre 1998 y 2007 Analysis of mortality and hospitalization for cardiovascular diseases in Niterói, between 1998 and 2007

    Directory of Open Access Journals (Sweden)

    Maria Luiza Garcia Rosa

    2011-06-01

    Full Text Available FUNDAMENTO: A redução da mortalidade por doenças cardiovasculares é observada no Brasil há anos, atribuída à queda nos fatores de risco, melhora na terapêutica e diminuição da mortalidade hospitalar. OBJETIVO: Comparar a mortalidade populacional, o coeficiente de internação e a mortalidade hospitalar em unidades do Sistema Único de Saúde, para doença isquêmica do coração (DIC, doenças cerebrovasculares (DCBV e insuficiência cardíaca (IC, no município de Niterói, entre 1998 e 2007. MÉTODOS: Foram utilizados o número de óbitos e o de internações e mortalidade hospitalar de residentes em Niterói para o capítulo IX do CID10 e causas específicas disponíveis no Datasus, na população de 30 anos e mais. A diferença entre a magnitude dos indicadores foi calculada para homens e mulheres considerando a média do primeiro triênio menos a média do segundo triênio. RESULTADOS: Houve queda dos coeficientes de mortalidade populacional em homens e mulheres, para todas as faixas etárias, nos três grupos de causas e para o capítulo IX. A tendência à queda dos coeficientes diminuiu com a idade. Para DIC houve queda na mortalidade hospitalar. Para DCBV e IC, aumento. Os coeficientes de internação hospitalar por DIC diminuíram, com exceção de algumas faixas. CONCLUSÃO: O presente estudo permitiu esclarecer alguns aspectos da morbimortalidade cardiovascular em Niterói. A redução da mortalidade populacional e hospitalar por DIC indica haver melhor qualidade na abordagem dessa condição. O aumento da mortalidade hospitalar por DCBV e IC aponta para a necessidade de se dar maior atenção à qualidade do cuidado hospitalar para esses grupos de doenças.FUNDAMENTO: La reducción de la mortalidad por enfermedades cardiovasculares se viene observando en Brasil desde hace años, se la asigna a un descenso en los factores de riesgo, a una mejora en el tratamiento y a una mortalidad hospitalaria reducida. OBJETIVO: Para

  19. Shopping cart injuries, entrapment, and childhood fatality.

    Science.gov (United States)

    Jensen, Lisbeth; Charlwood, Cheryl; Byard, Roger W

    2008-09-01

    Shopping carts may be associated with a variety of injuries, particularly in toddlers and young children. These usually relate to falls from carts or to tip-overs. Injuries that are sustained include hematomas/contusions, abrasions, lacerations, fractures, and fingertip amputations. Fatal episodes are uncommon and are usually due to blunt craniocerebral trauma from falls. A case involving a 19-month-old girl is reported who became entrapped when she inserted her head through the side frame of a cart that had been removed from a supermarket and left at her home address. Death was caused by neck compression. Although rare, the potential for lethal entrapment during unsupervised play means that the presence of stray shopping carts at private residences and in public places, including playgrounds and parks, is of concern. Strategies, such as coin deposits, should be encouraged to assist in the return of such carts to supermarkets.

  20. Tasas específicas de mortalidad en el hospital de Algeciras durante el período 1995-1996

    Directory of Open Access Journals (Sweden)

    García Ortega Cesáreo

    1997-01-01

    Full Text Available FUNDAMENTO: La mortalidad intrahospitalaria ha sido propuesta como un indicador de calidad asistencial. Así mismo, es un hecho que debe ser utilizado para la vigilancia epidemiológica y la planificación sanitaria. El objetivo de este trabajo es analizar la mortalidad del Hospital de Algeciras del Servicio Andaluz de Salud. MÉTODOS: Se ha realizado un estudio descriptivo de los enfermos dados de alta entre enero de 1995 y diciembre de 1996, utilizando como fuente de información el informe clínico de alta y/o la historia clínica. Se utilizó la estructura del informe conjunto mínimo básico de datos al alta hospitalaria (CMBD. Los episodios de hospitalización fueron agrupados en los grupos relacionados con el diagnóstico (GRD. Tras un primer análisis de todos los episodios de hospitalización, se analizaron los episodios de alta de los enfermos menores de 80 años, estableciendo el riesgo de fallecer en el hospital en función del motivo de ingreso. RESULTADOS: En el Hospital de Algeciras hubo entre enero de 1995 y diciembre de 1996 un total de 24.194 episodios de hospitalización, tasa de mortalidad del 4.1%. Se observó una mayor tasa de mortalidad en el sexo masculino (5.3% frente al femenino (3.2%, (P<0.01. En los pacientes menores de 80 años se han producido 750 muertes intrahospitalarias y continúa el exceso de mortalidad en el sexo masculino. Las causas más frecuentes de las defunciones en este grupo de edad son: 66 muertes por enfermedad cerebro-vascular (probabilidad de morir este grupo de edad si han ingresado por enfermedad cerebro-vascular IC 95% 0.12-0.19, 58 muertes por Sida (IC95% 0.09-0.15, 51 por neoplasias de bronquios y pulmón (IC95 0.18-0.30, 49 éxitus por infarto agudo de miocardio (IC95% 0.12-0.21, 39 por enfermedad pulmonar obstructiva crónica (IC95% 0.07-0.14.. CONCLUSIONES: Se confirma la numerosa información suministrada por las estadísticas de mortalidad hospitalaria, especialmente si se tienen en

  1. La mortalidad infantil y la mortalidad materna en el siglo XXI

    OpenAIRE

    Aguirre, Alejandro

    2009-01-01

    La mortalidad infantil y la mortalidad materna han sido reducidas de manera sustancial en los países desarrollados, por lo cual en esas naciones la mortalidad tiende a concentrarse en las edades avanzadas de las poblaciones. Sin embargo, en países como México no está ocurriendo un avance relevante en la disminución de la mortalidad infantil y materna, pues a pesar de los notables progresos conseguidos en ese sentido durante las décadas recientes, para seguir avanzando se requieren fuertes inv...

  2. Getting started with OpenCart module development

    CERN Document Server

    Nepali, Rupak

    2013-01-01

    Written as a step-by-step guide, Getting Started with OpenCart Module Development will teach you all you need to know about OpenCart, from custom extensions to module development.This book is for developers who want to develop OpenCart extensions and for those who want to learn more about the code workflow of OpenCart. Basic knowledge of OpenCart would be an added advantage.

  3. Análisis de eficiencia hospitalaria en Chile

    Directory of Open Access Journals (Sweden)

    Planck Barahona-Urbina

    2011-01-01

    Full Text Available Introducción: La importancia del análisis envolvente de datos (AED radica en poder determinar cuáles de los hospitales regionales presentan un mejor desempeño relativo y cuáles podrían mejorar el uso de los recursos. Objetivos: Analizar, haciendo uso de la técnica no paramétrica de análisis envolvente de datos, la eficiencia técnica hospitalaria en Chile. Diseño: Análisis de tipo no paramétrico. Lugar: Hospitales públicos regionales de Chile. Intervenciones: Aplicación del AED para la evaluación de la eficiencia de los establecimientos de la salud. Materiales: Se utilizó datos para el período comprendido entre 1997 y 2006 de las doce regiones del país más la región Metropolitana (RM, de 190 hospitales públicos de distintos grados de especialización. Se identificó datos de actividad hospitalaria y personal facultativo, esto es, como inputs a médicos, enfermeras, matronas, camas disponibles, y como variable output el egreso hospitalario. Principales medidas de resultados: Eficiencia hospitalaria. Resultados: En el año 1997, las regiones IV, VII, VIII, y IX fueron calificadas como técnicamente eficientes, lo que ha significado que han hecho un adecuado uso de sus recursos. Conclusiones: En diez años de estudio, 1997 a 2006, únicamente en el año 1997 cuatro regiones de Chile fueron eficientes. Los hospitales regionales deberían reducir sus inputs en promedio un 10% para situarse sobre la frontera eficiente. El análisis DEA es una buena herramienta para llevar a cabo mediciones de eficiencia y evaluar resultados de gestión, pues permite conocer aquellas unidades que realizan la mejor asignación de sus recursos en comparación al resto de la muestra.

  4. [THE TEN MOST CITED ARTICLES OF THE JOURNAL "NUTRICION HOSPITALARIA"].

    Science.gov (United States)

    Franco-López, Ángeles; González-Gallego, Javier; Sanz-Valero, Javier; Tuñón, María Jesús; García-De-Lorenzo, Abelardo; Culebras, Jesús M

    2015-12-01

    After 36 years of continued publication of the journal Nutrición Hospitalaria, a list with the ten most cited articles published in it is elaborated. The top ten most cited articles in the world literature and stratification according to language, English or Spanish, subject, or period of time published are also analyzed. Nutr Hosp is the most important Ibero latin American nutrition journal. Nutr Hosp published 369 items in 2014 gaining the fourth position among all the world's journals devoted to nutrition. Article publication in English, or simultaneously in Spanish and English and Open Access policy probably benefit the number of citations. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  5. [Evaluation of the journal Nutrición Hospitalaria. II. Productivity and collaboration].

    Science.gov (United States)

    Iglesias Vázquez, E; Culebras, J M; García de Lorenzo, A

    2001-01-01

    An analysis is effected of the production by authors publishing their papers in Nutrición Hospitalaria (Hospital Nutrition), as well as by the institutions at which these authors work. The productivity figures indicate a large group of sporadic authors, whereas the "regular contributors" exceed figure 1 in the indices established. In terms of collaboration, Nutrición Hospitalaria articles present between 3 and 5 signatories per paper, lower than in other journals in the same scientific field.

  6. GLYCAN-DIRECTED CAR-T CELLS.

    Science.gov (United States)

    Steentoft, Catharina; Migliorini, Denis; King, Tiffany R; Mandel, Ulla; June, Carl H; Posey, Avery D

    2018-01-23

    Cancer immunotherapy is rapidly advancing in the treatment of a variety of hematopoietic cancers, including pediatric acute lymphoblastic leukemia and diffuse large B cell lymphoma, with chimeric antigen receptor (CAR)-T cells. CARs are genetically encoded artificial T cell receptors that combine the antigen specificity of an antibody with the machinery of T cell activation. However, implementation of CAR technology in the treatment of solid tumors has been progressing much slower. Solid tumors are characterized by a number of challenges that need to be overcome, including cellular heterogeneity, immunosuppressive tumor microenvironment (TME), and, in particular, few known cancer-specific targets. Post-translational modifications that differentially occur in malignant cells generate valid cell surface, cancer-specific targets for CAR-T cells. We previously demonstrated that CAR-T cells targeting an aberrant O-glycosylation of MUC1, a common cancer marker associated with changes in cell adhesion, tumor growth, and poor prognosis, could control malignant growth in mouse models. Here, we discuss the field of glycan-directed CAR-T cells and review the different classes of antibodies specific for glycan-targeting, including the generation of high affinity O-glycopeptide antibodies. Finally, we discuss historic and recently investigated glycan targets for CAR-T cells and provide our perspective on how targeting the tumor glycoproteome and/or glycome will improve CAR-T immunotherapy. © The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Salud y mortalidad infantil en Brasil

    OpenAIRE

    Denisard Alves; Walter Belluzzo

    2005-01-01

    (Disponible en idioma inglés únicamente) La salud infantil es un aspecto fundamental del programa de políticas públicas de los países en desarrollo. A lo largo de los años se han puesto en práctica numerosas políticas destinadas al mejoramiento de la salud infantil, con diversos grados de éxito. En Brasil, dichas políticas han llevado a una disminución considerable de los niveles de mortalidad infantil durante los últimos 30 años. Sin embargo, a pesar de esa mejora, las tasas de mortalidad si...

  8. Clinical trials of CAR-T cells in China

    Directory of Open Access Journals (Sweden)

    Bingshan Liu

    2017-10-01

    Full Text Available Abstract Novel immunotherapeutic agents targeting tumor-site microenvironment are revolutionizing cancer therapy. Chimeric antigen receptor (CAR-engineered T cells are widely studied for cancer immunotherapy. CD19-specific CAR-T cells, tisagenlecleucel, have been recently approved for clinical application. Ongoing clinical trials are testing CAR designs directed at novel targets involved in hematological and solid malignancies. In addition to trials of single-target CAR-T cells, simultaneous and sequential CAR-T cells are being studied for clinical applications. Multi-target CAR-engineered T cells are also entering clinical trials. T cell receptor-engineered CAR-T and universal CAR-T cells represent new frontiers in CAR-T cell development. In this study, we analyzed the characteristics of CAR constructs and registered clinical trials of CAR-T cells in China and provided a quick glimpse of the landscape of CAR-T studies in China.

  9. Clinical trials of CAR-T cells in China.

    Science.gov (United States)

    Liu, Bingshan; Song, Yongping; Liu, Delong

    2017-10-23

    Novel immunotherapeutic agents targeting tumor-site microenvironment are revolutionizing cancer therapy. Chimeric antigen receptor (CAR)-engineered T cells are widely studied for cancer immunotherapy. CD19-specific CAR-T cells, tisagenlecleucel, have been recently approved for clinical application. Ongoing clinical trials are testing CAR designs directed at novel targets involved in hematological and solid malignancies. In addition to trials of single-target CAR-T cells, simultaneous and sequential CAR-T cells are being studied for clinical applications. Multi-target CAR-engineered T cells are also entering clinical trials. T cell receptor-engineered CAR-T and universal CAR-T cells represent new frontiers in CAR-T cell development. In this study, we analyzed the characteristics of CAR constructs and registered clinical trials of CAR-T cells in China and provided a quick glimpse of the landscape of CAR-T studies in China.

  10. Raca e mortalidade cerebrovascular no Brasil

    Directory of Open Access Journals (Sweden)

    Paulo Andrade Lotufo

    2013-12-01

    Full Text Available Sendo desconhecidas as taxas de mortalidade cerebrovascular segundo raça no Brasil, foram coletadas informações de óbitos de 2010 do Sistema de Informação de Mortalidade do Ministério da Saúde. Foram calculadas as taxas de mortalidade cerebrovascular, ajustadas por idade (por 100 mil, com intervalo de confiança de 95%, por sexo e raça/cor de pele. A diferença entre brancos, pardos e negros foi significativa para homens, com taxas, respectivamente, de 44,4 (43,5;45,3, 48,2 (47,1;49,3 e 63,3 (60.6;66,6; e para mulheres, com taxa, respectivamente, de 29,0 (28,3;29,7, 33,7 (32,8;34,6 e 51,0 (48,6;53,4. Em conclusão, a mortalidade cerebrovascular no Brasil é maior entre negros.

  11. La pedagogía hospitalaria como alternativa formativa

    Directory of Open Access Journals (Sweden)

    Marta Chaves Bellido

    2012-06-01

    Full Text Available En este artículo se presenta el trabajo que se viene realizando en el Instituto Nacional del Niño a través de la Asociación Aprendo Contigo como programa educativo recreativo que permite que los niños enfermos que ven impedida su escolaridad, tengan acceso a ella mientras están internados en los hospitales donde opera. Su misión es acompañar a los niños y jóvenes hospitalizados durante su permanencia en el hospital brindándoles educación y compañía. Este programa está adaptado a la realidad peruana ya que los niños atendidos provienen de muchas zonas del país con diferentes niveles de instrucción e incluso diferentes lenguas. La gran mayoría de niños proviene de lugares de extrema pobreza y condiciones sanitariasdeficientes. En este artículo exponemos las razones por las que consideramos que la pedagogía hospitalaria a través del Programa Aprendo Contigo es una excelente

  12. Hypothalamic CART is a new anorectic peptide regulated by leptin.

    Science.gov (United States)

    Kristensen, P; Judge, M E; Thim, L; Ribel, U; Christjansen, K N; Wulff, B S; Clausen, J T; Jensen, P B; Madsen, O D; Vrang, N; Larsen, P J; Hastrup, S

    1998-05-07

    The mammalian hypothalamus strongly influences ingestive behaviour through several different signalling molecules and receptor systems. Here we show that CART (cocaine- and amphetamine-regulated transcript), a brain-located peptide, is a satiety factor and is closely associated with the actions of two important regulators of food intake, leptin and neuropeptide Y. Food-deprived animals show a pronounced decrease in expression of CART messenger RNA in the arcuate nucleus. In animal models of obesity with disrupted leptin signalling, CART mRNA is almost absent from the arcuate nucleus. Peripheral administration of leptin to obese mice stimulates CART mRNA expression. When injected intracerebroventricularly into rats, recombinant CART peptide inhibits both normal and starvation-induced feeding, and completely blocks the feeding response induced by neuropeptide Y. An antiserum against CART increases feeding in normal rats, indicating that CART may be an endogenous inhibitor of food intake in normal animals.

  13. Factores relacionados con la mortalidad intrahospitalaria en el infarto agudo del miocardio

    Directory of Open Access Journals (Sweden)

    Yanier Coll Muñoz

    2012-09-01

    Full Text Available Fundamento: la identificación de los factores relacionados con la mortalidad en el infarto agudo del miocardio representa un eslabón primordial en la evaluación inicial de los pacientes. Objetivo: identificar los factores relacionados con la mortalidad intrahospitalaria de los pacientes con infarto agudo del miocardio, ingresados en la Unidad de Cuidados Intensivos Coronarios de Cienfuegos durante el año 2010. Método: se realizó un estudio de serie de casos, que incluyó 241 pacientes con diagnóstico de infarto agudo del miocardio, ingresados en la Unidad de Cuidados Intensivos Coronarios del Hospital General Universitario Dr. Gustavo Aldereguía Lima de Cienfuegos, en el año 2010. Las variables que se analizaron fueron: edad, sexo, antecedentes patológicos personales, tipo de infarto agudo del miocardio (según electrocardiograma y localización topográfica, frecuencia cardiaca y tensión arterial al ingreso, clasificación de la insuficiencia cardiaca según Killip Kimball, creatinina, glicemia, colesterol total, triglicéridos, CPK-MB, y eventos adversos cardiovasculares durante su estadía hospitalaria. Resultados: la edad media de los pacientes estudiados fue de 65,6 años, con predominio del sexo masculino. La hipertensión arterial, el tabaquismo y el infarto miocárdico previo fueron los antecedentes de mayor interés, predominan los pacientes sin insuficiencia cardiaca y fracción de eyección conservada. Los eventos adversos cardiovasculares más frecuentes fueron: la angina post-infarto, arritmias ventriculares malignas y el choque cardiogénico. Conclusiones: se encontró relación significativa con la mortalidad para la edad avanzada (>70 años, taquicardia, glicemia ≥7 mmol/l al ingreso, y la presentación de arritmias ventriculares y choque cardiogénico durante la evolución intrahospitalaria.

  14. Herramienta ALTER. Recursos educativos digitales en red y actividades con herramientas Web 2.0 para aulas hospitalarias

    OpenAIRE

    Serrano Sánchez, José Luis; Torres Soto, Ana

    2012-01-01

    Serrano, J.L. y Torres, A. (2012). Herramienta ALTER. Recursos educativos digitales en red y actividades con herramientas Web 2.0 para aulas hospitalarias. En M.P. Prendes y J.L. Serrano (Coords.), Las TIC en las aulas hospitalarias. Alicante: Marfil.

  15. Sistemas de Información de costos para la gestión hospitalaria

    OpenAIRE

    Vilma Vargas González; Carmen Hernández

    2009-01-01

    El presente trabajo pretende exponer aspectos fundamentales para el desarrollo de sistemas de información de costos para la gestión hospitalaria. Sistemas de información de costos, útiles en la toma de decisiones para la gestión hospitalaria, y cónsonos con los objetivos sociales que persiguen los hospitales, implica que el conocimiento de información de costos no tiene como objetivo la búsqueda de rentabilidad económica, sino optimización del uso de los recursos desde el punto de vista socia...

  16. Prevalencia de la desnutrición en pacientes con insuficiencia cardiaca congestiva y su influencia en la mortalidad

    Directory of Open Access Journals (Sweden)

    Luis G. Plata

    1994-10-01

    Full Text Available El objetivo del estudio fue determinar la frecuencia de la desnutrición (DNT en los pacientes con insuficiencia cardiaca congestiva (ICC y su relación con la morbilidad, la estancia hospitalaria y la mortalidad. A todos los pacientes con ICC que ingresaron al servicio de Medicina Interna entre febrero y diciembre de 1992, se les practicó una evaluación nutricional: antropometría (peso, talla, pliegues y circunferencias, impedancia bioeléctrica, recuento linfocitario y albumina. A cada paciente se le estableci6 la clasificación funcional, se registraron las complicaciones infecciosas y evolución de cada parámetro, estancia hospitalaria y estado al egreso. Se evaluaron 50 pacientes, 28 hombres y 22 mujeres, con una edad promedio 53.2±14.9 años, talla 161±10.05 cm y peso 59.38±13.8 Kg. EI 56 % pertenecían a la clase funcional III y IV Y la estancia fue en promedio 16.7±15.8 días. E172% presentaban algún déficit somático y el 89% visceral. EI grupo de pacientes que falleció (24 % presentaba reducción significativa de todos los pliegues cutáneos, circunferencia del brazo, resistencia, reactancia, hemoglobina y tensión arterial sistólica; igualmente presentaba mayor grado de edema y una clase funcional superior (p

  17. Primer reporte de miasis hospitalaria por Lucilia cuprina (Diptera: Calliphoridae en Costa Rica

    Directory of Open Access Journals (Sweden)

    Lucía Quesada-Lobo

    2012-12-01

    Full Text Available Introducción. Las miasis hospitalarias son entidades con una importancia manifiesta en salud pública. La documentación de este tipo de casos es escasa en la literatura biomédica regional y mundial. Objetivo. Informar un caso de miasis hospitalaria en Costa Rica, donde el agente etiológico implicado fue Lucilia cuprina (Diptera: Calliphoridae. Este caso de miasis hospitalaria figura como el primer informe para Latinoamérica asociado con este agente etiológico. Presentación del caso. Una paciente de 91 años de edad, con signos de inmunosupresión, afectación grave de la función pulmonar y asistencia respiratoria mecánica, presentó larvas en ambas fosas nasales al séptimo día después del ingreso hospitalario. Varios ejemplares fueron recolectados y procesados para su identificación. La identificación taxonómica de los ejemplares recolectados estableció que la especie de los muscomorfos correspondía a L. cuprina. Conclusión. El presente constituye el primer caso de miasis hospitalaria por L. cuprina en la literatura biomédica de Costa Rica y el primero registrado en Latinoamérica.   doi: http://dx.doi.org/10.7705/biomedica.v32i4.690

  18. Using CART to segment road images

    Science.gov (United States)

    Davies, Bob; Lienhart, Rainer

    2006-01-01

    The 2005 DARPA Grand Challenge is a 132 mile race through the desert with autonomous robotic vehicles. Lasers mounted on the car roof provide a map of the road up to 20 meters ahead of the car but the car needs to see further in order to go fast enough to win the race. Computer vision can extend that map of the road ahead but desert road is notoriously similar to the surrounding desert. The CART algorithm (Classification and Regression Trees) provided a machine learning boost to find road while at the same time measuring when that road could not be distinguished from surrounding desert.

  19. La carte scolaire et son assouplissement

    OpenAIRE

    Merle, Pierre

    2014-01-01

    Cet article a pour objet l'étude de la politique d’assouplissement de la carte scolaire mise en œuvre à partir de la rentrée scolaire 2007. Cette politique poursuit officiellement deux objectifs : apporter une plus grande liberté de choix de l’établissement aux parents ; favoriser la mixité sociale. L’étude de cette politique repose, dans un premier temps, sur l’analyse de la réalisation formelle des objectifs poursuivis (notamment la comparaison des anciens et nouveaux critères de dérogation...

  20. Guía de actividades manuales y grafoplásticas para maestros/as hospitalarias Activ Arte.

    OpenAIRE

    Villavicencio Alzamora, Ana Lucía

    2011-01-01

    El presente producto llamado Guía de Actividades Manuales y Grafoplásticas para Maestros/as Hospitalarias “ActivArte”, radica en la importancia de ofrecer una educación y ayuda los niños/as que se encuentran hospitalizados, con la adaptación de una pedagogía adecuada para ellos, definida como Pedagogía Hospitalaria. La Pedagogía Hospitalaria, debe proporcionar bienestar emocional al niño y a la familia, disminuyendo la ansiedad, mejorando su adaptación y ajuste a la hospitaliza...

  1. Resonance treatment methodology in DeCART

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kang Seog; Joo, Han Gyu; Lee, Chung Chan; Chang, Moon Hee

    2003-12-01

    The typical nuclear design procedure consists of two steps which are the transport lattice calculation for the fuel assembly and the nodal diffusion calculation for the reactor core. DeCART (Deterministic Core Analysis based on Ray Tracing) code has been developed to perform the 3-dimensional whole-core transport calculation removing some of the approximations in the 2-step procedure. This code employs the synthesis of 1- and 2-dimensional characteristics methods in the framework of the 3-dimensional CMFD (Coarse Mesh Finite Difference) formulation. The subgroup method is used for the resonance treatment. HELIOS library is used for the multi-group neutron cross section and the resonance data without any modification. This report includes the methodology of the resonance treatment in DeCART. And this report also includes the Monte Carlo resonance treatment under development for the generation of the resonance integral table and the subgroup data. The interpolation method of the equivalence cross section is reviewed for the efficient resonance transport calculation with thermal-hydraulic feedback, and the new method to consider the temperature distribution explicitly in the subgroup method is also introduced.

  2. Morbilidad y mortalidad por infecciones posoperatorias Morbidity and mortality from postoperative infections

    Directory of Open Access Journals (Sweden)

    Izvieta Despaigne Alba

    2013-03-01

    Full Text Available Introducción: a pesar de los avances de las técnicas quirúrgicas, anestésicas y de la biotecnología, las infecciones continúan aumentando la morbilidad y mortalidad del paciente operado. En este trabajo nos proponemos como objetivo determinar la morbilidad y mortalidad por infecciones posquirúrgicas según algunos factores que inciden en su aparición. Métodos: se realizó un estudio descriptivo, observacional y transversal de 207 pacientes ingresados y operados de cirugías mayores que presentaron infecciones posoperatorias en el Servicio de Cirugía General del Hospital Provincial Docente "Saturnino Lora" de Santiago de Cuba, durante el trienio 2008-2010. Resultados: la tasa global de infecciones posquirúrgicas fue de 4,6 %, mientras que la de heridas limpias representó 1,6 %. El número de intervenciones urgentes y su tasa de infección posoperatoria global superaron los de las electivas. Las infecciones incisionales superficiales, seguidas de las localizadas en órgano y espacio fueron las más frecuentes. El tiempo quirúrgico y la estadía hospitalaria promedio se elevaron en los pacientes infectados. Fallecieron 16 integrantes de la casuística, para una tasa de mortalidad de 7,7 %, atribuible fundamentalmente a la infección generalizada y el choque séptico. Conclusiones: el grado de contaminación y el tipo de cirugía se relacionaron significativamente con la aparición de las infecciones posquirúrgicas, aunque también pueden incidir las características clínico-epidemiológicas de los pacientes y la prolongación del tiempo quirúrgico, en tanto que las tasas de las infecciones posoperatorias en general y de las de heridas limpias en particular, se consideraron aceptables, así como bajas las de mortalidad al compararlas con los informes nacionales y extranjeros sobre el tema.Introduction: Despite the advances in the surgical and anesthetic techniques and in biotechnology, infections are still increasing the morbidity

  3. Professor: A motorized field-based phenotyping cart

    Science.gov (United States)

    An easy-to-customize, low-cost, low disturbance, motorized proximal sensing cart for field-based high-throughput phenotyping is described. General dimensions, motor specifications, and a remote operation application are given. The cart, named Professor, supports mounting multiple proximal sensors an...

  4. The Retarding Force on a Fan-Cart Reversing Direction

    Science.gov (United States)

    Aurora, Tarlok S.; Brunner, Bernard J.

    2011-01-01

    In introductory physics, students learn that an object tossed upward has a constant downward acceleration while going up, at the highest point and while falling down. To demonstrate this concept, a self-propelled fan cart system is used on a frictionless track. A quick push is given to the fan cart and it is allowed to move away on a track under…

  5. Shoulder joint loading and posture during medicine cart pushing task.

    Science.gov (United States)

    Xu, Xu; Lin, Jia-Hua; Boyer, Jon

    2013-01-01

    Excessive physical loads and awkward shoulder postures during pushing and pulling are risk factors for shoulder pain. Pushing a medicine cart is a major component of a work shift for nurses and medical assistants in hospitals and other health care facilities. A laboratory experiment was conducted to examine the effects of common factors (e.g., lane congestion, cart load stability, floor surface friction) on shoulder joint moment and shoulder elevation angle of participants during cart pushing. Participants pushed a medicine cart on straight tracks and turning around right-angle corners. Peak shoulder joint moments reached 25.1 Nm, 20.3 Nm, and 26.8 Nm for initial, transition, and turning phases of the pushing tasks, indicating that shoulder joint loading while pushing a medical cart is comparable to levels previously reported from heavy manual activities encountered in industry (e.g., garbage collection). Also, except for user experience, all other main study factors, including congestion level, cart load stability, location of transition strip, shoulder tendency, surface friction, and handedness, significantly influenced shoulder joint moment and shoulder elevation angle. The findings provide a better understanding of shoulder exposures associated with medicine cart operations and may be helpful in designing and optimizing the physical environment where medicine carts are used.

  6. CART in the Regulation of Appetite and Energy Homeostasis

    Directory of Open Access Journals (Sweden)

    Jackie eLau

    2014-10-01

    Full Text Available The cocaine- and amphetamine-regulated transcript (CART has been the subject of significant interest for over a decade. Work to decipher the detailed mechanism of CART function has been hampered by the lack of specific pharmacological tools like antagonists and the absence of a specific CART receptor(s. However, extensive research has been devoted to elucidate the role of the CART peptide and it is now evident that CART is a key neurotransmitter and hormone involved in the regulation of diverse biological processes, including food intake, maintenance of body weight, reward and addiction, stress response, psychostimulant effects and endocrine functions1,2. In this review, we focus on knowledge gained on CART’s role in controlling appetite and energy homeostasis, and also address certain species differences between rodents and humans.

  7. Establishing guidelines for CAR-T cells: challenges and considerations.

    Science.gov (United States)

    Wang, Wei; Qin, Di-Yuan; Zhang, Bing-Lan; Wei, Wei; Wang, Yong-Sheng; Wei, Yu-Quan

    2016-04-01

    T cells, genetically modified by chimeric antigen receptors (CAR-T), are endowed with specificity to a desired antigen and are cytotoxic to cells expressing the targeted antigen. CAR-T-based cancer immunotherapy is a promising therapy for curing hematological malignancy, such as acute lymphoid leukemia, and is promising for extending their efficacy to defeat solid tumors. To date, dozens of different CAR-T cells have been evaluated in clinical trials to treat tumors; this necessitates the establishment of guidelines for the production and application of CAR-T cells. However, it is challenging to standardize CAR-T cancer therapy because it involves a combination of gene therapy and cell therapy. In this review, we compare the existing guidelines for CAR-T cells and discuss the challenges and considerations for establishing guidance for CAR-T-based cancer immunotherapy.

  8. Involvement of CART in estradiol-induced anorexia.

    Science.gov (United States)

    Dandekar, Manoj P; Nakhate, Kartik T; Kokare, Dadasaheb M; Subhedar, Nishikant K

    2012-01-18

    Since estradiol exercises inhibitory effect on food intake, we wanted to find out if this influence of estradiol is mediated by cocaine- and amphetamine-regulated transcript peptide (CART), a well established anorectic agent in the brain. Ovariectomized (OVX) rats, replaced with estradiol to produce estrous-phase like conditions, showed a significant decrease in food intake as compared with that in OVX controls. Intracerebroventricular (icv) administration of CART (0.5-1 μg/rat) to OVX rats, resulted in a dose-dependent reduction in the food intake. The lower dose (0.25 μg) had no effect, and was considered subeffective. In estradiol replaced OVX rats, CART at subeffective dose, further reduced food intake. However, CART failed to reduce food intake in estradiol replaced OVX rats pretreated with anti-estrogenic agent tamoxifen (3 mg/kg, subcutaneous). Administration of CART antibody (1:500 dilution/rat, i.c.v.) significantly attenuated estradiol-induced anorexia in the OVX rats. While estradiol replacement significantly increased CART-immunoreactivity in the cells/fibers of paraventricular nucleus (PVN) of OVX rats, fibers in the anteroventral periventricular nucleus (AVPV), and cells/fibers in the arcuate nucleus (ARC) showed considerable reduction. These changes were attenuated following concurrent injection of tamoxifen to the estradiol replaced OVX rats. However, CART-immunoreactive cells/fibers in the periventricular area did not respond to any of the treatments. We suggest that estradiol treatment might influence the hypothalamic CART system in a site specific manner. While increased CART activity in the PVN might produce anorexia, reduction of CART in ARC and AVPV might represent a compensatory homeostatic response. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Evaluation of the New York City Green Carts program

    Directory of Open Access Journals (Sweden)

    Shannon M Farley

    2015-12-01

    Full Text Available Access to fresh fruits and vegetables is a concern, particularly among low-income populations. Mobile vending is one strategy to expand produce availability and access to increase consumption. In 2008, New York City launched a mobile vending initiative, Green Carts. We report on the evaluation. Three waves of cross-sectional observational surveys of produce availability, variety, and quality were conducted during the summers of 2008, 2009, and 2011 in a stratified random sample of stores and carts comparing establishments in Green Cart neighborhoods (n = 13 with comparison neighborhoods (n = 3. Bivariate analyses for availability, variety, and quality comparing Green Cart and comparison neighborhoods were presented across years, and logistic and negative binomial regressions were used to test whether fruit and vegetable availability, variety, and quality increased in Green Cart compared with comparison neighborhoods, adjusting for clustering and neighborhood demographics. Establishments selling fruits and vegetables in Green Cart neighborhoods increased between 2008 and 2011 (50% to 69%, p <0.0001; there was no comparable increase in comparison neighborhoods. Establishments selling more than 10 fruits and vegetables types increased from 31% to 38% (p = 0.0414 in Green Cart neighborhoods; there was no change in comparison neighborhoods. Produce quality was high among comparison establishments, with 95% and 94% meeting the quality threshold in 2008 and 2011, while declining in Green Cart neighborhood establishments from 96% to 88% (p < 0.0001. Sustained produce availability was found in Green Cart neighborhoods between 2008–2011. Green Carts are one strategy contributing to improving produce access among New Yorkers.

  10. La carte des 36 000 communes

    Directory of Open Access Journals (Sweden)

    Aliette DELAMARRE

    1989-12-01

    Full Text Available La carte généralisée du maillage communal français, obtenue à partir d'un sondage spatial au quart, met en évidence des modèles régionaux caractérisés par des mailles inégalement fines. Cette division du territoire, héritée de la trame paroissiale, a été mise en mémoire par la création, en 1789, de l'institution communale. Seuls les travaux de géographie historique permettront de découvrir les mécanismes de sa mise en place à dater des Xe-XIe, voire des VIe et VIIe siècles.

  11. Factores de riesgo de mortalidad perinatal en hospitales de la seguridad social peruana: análisis de los datos del Sistema de Vigilancia Perinatal de EsSalud

    Directory of Open Access Journals (Sweden)

    Alejandro Arrieta-Herrera

    2009-12-01

    Full Text Available Introducción: El estudio utiliza la información del Sistema de Vigilancia Perinatal (SVP de la red hospitalaria del Seguro Social de Salud del Perú (EsSalud para identificar factores de riesgo que inciden en la mortalidad perinatal. El SVP incluye policlínicos y hospitales en todo el Perú, con diferentes niveles de capacidad resolutiva. El estudio agrupa hospitales según mayor y menor capacidad de resolución, para investigar la magnitud de la incidencia de los factores de riesgo en cada grupo. Finalmente, el estudio resalta la importancia de mantener un sistema de información perinatal eficiente y ágil que pueda ser integrado entre diferentes redes de salud en el país, con el objetivo de reducir la mortalidad perinatal nacional. Objetivos: El primer objetivo fue encontrar los principales factores de riesgo de mortalidad perinatal en la red hospitalaria de EsSalud. El segundo objetivo fue identificar diferencias en la magnitud de la incidencia de dichos factores en hospitales de menor y mayor capacidad resolutiva. Diseño: Estudio descriptivo, comparativo y transversal. Lugar: Red nacional de hospitales de EsSalud, Perú. Participantes: Madres y sus recién nacidos. Intervenciones: Se utilizó información clínica del SVP de EsSalud para estimar probabilidad de muerte perinatal, basado en un modelo logístico multivariado, que incluyó 108 813 nacimientos correspondientes a madres y sus recién nacidos en EsSalud, en los años 2005 y 2006. Principales medidas de resultados: Muertes perinatales. Resultados: La anomalía congénita fue el principal factor de riesgo de la mortalidad perinatal en los hospitales de menor y mayor capacidad resolutiva (OR=30,99 y 15,26, respectivamente, seguido por prematuridad menor a 32 semanas (OR=15,68 y 4,20 y peso mayor a 4 000 gramos (OR=4,17 y 3,87. Factores de riesgo de la madre también resultaron asociados a mortalidad perinatal, pero en menor magnitud, resaltando el sangrado genital después de la

  12. Sistemas de Información de costos para la gestión hospitalaria

    Directory of Open Access Journals (Sweden)

    Vilma Vargas González

    2009-01-01

    Full Text Available El presente trabajo pretende exponer aspectos fundamentales para el desarrollo de sistemas de información de costos para la gestión hospitalaria. Sistemas de información de costos, útiles en la toma de decisiones para la gestión hospitalaria, y cónsonos con los objetivos sociales que persiguen los hospitales, implica que el conocimiento de información de costos no tiene como objetivo la búsqueda de rentabilidad económica, sino optimización del uso de los recursos desde el punto de vista social. En la elaboración del estudio, se realizó un análisis teórico-bibliográfico, articulación de la teoría con la evidencia empírica y revisión del marco legal. Se concluye sobre la necesidad de fortalecer el cálculo y desarrollo de indicadores y sistemas de información de costos con personal capacitado para su implementación, asegurando la confiabilidad, pertinencia y oportunidad de los resultados generados por dichos sistemas, y su uso efectivo para la gestión hospitalaria.

  13. [Analysis of citations and national and international impact factor of Farmacia Hospitalaria (2001-2005)].

    Science.gov (United States)

    Aleixandre-Benavent, R; González Alcaide, G; Miguel-Dasit, A; González de Dios, J; de Granda Orive, J I; Valderrama Zurián, J C

    2007-01-01

    The objective of this study is to analyse the citation patterns and impact and immediacy indicators of the Farmacia Hospitalaria journal during the period 2001-2005. An analysis of citations chosen from 101 Spanish health science journals was carried out in order to determine the citing and cited journals and the national and international impact and immediacy indicators. A similar methodology used by Thomson ISI in Science Citation Index (SCI) and Journal Citation Reports (JRC) was applied. Farmacia Hospitalaria made 1,370 citations to 316 different journals. The percentage of self-citations was 9%. The national impact factor increased from 0.178 points in 2001 to 0.663 points in 2005 while the international impact factor increased from 0.178 to 0.806 for the same period. The analysis of citation patterns demonstrates the multidisciplinary nature of Farmacia Hospitalaria and a significant growth in the impact indicators over recent years. These indicators are higher than those of some other pharmacy journals included in Journal Citation Reports. Self-citation was not excessive and was similar to that of other journals.

  14. La mortalidad perinatal según 2 fuentes de información Perinatal mortality according to 2 information sources

    Directory of Open Access Journals (Sweden)

    Adriana Freitas Ramírez

    2008-08-01

    Full Text Available Objetivo: Evaluar la diferencia en muertes perinatales (MP ocurridas en Cataluña y su evolución según 2 fuentes de información sanitaria. Métodos: Los datos proceden de la estadística de mortalidad (Departament de Salut e Institut d'Estadística de Catalunya y del Conjunto Mínimo Básico de Datos de Altas Hospitalarias (CMBDAH del Servei Català de la Salut del período 2000-2003. Se describen las frecuencias totales de MP según si cumplen o no criterio legal de declaración. Resultados: La estadística de mortalidad registró un 27,2% menos de MP, un 44,77% menos de muertes fetales y un 13,5% más de muertes neonatales precoces que el CMBDAH. Estos porcentajes son menores considerando sólo los casos con criterios legales de declaración. Conclusión: Las diferencias de casos entre ambas fuentes están relacionadas con características del recién nacido: bajo peso al nacer, prematuridad y lugar en que se produjo. Los datos hospitalarios podrían mejorar la estadística de mortalidad perinatal.Objective: To evaluate differences in the number of cases of perinatal mortality in Catalonia (Spain recorded in 2 health information systems, as well as trends in this phenomenon. Methods: Data were obtained from the mortality statistics (Health Department and the Catalan Institute of Statistics and the minimum data set (MDS for hospital discharges of the Catalan Health Service from 2000-2003. The frequencies are given for the cases reported and for cases following the legal criteria for reporting. Results: The mortality statistics registered 27.2% fewer perinatal deaths, 44.77% fewer fetal deaths and 13.5% more early neonatal deaths than the MDS. These percentages were lower when only the cases following the legal criteria for reporting were considered. Conclusion: The differences between the two sources were related to low birth weight, prematurity, and the place of occurrence. Use of hospital data might improve the quality of perinatal

  15. Factores de riesgo y evaluación del riesgo de muerte hospitalaria en la sustitución valvular mitral con prótesis mecánica

    Directory of Open Access Journals (Sweden)

    Karel Morlans Hernández

    2003-06-01

    Full Text Available Se realizó un estudio prospectivo en 1301 pacientes sometidos a sustitución valvular mitral, en el Instituto de Cardiología y Cirugía Cardiovascular entre enero de 1996 y mayo de 2001. Los objetivos fueron conocer la mortalidad operatoria y establecer las bases de un sistema de puntaje de riesgo de mortalidad. Se determinó el riesgo relativo y las probabilidades de muerte. La mortalidad hospitalaria fue de 9,0 % (27 pacientes. La causa de muerte más frecuente fue el fallo multiorgánico (14 pacientes,51,8 %. Los factores de riesgo más importantes fueron: en el preoperatorio, la cardiomegalia severa (RR 6,1 y la urgencia de la operación (RR 5,1; en el transoperatorio, el bajo gasto cardíaco (RR 6,0 y en el posoperatorio la disfunción neurológica (RR ,33,6 y el fallo multiorgánico (RR 26,9. La mortalidad operatoria es aceptable. El sistema de puntaje de riesgo de muerte es factible y debe ser automatizado y validadoA prospective study was conducted among 1 301 patients who underwent valvular mitral replacement at the Institute of Cardiology and Cardiovascular Surgery from January, 1996, to May, 2001, aimed at knowing the operative mortality and to establish the bases of a mortality risk scoring system. The relative risk and the death probabilities were determined. The hospital mortality was 9.0 % (27 patients. The most frequent cause of death was multiple organ failure (14 patients, 51.8 % The most important risk factors were: in the preoperative, severe cardiomegaly (RR 6.1 and emergency surgery (RR 5.1; in the transoperative, low cardiac output (RR 6.0; and in the postoperative, neurological dysfunction (RR 33.6 and multiple organ failure (RR 26.9. Operative mortality was acceptable. The death risk scoring system is feasible and it should be automated and validated

  16. Prevalencia de infecciones hospitalarias en un hospital peruano de nivel IV, en el año 2008.

    Directory of Open Access Journals (Sweden)

    Luis Francisco Hidalgo

    2011-04-01

    Full Text Available Objetivo: Determinar la prevalencia puntual de infecciones hospitalarias (IH en un hospital peruano de Nivel IV, en el año 2008. Material y métodos: Estudio descriptivo de corte transversal. Infecciones hospitalarias fueron identificadas empleando los criterios del Centers for Disease Control and Prevention (CDC de 1999. Resultados: En total se evaluaron 1578 pacientes: 685 varones y 893 mujeres. La prevalencia de infecciones hospitalarias por 100 pacientes hospitalizados fue de 7,54 (7,05, 6,77, 7,31, 4,55, 0,75 y 26,85, en los servicios de Medicina, Cirugía, Pediatría, Ginecología–Obstetricia, Emergencia y Unidad de Cuidados Intensivos respectivamente. El número de pacientes con infecciones hospitalarias fue 119, 62 varones y 57 mujeres. La mediana de hospitalización en los pacientes con infecciones hospitalarias fue de 22 días y 6 días en los pacientes que no presentaron IH. 127 infecciones hospitalarias diagnosticadas en los 119 pacientes: 113 con una infección hospitalaria, cuatro pacientes con dos y dos pacientes con tres. La IH más común fue neumonía (25,2%, seguida por infecciones de tracto urinario (24,4%, infección de herida quirúrgica profunda (11% y bacteriemia (6,3%. De 32 pacientes con neumonía nosocomial, 10 tenían ventilación mecánica. 61,3% de los pacientes con infección de tracto urinario hospitalario contaba con catéter urinario. Los agentes infecciosos más comunes fueron Pseudomona aeruginosa 16,1% y Staphylococcus aureus 9,7%. Conclusiones: La prevalencia de infecciones intrahospitalarias hallada se encuentra en el rango esperado para hospitales de similar complejidad. (Rev Med Hered 2011;22:76-81.

  17. CAR-T Cell Therapies From the Transfusion Medicine Perspective.

    Science.gov (United States)

    Fesnak, Andrew; Lin, ChieYu; Siegel, Don L; Maus, Marcela V

    2016-07-01

    The use of chimeric antigen receptor (CAR)-T cell therapy for the treatment of hematologic malignancies has generated significant excitement over the last several years. From a transfusion medicine perspective, the implementation of CAR-T therapy as a potential mainstay treatment for not only hematologic but also solid-organ malignancies represents a significant opportunity for growth and expansion. In this review, we will describe the rationale for the development of genetically redirected T cells as a cancer therapeutic, the different elements that are required to engineer these cells, as well as an overview of the process by which patient cells are harvested and processed to create and subsequently validate CAR-T cells. Finally, we will briefly describe some of the toxicities and clinical efficacy of CAR-T cells in the setting of patients with advanced malignancy. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Ejection of a rear facing, golf cart passenger.

    Science.gov (United States)

    Schau, Kyle; Masory, Oren

    2013-10-01

    The following report details the findings of a series of experiments and simulations performed on a commercially available, shuttle style golf cart during several maneuvers involving rapid accelerations of the vehicle. It is determined that the current set of passive restraints on these types of golf carts are not adequate in preventing ejection of a rear facing passenger during rapid accelerations in the forward and lateral directions. Experimental data and simulations show that a hip restraint must be a minimum of 13 in. above the seat in order to secure a rear facing passenger during sharp turns, compared to the current restraint height of 5 in. Furthermore, it is determined that a restraint directly in front of the rear facing passenger is necessary to prevent ejection. In addressing these issues, golf cart manufacturers could greatly reduce the likelihood of injury due to ejection of a rear facing, golf cart passenger. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Factores de riesgo de mortalidad precoz del Trasplante Pulmonar

    OpenAIRE

    Kreis Esmendi, Germán

    2006-01-01

    Consultable des del TDX Títol obtingut de la portada digitalitzada A pesar de la experiencia acumulada, la mortalidad postoperatoria temprana del trasplante pulmonar continua siendo elevada. Los factores asociados a este evento permanecen siendo controvertidos. Objetivo: Revisar la serie de trasplantes pulmonares realizados en el Hospital Vall d' Hebron para establecer la supervivencia acumulada e identificar los factores asociados con riesgo de mortalidad postoperatoria precoz. Pacient...

  20. Clinical trials of CAR-T cells in China

    OpenAIRE

    Bingshan Liu; Yongping Song; Delong Liu

    2017-01-01

    Abstract Novel immunotherapeutic agents targeting tumor-site microenvironment are revolutionizing cancer therapy. Chimeric antigen receptor (CAR)-engineered T cells are widely studied for cancer immunotherapy. CD19-specific CAR-T cells, tisagenlecleucel, have been recently approved for clinical application. Ongoing clinical trials are testing CAR designs directed at novel targets involved in hematological and solid malignancies. In addition to trials of single-target CAR-T cells, simultaneous...

  1. La Carte de Localisation Probable des Avalanches (CPLA

    Directory of Open Access Journals (Sweden)

    Gilles BORREL

    1994-12-01

    Full Text Available La Carte de Localisation Probable des Avalanches (CPLA indique l’enveloppe des limites extrêmes connues atteintes par les avalanches, ainsi que les travaux de protection associés. Il s’agit d’un document informatif et non d’une carte de risque. Depuis 1990, les données thématiques sont numérisées.

  2. Conocimientos y actitudes sobre bioseguridad hospitalaria de los internos de salud en la ciudad de Iquitos;

    OpenAIRE

    Ferreira Yong, Bessy Del Pilar; Chau Quintanilla, Víctor

    2010-01-01

    El presente estudio tiene como objetivo determinar la relación entre el nivel de conocimiento y las actitudes de los internos de las ciencias de la salud sobre normas de bioseguridad de los hospitales del Ministerio de Salud y Hospital Ill EsSalud, !quitos 2009. Se planteó la hipótesis: Existe relación significativa entre el nivel de conocimiento y las actitudes sobre la práctica de las normas de bioseguridad hospitalaria. El método empleado fue no experimental, correlacional y transversal. L...

  3. Atención a la salud y morbimortalidad materna: un estudio de casos y controles de base hospitalaria en dos regiones de Colombia (Bogotá y Antioquia, 2009-2011

    Directory of Open Access Journals (Sweden)

    Francisco J. Yepes

    Full Text Available Resumen: El objetivo fue identificar si formas de pago y regímenes de aseguramiento están asociados con la mortalidad materna y morbilidad obstétrica extrema. Estudio de casos y controles de base hospitalaria en dos regiones de Colombia, 2009-2011. Los datos se obtuvieron de la historia clínica de cada gestante. Se utilizó regresión logística no condicional. El resultado fue: 1.011 pacientes, 337 casos y 674 controles. Ningún componente de calidad fue estadísticamente significativo en ambas regiones. En Bogotá, el riesgo de complicación obstétrica, significativamente mayor en Régimen Contributivo que en Subsidiado y no aseguradas; Antioquia, aunque hubo asociaciones similares, no estadísticamente significativas. Diferencias en morbilidad por régimen de pago no estadísticamente significativas en Antioquia ni Bogotá. Factores asociados a la morbimortalidad materna diferentes, según la población estudiada, lo que sugiere la necesidad de estudios locales para identificar factores determinantes propios y tomar decisiones pertinentes.

  4. La vida: medición y análisis de la mortalidad

    OpenAIRE

    Rodríguez Jaume, María José

    2008-01-01

    Presentación de: las fuentes demográficas para el estudio de la mortalidad, de las características de la mortalidad como fenómeno demográfico; y de los conceptos con los que se operacionaliza el fenómeno demográfico objeto de estudio. Introduccion en la medición del fenómeno de la mortalidad de la mano de tres indicadores: Tasa Bruta de Mortalidad, Tasas Específicas de Mortalidad, Tasa de Mortalidad Infantil.

  5. Parallelization characteristics of the DeCART code

    International Nuclear Information System (INIS)

    Cho, J. Y.; Joo, H. G.; Kim, H. Y.; Lee, C. C.; Chang, M. H.; Zee, S. Q.

    2003-12-01

    This report is to describe the parallelization characteristics of the DeCART code and also examine its parallel performance. Parallel computing algorithms are implemented to DeCART to reduce the tremendous computational burden and memory requirement involved in the three-dimensional whole core transport calculation. In the parallelization of the DeCART code, the axial domain decomposition is first realized by using MPI (Message Passing Interface), and then the azimuthal angle domain decomposition by using either MPI or OpenMP. When using the MPI for both the axial and the angle domain decomposition, the concept of MPI grouping is employed for convenient communication in each communication world. For the parallel computation, most of all the computing modules except for the thermal hydraulic module are parallelized. These parallelized computing modules include the MOC ray tracing, CMFD, NEM, region-wise cross section preparation and cell homogenization modules. For the distributed allocation, most of all the MOC and CMFD/NEM variables are allocated only for the assigned planes, which reduces the required memory by a ratio of the number of the assigned planes to the number of all planes. The parallel performance of the DeCART code is evaluated by solving two problems, a rodded variation of the C5G7 MOX three-dimensional benchmark problem and a simplified three-dimensional SMART PWR core problem. In the aspect of parallel performance, the DeCART code shows a good speedup of about 40.1 and 22.4 in the ray tracing module and about 37.3 and 20.2 in the total computing time when using 48 CPUs on the IBM Regatta and 24 CPUs on the LINUX cluster, respectively. In the comparison between the MPI and OpenMP, OpenMP shows a somewhat better performance than MPI. Therefore, it is concluded that the first priority in the parallel computation of the DeCART code is in the axial domain decomposition by using MPI, and then in the angular domain using OpenMP, and finally the angular

  6. CAR-T therapy for leukemia: progress and challenges.

    Science.gov (United States)

    Wang, Xin; Xiao, Qing; Wang, Zhe; Feng, Wen-Li

    2017-04-01

    Despite the rapid development of therapeutic strategies, leukemia remains a type of difficult-to-treat hematopoietic malignancy that necessitates introduction of more effective treatment options to improve life expectancy and quality of patients. Genetic engineering in adoptively transferred T cells to express antigen-specific chimeric antigen receptors (CARs) has proved highly powerful and efficacious in inducing sustained responses in patients with refractory malignancies, as exemplified by the success of CD19-targeting CAR-T treatment in patients with relapsed acute lymphoblastic leukemia. Recent strategies, including manipulating intracellular activating domains and transducing viral vectors, have resulted in better designed and optimized CAR-T cells. This is further facilitated by the rapid identification of an accumulating number of potential leukemic antigens that may serve as therapeutic targets for CAR-T cells. This review will provide a comprehensive background and scrutinize recent important breakthrough studies on anti-leukemia CAR-T cells, with focus on recently identified antigens for CAR-T therapy design and approaches to overcome critical challenges. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Implementation of Generalized Adjoint Equation Solver for DeCART

    International Nuclear Information System (INIS)

    Han, Tae Young; Cho, Jin Young; Lee, Hyun Chul; Noh, Jae Man

    2013-01-01

    In this paper, the generalized adjoint solver based on the generalized perturbation theory is implemented on DeCART and the verification calculations were carried out. As the results, the adjoint flux for the general response coincides with the reference solution and it is expected that the solver could produce the parameters for the sensitivity and uncertainty analysis. Recently, MUSAD (Modules of Uncertainty and Sensitivity Analysis for DeCART) was developed for the uncertainty analysis of PMR200 core and the fundamental adjoint solver was implemented into DeCART. However, the application of the code was limited to the uncertainty to the multiplication factor, k eff , because it was based on the classical perturbation theory. For the uncertainty analysis to the general response as like the power density, it is necessary to develop the analysis module based on the generalized perturbation theory and it needs the generalized adjoint solutions from DeCART. In this paper, the generalized adjoint solver is implemented on DeCART and the calculation results are compared with the results by TSUNAMI of SCALE 6.1

  8. IL-7 and CCL19 expression in CAR-T cells improves immune cell infiltration and CAR-T cell survival in the tumor.

    Science.gov (United States)

    Adachi, Keishi; Kano, Yosuke; Nagai, Tomohiko; Okuyama, Namiko; Sakoda, Yukimi; Tamada, Koji

    2018-04-01

    Infiltration, accumulation, and survival of chimeric antigen receptor T (CAR-T) cells in solid tumors is crucial for tumor clearance. We engineered CAR-T cells to express interleukin (IL)-7 and CCL19 (7 × 19 CAR-T cells), as these factors are essential for the maintenance of T-cell zones in lymphoid organs. In mice, 7 × 19 CAR-T cells achieved complete regression of pre-established solid tumors and prolonged mouse survival, with superior anti-tumor activity compared to conventional CAR-T cells. Histopathological analyses showed increased infiltration of dendritic cells (DC) and T cells into tumor tissues following 7 × 19 CAR-T cell therapy. Depletion of recipient T cells before 7 × 19 CAR-T cell administration dampened the therapeutic effects of 7 × 19 CAR-T cell treatment, suggesting that CAR-T cells and recipient immune cells collaborated to exert anti-tumor activity. Following treatment of mice with 7 × 19 CAR-T cells, both recipient conventional T cells and administered CAR-T cells generated memory responses against tumors.

  9. Simulation and Test of a Fuel Cell Hybrid Golf Cart

    Directory of Open Access Journals (Sweden)

    Jingming Liang

    2014-01-01

    Full Text Available This paper establishes the simulation model of fuel cell hybrid golf cart (FCHGC, which applies the non-GUI mode of the Advanced Vehicle Simulator (ADVISOR and the genetic algorithm (GA to optimize it. Simulation of the objective function is composed of fuel consumption and vehicle dynamic performance; the variables are the fuel cell stack power sizes and the battery numbers. By means of simulation, the optimal parameters of vehicle power unit, fuel cell stack, and battery pack are worked out. On this basis, GUI mode of ADVISOR is used to select the rated power of vehicle motor. In line with simulation parameters, an electrical golf cart is refitted by adding a 2 kW hydrogen air proton exchange membrane fuel cell (PEMFC stack system and test the FCHGC. The result shows that the simulation data is effective but it needs improving compared with that of the real cart test.

  10. New development in CAR-T cell therapy.

    Science.gov (United States)

    Wang, Zhenguang; Wu, Zhiqiang; Liu, Yang; Han, Weidong

    2017-02-21

    Chimeric antigen receptor (CAR)-engineered T cells (CAR-T cells) have yielded unprecedented efficacy in B cell malignancies, most remarkably in anti-CD19 CAR-T cells for B cell acute lymphoblastic leukemia (B-ALL) with up to a 90% complete remission rate. However, tumor antigen escape has emerged as a main challenge for the long-term disease control of this promising immunotherapy in B cell malignancies. In addition, this success has encountered significant hurdles in translation to solid tumors, and the safety of the on-target/off-tumor recognition of normal tissues is one of the main reasons. In this mini-review, we characterize some of the mechanisms for antigen loss relapse and new strategies to address this issue. In addition, we discuss some novel CAR designs that are being considered to enhance the safety of CAR-T cell therapy in solid tumors.

  11. Improving Odometric Accuracy for an Autonomous Electric Cart

    Directory of Open Access Journals (Sweden)

    Jonay Toledo

    2018-01-01

    Full Text Available In this paper, a study of the odometric system for the autonomous cart Verdino, which is an electric vehicle based on a golf cart, is presented. A mathematical model of the odometric system is derived from cart movement equations, and is used to compute the vehicle position and orientation. The inputs of the system are the odometry encoders, and the model uses the wheels diameter and distance between wheels as parameters. With this model, a least square minimization is made in order to get the nominal best parameters. This model is updated, including a real time wheel diameter measurement improving the accuracy of the results. A neural network model is used in order to learn the odometric model from data. Tests are made using this neural network in several configurations and the results are compared to the mathematical model, showing that the neural network can outperform the first proposed model.

  12. Improving Odometric Accuracy for an Autonomous Electric Cart.

    Science.gov (United States)

    Toledo, Jonay; Piñeiro, Jose D; Arnay, Rafael; Acosta, Daniel; Acosta, Leopoldo

    2018-01-12

    In this paper, a study of the odometric system for the autonomous cart Verdino, which is an electric vehicle based on a golf cart, is presented. A mathematical model of the odometric system is derived from cart movement equations, and is used to compute the vehicle position and orientation. The inputs of the system are the odometry encoders, and the model uses the wheels diameter and distance between wheels as parameters. With this model, a least square minimization is made in order to get the nominal best parameters. This model is updated, including a real time wheel diameter measurement improving the accuracy of the results. A neural network model is used in order to learn the odometric model from data. Tests are made using this neural network in several configurations and the results are compared to the mathematical model, showing that the neural network can outperform the first proposed model.

  13. New development in CAR-T cell therapy

    Directory of Open Access Journals (Sweden)

    Zhenguang Wang

    2017-02-01

    Full Text Available Abstract Chimeric antigen receptor (CAR-engineered T cells (CAR-T cells have yielded unprecedented efficacy in B cell malignancies, most remarkably in anti-CD19 CAR-T cells for B cell acute lymphoblastic leukemia (B-ALL with up to a 90% complete remission rate. However, tumor antigen escape has emerged as a main challenge for the long-term disease control of this promising immunotherapy in B cell malignancies. In addition, this success has encountered significant hurdles in translation to solid tumors, and the safety of the on-target/off-tumor recognition of normal tissues is one of the main reasons. In this mini-review, we characterize some of the mechanisms for antigen loss relapse and new strategies to address this issue. In addition, we discuss some novel CAR designs that are being considered to enhance the safety of CAR-T cell therapy in solid tumors.

  14. Mortalidad por paludismo en Colombia, 1979-2008

    OpenAIRE

    Pablo Chaparro; Julio Padilla

    2012-01-01

    Introducción. En Colombia, el paludismo representa un grave problema de salud pública. Se estima que, aproximadamente, 60 % de la población se encuentra en riesgo de enfermar o de morir por esta causa. Objetivo. Describir la tendencia de la mortalidad por paludismo en Colombia desde 1979 hasta 2008. Materiales y métodos. Se llevó a cabo un estudio descriptivo para determinar la tendencia de las tasas de mortalidad. Las fuentes de información fueron las bases de datos de las defunciones...

  15. Mortalidad cardiovascular: ¿cómo prevenirla?

    OpenAIRE

    Estruch, Ramón

    2014-01-01

    El primer escalón en la prevención y tratamiento de muchas enfermedades crónicas como las enfermedades cardiovasculares es el seguimiento de una dieta saludable. Varios estudios epidemiológicos han mostrado que el seguimiento de una dieta mediterránea tradicional reduce la mortalidad global, la mortalidad cardiovascular y la incidencia de enfermedades crónicas como las cardiovasculares, el cáncer y las patologías neurodegenerativas. No obstante, un único estudio ha analizado los efectos de la...

  16. An rf communications system for the West Valley transfer cart

    International Nuclear Information System (INIS)

    Crutcher, R.I.; Moore, M.R.

    1993-01-01

    A prototype radio frequency communications system for digital data was designed and built by Oak Ridge National Laboratory for use in controlling the vitrification facility transfer cart at the West Valley Nuclear Services facility in New York. The communications system provides bidirectional wireless data transfer between the operator control station and the material transfer cart. The system was designed to operate in radiation fields of 10 4 R/h while withstanding a total integrated dose of 10 7 R of gamma radiation. Implementation of antenna spatial diversity, automatic gain control, and spectral processing improves operation in the reflective environment of the metal-lined reprocessing cells

  17. Vermeer et les cartes de géographie.

    Directory of Open Access Journals (Sweden)

    Jean MARTINON

    1987-09-01

    Full Text Available De nombreux tableaux de Vermeer sont «tapissés» de cartes de géographie. Objets scientifiques, elles témoignent de l'importance des découvertes au XVIIe siècle en Europe et de l'ouverture des Pays-Bas sur le monde. Objets de décoration, les cartes tendent à se confondre avec des représentations paysagères. Objets romanesques, elles introduisent le lointain et le rêve dans les intérieurs confinés de la bourgeoisie d'Amsterdam.

  18. CART neurons in the arcuate nucleus and lateral hypothalamic area exert differential controls on energy homeostasis

    Directory of Open Access Journals (Sweden)

    Jackie Lau

    2018-01-01

    Full Text Available Objective: The cocaine- and amphetamine-regulated transcript (CART codes for a pivotal neuropeptide important in the control of appetite and energy homeostasis. However, limited understanding exists for the defined effector sites underlying CART function, as discrepant effects of central CART administration have been reported. Methods: By combining Cart-cre knock-in mice with a Cart adeno-associated viral vector designed using the flip-excision switch (AAV-FLEX technology, specific reintroduction or overexpression of CART selectively in CART neurons in the arcuate nucleus (Arc and lateral hypothalamic area (LHA, respectively, was achieved. The effects on energy homeostasis control were investigated. Results: Here we show that CART neuron-specific reintroduction of CART into the Arc and LHA leads to distinct effects on energy homeostasis control. Specifically, CART reintroduction into the Arc of otherwise CART-deficient Cartcre/cre mice markedly decreased fat mass and body weight, whereas CART reintroduction into the LHA caused significant fat mass gain and lean mass loss, but overall unaltered body weight. The reduced adiposity in ArcCART;Cartcre/cre mice was associated with an increase in both energy expenditure and physical activity, along with significantly decreased Npy mRNA levels in the Arc but with no change in food consumption. Distinctively, the elevated fat mass in LHACART;Cartcre/cre mice was accompanied by diminished insulin responsiveness and glucose tolerance, greater spontaneous food intake, and reduced energy expenditure, which is consistent with the observed decrease of brown adipose tissue temperature. This is also in line with significantly reduced tyrosine hydroxylase (Th and notably increased corticotropin-releasing hormone (Crh mRNA expressions in the paraventricular nucleus (PVN. Conclusions: Taken together, these results identify catabolic and anabolic effects of CART in the Arc and LHA, respectively, demonstrating for

  19. Overview of the West Valley Vitrification Facility transfer cart control system

    International Nuclear Information System (INIS)

    Bradley, E.C.; Rupple, F.R.

    1993-01-01

    Oak Ridge National Laboratory (ORNL) has designed the control system for the West Valley Demonstration Project Vitrification Facility transfer cart. The transfer cart will transfer canisters of vitrified high-level waste remotely within the Vitrification Facility. The control system will operate the cart under battery power by wireless control. The equipment includes cart mounted control electronics, battery charger, control pendants, engineer's console, and facility antennas

  20. Mortalidade por insuficiência cardíaca: análise ampliada e tendência temporal em três estados do Brasil Mortalidad por insuficiencia cardiaca: análisis ampliado y tendencia temporal en tres estados de Brasil Mortality due to heart failure: extended analysis and temporal trend in three states of Brazil

    Directory of Open Access Journals (Sweden)

    Eduardo Nagib Gaui

    2010-01-01

    Full Text Available FUNDAMENTO: A insuficiência cardíaca (IC é uma doença crônica de grande prevalência e altas taxas de mortalidade. A mortalidade por IC, no Brasil, tem sido estudada mais frequentemente com dados de internações hospitalares. OBJETIVO: Avaliar as taxas de mortalidade por IC, por sexo e faixa etária, no conjunto dos estados do Rio de Janeiro, São Paulo e Rio Grande do Sul, de 1999 a 2005. MÉTODOS: As informações foram obtidas dos atestados de óbito examinados nos três estados. A mortalidade por IC foi avaliada em modo restrito (causa básica de morte, modo abrangente (presente em qualquer linha do atestado e modo ampliado (todos os códigos com presença de IC. RESULTADOS: As taxas específicas de mortalidade apresentaram tendências de quedas nítidas nos grupos de idade, exceto nos de 80 anos ou mais. As taxas aumentaram com a idade, sendo maiores nos homens, de forma clara, até os 80 anos. As taxas de mortalidade por IC foram três vezes maiores no modo abrangente do que no modo restrito. O modo ampliado acrescentou ainda 20% de óbitos em que havia IC. CONCLUSÃO: Os resultados deste estudo demonstram tendências de quedas nas taxas de mortalidade por IC no conjunto dos três estados - cerca de 43% do Brasil -, de 1999 a 2005. A metodologia de causas múltiplas de morte, além das básicas, permite apresentar dimensão mais abrangente da importância da IC como causa de óbito. A seleção adequada dos códigos da Classificação Internacional de Doenças (CID, que compreendem a totalidade do fenômeno de IC, permanece como desafio para futuros estudos.FUNDAMENTO: La insuficiencia cardiaca (IC es una enfermedad crónica de gran prevalencia y altas tasas de mortalidad. La mortalidad por IC, en Brasil, se ha estudiado más frecuentemente con datos de internaciones hospitalarias. OBJETIVO: Evaluar las tasas de mortalidad por IC, por sexo e intervalo de edades, en el conjunto de los estados de Rio de Janeiro, São Paulo y Rio Grande

  1. Análisis predictivo de los eventos adversos relacionados con los indicadores de eficiencia hospitalaria de una IPS de Bogotá

    OpenAIRE

    Salamanca, Lucia; Mora, Sandra

    2015-01-01

    En este estudio se realizó un análisis predictivo de la aparición de eventos adversos de los pacientes de una IPS de Bogotá, Mederi Hospital Universitario de Barrios Unidos (HUBU) durante el año 2013; relacionados con los indicadores de eficiencia hospitalaria (Porcentaje de ocupación hospitalaria, número de egresos hospitalarios, promedio de estancia hospitalaria, número de egresos de urgencias, promedio de estancia en urgencias). Los datos fueron exportados a una matriz de análisis de...

  2. Mortalidade e morbidade da cidade do Rio de Janeiro imperial

    Directory of Open Access Journals (Sweden)

    Maria Luiza Marcílio

    1993-07-01

    Full Text Available Trata o artigo dos primeiros resultados de um Projeto de Pesquisa sobre a "História Social da Saúde no Brasil (séculos 18 e 19", que estamos desenvolvendo. Contextualizamos sumariamente as condições sanitárias do Rio de Janeiro, durante o Império e a ação do Governo e da Academia Imperial de Medicina.  Calculamos os níveis da mortalidade geral e diferenciada (livres e escravos e mortalidade infantil. Descobrimos que anualmente e até o final do século, a mortalidade foi inferior à natalidade. O movimento sazonal mostrou aos que os meses quentes e úmidos eram os de maior mortalidade. Enfim, procuramos mapear a cronologia das grandes epidemias que assolaram a população carioca no século passado e conhecer as principais moléstias crônicas mais mortíferas. A tuberculose pulmonar por si só foi responsável por cerca de 15% das mortes em todo o período.

  3. Smart Shopping Carts: How Real-Time Feedback Influences Spending

    NARCIS (Netherlands)

    Ittersum, van K.; Wansink, B.; Pennings, J.M.E.; Sheehan, D.

    2013-01-01

    Although interest in smart shopping carts is increasing, both retailers and consumer groups have concerns about how real-time spending feedback will influence shopping behavior. Building on budgeting and spending theories, the authors conduct three lab and grocery store experiments that robustly

  4. Smart shopping carts : How real-time feedback influences spending

    NARCIS (Netherlands)

    van Ittersum, Koert; Wansink, B.; Pennings, J.M.E.; Sheehan, D.

    Although interest in smart shopping carts is increasing, both retailers and consumer groups have concerns about how real-time spending feedback will influence shopping behavior. Building on budgeting and spending theories, the authors conduct three lab and grocery store experiments that robustly

  5. Smart shopping carts : How real-time feedback influences spending

    NARCIS (Netherlands)

    van Ittersum, Koert; Wansink, B.; Pennings, J.M.E.; Sheehan, D.

    2013-01-01

    Although interest in smart shopping carts is increasing, both retailers and consumer groups have concerns about how real-time spending feedback will influence shopping behavior. Building on budgeting and spending theories, the authors conduct three lab and grocery store experiments that robustly

  6. Acceptance Test Report for Gamma Carts A and B

    International Nuclear Information System (INIS)

    FULLER, P.J.

    2000-01-01

    Report of Shop Test of the Gamma Cart System to be used in the AZ-101 Mixer Pump Demonstration Test. Reports of the hardware and software tests. The objective of the testing was to verify in the shop that the hardware and software operated according to design specifications before field-testing and installation

  7. TEST OF AN ANIMAL DRAWN FIELD IMPLEMENT CART

    Directory of Open Access Journals (Sweden)

    Paolo Spugnoli

    2008-06-01

    Full Text Available The field performance of a horse-drawn hitch cart equipped with a PTO system powered by the two cart ground wheels have been investigated. For this purpose field tests on clay and turf soil, with varying ballast and PTO torque, have been carried out pulling the cart by a tractor. Preliminary tests were aimed at assessing the traction capability of horse breed. These tests showed that the mean draught force given by two of these horses was 173daN, average working speed was about 1m*s-1, resulting a mean draught power developed by each horse of about 0.86kW. The PTO cart system performance has shown that the torque has not exceeded 2.4daN*m, maximum draught or PTO power was 1.15kW, rotation speed just higher than 400min-1, with mean efficiency of about 50%. These values are consistent with horse performance and small haymaking, fertilizing, seeding and chemical application machine requirements.

  8. Arquitectura hospitalaria

    OpenAIRE

    Insua Cabanas, Mercedes

    2011-01-01

    [Resumen] Estudio análisis e investigación de los hospitales de pabellones aislados gallegos, su evolución y comparación con la missma tipología en Europa y en España, así como su estudio pormenorizado.

  9. Farmacovigilancia hospitalaria

    Directory of Open Access Journals (Sweden)

    Ana Julia García Milián

    Full Text Available En la práctica clínica existen varios factores que dificultan la detección de las reacciones adversas producidas por medicamentos. La farmacovigilancia es utilizada para la prevención de riesgos de los medicamentos en los seres humanos y para evitar los costes económicos asociados a los efectos adversos no esperados. Esta vigilancia en el marco de la práctica habitual se realiza por los sistemas de farmacovigilancia, y se considera necesaria en cada país, ya que hay diferencias entre países (y aún entre regiones en algunos países en la manifestación de reacciones adversas a medicamentos y otros problemas relacionados con estos, lo que puede ocurrir por las diferencias en la producción, la distribución y el uso (por ejemplo: indicaciones, dosis y disponibilidad. Teniendo en cuenta la baja incidencia general de reporte de reacciones adversas procedentes de los hospitales en general y de la especialidad de Oftalmología en particular, debe mantenerse una colaboración multicéntrica para la notificación de las reacciones adversas producidas por fármacos en los servicios de Oftalmología. El desarrollo de un Programa de farmacovigilancia en un hospital exige cumplir con requisitos básicos en el plano técnico, ético y de la coordinación interhospitalaria y general.

  10. Mortalidad infantil: Análisis de un decenio

    Directory of Open Access Journals (Sweden)

    Rogelio León López

    1998-12-01

    Full Text Available Se efectúo un estudio descriptivo y retrospectivo con la finalidad de conocer el comportamiento de la mortalidad infantil en el policlínico docente "30 de Noviembre" durante el decenio 1985-1994. El universo de estudio estuvo conformado por los 29 fallecidos menores de un año ocurridos en el período referido en dicha área de salud. Se calculó la tasa de mortalidad infantil en sus diferentes componentes en cada año motivo de estudio. Se encontró que la tasa de mortalidad infantil en nuestra área tiene un comportamiento cíclico, que la mortalidad neonatal precoz fue la que más fallecidos aportó y que las principales causas de muerte fueron la sepsis, el bajo peso al nacer y la hipoxia. Se enfatiza en la importancia de establecer un Plan de Medidas encaminado a disminuir la mortalidad infantil del áreaA descriptive and retrospective study was conducted aimed at knowing the behavior of infant mortality rate at the "30 de Noviembre" Teaching Polyclinic from 1985 to 1994. The 29 infants under one year who died in that health area during that period were studied. Infant mortality rate in its different components was calculated by every year under study. It was found that infant mortality rates in our area had a cyclical behavior, that early neonatal mortality had the highest number of deaths, and that the main cause of death were sepsis, low birth weight and hypoxia. Emphasis is made on the need of implementing a plan of measures to reduce infant mortality rate in the area

  11. Mortalidad neonatal, análisis de registros de vigilancia e historias clínicas del año 2011 neonatales en Huánuco y Ucayali, Perú

    Directory of Open Access Journals (Sweden)

    José Enrique Velásquez Hurtado

    Full Text Available Objetivos. Estimar la tasa de mortalidad neonatal y describir las defunciones neonatales ocurridas en el 2011 en hospitales del Ministerio de Salud de las regiones Huánuco y Ucayali, Perú. Materiales y Métodos .Estudio transversal realizado de septiembre a noviembre de 2012 en Huánuco y Ucayali. Se revisaron los registros de las defunciones neonatales ocurridas en el 2011 en municipalidades provinciales, direcciones regionales de salud y cuatro hospitales de referencia. Para el cálculo de las tasas de mortalidad se utilizaron las fuentes de información más confiables por región. La revisión de 185 historias clínicas en los hospitales permitió describir las causas básicas de las muertes neonatales. Resultados. En el 2011 se reportaron en Huánuco 10 886 recién nacidos vivos y 158 muertes neonatales, con una tasa de 14,5 muertes por 1000 nacidos vivos. En Ucayali, se reportaron 11 441 recién nacidos vivos y 138 muertes neonatales, con una tasa de 12,1 muertes por 1000 nacidos vivos. La mayoría de muertes neonatales hospitalarias ocurrieron en los primeros 7 días de vida (87%, en neonatos prematuros (73,9% y con bajo peso al nacimiento (67%. Las causas básicas más frecuentes en las muertes neonatales fueron: infección (31,4%, malformación congénita (22,2% y prematuridad (18,9%. . Conclusiones La tasa de mortalidad neonatal en las regiones estudiadas fue superior a la media nacional. Los resultados sugieren la necesidad de intervenciones efectivas e integrales durante el embarazo, parto y periodo posnatal temprano; siendo este último periodo el de mayor vulnerabilidad en el neonato

  12. Mortalidad neonatal, análisis de registros de vigilancia e historias clínicas del año 2011 en Huánuco y Ucayali, Perú

    Directory of Open Access Journals (Sweden)

    José Enrique Velásquez Hurtado

    Full Text Available Objetivos. Estimar la tasa de mortalidad neonatal y describir las defunciones neonatales ocurridas en el 2011 en hospitales del Ministerio de Salud de las regiones Huánuco y Ucayali, Perú. Materiales y Métodos .Estudio transversal realizado de septiembre a noviembre de 2012 en Huánuco y Ucayali. Se revisaron los registros de las defunciones neonatales ocurridas en el 2011 en municipalidades provinciales, direcciones regionales de salud y cuatro hospitales de referencia. Para el cálculo de las tasas de mortalidad se utilizaron las fuentes de información más confiables por región. La revisión de 185 historias clínicas en los hospitales permitió describir las causas básicas de las muertes neonatales. Resultados. En el 2011 se reportaron en Huánuco 10 886 recién nacidos vivos y 158 muertes neonatales, con una tasa de 14,5 muertes por 1000 nacidos vivos. En Ucayali, se reportaron 11 441 recién nacidos vivos y 138 muertes neonatales, con una tasa de 12,1 muertes por 1000 nacidos vivos. La mayoría de muertes neonatales hospitalarias ocurrieron en los primeros 7 días de vida (87%, en neonatos prematuros (73,9% y con bajo peso al nacimiento (67%. Las causas básicas más frecuentes en las muertes neonatales fueron: infección (31,4%, malformación congénita (22,2% y prematuridad (18,9%. . Conclusiones La tasa de mortalidad neonatal en las regiones estudiadas fue superior a la media nacional. Los resultados sugieren la necesidad de intervenciones efectivas e integrales durante el embarazo, parto y periodo posnatal temprano; siendo este último periodo el de mayor vulnerabilidad en el neonato

  13. [The impact factor of Nutrición Hospitalaria is 1.096].

    Science.gov (United States)

    Culebras, J M; García de Lorenzo, A

    2009-01-01

    The editors of Nutrición Hospitalaria (Nutr Hosp) analyze the journal from its foundation in 1979 to the present time, on occasion of the first publication of its impact factorby Journal Citation Reports (JCR). The actions taken along this thirty year period are described, including its incorporation to multiple web databases, the Open Access policy of the journal, its progressive internationality, and the bibliometric analysis made in 1999. A figure with the journal citation trends is included. Nutr Hosp, included in the "Nutrition & Dietetics" group of JCR, is in the position 42/59, i.e. in the third quartile. Among the Spanish journals included in JCR,Nutr Hosp is located in the 14/37 position. A few considerations are made related to the economical aspects of the journal, the number of articles received so far, the articles expected in the future, the rejection rate and the language (Spanish or English) in which Nutr Hosp should be published.

  14. REMOCION DE LA MATERIA ORGANICA Y TOXICIDAD EN AGUAS RESIDUALES HOSPITALARIAS APLICANDO OZONO

    Directory of Open Access Journals (Sweden)

    DAYANA GRISALES PENAGOS

    2012-01-01

    Full Text Available Las aguas residuales hospitalarias se consideran como una de las principales fuentes de contaminantes emergentes, resultado de las diferentes actividades que allí se realizan y la excreción de las sustancias por los pacientes. Estudios han demostrado que estos componentes no son fácilmente removidos por medio de procesos de tratamiento convencionales como las plantas de tratamiento que emplean procesos biológicos. En este sentido el propósito de este trabajo consistió en evaluar la degradación de la materia orgánica presente en aguas hospitalarias reales aplicando ozono en diferentes condiciones de pH (3,0, 6,7, 10. Para esto se analizaron los valores de la UV254, la relación de biodegradabilidad DQO/DBO5 y el color (VIS436. Adicional a esto, se realizó un ensayo de toxicidad aguda, utilizando bulbos de cebolla común (Allium cepa L. Los resultados mostraron que con una dosis aplicada de ozono de 187 mgO3/h y valores de pH=10 la biodegradabilidad se aumento en un 70% y la toxicidad aguda se redujo en 62%, mientras que para valores de pH =3,0, se favoreció la remoción de la UV254 y el color. La aplicación de ozono demostró ser una alternativa viable para tratar efluentes hospitalarios como pretratamiento de un proceso biológico.

  15. Maternal mortality due to hemorrhage in Brazil Mortalidad materna en Brasil debida a hemorragia Mortalidade materna por hemorragia no Brasil

    Directory of Open Access Journals (Sweden)

    Maria de Lourdes de Souza

    2013-06-01

    Full Text Available OBJECTIVE: to analyze the rates of maternal mortality due to hemorrhage identified in Brazil from 1997 to 2009. Methods: the time series and population data from the Brazilian Health Ministry, Mortality Information System and Live Birth Information System were examined. From the Mortality Information System, we initially selected all reported deaths of women between 10 and 49 years old, which occurred from January 1, 1997 to December 31, 2009 in Brazil, recorded as a "maternal death". RESULTS: during the research period, 22,281 maternal deaths were identified, among which 3,179 were due to hemorrhage, accounting for 14.26% of the total deaths. The highest rates of maternal mortality were found in the North and Northeast areas of Brazil. CONCLUSIONS: the Brazilian scenario shows regional inequalities regarding maternal mortality. It presents hemorrhaging as a symptom and not as a cause of death. OBJETIVO: analizar las tasas de mortalidad materna debida a hemorragia, identificadas en Brasil durante el periodo de 1997 a 2009. MÉTODOS: fueron examinados los datos de series temporales y de población del Ministerio de la Salud de Brasil, del Sistema de Información de Mortalidad y del Sistema de Información de Nacidos Vivos. Del Sistema de Información de Mortalidad, inicialmente seleccionamos todos los informes sobre muerte de mujeres con edad entre 10 y 49 años, que ocurrieron entre el 01 de enero de 1997 y el 31 de diciembre de 2009, en Brasil, clasificadas como "muertes maternas". RESULTADOS: durante el periodo de investigación, fueron identificadas 22.281 muertes maternas, entre las cuales 3.179 se debieron a hemorragia, siendo responsables por 14,26% del total de muertes. La tasa más alta de mortalidad materna fue encontrada en las regiones Norte y Noreste de Brasil. CONCLUSIONES: el escenario brasileño muestra desigualdades regionales en lo que se refiere a mortalidad materna; este presenta la hemorragia como un síntoma y no como la

  16. Testing of the West Valley Vitrification Facility transfer cart control system

    International Nuclear Information System (INIS)

    Halliwell, J.W.; Bradley, E.C.

    1995-01-01

    Oak Ridge National Laboratory (ORNL) has designed and tested the control system for the West Valley Demonstration Project Vitrification Facility transfer cart. The transfer cart will transfer canisters of vitrified high-level waste remotely within the Vitrification Facility. The control system operates the cart under battery power by wireless control. The equipment includes cart-mounted control electronics, battery charger, control pendants, engineer's console, and facility antennas. Testing was performed in several phases of development: (1) prototype equipment was built and tested during design, (2) board-level testing was then performed at ORNL during fabrication, and (3) system-level testing was then performed by ORNL at the fabrication subcontractor's facility for the completed cart system. These tests verified (1) the performance of the cart relative to design requirements and (2) operation of various built-in cart features. The final phase of testing is planned to be conducted during installation at the West Valley Vitrification Facility

  17. Mortalidade por leucemias relacionada à industrialização

    Directory of Open Access Journals (Sweden)

    Leal Carmen Helena Seoane

    2002-01-01

    Full Text Available OBJETIVO: Analisar a distribuição espacial da mortalidade por leucemia na população, buscando identificar agregados e estabelecer sua relação com os níveis de industrialização. MÉTODOS: O estudo foi realizado nas 43 regiões de governo do Estado de São Paulo, no qüinqüênio 1991-1995. Foi construído um "índice de industrialização relativo à leucemia" (IIRL baseado no número de indústrias e empregos industriais por 100.000 habitantes, valor adicionado fiscal, variedade de ramos industriais e indústrias com potenciais exposições de risco para a leucemia. O IIRL foi distribuído em cinco categorias. Verificaram-se os coeficientes padronizados de mortalidade por leucemia em cada uma das regiões, também distribuídos em cinco categorias e comparados ao mapa IIRL. RESULTADOS: As regiões mais industrializadas em ordem decrescente foram Campinas, Piracicaba, Jundiaí, Sorocaba e São Paulo. Não foi encontrada associação entre mortalidade, por nenhum tipo de leucemia, e industrialização. A região de Jales foi a que apresentou o mais alto coeficiente padronizado de mortalidade por leucemia. CONCLUSÕES: A distribuição da mortalidade por leucemia ocorreu de forma homogênea no Estado de São Paulo, não apresentando correlação com o nível de industrialização. Entretanto, aspectos relacionados ao método epidemiológico adotado -- estudo ecológico -- e ao uso do parâmetro "mortalidade por leucemia", doença cujo prognóstico tem mudado muito nas últimas décadas, limitaram a interpretação dos resultados.

  18. Finding and applying evidence during clinical rounds: the "evidence cart".

    Science.gov (United States)

    Sackett, D L; Straus, S E

    1998-10-21

    Physicians need easy access to evidence for clinical decisions while they care for patients but, to our knowledge, no investigators have assessed use of evidence during rounds with house staff. To determine if it was feasible to find and apply evidence during clinical rounds, using an "evidence cart" that contains multiple sources of evidence and the means for projecting and printing them. Descriptive feasibility study of use of evidence during 1 month (April 1997) and anonymous questionnaire (May 1997). General medicine inpatient service. Medical students, house staff, fellows, and attending consultant. Evidence cart that included 2 secondary sources developed by the department (critically appraised topics [CATs] and Redbook), Best Evidence, JAMA Rational Clinical Examination series, the Cochrane Library, MEDLINE, a physical examination textbook, a radiology anatomy textbook, and a Simulscope, which allows several people to listen simultaneously to the same signs on physical examination. Number of times sources were used, type of sources searched and success of searches, time needed to search, and whether the search affected patient care. The evidence cart was used 98 times, but could not be taken on bedside rounds because of its bulk; hard copies of several sources were taken instead. When the evidence cart was used during team rounds and student rounds, some sources could be accessed quickly enough (10.2-25.4 seconds) to be practical on our service. Of 98 searches, 79 (81%) sought evidence that could affect diagnostic and/or treatment decisions. Seventy-one (90%) of 79 searches regarding patient management were successful, and when assessed from the perspective of the most junior team members responsible for each patient's evaluation and management, 37 (52%) of the 71 successful searches confirmed their current or tentative diagnostic or treatment plans, 18 (25%) led to a new diagnostic skill, an additional test, or a new management decision, and 16 (23

  19. Desarrollo y estudio piloto de un cuestionario para evaluar la satisfacción con la estancia hospitalaria en población infanto-juvenil

    Directory of Open Access Journals (Sweden)

    Montserrat Gómez de Terreros Guardiola

    2017-11-01

    Discusión: Se ha obtenido un cuestionario breve, de fácil aplicación, fiable en cuanto a su consistencia interna y sensible para detectar diferencias en las dimensiones de satisfacción hospitalaria. Una vez terminada su validación, servirá para evaluar la satisfacción de los menores con su estancia hospitalaria, además de ser un potencial indicador de calidad asistencial.

  20. A School Experiment in Kinematics: Shooting from a Ballistic Cart

    Science.gov (United States)

    Kranjc, T.; Razpet, N.

    2011-10-01

    Many physics textbooks start with kinematics. In the lab, students observe the motions, describe and make predictions, and get acquainted with basic kinematics quantities and their meaning. Then they can perform calculations and compare the results with experimental findings. In this paper we describe an experiment that is not often done, but is interesting and attractive to students—the ballistic cart, i.e., the shooting of a ball from a cart moving along a slope. For that, one has to be familiar with one-dimensional uniform motion and one-dimensional motion with constant acceleration, as well as curvilinear motion that is a combination of such motions.1,2 The experimental results confirm theoretical predictions.

  1. Pushing, pulling and manoeuvring an industrial cart: a psychophysiological study.

    Science.gov (United States)

    Giagloglou, Evanthia; Radenkovic, Milan; Brankovic, Sasa; Antoniou, Panagiotis; Zivanovic-Macuzic, Ivana

    2017-09-18

    One of the most frequent manual occupational tasks involves the pushing and pulling of a cart. Although several studies have associated health risks with pushing and pulling, the effects are not clear since occupational tasks have social, cognitive and physical components. The present work investigates a real case of a pushing and pulling occupational task from a manufacturing company. The study initially characterizes the case in accordance with Standard No. ISO 11228-2:2007 as low risk. An experiment with 14 individuals during three modalities of pushing and pulling was performed in order to further investigate the task with the application of electrophysiology. At the end, a simple questionnaire was given. The results show electrophysiological differences among the three modalities of pushing and pulling, with a major difference between action with no load and fully loaded with a full range of motions on the cart to handle.

  2. MORTALIDAD INNECESARIAMENTE PREMATURA Y SANITARIAMENTE EVITABLE EN COSTA RICA

    Directory of Open Access Journals (Sweden)

    Fernando Llorca Castro

    2010-01-01

    Full Text Available Fundamentos: Para desarrollar políticas y estrategias orientadas a mitigarlas es fundamental identificar las desigualdades. El objetivo del trabajo es analizar las variaciones de la Mortalidad Innecesariamente Prematura y Sanitariamente Evitable (MIPSE para cada uno de los 81 cantones de Costa Rica durante el período 2000-2005. Métodos: Se aplicó la clasificación MIPSE propuesta por miembros del Servicio de Información y Estudios de la Dirección General de Recursos Sanitarios de Catalunya. Mediante el empleo de el Indicador de Desarrollo Socioeconómico (IDSE establecido por economistas de la Universidad de Costa Rica, previa estandarización de la población, se ordenaron los cantones en grupos por quintiles (I el más rico, Vel más pobre. Resultados: Se encontraron como causas principales de mortalidad MIPSE la enfermedad isquémica del corazón (19,55% causas MIPSE, accidentes de tránsito con vehículos a motor (11,60%, enfermedades cerebrovasculares (6,95%, perinatal (6,92% y suicidios (5,14%. Conclusión: La mortalidad por HIVy el Sida, el cáncer de mamá en mujeres, cáncer de cuerpo de útero, cáncer de piel y por hepatitis secundaria al consumo de alcohol, afectan más a los cantones con mayores ingresos. La mortalidad por hiperplasia benigna de próstata, la materna asociada al embarazo, parto o puerperio y la hernia abdominal afectan más a los de menor nivel económico. Se identificaron dos grupos de MIPSE con desigualdad equidistribuida: leucemia y enfermedades cardiovasculares congénitas.

  3. Desigualdade espacial da mortalidade neonatal no Brasil: 2006 a 2010

    Directory of Open Access Journals (Sweden)

    Genyklea Silva de Oliveira

    2013-08-01

    Full Text Available O objetivo deste estudo é analisar a distribuição espacial da mortalidade neonatal e sua correlação com os fatores biológicos, socioeconômicos e de atenção à saúde materno-infantil, nos estados brasileiros, no período de 2006 a 2010. Foram construídos mapas temáticos e de correlação (LISA para verificação de dependência espacial e modelos de regressão linear múltipla. Verificou-se que não há autocorrelação espacial para mortalidade neonatal nos estados brasileiros (I = 0,002; p = 0,48. A maioria das variáveis estava correlacionada (r > 0,3, p < 0,05 com a mortalidade neonatal, formando clusters em estados do Norte e Nordeste, com maiores taxas de mães adolescentes, renda domiciliar per capta baixa, menor realização de consultas de pré-natal e de leitos de UTI Neonatal. O número de leitos de UTI Neonatal manteve efeito independente após a análise de regressão. Conclui-se que as desigualdades regionais das condições de vida e, principalmente, de acesso aos serviços de saúde materno-infantil contribuem para a distribuição desigual da mortalidade neonatal no Brasil.

  4. Realidad actual de la triste y desesperante mortalidad materna

    Directory of Open Access Journals (Sweden)

    Fadlalla Bahsas Bahsas

    2015-05-01

    Full Text Available Si bien el anuncio viene a completar el mandato del Plan de la Patria 2013-2019, que tiene entre sus objetivos “garantizar que los partos sean atendidos en condiciones seguras y reducir las tasas de mortalidad materna, perinatal e infantil”. “La tasa de mortalidad Infantil y Materna son indicadores que determinan el nivel del desarrollo del País”, sin embargo en la práctica en nuestro país, la mortalidad infantil y materna ha ido en ascenso en los últimos años. La muerte materna es un indicador claro de injusticia social, inequidad de género y pobreza: el que un embarazo o parto desemboque en la muerte de la mujer refleja problemas estructurales, tanto de acceso como de atención a la salud; de hecho es el más dramático de una serie de eventos que revelan la falta de acciones para atender la situación de atraso, marginación y rezago en la que vive un sector de las mujeres pobres; así como las personas que conviven con ellas, del personal de salud y autoridades gubernamentales. Por otro lado, da cuenta de una serie de relaciones económicas, sociales y culturales que ubican a la mujer en una franca desventaja.

  5. FATORES DE RISCO MATERNOS E INFANTIS ASSOCIADOS À MORTALIDADE NEONATAL

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Munhoz Gaiva

    2016-01-01

    Full Text Available En este trabajo se estudiaron los factores materno-infantiles relacionados con la mortalidad neonatal, a partir de datos obtenidos de los Sistemas de Información de Nacidos Vivos y Mortalidad integrados por vinculación. Se analizaron 9.349 nacidos vivos en Cuiabá-MT, en 2010, 78 de los cuales murieron en el período neonatal. Se realizó análisis univariado y multivariado empleando la regresión logística. En el modelo múltiple, se mantuvo asociada con la mortalidad neonatal: la edad materna menor de 20 años; la prematuridad; bajo peso al nacer; Apgar menor a siete en el 1 y 5 minutos; y la presencia de anomalías congénitas. Los resultados indicaron la necesidad de mejorar la calidad de la atención prenatal, para la prevención del bajo peso al nacer y la prematuridad. La asociación entre la muerte neonatal y baja puntuación de Apgar en el 1 y 5 minutos indica, a su vez, la importancia de la atención del parto.

  6. A cloud climatology of the Southern Great Plains ARM CART

    Energy Technology Data Exchange (ETDEWEB)

    Lazarus, S.M.; Krueger, S.K.; Mace, G.G.

    2000-05-15

    Cloud amount statistics from three different sources were processed and compared. Surface observations from a National Centers for Environmental Prediction dataset were used. The data (Edited Cloud Report; ECR) consist of synoptic weather reports that have been edited to facilitate cloud analysis. Two stations near the Southern Great Plains (SGP) Cloud and Radiation Test Bed (CART) in north-central Oklahoma (Oklahoma City, Oklahoma and Wichita, Kansas) were selected. The ECR data span a 10-yr period from December 1981 to November 1991. The International Satellite Cloud Climatology Project (ISCCP) provided cloud amounts over the SGP CART for an 8-yr period (1983--91). Cloud amounts were also obtained from Micro Pulse Lidar (MPL) and Belfort Ceilometer (BLC) cloud-base height measurements made at the SGP CART over a 1-yr period. The annual and diurnal cycles of cloud amount as a function of cloud height and type were analyzed. The three datasets closely agree for total cloud amount. Good agreement was found in the ECR and MPL-BLC monthly low cloud amounts. With the exception of summer and midday in other seasons, the ISCCP low cloud amount estimates are generally 5%--10% less than the others. The ECR high cloud amount estimates are typically 10%--15% greater than those obtained from either the ISCCP or MPL-BLC datasets. The observed diurnal variations of altocumulus support the authors' model results of radiatively induced circulations.

  7. Control borroso para la valoración del impacto ambiental generado por contaminantes emergentes en aguas residuales hospitalarias

    OpenAIRE

    Leadina Sánchez Barboza

    2015-01-01

    La valoración de impactos ambientales está sujeta a imprecisión, vaguedad y subjetividad. Estas características son extensivas al impacto generado por la presencia de contaminantes emergentes -fármacos- en aguas residuales hospitalarias, por lo que este trabajo propone valorar el impacto de dichos contaminantes mediante un sistema de inferencia borrosa, utilizando el toolbox fuzzy logic de MATLAB®, aplicando el sistema experto Mamdani. Los conjuntos borrosos de entrada se establecieron a part...

  8. Regional CAR-T cell infusions for peritoneal carcinomatosis are superior to systemic delivery.

    Science.gov (United States)

    Katz, S C; Point, G R; Cunetta, M; Thorn, M; Guha, P; Espat, N J; Boutros, C; Hanna, N; Junghans, R P

    2016-05-01

    Metastatic spread of colorectal cancer (CRC) to the peritoneal cavity is common and difficult to treat, with many patients dying from malignant bowel obstruction. Chimeric antigen receptor T cell (CAR-T) immunotherapy has shown great promise, and we previously reported murine and phase I clinical studies on regional intrahepatic CAR-T infusion for CRC liver metastases. We are now studying intraperitoneal (IP) delivery of CAR-Ts for peritoneal carcinomatosis. Regional IP infusion of CAR-T resulted in superior protection against carcinoembryonic antigen (CEA+) peritoneal tumors, when compared with systemically infused CAR-Ts. IP CAR-Ts also provided prolonged protection against IP tumor re-challenges and demonstrated an increase in effector memory phenotype over time. IP CAR-Ts provided protection against tumor growth at distant subcutaneous (SC) sites in association with increases in serum IFNγ levels. Given the challenges posed by immunoinhibitory pathways in solid tumors, we combined IP CAR-T treatment with suppressor cell targeting. High frequencies of myeloid-derived suppressor cells (MDSC) and regulatory T cells (Treg) were found within the IP tumors, with MDSC expressing high levels of immunosuppressive PD-L1. Combinatorial IP CAR-T treatment with depleting antibodies against MDSC and Treg further improved efficacy against peritoneal metastases. Our data support further development of combinatorial IP CAR-T immunotherapy for peritoneal malignancies.

  9. Avaliação dos dados do cartão de pré-natal e registro da rotina prevista na assistência pré-natal de baixo risco em uma coorte de gestantes em Belo Horizonte

    OpenAIRE

    Juliana Moraes Carrilho

    2014-01-01

    A adequação da atenção pré-natal é relevante para redução das taxas de mortalidade materna e perinatal, sendo fundamental a integração das informações nos diferentes níveis de atenção à gestante. Este estudo teve como objetivo principal avaliar a completude dos dados dos cartões de pré-natal apresentados por uma coorte de gestantes admitidas em dois hospitais universitários de Belo Horizonte, conforme rotina prevista pelo MS e o protocolo da Prefeitura Municipal de Belo Horizonte (PBH), para ...

  10. CryoCart Restoration and Vacuum Pipe Construction

    Science.gov (United States)

    Chaidez, Mariana

    2016-01-01

    first completed at the component level. During this process, the igniter of the main engine and the RCS thrusters will be tested under a vacuum. To complete the testing of the components, the test setup first needed to be finalized. The CryoCart is being used to feed the propellants to the test article. The CryoCart is a movable test set-up that was developed in 2009 to provide a mobile platform for testing oxygen/methane systems with hot-fire capability up to 100 lbf. The CryoCart consists of three different systems: Oxygen, Methane, and liquid Nitrogen. The Oxygen and Methane systems are placed into two different carts while the liquid nitrogen system is mainly located in the methane cart. Over the years, the CryoCart has been utilized for different projects and has undergone deterioration. For this reason, a new phase has been developed to rebuild it to working conditions once again. During my internship, I was aiding in the construction and restoration of the CryoCart. In the initial stages of the process, I updated the fluid and electrical schematics for the oxygen, methane, and test article systems. The original CryoCart consisted of an electrical panel that utilized electromechanical relays and a terminal to drive the igniter power and signal, as well as the main fuel and oxygen valves. This electrical panel connected to the CryoCart through various wire harnesses that could be found exiting from the CryoCart. First, it was determined how these harnesses connected to the electromechanical relays so that they worked correctly. Once the electrical system was understood, an alternative for the electromechanical relays and the Molex connectors used throughout the system was sought since these components can often prove to be unreliable. Solid State relays and MIL connectors were purchased to serve as replacements. Upon arrival of the parts, crimping and wiring was completed to install the new solid state relays and MIL connectors. During the replacement of the relays

  11. Los determinantes de la mortalidad y las diferencias socioeconómicas de la mortalidad en la infancia

    Directory of Open Access Journals (Sweden)

    Hugo Behm Rosas

    2016-02-01

    Full Text Available PRESENTACIÓN: El texto que se reproduce a continuación, escrito por el Dr. Hugo Behm Rosas, nacido en el año 1913, a inicios de los años noventa, sintetiza lo que fue un largo y prolífico trabajo de análisis de la mortalidad infantil en América Latina. Así lo atestiguan los estudios que publicó desde los inicios de los años sesenta del siglo pasado hasta el primer lustro de este siglo. El texto: Las diferencias socioeconómicas de la mortalidad en la infancia es un capítulo del libro Las desigualdades sociales ante la muerte en América Latina publicado en el año 1992 por el Centro Latinoamericano y Caribeño de Demografía (CELADE de la Comisión Económica para América Latina y el Caribe (CEPAL y la Organización Holandesa para la Cooperación Internacional en Educación Superior. El texto constituye una síntesis de los múltiples estudios sobre diferencias de la mortalidad infantil entre grupos sociales. Las contribuciones del Dr. Behm para entender las diferencias de mortalidad infantil entre distintos grupos sociales fueron muchas. Estas empezaron cuando, como lo narra en el prólogo a una reedición de una de sus primeras publicacionesi, el Dr. Behm dejó la clínica por la salud pública para emprender una investigación sobre las diferencias de mortalidad infantil en Chile. En 1962 publicó Mortalidad infantil y nivel de vida publicado por la Escuela de Salud pública de la Universidad de Chile y recientemente reeditado por la unidad de Patrimonio Cultural de la Salud. A partir de este influyente estudio donde escribe “La mortalidad infantil viene a ser, en consecuencia, un indicador del alto precio que los pueblos pagan por las formas de organización económicamente ineficientes y socialmente injustas que han logrado darse” ii, emprendió muchos otros explorando las desigualdades sociales en la mortalidad infantil. Los últimos estudios los realizó en la subsede de CELADE en Costa Rica donde junto a muchos

  12. Mortalidad perinatal en el Hospital Nacional Edgardo Rebagliati Martins

    Directory of Open Access Journals (Sweden)

    Lizeth Diaz Ledesma

    2003-07-01

    Full Text Available Objetivo: Conocer la tasa de mortalidad perinatal en el Hospital Nacional Edgardo Rebagliati Martins y sus características. Materiales y Métodos: El estudio comprendió la revisión de todas las historias clínicas de gestantes portadoras de óbito fetal (mayor de 28 semanas de gestación o mayor de 1000gramos, de recién nacidos que fallecieron dentro de los primeros 7 días de vida y de sus madres durante el año 2000. Resultados: La tasa de mortalidad perinatal fue de 10.5 por mil nacidos vivos. La edad promedio materna fue de 31.6 años, + 5.9 y un rango entre 14 y 44 años. El 30.1% de partos correspondió a nulíparas, el 61.6% a multíparas y el 8.3% a gran multíparas. El promedio de visitas al control prenatal fue de 4.8 + 2.7. El 53.4% de las madres tuvo algún antecedente relacionado a mala historia obstétrica, siendo los más frecuentes historia de aborto previo (27.4%, cesárea anterior (13.7% y pre eclampsia (12.3%. Las causas asociadas a mortalidad perinatal fueron madres con pre eclampsia severa (38.4% y hemorragia en el tercer trimestre (15.1% y fetos con malformaciones congénitas severas (27.4%. La vía de parto fue abdominal en 68.5% y vaginal en 31.5%. Se tuvo 83.6% de gestaciones únicas y 16.4% de gestaciones múltiples. El peso de los productos fue 1985.2 + 945.8 gramos. El 61.6% de muertes perinatales correspondieron a prematuros. Conclusiones:La tasa de mortalidad neonatal en el HNERM durante el año 2000 fue de 10.5 por mil nacidos vivos y los factores relacionados a mortalidad perinatal fueron pre-eclampsia severa, malformaciones congénitas severas y hemorragias del tercer trimestre. ( Rev Med Hered 2003; 14: 117-121.

  13. The PASCO Wireless Smart Cart: A Game Changer in the Undergraduate Physics Laboratory

    Science.gov (United States)

    Shakur, Asif; Connor, Rainor

    2018-03-01

    With the introduction of the Wireless Smart Cart by PASCO scientific in April 2016, we expect a paradigm shift in undergraduate physics laboratory instruction. We have evaluated the feasibility of using the smart cart by carrying out experiments that are usually performed using traditional PASCO equipment. The simplicity, convenience, and cost-saving achieved by replacing a plethora of traditional laboratory sensors, wires, and equipment clutter with the smart cart are reported here.

  14. Differential expression of CART in feeding and reward circuits in binge eating rat model.

    Science.gov (United States)

    Bharne, Ashish P; Borkar, Chandrashekhar D; Subhedar, Nishikant K; Kokare, Dadasaheb M

    2015-09-15

    Binge eating (BE) disrupts feeding and subverts reward mechanism. Since cocaine- and amphetamine-regulated transcript peptide (CART) mediates satiety as well as reward, its role in BE justifies investigation. To induce BE, rats were provided restricted access to high fat sweet palatable diet (HFSPD) for a period of 4 weeks. Immunoreactivity profile of the CART elements, and accompanying neuroplastic changes were studied in satiety- and reward-regulating brain nuclei. Further, we investigated the effects of CART, CART-antibody or rimonabant on the intake of normal chow or HFSPD. Rats fed on HFSPD showed development of BE-like phenotype as reflected by significant consumption of HFSPD in short time frame, suggestive of dysregulated satiety mechanisms. At the mid-point during BE, CART-immunoreactivity was significantly increased in hypothalamic arcuate (ARC), lateral (LH), nucleus accumbens shell (AcbSh) and paraventricular nucleus of thalamus (PVT). However, for next 22-h post-binge time-period, the animals showed no interest in food, and low CART expression. Pre-binge treatment with rimonabant, a drug recommended for the treatment of BE, produced anorexia, increased CART expression in ARC and LH, but not in AcbSh and PVT. Higher dose of CART was required to produce anorexia in binged rats. While neuronal tracing studies confirmed CART fiber connectivity from ARC and LH to AcbSh, increase in CART and synaptophysin immunostaining in this pathway in BE rats suggested strengthening of the CART connectivity. We conclude that CART bearing ARC-LH-PVT-AcbSh reward circuit may override the satiety signaling in ARC-PVN pathway in BE rats. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. El empoderamiento político de los enfermeros en la práctica hospitalaria

    Directory of Open Access Journals (Sweden)

    Adrize Rutz Porto

    2015-06-01

    Full Text Available Objetivo: comprender el proceso de búsqueda del empoderamiento político de las enfermeras en la práctica hospitalaria. Metodología: se trata de un estudio cualitativo, participaron 10 enfermeras de diferentes unidades de un hospital escuela en Rio Grande do Sul. Los datos fueron recolectados entre abril y julio de 2011, mediante observación simple, entrevistas semiestructuradas y grupo focal. El contenido obtenido fue tratado por el análisis temático, surgiendo dos temas sobre los obstáculos, bien como de las potencialidades de los enfermeros en su búsqueda del empoderamiento político. Resultados principales: se puede visualizar la correlación de fuerzas existentes en el hospital con respecto a el enfermero como un ser político. Conclusión: por un lado, existe la alienación, la propagación del conformismo, de los otros, medios posibles del poder en trabajar juntos, a través de posicionamiento con conocimiento y conciencia crítica sobre el proceso de trabajo y las relaciones interpersonales.

  16. Characterisation of CART-containing neurons and cells in the porcine pancreas, gastro-intestinal tract, adrenal and thyroid glands

    Directory of Open Access Journals (Sweden)

    Gunnarsdóttir Anna

    2007-07-01

    Full Text Available Abstract Background The peptide CART is widely expressed in central and peripheral neurons, as well as in endocrine cells. Known peripheral sites of expression include the gastrointestinal (GI tract, the pancreas, and the adrenal glands. In rodent pancreas CART is expressed both in islet endocrine cells and in nerve fibers, some of which innervate the islets. Recent data show that CART is a regulator of islet hormone secretion, and that CART null mutant mice have islet dysfunction. CART also effects GI motility, mainly via central routes. In addition, CART participates in the regulation of the hypothalamus-pituitary-adrenal-axis. We investigated CART expression in porcine pancreas, GI-tract, adrenal glands, and thyroid gland using immunocytochemistry. Results CART immunoreactive (IR nerve cell bodies and fibers were numerous in pancreatic and enteric ganglia. The majority of these were also VIP IR. The finding of intrinsic CART containing neurons indicates that pancreatic and GI CART IR nerve fibers have an intrinsic origin. No CART IR endocrine cells were detected in the pancreas or in the GI tract. The adrenal medulla harboured numerous CART IR endocrine cells, most of which were adrenaline producing. In addition CART IR fibers were frequently seen in the adrenal cortex and capsule. The capsule also contained CART IR nerve cell bodies. The majority of the adrenal CART IR neuronal elements were also VIP IR. CART IR was also seen in a substantial proportion of the C-cells in the thyroid gland. The majority of these cells were also somatostatin IR, and/or 5-HT IR, and/or VIP IR. Conclusion CART is a major neuropeptide in intrinsic neurons of the porcine GI-tract and pancreas, a major constituent of adrenaline producing adrenomedullary cells, and a novel peptide of the thyroid C-cells. CART is suggested to be a regulatory peptide in the porcine pancreas, GI-tract, adrenal gland and thyroid.

  17. Patrones Geográficos de la Mortalidad y de las Desigualdades Socioeconómicas en Mortalidad en España

    OpenAIRE

    Laura Reques; Estrella Miqueleiz; Carolina Giráldez García; Juana M. Santos; David Martínez; Enrique Regidor

    2015-01-01

    Las estimaciones sobre desigualdades socioeconómicas en mortalidad a partir de registros individuales de defunciones y población son escasas y proceden únicamente de la la ciudad de Barcelona, la Comunidad de Madrid y el País Vasco. El objetivo del presente estudio fue mostrar el patrón geográfico de mortalidad en diferentes grupos socioeconómicos, así como el de las desigualdades en mortalidad en el conjunto del territorio español. Métodos: Se realizó el seguimiento de todos los individuos ...

  18. Mortalidad atribuible al alcohol en Cataluña: 1994

    Directory of Open Access Journals (Sweden)

    Alsedá Graells Miquel

    1998-01-01

    Full Text Available FUNDAMENTO: El objetivo de este estudio es evaluar la contribución del consumo de alcohol a la mortalidad en Cataluña durante 1994, así como su contribución a las muertes prematuras. MÉTODOS: En este estudio se han utilizado los datos de las causas de muerte en Cataluña durante 1994 del Servei d'Informació i Estudis de la Direcció General de Recursos Sanitaris del Departament de Sanitat i Seguretat Social de Catalunya. Las fracciones atribuibles al alcohol están basadas en las utilizadas en el estudio de la mortalidad relacionada con el alcohol en Estados Unidos en 1987. RESULTADOS: El 5,3% de las muertes en Cataluña durante 1994 estuvieron relacionadas con el consumo de alcohol. Esta mortalidad fue del 6,5% entre los hombres y del 3,9% entre las mujeres. La categoría diagnóstica que más contribuyó al número de muertes fue la de las neoplasias malignas (29,3%. El estudio de las muertes prematuras muestra que los accidentes no intencionales son la causa más importante (52,3%. En esta categoría diagnóstica los accidentes con vehículos a motor son los principales responsables de los años potenciales de vida perdidos (APVP. La media de APVP por cada muerte atribuible al alcohol hasta la edad de 65 fue de 7,5. CONCLUSIONES: Este estudio muestra la magnitud que tiene el alcohol como problema de salud pública en Cataluña.

  19. Factores de riesgo para mortalidad en gangrena de Fournier

    OpenAIRE

    Azolas M,Rodrigo

    2011-01-01

    Introducción: La Gangrena de Fournier fue descrita por Fournier en 1883, es una fasceitis necrotizan-te que afecta la región perianal y genital. El objetivo del presente trabajo es analizar los factores de riesgo de mortalidad en pacientes portadores de Gangrena de Fournier y su relación con el score pronóstico FGSI (Fournier Gangrene Severity Index Score). Material y Método: Estudio prospectivo entre enero de 2000 y diciembre de 2007 en el Hospital Barros Luco Trudeau, que incluyó 31 pacient...

  20. E-Commerce Performance. Shopping Cart Key Performance Indicators

    Directory of Open Access Journals (Sweden)

    Mihaela I. MUNTEAN

    2016-01-01

    Full Text Available In an e-commerce performance framework is important to identify the key performance indicators that measure success and together provide the greatest context into the business perfor-mance. Shopping carts are an essential part of ecommerce, a minimal set of key performance indicators being the subject of our debate. The theoretical approach is sustained by a case study, an e-shop implemented using PHP and MySQL, for simulating main business processes within the considered performance framework. Our approach opens a perspective for future research using additional indicators in order to properly evaluate the global performance of any e-shop.

  1. Mortalidade materna na perspectiva do familiar Mortalidad materna en la perspectiva del familiar Maternal mortality on the family members' perspective

    Directory of Open Access Journals (Sweden)

    Flávia Azevedo Gomes

    2006-03-01

    Full Text Available A mortalidade materna é um dos indicadores do desenvolvimento de saúde e social de um país. É uma tragédia para a família, pois a morte da mãe priva a criança da amamentação e do contato materno, e pelo fato de caber à mulher manter a unidade da família. Este estudo teve como objetivo compreender o significado da morte atribuído por familiares das mulheres falecidas por causas maternas. A população foi constituída por dez familiares de sete mulheres que morreram durante o ciclo grávido-puerperal no município de Ribeirão Preto. Realizamos visitas domiciliares e a coleta de dados foi realizada por meio de entrevista dada pelo familiar da mulher. Para a análise dos dados, utilizamos a análise temática, em que depreendemos três categorias temáticas: significado da morte materna, vivenciando a mortalidade materna na família e vivenciando a mortalidade materna na instituição de saúde. As visitas domiciliares confirmaram que existem fatores coadjuvantes que influenciaram na ocorrência das mortes maternas.La mortalidad materna es uno de los indicadores del desarrollo en salud y social de un país. Es una tragedia para la familia, pues la muerte de la madre priva al niño del amamantamiento y del contacto materno, y por el hecho de que cabe a la mujer mantener la unidad de la familia. Este estudio tuvo como objetivo comprender el significado de la muerte atribuido por familiares de las mujeres fallecidas por causas maternas. La población estuvo constituida por diez familiares de siete mujeres que murieron durante el ciclo grávido-puerperal en el municipio de Ribeirão Preto. Se efectuaron visitas domiciliarias y la recolección de datos fue realizada por medio de entrevista al familiar de la mujer. Para el análisis de los datos, se utilizó el análisis temático, desprendiéndose tres categorías temáticas: significado de la muerte materna, vivenciando la mortalidad materna en la familia y vivenciando la mortalidad

  2. DeCART v1.2 User's Manual

    International Nuclear Information System (INIS)

    Cho, J. Y.; Kim, K. S.; Kim, H. Y.; Lee, C. C.; Zee, S. Q; Joo, H. G.

    2007-07-01

    DeCART (Deterministic Core Analysis based on Ray Tracing) is a whole core neutron transport code capable of direct subpin level flux calculation at power generating conditions. It does not require a priori homogenization nor group condensation needed in conventional reactor physics calculations. The depletion and transient calculation capabilities are also available. This manual serves as a self-sufficient guide to use the code. First of all, the various features of the code are explained which encompass various modeling options as well as the basic calculation functionalities. The instructions for running the code are also given with a description of the output files generated. Next, the underlying concepts and principles of preparing a DeCART model for a problem under consideration are presented. Each part of the input needed to specify the geometry, material composition, thermal operating condition, program execution control parameters are explained with examples. The descriptions of all the input cards are then followed. Finally, various sample model inputs ranging from a simple 2D pin cell to a realistic 3D core problem, steady-state to transient problems, and from rectangular to hexagonal core problems are presented

  3. DeCART v1.1 user's manual

    International Nuclear Information System (INIS)

    Cho, J. Y.; Kim, K. S.; Kim, H. Y.; Lee, C. C.; Zee, S. Q.; Joo, H. G.

    2005-03-01

    DeCART (Deterministic Core Analysis based on Ray Tracing) is a whole core neutron transport code capable of direct subpin level flux calculation at power generating conditions. It does not require a priori homogenization nor group condensation needed in conventional reactor physics calculations. The depletion and transient calculation capabilities are also available. This manual serves as a self-sufficient guide to use the code. First of all, the various features of the code are explained which encompass various modeling options as well as the basic calculation functionalities. The instructions for running the code are also given with a description of the output files generated. Next, the underlying concepts and principles of preparing a DeCART model for a problem under consideration are presented. Each part of the input needed to specify the geometry, material composition, thermal operating condition, program execution control parameters are explained with examples. The descriptions of all the input cards are then followed. Finally, various sample model inputs ranging from a simple 2D pin cell to a realistic 3D core problem, steady-state to transient problems, are presented

  4. The PASCO Wireless Smart Cart: A Game Changer in the Undergraduate Physics Laboratory

    Science.gov (United States)

    Shakur, Asif; Connor, Rainor

    2018-01-01

    With the introduction of the Wireless Smart Cart by PASCO scientific in April 2016, we expect a paradigm shift in undergraduate physics laboratory instruction. We have evaluated the feasibility of using the smart cart by carrying out experiments that are usually performed using traditional PASCO equipment. The simplicity, convenience, and…

  5. CART peptide is a potential endogenous antioxidant and preferentially localized in mitochondria.

    Directory of Open Access Journals (Sweden)

    Peizhong Mao

    Full Text Available The multifunctional neuropeptide Cocaine and Amphetamine Regulated Transcript (CART is secreted from hypothalamus, pituitary, adrenal gland and pancreas. It also can be found in circulatory system. This feature suggests a general role for CART in different cells. In the present study, we demonstrate that CART protects mitochondrial DNA (mtDNA, cellular proteins and lipids against the oxidative action of hydrogen peroxide, a widely used oxidant. Using cis-parinaric acid as a sensitive reporting probe for peroxidation in membranes, and a lipid-soluble azo initiator of peroxyl radicals, 2,2'-azobis(2,4-dimethylvaleronitrile we found that CART is an antioxidant. Furthermore, we found that CART localized to mitochondria in cultured cells and mouse brain neuronal cells. More importantly, pretreatment with CART by systemic injection protects against a mouse oxidative stress model, which mimics the main features of Parkinson's disease. Given the unique molecular structure and biological features of CART, we conclude that CART is an antioxidant peptide (or antioxidant hormone. We further propose that it may have strong therapeutic properties for human diseases in which oxidative stress is strongly involved such as Parkinson's disease.

  6. Schoolchildren's Consumption of Competitive Foods and Beverages, Excluding a la Carte

    Science.gov (United States)

    Kakarala, Madhuri; Keast, Debra R.; Hoerr, Sharon

    2010-01-01

    Background: Competitive foods/beverages are those in school vending machines, school stores, snack bars, special sales, and items sold a la carte in the school cafeteria that compete with United States Department of Agriculture (USDA) meal program offerings. Grouping a la carte items with less nutritious items allowed in less regulated venues may…

  7. AZ-101 Mixer Pump Demonstration Data Acquisition System and Gamma Cart Data Acquisition Control System Software Configuration Management Plan

    International Nuclear Information System (INIS)

    WHITE, D.A.

    1999-01-01

    This Software Configuration Management Plan (SCMP) provides the instructions for change control of the AZ1101 Mixer Pump Demonstration Data Acquisition System (DAS) and the Sludge Mobilization Cart (Gamma Cart) Data Acquisition and Control System (DACS)

  8. La actuación de enfermería ante las enfermedades infecciosas en la urgencias hospitalarias

    OpenAIRE

    Suárez Domínguez, Sara

    2017-01-01

    [EN] Una enfermedad infecciosa se define como aquella enfermedad producida por microorganismos patógenos como bacterias, hongos, virus o parásitos, la cual puede contagiarse por contacto con animales, insectos o de una persona a otra. A lo largo de este trabajo estudiaremos las Enfermedades Infecciosas Hospitalarias, concretamente en la enfermedad por virus Ébola y en las diferentes actuaciones de enfermería ante la misma. Para ello, se realizará un repaso en la historia y el desarrollo de...

  9. Triage en urgencias y emergencias hospitalarias: revisión de los principales sistemas de triage internacionales.

    OpenAIRE

    Estebaranz Santamaría, Cristina

    2014-01-01

    Trabajo fin de grado en Enfermería Introducción. El “triage” es un proceso de valoración que permite priorizar el nivel de urgencia de los pacientes. Para su aplicación, se utilizan los sistemas de triage estructurado, existiendo en la actualidad cinco modelos a nivel internacional. Objetivo. Analizar los sistemas de triage en el servicio de urgencias y emergencias hospitalarias, determinando las diferencias de sus últimas actualizaciones. Material y método. Revisión narrati...

  10. Necesidad de legislar como contravenciones, las violaciones de normas de bioseguridad e higiene y epidemiología hospitalaria

    OpenAIRE

    Betancourt Doimeadios, Juan Eusebio; Lores Hernández, Luis Enrique; Calzadilla Castillo, Wilmar; Cruz Ávila, Geanela; Marrero Pastor, Alberto

    2014-01-01

    Se realizó una revisión bibliográfica con el objetivo de profundizar conocimientos relacionados con la bioseguridad, las infecciones asociadas a la asistencia sanitaria y la epidemiología hospitalaria. La revisión contempló normas, programas y artículos afines a estos temas y la legislación vigente relacionada con la imposición de multas por contravenciones personales en materia de higiene. Se analizaron las violaciones que con mayor frecuencia se observan en la prestación de la asistencia y ...

  11. La arquitectura hospitalaria y su evolución programática. Lima y Callao, 1955-2005

    OpenAIRE

    Villavisencio Ordóñez, Jorge Mauro Augusto; Villavisencio Ordóñez, Jorge Mauro Augusto

    2013-01-01

    La Tesis tiene como objetivo contar con los acercamientos históricos en la evolución de los programas arquitectónicos de los hospitales de Lima y Callao, en el periodo de 1955 a 2005. Se da inicio la investigación científica a partir de la historia de la arquitectura hospitalaria. Presentamos de forma objetiva como se realiza la programación de hospitales, en las unidades de los espacios y de sus relaciones interfuncionales del hospital. La importancia de saber cual es el significado del e...

  12. CRISPR-Cas9 mediated LAG-3 disruption in CAR-T cells.

    Science.gov (United States)

    Zhang, Yongping; Zhang, Xingying; Cheng, Chen; Mu, Wei; Liu, Xiaojuan; Li, Na; Wei, Xiaofei; Liu, Xiang; Xia, Changqing; Wang, Haoyi

    2017-12-01

    T cells engineered with chimeric antigen receptor (CAR) have been successfully applied to treat advanced refractory B cell malignancy. However, many challenges remain in extending its application toward the treatment of solid tumors. The immunosuppressive nature of tumor microenvironment is considered one of the key factors limiting CAR-T efficacy. One negative regulator of Tcell activity is lymphocyte activation gene-3 (LAG-3). We successfully generated LAG-3 knockout Tand CAR-T cells with high efficiency using CRISPR-Cas9 mediated gene editing and found that the viability and immune phenotype were not dramatically changed during in vitro culture. LAG-3 knockout CAR-T cells displayed robust antigen-specific antitumor activity in cell culture and in murine xenograft model, which is comparable to standard CAR-T cells. Our study demonstrates an efficient approach to silence immune checkpoint in CAR-T cells via gene editing.

  13. [Current Status and Challenges of CAR-T Immunotherapy in Hematologic Malignancies -Review].

    Science.gov (United States)

    Cheng, Xin; Wang, Ya-Jie; Feng, Shuai; Wu, Ya-Yun; Yang, Tong-Hua; Lai, Xun

    2018-04-01

    The chimeric antigen receptor (CAR) T cell therapy has gradually became a new trend in the treatment of refractory and relapsed hematologic malignancies by developing for 30 years. With the exciting development of genetic engineering, CAR-T technology has subjected to 4 generations of innovation. Structure of CAR-T started from a single signal molecule to 2 or more than 2 co-stimulatory molecules, and then coding the CAR gene or promoter. CAR-T can specifically recognize tumor antigens, and does not be restricted by major histocompatibility complex (MHC), thus making a breakthrough in clinical treatment. In this review, the history, structure and mechanism of action of CAR-T, as well as the current status and challenges of CAR-T immunotherapy in acute lymphoblastic leukemia, acute myeloid leukemia, chronic myeloid leukemia and multiple myeloma are summarized.

  14. Insights into cytokine release syndrome and neurotoxicity after CD19-specific CAR-T cell therapy.

    Science.gov (United States)

    Gauthier, Jordan; Turtle, Cameron J

    2018-04-03

    T-cells engineered to express CD19-specific chimeric antigen receptors (CD19 CAR-T cells) can achieve high response rates in patients with refractory/relapsed (R/R) CD19+ hematologic malignancies. Nonetheless, the efficacy of CD19-specific CAR-T cell therapy can be offset by significant toxicities, such as cytokine release syndrome (CRS) and neurotoxicity. In this report of our presentation at the 2018 Second French International Symposium on CAR-T cells (CAR-T day), we describe the clinical presentations of CRS and neurotoxicity in a cohort of 133 adults treated with CD19 CAR-T cells at the Fred Hutchinson Cancer Research Center, and provide insights into the mechanisms contributing to these toxicities. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  15. Análisis del comportamiento de la mortalidad materna y perinatal

    Directory of Open Access Journals (Sweden)

    Angélica Uribe-Meneses

    2011-12-01

    Full Text Available Este estudio se orientó a identificar las causas, calcular la tasa y caracterizar los casos de mortalidad materna y perinatal en la Empresa Social del Estado Hospital Regional Noroccidental del departamento Norte de Santander, entre los años 2006 a 2009. La investigación es de carácter cuantitativo, descriptivo, con enfoque retrospectivo. Se emplearon los siguientes instrumentos para la recolección de información: Ficha SIVIGILA de notificación mortalidad materno perinatal del Instituto Nacional de Salud, encuesta de visita de campo del protocolo para la vigilancia de la mortalidad materno-perinatal del Instituto Nacional de Salud, historias clínicas de cada uno de los casos objeto de estudio. La población es tomada del total de muertes maternas y perinatales de procedencia de la Empresa Social del Estado Hospital Regional Noroccidental del departamento Norte de Santander, la muestra está representada en el 100% de los de casos de mortalidad materna y perinatal de la ESE, que en total son 65 casos, 7 de mortalidad materna y 58 de mortalidad perinatal. Entre las causas identificadas como más prevalentes para la mortalidad materna fueron la eclampsia y/ pre-eclampsia, y la causa de mortalidad perinatal fue el síndrome de dificultad respiratoria, la tasa más alta de mortalidad materna la presentó el municipio del Carmen con 1.49 y convención con 1.41 por 10.000 MEF y la tasa de mortalidad perinatal la presentó el municipio del Carmen con una tasa de 29.65 por 1.000 nacidos vivos.

  16. En plena crisis económica: coste y efectividad de las unidades de estancia corta hospitalarias Economic crisis: cost and effectiveness of short stay hospital units

    OpenAIRE

    F. Epelde; M.L. Iglesias-Lepine; L. Anarte

    2012-01-01

    Fundamento. La duración de la estancia es el principal determinante del coste de una hospitalización, por lo que se deben implementar estrategias para reducir la estancia hospitalaria convencional manteniéndose los niveles de calidad. Las Unidades de Estancia Corta (UEC) nacen con el objetivo de disminuir la estancia hospitalaria en un grupo de patologias y pacientes determinados. El objetivo de este original es evaluar la bibliografía existente sobre la evidencia de la disminución del period...

  17. Efectos del alta hospitalaria temprana en el periodo posparto en la Clínica del Prado, Medellín, Colombia

    OpenAIRE

    Cardona-Ospina, Arturo; Ordoñez-Molina, Jaime; Vásquez-Trespalacios, Elsa María; Universidad CES; Mestra-Palomino, Laureano; García-Posada, Raúl Alejandro

    2014-01-01

    Problema: evaluar el efecto del alta hospitalaria temprana en pacientes sanas. Objetivo: establecerel riesgo de complicaciones en pacientes obstétricas con alta temprana respecto a aquellasque egresan después de 24 horas. Métodos: cohorte prospectiva con seguimiento postparto.Resultados: 750 pacientes, edad promedio de 24,5 años y edad gestacional de 38,5 semanas.El porcentaje de consulta luego del alta fue 2,0 %. El efecto del alta hospitalaria tempranasobre la necesidad de consultar luego d...

  18. Italian translation and cross-cultural comparison with the Childhood Attachment and Relational Trauma Screen (CARTS).

    Science.gov (United States)

    Simonelli, A; Sacchi, C; Cantoni, L; Brown, M; Frewen, P

    2017-01-01

    Background : The Childhood Attachment and Relational Trauma Screen (CARTS) is a computer-administered survey designed to assess retrospectively the socio-ecological context in which instances of child abuse may have occurred. To date, studies supporting the validity of the CARTS have only been undertaken in English-speaking North American populations. Validation projects in other countries and cross-cultural comparisons are therefore warranted. Objective : Develop and preliminarily evaluate the psychometric properties of an Italian version of the CARTS on college students and compare such observations to data acquired from Canadian students. Method : Seventy-nine undergraduate students from the University of Padua (Italy) completed an Italian translation of the CARTS as well as measures of childhood experiences, mental health and attachment, responses to which were compared to those obtained in 288 Canadian students who completed the CARTS in English. Results : Internal consistency and convergent validity with the Childhood Trauma Questionnaire and Parental Bonding Instrument were found to be acceptable for the Italian translation. Within the Italian sample, correlation analyses suggested that CARTS Mother ratings referring to attachment and abuse were associated with romantic attachment, whereas CARTS Father ratings were significantly correlated to PTSD symptoms and other symptoms of psychopathology-distress. Significant differences between Italian and Canadian students across the relationship types for the CARTS abuse and attachment scales were found, indicating that Italian students rated their mothers and fathers as simultaneously less abusive, but also less as a source of secure attachment. Conclusions : The results of this preliminary study seem to suggest convergent validity of the Italian CARTS and the association between childhood attachment-related experiences and romantic attachment. Cultural variations were identified between Canadian and Italian

  19. Association of Cocaine- and Amphetamine-Regulated Transcript (CART) Messenger RNA Level, Food Intake, and Growth in Channel Catfish

    Science.gov (United States)

    Cocaine-and Amphetamine-Regulated Transcript (CART) is a potent hypothalamic anorectic peptide in mammals and fish. We hypothesized that increased food intake is associated with changes in expression of CART mRNA within the brain of channel catfish. Objectives were to clone the CART gene, examine ...

  20. Purification and characterisation of a new hypothalamic satiety peptide, cocaine and amphetamine regulated transcript (CART), produced in yeast.

    Science.gov (United States)

    Thim, L; Nielsen, P F; Judge, M E; Andersen, A S; Diers, I; Egel-Mitani, M; Hastrup, S

    1998-05-29

    Cocaine and amphetamine regulated transcript (CART) is a newly discovered hypothalamic peptide with a potent appetite suppressing activity following intracerebroventricular administration. When the mature rat CART sequence encoding CART(1-102) was inserted in the yeast expression plasmid three CART peptides could be purified from the fermentation broth reflecting processing at dibasic sequences. None of these corresponded to the naturally occurring CART(55-102). In order to obtain CART(55-102) the precursor Glu-Glu-Ile-Asp-CART(55-102) has been produced and CART(55-102) was generated by digestion of the precursor with dipeptidylaminopeptidase-1. All four generated CART peptides have been characterised by N-terminal amino acid sequencing and mass spectrometry. The CART peptides contain six cysteine residues and using the yeast expressed CART(62-102) the disulphide bond configuration was found to be I-III, II-V and IV-VI. When the four CART peptides were intracerebroventricularly injected in fasted mice (0.1 to 2.0 microg) they all produced a dose dependent inhibition of food intake.

  1. Causas externas e mortalidade materna: proposta de classificacao

    Directory of Open Access Journals (Sweden)

    Mercia Maria Rodrigues Alves

    2013-06-01

    Full Text Available OBJETIVO: Analisar os óbitos por causas externas e causas mal definidas em mulheres em idade fértil ocorridos na gravidez e no puerpério precoce. MÉTODOS: Foram estudados 399 óbitos de mulheres em idade fértil de Recife, PE, de 2004 a 2006. A pesquisa utilizou o método Reproductive Age Mortality Survey e um conjunto de instrumentos de investigação padronizados. Foram usados como fontes de dados laudos do Instituto Médico Legal, prontuários hospitalares e da Estratégia Saúde da Família e entrevistas com os familiares das mulheres falecidas. Óbitos por causa externa na gravidez foram classificados de acordo com a circunstância da morte usando-se o código O93 e calculadas as razões de mortalidade materna antes e depois da classificação. RESULTADOS: Foram identificados 18 óbitos na presença de gravidez. A maioria das mulheres tinha entre 20 e 29 anos, de quatro a sete anos de estudo, eram negras, solteiras. Quinze óbitos foram classificados com o código O93 como morte relacionada à gravidez (13 por homicídio - O93.7; dois por suicídio - O93.6 e três mortes maternas obstétricas indiretas (uma homicídio - O93.7 e duas por suicídio - O93.6. Houve incremento médio de 35,0% nas razões de mortalidade materna após classificação. CONCLUSÕES: Os óbitos por causas mal definidas e no puerpério precoce não ocorrem por acaso e sua exclusão dos cálculos dos indicadores de mortalidade materna aumentam os níveis de subinformação.

  2. Mortalidade materna na cidade do Recife Maternal mortality in Recife

    Directory of Open Access Journals (Sweden)

    Aurélio Antônio Ribeiro Costa

    2002-08-01

    Full Text Available Objetivos: determinar a Razão de Mortalidade Materna (RMM entre mulheres residentes na cidade do Recife, pela análise de todas as declarações de óbito de mulheres na idade entre 10-49 anos. Determinar a taxa de sub-registro e estudar as principais características, causas básicas, classificação e evitabilidade das mortes maternas. Métodos: realizou-se estudo descritivo de base populacional, analisando-se todos as declarações de óbito de mulheres entre 10-40 anos e utilizando-se os critérios de Laurenti para classificá-los como declarados ou presumíveis. Estudaram-se os prontuários médicos e os dados de autópsia, quando disponíveis, determinando-se as causas básicas dos óbitos e calculando-se a taxa de sub-registro. A Razão de Mortalidade Materna foi calculada usando as informações sobre nascidos vivos do SINASC (Sistema de Informações dos Nascidos Vivos. Resultados: encontraram-se 144 mortes maternas, sendo 104 declaradas e 44 presumíveis, confirmadas após investigação. A Razão de Mortalidade Materna foi 75,5 por 100.000 nascidos vivos e o percentual de sub-registro foi 27,8%. Observou-se uma predominância de causas diretas, sendo as mais freqüentes hipertensão (19%, hemorragia (16% e infecção (11%. Cerca de 82% das mortes foram consideradas evitáveis por meio de assistência adequada ao pré-natal, parto e puerpério. Conclusões: a Razão de Mortalidade Materna é alta na cidade de Recife, e o percentual de subnotificação permanece elevado. Predominam as causas diretas e os óbitos evitáveis, evidenciando ausência de assistência adequada ao pré-natal, parto e puerpério.Purpose: to determine the Maternal Mortality Ratio (MMR among women living in the city of Recife, Brazil through the analysis of all death certificates of women aged 10-49 years from 1994 to 2000. To determine the underreporting rate and to study the main characteristics, basic causes, classification and avoidance of maternal deaths

  3. Differential expression of CART in ewes with differing ovulation rates.

    Science.gov (United States)

    Juengel, Jennifer L; French, Michelle C; Quirke, Laurel D; Kauff, Alexia; Smith, George W; Johnstone, Peter D

    2017-04-01

    We hypothesised that cocaine- and amphetamine-regulated transcript ( CARTPT ) would be differentially expressed in ewes with differing ovulation rates. Expression of mRNA for CARTPT , as well as LHCGR , FSHR , CYP19A1 and CYP17A1 was determined in antral follicles ≥1 mm in diameter collected during the follicular phase in ewes heterozygous for the Booroola and Inverdale genes (I+B+; average ovulation rate 4) and ++ contemporaries (++; average ovulation rate 1.8). In ++ ewes ( n  = 6), CARTPT was expressed in small follicles (1 to ewes. In I+B+ ewes, 5/6 ewes did not have any follicles that expressed CARTPT , and no CART peptide was detected in any follicle examined. Expression pattern of CYP19A1 differed between I+B+ and ++ ewes with an increased percentage of small and medium follicles (3 to ewes. Many of the large follicles from the I+B+ ewes appeared non-functional and expression of LHCGR , FSHR , CYP17A1 and CYP19A1 was less than that observed in ++ ewes. Expression of FSHR and CYP17A1 was not different between groups in small and medium follicles, but LHCGR expression was approximately double in I+B+ ewes compared to that in ++ ewes. Thus, ewes with high ovulation rates had a distinct pattern of expression of CARTPT mRNA and protein compared to ewes with normal ovulation rates, providing evidence for CART being important in the regulation of ovulation rate. © 2017 Society for Reproduction and Fertility.

  4. Brechas regionales de la mortalidad infantil en Colombia

    Directory of Open Access Journals (Sweden)

    Marta C Jaramillo-Mejía

    Full Text Available Objetivos. Estudiar las variaciones de la tasa de mortalidad infantil (TMI en los departamentos de Colombia durante el período 2003-2009, examinar la persistencia de las variaciones entre los departamentos sobre el tiempo y relacionarlas con el impacto de las condiciones socioeconómicas y la disponibilidad de servicios de salud, sobre la mortalidad infantil. Materiales y métodos. Utilizando estadísticas vitales y relacionando datos socioeconómicos y de servicios de salud, se analizaron tres aspectos: la variación de la TMI departamental (2003-2009, la relación entre la TMI departamental y determinantes claves en el tiempo, y las líneas de causalidad e impacto relativo de los diferentes factores. Se emplearan ecuaciones estructurales. Resultados. Se encontró una razón de 4,7 entre la mayor y menor TMI departamental (2009, esta podría estar subestimada principalmente por el subregistros en departamentos de bajos ingresos. Hay una relación negativa entre la TMI departamental con el tiempo y variables altamente correlacionadas, como educación de la madre, ingreso per cápita, cobertura de aseguramiento y acceso a servicios. Conclusiones. El efecto del aseguramiento, disponibilidad de camas privadas y atención médica, es superior al impacto de mejores condiciones socioeconómicas sobre la TMI. La oferta de servicios no parece estar influenciada por una política racional, los recursos no se asignan de acuerdo con las necesidades, sino con el desarrollo general. Las camas privadas se hacen disponibles donde hay mejor aseguramiento en salud y menor TMI

  5. Brechas regionales de la mortalidad infantil en Colombia

    Directory of Open Access Journals (Sweden)

    Marta C. Jaramillo-Mejía

    2013-12-01

    Full Text Available Objetivos. Estudiar las variaciones de la tasa de mortalidad infantil (TMI en los departamentos de Colombia durante el período 2003-2009, examinar la persistencia de las variaciones entre los departamentos sobre el tiempo y relacionarlas con el impacto de las condiciones socioeconómicas y la disponibilidad de servicios de salud, sobre la mortalidad infantil. Materiales y métodos. Utilizando estadísticas vitales y relacionando datos socioeconómicos y de servicios de salud, se analizaron tres aspectos: la variación de la TMI departamental (2003-2009, la relación entre la TMI departamental y determinantes claves en el tiempo, y las líneas de causalidad e impacto relativo de los diferentes factores. Se emplearan ecuaciones estructurales. Resultados. Se encontró una razón de 4,7 entre la mayor y menor TMI departamental (2009, esta podría estar subestimada principalmente por el subregistros en departamentos de bajos ingresos. Hay una relación negativa entre la TMI departamental con el tiempo y variables altamente correlacionadas, como educación de la madre, ingreso per cápita, cobertura de aseguramiento y acceso a servicios. Conclusiones. El efecto del aseguramiento, disponibilidad de camas privadas y atención médica, es superior al impacto de mejores condiciones socioeconómicas sobre la TMI. La oferta de servicios no parece estar influenciada por una política racional, los recursos no se asignan de acuerdo con las necesidades, sino con el desarrollo general. Las camas privadas se hacen disponibles donde hay mejor aseguramiento en salud y menor TMI

  6. Perfil de la casuística hospitalaria de la población inmigrante en Barcelona

    Directory of Open Access Journals (Sweden)

    Cots F.

    2002-01-01

    Full Text Available Objetivo: A pesar de que en los últimos 5 años la población inmigrante se ha triplicado en ciudades como Barcelona, hasta el momento no se ha evaluado de forma rigurosa el impacto de este colectivo en el sistema sanitario. El objetivo del presente estudio ha sido comparar el perfil de la hospitalización de la población inmigrante con la autóctona, desde el punto de vista de la casuística, gravedad, características demográficas y consumo de estancias. Material y métodos: Se han analizado las 15.057 altas del Hospital del Mar de Barcelona en el año 2000. Este hospital asiste el 60% de los ingresos hospitalarios del distrito de Ciutat Vella, distrito que presentaba en el año 2000 un porcentaje de inmigrantes residentes del 21%. Se han comparado las características sociodemográficas y de casuística de los pacientes en razón de ser o no inmigrantes. También se ha comparado el consumo de recursos hospitalarios teniendo en cuenta la edad, la casuística (grupos relacionados por el diagnóstico y la gravedad (severidad, complicaciones y comorbilidades de la patología atendida. Resultados: La población inmigrante ha presentado una casuística distinta de la autóctona por la marcada diferencia en la edad y por su mayor tasa de fecundidad. El 33% de los ingresos de inmigrantes han sido partos. El coste medio de las altas de inmigrantes de países de renta baja valorado en consumo de estancias hospitalarias, ha sido un 30% menor que el del resto de las altas. Una vez ajustadas la edad, la casuística y la severidad, el consumo de estancias hospitalarias en la población inmigrante ha sido significativamente menor. La diferencia se ha cifrado en un 5% cuando sólo se ha ajustado por patología y en un 10% cuando han sido considerados todos los factores. Conclusiones: Las diferencias en la casuística vienen marcadas por la edad y por las diferencias socioculturales. La pirámide de edad de la población hospitalaria inmigrante recompone

  7. Mortalidade por acidentes de motocicleta no Brasil: analise de tendencia temporal, 1996-2009

    Directory of Open Access Journals (Sweden)

    Evandro Tostes Martins

    2013-10-01

    Full Text Available OBJETIVO Analisar a tendência da mortalidade por acidentes de motocicleta no Brasil. MÉTODOS Estudo descritivo de séries temporais sobre a taxa de mortalidade de acidentes de motocicleta no Brasil, segundo unidades federativas e faixas etárias entre 1996 e 2009. Os dados de óbitos foram obtidos no Sistema de Informação sobre Mortalidade do Ministério da Saúde e da população no Instituto Brasileiro de Geografia Estatística. Taxas de mortalidade padronizadas foram calculadas no período para o Brasil como um todo e Unidades Federativas. Variações anuais das taxas de mortalidade foram estimadas pelo método de Prais-Winsten de regressão linear. RESULTADOS A taxa de mortalidade por acidentes de motocicleta aumentou de 0,5 para 4,5/100.000 habitantes de 1996 a 2009 (aumento de 800% no período e 19% ao ano. Estados com maiores taxas em 2009 foram: Piauí, Tocantins, Sergipe e Mato Grosso. As maiores taxas de crescimento foram observadas nos Estados das regiões Norte, Nordeste e Centro-Oeste. CONCLUSÕES Houve grande aumento das taxas de mortalidade por acidente de motocicleta em todo o Brasil no período, principalmente nos Estados do Nordeste.

  8. Different Subsets of T Cells, Memory, Effector Functions, and CAR-T Immunotherapy.

    Science.gov (United States)

    Golubovskaya, Vita; Wu, Lijun

    2016-03-15

    This review is focused on different subsets of T cells: CD4 and CD8, memory and effector functions, and their role in CAR-T therapy--a cellular adoptive immunotherapy with T cells expressing chimeric antigen receptor. The CAR-T cells recognize tumor antigens and induce cytotoxic activities against tumor cells. Recently, differences in T cell functions and the role of memory and effector T cells were shown to be important in CAR-T cell immunotherapy. The CD4⁺ subsets (Th1, Th2, Th9, Th17, Th22, Treg, and Tfh) and CD8⁺ memory and effector subsets differ in extra-cellular (CD25, CD45RO, CD45RA, CCR-7, L-Selectin [CD62L], etc.); intracellular markers (FOXP3); epigenetic and genetic programs; and metabolic pathways (catabolic or anabolic); and these differences can be modulated to improve CAR-T therapy. In addition, CD4⁺ Treg cells suppress the efficacy of CAR-T cell therapy, and different approaches to overcome this suppression are discussed in this review. Thus, next-generation CAR-T immunotherapy can be improved, based on our knowledge of T cell subsets functions, differentiation, proliferation, and signaling pathways to generate more active CAR-T cells against tumors.

  9. Different Subsets of T Cells, Memory, Effector Functions, and CAR-T Immunotherapy

    Directory of Open Access Journals (Sweden)

    Vita Golubovskaya

    2016-03-01

    Full Text Available This review is focused on different subsets of T cells: CD4 and CD8, memory and effector functions, and their role in CAR-T therapy––a cellular adoptive immunotherapy with T cells expressing chimeric antigen receptor. The CAR-T cells recognize tumor antigens and induce cytotoxic activities against tumor cells. Recently, differences in T cell functions and the role of memory and effector T cells were shown to be important in CAR-T cell immunotherapy. The CD4+ subsets (Th1, Th2, Th9, Th17, Th22, Treg, and Tfh and CD8+ memory and effector subsets differ in extra-cellular (CD25, CD45RO, CD45RA, CCR-7, L-Selectin [CD62L], etc.; intracellular markers (FOXP3; epigenetic and genetic programs; and metabolic pathways (catabolic or anabolic; and these differences can be modulated to improve CAR-T therapy. In addition, CD4+ Treg cells suppress the efficacy of CAR-T cell therapy, and different approaches to overcome this suppression are discussed in this review. Thus, next-generation CAR-T immunotherapy can be improved, based on our knowledge of T cell subsets functions, differentiation, proliferation, and signaling pathways to generate more active CAR-T cells against tumors.

  10. New analogs of the CART peptide with anorexigenic potency: the importance of individual disulfide bridges.

    Science.gov (United States)

    Blechová, Miroslava; Nagelová, Veronika; Záková, Lenka; Demianová, Zuzana; Zelezná, Blanka; Maletínská, Lenka

    2013-01-01

    The CART (cocaine- and amphetamine-regulated transcript) peptide is an anorexigenic neuropeptide that acts in the hypothalamus. The receptor and the mechanism of action of this peptide are still unknown. In our previous study, we showed that the CART peptide binds specifically to PC12 rat pheochromocytoma cells in both the native and differentiated into neuronal phenotype. Two biologically active forms, CART(55-102) and CART(61-102), with equal biological activity, contain three disulfide bridges. To clarify the importance of each of these disulfide bridges in maintaining the biological activity of CART(61-102), an Ala scan at particular S-S bridges forming cysteines was performed, and analogs with only one or two disulfide bridges were synthesized. In this study, a stabilized CART(61-102) analog with norleucine instead of methionine at position 67 was also prepared and was found to bind to PC12 cells with an anorexigenic potency similar to that of CART(61-102). The binding study revealed that out of all analogs tested, [Ala(68,86)]CART(61-102), which contains two disulfide bridges (positions 74-94 and 88-101), preserved a high affinity to both native PC12 cells and those that had been differentiated into neurons. In food intake and behavioral tests with mice after intracerebroventricular administration, this analog showed strong and long-lasting anorexigenic potency. Therefore, the disulfide bridge between cysteines 68 and 86 in CART(61-102) can be omitted without a loss of biological activity, but the preservation of two other disulfide bridges and the full-length peptide are essential for biological activity. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Myeloid Conditioning with c-kit-Targeted CAR-T Cells Enables Donor Stem Cell Engraftment.

    Science.gov (United States)

    Arai, Yasuyuki; Choi, Uimook; Corsino, Cristina I; Koontz, Sherry M; Tajima, Masaki; Sweeney, Colin L; Black, Mary A; Feldman, Steven A; Dinauer, Mary C; Malech, Harry L

    2018-05-02

    We report a novel approach to bone marrow (BM) conditioning using c-kit-targeted chimeric antigen receptor T (c-kit CAR-T) cells in mice. Previous reports using anti-c-kit or anti-CD45 antibody linked to a toxin such as saporin have been promising. We developed a distinctly different approach using c-kit CAR-T cells. Initial studies demonstrated in vitro killing of hematopoietic stem cells by c-kit CAR-T cells but poor expansion in vivo and poor migration of CAR-T cells into BM. Pre-treatment of recipient mice with low-dose cyclophosphamide (125 mg/kg) together with CXCR4 transduction in the CAR-T cells enhanced trafficking to and expansion in BM (c-kit + population (9.0%-0.1%). Because congenic Thy1.1 CAR-T cells were used in the Thy1.2-recipient mice, anti-Thy1.1 antibody could be used to deplete CAR-T cells in vivo before donor BM transplant. This achieved 20%-40% multilineage engraftment. We applied this conditioning to achieve an average of 28% correction of chronic granulomatous disease mice by wild-type BM transplant. Our findings provide a proof of concept that c-kit CAR-T cells can achieve effective BM conditioning without chemo-/radiotherapy. Our work also demonstrates that co-expression of a trafficking receptor can enhance targeting of CAR-T cells to a designated tissue. Published by Elsevier Inc.

  12. Autopercepción de salud general y mortalidad en adultos mayores

    Directory of Open Access Journals (Sweden)

    Ximena Moreno

    2014-05-01

    Conclusiones: Los resultados apoyan los hallazgos previos respecto a que la autopercepción de la salud general negativa predice la mortalidad. Es necesario dilucidar los mecanismos por los que este indicador puede predecir la mortalidad en los adultos mayores, que pueden ser diferentes para hombres y mujeres. Se sugiere investigar el papel de la depresión, considerando que el efecto de la autopercepción de la salud sobre la mortalidad no estaba presente en los estudios que la incluían.

  13. Quantitative evaluation of CART-containing cells in urinary bladder of rats with renovascular hypertension

    Directory of Open Access Journals (Sweden)

    I. Janiuk

    2015-04-01

    Full Text Available Recent biological advances make it possible to discover new peptides associated with hypertension. The cocaine- and amphetamine-regulated transcript (CART is a known factor in appetite and feeding behaviour. Various lines of evidence suggest that this peptide participates not only in control of feeding behaviour but also in the regulation of the cardiovascular and sympathetic systems and blood pressure. The role of CART in blood pressure regulation led us to undertake a study aimed at analysing quantitative changes in CART-containing cells in urinary bladders (UB of rats with renovascular hypertension. We used the Goldblatt model of arterial hypertension (two-kidney, one clip to evaluate quantitative changes. This model provides researchers with a commonly used tool to analyse the renin-angiotensin system of blood pressure control and, eventually, to develop drugs for the treatment of chronic hypertension. The study was performed on sections of urinary bladders of rats after 3-, 14-, 28-, 42 and 91 days from hypertension induction. Immunohistochemical identification of CART cells was performed on paraffin for the UBs of all the study animals. CART was detected in the endocrine cells, especially numerous in the submucosa and muscularis layers, with a few found in the transitional epithelium and only occasionally in serosa. Hypertension significantly increased the number of CART-positive cells in the rat UBs. After 3 and 42 days following the procedure, statistically significantly higher numbers of CART-positive cells were identified in comparison with the control animals. The differences between the hypertensive rats and the control animals concerned not only the number density of CART-immunoreactive cells but also their localization. After a 6-week period, each of the rats subjected to the renal artery clipping procedure developed stable hypertension. CART appeared in numerous transitional epithelium cells. As this study provides novel findings

  14. STS-37 crewmembers test CETA hand cart during training session in JSC's WETF

    Science.gov (United States)

    1989-01-01

    STS-37 Atlantis, Orbiter Vehicle (OV) 104, Mission Specialist (MS) Jerry L. Ross and MS Jerome Apt test crew and equipment translation aid (CETA) manual hand over hand cart during underwater session in JSC's Weightless Environment Training Facility (WETF) Bldg 29. Wearing an extravehicular mobility unit (EMU), Ross pulls the CETA manual cart along the rail while Apt holds onto the back of the cart. The test will determine how difficult it is to maneuver cargo in such a manner when it is done in space on STS-37. The goal is to find the best method for astronauts to move around the exterior of Space Station Freedom (SSF).

  15. Morbilidad y mortalidad en el servicio de hospitalización del Departamento de enfermedades infecciosas, tropicales y dermatológicas del Hospital Nacional Cayetano Heredia entre 1990 - 2000

    Directory of Open Access Journals (Sweden)

    Carlos Zamudio Fuertes

    2004-10-01

    Full Text Available Objetivo: Describir la demografía, e identificar la morbilidad más frecuente y las tasas de mortalidad de la unidad de enfermedades infecciosas en un hospital de referencia, público y docente, localizado en el norte de Lima-Perú. Material y métodos: Se realizó un estudio retrospectivo donde se incluyeron todas las hospitalizaciones del Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas del Hospital Nacional Cayetano Heredia, entre enero de 1990 y diciembre del 2000. Se registraron los datos demográficos, las fechas de ingreso y de alta, todos los diagnósticos, y la condición al alta. Los diagnósticos fueron codificados según la Novena Revisión de la Clasificación Internacional de Enfermedades (CIE-9. Resultados: De 7192 hospitalizaciones registradas, 4603 (64% fueron de pacientes varones, la edad media fue 39.2 ±19 años. Las hospitalizaciones prácticamente se duplicaron (de 440 a 817 durante el periodo en estudio. La edad media aumentó de 36.6 ±16.1 años a 41 ± 19.9 años, las hospitalizaciones de pacientes geriátricos aumentó de 11.8% a 21.3%, y la relación VIH/ no VIH aumentó de 0.07 a 0.25. El índice de rotación de cama aumentó de 12.2 a 22.7. Los diagnósticos más frecuentes fueron: VIH 1209 (10.2%, tuberculosis 1201 (10.1%, celulitis 653 (5.5% y neumonía 651 (5.5%. La mortalidad hospitalaria durante el estudio fue de 8.1%, manteniéndose en promedio constante. Conclusiones: Se observó un aumento en el número de hospitalizaciones, especialmente debido a pacientes geriátricos, sin encontrarse cambios en las tasas de mortalidad. Tuberculosis y VIH fueron los diagnósticos más frecuentes en este estudio. (Rev Med Hered 2004; 15:181-187.

  16. La percepcion de las familias ante la animacion hospitalaria: estudio realizado en el Hospital Materno-Infantil de Oviedo

    Directory of Open Access Journals (Sweden)

    M Teresa Bermudez Rey

    2012-07-01

    Full Text Available En estas líneas se recoge parte de una investigación financiada por la Universidad de Oviedo, sobre la animación realizada en las plantas de Pediatría del Hospital Materno-Infantil de la capital asturiana.La animación hospitalaria es llevada a cabo por asociaciones de voluntariado de reconocida trayectoria: CRUZ ROJA, GALBÁN, (que realiza sólo animación con pacientes pediátricos oncológicos, Voluntariado de la Fundación “la Caixa” (que abre las puertas de las ciber@ulas a todos los niños ingresados en el centro sanitario y SED (Solidaridad, Educación y Desarrollo,En concreto se hace referencia a la opinión de los padres de niños hospitalizados sobre el empleo del tiempo libre de los enfermos, en el que se recogían aspectos como la ocupación del paciente en el tiempo libre; con quién lo comparte; el lugar de juego; la influencia, dedicación y relación con el voluntariado; los efectos que la animación  tiene sobre los enfermos y las familias; la existencia de animación con los hermanos del paciente pediátrico; así como las  características físicas que a su juicio, debieran reunir  tanto el hospital como  las habitaciones de los enfermos.El análisis del estudio, permite identificar la gran aceptación que los padres de los pacientes pediátricos muestran, con respecto a la animación hospitalaria llevada a cabo en el hospital por las cuatro asociaciones antes mencionadas, y pone de manifiesto las consecuencias positivas derivadas de la realización de la misma.Estos resultados avalan la necesidad de profesionalizar la animación hospitalaria, sin que ello suponga prescindir de las valiosas aportaciones del voluntariado. En  consonancia con lo cual se trazan unas líneas generales de actuación.

  17. La mortalidad por tuberculosis en Argentina a lo largo del siglo XX

    Directory of Open Access Journals (Sweden)

    Maria Belen Herrero

    2013-06-01

    Full Text Available El objetivo de este artículo es realizar un análisis de la curva de mortalidad por tuberculosis en Argentina a lo largo del siglo XX, desde 1911 hasta 2007. A partir de los datos obtenidos de diversas fuentes de carácter oficial se marcan las etapas históricas de dicha mortalidad, generando dentro de éstas subperíodos, a fin de entender el comportamiento de la mortalidad por tuberculosis, dependiendo del momento histórico. De esta forma, se vincula el desarrollo de la enfermedad con los dispositivos que se generaron para combatirla. Se realiza un análisis del comportamiento de la mortalidad por regiones del país, partiendo del supuesto que el desarrollo de la misma fue diferente según condiciones económicas y sociales y desarrollo sanitario.

  18. The Communities Advancing Resilience Toolkit (CART): an intervention to build community resilience to disasters.

    Science.gov (United States)

    Pfefferbaum, Rose L; Pfefferbaum, Betty; Van Horn, Richard L; Klomp, Richard W; Norris, Fran H; Reissman, Dori B

    2013-01-01

    Community resilience has emerged as a construct to support and foster healthy individual, family, and community adaptation to mass casualty incidents. The Communities Advancing Resilience Toolkit (CART) is a publicly available theory-based and evidence-informed community intervention designed to enhance community resilience by bringing stakeholders together to address community issues in a process that includes assessment, feedback, planning, and action. Tools include a field-tested community resilience survey and other assessment and analytical instruments. The CART process encourages public engagement in problem solving and the development and use of local assets to address community needs. CART recognizes 4 interrelated domains that contribute to community resilience: connection and caring, resources, transformative potential, and disaster management. The primary value of CART is its contribution to community participation, communication, self-awareness, cooperation, and critical reflection and its ability to stimulate analysis, collaboration, skill building, resource sharing, and purposeful action.

  19. Shopper marketing nutrition interventions: Social norms on grocery carts increase produce spending without increasing shopper budgets

    Directory of Open Access Journals (Sweden)

    Collin R. Payne

    2015-01-01

    Conclusions: Descriptive and provincial social norm messages (i.e., on grocery cart placards may be an overlooked tool to increase produce demand without decreasing store profitability and increasing shopper budgets.

  20. Strategies from a nationwide health information technology implementation: the VA CART story.

    Science.gov (United States)

    Box, Tamára L; McDonell, Mary; Helfrich, Christian D; Jesse, Robert L; Fihn, Stephan D; Rumsfeld, John S

    2010-01-01

    The VA Cardiovascular Assessment, Reporting, and Tracking (CART) system is a customized electronic medical record system which provides standardized report generation for cardiac catheterization procedures, serves as a national data repository, and is the centerpiece of a national quality improvement program. Like many health information technology projects, CART implementation did not proceed without some barriers and resistance. We describe the nationwide implementation of CART at the 77 VA hospitals which perform cardiac catheterizations in three phases: (1) strategic collaborations; (2) installation; and (3) adoption. Throughout implementation, success required a careful balance of technical, clinical, and organizational factors. We offer strategies developed through CART implementation which are broadly applicable to technology projects aimed at improving the quality, reliability, and efficiency of health care.

  1. Parallelization characteristics of a three-dimensional whole-core code DeCART

    International Nuclear Information System (INIS)

    Cho, J. Y.; Joo, H.K.; Kim, H. Y.; Lee, J. C.; Jang, M. H.

    2003-01-01

    Neutron transport calculation for three-dimensional amount of computing time but also huge memory. Therefore, whole-core codes such as DeCART need both also parallel computation and distributed memory capabilities. This paper is to implement such parallel capabilities based on MPI grouping and memory distribution on the DeCART code, and then to evaluate the performance by solving the C5G7 three-dimensional benchmark and a simplified three-dimensional SMART core problem. In C5G7 problem with 24 CPUs, a speedup of maximum 22 is obtained on IBM regatta machine and 21 on a LINUX cluster for the MOC kernel, which indicates good parallel performance of the DeCART code. The simplified SMART problem which need about 11 GBytes memory with one processors requires about 940 MBytes, which means that the DeCART code can now solve large core problems on affordable LINUX clusters

  2. Mortalidad atribuible al consumo de tabaco en México

    Directory of Open Access Journals (Sweden)

    Kuri-Morales Pablo

    2002-01-01

    Full Text Available Objetivo. Estudiar la asociación entre defunciones registradas en la delegación Coyoacán y consumo de tabaco y alcohol. Material y métodos. Estudio de mortalidad proporcional y determinación de fracción atribuible en una cohorte de sujetos de la ciudad de México, D.F., México. Se reunió información de todas las defunciones de 1998 captadas a través del Sistema Estadístico y Epidemiológico de las Defunciones (SEED en la delegación Coyoacán, clasificándolas por diagnóstico en enfermedades del sistema circulatorio (ESC, sistema respiratorio (EPOC, neoplasias (NEO. Se encuestó a familiares de los fallecidos sobre consumo de tabaco y alcohol. Resultados. Fumar los últimos 10 años de vida fue significativo para ESC en hombres de 70 años y más (RM: 2.06, IC 95%=1.18-3.58; y continuar fumando el último año de vida fue significativo para NEO y para EPOC en mujeres de 70 años y más (NEO= RM: 7.24, IC 95%=1.71-30.53; ESR= RM: 4.82, IC 95%=1.41-16.50. En el modelo de regresión para ESC, las personas con tabaquismo intenso tuvieron una posibilidad 0.83 veces mayor de fallecer por ESC, y el RA de esta variable para las ESC en la población general fue 45%. (RM=1.83; IC 95% = 1.1-2.8 p<0.01. Conclusiones. La exposición a tabaco es responsible de la elevada incidencia y mortalidad de enfermedades del sistema circulatorio y respiratorio, así como de neoplasias, en una muestra poblacional de sujetos de la ciudad de México.

  3. Creación de índices de gestión hospitalaria mediante análisis de componentes principales Construction of hospital management indices using principal component analysis

    Directory of Open Access Journals (Sweden)

    José Almenara-Barrios

    2002-11-01

    Full Text Available Objetivo. Obtener índices útiles para la gestión hospitalaria basados en técnicas estadísticas multivariantes descriptivas. Material y métodos. Durante 1999 y 2000 se recogió información del Hospital de Algeciras correspondiente a los ingresos hospitalarios del periodo 1997-1998. Se estudiaron las variables habitualmente monitorizadas por el Servicio Andaluz de Salud, del Sistema Nacional de Salud Español: número de ingresos, mortalidad, número de reingresos, número de consultas externas, índice case-mix, número de estancias e índice funcional. Las variables se midieron en un total de 22 486 ingresos. Aplicamos la técnica de análisis de componentes principales (ACP, y se utilizó la matriz de correlaciones R. Resultados. Se seleccionaron las dos primeras componentes, con un porcentaje acumulado de variabilidad de 62.67%. Conclusiones. La primera componente puede ser asimilada a un nuevo índice que tiene que ver con la cuantía de personas atendidas, llamado demanda asistencial. La segunda explicaría la dificultad de los casos atendidos; le hemos llamado complejidad asistencial. Ambos índices permiten dar una clasificación de los servicios hospitalarios.Objective. To construct useful indices for hospital management, based on descriptive multivariate techniques. Material and Methods. Data were collected during 1999 and 2000, on hospital admissions occurring during 1997-1998 at Hospital General de Algeciras, part of Servicio Andaluz de Salud (SAS of Sistema Nacional de Salud Español (Spanish National Health Service. The following variables routinely monitored by health authorities were analyzed: number of admissions, mortality, number of re-admissions, number of outpatient consultations, case-mix index, number of stays, and functional index. Variables were measured in a total of 22486 admissions. We applied the Principal Components Analysis (PCA method using the R correlation matrix. Results. The first two components were

  4. Raíces Históricas de la Institución Hospitalaria

    Directory of Open Access Journals (Sweden)

    Alberto Amaris Mora

    1996-04-01

    Full Text Available

    “Es la historia madre de la verdad, émula del tiempo, depósito de las acciones, testigo de lo pasado, ejemplo y aviso de lo presente, advertencia de lo porvenir”.

    Miguel de Cervantes Saavedra

    Introducción

    El vocablo español “HOSPITAL” procede de dos voces latinas que significan cada una “huésped” (bien sea el que hospeda o el que es hospedado: hospes, itis y hospitalis,e.

    Para satisfacer el título enunciado nos propusimos realizar una investigación de carácter bibliográfico e histórico, con el fin de conocer en lo posible, hasta donde lo permitiera la información disponible a nuestro alcance, las facetas que en el manejo de los enfermos y a través de los siglos pueden señalarse como similares, equivalentes o precursoras de cualquiera de las actividades que adelantan los hospitales de nuestros días, algunas de cuyas características principales lo presentan como punto de referencia y sitio de internamiento de los enfermos para su tratamiento, constituyéndose a la vez en columna fundamental del ejercicio de todas las profesiones atinentes a la salud, en especial de la Medicina en cuanto tiene que ver con su preservación, o con su recuperación cuando quiera que se ha perdido, y con la atención de las secuelas o limitaciones funcionales que en no pocas ocasiones quedan tras el ataque patológico.

    Además de las acciones específicas atrás relacionadas, el hospital es elemento insustituible en la enseñanza de la Medicina y otras profesiones de salud, apareándose codo a codo con las universidades, que necesitan más de él que él de ellas, sin que esta afirmación pretenda desconocer el muy importante aporte de la institución docente a la institución hospitalaria.

    El Hospital tiene también las funciones de transmitir, actualizar y generar conocimientos, para lo cual

  5. Phase I Escalating-Dose Trial of CAR-T Therapy Targeting CEA+ Metastatic Colorectal Cancers.

    Science.gov (United States)

    Zhang, Chengcheng; Wang, Zhe; Yang, Zhi; Wang, Meiling; Li, Shiqi; Li, Yunyan; Zhang, Rui; Xiong, Zhouxing; Wei, Zhihao; Shen, Junjie; Luo, Yongli; Zhang, Qianzhen; Liu, Limei; Qin, Hong; Liu, Wei; Wu, Feng; Chen, Wei; Pan, Feng; Zhang, Xianquan; Bie, Ping; Liang, Houjie; Pecher, Gabriele; Qian, Cheng

    2017-05-03

    Chimeric antigen receptor T (CAR-T) cells have shown promising efficacy in treatment of hematological malignancies, but its applications in solid tumors need further exploration. In this study, we investigated CAR-T therapy targeting carcino-embryonic antigen (CEA)-positive colorectal cancer (CRC) patients with metastases to evaluate its safety and efficacy. Five escalating dose levels (DLs) (1 × 10 5 to 1 × 10 8 /CAR + /kg cells) of CAR-T were applied in 10 CRC patients. Our data showed that severe adverse events related to CAR-T therapy were not observed. Of the 10 patients, 7 patients who experienced progressive disease (PD) in previous treatments had stable disease after CAR-T therapy. Two patients remained with stable disease for more than 30 weeks, and two patients showed tumor shrinkage by positron emission tomography (PET)/computed tomography (CT) and MRI analysis, respectively. Decline of serum CEA level was apparent in most patients even in long-term observation. Furthermore, we observed persistence of CAR-T cells in peripheral blood of patients receiving high doses of CAR-T therapy. Importantly, we observed CAR-T cell proliferation especially in patients after a second CAR-T therapy. Taken together, we demonstrated that CEA CAR-T cell therapy was well tolerated in CEA + CRC patients even in high doses, and some efficacy was observed in most of the treated patients. Copyright © 2017 The American Society of Gene and Cell Therapy. Published by Elsevier Inc. All rights reserved.

  6. Anthelmintic Resistance of Strongyle Nematodes to Ivermectin and Fenbendazole on Cart Horses in Gondar, Northwest Ethiopia

    OpenAIRE

    Seyoum, Zewdu; Zewdu, Alemu; Dagnachew, Shimelis; Bogale, Basazinew

    2017-01-01

    A study was conducted from November 2015 to April 2016 to determine fenbendazole and ivermectin resistance status of intestinal nematodes of cart horses in Gondar, Northwest Ethiopia. Forty-five strongyle infected animals were used for this study. The animals were randomly allocated into three groups (15 horses per group). Group I was treated with fenbendazole and Group II with ivermectin and Group III was left untreated. Faecal samples were collected from each cart horse before and after tre...

  7. Evaluation of solar-assisted, electric and gas golf carts, Bathurst Glen golf course, Richmond Hill, Ontario

    International Nuclear Information System (INIS)

    2010-08-01

    Municipalities try to limit air pollution resulting from the use of small gasoline engines. Indeed, these engines participate in the smog and greenhouse gas (GHG) emissions and they present operating costs more important than electric equivalents. The potential positive impacts of the use of electric or solar electric golf carts instead of gasoline carts are analyzed through a study that compares two solar-assisted electric golf carts, two standard electric golf carts and two gas-powered golf carts. The energy use and related Co2 emissions, the dependability, and the relative costs were evaluated and Golfer preference was also considered thanks to a feedback survey. The comparison between the solar-assisted and the standard electric carts was made on the basis of electricity measures at three points: alternating current (AC) electricity taken from the grid, direct current (DC) electricity flowing into and out of the batteries, and DC electricity generated by the solar panels. The data collected during this study suggested that other factors associated with cart condition or driver behaviours can be more important than the solar panels in determining overall energy consumption. Choosing an area with full sun exposure to install the solar panel and connecting directly to the grid would also maximize generation potential. The comparison of performance between electric carts and gas carts showed the most considerable positive findings. Indeed, fuel costs and emissions are significantly lower in the case of the electric carts, which also present a better fuel efficiency. Switching the 20 percent of gas-powered carts counted within a 100 km radius of Toronto with electric carts could be comparable to removing 155 mid-sized gasoline cars of the road. The electric golf carts present many important financial and environmental benefits when compared to gas carts. The performance is marginally enhanced with the use of solar panels on electric carts and the date collected from

  8. CAR-T Cells: A Systematic Review and Mixed Methods Analysis of the Clinical Trial Landscape.

    Science.gov (United States)

    Pettitt, David; Arshad, Zeeshaan; Smith, James; Stanic, Tijana; Holländer, Georg; Brindley, David

    2018-02-07

    CAR-T cells are a promising new therapy that offer significant advantages compared with conventional immunotherapies. This systematic review and clinical trial landscape identifies and critiques published CAR-T cell clinical trials and examines the critical factors required to enable CAR-T cells to become a standard therapy. A review of the literature was conducted to identify suitable studies from the MEDLINE and Ovid bibliographic databases. The literature and database searches identified 20 studies for inclusion. The average number of participants per clinical trial examined was 11 patients. All studies included in this systematic review investigated CAR-T cells and were prospective, uncontrolled clinical studies. Leukemia is the most common cancer subtype and accounts for 57.4% (n = 120) of disease indications. The majority of studies used an autologous cell source (85%, n = 17) rather than an allogeneic cell source. Translational challenges encompass technical considerations relating to CAR-T cell development, manufacturing practicability, clinical trial approaches, CAR-T cell quality and persistence, and patient management. Copyright © 2017 The American Society of Gene and Cell Therapy. Published by Elsevier Inc. All rights reserved.

  9. Cocaine-and Amphetamine Regulated Transcript (CART) Peptide Is Expressed in Precursor Cells and Somatotropes of the Mouse Pituitary Gland

    Science.gov (United States)

    Mortensen, Amanda H.

    2016-01-01

    Cocaine-and Amphetamine Regulated Transcript (CART) peptide is expressed in the brain, endocrine and neuroendocrine systems and secreted into the serum. It is thought to play a role in regulation of hypothalamic pituitary functions. Here we report a spatial and temporal analysis of Cart expression in the pituitaries of adult and developing normal and mutant mice with hypopituitarism. We found that Prop1 is not necessary for initiation of Cart expression in the fetal pituitary at e14.5, but it is required indirectly for maintenance of Cart expression in the postnatal anterior pituitary gland. Pou1f1 deficiency has no effect on Cart expression before or after birth. There is no 1:1 correspondence between CART and any particular cell type. In neonates, CART is detected primarily in non-proliferating, POU1F1-positive cells. CART is also found in some cells that express TSH and GH suggesting a correspondence with committed progenitors of the POU1F1 lineage. In summary, we have characterized the normal temporal and cell specific expression of CART in mouse development and demonstrate that postnatal CART expression in the pituitary gland requires PROP1. PMID:27685990

  10. Cocaine-and Amphetamine Regulated Transcript (CART Peptide Is Expressed in Precursor Cells and Somatotropes of the Mouse Pituitary Gland.

    Directory of Open Access Journals (Sweden)

    Amanda H Mortensen

    Full Text Available Cocaine-and Amphetamine Regulated Transcript (CART peptide is expressed in the brain, endocrine and neuroendocrine systems and secreted into the serum. It is thought to play a role in regulation of hypothalamic pituitary functions. Here we report a spatial and temporal analysis of Cart expression in the pituitaries of adult and developing normal and mutant mice with hypopituitarism. We found that Prop1 is not necessary for initiation of Cart expression in the fetal pituitary at e14.5, but it is required indirectly for maintenance of Cart expression in the postnatal anterior pituitary gland. Pou1f1 deficiency has no effect on Cart expression before or after birth. There is no 1:1 correspondence between CART and any particular cell type. In neonates, CART is detected primarily in non-proliferating, POU1F1-positive cells. CART is also found in some cells that express TSH and GH suggesting a correspondence with committed progenitors of the POU1F1 lineage. In summary, we have characterized the normal temporal and cell specific expression of CART in mouse development and demonstrate that postnatal CART expression in the pituitary gland requires PROP1.

  11. Intermediate transport in Southeast Asia. [Carts, cycles, mini-buses

    Energy Technology Data Exchange (ETDEWEB)

    Meier, A.K.

    1977-06-01

    Traffic flows through the streets of Southeast Asian countries even though they are used for almost all aspects of human and animal existence. The carts, bicycles, tricycles, and motorcycles, motorized three-wheelers, mini-buses are the so-called intermediate-transport vehicles. It is upon this group of vehicles that a culture--constrained by its own unique economic, environmental, and technological factors--exerts its influence most directly toward the solution of the transport problem. Transportation fills more service roles in Southeast Asian cities than in Western cities. Communication facilities such as telephones and postal services are notoriously unreliable. The personal encounter is all important in social and business interactions in Southeast Asia. Each of the transport modes is examined in view of design and use in a number of specific cultural settings for the countries in Southeast Asia. Present use of intermediate transport in developed countries is discussed briefly, and its further development predicted--pointing out the health and conservation advantages. (MCW)

  12. Motion sickness in ancient China: Seasickness and cart-sickness.

    Science.gov (United States)

    Brandt, Thomas; Bauer, Matthias; Benson, Judy; Huppert, Doreen

    2016-07-19

    To find and analyze descriptions of motion sickness in Chinese historical sources. Databases and dictionaries were searched for various terms for seasickness and travel sickness, which were then entered into databases of full texts allowing selection of relevant passages from about the third to the 19th century ad. Already in 300 ad the Chinese differentiated cart-sickness, particularly experienced by persons from the arid north of China, from a ship-illness experienced by persons from the south, where rivers were important for transportation and travel. In the Middle Ages, a third form of motion sickness was called litter-influence experienced by persons transported in a bed suspended between 2 long poles. The ancient Chinese recognized the particular susceptibility of children to motion sickness. Therapeutic recommendations include drinking the urine of young boys, swallowing white sand-syrup, collecting water drops from a bamboo stick, or hiding some earth from the middle of the kitchen hearth under the hair. The Chinese medical classics distinguished several forms of travel sickness, all of which had their own written characters. The pathophysiologic mechanism was explained by the medicine of correspondences, which was based on malfunctions within the body, its invasion by external pathogens like wind, or the deficit or surfeit of certain bodily substances such as the life force Qi. The concept of motion as the trigger of sickness initially appeared in a chapter on warding off the influence of demons and corpses, e.g., ancient magic and beliefs. © 2016 American Academy of Neurology.

  13. Multidisciplinary approach to converting power chair into motorized prone cart.

    Science.gov (United States)

    Brose, Steven W; Wali, Eisha

    2014-01-01

    Pressure ulcers remain a major source of morbidity and mortality in veterans with neurologic impairment. Management of pressure ulcers typically involves pressure relief over skin regions containing wounds, but this can lead to loss of mobility and independence when the wounds are located in regions that receive pressure from sitting. An innovative, low-cost, multidisciplinary effort was undertaken to maximize quality of life in a veteran with a thoracic-4 level complete spinal cord injury and a stage 4 ischial wound. The person's power wheelchair was converted into a motorized prone cart, allowing navigation of the Department of Veterans Affairs spinal cord injury hospital ward and improved socialization while relieving pressure on the wound. Physical and occupational therapy assisted with the reconfiguration of the power chair and verified safe transfers into the chair and driving of the device. Psychology verified positive psychosocial benefit, while nursing and physician services verified an absence of unwanted pain or skin injury resulting from use of the device. Further investigation of ways to apply this technique is warranted to improve the quality of life of persons with pressure ulcers.

  14. To Love—To Live: Barrow and Cart

    Directory of Open Access Journals (Sweden)

    Lisa McDonald

    2013-02-01

    Full Text Available From the residue of meaning, an ensemble of shadows. From the glint of souvenir, pliable impressions. In this paper, we work a poetics of encounter, of being, keeping, homage, of paying homage to fragility, to object and to interspecies—ways are found to engage motion from within and around co-extensive bodies. With the consolation of images, we follow the terse rhythms of routine and street where dwelling is a case of affective dissent. Zones of departure appear through testimony as well as chance, taking their own form. A footfall brings us as observers into quiet spaces which refuse self-estrangement as we travel by way of an unquiet ground. Breath, respiration, aspiration. Precipitation. Sculptures of mist are also the language of lives, of kinship between object, footfall and air. A language of brackets, questions, ellipses. There may be a man, a dog, a barrow. There may be a woman, a cart. Air. How shall this image be made?

  15. Factores de riesgo asociados a la mortalidad por enterocolitis necrotizante

    Directory of Open Access Journals (Sweden)

    Vivian R. Mena Miranda

    Full Text Available La enterocolitis necrotizante es una urgencia gastrointestinal de causa multifactorial muy relacionada con el neonato pretérmino. Su elevada mortalidad radica en la falta de prevención por el médico a cualquier nivel de atención y a su diagnóstico tardío en los grupos de riesgo. Se realizó un estudio retrospectivo de los 63 pacientes fallecidos por enterocolitis necrotizante durante un período de 25 años en el Hospital Pediátrico Docente de Centro Habana, donde se encontró que el 71,4 % de los afectados era de la raza blanca y el 68,2 % del sexo masculino. La edad más frecuente se encontró en los menores de 3 meses de edad (36,5 % y el 46 % del total de la muestra estudiada tuvo un peso al nacer inferior a los 1 500 g. La prematuridad apareció asociada en el 55,5 % de los fallecidos y el 65 % tuvo lactancia mixta desde el momento de nacimiento.

  16. Factores de riesgo asociados a la mortalidad por enterocolitis necrotizante

    Directory of Open Access Journals (Sweden)

    Vivian R. Mena Miranda

    Full Text Available La enterocolitis necrotizante (ECN es una urgencia gastrointestinal de causa multifactorial muy relacionada con el neonato pretérmino. Su elevada mortalidad radica en la falta de prevención por el médico a cualquier nivel de atención y a su diagnóstico tardío en los grupos de riesgo. Se realizó un estudio retrospectivo de los 63 pacientes fallecidos por ECN durante un período de 25 años en el Hospital Pediátrico Docente "Centro Habana", donde se encontró que 71,4 % de los afectados eran de la raza blanca y el 68,2 % del sexo masculino. La edad más frecuente se halló en los menores de 3 meses de edad (36,5 % y el 46 % del total de la muestra estudiada tuvo un peso al nacer inferior a los 1 500 g. La prematuridad apareció asociada en el 55,5 % de los fallecidos y el 65 % tuvo lactancia mixta desde el momento de nacimiento.

  17. Demographic and financial characteristics of school districts with low and high à la Carte sales in rural Kansas Public Schools.

    Science.gov (United States)

    Nollen, Nicole L; Kimminau, Kim S; Nazir, Niaman

    2011-06-01

    Reducing à la carte items in schools-foods and beverages sold outside the reimbursable meals program-can have important implications for childhood obesity. However, schools are reluctant to reduce à la carte offerings because of the impact these changes could have on revenue. Some foodservice programs operate with limited à la carte sales, but little is known about these programs. This secondary data analysis compared rural and urban/suburban school districts with low and high à la carte sales. Foodservice financial records (2007-2008) were obtained from the Kansas State Department of Education for all public K-12 school districts (n=302). χ² and t tests were used to examine the independent association of variables to à la carte sales. A multivariate model was then constructed of the factors most strongly associated with low à la carte sales. In rural districts with low à la carte sales, lunch prices and participation were higher, lunch costs and à la carte quality were lower, and fewer free/reduced price lunches were served compared to rural districts with high à la carte sales. Lunch price (odds ratio=1.2; 95% confidence interval, 1.1 to 1.4) and free/reduced price lunch participation (odds ratio=3.0; 95% confidence interval, 1.0 to 9.8) remained in the multivariate model predicting low à la carte sales. No differences were found between urban/suburban districts with low and high à la carte sales. Findings highlight important factors to maintaining low à la carte sales. Schools should consider raising lunch prices and increasing meal participation rates as two potential strategies for reducing the sale of à la carte items without compromising foodservice revenue. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

  18. Predictores de mortalidad hospitalaria y a medio plazo tras el reemplazo valvular aórtico transcatéter: datos del registro nacional TAVI 2010-2011

    Directory of Open Access Journals (Sweden)

    Manel Sabaté

    2013-10-01

    Conclusiones: La selección del paciente teniendo en cuenta su comorbilidad y la optimización del resultado para minimizar el grado de insuficiencia aórtica residual pueden mejorar el pronóstico de estos pacientes.

  19. Mortalidade infantil em duas coortes de base populacional no Sul do Brasil: tendências e diferenciais Infant mortality in two population-based cohorts in southern Brazil: trends and differentials

    Directory of Open Access Journals (Sweden)

    Ana M. B. Menezes

    1996-01-01

    Full Text Available Estudou-se a tendência temporal da mortalidade infantil através de dois estudos de coorte realizados em Pelotas, Rio Grande do Sul, em 1982 e 1993. Ambas coortes incluíram todos os nascimentos hospitalares e óbitos verificados através de visitas regulares aos hospitais, cartórios e cemitérios. As informações sobre a causa de morte foram obtidas através de entrevistas com pediatras, revisão do prontuário, necrópsias e entrevista com os pais das crianças. O coeficiente de mortalidade infantil caiu de 36,4 por mil nascidos vivos para 21,1 na década. As principais causas de mortalidade infantil em 1993 foram as perinatais, malformações congênitas, diarréia e infecções respiratórias. Crianças com baixo peso ao nascer apresentaram mortalidade 12 vezes maior do que crianças com peso adequado, e crianças pré-termo, duas vezes mais do que crianças com retardo de crescimento intra-uterino. Crianças de famílias com renda baixa (um salário mínimo apresentaram mortalidade sete vezes superior àquelas com renda alta (10 salários mínimos. A mortalidade de crianças de baixo peso ao nascer e alta renda familiar decresceu em 67%, contra apenas 36% para as de baixa renda. Conclui-se que, mesmo com uma queda expressiva da mortalidade infantil na década, persistem importantes desigualdades sociais.Time trends in infant mortality were assessed through two cohort studies carried out in Pelotas, Southern Brazil, in 1982 and 1993. Both cohorts included all hospital deliveries, and deaths were monitored through regular visits to hospitals, cemeteries, and notary publics. Information on cause of death was obtained from pediatricians, case notes, autopsies, and home visits to parents. The infant mortality rate fell from 36.4 in 1982 to 21.1 per thousand live births in 1993. The main causes of death in 1993 were perinatal, congenital malformations, diarrhea, and respiratory infections. Low birthweight babies were twelve times more likely

  20. Patrones diferenciales de mortalidad entre inmigrantes nicaragüenses y residentes nativos de Costa Rica

    Directory of Open Access Journals (Sweden)

    Herring, Andrew A.

    2008-07-01

    Full Text Available Utilizando datos del Registro Nacional de defunciones de los años 1996-2005 se calcularon las tasas de mortalidad estandarizadas por edad para personas nacidas en Nicaragua versus personas nacidas en Costa Rica. Así mismo, utilizando modelos de regresión binomial se determinaron los riesgos relativos de mortalidad de los inmigrantes nicaragüenses versus personas nativas de Costa Rica con ajustes por edad, urbanización, desempleo, pobreza, educación y segregación residencial. Los hombres y mujeres nacidos en Nicaragua tuvieron un riesgo reducido de mortalidad de 32% y 34% respectivamente con relación a sus contrapartes nacidas en Costa Rica. Se notó que los riesgos de mortalidad por enfermedades infecciosas, cáncer, enfermedades crónicas pulmonares, enfermedades cardiovasculares, y enfermedades crónicas del hígado eran significativamente reducidos entre los inmigrantes nacidos en Nicaragua. El exceso significativo de mortalidad por homicidios se encontró entre los hombres nacidos en Nicaragua (RT = 1,35, 95% IC: 1,19; 1,53 y en mujeres (RT = 1,41, 95% IC: 1,02; 1,95. El riesgo relativo de causas de mortalidad de origen de tipo exógeno entre los inmigrantes nicaragüenses fue más grande entre los grupos de edad joven en áreas de baja densidad de inmigrantes nicaragüenses. La población nacida en Nicaragua residiendo en Costa Rica tiene un riesgo reducido de mortalidad por causas generales versus las personas nacidas en Costa Rica en los años entre 1996-2005. Esto se debe a una mortalidad por enfermedad reducida, la cual es bastante marcada. El homicidio es un una razón de mayor mortalidad entre los inmigrantes nacidos en Nicaragua versus los nativos costarricenses. Hay una gran necesidad de llevar acabo investigaciones adicionales sobre el rol de la migración, estatus socioeconómico y comportamientos entorno a la salud para poder explicar más a fondo los patrones de mortalidad diferenciales entre los inmigrantes nicarag

  1. UNA APROXIMACION A LOS DETERMINANTES SOCIOECONOMICOS DE LA MORTALIDAD INFANTIL Y DE NIÑEZ EN BOLIVIA: USO DE METODOS INDIRECTOS DE CALCULO DE MORTALIDAD Y ANALISIS BIVARIADO

    Directory of Open Access Journals (Sweden)

    Pamela Córdova

    2016-01-01

    Full Text Available A pesar de las importantes mejoras en los resultados de salud infantil y de niñez durante el Siglo XXI en América Latina, las tasas de mortalidad infantil y de niñez permanecen inaceptablemente altas en Bolivia encontrándose entre las más elevadas la región, solo por debajo de Haití, dirigiéndose a una deficiente salud infantil y de niñez. Estos resultados requieren de evidencia científica sobre la mejor manera de hacer frente a sus determinantes. Este estudio aproxima, teóricamente, mediante el marco teórico propuesto por Mosley-Chen y Sastry, los determinantes de la mortalidad infantil y de niñez en Bolivia enfocados en características individuales, del hogar y contextual. Además se examina de manera preliminar los niveles y magnitudes de la mortalidad mediante el uso de métodos directos e indirectos de estimación mediante la técnica propuesta por la versión Trussel y la versión Palloni-Heligman del Método de Brass y se realiza un análisis bivariado que da cuenta de relaciones existentes entre la mortalidad infantil y de niñez y las variables a nivel del hogar, individual y contextual relacionado con las políticas públicas.

  2. CART (cocaine- and amphetamine-regulated transcript) peptide specific binding sites in PC12 cells have characteristics of CART peptide receptors

    Czech Academy of Sciences Publication Activity Database

    Nagelová, Veronika; Pirnik, Z.; Železná, Blanka; Maletínská, Lenka

    2014-01-01

    Roč. 1547, Feb 14 (2014), s. 16-24 ISSN 0006-8993 R&D Projects: GA ČR GAP303/10/1368 Institutional support: RVO:61388963 Keywords : CART peptide * PC12 cell * differentiation * binding * signaling * c-Jun Subject RIV: CE - Biochemistry Impact factor: 2.843, year: 2014

  3. CAR-T cells and allogeneic hematopoietic stem cell transplantation for relapsed/refractory B-cell acute lymphoblastic leukemia.

    Science.gov (United States)

    Liu, Jun; Zhang, Xi; Zhong, Jiang F; Zhang, Cheng

    2017-10-01

    Relapsed/refractory acute lymphoblastic leukemia (ALL) has a low remission rate after chemotherapy, a high relapse rate and poor long-term survival even when allogeneic hematopoietic stem cell transplantation (allo-HSCT) is performed. Chimeric antigen receptors redirected T cells (CAR-T cells) can enhance disease remission with a favorable outcome for relapsed/refractory ALL, though some cases quickly relapsed after CAR-T cell treatment. Thus, treatment with CAR-T cells followed by allo-HSCT may be the best way to treat relapsed/refractory ALL. In this review, we first discuss the different types of CAR-T cells. We then discuss the treatment of relapsed/refractory ALL using only CAR-T cells. Finally, we discuss the use of CAR-T cells, followed by allo-HSCT, for the treatment of relapsed/refractory ALL.

  4. Factores de riesgo asociados a la mortalidad por enterocolitis necrotizante

    Directory of Open Access Journals (Sweden)

    Vivian R. Mena Miranda

    1998-06-01

    Full Text Available La enterocolitis necrotizante es una urgencia gastrointestinal de causa multifactorial muy relacionada con el neonato pretérmino. Su elevada mortalidad radica en la falta de prevención por el médico a cualquier nivel de atención y a su diagnóstico tardío en los grupos de riesgo. Se realizó un estudio retrospectivo de los 63 pacientes fallecidos por enterocolitis necrotizante durante un período de 25 años en el Hospital Pediátrico Docente de Centro Habana, donde se encontró que el 71,4 % de los afectados era de la raza blanca y el 68,2 % del sexo masculino. La edad más frecuente se encontró en los menores de 3 meses de edad (36,5 % y el 46 % del total de la muestra estudiada tuvo un peso al nacer inferior a los 1 500 g. La prematuridad apareció asociada en el 55,5 % de los fallecidos y el 65 % tuvo lactancia mixta desde el momento de nacimiento.Necrotizing enterocolitis is a gastrointestinal urgency of multifactorial cause taht is closely connected with the preterm neonatus. Its high mortality results from the lack of prevention on the part of the physician at any level of attention and from its late diagnosis in the risk groups. A retrospective study of 63 patients who died of necrotizing enterocolitis during a period of 25 years at the Pediatric Teaching Hospital of Central Havana was conducted. It was found that 71.4 % of the affected were white and 68.2 % were males. It was more frequent among those under 3 months (36.5 %. 46 % of the total of the sample studied had a birth weight of less than 1 500 g. Prematurity appeared associated in 55 % of the dead, whereas 65 % had a mixed lactation since their birth.

  5. Mortalidad por meningitis por Pasteurella canis. Oportunidades de aprendizaje

    Directory of Open Access Journals (Sweden)

    Ana Rosa Ropero Vera

    2016-01-01

    Full Text Available La meningitis bacteriana es una enfermedad importante de distribución mundial, causa mayor y sustancial de mortalidad y morbilidad en países en desarrollo. La Organización Mundial de la Salud (OMS sostiene que la meningitis es una de las diez afecciones principales del ser humano y debe ser considerada como una emergencia infectológica; por eso es fundamental reconocer que esta enfermedad es causa de muerte en niños de todo el mundo, sin distinción de raza, nivel económico o sociocultural. Se realizó una investigación de caso en menor de 53 días de nacido, que cumplía con los criterios clínicos y de laboratorio compatible con meningitis bacteriana, con el propósito de analizar y fortalecer la toma de decisiones en salud pública por parte de la secretaría local de salud del municipio de Valledupar (Colombia. Entre los hallazgos se encontró antecedentes infecciosos en el menor, coloración de Gram y cultivo de LCR, en el que se identificó cocobacilos Gram negativos, que fueron aislados como agente causal Pasteurella canis. Este estudio pretende sensibilizar a los prestadores de salud para que cuenten con personal altamente capacitado para brindar tratamientos adecuados y prevenir complicaciones en la meningitis bacteriana en niños, y así disminuir la posibilidad de secuelas o muerte, tanto en pacientes con compromiso inmunológico o sin este.

  6. 241-AZ-101 Mixer Pump Demonstration Test Gamma Cart Acceptance Test Procedure and Quality Test Plan (ATP and QTP)

    International Nuclear Information System (INIS)

    WHITE, D.A.

    2000-01-01

    Shop test of the sludge mobilization cart system to be used in the AZ-101 Mixer Pump Demonstration Test Tests hardware and software. This procedure involves testing the Instrumentation involved with the Gamma Cart System, local and remote, including depth indicators, speed controls, interface to data acquisition software and the raising and lowering functions. This Procedure will be performed twice, once for each Gamma Cart System. This procedure does not test the accuracy of the data acquisition software

  7. 241-AZ-101 Mixer Pump Demonstration Test Gamma Cart Acceptance Test Procedure and Quality Test Plan (ATP and QTP)

    International Nuclear Information System (INIS)

    WHITE, D.A.

    2000-01-01

    Shop Test of the Gamma Cart System to be used in the AZ-101 Mixer Pump Demonstration Test. Tests hardware and software. This procedure involves testing the Instrumentation involved with the Gamma Cart System, local and remote, including: depth indicators, speed controls, interface to data acquisition software and the raising and lowering functions. This Procedure will be performed twice, once for each Gamma Cart System. This procedure does not test the accuracy of the data acquisition software

  8. Estrategias para reducir la mortalidad infantil, Cuba 1959-1999

    Directory of Open Access Journals (Sweden)

    Raúl L. Riverón Corteguera

    2000-09-01

    Full Text Available Se describen las estrategias utilizadas por el Ministerio de Salud Pública en las diferentes etapas del Programa de Atención Maternoinfantil, para reducir la mortalidad infantil en Cuba de 1959 a 1999. Este período se dividió para su comprensión en 4 decenios. Se hace referencia a las diferentes medidas utilizadas, desde la creación del Sistema Nacional de Salud, la formación de recursos humanos; el desarrollo de la Educación Médica, la edificación de Facultades de Ciencias Médicas y la capacitación del posgraduado, el incremento de hospitales y el aumento de las camas hasta los programas de inmunización, de lucha contra la gastroenteritis y para disminuir el bajo peso al nacer, el uso racional de los antimicrobianos; la presencia de la madre acompañante; la implantación del uso de las sales de rehidratación oral (SRO para prevenir y tratar la deshidratación por enfermedades diarreicas; el desarrollo de la Atención Primaria de Salud; los programas de tecnología avanzada para la detección de anomalías congénitas; la promoción de la lactancia materna exclusiva (LME; la categorización, por UNICEF, de los hospitales "Amigos de la Madres y el Niño", el desarrollo de investigaciones que sirvieron de base al Programa de Atención Maternoinfantil; la edificación de hospitales; la construcción de las unidades de terapia intensiva con equipamiento moderno tanto en pediatría como en neonatología y otros muchos elementos puestos en prácticas durante estos 40 años. Esto ha contribuido a que la mortalidad infantil, a pesar de haberse incrementado en el primer decenio (1959-1969 en el 25,5 %, a partir del 2do. decenio (1970-1979 iniciara un descenso mantenido en el 50 %; en el 3er. decenio (1980-1989 del 43,4 % y en el 4to. decenio (1990-1999 del 40,2 %. Se concluye exponiendo las principales estrategias que contribuyeron a reducir la mortalidad infantil en los últimos años de este siglo.The strategies used by the Ministry of

  9. Variación estacional de la mortalidad en la ciudad de Valencia, España

    OpenAIRE

    BALLESTER-DÍEZ FERRAN; CORELLA-PIQUER DOLORS; PÉREZ-HOYOS SANTIAGO; HERVÁS-HERNANDORENA ANNA; MERINO-EGEA CAYETANO

    1997-01-01

    Objetivo. Estudiar la variación estacional de la mortalidad por todas las causas según grupo de edad y sexo, en la ciudad de Valencia, España, durante el periodo 1976-1990, y su relación con la temperatura. Material y métodos. Se hizo un estudio ecológico de series mensuales de mortalidad global y temperatura media. La variable principal de resultado fue la mortalidad por todas las causas. Se calcularon las tasas de mortalidad específicas por grupos de edad (0-4, 35-39, 50-64, 65-74 y > o = ...

  10. Mortalidade de motociclistas em acidentes de transporte no Distrito Federal, 1996 a 2007

    Directory of Open Access Journals (Sweden)

    Marli de Mesquita Silva Montenegro

    2011-06-01

    Full Text Available OBJETIVO: Descrever características sociodemográficas e analisar a tendência temporal da mortalidade de motociclistas traumatizados em acidentes de transporte. MÉTODOS: Estudo de séries temporais com dados de 580 óbitos de motociclistas do Distrito Federal, de 1996 a 2007, obtidos do Sistema de Informações sobre Mortalidade. Foram calculadas as taxas de mortalidade específicas segundo idade e sexo, as taxas padronizadas (método direto e a razão de óbitos por frota (motocicletas. A média móvel centralizada da taxa padronizada de mortalidade de homens foi calculada para o período de três anos e um modelo de regressão linear foi construído para estudar a evolução temporal da mortalidade. Para calcular o incremento anual da taxa de mortalidade padronizada utilizou-se o método joinpoint (ponto de inflexão. RESULTADOS: A maior parte dos motociclistas mortos era do sexo masculino, (94,3%, pardo (71,0% e tinha entre 20 e 39 anos (73,8%. A taxa padronizada de mortalidade de motociclistas (homens residentes foi de 1,9 para 7,2 óbitos/100 mil homens entre 1996 e 2007. Entre 1998 e 2007, a razão de óbitos por frota passou de 2,0 óbitos/10 mil motocicletas para 10,0 óbitos/10 mil motocicletas entre os homens. Estimou-se incremento anual de 0,48 óbito/100 mil homens (IC95% 0,31;0,65; p < 0,001. O incremento percentual anual da taxa padronizada de mortalidade para o sexo masculino foi de 36,2% no período 1998-2007 (IC 95% 21,2%;53,2%; p < 0,05. CONCLUSÕES: A taxa de mortalidade de motociclistas decorrente de acidentes de transporte aumentou expressivamente. Esse aumento é explicado apenas em parte pelo aumento da frota de motocicletas. Características individuais dos condutores, bem como as condições locais do tráfego, necessitam ser investigadas para o planejamento de políticas preventivas.

  11. MORTALIDADE POR CÂNCER DE COLO UTERINO, 1996-2011, SANTA CATARINA, BRASIL

    Directory of Open Access Journals (Sweden)

    Kathleen Mary Hegadoren

    2014-01-01

    Full Text Available Estudio cuantitativo de base poplacional. Los autores tienen como objectivo examinar las influencias de la región, la edad y el tiempo en la mortalidad por cáncer de cuello uterino. Las tasas de mortalidad que ocurrieron en el Estado de Santa Catarina, entre 1996 y 2011 fueron analizados. Los datos fueron obtenidos del Sistema de Información de Mortalidad del Ministerio de Salud, Brasil, en el año 2013. El analisis de los datos fue realizada fundamentada en la epidemiologia descritiva. Las tasas de mortalidad por cáncer de cuello uterino variaron desde 3,6 hasta 5,0 / 100.000 mujeres. Estas tasas aumentaron en los grupos de mayor edad y presentaron los valores más altos después de 70 años. La conciencia de la mujer acerca de la importancia del la prueba de Papanicolaou en sus evaluaciones de salud, puede ser diferente según la edad y las regiones en las que viven. La frecuencia de la prueba de Papanicolaou debe cambiar mediante la observación de la evolución de las tasas de mortalidad en el tiempo.

  12. Simulación para el Aprendizaje Experiencial en la Optimización y Mejora de Procesos de Servicios de Salud y Atención Hospitalaria

    OpenAIRE

    Salinas, David; Montesinos, Luis

    2013-01-01

    La creciente demanda de servicios de salud de mayor calidad y la insuficiente disponibilidad de recursos económicos, materiales y humanos para responder satisfactoriamente a esta, ha propiciado que los conocimientos y las herramientas de la ingeniería de procesos hayan encontrado nuevas oportunidades de aplicación en la optimización y mejora de servicios de atención hospitalaria. Este cambio requiere la formación de profesionistas capaces de cruzar la...

  13. Parallelization of a three-dimensional whole core transport code DeCART

    Energy Technology Data Exchange (ETDEWEB)

    Jin Young, Cho; Han Gyu, Joo; Ha Yong, Kim; Moon-Hee, Chang [Korea Atomic Energy Research Institute, Yuseong-gu, Daejon (Korea, Republic of)

    2003-07-01

    Parallelization of the DeCART (deterministic core analysis based on ray tracing) code is presented that reduces the computational burden of the tremendous computing time and memory required in three-dimensional whole core transport calculations. The parallelization employs the concept of MPI grouping and the MPI/OpenMP mixed scheme as well. Since most of the computing time and memory are used in MOC (method of characteristics) and the multi-group CMFD (coarse mesh finite difference) calculation in DeCART, variables and subroutines related to these two modules are the primary targets for parallelization. Specifically, the ray tracing module was parallelized using a planar domain decomposition scheme and an angular domain decomposition scheme. The parallel performance of the DeCART code is evaluated by solving a rodded variation of the C5G7MOX three dimensional benchmark problem and a simplified three-dimensional SMART PWR core problem. In C5G7MOX problem with 24 CPUs, a speedup of maximum 21 is obtained on an IBM Regatta machine and 22 on a LINUX Cluster in the MOC kernel, which indicates good parallel performance of the DeCART code. In the simplified SMART problem, the memory requirement of about 11 GBytes in the single processor cases reduces to 940 Mbytes with 24 processors, which means that the DeCART code can now solve large core problems with affordable LINUX clusters. (authors)

  14. CAR-T cell therapy in gastrointestinal tumors and hepatic carcinoma: From bench to bedside.

    Science.gov (United States)

    Zhang, Qi; Zhang, Zimu; Peng, Meiyu; Fu, Shuyu; Xue, Zhenyi; Zhang, Rongxin

    2016-01-01

    The chimeric antigen receptor (CAR) is a genetically engineered receptor that combines a scFv domain, which specifically recognizes the tumor-specific antigen, with T cell activation domains. CAR-T cell therapies have demonstrated tremendous efficacy against hematologic malignancies in many clinical trials. Recent studies have extended these efforts to the treatment of solid tumors. However, the outcomes of CAR-T cell therapy for solid tumors are not as remarkable as the outcomes have been for hematologic malignancies. A series of hurdles has arisen with respect to CAR-T cell-based immunotherapy, which needs to be overcome to target solid tumors. The major challenge for CAR-T cell therapy in solid tumors is the selection of the appropriate specific antigen to demarcate the tumor from normal tissue. In this review, we discuss the application of CAR-T cells to gastrointestinal and hepatic carcinomas in preclinical and clinical research. Furthermore, we analyze the usefulness of several specific markers in the study of gastrointestinal tumors and hepatic carcinoma.

  15. Cancer Immunotherapy Using CAR-T Cells: From the Research Bench to the Assembly Line.

    Science.gov (United States)

    Gomes-Silva, Diogo; Ramos, Carlos A

    2018-02-01

    The focus of cancer treatment has recently shifted toward targeted therapies, including immunotherapy, which allow better individualization of care and are hoped to increase the probability of success for patients. Specifically, T cells genetically modified to express chimeric antigen receptors (CARs; CAR-T cells) have generated exciting results. Recent clinical successes with this cutting-edge therapy have helped to push CAR-T cells toward approval for wider use. However, several limitations need to be addressed before the widespread use of CAR-T cells as a standard treatment. Here, a succinct background on adoptive T-cell therapy (ATCT)is given. A brief overview of the structure of CARs, how they are introduced into T cells, and how CAR-T cell expansion and selection is achieved in vitro is then presented. Some of the challenges in CAR design are discussed, as well as the difficulties that arise in large-scale CAR-T cell manufacture that will need to be addressed to achieve successful commercialization of this type of cell therapy. Finally, developments already on the horizon are discussed. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. The development of CAR design for tumor CAR-T cell therapy.

    Science.gov (United States)

    Xu, Dandan; Jin, Guoliang; Chai, Dafei; Zhou, Xiaowan; Gu, Weiyu; Chong, Yanyun; Song, Jingyuan; Zheng, Junnian

    2018-03-02

    In recent years, the chimeric antigen receptor modified T cells (Chimeric antigen receptor T cells, CAR-T) immunotherapy has developed rapidly, which has been considered the most promising therapy. Efforts to enhance the efficacy of CAR-based anti-tumor therapy have been made, such as the improvement of structures of CAR-T cells, including the development of extracellular antigen recognition receptors, intracellular co-stimulatory molecules and the combination application of CARs and synthetic small molecules. In addition, effects on the function of the CAR-T cells that the space distance between the antigen binding domains and tumor targets and the length of the spacer domains have are also being investigated. Given the fast-moving nature of this field, it is necessary to make a summary of the development of CAR-T cells. In this review, we mainly focus on the present design strategies of CAR-T cells with the hope that they can provide insights to increase the anti-tumor efficacy and safety.

  17. CD47-CAR-T Cells Effectively Kill Target Cancer Cells and Block Pancreatic Tumor Growth.

    Science.gov (United States)

    Golubovskaya, Vita; Berahovich, Robert; Zhou, Hua; Xu, Shirley; Harto, Hizkia; Li, Le; Chao, Cheng-Chi; Mao, Mike Ming; Wu, Lijun

    2017-10-21

    CD47 is a glycoprotein of the immunoglobulin superfamily that is often overexpressed in different types of hematological and solid cancer tumors and plays important role in blocking phagocytosis, increased tumor survival, metastasis and angiogenesis. In the present report, we designed CAR (chimeric antigen receptor)-T cells that bind CD47 antigen. We used ScFv (single chain variable fragment) from mouse CD47 antibody to generate CD47-CAR-T cells for targeting different cancer cell lines. CD47-CAR-T cells effectively killed ovarian, pancreatic and other cancer cells and produced high level of cytokines that correlated with expression of CD47 antigen. In addition, CD47-CAR-T cells significantly blocked BxPC3 pancreatic xenograft tumor growth after intratumoral injection into NSG mice. Moreover, we humanized mouse CD47 ScFv and showed that it effectively bound CD47 antigen. The humanized CD47-CAR-T cells also specifically killed ovarian, pancreatic, and cervical cancer cell lines and produced IL-2 that correlated with expression of CD47. Thus, CD47-CAR-T cells can be used as a novel cellular therapeutic agent for treating different types of cancer.

  18. Active-passive vibration absorber of beam-cart-seesaw system with piezoelectric transducers

    Science.gov (United States)

    Lin, J.; Huang, C. J.; Chang, Julian; Wang, S.-W.

    2010-09-01

    In contrast with fully controllable systems, a super articulated mechanical system (SAMS) is a controlled underactuated mechanical system in which the dimensions of the configuration space exceed the dimensions of the control input space. The objectives of the research are to develop a novel SAMS model which is called beam-cart-seesaw system, and renovate a novel approach for achieving a high performance active-passive piezoelectric vibration absorber for such system. The system consists of two mobile carts, which are coupled via rack and pinion mechanics to two parallel tracks mounted on pneumatic rodless cylinders. One cart carries an elastic beam, and the other cart acts as a counterbalance. One adjustable counterweight mass is also installed underneath the seesaw to serve as a passive damping mechanism to absorb impact and shock energy. The motion and control of a Bernoulli-Euler beam subjected to the modified cart/seesaw system are analyzed first. Moreover, gray relational grade is utilized to investigate the sensitivity of tuning the active proportional-integral-derivative (PID) controller to achieve desired vibration suppression performance. Consequently, it is shown that the active-passive vibration absorber can not only provide passive damping, but can also enhance the active action authority. The proposed software/hardware platform can also be profitable for the standardization of laboratory equipment, as well as for the development of entertainment tools.

  19. Otolaryngology Consult Carts: Maximizing Patient Care, Surgeon Efficiency, and Cost Containment.

    Science.gov (United States)

    Royer, Mark C; Royer, Allison K

    2015-11-01

    The objective of this study was to develop an otolaryngology consult cart system to ensure prompt delivery to the bedside of all the unique equipment and medications required for emergent and urgent otolaryngology consults. An otolaryngology practice responsible for emergency room and hospital consult coverage sought to create a cart containing all equipment, medications, and supplies for otolaryngology consults. Meetings with hospital administration and emergency room, nursing, pharmacy, central processing, and operating room staff were held to develop a system for the emergent delivery of the cart to the needed location, sterilization and restocking of equipment between uses, and appropriate billing of supplies. Two months were required from conception to implementation. All equipment was purchased new, including flexible scopes and headlights. The cart is sterilized, restocked, and maintained by central processing after each use. The equipment is available to handle all airway emergencies as well as all common otolaryngology consults and is delivered bedside in less than 5 minutes. The development of a self-contained otolaryngology consult cart requires coordination with a wide variety of hospital departments. This system, while requiring initial monetary and time investment, has resulted in improved patient care, cost containment, and surgeon convenience. © The Author(s) 2015.

  20. [Bibliometric study of the journal Nutrición Hospitalaria for the period 2001--2005: Part 2, consumption analysis; the bibliographic references].

    Science.gov (United States)

    Castera, V T; Sanz Valero, J; Juan-Quilis, V; Wanden-Berghe, C; Culebras, J M; García de Lorenzo y Mateos, A

    2008-01-01

    To describe and assess the consumption of the information consulted and cited in the articles published in the journal Nutrición Hospitalaria for the period 2001--2005 by means of bibliometric analysis. Cross-sectional descriptive analysis of the results obtained from the analysis of the lists of bibliographic references of the articles published at Nutrición Hospitalaria. We studied the most cited journals, the signatures index, the type of document referred, the publication language, the distribution of geographical origin, and obsolescence and readiness index. We took into account all types of documents with the exception of Communications to Congresses. 345 articles were published at Nutr Hosp, containing 8,113 bibliographic references, with a median of 18, a maximum of 136 and minimum of 0 BR per article. The mean (rate of publications per published article during the specified period) is 23.52 (95% IC 20.93-26.10) and the mean at 5% is 20.66 per article. The 25th and 75th percentiles are 6 and 32, respectively, the interquartile interval being 26 BR per document. The semi-period of Burton and Kebler is 7 years and the Price Index is 38.18%. The bibliographic references, the consumption of information, of the articles published at Nutrición Hospitalaria present parameters similar to other journals on health science. However, good data on obsolescence are observed, which reveal the good validity of most of the references studied.

  1. Gestión de mantenimiento de la red hospitalaria del estado Anzoátegui, caso: Hospital Universitario "Dr. Luis Razetti"

    Directory of Open Access Journals (Sweden)

    Tony Castillo Calzadilla

    2011-01-01

    Full Text Available El objetivo de esta investigación es diagnosticar la gestión de mantenimiento de la red hospitalaria del estado Anzoátegui, a partir de un estudio de caso Hospital "Dr. Luis Razetti", siendo éste el más importante de la región y con ello determinar las causas por las cuales los activos en la red hospitalaria se deterioran tan aceleradamente. El estudio se fundamenta en una investigación "descriptiva" con diseño de campo, recurriéndose a directivos, supervisores y operarios del hospital, quienes respondieron un cuestionario dirigido adaptado de la Norma covenin 2500- 93. Se concluyó que la red hospitalaria del Estado se encuentra en estado grave en cuanto a la Gestión del Mantenimiento para este tipo de instalaciones y que en las mismas se carece de una visión de ingeniería clínica.

  2. Pequenos para idade gestacional: fator de risco para mortalidade neonatal

    Directory of Open Access Journals (Sweden)

    Almeida Márcia Furquim de

    1998-01-01

    Full Text Available OBJETIVO: Estudar as variáveis contempladas na Declaração de Nascimento (DN como possíveis fatores de risco para nascimentos pequenos para a idade gestacional (PIG e o retardo de crescimento intra-uterino como fator de risco para a mortalidade neonatal. MATERIAL E MÉTODO: As variáveis existentes na DN foram obtidas diretamente de prontuários hospitalares. Os dados referem-se a uma coorte de nascimentos obtida por meio da vinculação das declarações de nascimento e óbito, correspondendo a 2.251 nascimentos vivos hospitalares, de mães residentes, ocorridos no Município de Santo André, Região Metropolitana de São Paulo, no período de l/1 a 30/6/1992, e aos óbitos neonatais verificados nessa coorte. RESULTADOS: Obteve-se a proporção de 4,3% de nascimentos PIG, significativamente maior entre os recém-nascidos de pré-termo e pós-termo, entre os nascimentos cujas mães tinham mais de 35 anos de idade e grau de instrução inferior ao primeiro grau completo. Os recém-nascidos PIG apresentam maior risco de morte neonatal que aqueles que não apresentavam sinais de retardo de crescimento intra-uterino. CONCLUSÕES: Em áreas com menor freqüência de baixo peso ao nascer, é importante investigar a presença de retardo de crescimento intra-uterino entre os nascimentos prematuros e não apenas nos nascimentos de termo. O registro da data da última menstruação (ou da idade gestacional em semanas não agregadas na DN facilitaria a detecção de PIGs na população de recém-nascidos.

  3. Factores de riesgo asociados a la mortalidad por enterocolitis necrotizante

    Directory of Open Access Journals (Sweden)

    Vivian R. Mena Miranda

    1998-12-01

    Full Text Available La enterocolitis necrotizante (ECN es una urgencia gastrointestinal de causa multifactorial muy relacionada con el neonato pretérmino. Su elevada mortalidad radica en la falta de prevención por el médico a cualquier nivel de atención y a su diagnóstico tardío en los grupos de riesgo. Se realizó un estudio retrospectivo de los 63 pacientes fallecidos por ECN durante un período de 25 años en el Hospital Pediátrico Docente "Centro Habana", donde se encontró que 71,4 % de los afectados eran de la raza blanca y el 68,2 % del sexo masculino. La edad más frecuente se halló en los menores de 3 meses de edad (36,5 % y el 46 % del total de la muestra estudiada tuvo un peso al nacer inferior a los 1 500 g. La prematuridad apareció asociada en el 55,5 % de los fallecidos y el 65 % tuvo lactancia mixta desde el momento de nacimiento.Necrotizing enterocolitis (NEC is a multifactorial caused gastrointestinal urgency closely related to the preterm newborn. Its high mortality has roots in the lack of prevention by the physician at any level of care, and due to a late diagnosis in risk groups. A retrospective study was carried out about 63 deceased patients as a result of NEC, along a 25 years period at the Centro Habana Teaching Pediatric Hospital, and it was found that 71,4 % of the affected infants were white, and that 68,2 % were masculin. The most frequent age was found in infants less than 3 months old (36,5 %, and 46 % of the total sample investigated had a birth weight lower than 1 500 g. Prematurity appeared associated in 55,5 % of the deceased, and 65 % had mixed lactation from the birth on.

  4. Diagnósticos de enfermería al alta hospitalaria en personas con Síndrome Coronario Agudo

    Directory of Open Access Journals (Sweden)

    Clara Inés Padilla García

    2017-04-01

    Full Text Available Introducción: Enfermería juega un rol fundamental en las diferentes etapas de la atención de las personas con síndrome coronario agudo, entre ellas el egreso hospitalario. Brindar cuidado acorde a las necesidades propias de estas personas, requiere de la identificación de los principales diagnósticos de enfermería. Objetivo: Determinar la prevalencia de diagnósticos de Enfermería de las personas con síndrome coronario agudo al momento del alta hospitalaria. Metodología: Estudio de corte transversal en 196 personas hospitalizadas por el evento de interés, se utilizó instrumento de valoración focalizada que evaluaba las características definitorias de los diagnósticos de enfermería: ansiedad, afrontamiento ineficaz, disposición para mejorar la religiosidad, disposición para mejorar los conocimientos, intolerancia a la actividad; los cuales fueron identificados como prioritarios según la literatura científica y por consenso de expertos. Para determinar la prevalencia de los diagnósticos se realizó análisis de definición y características definitorias. Resultados: Se evidenció como principal problema de la población de estudio los conocimientos deficientes, seguido de la intolerancia a la actividad y la ansiedad. De igual forma se logró identificar diagnósticos positivos como la disposición para mejorar los conocimientos y la religiosidad. Conclusiones: El presente trabajo nos permitió identificar necesidades reales y reconocer factores protectores al momento del alta hospitalaria en personas que han vivido un evento coronario agudo, lo cual constituye un punto de partida para el diseño de planes de cuidado y la puesta en marcha de intervenciones que conduzcan a mejorar la situación de salud de este grupo de personas.

  5. Golf cart prototype development and navigation simulation using ROS and Gazebo

    Directory of Open Access Journals (Sweden)

    Shimchik Ilya

    2016-01-01

    Full Text Available This paper presents our approach to development of an autonomous golf cart, which will navigate in inaccessible by regular vehicles private areas. For this purpose, we have built a virtual golf course terrain and golf cart model in Gazebo, selected and modernized ROS-based packages in order to use them with Ackermann steering vehicle simulation. To verify our simulation and algorithms, we navigated the golf cart model from one golf hole to another within a virtual 3D golf course. For the real world algorithms’ verification, we developed a small-size vehicle prototype based on Traxxas radio-controlled car model, which is equipped with an on-board controller and sensors. The autonomous navigation of Traxxas-based vehicle prototype has been tested in indoor environment, where it utilized sensory data about environment and vehicle states, and performed localization, optimal trajectory computation and dynamic obstacles’ recognition with adjusting the route in real time.

  6. Hurdles of CAR-T cell-based cancer immunotherapy directed against solid tumors.

    Science.gov (United States)

    Zhang, Bing-Lan; Qin, Di-Yuan; Mo, Ze-Ming; Li, Yi; Wei, Wei; Wang, Yong-Sheng; Wang, Wei; Wei, Yu-Quan

    2016-04-01

    Recent reports on the impressive efficacy of chimeric antigen receptor (CAR)-modified T cells against hematologic malignancies have inspired oncologists to extend these efforts for the treatment of solid tumors. Clinical trials of CAR-T-based cancer immunotherapy for solid tumors showed that the efficacies are not as remarkable as in the case of hematologic malignancies. There are several challenges that researchers must face when treating solid cancers with CAR-T cells, these include choosing an ideal target, promoting efficient trafficking and infiltration, overcoming the immunosuppressive microenvironment, and avoiding associated toxicity. In this review, we discuss the obstacles imposed by solid tumors on CAR-T cell-based immunotherapy and strategies adopted to improve the therapeutic potential of this approach. Continued investigations are necessary to improve therapeutic outcomes and decrease the adverse effects of CAR-T cell therapy in patients with solid malignancies in the future.

  7. New Approaches in CAR-T Cell Immunotherapy for Breast Cancer.

    Science.gov (United States)

    Wang, Jinghua; Zhou, Penghui

    2017-01-01

    Despite significant advances in surgery, chemotherapy, radiotherapy, endocrine therapy, and molecular-targeted therapy, breast cancer remains the leading cause of death from malignant tumors among women. Immunotherapy has recently become a critical component of breast cancer treatment with encouraging activity and mild safety profiles. CAR-T therapy using genetically modifying T cells with chimeric antigen receptors (CAR) is the most commonly used approach to generate tumor-specific T cells. It has shown good curative effect for a variety of malignant diseases, especially for hematological malignancies. In this review, we briefly introduce the history and the present state of CAR research. Then we discuss the barriers of solid tumors for CARs application and possible strategies to improve therapeutic response with a focus on breast cancer. At last, we outlook the future directions of CAR-T therapy including managing toxicities and developing universal CAR-T cells.

  8. Chimeric-antigen receptor T (CAR-T) cell therapy for solid tumors: challenges and opportunities.

    Science.gov (United States)

    Xia, An-Liang; Wang, Xiao-Chen; Lu, Yi-Jun; Lu, Xiao-Jie; Sun, Beicheng

    2017-10-27

    Chimeric antigen receptor (CAR)-engineered T cells (CAR-T cells) have been shown to have unprecedented efficacy in B cell malignancies, most notably in B cell acute lymphoblastic leukemia (B-ALL) with up to a 90% complete remission rate using anti-CD19 CAR-T cells. However, CAR T-cell therapy for solid tumors currently is faced with numerous challenges such as physical barriers, the immunosuppressive tumor microenvironment and the specificity and safety. The clinical results in solid tumors have been much less encouraging, with multiple cases of toxicity and a lack of therapeutic response. In this review, we will discuss the current stats and challenges of CAR-T cell therapy for solid tumors, and propose possibl e solutions and future perspectives.

  9. The Coach-Athlete Relationship Questionnaire (CART-Q): development and initial validation.

    Science.gov (United States)

    Jowett, Sophia; Ntoumanis, Nikos

    2004-08-01

    The purpose of the present study was to develop and validate a self-report instrument that measures the nature of the coach-athlete relationship. Jowett et al.'s (Jowett & Meek, 2000; Jowett, in press) qualitative case studies and relevant literature were used to generate items for an instrument that measures affective, cognitive, and behavioral aspects of the coach-athlete relationship. Two studies were carried out in an attempt to assess content, predictive, and construct validity, as well as internal consistency, of the Coach-Athlete Relationship Questionnaire (CART-Q), using two independent British samples. Principal component analysis and confirmatory factor analysis were used to reduce the number of items, identify principal components, and confirm the latent structure of the CART-Q. Results supported the multidimensional nature of the coach-athlete relationship. The latent structure of the CART-Q was underlined by the latent variables of coaches' and athletes' Closeness (emotions), Commitment (cognitions), and Complementarity (behaviors).

  10. The use of ZIP and CART to model cryptosporidiosis in relation to climatic variables.

    Science.gov (United States)

    Hu, Wenbiao; Mengersen, Kerrie; Fu, Shiu-Yun; Tong, Shilu

    2010-07-01

    This research assesses the potential impact of weekly weather variability on the incidence of cryptosporidiosis disease using time series zero-inflated Poisson (ZIP) and classification and regression tree (CART) models. Data on weather variables, notified cryptosporidiosis cases and population size in Brisbane were supplied by the Australian Bureau of Meteorology, Queensland Department of Health, and Australian Bureau of Statistics, respectively. Both time series ZIP and CART models show a clear association between weather variables (maximum temperature, relative humidity, rainfall and wind speed) and cryptosporidiosis disease. The time series CART models indicated that, when weekly maximum temperature exceeded 31 degrees C and relative humidity was less than 63%, the relative risk of cryptosporidiosis rose by 13.64 (expected morbidity: 39.4; 95% confidence interval: 30.9-47.9). These findings may have applications as a decision support tool in planning disease control and risk-management programs for cryptosporidiosis disease.

  11. Depletion methodology in the 3-D whole core transport code DeCART

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kang Seog; Cho, Jin Young; Zee, Sung Quun

    2005-02-01

    Three dimensional whole-core transport code DeCART has been developed to include a characteristics of the numerical reactor to replace partly the experiment. This code adopts the deterministic method in simulating the neutron behavior with the least assumption and approximation. This neutronic code is also coupled with the thermal hydraulic code CFD and the thermo mechanical code to simulate the combined effects. Depletion module has been implemented in DeCART code to predict the depleted composition in the fuel. The exponential matrix method of ORIGEN-2 has been used for the depletion calculation. The library of including decay constants, yield matrix and others has been used and greatly simplified for the calculation efficiency. This report summarizes the theoretical backgrounds and includes the verification of the depletion module in DeCART by performing the benchmark calculations.

  12. Mortalidad por defectos del tubo neural en México, 1980-1997

    Directory of Open Access Journals (Sweden)

    Ramírez-Espitia José A

    2003-01-01

    Full Text Available OBJETIVO: Describir la mortalidad en México por defectos del tubo neural, durante el periodo 1980-1997. MATERIAL Y MÉTODOS: Las tasas anuales de mortalidad estatales y nacionales, por defectos del tubo neural, se calcularon por 10 000 nacidos vivos. La tendencia temporal fue evaluada por el porcentaje de cambio anual obtenido mediante un modelo de regresión de Poisson. Se calculó la razón de mortalidad, tomando la media nacional como referencia. Las tasas y las razones se representaron gráficamente en mapas. RESULTADOS: Durante el periodo la tasa bruta de mortalidad por defectos del tubo neural fue de 5.8 por 10 000 nacidos vivos. La anencefalia fue el tipo de defecto más frecuente (37.7%, seguida de la espina bífida sin hidrocefalia (31.6%. La tendencia nacional de la mortalidad por defectos del tubo neural fue ascendente entre 1980 y 1990 (porcentaje de cambio anual 7.5 IC 95% 6.5, 8.6 y descendente entre 1990-1997 (porcentaje de cambio anual -2.3 IC 95% -3.6, -0.9. CONCLUSIONES: Las altas tasas de mortalidad por defectos del tubo neural fueron debidas principalmente a la elevada frecuencia de las anencefalias. El incremento observado parece no ser sólo atribuible a cuestiones puramente diagnósticas o de mejora en los registros. La influencia de factores asociados a estos defectos, como determinados polimorfismos genéticos, la deficiencia de ácido fólico, la obesidad materna, la exposición laboral a plaguicidas y la pobreza deberán evaluarse mediante estudios específicos.

  13. Trauma na gestante: análise da mortalidade materna e fetal

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Corsi

    Full Text Available Foram analisadas retrospectivamente 26 pacientes gestantes traumatizadas, num período de nove anos. A média de idade foi 23,7 anos (16-42. A idade gestacional variou de dez a quarenta semanas (média 21,5 semanas; a maioria (46,1% no segundo trimestre. O mecanismo predominante (65,3% foi o trauma abdominal fechado por acidente automobilístico (atropelamento ou colisão. Na admissão, oito (30,7% pacientes apresentavam alterações hemodinâmicas. Seis doentes (23,0% apresentavam sangramento vaginal e, destas, quatro estavam hemodinamicamente normais. Analisamos a mortalidade materna, a mortalidade fetal e suas causas. Comparamos também a mediana dos valores do RTS e TRISS entre os grupos, sobrevida materno-fetal, sobrevida materna e óbito materno-fetal. Todas as gestantes admitidas com sangramento vaginal apresentaram óbito fetal. A mortalidade materna foi de 11,5%, por choque hemorrágico. A mortalidade fetal foi de 30,7%, sendo que 37,5% destes óbitos foram provocados pela morte materna. A principal causa de mortalidade fetal foi o descolamento de placenta (50,0%. Os índices de trauma, RTS e TRISS, foram significativamente menor (p=0,0025 e p<0,0001 no grupo óbito materno-fetal, porém esses índices não apresentaram valor prognóstico na mortalidade fetal.

  14. Mortalidad infantil y migración en Chiapas, México

    Directory of Open Access Journals (Sweden)

    Olga Lidia Lópes-Gonzáles

    2010-01-01

    Full Text Available El objetivo de este trabajo fue analizar, en términos causales, la relación entre mortalidad infantil y migración en cuatro zonas socioeconómicas de la región Soconusco en Chiapas, México. El análisis de este estudio se basó en los resultados de una encuesta socio demográfica y de salud con base poblacional (probabilística que se llevó a cabo en el Soconusco, Chiapas en 1996-97. Se contrastan zonas con distinta condición socioeconómica, cultural y productiva. Se realizó análisis de regresión lineal y logística para identificar el efecto de la migración y la mortalidad infantil, así como de la migración y la zona geográfica sobre la tasa de mortalidad infantil. Los datos muestran que aunque más del 70% de la varianza de la mortalidad infantil se explica por la migración, no existe evidencia de una relación causal concluyente. La relación identificada entre mortalidad infantil, migración y zonas geográficas orientan a una explicación alternativa. Planteamos la hipótesis de que en la región estudiada, la magnitud y características de la emigración, así como de las tasas de mortalidad infantil, son consecuencia de las condiciones de vulnerabilidad económica y social de las poblaciones.

  15. Mortalidad infantil y migración en Chiapas, México

    Directory of Open Access Journals (Sweden)

    Olga Lidia Lópes-Gonzáles

    2010-07-01

    Full Text Available El objetivo de este trabajo fue analizar, en términos causales, la relación entre mortalidad infantil y migración en cuatro zonas socioeconómicas de la región Soconusco en Chiapas, México. El análisis de este estudio se basó en los resultados de una encuesta socio demográfica y de salud con base poblacional (probabilística que se llevó a cabo en el Soconusco, Chiapas en 1996-97. Se contrastan zonas con distinta condición socioeconómica, cultural y productiva. Se realizó análisis de regresión lineal y logística para identificar el efecto de la migración y la mortalidad infantil, así como de la migración y la zona geográfica sobre la tasa de mortalidad infantil. Los datos muestran que aunque más del 70% de la varianza de la mortalidad infantil se explica por la migración, no existe evidencia de una relación causal concluyente. La relación identificada entre mortalidad infantil, migración y zonas geográficas orientan a una explicación alternativa. Planteamos la hipótesis de que en la región estudiada, la magnitud y características de la emigración, así como de las tasas de mortalidad infantil, son consecuencia de las condiciones de vulnerabilidad económica y social de las poblaciones.

  16. Fatores preditivos de morbidade e mortalidade no trauma penetrante do cólon

    OpenAIRE

    Thiago Rodrigues Araujo Calderan

    2014-01-01

    Resumo: A lesão de cólon, que ocorre em 25% a 41% dos ferimentos por projétil de arma de fogo (FPAF) e em 5% a 20% dos ferimentos por arma branca (FAB) que acometem o abdome, apesar de possuir baixa mortalidade, apresenta uma alta morbidade. O presente estudo teve como objetivo analisar quais os fatores prognósticos envolvidos no aumento da morbidade e da mortalidade no trauma penetrante do cólon. Foi realizado um estudo retrospectivo de 21 anos, em que 462 pacientes foram admitidos com traum...

  17. Evaluación del crecimiento y mortalidad en cobayos suplementados con pulpa de naranja

    OpenAIRE

    Ordóñez Panamá, Erika Esperanza

    2016-01-01

    El documento consiste en evaluar el crecimiento y mortalidad de cobayos destetados a los 15 días suplementados con pulpa de naranja, se analizaron variables como: peso vivo, incremento de peso, consumo de alimento, conversión alimenticia e índice de mortalidad con el fin de comparar la eficacia de los tratamientos realizados. This document consist in evaluate the growth and mortality of guinea pigs weaned at 15 days supplemented with orange pulp, the variables analyzed were: body weight, w...

  18. CAR-T cells: the long and winding road to solid tumors.

    Science.gov (United States)

    D'Aloia, Maria Michela; Zizzari, Ilaria Grazia; Sacchetti, Benedetto; Pierelli, Luca; Alimandi, Maurizio

    2018-02-15

    Adoptive cell therapy of solid tumors with reprogrammed T cells can be considered the "next generation" of cancer hallmarks. CAR-T cells fail to be as effective as in liquid tumors for the inability to reach and survive in the microenvironment surrounding the neoplastic foci. The intricate net of cross-interactions occurring between tumor components, stromal and immune cells leads to an ineffective anergic status favoring the evasion from the host's defenses. Our goal is hereby to trace the road imposed by solid tumors to CAR-T cells, highlighting pitfalls and strategies to be developed and refined to possibly overcome these hurdles.

  19. Incorporation of Immune Checkpoint Blockade into Chimeric Antigen Receptor T Cells (CAR-Ts): Combination or Built-In CAR-T.

    Science.gov (United States)

    Yoon, Dok Hyun; Osborn, Mark J; Tolar, Jakub; Kim, Chong Jai

    2018-01-24

    Chimeric antigen receptor (CAR) T cell therapy represents the first U.S. Food and Drug Administration approved gene therapy and these engineered cells function with unprecedented efficacy in the treatment of refractory CD19 positive hematologic malignancies. CAR translation to solid tumors is also being actively investigated; however, efficacy to date has been variable due to tumor-evolved mechanisms that inhibit local immune cell activity. To bolster the potency of CAR-T cells, modulation of the immunosuppressive tumor microenvironment with immune-checkpoint blockade is a promising strategy. The impact of this approach on hematological malignancies is in its infancy, and in this review we discuss CAR-T cells and their synergy with immune-checkpoint blockade.

  20. Incorporation of Immune Checkpoint Blockade into Chimeric Antigen Receptor T Cells (CAR-Ts: Combination or Built-In CAR-T

    Directory of Open Access Journals (Sweden)

    Dok Hyun Yoon

    2018-01-01

    Full Text Available Chimeric antigen receptor (CAR T cell therapy represents the first U.S. Food and Drug Administration approved gene therapy and these engineered cells function with unprecedented efficacy in the treatment of refractory CD19 positive hematologic malignancies. CAR translation to solid tumors is also being actively investigated; however, efficacy to date has been variable due to tumor-evolved mechanisms that inhibit local immune cell activity. To bolster the potency of CAR-T cells, modulation of the immunosuppressive tumor microenvironment with immune-checkpoint blockade is a promising strategy. The impact of this approach on hematological malignancies is in its infancy, and in this review we discuss CAR-T cells and their synergy with immune-checkpoint blockade.

  1. Control borroso para la valoración del impacto ambiental generado por contaminantes emergentes en aguas residuales hospitalarias

    Directory of Open Access Journals (Sweden)

    Leadina Sánchez Barboza

    2015-06-01

    Full Text Available La valoración de impactos ambientales está sujeta a imprecisión, vaguedad y subjetividad. Estas características son extensivas al impacto generado por la presencia de contaminantes emergentes -fármacos- en aguas residuales hospitalarias, por lo que este trabajo propone valorar el impacto de dichos contaminantes mediante un sistema de inferencia borrosa, utilizando el toolbox fuzzy logic de MATLAB®, aplicando el sistema experto Mamdani. Los conjuntos borrosos de entrada se establecieron a partir de las concentraciones de los fármacos mediante variables lingüísticas definidas por medio de funciones de pertenencia trapezoidales, y el conjunto borroso de salida comprende la magnitud del impacto definida a través de una función de pertenencia triangular. Posteriormente, se obtuvo una valoración (en escala de 0 a 100 para concentraciones de fármacos máximas y promedios presentes en el agua residual, y por último, con estos valores se determina la magnitud del impacto ambiental a través del sistema de inferencia borrosa diseñado. El tratamiento borroso es útil para valorar los impactos ambientales en aguas residuales de contaminantes emergentes como los compuestos farmacéuticos.

  2. Changes in RANKL during the first two years after cART initiation in HIV-infected cART naïve adults

    DEFF Research Database (Denmark)

    Mathiesen, Inger Hee Mabuza; Salem, Mohammad; Gerstoft, Jan

    2017-01-01

    accelerated bone loss could be mediated by increased soluble RANKL (sRANKL) levels associated with CD4+ T cell recovery. METHODS: We used multiplex immunoassays to determine sRANKL and OPG concentrations in plasma from 48 HIV patients at baseline and 12, 24, 48 and 96 weeks after cART initiation. RESULTS......: Soluble RANKL changed significantly over time (overall p = 0.02) with 25% decrease (95% CI: -42 to -5) at week 24 compared to baseline and stabilized at a lower level thereafter. We found no correlation between CD4+ T cell count increment and changes in sRANKL or between percentage change in BMD...... and changes in sRANKL. CONCLUSION: In this study there was no indication that the accelerated bone loss after cART initiation was mediated by early changes in sRANKL due to CD4+ T cell recovery. Future studies should focus on the initial weeks after initiation of cART. TRIAL REGISTRATION: Clinical...

  3. Mortalidad atribuible al consumo de tabaco en México

    Directory of Open Access Journals (Sweden)

    Pablo Kuri-Morales

    2002-01-01

    Full Text Available Objetivo. Estudiar la asociación entre defunciones registradas en la delegación Coyoacán y consumo de tabaco y alcohol. Material y métodos. Estudio de mortalidad proporcional y determinación de fracción atribuible en una cohorte de sujetos de la ciudad de México, D.F., México. Se reunió información de todas las defunciones de 1998 captadas a través del Sistema Estadístico y Epidemiológico de las Defunciones (SEED en la delegación Coyoacán, clasificándolas por diagnóstico en enfermedades del sistema circulatorio (ESC, sistema respiratorio (EPOC, neoplasias (NEO. Se encuestó a familiares de los fallecidos sobre consumo de tabaco y alcohol. Resultados. Fumar los últimos 10 años de vida fue significativo para ESC en hombres de 70 años y más (RM: 2.06, IC 95%=1.18-3.58; y continuar fumando el último año de vida fue significativo para NEO y para EPOC en mujeres de 70 años y más (NEO= RM: 7.24, IC 95%=1.71-30.53; ESR= RM: 4.82, IC 95%=1.41-16.50. En el modelo de regresión para ESC, las personas con tabaquismo intenso tuvieron una posibilidad 0.83 veces mayor de fallecer por ESC, y el RA de esta variable para las ESC en la población general fue 45%. (RM=1.83; IC 95% = 1.1-2.8 pObjective. To study the mortality attributable to tobacco and alcohol consumption. Material and Methods. Deaths occurring in 1998, abstracted from the mortality statistics registry in the Coyoacan District of Mexico City, were classified by cause as: Cardiovascular Diseases, Respiratory Diseases, and Neoplasias. Relatives of the deceased were interviewed to answer a questionnaire on tobacco smoking and alcohol drinking. Results. Smoking during the last ten years of life was significantly associated with cardiovascular disease in men aged 70 years or older (OR 2.06, 95% CI 1.18-3.58. Persistent smoking in the last year of life was significantly associated with deaths from neoplasias and respiratory diseases in women aged 70 years or older (OR: 7.24, 95

  4. CD19 CAR-T cells of defined CD4+:CD8+ composition in adult B cell ALL patients.

    Science.gov (United States)

    Turtle, Cameron J; Hanafi, Laïla-Aïcha; Berger, Carolina; Gooley, Theodore A; Cherian, Sindhu; Hudecek, Michael; Sommermeyer, Daniel; Melville, Katherine; Pender, Barbara; Budiarto, Tanya M; Robinson, Emily; Steevens, Natalia N; Chaney, Colette; Soma, Lorinda; Chen, Xueyan; Yeung, Cecilia; Wood, Brent; Li, Daniel; Cao, Jianhong; Heimfeld, Shelly; Jensen, Michael C; Riddell, Stanley R; Maloney, David G

    2016-06-01

    T cells that have been modified to express a CD19-specific chimeric antigen receptor (CAR) have antitumor activity in B cell malignancies; however, identification of the factors that determine toxicity and efficacy of these T cells has been challenging in prior studies in which phenotypically heterogeneous CAR-T cell products were prepared from unselected T cells. We conducted a clinical trial to evaluate CD19 CAR-T cells that were manufactured from defined CD4+ and CD8+ T cell subsets and administered in a defined CD4+:CD8+ composition to adults with B cell acute lymphoblastic leukemia after lymphodepletion chemotherapy. The defined composition product was remarkably potent, as 27 of 29 patients (93%) achieved BM remission, as determined by flow cytometry. We established that high CAR-T cell doses and tumor burden increase the risks of severe cytokine release syndrome and neurotoxicity. Moreover, we identified serum biomarkers that allow testing of early intervention strategies in patients at the highest risk of toxicity. Risk-stratified CAR-T cell dosing based on BM disease burden decreased toxicity. CD8+ T cell-mediated anti-CAR transgene product immune responses developed after CAR-T cell infusion in some patients, limited CAR-T cell persistence, and increased relapse risk. Addition of fludarabine to the lymphodepletion regimen improved CAR-T cell persistence and disease-free survival. Immunotherapy with a CAR-T cell product of defined composition enabled identification of factors that correlated with CAR-T cell expansion, persistence, and toxicity and facilitated design of lymphodepletion and CAR-T cell dosing strategies that mitigated toxicity and improved disease-free survival. ClinicalTrials.gov NCT01865617. R01-CA136551; Life Science Development Fund; Juno Therapeutics; Bezos Family Foundation.

  5. Preconception use of cART by HIV-positive pregnant women increases the risk of infants being born small for gestational age

    NARCIS (Netherlands)

    Snijdewind, Ingrid J. M.; Smit, Colette; Godfried, Mieke H.; Bakker, Rachel; Nellen, Jeannine F. J. B.; Jaddoe, Vincent W. V.; van Leeuwen, Elisabeth; Reiss, Peter; Steegers, Eric A. P.; van der Ende, Marchina E.

    2018-01-01

    Background The benefits of combination anti-retroviral therapy (cART) in HIV-positive pregnant women (improved maternal health and prevention of mother to child transmission [pMTCT]) currently outweigh the adverse effects due to cART. As the variety of cART increases, however, the question arises as

  6. Mortalidad intrahospitalaria en pacientes con diarrea asociada a infección por Clostridium difficile

    Directory of Open Access Journals (Sweden)

    A. Ramírez-Rosales

    2012-04-01

    Conclusión: Encontramos una mortalidad elevada en pacientes con DACD hospitalizados en la Unidad de Cuidados Intensivos, lo cual nos obliga a mantener una vigilancia estrecha en esta población, para realizar una detección y tratamiento oportuno.

  7. Câncer de colo do útero: mortalidade em santa catarina - Brasil, 2000 a 2009

    Directory of Open Access Journals (Sweden)

    Maria Angélica Arzuaga-Salazar

    2011-01-01

    Full Text Available El cáncer de cuello uterino en Brasil es la tercera neoplasia más común en mujeres y presenta alta mortalidad. El objetivo del estudio fue evaluar la mortalidad por causa del cáncer de cuello uterino en el Estado de Santa Catarina, en el periodo de 2000 a 2009. Es un estudio descriptivo, con la inclusión de todas las muertes de mujeres por causa del cáncer de cuello uterino. En los datos recogidos en el Sistema de Información sobre Mortalidad del Ministerio de Salud de Brasil, identificó 1253 muertes de mujeres relacionadas con esta neoplasia. La tasa de mortalidad calculada en el período varió 3,6 a 4,9 muertes por 100.000 mujeres, siendo mayor en las mujeres con más de sesenta años. La enfermería contribuye a construir una cultura de prevención de esta neoplasia, para realización de las pruebas de diagnóstico y para la captura y seguimiento de las mujeres en riesgo por la red atención primaria de salud.

  8. EL COSTE DE MORTALIDAD ASOCIADO AL CONSUMO DE TABACO EN ESPAÑA

    Directory of Open Access Journals (Sweden)

    Mª Belén Cobacho Tornel

    2010-01-01

    cigarrillos en el caso de los hombres, y 54 euros para las mujeres (euros año 2000. Conclusiones: El coste por mortalidad prematura por paquete de cigarrillos que se obtiene sobrepasa con creces su precio de venta al público.

  9. Modelos de supervivencia adecuados para análisis actuariales de mortalidad.

    Directory of Open Access Journals (Sweden)

    Medina lópez, Ana

    2003-01-01

    Full Text Available En el seguro de vida, se destacará el interés de los denominados modelos o funciones de supervivencia como instrumentos imprescindibles en distintas fases del análisis de mortalidad. El estudio se adaptará a los mejores datos reales disponibles en las aseguradoras respecto de la población objetivo (población asegurable: datos de pólizas que evitan sesgos derivados del uso de tablas de población general. Se analizará la utilidad de los modelos de supervivencia actuarial a tres niveles. En primer lugar, se mostrará la necesidad de utilizar hipótesis de mortalidad intraintervalo para estimar las probabilidades anuales de muerte que permitan obtener un modelo tabular. En segundo lugar, los modelos se emplearán en la denominada graduación paramétrica para mejorar las estimaciones iniciales incorporando información sobre relaciones existentes en el conjunto de estimaciones y sobre creencias previas a las observaciones. En tercer lugar, nuevos modelos serán los instrumentos que proyecten el fenómeno de la mortalidad a futuro según la dinamicidad del colectivo estudiado respecto a la mortalidad. Se presentará una visión actual de las posibilidades existentes, valorando las alternativas y trabajos empíricos ya realizados, y ofreciendo nuevas posibilidades.

  10. Anorexigenní neuropeptid CART v regulaci příjmu potravy

    Czech Academy of Sciences Publication Activity Database

    Nagelová, Veronika; Železná, Blanka; Maletínská, Lenka

    2014-01-01

    Roč. 108, č. 4 (2014), s. 354-357 ISSN 0009-2770 R&D Projects: GA ČR GAP303/10/1368 Institutional support: RVO:61388963 Keywords : CART * cocaine and amphetamine regulated transcript * anorexigenic neuropeptide Subject RIV: CE - Biochemistry Impact factor: 0.272, year: 2014

  11. Structure-activity relationship of CART (cocaine- and amphetamine-regulated transcript) peptide fragments

    Czech Academy of Sciences Publication Activity Database

    Maixnerová, Jana; Hlaváček, Jan; Blokešová, Darja; Kowalczyk, W.; Elbert, Tomáš; Šanda, Miloslav; Blechová, Miroslava; Železná, Blanka; Slaninová, Jiřina; Maletínská, Lenka

    2007-01-01

    Roč. 28, č. 10 (2007), s. 1945-1953 ISSN 0196-9781 R&D Projects: GA ČR GA303/05/0614 Institutional research plan: CEZ:AV0Z40550506 Keywords : CART peptide * fragments * binding * PC12 cells Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 2.368, year: 2007

  12. Robust Takagi-Sugeno Fuzzy Dynamic Regulator for Trajectory Tracking of a Pendulum-Cart System

    Directory of Open Access Journals (Sweden)

    Miguel A. Llama

    2015-01-01

    Full Text Available Starting from a nonlinear model for a pendulum-cart system, on which viscous friction is considered, a Takagi-Sugeno (T-S fuzzy augmented model (TSFAM as well as a TSFAM with uncertainty (TSFAMwU is proposed. Since the design of a T-S fuzzy controller is based on the T-S fuzzy model of the nonlinear system, then, to address the trajectory tracking problem of the pendulum-cart system, three T-S fuzzy controllers are proposed via parallel distributed compensation: (1 a T-S fuzzy servo controller (TSFSC designed from the TSFAM; (2 a robust TSFSC (RTSFSC designed from the TSFAMwU; and (3 a robust T-S fuzzy dynamic regulator (RTSFDR designed from the RTSFSC with the addition of a T-S fuzzy observer, which estimates cart and pendulum velocities. Both TSFAM and TSFAMwU are comprised of two fuzzy rules and designed via local approximation in fuzzy partition spaces technique. Feedback gains for the three fuzzy controllers are obtained via linear matrix inequalities approach. A swing-up controller is developed to swing the pendulum up from its pendant position to its upright position. Real-time experiments validate the effectiveness of the proposed schemes, keeping the pendulum in its upright position while the cart follows a reference signal, standing out the RTSFDR.

  13. Fire behavior of e-tablets stored in aircraft galley carts.

    Science.gov (United States)

    2015-04-01

    The use of electronic-tablets (e-tablets) as replacements for conventional in-flight entertainment systems has gained popularity : among airlines globally. Innovative methods of storing and charging e-tablets in galley carts have been suggested or ar...

  14. New analogs of the CART peptide with anorexigenic potency: The importance of individual disulfide bridges

    Czech Academy of Sciences Publication Activity Database

    Blechová, Miroslava; Nagelová, Veronika; Žáková, Lenka; Demianova, Zuzana; Železná, Blanka; Maletínská, Lenka

    2013-01-01

    Roč. 39, January (2013), s. 138-144 ISSN 0196-9781 R&D Projects: GA ČR GAP303/10/1368 Institutional support: RVO:61388963 Keywords : CART peptide analogs * sulfitolysis * PC12 cells * binding * food intake Subject RIV: CE - Biochemistry Impact factor: 2.614, year: 2013

  15. Automated cart with VIS/NIR hyperspectral reflectance and fluorescence imaging capabilities

    Science.gov (United States)

    A system to take high-resolution VIS/NIR hyperspectral reflectance and fluorescence images in outdoor fields using ambient lighting or a pulsed laser (355 nm), respectively, for illumination was designed, built, and tested. Components of the system include a semi-autonomous cart, a gated-intensified...

  16. Health constraints of Cart Horses in the Dry warm, Sub-moist tepid ...

    African Journals Online (AJOL)

    The objectives of this study were to identify the major health and welfare constraints of cart horses in the dry warm, sub-moist tepid and moist cool climatic zones of Ethiopia. The study was cross sectional and a total of 837 horses were examined. Five major health problems and welfare issues were identified. Lymphangitis ...

  17. CAR-T cells and combination therapies: What's next in the immunotherapy revolution?

    Science.gov (United States)

    Ramello, Maria C; Haura, Eric B; Abate-Daga, Daniel

    2018-03-01

    Cancer immunotherapies are dramatically reshaping the clinical management of oncologic patients. For many of these therapies, the guidelines for administration, monitoring, and management of associated toxicities are still being established. This is especially relevant for adoptively transferred, genetically-modified T cells, which have unique pharmacokinetic properties, due to their ability to replicate and persist long-term, following a single administration. Furthermore, in the case of CAR-T cells, the use of synthetic immune receptors may impact signaling pathways involved in T cell function and survival in unexpected ways. We, herein, comment on the most salient aspects of CAR-T cell design and clinical experience in the treatment of solid tumors. In addition, we discuss different possible scenarios for combinations of CAR-T cells and other treatment modalities, with a special emphasis on kinase inhibitors, elaborating on the strategies to maximize synergism. Finally, we discuss some of the technologies that are available to explore the molecular events governing the success of these therapies. The young fields of synthetic and systems biology are likely to be major players in the advancement of CAR-T cell therapies, providing the tools and the knowledge to engineer patients' T lymphocytes into intelligent cancer-fighting micromachines. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Biomarkers of cytokine release syndrome and neurotoxicity related to CAR-T cell therapy.

    Science.gov (United States)

    Wang, Zhenguang; Han, Weidong

    2018-01-01

    Severe cytokine release syndrome (CRS) and neurotoxicity following chimeric antigen receptor T cell (CAR-T) therapy can be life-threatening in some cases, and management of those toxicities is still a great challenge for physicians. Researchers hope to understand the pathophysiology of CRS and neurotoxicity, and identify predictive biomarkers that can forecast those toxicities in advance. Some risk factors for severe CRS and/or neurotoxicity including patient and treatment characteristics have been identified in multiple clinical trials of CAR-T cell therapy. Moreover, several groups have identified some predictive biomarkers that are able to determine beforehand which patients may suffer severe CRS and/or neurotoxicity during CAR-T cell therapy, facilitating testing of early intervention strategies for those toxicities. However, further studies are needed to better understand the biology and related risk factors for CRS and/or neurotoxicity, and determine if those identified predictors can be extrapolated to other series. Herein, we review the pathophysiology of CRS and neurotoxicity, and summarize the progress of predictive biomarkers to improve CAR-T cell therapy in cancer.

  19. A Rapid Cell Expansion Process for Production of Engineered Autologous CAR-T Cell Therapies.

    Science.gov (United States)

    Lu, Tangying Lily; Pugach, Omar; Somerville, Robert; Rosenberg, Steven A; Kochenderfer, James N; Better, Marc; Feldman, Steven A

    2016-12-01

    The treatment of B-cell malignancies by adoptive cell transfer (ACT) of anti-CD19 chimeric antigen receptor T cells (CD19 CAR-T) has proven to be a highly successful therapeutic modality in several clinical trials. 1-6 The anti-CD19 CAR-T cell production method used to support initial trials relied on numerous manual, open process steps, human serum, and 10 days of cell culture to achieve a clinical dose. 7 This approach limited the ability to support large multicenter clinical trials, as well as scale up for commercial cell production. Therefore, studies were completed to streamline and optimize the original National Cancer Institute production process by removing human serum from the process in order to minimize the risk of viral contamination, moving process steps from an open system to functionally closed system operations in order to minimize the risk of microbial contamination, and standardizing additional process steps in order to maximize process consistency. This study reports a procedure for generating CD19 CAR-T cells in 6 days, using a functionally closed manufacturing process and defined, serum-free medium. This method is able to produce CD19 CAR-T cells that are phenotypically and functionally indistinguishable from cells produced for clinical trials by the previously described production process.

  20. KLASIFIKASI KARAKTERISTIK KECELAKAAN LALU LINTAS DI KOTA DENPASAR DENGAN PENDEKATAN CLASSIFICATION AND REGRESSION TREES (CART

    Directory of Open Access Journals (Sweden)

    I GEDE AGUS JIWADIANA

    2015-11-01

    Full Text Available The aim of this research is to determine the classification characteristics of traffic accidents in Denpasar city in January-July 2014 by using Classification And Regression Trees (CART. Then, for determine the explanatory variables into the main classifier of CART. The result showed that optimum CART generate three terminal node. First terminal node, there are 12 people were classified as heavy traffic accident characteritics with single accident, and second terminal nodes, there are 68 people were classified as minor traffic accident characteristics by type of traffic accident front-rear, front-front, front-side, pedestrians, side-side and location of traffic accident in district road and sub-district road. For third terminal node, there are 291 people were classified as medium traffic accident characteristics by type of traffic accident front-rear, front-front, front-side, pedestrians, side-side and location of traffic accident in municipality road and explanatory variables into the main splitter to make of CART is type of traffic accident with maximum homogeneity measure of 0.03252.

  1. Control of trunk motion following sudden stop perturbations during cart pushing.

    Science.gov (United States)

    Lee, Yun-Ju; Hoozemans, Marco J M; van Dieën, Jaap H

    2011-01-04

    External perturbations during pushing tasks have been suggested to be a risk factor for low-back symptoms. An experiment was designed to investigate whether self-induced and externally induced sudden stops while pushing a high inertia cart influence trunk motions, and how flexor and extensor muscles counteract these perturbations. Twelve healthy male participants pushed a 200 kg cart at shoulder height and hip height. Pushing while walking was compared to situations in which participants had to stop the cart suddenly (self-induced stop) or in which the wheels of the cart were unexpectedly blocked (externally induced stop). For the perturbed conditions, the peak values and the maximum changes from the reference condition (pushing while walking) of the external moment at L5/S1, trunk inclination and electromyographic amplitudes of trunk muscles were determined. In the self-induced stop, a voluntary trunk extension occurred. Initial responses in both stops consisted of flexor and extensor muscle cocontraction. In self-induced stops this was followed by sustained extensor activity. In the externally induced stops, an external extension moment caused a decrease in trunk inclination. The opposite directions of the internal moment and trunk motion in the externally induced stop while pushing at shoulder height may indicate insufficient active control of trunk posture. Consequently, sudden blocking of the wheels in pushing at shoulder height may put the low back at risk of mechanical injury. Copyright © 2010 Elsevier Ltd. All rights reserved.

  2. Mortality among critically ill patients with methicillin-resistant Staphylococcus aureus bacteremia: a multicenter cohort study in Colombia Mortalidad en pacientes gravemente enfermos con bacteriemia por Staphylococcus aureus resistente a la meticilina: un estudio multicéntrico de cohortes en Colombia

    Directory of Open Access Journals (Sweden)

    Juan S. Castillo

    2012-11-01

    TODOS: Estudio retrospectivo multicéntrico de cohortes realizado en el período del 2005 al 2008 en 16 instituciones de atención de salud de referencia públicas y privadas de Bogotá, Colombia, que forman parte de una red nacional de vigilancia epidemiológica y de una red hospitalaria de 4 469 camas. Se analizaron la aparición de resistencia a la meticilina y la mortalidad mediante análisis descriptivos y de tiempo transcurrido hasta un suceso; se estableció un modelo multifactorial de regresión de riesgos proporcionales de Cox para evaluar la asociación entre la resistencia a la meticilina y la mortalidad. RESULTADOS: Se estudiaron 372 pacientes: 186 con bacteriemia por MRSA, apareados aleatoriamente con 186 con bacteriemia por Staphylococcus aureus sensible a la meticilina (MSSA. La cirugía previa, el tratamiento con antibióticos y las infecciones intrahospitalarias se asociaron independientemente con la resistencia a la meticilina. El MRSA provocó hospitalizaciones más prolongadas en los sobrevivientes (mediana de 24 frente a 18 días, P = 0,014. Los factores predictivos de mortalidad fueron: la edad del paciente, un nivel de creatinina superior a 1,21 mg/dl al ingresar en la UCI, la septicemia grave y el requerimiento de inotrópicos. El tratamiento antimicrobiano apropiado y el cambio de tratamiento antimicrobiano constituyeron factores protectores independientes, igual que el sexo masculino. CONCLUSIONES: La resistencia a la meticilina per se no fue un factor pronóstico independiente de la mortalidad. Las condiciones previas, como la edad, la insuficiencia renal inicial, la septicemia grave y el requerimiento de inotrópicos explicaron la mortalidad observada. El tratamiento antimicrobiano apropiado seguía siendo un factor protector. Es obligatorio hacer un llamamiento para mejorar las medidas de control de las infecciones en Colombia y en otros contextos similares.

  3. The nucleus accumbens 5-HTR4-CART pathway ties anorexia to hyperactivity

    Science.gov (United States)

    Jean, A; Laurent, L; Bockaert, J; Charnay, Y; Dusticier, N; Nieoullon, A; Barrot, M; Neve, R; Compan, V

    2012-01-01

    In mental diseases, the brain does not systematically adjust motor activity to feeding. Probably, the most outlined example is the association between hyperactivity and anorexia in Anorexia nervosa. The neural underpinnings of this ‘paradox', however, are poorly elucidated. Although anorexia and hyperactivity prevail over self-preservation, both symptoms rarely exist independently, suggesting commonalities in neural pathways, most likely in the reward system. We previously discovered an addictive molecular facet of anorexia, involving production, in the nucleus accumbens (NAc), of the same transcripts stimulated in response to cocaine and amphetamine (CART) upon stimulation of the 5-HT4 receptors (5-HTR4) or MDMA (ecstasy). Here, we tested whether this pathway predisposes not only to anorexia but also to hyperactivity. Following food restriction, mice are expected to overeat. However, selecting hyperactive and addiction-related animal models, we observed that mice lacking 5-HTR1B self-imposed food restriction after deprivation and still displayed anorexia and hyperactivity after ecstasy. Decryption of the mechanisms showed a gain-of-function of 5-HTR4 in the absence of 5-HTR1B, associated with CART surplus in the NAc and not in other brain areas. NAc-5-HTR4 overexpression upregulated NAc-CART, provoked anorexia and hyperactivity. NAc-5-HTR4 knockdown or blockade reduced ecstasy-induced hyperactivity. Finally, NAc-CART knockdown suppressed hyperactivity upon stimulation of the NAc-5-HTR4. Additionally, inactivating NAc-5-HTR4 suppressed ecstasy's preference, strengthening the rewarding facet of anorexia. In conclusion, the NAc-5-HTR4/CART pathway establishes a ‘tight-junction' between anorexia and hyperactivity, suggesting the existence of a primary functional unit susceptible to limit overeating associated with resting following homeostasis rules. PMID:23233022

  4. Simulation at the point of care: reduced-cost, in situ training via a mobile cart.

    Science.gov (United States)

    Weinstock, Peter H; Kappus, Liana J; Garden, Alexander; Burns, Jeffrey P

    2009-03-01

    The rapid growth of simulation in health care has challenged traditional paradigms of hospital-based education and training. Simulation addresses patient safety through deliberative practice of high-risk low-frequency events within a safe, structured environment. Despite its inherent appeal, widespread adoption of simulation is prohibited by high cost, limited space, interruptions to clinical duties, and the inability to replicate important nuances of clinical environments. We therefore sought to develop a reduced-cost low-space mobile cart to provide realistic simulation experiences to a range of providers within the clinical environment and to serve as a model for transportable, cost-effective, widespread simulation-based training of bona-fide workplace teams. Descriptive study. A tertiary care pediatric teaching hospital. A self-contained mobile simulation cart was constructed at a cost of $8054 (mannequin not included). The cart is compatible with any mannequin and contains all equipment needed to produce a high quality simulation experience equivalent to that of our on-site center--including didactics and debriefing with videotaped recordings complete with vital sign overlay. Over a 3-year period the cart delivered 57 courses to 425 participants from five pediatric departments. All individuals were trained among their native teams and within their own clinical environment. By bringing all pedagogical elements to the actual clinical environment, a mobile cart can provide simulation to hospital teams that might not otherwise benefit from the educational tool. By reducing the setup cost and the need for dedicated space, the mobile approach provides a mechanism to increase the number of institutions capable of harnessing the power of simulation-based education internationally.

  5. The nucleus accumbens 5-HTR₄-CART pathway ties anorexia to hyperactivity.

    Science.gov (United States)

    Jean, A; Laurent, L; Bockaert, J; Charnay, Y; Dusticier, N; Nieoullon, A; Barrot, M; Neve, R; Compan, V

    2012-12-11

    In mental diseases, the brain does not systematically adjust motor activity to feeding. Probably, the most outlined example is the association between hyperactivity and anorexia in Anorexia nervosa. The neural underpinnings of this 'paradox', however, are poorly elucidated. Although anorexia and hyperactivity prevail over self-preservation, both symptoms rarely exist independently, suggesting commonalities in neural pathways, most likely in the reward system. We previously discovered an addictive molecular facet of anorexia, involving production, in the nucleus accumbens (NAc), of the same transcripts stimulated in response to cocaine and amphetamine (CART) upon stimulation of the 5-HT(4) receptors (5-HTR(4)) or MDMA (ecstasy). Here, we tested whether this pathway predisposes not only to anorexia but also to hyperactivity. Following food restriction, mice are expected to overeat. However, selecting hyperactive and addiction-related animal models, we observed that mice lacking 5-HTR(1B) self-imposed food restriction after deprivation and still displayed anorexia and hyperactivity after ecstasy. Decryption of the mechanisms showed a gain-of-function of 5-HTR(4) in the absence of 5-HTR(1B), associated with CART surplus in the NAc and not in other brain areas. NAc-5-HTR(4) overexpression upregulated NAc-CART, provoked anorexia and hyperactivity. NAc-5-HTR(4) knockdown or blockade reduced ecstasy-induced hyperactivity. Finally, NAc-CART knockdown suppressed hyperactivity upon stimulation of the NAc-5-HTR(4). Additionally, inactivating NAc-5-HTR(4) suppressed ecstasy's preference, strengthening the rewarding facet of anorexia. In conclusion, the NAc-5-HTR(4)/CART pathway establishes a 'tight-junction' between anorexia and hyperactivity, suggesting the existence of a primary functional unit susceptible to limit overeating associated with resting following homeostasis rules.

  6. Prediction of radiation levels in residences: A methodological comparison of CART [Classification and Regression Tree Analysis] and conventional regression

    International Nuclear Information System (INIS)

    Janssen, I.; Stebbings, J.H.

    1990-01-01

    In environmental epidemiology, trace and toxic substance concentrations frequently have very highly skewed distributions ranging over one or more orders of magnitude, and prediction by conventional regression is often poor. Classification and Regression Tree Analysis (CART) is an alternative in such contexts. To compare the techniques, two Pennsylvania data sets and three independent variables are used: house radon progeny (RnD) and gamma levels as predicted by construction characteristics in 1330 houses; and ∼200 house radon (Rn) measurements as predicted by topographic parameters. CART may identify structural variables of interest not identified by conventional regression, and vice versa, but in general the regression models are similar. CART has major advantages in dealing with other common characteristics of environmental data sets, such as missing values, continuous variables requiring transformations, and large sets of potential independent variables. CART is most useful in the identification and screening of independent variables, greatly reducing the need for cross-tabulations and nested breakdown analyses. There is no need to discard cases with missing values for the independent variables because surrogate variables are intrinsic to CART. The tree-structured approach is also independent of the scale on which the independent variables are measured, so that transformations are unnecessary. CART identifies important interactions as well as main effects. The major advantages of CART appear to be in exploring data. Once the important variables are identified, conventional regressions seem to lead to results similar but more interpretable by most audiences. 12 refs., 8 figs., 10 tabs

  7. The costs and calorie content of à la carte food items purchased by students during school lunch

    Directory of Open Access Journals (Sweden)

    Betsey Ramirez

    2018-06-01

    Full Text Available School environments influence student food choices. À la carte foods and beverages are often low nutrient and energy dense. This study assessed how much money students spent for these foods, and the total kilocalories purchased per student during the 2012–2013 school year. Six elementary and four intermediate schools in the Houston area provided daily food purchase transaction data, and the cost and the calories for each item. Chi-square analysis assessed differences in the number of students purchasing à la carte items by grade level and school free/reduced-price meal (FRP eligibility. Analysis of covariance assessed grade level differences in cost and calories of weekly purchases, controlling for FRP eligibility. Intermediate grade students spent significantly more on à la carte food purchases and purchased more calories (both p < 0.001 than elementary school students. Lower socioeconomic status (SES elementary and intermediate school students purchased fewer à la carte foods compared to those in higher SES schools (p < 0.001. Intermediate school students purchased more à la carte foods and calories from à la carte foods than elementary students. Whether the new competitive food rules in schools improve student food selection and purchase, and dietary intake habits across all grade levels remains unknown. Keywords: National School Lunch Program, Elementary schools, Intermediate schools, À la carte foods, Competitive foods, Costs, Calories

  8. Bagging Approach for Increasing Classification Accuracy of CART on Family Participation Prediction in Implementation of Elderly Family Development Program

    Directory of Open Access Journals (Sweden)

    Wisoedhanie Widi Anugrahanti

    2017-06-01

    Full Text Available Classification and Regression Tree (CART was a method of Machine Learning where data exploration was done by decision tree technique. CART was a classification technique with binary recursive reconciliation algorithms where the sorting was performed on a group of data collected in a space called a node / node into two child nodes (Lewis, 2000. The aim of this study was to predict family participation in Elderly Family Development program based on family behavior in providing physical, mental, social care for the elderly. Family involvement accuracy using Bagging CART method was calculated based on 1-APER value, sensitivity, specificity, and G-Means. Based on CART method, classification accuracy was obtained 97,41% with Apparent Error Rate value 2,59%. The most important determinant of family behavior as a sorter was society participation (100,00000, medical examination (98,95988, providing nutritious food (68.60476, establishing communication (67,19877 and worship (57,36587. To improved the stability and accuracy of CART prediction, used CART Bootstrap Aggregating (Bagging with 100% accuracy result. Bagging CART classifies a total of 590 families (84.77% were appropriately classified into implement elderly Family Development program class.

  9. Chimeric antigen receptor T cell (CAR-T) immunotherapy for solid tumors: lessons learned and strategies for moving forward.

    Science.gov (United States)

    Li, Jian; Li, Wenwen; Huang, Kejia; Zhang, Yang; Kupfer, Gary; Zhao, Qi

    2018-02-13

    Recently, the US Food and Drug Administration (FDA) approved the first chimeric antigen receptor T cell (CAR-T) therapy for the treatment CD19-positive B cell acute lymphoblastic leukemia. While CAR-T has achieved remarkable success in the treatment of hematopoietic malignancies, whether it can benefit solid tumor patients to the same extent is still uncertain. Even though hundreds of clinical trials are undergoing exploring a variety of tumor-associated antigens (TAA), no such antigen with comparable properties like CD19 has yet been identified regarding solid tumors CAR-T immunotherapy. Inefficient T cell trafficking, immunosuppressive tumor microenvironment, suboptimal antigen recognition specificity, and lack of safety control are currently considered as the main obstacles in solid tumor CAR-T therapy. Here, we reviewed the solid tumor CAR-T clinical trials, emphasizing the studies with published results. We further discussed the challenges that CAR-T is facing for solid tumor treatment and proposed potential strategies to improve the efficacy of CAR-T as promising immunotherapy.

  10. [Bibliometric study of the Journal Nutrición Hospitalaria for the period 2001-2005: Part 1, Analysis of the scientific production].

    Science.gov (United States)

    Casterá, V T; Sanz-Valero, J; Juan-Quilis, V; Wanden-Berghe, C; Culebras, J M; García de Lorenzo y Mateos, A

    2008-01-01

    To assess the scientific activity and information production of the journal Nutrición Hospitalaria, for the period 2001-2005 by means of a Bibliometric study. Cross-sectional descriptive study of the results obtained from the analysis of the articles published in the journal Nutrición Hospitalaria. The data were obtained by consulting the electronic version through the Web. In those cases in which there was a link breakdown, and thus, the inability to have access to the electronic document the printed version was consulted. All the documental possibilities were taken into account with the exception of communications to congresses. A total of 345 articles were published, 187 (54.20%) being original articles. The geographical distribution of the first author was Spanish in 287 articles (83.19%) and Latin American in 27 (7.83%). Most of the articles are from health care centers (172 articles (49.86%)), and the cooperation index being 4.15. Madrid is the most productive province, for both the absolute and adjusted frequencies. The median number of references per article is 18, the mean being 23.52 (95% CI 20.93 - 26.10). The predominant language was Spanish, with 308 articles (89.28%). Nutrición Hospitalaria may be considered as a reference journal regarding information and scientific communication on Nutrition for both the Spanish and Latin American communities. The bibliometric parameters studied compare with those verified for the remaining top of the list Spanish scientific journals on health sciences.

  11. Análisis de los procesos de atención hospitalaria y su impacto en los niveles de satisfacción

    Directory of Open Access Journals (Sweden)

    Omar Franco

    2014-12-01

    Full Text Available Se analizan los procesos de atención hospitalaria del Subcentro de Salud de la Parroquia Pedro J. Montero y su impacto en los niveles de satisfacción de sus usuarios. Los servicios de atención hospitalaria están en constante mejora para lograr el incremento del índice de satisfacción y aceptación por parte de los usuarios de las entidades hospitalarias de tercer nivel denominadas Subcentros de Salud. Este estudio está enfocado en determinar los factores que inciden en la insatisfacción de los usuarios del Subcentro de Salud, por lo cual aplicamos algunos tipos de investigación por ejemplo: investigación aplicada mediante la cual se busca la mejora de los procesos; de tipo descriptiva, analizando los aspectos positivos y negativos de cada una de las características del Subcentro de Salud; de tipo exploratoria porque no se cuenta con registros históricos de estudios en base a esta problemática; de tipo correlacional, de campo y cuantitativa. Los resultados nos indican que los usuarios en su mayoría tienen un conocimiento básico de los beneficios con los que cuentan y piensan que la gestión actual no es del todo eficaz debido a la identificación de falencias como lentitud en la mayoría de los procesos de atención.

  12. Cocaine- and amphetamine-regulated transcript (CART signaling within the paraventricular thalamus modulates cocaine-seeking behaviour.

    Directory of Open Access Journals (Sweden)

    Morgan H James

    Full Text Available BACKGROUND: Cocaine- and amphetamine-regulated transcript (CART has been demonstrated to play a role in regulating the rewarding and reinforcing effects of various drugs of abuse. A recent study demonstrated that i.c.v. administration of CART negatively modulates reinstatement of alcohol seeking, however, the site(s of action remains unclear. We investigated the paraventricular thalamus (PVT as a potential site of relapse-relevant CART signaling, as this region is known to receive dense innervation from CART-containing hypothalamic cells and to project to a number of regions known to be involved in mediating reinstatement, including the nucleus accumbens (NAC, medial prefrontal cortex (mPFC and basolateral amygdala (BLA. METHODOLOGY/PRINCIPAL FINDINGS: Male rats were trained to self-administer cocaine before being extinguished to a set criterion. One day following extinction, animals received intra-PVT infusions of saline, tetrodotoxin (TTX; 2.5 ng, CART (0.625 µg or 2.5 µg or no injection, followed by a cocaine prime (10 mg/kg, i.p.. Animals were then tested under extinction conditions for one hour. Treatment with either TTX or CART resulted in a significant attenuation of drug-seeking behaviour following cocaine-prime, with the 2.5 µg dose of CART having the greatest effect. This effect was specific to the PVT region, as misplaced injections of both TTX and CART resulted in responding that was identical to controls. CONCLUSIONS/SIGNIFICANCE: We show for the first time that CART signaling within the PVT acts to inhibit drug-primed reinstatement of cocaine seeking behaviour, presumably by negatively modulating PVT efferents that are important for drug seeking, including the NAC, mPFC and BLA. In this way, we identify a possible target for future pharmacological interventions designed to suppress drug seeking.

  13. Evaluation of CART peptide level in rat plasma and CSF: Possible role as a biomarker in opioid addiction.

    Science.gov (United States)

    Bakhtazad, Atefeh; Vousooghi, Nasim; Garmabi, Behzad; Zarrindast, Mohammad Reza

    2016-10-01

    It has been shown previously that cocaine- and amphetamine-regulated transcript (CART) peptide has a modulatory role and homeostatic regulatory effect in motivation to and reward of the drugs of abuse specially psychostimulants. Recent data also showed that in addition to psychostimulants, CART is critically involved in the different stages of opioid addiction. Here we have evaluated the fluctuations in the level of CART peptide in plasma and CSF in different phases of opioid addiction to find out whether CART can serve as a suitable marker in opioid addiction studies. Male rats were randomly distributed in groups of control, acute low-dose (10mg/kg) morphine, acute high-dose morphine (80mg/kg), chronic escalating doses of morphine, withdrawal syndrome precipitated by administration of naloxone (1mg/kg), and abstinent after long-term drug-free maintenance of addicted animals. The level of CART peptide in CSF and plasma samples was measured by enzyme immunoassay. CART peptide concentration in the CSF and plasma was significantly elevated in acute high-dose morphine and withdrawal state animals and down-regulated in addicted rats. In abstinent group, CART peptide level was up-regulated in plasma but not in CSF samples. As the observed results are in agreement with data regarding the CART mRNA and protein expression in the brain reward pathway in opioid addiction phases, it may be suggested that evaluation of CART peptide level in CSF or plasma could be a suitable marker which reflects the rises and falls of the peptide concentration in brain in the development of opioid addiction. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Increase in cocaine- and amphetamine-regulated transcript (CART) in specific areas of the mouse brain by acute caffeine administration.

    Science.gov (United States)

    Cho, Jin Hee; Cho, Yun Ha; Kim, Hyo Young; Cha, Seung Ha; Ryu, Hyun; Jang, Wooyoung; Shin, Kyung Ho

    2015-04-01

    Caffeine produces a variety of behavioral effects including increased alertness, reduced food intake, anxiogenic effects, and dependence upon repeated exposure. Although many of the effects of caffeine are mediated by its ability to block adenosine receptors, it is possible that other neural substrates, such as cocaine- and amphetamine-regulated transcript (CART), may be involved in the effects of caffeine. Indeed, a recent study demonstrated that repeated caffeine administration increases CART in the mouse striatum. However, it is not clear whether acute caffeine administration alters CART in other areas of the brain. To explore this possibility, we investigated the dose- and time-dependent changes in CART immunoreactivity (CART-IR) after a single dose of caffeine in mice. We found that a high dose of caffeine (100 mg/kg) significantly increased CART-IR 2 h after administration in the nucleus accumbens shell (AcbSh), dorsal bed nucleus of the stria terminalis (dBNST), central nucleus of the amygdala (CeA), paraventricular hypothalamic nucleus (PVN), arcuate hypothalamic nucleus (Arc), and locus coeruleus (LC), and returned to control levels after 8 h. But this increase was not observed in other brain areas. In addition, caffeine administration at doses of 25 and 50 mg/kg appears to produce dose-dependent increases in CART-IR in these brain areas; however, the magnitude of increase in CART-IR observed at a dose of 50 mg/kg was similar or greater than that observed at a dose of 100 mg/kg. This result suggests that CART-IR in AcbSh, dBNST, CeA, PVN, Arc, and LC is selectively affected by caffeine administration. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Chromatin immunoprecipitation assays revealed CREB and serine 133 phospho-CREB binding to the CART gene proximal promoter.

    Science.gov (United States)

    Rogge, George A; Shen, Li-Ling; Kuhar, Michael J

    2010-07-16

    Both over expression of cyclic AMP response element binding protein (CREB) in the nucleus accumbens (NAc), and intra-accumbal injection of cocaine- and amphetamine-regulated transcript (CART) peptides, have been shown to decrease cocaine reward. Also, over expression of CREB in the rat NAc increased CART mRNA and peptide levels, but it is not known if this was due to a direct action of P-CREB on the CART gene promoter. The goal of this study was to test if CREB and P-CREB bound directly to the CRE site in the CART promoter, using chromatin immunoprecipitation (ChIP) assays. ChIP assay with anti-CREB antibodies showed an enrichment of the CART promoter fragment containing the CRE region over IgG precipitated material, a non-specific control. Forskolin, which was known to increase CART mRNA levels in GH3 cells, was utilized to show that the drug increased levels of P-CREB protein and P-CREB binding to the CART promoter CRE-containing region. A region of the c-Fos promoter containing a CRE cis-regulatory element was previously shown to bind P-CREB, and it was used here as a positive control. These data suggest that the effects of CREB over expression on blunting cocaine reward could be, at least in part, attributed to the increased expression of the CART gene by direct interaction of P-CREB with the CART promoter CRE site, rather than by some indirect action. Copyright (c) 2010 Elsevier B.V. All rights reserved.

  16. Sistema informático para la gestión de la información hospitalaria del infarto agudo de miocardio (RHIMA)

    OpenAIRE

    Yanier Coll Muñoz; Francisco Valladares Carvajal; Jorge L. Fernández Curbelo; Ing. Luis E. Fernández Curbelo

    2015-01-01

    Introducción: La difícil recopilación de información sobre la prevalencia y desarrollo del infarto agudo de miocardio imposibilita medir la calidad del tratamiento durante la evolución de la enfermedad en un determinado grupo de pacientes.Objetivo: Desarrollar un sistema informático que permita la gestión de la información hospitalaria del infarto agudo de miocardio en el Servicio de Cardiología.Método: Se identificaron las variables necesarias para la confección del registro, divididas por b...

  17. Combinación de procesos de oxidación avanzada y procesos anaerobios para tratamiento de aguas residuales hospitalarias

    OpenAIRE

    , Carlos; Chaparro, Tatiana

    2014-01-01

    Las aguas residuales hospitalarias son una de las principalesfuentes de contaminantes emergentes (e.g. antibióticos,antiepilépticos, hormonas). Debido a la baja eficiencia de los procesos convencionales usados en las plantas de tratamiento de aguas residuales municipales, para eliminar la materia orgánica de este origen, combinar procesos de oxidación avanzada con tratamientos biológicos, surge como una alternativa para reducir el impacto en en el ambiente de estas aguas residuales. Con base ...

  18. Safety, tumor trafficking and immunogenicity of chimeric antigen receptor (CAR)-T cells specific for TAG-72 in colorectal cancer.

    Science.gov (United States)

    Hege, Kristen M; Bergsland, Emily K; Fisher, George A; Nemunaitis, John J; Warren, Robert S; McArthur, James G; Lin, Andy A; Schlom, Jeffrey; June, Carl H; Sherwin, Stephen A

    2017-01-01

    T cells engineered to express chimeric antigen receptors (CARs) have established efficacy in the treatment of B-cell malignancies, but their relevance in solid tumors remains undefined. Here we report results of the first human trials of CAR-T cells in the treatment of solid tumors performed in the 1990s. Patients with metastatic colorectal cancer (CRC) were treated in two phase 1 trials with first-generation retroviral transduced CAR-T cells targeting tumor-associated glycoprotein (TAG)-72 and including a CD3-zeta intracellular signaling domain (CART72 cells). In trial C-9701 and C-9702, CART72 cells were administered in escalating doses up to 10 10 total cells; in trial C-9701 CART72 cells were administered by intravenous infusion. In trial C-9702, CART72 cells were administered via direct hepatic artery infusion in patients with colorectal liver metastases. In both trials, a brief course of interferon-alpha (IFN-α) was given with each CART72 infusion to upregulate expression of TAG-72. Fourteen patients were enrolled in C-9701 and nine in C-9702. CART72 manufacturing success rate was 100% with an average transduction efficiency of 38%. Ten patients were treated in CC-9701 and 6 in CC-9702. Symptoms consistent with low-grade, cytokine release syndrome were observed in both trials without clear evidence of on target/off tumor toxicity. Detectable, but mostly short-term (≤14 weeks), persistence of CART72 cells was observed in blood; one patient had CART72 cells detectable at 48 weeks. Trafficking to tumor tissues was confirmed in a tumor biopsy from one of three patients. A subset of patients had 111 Indium-labeled CART72 cells injected, and trafficking could be detected to liver, but T cells appeared largely excluded from large metastatic deposits. Tumor biomarkers carcinoembryonic antigen (CEA) and TAG-72 were measured in serum; there was a precipitous decline of TAG-72, but not CEA, in some patients due to induction of an interfering antibody to the TAG-72

  19. Substance use and adherence among people living with HIV/AIDS receiving cART in Latin America

    OpenAIRE

    De Boni, Raquel B.; Shepherd, Bryan E.; Grinsztejn, Beatriz; Cesar, Carina; Cortés, Claudia; Padgett, Denis; Gotuzzo, Eduardo; Belaunzarán-Zamudio, Pablo F.; Rebeiro, Peter F.; Duda, Stephany N.; McGowan, Catherine C.

    2016-01-01

    This cross-sectional study describes substance use prevalence and its association with cART adherence among 3343 individuals receiving care at HIV clinics in Argentina, Brazil, Chile, Honduras, Mexico, and Peru. A rapid screening tool evaluated self-reported 7-day recall of alcohol, marijuana, cocaine, heroin, and methamphetamine use, and missed cART doses. Overall, 29.3% individuals reported having ≥ 1 alcoholic drinks, 5.0% reported any illicit drug use and 17.0% reported missed cART doses....

  20. Etiologies of pediatric craniofacial injuries: a comparison of injuries involving all-terrain vehicles and golf carts.

    Science.gov (United States)

    White, Lauren C; McKinnon, Brian J; Hughes, C Anthony

    2013-03-01

    To determine incidence and etiologies of craniofacial injuries in the pediatric population through comparison of injuries caused by all-terrain vehicles and golf cart trauma. Case series with chart review. Level 1 trauma center. Retrospective review of pediatric traumas at a tertiary academic medical center from 2003 to 2012 identified 196 patients whose injuries resulted from accidents involving either all-terrain vehicles or golf carts. Data was collected and variables such as age, gender, driver vs. passenger, location of accident, Glasgow coma scale, Injury severity scale, Abbreviated injury scale, and presence or absence of helmet use were examined. 196 pediatric patients were identified: 68 patients had injuries resulting from golf cart accidents, and 128 patients from ATV accidents. 66.4% of ATV-related traumas were male, compared to 52.9% of golf cart-related traumas. Ages of injured patients were similar between the two modalities with average age of ATV traumas 10.8 (±4.0) years and golf cart traumas 10.0 (±4.6) years. Caucasians were most commonly involved in both ATV (79.7%) and golf cart traumas (85.3%). 58.6% of all ATV related trauma and 69.1% of all golf cart trauma resulted in craniofacial injuries. The most common craniofacial injury was a closed head injury with brief loss of consciousness, occurring in 46.1% of the ATV traumas and 54.4% of the golf cart traumas. Temporal bone fractures were the second most common type of craniofacial injury, occurring in 5.5% of ATV accidents and 7.4% of the golf cart traumas. Length of hospital stay and, cases requiring surgery and severity scores were similar between both populations. Intensive care admissions and injury severity scores approached but not reach statistical significance (0.096 and 0.083, respectively). The only statistically significant differences between the two modalities were helmet use (P=0.00018%) and days requiring ventilator assistance (P=0.025). ATVs and golf carts are often exempt

  1. EL PRECURSOR DEL NEUROPEPTIDO CART POSEE UNA SEÑAL DE DESTINACION A LAS VESICULAS DE SECRECION REGULADA

    OpenAIRE

    BLANCO NAHUELQUEO, ELIAS HUMBERTO; BLANCO NAHUELQUEO, ELIAS HUMBERTO

    2011-01-01

    CART (Cocaine- Amphetamine Regulated Transcript} fue descubierto como un RNAm que es inducido por una dosis aguda de cocaína y también de anfetamina en el estriado de cerebro de rata. A partir de su descubrimiento el neuropéptido CART fue vinculado a drogas de abuso, sin embargo existe mayor evidencia que lo vincula al control del apetito. El neuropéptido CART inhibe potentemente el apetito (efecto anorexigénico} cuando es administrado intra-cerebralmente a roedores. Una subregión de...

  2. Tablas de mortalidad, jubilación e invalidez, Costa Rica 2000-2005

    Directory of Open Access Journals (Sweden)

    Rosero Bixby, Luis

    2008-07-01

    Full Text Available Se estimaron las tablas de vida de Costa Rica del período 2000-2005, detalladas por edades simples y hasta los 115 años de edad. Además, se comparó el patrón de mortalidad general con la de los derecho habientes a pensión dentro de los regímenes contributivos. También, se proyectó una tabla de vida para 2025-2030 y un modelo para estimar las probabilidades de muerte por edades simples, sexo y año calendario dentro del período 2006-2050. La comparación tabla de vida 2000-05 con la de cinco años atrás muestra el progreso en la esperanza de vida. Al nacer, la esperanza de vida fue de 78,2 años para ambos sexos (75,9 para los hombres y 80,6 las mujeres. Costa Rica continúa ocupando el segundo lugar de América como el país de mayor esperanza de vida al nacer, solo superado por Canadá. La esperanza de vida a los 65 años (edad aproximada de jubilación, aumentó medio año para los varones y casi un año para las mujeres; pasando de 16,9 a 17,5 años en hombres y de 19,1 a 19,9 en mujeres. La comparación de los patrones de mortalidad de la población general con las poblaciones con derecho a pensión, mostró que la mortalidad de los derecho habientes no difiere significativamente de la mortalidad de la población total, en cambio para los jubilados e inválidos si se observaron diferencias. La tabla de mortalidad proyectada estima las condiciones probables de mortalidad que vivirán quienes se pensionen en 2007-2011. La proyección supuso un progreso cada vez más lento en la esperanza de vida. Estas tablas de vida se prepararon para la Superintendencia de Pensiones, de manera que sirvan como referencia en cálculos actuariales de seguros de vida y pensiones vitalicias.

  3. Tablas de mortalidad, jubilación e invalidez, Costa Rica 2000-2005

    Directory of Open Access Journals (Sweden)

    Luis Rosero Bixby

    2008-01-01

    Full Text Available Se estimaron las tablas de vida de Costa Rica del período 2000-2005, detalladas por edades simples y hasta los 115 años de edad. Además, se comparó el patrón de mortalidad general con la de los derecho habientes a pensión dentro de los regímenes contributivos. También, se proyectó una tabla de vida para 2025-2030 y un modelo para estimar las probabilidades de muerte por edades simples, sexo y año calendario dentro del período 2006-2050. La comparación tabla de vida 2000-05 con la de cinco años atrás muestra el progreso en la esperanza de vida. Al nacer, la esperanza de vida fue de 78,2 años para ambos sexos (75,9 para los hombres y 80,6 las mujeres. Costa Rica continúa ocupando el segundo lugar de América como el país de mayor esperanza de vida al nacer, solo superado por Canadá. La esperanza de vida a los 65 años (edad aproximada de jubilación, aumentó medio año para los varones y casi un año para las mujeres; pasando de 16,9 a 17,5 años en hombres y de 19,1 a 19,9 en mujeres. La comparación de los patrones de mortalidad de la población general con las poblaciones con derecho a pensión, mostró que la mortalidad de los derecho habientes no difiere significativamente de la mortalidad de la población total, en cambio para los jubilados e inválidos si se observaron diferencias. La tabla de mortalidad proyectada estima las condiciones probables de mortalidad que vivirán quienes se pensionen en 2007-2011. La proyección supuso un progreso cada vez más lento en la esperanza de vida. Estas tablas de vida se prepararon para la Superintendencia de Pensiones, de manera que sirvan como referencia en cálculos actuariales de seguros de vida y pensiones vitalicias.

  4. Efeito idade-periodo-coorte na mortalidade por cancer do colo uterino

    Directory of Open Access Journals (Sweden)

    Karina Cardoso Meira

    2013-06-01

    Full Text Available OBJETIVO: Estimar o efeito da idade, período e coorte de nascimento na mortalidade por câncer do colo do útero. MÉTODOS: Foram analisados dados de mortalidade por câncer do colo do útero em mulheres ≥ 30 anos nos municípios do Rio de Janeiro, RJ, e São Paulo, SP, de 1980 a 2009. Os dados foram extraídos do Sistema de Informação Sobre Mortalidade. A variação percentual anual estimada foi calculada para os períodos de 1980-1994 e 1995-2009. O efeito da idade, período e coorte de nascimento foi calculado pelo modelo de regressão de Poisson, utilizando funções estimáveis: desvios, curvaturas e drift , por meio da biblioteca Epi do programa estatístico R versão 2.7.2. RESULTADOS: A taxa de mortalidade média do período por 100.000 mulheres foi 15,90 no Rio de Janeiro e 15,87 em São Paulo. Houve redução significativa na mortalidade por câncer do colo do útero nos dois períodos: no Rio de Janeiro, -1,20% (IC95% -2,20;-0,09 e -1,46% (IC95% -2,30;-0,61, e em São Paulo, -2,58% (IC95% -3,41;-1,76 e -3,30% (IC95% -4,30;-2,29. A análise da curvatura dos efeitos indicou tendência de redução do risco de morte nas sucessivas coortes (RR < 1 nas mulheres nascidas após a década de 1960. Observou-se redução acentuada no risco relativo (RR a partir dos anos 2000. CONCLUSÕES: O estudo evidenciou efeito de período na redução das taxas de mortalidade por câncer do colo do útero no período analisado, tendo em vista que houve efeito de proteção (RR < 1 a partir dos anos 2000 e nas mulheres nascidas após a década de 1960.

  5. Emerging immunotherapeutics in adenocarcinomas: A focus on CAR-T cells.

    Science.gov (United States)

    Yazdanifar, Mahboubeh; Zhou, Ru; Mukherjee, Pinku

    2016-01-01

    More than 80% of all cancers arise from epithelial cells referred to as carcinomas. Adenocarcinomas are the most common type of carcinomas arising from the specialized epithelial cells that line the ducts of our major organs. Despite many advances in cancer therapies, metastatic and treatment-refractory cancers remain the 2 nd leading cause of death. Immunotherapy has offered potential opportunities with specific targeting of tumor cells and inducing remission in many cancer patients. Numerous therapies using antibodies as antagonists or checkpoint inhibitors/immune modulators, peptide or cell vaccines, cytokines, and adoptive T cell therapies have been developed. The most innovative immunotherapy approach so far has been the use of engineered T cell, also referred to as chimeric antigen receptor T cells (CAR-T cells). CAR-T cells are genetically modified naïve T cells that express a chimeric molecule which comprises of the antigen-recognition domains (scFv) of an anti-tumor antibody and one, two, or three intracellular signaling domains of the T cell receptor (TCR). When these engineered T cells recognize and bind to the tumor antigen target via the scFv fragment, a signal is sent to the intracellular TCR domains of the CAR, leading to activation of the T cells to become cytolytic against the tumor cells. CAR-T cell therapy has shown tremendous success for certain hematopoietic malignancies, but this success has not been extrapolated to adenocarcinomas. This is due to multiple factors associated with adenocarcinoma that are different from hematopoietic tumors. Although many advances have been made in targeting multiple cancers by CAR-T cells, clinical trials have shown adverse effects and toxicity related to this treatment. New strategies are yet to be devised to manage side effects associated with CAR-T cell therapies. In this review, we report some of the promising immunotherapeutic strategies being developed for treatment of most common adenocarcinomas with

  6. Mortalidad por cáncer en los mineros del mercurio Cancer mortality in mercury miners

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    Montserrat García Gómez

    2007-06-01

    Full Text Available Objetivos: Analizar la mortalidad por cáncer en una cohorte de mineros del mercurio. Métodos: Estudiamos la mortalidad por cáncer de 3.998 mineros expuestos a mercurio de Minas de Almadén y Arrayanes, S.A. El período de seguimiento comprendió desde 1895 hasta 1994. Se determinó el estado vital y la causa básica de defunción. Se calcularon las razones de mortalidad estandarizadas (RME según la edad, el sexo y el período de calendario. Las muertes esperadas se obtuvieron de las tasas específicas españolas. Resultados: Se determinó el estado vital del 92% de los trabajadores: 1.786 estaban vivos en 1994 (49%, 1.535 habían muerto (42% y de 327 no pudo conocerse el estado vital (8%. La mortalidad por cáncer fue significativamente menor de la esperada (RME de 0,72; intervalo de confianza del 95%, 0,63-0,82, y se encontró el déficit principalmente en los cánceres de colon y vejiga. Se encontró un pequeño exceso en la mortalidad por cáncer de hígado, para el que se registraron 20 muertes, mientras se esperaban 17. La mortalidad por cáncer de pulmón y del sistema nervioso central fue prácticamente igual a la esperada; la mortalidad por cáncer de riñón fue menor de la esperada. Se observó una tendencia positiva en la mortalidad por todos los tipos de cáncer con la duración de la exposición. Conclusiones: Esta investigación aporta evidencias adicionales de la ausencia de un aumento sustancial del riesgo de cáncer en los trabajadores expuestos al mercurio inorgánico.Objectives: To analyze cancer mortality in a cohort of mercury miners. Methods: Cancer mortality in 3,998 workers exposed to mercury in Minas de Almadén y Arrayanes S.A. was studied. The follow-up period was from 1895 to 1994. Vital status and the basic cause of death, in the case of fatalities, were determined. Standardized mortality ratios (SMR by age, sex and calendar period were calculated. Expected deaths were obtained from age, sex and calendar period

  7. Mortalidad infantil en Uruguay: un análisis de supervivencia

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    Jewell R. Todd

    2010-12-01

    Full Text Available A partir de todos los nacimientos ocurridos en el Uruguay entre 2002 y 2003 y las defunciones ocurridas en el primer año de vida, se estima la tasa de mortalidad infantil a través de modelos probit y hazard. Debido a que las muertes se concentran en los primeros días y semanas de vida, el modelo hazard es preferible al probit, encontrándose que la estimación probit sobreestima los efectos de las covariables. Los resultados muestran que las variables más importantes son la edad y la educación de la madre, los cuidados prenatales y los denominados predictores de la mortalidad (bajo peso al nacer, semanas de gestación y APGAR.

  8. Tendencias de mortalidad por cánceres atribuibles al tabaco en México

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    Tovar-Guzmán Víctor José

    2002-01-01

    Full Text Available Objetivo. Describir la tendencia de la mortalidad por cáncer atribuible al consumo de tabaco, particularmente neoplasias del pulmón, en México, durante el periodo 1980-1997. Material y métodos. Se hizo un análisis de tendencias de mortalidad para cada tipo de cáncer asociado con el tabaco, según la Clasificación Internacional de Enfermedades. Las tasas cruda y ajustada de mortalidad fueron estimadas en términos de edad, género, causa básica de la muerte y año, entre 1980 y 1997. Se estimó la razón de género y proporción relativa para los casos que estaban en el grupo de edad entre 35 y 64 años y para toda la población estudiada. Como denominador se utilizaron las proyecciones por edad calculadas por el Consejo Nacional de Población (1970-2010. Resultados. La razón de género para las tasas de mortalidad por cáncer de laringe, esófago, cavidad oral y faringe fue de 2.10:1.00 (hombre: mujer. La razón de género para el cáncer de laringe es enorme: 4.21: 1.00, probablemente debida a la mayor prevalencia de hombres fumadores de tabaco. La proporción relativa estimada, usando la mortalidad total debida a tumores malignos, entre 1980 y 1997 fue la siguiente: cáncer de pulmón 12.31%, laringe 1.71%, esófago 1.55% y cavidad oral/faringe 1.49%. El antecedente de tabaquismo tiene correlación con la tendencia de la tasa de mortalidad por cáncer del pulmón (Beta: 0.910, IC 95%: 1.097-1.797; R² 0.827. Para los grupos sociales mas pobres, por entidad federativa, la correlación está invertida (Beta: -0.510, IC 95%: -0.170, -0.039, R²: 0.260. Conclusiones. En México, la mejoría en el diagnóstico, la transición demográfica y el incremento del consumo de tabaco son, probablemente, los principales factores a los que se atribuye la tasa de mortalidad por cáncer. No obstante, otras variables asociadas con el estilo de vida, como urbanización, actividad física, ingesta de carotenoides y otros componentes dietéticos y t

  9. Correcao de informacoes vitais: estimacao da mortalidade infantil, Brasil, 2000-2009

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    Paulo Germano de Frias

    2013-12-01

    Full Text Available OBJETIVO : Propor método simplificado para corrigir informações vitais e estimar o coeficiente de mortalidade infantil no Brasil. MÉTODOS : A correção dos dados vitais dos sistemas de informação sobre mortalidade e nascidos vivos foi obtida por meio de fatores de correção, estimados com base em eventos não informados ao Ministério da Saúde e captados por pesquisa de busca ativa. O método simplificado de correção das informações vitais, de 2000-2009 para o Brasil e unidades da federação, estabelece o nível de adequação das informações de óbitos e nascidos vivos, pelo cálculo do coeficiente geral de mortalidade padronizado por idade e da razão entre os nascidos vivos, informados e esperados, respectivamente, em cada município brasileiro. A partir da aplicação dos fatores de correção ao número de óbitos e nascidos vivos, informados em cada município, as estatísticas vitais foram corrigidas, possibilitando estimar o coeficiente de mortalidade infantil. RESULTADOS : Os maiores fatores de correção foram referentes aos óbitos infantis que atingiram valores maiores do que 7 para municípios com grande precariedade de informações de mortalidade. Os fatores de correção apresentaram gradiente decrescente à medida que melhoraram os indicadores de adequação das informações vitais para óbitos e nascidos vivos. As informações vitais corrigidas pelo método simplificado por unidade da federação, em 2008, foram similares às obtidas na pesquisa de busca ativa. A taxa de natalidade e o coeficiente de mortalidade infantil decresceram em todas as regiões brasileiras, no período. A taxa de decréscimo anual foi de 6,0% no Nordeste, a maior do Brasil (4,7%. CONCLUSÕES : A busca ativa de óbitos e nascimentos possibilitou calcular fatores de correção por nível de adequação das informações de mortalidade e de nascidos vivos. O método simplificado proposto permitiu corrigir as informações vitais por

  10. Clinical pharmacology of CAR-T cells: Linking cellular pharmacodynamics to pharmacokinetics and antitumor effects.

    Science.gov (United States)

    Norelli, M; Casucci, M; Bonini, C; Bondanza, A

    2016-01-01

    Adoptive cell transfer of T cells genetically modified with tumor-reactive chimeric antigen receptors (CARs) is a rapidly emerging field in oncology, which in preliminary clinical trials has already shown striking antitumor efficacy. Despite these premises, there are still a number of open issues related to CAR-T cells, spanning from their exact mechanism of action (pharmacodynamics), to the factors associated with their in vivo persistence (pharmacokinetics), and, finally, to the relative contribution of each of the two in determining the antitumor effects and accompanying toxicities. In light of the unprecedented curative potential of CAR-T cells and of their predicted wide availability in the next few years, in this review we will summarize the current knowledge on the clinical pharmacology aspects of what is anticipated to be a brand new class of biopharmaceuticals to join the therapeutic armamentarium of cancer doctors. Copyright © 2015. Published by Elsevier B.V.

  11. Investigation on Superior Performance by Fractional Controller for Cart-Servo Laboratory Set-Up

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    Ameya Anil Kesarkar

    2014-01-01

    Full Text Available In this paper, an investigation is made on the superiority of fractional PID controller (PI^alpha D^beta over conventional PID for the cart-servo laboratory set-up. The designed controllers are optimum in the sense of Integral Absolute Error (IAE and Integral Square Error (ISE. The paper contributes in three aspects: 1 Acquiring nonlinear mathematical model for the cart-servo laboratory set-up, 2 Designing fractional and integer order PID for minimizing IAE, ISE, 3 Analyzing the performance of designed controllers for simulated plant model as well as real plant. The results show a significantly superior performance by PI^alpha D^beta as compared to the conventional PID controller.

  12. Penser et activer les relations entre cartes et récits

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    SÉBASTIEN CAQUARD

    2015-03-01

    Full Text Available De prime abord, récit et carte semblent en opposition directe. Le récit offre un point de vue partiel et personnel, souvent chronologique et intimement associé à une trame narrative structurée autour d’évènements vécus, imaginés ou remémorés par un sujet concret engagé dans un cheminement. La carte s’ingénie à présenter de manière synthétique et abstraite des données quantifiables à partir d’un point distant, figé dans le temps, dépersonnalisé et aérien.

  13. Mortalidad en un área indígena de Veracruz. Enfermedades transmisibles y no transmisibles

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    Elda MONTERO-MENDOZA

    2011-01-01

    municipios con el objetivo de obtener información sociodemográfi ca e indicadores económicos y de salud. A partir de los resultados se discuten dos aspectos: las principales causas de mortalidad en los hombres y en las mujeres de los cuatro municipios, y la importancia del certifi cado de defunción como fuente primaria de las estadísticas de mortalidad.

  14. Valor preditivo da frequência cardíaca em repouso do teste ergométrico na mortalidade

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    Jaqueline Eilert Fagundes

    2010-12-01

    Full Text Available FUNDAMENTO: A frequência cardíaca em repouso (cuja média está entre 60 e 80 bpm é uma das mais simples variáveis cardiovasculares e tem sido considerada como um preditor de mortalidade cardiovascular e geral. OBJETIVO: Avaliar o valor preditivo da frequência cardíaca em repouso (FCR, antes do teste ergométrico (TE, na mortalidade cardiovascular (CV e geral. MÉTODOS: Estudo de caso-controle, que utilizou informações contidas nos bancos de dados do laboratório de ergometria de um hospital especializado em cardiologia e os registros de óbitos da Secretaria da Saúde em uma cidade do sul do Brasil, de janeiro de 1995 a junho de 2007. Foram analisados 7.055 pacientes, sendo 1.645 (23,3% do grupo caso (óbitos e 5.410 (76,7% do grupo controle (vivos. Foi calculado o ponto de corte da FCR para mortalidade, através da curva ROC e realizada a análise multivariada para as variáveis selecionadas. Os desfechos foram mortalidade CV e geral. RESULTADOS: A incidência de mortalidade CV foi de 674 casos (9,5%; a FCR > 78 bpm foi o ponto de corte. Após ajustado para as variáveis selecionadas, o odds ratio (OR para FCR > 78 bpm foi de 3,5 (IC 95% = 2,9 - 4,2 para mortalidade CV e 3,6 (IC 95% = 3,2 - 4,0 para mortalidade geral. CONCLUSÃO: A FCR > 78 bpm é um preditor independente de mortalidade cardiovascular e geral.

  15. Evaluación de la respuesta educativa al alumnado de aulas hospitalarias en la provincia de Almería

    Directory of Open Access Journals (Sweden)

    Antonio Sánchez Palomino

    2016-06-01

    Full Text Available Con esta investigación, que forma parte de una tesis doctoral en proceso, pretendemos evaluar la respuesta educativa ofrecida al alumnado de las aulas hospitalarias ubicadas en la provincia de Almería (Complejo Hospitalario de Torrecárdenas, Hospital del Poniente y Hospital La Inmaculada. Para ello, hemos utilizado como grupos informantes a los tres colectivos presentes, alumnado, familiares y personal médico-sanitario.Utilizamos como técnica de recogida de información el sistema de encuestas y, como instrumento, los cuestionarios tipo Likert con respuesta múltiple cerrada, cuyos datos han sido posteriormente analizados mediante SPSS.Los resultados obtenidos muestran que se encuentran satisfechos con la respuesta educativa, no sólo en los aspectos curriculares y educativos, sino también con los distintos programas educativos de carácter lúdico que desarrollan los docentes. De otra parte, se confirma la necesidad de implementar programas de formación específica dirigidos al personal médico-sanitario, pues muestran una actitud pasiva y desinteresada hacia el aula hospitalaria.

  16. Variaciones regionales de la mortalidad por homicidios en Jalisco, México

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    Vega-López María Guadalupe

    2003-01-01

    Full Text Available El presente estudio busca describir las variaciones regionales de la mortalidad por homicidios en el estado de Jalisco, México, en 1989-1991, 1994-1996 y 1999-2000, analizando a su vez el comportamiento de la tasa de homicidios según género y estratos de bienestar socioeconómico. A partir de la información sobre mortalidad generada por el Instituto Nacional de Estadística, Geografía y Informática, se calcularon tasas ajustadas por edad y género e índices de sobremortalidad masculina. Además, se calcularon razones de tasa y su intervalo de confianza (95%. Los resultados reflejan que la tasa de homicidios presenta una tendencia decreciente en los años 90; que existe un patrón regional de la mortalidad por homicidios, observándose las tasas más altas en regiones periféricas del estado consideradas entre las más pobres; que los municipios ubicados en el estrato de bienestar más bajo presentan un exceso de mortalidad por homicidios estadísticamente significativo, y que hay una evidente sobremortalidad masculina por esta causa. Aspectos como los antes descritos implican tareas y desafíos para la salud pública y para los organismos encargados de preservar la ley y el orden, entre ellos la necesidad de implementar políticas intersectoriales diferenciadas, que tomen en consideración las particularidades que rodean al homicidio y al crimen violento en Jalisco.

  17. Mortalidad por neumonía en menores de 5 años

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    Caridad María Tamayo Reus

    2014-03-01

    Full Text Available Se llevó a cabo un estudio observacional, descriptivo y transversal de 18 niños menores de 5 años de edad, fallecidos por neumonía adquirida en la comunidad (como causa básica de muerte en el Hospital Docente Pediátrico Sur durante el período de enero de 1997 a diciembre de 2011, con vistas a caracterizarles y determinar las tasas de mortalidad por dicha causa. Las variables clínicas, epidemiológicas y paraclínicas se obtuvieron de los registros de defunciones y morbilidad del Departamento de Estadística de la institución, así como de las historias clínicas de los pacientes. En la investigación se observó que el mayor número de fallecidos correspondiera al sexo masculino (67,7 % y al grupo etario de 1-4 años (58,8 %; además primaron el cuadro clínico muy grave al momento del ingreso (44,4 %, la anemia (82,3 %, los ingresos previos (100,0 %, el hacinamiento (77,7 %, el asma bronquial como enfermedad crónica (61,1%, la linfocitosis (61,1 %, el recuento de leucocitos normal (50,0 % y las imágenes de condensación inflamatoria bilateral en las radiografías (61,1 %. Las tasas de mortalidad específica y mortalidad proporcional por neumonía mostraron tendencias evolutivas descendentes, en tanto la de mortalidad bruta reveló menor cuantía

  18. Tendencias de mortalidad por traumatismos y envenenamientos en adolescentes: México, 1979-1997

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    Celis Alfredo

    2003-01-01

    Full Text Available OBJETIVO: Describir las causas externas de la mortalidad por traumatismos y envenenamientos, así como la tendencia que estas causas han mostrado entre adolescentes en México, de 1979 a 1997. MATERIAL Y MÉTODOS: Para la realización de este estudio descriptivo de la mortalidad se utilizaron las bases de datos de mortalidad registrada en México de 1979 a 1997. Los datos son recabados, codificados y capturados por el Instituto Nacional de Estadística, Geografía e Informática, y se obtuvieron a través del Instituto Nacional de Salud Pública. Los datos fueron tabulados durante el último semestre de 2000, en Jalisco, en la Unidad de Investigación Epidemiológica y en Servicios de Salud del Adolescente del Instituto Mexicano del Seguro Social. RESULTADOS: Los traumatismos y envenenamientos ocuparon el primer lugar en la mortalidad del grupo adolescente (tasa de 13.35/100 000 con una tendencia descendente de -41.4% durante el periodo 1979-1997, no obstante el incremento de homicidios y suicidios (9.5% y 104.0% respectivamente. Los mecanismos más frecuentes fueron los vehículos de tráfico de motor, las armas de fuego, las intoxicaciones, las sofocaciones y las asfixias por inmersión. CONCLUSIONES: Los traumatismos y envenenamientos que experimenta la población de países en desarrollo muestran frecuencias diferentes a lo registrado en los más desarrollados, haciendo necesario el estudio de los mismos para implantar las medidas preventivas acordes con las condiciones socioculturales y ambientales de cada entorno.

  19. Tendencias de la mortalidad por fiebre amarilla, Colombia, 1998-2009

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    Ángela María Segura

    2013-08-01

    Full Text Available Introducción. La fiebre amarilla es una enfermedad tropical desatendida, razón por la cual el conocer las tendencias de mortalidad por fiebre amarilla en Colombia, constituye una importante fuente de información para la toma de decisiones y las intervenciones en salud pública. Objetivo. Analizar las tendencias de mortalidad fiebre amarilla en Colombia (1998-2009 y las diferencias que presentan las fuentes de información de morbilidad y mortalidad en el país, que afectan indicadores como el de letalidad. Materiales y métodos. Es un estudio descriptivo de las muertes por fiebre amarilla, según el Departamento Administrativo Nacional de Estadística, y de la incidencia de la enfermedad, según el Instituto Nacional de Salud. Se usaron fuentes secundarias de información en el cálculo de proporciones de las características sociodemográficas de los fallecidos y las medidas epidemiológicas de letalidad, incidencia y mortalidad por fiebre amarilla, por departamento de residencia de los fallecidos. Resultados. Las muertes por fiebre amarilla se presentan principalmente en hombres, en edad de trabajar, residentes en zonas rurales dispersas, afiliados al régimen vinculado, residentes en las zonas oriental, suroriental, norte y central del país. Se observaron inconsistencias en los informes reportados que afectan el análisis comparativo. Conclusión. Los habitantes de los departamentos ubicados en los territorios nacionales y en Norte de Santander presentan mayor riesgo de enfermar y de morir por fiebre amarilla, pero esta información pudiera estar subestimada, según la fuente de información utilizada en su cálculo.   doi: http://dx.doi.org/10.7705/biomedica.v33i0.698

  20. MORTALIDAD YCOSTES ASOCIADOS A LA DEMORA DEL TRATAMIENTO QUIRÚRGICO POR FRACTURA DE CADERA

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    Iñigo Etxebarria-Foronda

    2013-01-01

    Full Text Available Fundamentos: La intervención quirúrgica en las fracturas de cadera suele demorarse varios días. Nuestro trabajo tiene dos objetivos. Estudiar la estancia preoperatoria de los pacientes ingresados por fractura de cade- ra en los hospitales vascos durante el año 2010 y medir su posible asocia- ción con la mortalidad intrahospitalaria, y estimar el coste económico que supone la estancia preoperatoria. Métodos. Se realizó un estudio observacional analizando los siguien- tes datos del Conjunto Mínimo Básico de Datos (CMBD: hospital, edad, sexo, estancia preoperatoria, estado al alta, diagnósticos asociados y pro- cedimiento quirúrgico. Además, se estudió el índice de comorbilidad de Charlson y se calculó el coste unitario de la estancia pre y postoperatoria mediante modelos de regresión múltiple. Resultados. Se analizó una muestra de 1.856 intervenciones. La es- tancia preoperatoria fue de 2,7 días y la postoperatoria de 9,7 días. El cos- te medio por ingreso fue de 12.552,12 euros. El coste medio de la estan- cia preoperatoria fue de 1295,5 euros. La mortalidad fue del 5%. Conclusiones. La estancia preoperatoria no es un factor estadística- mente asociado con la mortalidad, aunque aumenta significativamente el coste total. No encontramos una asociación entre la demora quirúrgica y la mortalidad, aunque sí tiene una clara influencia en el coste total del proceso. La reducción del tiempo prequirúrgico permite ahorrar costes.

  1. Assessing the HIV Care Continuum in Latin America: progress in clinical retention, cART use and viral suppression

    Science.gov (United States)

    Rebeiro, Peter F; Cesar, Carina; Shepherd, Bryan E; De Boni, Raquel B; Cortés, Claudia P; Rodriguez, Fernanda; Belaunzarán-Zamudio, Pablo; Pape, Jean W; Padgett, Denis; Hoces, Daniel; McGowan, Catherine C; Cahn, Pedro

    2016-01-01

    Introduction We assessed trends in HIV Care Continuum outcomes associated with delayed disease progression and reduced transmission within a large Latin American cohort over a decade: clinical retention, combination antiretroviral therapy (cART) use and viral suppression (VS). Methods Adults from Caribbean, Central and South America network for HIV epidemiology clinical cohorts in seven countries contributed data between 2003 and 2012. Retention was defined as two or more HIV care visits annually, >90 days apart. cART was defined as prescription of three or more antiretroviral agents annually. VS was defined as HIV-1 RNA <200 copies/mL at last measurement annually. cART and VS denominators were subjects with at least one visit annually. Multivariable modified Poisson regression was used to assess temporal trends and examine associations between age, sex, HIV transmission mode, cohort, calendar year and time in care. Results Among 18,799 individuals in retention analyses, 14,380 in cART analyses and 13,330 in VS analyses, differences existed between those meeting indicator definitions versus those not by most characteristics. Retention, cART and VS significantly improved from 2003 to 2012 (63 to 77%, 74 to 91% and 53 to 82%, respectively; p<0.05, each). Female sex (risk ratio (RR)=0.97 vs. males) and injection drug use as HIV transmission mode (RR=0.83 vs. male sexual contact with males (MSM)) were significantly associated with lower retention, but unrelated with cART or VS. MSM (RR=0.96) significantly decreased the probability of cART compared with heterosexual transmission. Conclusions HIV Care Continuum outcomes improved over time in Latin America, though disparities for vulnerable groups remain. Efforts must be made to increase retention, cART and VS, while engaging in additional research to sustain progress in these settings. PMID:27065108

  2. Inventaire des cartes climatiques conservées à la cartothèque de l' IGN

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    Bernadette Joseph

    2010-12-01

    Full Text Available Cet inventaire présente la liste des cartes climatiques étrangères, conservées à la cartothèque de l' IGN. Ce fonds très riche en cartes thématiques n'est actuellement pas répertorié dans les catalogues SUDOC ou OPALE. Il n'est accessible qu'en interne sur fichiers papier.

  3. Synergistic effect of CART (cocaine- and amphetamine-regulated transcript peptide and cholecystokinin on food intake regulation in lean mice

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    Kiss Alexander

    2008-10-01

    Full Text Available Abstract Background CART (cocaine- and amphetamine-regulated transcript peptide and cholecystokinin (CCK are neuromodulators involved in feeding behavior. This study is based on previously found synergistic effect of leptin and CCK on food intake and our hypothesis on a co-operation of the CART peptide and CCK in food intake regulation and Fos activation in their common targets, the nucleus tractus solitarii of the brainstem (NTS, the paraventricular nucleus (PVN, and the dorsomedial nucleus (DMH of the hypothalamus. Results In fasted C57BL/6 mice, the anorexigenic effect of CART(61-102 in the doses of 0.1 or 0.5 μg/mouse was significantly enhanced by low doses of CCK-8 of 0.4 or 4 μg/kg, while 1 mg/kg dose of CCK-A receptor antagonist devazepide blocked the effect of CART(61-102 on food intake. After simultaneous administration of 0.1 μg/mouse CART(61-102 and of 4 μg/kg of CCK-8, the number of Fos-positive neurons in NTS, PVN, and DMH was significantly higher than after administration of each particular peptide. Besides, CART(61-102 and CCK-8 showed an additive effect on inhibition of the locomotor activity of mice in an open field test. Conclusion The synergistic and long-lasting effect of the CART peptide and CCK on food intake and their additive effect on Fos immunoreactivity in their common targets suggest a co-operative action of CART peptide and CCK which could be related to synergistic effect of leptin on CCK satiety.

  4. Cocaine- and amphetamine-regulated transcript (CART) peptide specific binding in pheochromocytoma cells PC12

    Czech Academy of Sciences Publication Activity Database

    Maletínská, Lenka; Maixnerová, Jana; Matyšková, Resha; Haugvicová, Renata; Šloncová, Eva; Elbert, Tomáš; Slaninová, Jiřina; Železná, Blanka

    2007-01-01

    Roč. 559, 2/3 (2007), s. 109-114 ISSN 0014-2999 R&D Projects: GA ČR GA303/05/0614 Institutional research plan: CEZ:AV0Z40550506; CEZ:AV0Z50520514; CEZ:AV0Z50200510 Keywords : radioligand binding * CART * PC12 cells * food intake Subject RIV: CE - Biochemistry Impact factor: 2.376, year: 2007

  5. Peptid CART (cocaine- and amphetamine- regulated transcript) v signalizaci buněk PC12

    Czech Academy of Sciences Publication Activity Database

    Nagelová, Veronika; Železná, Blanka; Maletínská, Lenka

    2014-01-01

    Roč. 108, č. 5 (2014), s. 543 ISSN 0009-2770. [Mezioborové setkání mladých biologů, biochemiků a chemiků /14./. 13.05.2014-16.05.2014, Milovy] R&D Projects: GA ČR GAP303/10/1368 Institutional support: RVO:61388963 Keywords : peptide CART * PC12 * c-Jun * SAPK/JNK Subject RIV: CE - Biochemistry

  6. VERA Pin and Fuel Assembly Depletion Benchmark Calculations by McCARD and DeCART

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ho Jin; Cho, Jin Young [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2016-10-15

    Monte Carlo (MC) codes have been developed and used to simulate a neutron transport since MC method was devised in the Manhattan project. Solving the neutron transport problem with the MC method is simple and straightforward to understand. Because there are few essential approximations for the 6- dimension phase of a neutron such as the location, energy, and direction in MC calculations, highly accurate solutions can be obtained through such calculations. In this work, the VERA pin and fuel assembly (FA) depletion benchmark calculations are performed to examine the depletion capability of the newly generated DeCART multi-group cross section library. To obtain the reference solutions, MC depletion calculations are conducted using McCARD. Moreover, to scrutinize the effect by stochastic uncertainty propagation, uncertainty propagation analyses are performed using a sensitivity and uncertainty (S/U) analysis method and stochastic sampling (S.S) method. It is still expensive and challenging to perform a depletion analysis by a MC code. Nevertheless, many studies and works for a MC depletion analysis have been conducted to utilize the benefits of the MC method. In this study, McCARD MC and DeCART MOC transport calculations are performed for the VERA pin and FA depletion benchmarks. The DeCART depletion calculations are conducted to examine the depletion capability of the newly generated multi-group cross section library. The DeCART depletion calculations give excellent agreement with the McCARD reference one. From the McCARD results, it is observed that the MC depletion results depend on how to split the burnup interval. First, only to quantify the effect of the stochastic uncertainty propagation at 40 DTS, the uncertainty propagation analyses are performed using the S/U and S.S. method.

  7. Registro de los cartógrafos medievales activos en el puerto de Mallorca

    Directory of Open Access Journals (Sweden)

    Llompart, Gabriel

    1997-12-01

    Full Text Available In medieval times, with the opening of the Atlantic trading routes at the beginning of the 14th century, the port of the Ciutat de Mallorques became important as the base of a gathering of both cartographers and copiers of maps. Today these maps are dispersed in museums throughout the world. Until the present day, these early map makers were known only through their works. Presented here is the first register of the "maestros" of navigational charts who worked in the "port of Mallorca". The documentation is taken from local notarial and administrative sources, all of which help the better clarification of their names, birthplaces, their Sitz im Leben and their methods of production, which were later surpassed and improved by the advent of the modern printing press.[fr] Le port de Ciutat de Mallorques fût très important pour l'histoire de la cartographie médiévale, parce-qu'un certain nombre de dessinateurs et copistes de cartes s'établirent là au commencement du XIV siècle, en raison de l'ouverture de la route atlantique. Maintenant, ces cartes se trouvent dispersées en diferents musées par tout le monde. Les auteurs de ces cartes étaient connus et datés jusqu'aujourd'hui à travers ses ouvrages. Dans cet article nous est donné un premier registre des maîtres de cartes de naviguer que travaillèrent au port de Majorque, provenant de sources locales, notariales et administratives, que nous permettent d'eclircir leurs noms, leur date de naissance leur Sitz im Leben et leurs méthodes de travail, peu après débordés et dépassés par la presse moderne.

  8. CAR-T cells targeting CLL-1 as an approach to treat acute myeloid leukemia.

    Science.gov (United States)

    Wang, Jinghua; Chen, Siyu; Xiao, Wei; Li, Wende; Wang, Liang; Yang, Shuo; Wang, Weida; Xu, Liping; Liao, Shuangye; Liu, Wenjian; Wang, Yang; Liu, Nawei; Zhang, Jianeng; Xia, Xiaojun; Kang, Tiebang; Chen, Gong; Cai, Xiuyu; Yang, Han; Zhang, Xing; Lu, Yue; Zhou, Penghui

    2018-01-10

    Acute myeloid leukemia (AML) is one of the most common types of adult acute leukemia. Standard chemotherapies can induce complete remission in selected patients; however, a majority of patients eventually relapse and succumb to the disease. Thus, the development of novel therapeutics for AML is urgently needed. Human C-type lectin-like molecule-1 (CLL-1) is a type II transmembrane glycoprotein, and its expression is restricted to myeloid cells and the majority of AML blasts. Moreover, CLL-1 is expressed in leukemia stem cells (LSCs), but absent in hematopoietic stem cells (HSCs), which may provide a potential therapeutic target for AML treatment. We tested the expression of CLL-1 antigen on peripheral blood cells and bone marrow cells in healthy donor and AML patients. Then, we developed a chimeric antigen receptor (CAR) containing a CLL1-specific single-chain variable fragment, in combination with CD28, 4-1BB costimulatory domains, and CD3-ζ signaling domain. We further investigate the function of CLL-1 CAR-T cells. The CLL-1 CAR-T cells specifically lysed CLL-1 + cell lines as well as primary AML patient samples in vitro. Strong anti-leukemic activity was observed in vivo by using a xenograft model of disseminated AML. Importantly, CLL-1 + myeloid progenitor cells and mature myeloid cells were specifically eliminated by CLL-1 CAR-T cells, while normal HSCs were not targeted due to the lack of CLL-1 expression. CLL-1 CAR-T represents a promising immunotherapy for the treatment of AML.

  9. The vending and à la carte policy intervention in Maine public high schools.

    Science.gov (United States)

    Davee, Anne-Marie; Blum, Janet E Whatley; Devore, Rachel L; Beaudoin, Christina M; Kaley, Lori A; Leiter, Janet L; Wigand, Debra A

    2005-11-01

    A healthy school nutrition environment may be important for decreasing childhood overweight. This article describes a project to make healthier snacks and beverages available in vending machines and à la carte programs in Maine public high schools. Seven public high schools in Maine volunteered to participate in this project. Four schools made changes to the nutrition environment, and three schools that served as controls did not. The nutrition guidelines were to offer only low-fat (not more than 30% of total calories from fat) and low-sugar (not more than 35% by weight of sugar) items in vending machines and à la carte programs. Strategies to implement the project included early communications with school officials, monetary stipends for participation, identification of a school liaison, and a committee at each school to promote the healthy changes. Baseline nutrient content and sales of all competitive foods and beverages were assessed to develop the guidelines for changes in the four schools. Student volunteers at all seven schools were measured for height, weight, diet quality, and physical activity level to assess the impact of the change to the nutrition environment. Baseline measures were taken in the spring semester of 2004. Nutrition changes were made to the à la carte programs and vending machines in the four intervention schools at the start of the fall semester of 2004. Follow-up nutrition assessment and student data collection occurred in the spring semester of 2005. Healthy changes in vending machines were more easily achieved than those made in the à la carte programs. Technical assistance and ongoing support were essential for successful implementation of this intervention. It is possible to improve the nutrition environment of Maine public high schools. Stakeholder support is essential to sustain healthy changes.

  10. Pendekatan Cart untuk Mendapatkan Faktor yang Mempengaruhi Terjangkitnya Penyakit Demam Tifoid di Aceh Utara

    Directory of Open Access Journals (Sweden)

    Dina Yuanita

    2010-05-01

    research conducted to find factors that influence the outbreak of typhoid fever in NAD. research using the CART Method. The results of the analysis indicate that the main factor causing typhoid fever was drinking water reservoirs. The other factors are waste water reservoirs, the physical quality of drinking water, a habit washing hands with soap before eating, the bowel, the dump, gender, socioeconomic status, habits of washing hands with soap after defecation and health education.

  11. Penyusunan Dan Penyelenggaran A La Carte Menu Pada Hotel Sinabung Dan Resort

    OpenAIRE

    Nasution, Rahmawaty

    2011-01-01

    Dalam operasional hotel, hotel memiliki beberapa departemen yang mempunyai peranan yang sangat penting dalam penjualan jasa dan pelayanan, dan salah satunya adalah departemen Food & Beverage. Food & Beverage mempunyai peran yang sangat besar dalam sebuah hotel, karena pendapatan sebuah hotel yang terbesar ada pada Food & Beverage terutama pada restoran. Adapun salah satu nama jenis restoran yang ada di Hotel Sinabung. Hotel Sinabung menyediakan jenis menu antara lain A La Carte Menu. M...

  12. Shopper marketing nutrition interventions: Social norms on grocery carts increase produce spending without increasing shopper budgets☆

    Science.gov (United States)

    Payne, Collin R.; Niculescu, Mihai; Just, David R.; Kelly, Michael P.

    2015-01-01

    Objectives We assessed the efficacy of an easy-to-implement shopper marketing nutrition intervention in a pilot and two additional studies to increase produce demand without decreasing store profitability or increasing shopper budgets. Methods We created grocery cart placards that detailed the number of produce items purchased (i.e., descriptive norm) at particular stores (i.e., provincial norm). The effect of these placards on produce spending was assessed across 971,706 individual person grocery store transactions aggregated by day. The pilot study designated a baseline period (in both control and intervention store) followed by installation of grocery cart placards (in the intervention store) for two weeks. The pilot study was conducted in Texas in 2012. In two additional stores, we designated baseline periods followed by 28 days of the same grocery cart placard intervention as in the pilot. Additional interventions were conducted in New Mexico in 2013. Results The pilot study resulted in a significant difference between average produce spending per day per person across treatment periods (i.e., intervention versus same time period in control) (16%) and the difference between average produce spending per day per person across stores in the control periods (4%); Furthermore, the same intervention in two additional stores resulted in significant produce spending increases of 12.4% and 7.5% per day per person respectively. In all stores, total spending did not change. Conclusions Descriptive and provincial social norm messages (i.e., on grocery cart placards) may be an overlooked tool to increase produce demand without decreasing store profitability and increasing shopper budgets. PMID:26844084

  13. Le CO.C.A.O: le commentaire de carte assisté par ordinateur

    Directory of Open Access Journals (Sweden)

    Joël CHARRE

    1991-12-01

    Full Text Available Le contenu d’une carte topographique peut être enregistré informatiquement sous forme d’un Système d’Information Géographique (SIG raster. En changeant de support, l’information change de nature: de fixe, elle devient manipulable, adaptable, vivante. L’analyse spatiale peut alors reposer sur des mesures de superficies, des fréquences de co-occurrences, des proximités...

  14. P300/CBP acts as a coactivator to cartilage homeoprotein-1 (Cart1), paired-like homeoprotein, through acetylation of the conserved lysine residue adjacent to the homeodomain.

    Science.gov (United States)

    Iioka, Takashi; Furukawa, Keizo; Yamaguchi, Akira; Shindo, Hiroyuki; Yamashita, Shunichi; Tsukazaki, Tomoo

    2003-08-01

    The paired-like homeoprotein, Cart1, is involved in skeletal development. We describe here that the general coactivator p300/CBP controls the transcription activity of Cart1 through acetylation of a lysine residue that is highly conserved in other homeoproteins. Acetylation of this residue increases the interaction between p300/CBP and Cart1 and enhances its transcriptional activation. Cart1 encodes a paired-like homeoprotein expressed selectively in chondrocyte lineage during embryonic development. Although its target gene remains unknown, gene disruption studies have revealed that Cart1 plays an important role for craniofacial bone formation as well as limb development by cooperating with another homeoprotein, Alx4. In this report, we study the functional involvement of p300/CBP, coactivators with intrinsic histone acetyltransferase (HAT) activity, in the transcriptional control of Cart1. To study the transcription activity of Cart1, a reporter construct containing a putative Cart1 binding site was transiently transfected with the expression vectors of each protein. The interaction between p300/CBP and Cart1 was investigated by glutathione S-transferase (GST) pull-down, yeast two-hybrid, and immunoprecipitation assays. In vitro acetylation assay was performed with the recombinant p300-HAT domain and Cart1 in the presence of acetyl-CoA. p300 and CBP stimulate Cart1-dependent transcription activity, and this transactivation is inhibited by E1A and Tax, oncoproteins that suppress the activity of p300/CBP. Cart1 binds to p300 in vivo and in vitro, and this requires the homeodomain of Cart 1 and N-terminal 139 amino acids of p300. Confocal microscopy analysis shows that Cart1 recruits overexpressed and endogenous p300 to a Cart1-specific subnuclear compartment. Cart1 is acetylated in vivo and sodium butyrate and trichostatin A, histone deacetylase inhibitors, markedly enhance the transcription activity of Cart1. Deletion and mutagenesis analysis identifies the 131st

  15. Diagnósticos al alta hospitalaria de las personas inmigrantes en la ciudad de Valencia (2001-2002

    Directory of Open Access Journals (Sweden)

    Antonio Salazar

    2003-01-01

    Full Text Available Fundamento:La inmigración en España se ha incrementado de forma notable en la última década. Por razones teóricas se ha planteado que esta población pudiera ser responsable de un aumento de la incidencia y/o transmisión de enfermedades infecciosas. Sin embargo, existen escasos estudios acerca de las enfermedades de este colectivo que permitan conocer la importancia de esta afirmación. El objetivo de este estudio es cuantificar la atención hospitalaria a esta población en la ciudad de Valencia. Métodos: Se obtuvieron los registros de altas de los Servicios de Admisión de los hospitales públicos de la ciudad de Valencia. Se desarrolló un estudio observacional retrospectivo para el año comprendido entre el 1 de octubre de 2001 al 30 de septiembre del 2002. Resultados: Recuperamos 8.444 ingresos que identificaron 1.577 ingresos de inmigrantes. Se evidenció una proporción similar de inmigrantes registrados con documentación reglada (841, 51,16% e inmigrantes supuestamente no regularizados (803, 48,84%. Predominaron las mujeres (68,3% frente a los varones (31,7% y una media de edad inferior a los 30 años. El diagnóstico de alta más frecuente fue «complicaciones del embarazo, parto y puerperio» con 37,7% del total. Los «traumatismos y envenenamientos », «enfermedades del aparato digestivo» y «enfermedades del aparato respiratorio» representaron el 12,9%, el 7,8% y el 5,4%, respectivamente. Las «enfermedades infecciosas y parasitarias» supusieron el 4,4%. Conclusiones: La proporción de enfermedades infecciosas e infectocontagiosas observadas no contribuyen a alentar las opiniones difundidas sobre importación o reemergencia de enfermedades desde los colectivos de inmigrantes. La inmigración masiva acaecida requiere múltiples adaptaciones del Sistema de Salud que permitan establecer el perfil de salud de este colectivo, basado en estimaciones poblacionales.

  16. Diagnósticos al alta hospitalaria de las personas inmigrantes en la ciudad de Valencia (2001-2002

    Directory of Open Access Journals (Sweden)

    Salazar Antonio

    2003-01-01

    Full Text Available Fundamento: La inmigración en España se ha incrementado de forma notable en la última década. Por razones teóricas se ha planteado que esta población pudiera ser responsable de un aumento de la incidencia y/o transmisión de enfermedades infecciosas. Sin embargo, existen escasos estudios acerca de las enfermedades de este colectivo que permitan conocer la importancia de esta afirmación. El objetivo de este estudio es cuantificar la atención hospitalaria a esta población en la ciudad de Valencia. Métodos: Se obtuvieron los registros de altas de los Servicios de Admisión de los hospitales públicos de la ciudad de Valencia. Se desarrolló un estudio observacional retrospectivo para el año comprendido entre el 1 de octubre de 2001 al 30 de septiembre del 2002. Resultados: Recuperamos 8.444 ingresos que identificaron 1.577 ingresos de inmigrantes. Se evidenció una proporción similar de inmigrantes registrados con documentación reglada (841, 51,16% e inmigrantes supuestamente no regularizados (803, 48,84%. Predominaron las mujeres (68,3% frente a los varones (31,7% y una media de edad inferior a los 30 años. El diagnóstico de alta más frecuente fue «complicaciones del embarazo, parto y puerperio» con 37,7% del total. Los «traumatismos y envenenamientos», «enfermedades del aparato digestivo» y «enfermedades del aparato respiratorio» representaron el 12,9%, el 7,8% y el 5,4%, respectivamente. Las «enfermedades infecciosas y parasitarias» supusieron el 4,4%. Conclusiones: La proporción de enfermedades infecciosas e infecto-contagiosas observadas no contribuyen a alentar las opiniones difundidas sobre importación o reemergencia de enfermedades desde los colectivos de inmigrantes. La inmigración masiva acaecida requiere múltiples adaptaciones del Sistema de Salud que permitan establecer el perfil de salud de este colectivo, basado en estimaciones poblacionales.

  17. Mortalidade por tumores de cérebro no Brasil, 1980-1998

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    Monteiro Gina Torres Rego

    2003-01-01

    Full Text Available Os tumores cerebrais são raros, mas sua incidência e mortalidade vêm aumentando ao longo das últimas décadas em vários países, inclusive no Brasil, particularmente entre idosos. O presente artigo descreve o perfil da mortalidade desses tumores no país, analisando a distribuição de suas taxas segundo sexo, idade, topografia e natureza tumoral entre 1980 e 1998. As taxas de mortalidade por esta neoplasia, ajustadas por idade pela população mundial, cresceram de 2,24/100 mil para 3,35/100 mil, correspondendo a um aumento de 50%. Estas foram mais elevadas na infância que na adolescência, aumentando posteriormente com a idade e alcançando níveis altos nos mais idosos, sendo o crescimento médio nos maiores de 70 anos de 6% ao ano ao longo da série estudada. São analisadas as taxas de tumores do encéfalo e das meninges cerebrais para o país e para capitais selecionadas. A constatação do aumento dessas taxas demanda a elaboração de estudos com vistas a elucidar o papel de novas tecnologias diagnósticas, assim como de potenciais fatores de risco ambientais.

  18. Mortalidad por accidentes de tránsito en Bayamo, Cuba 2011

    Directory of Open Access Journals (Sweden)

    Arlines Piña-Tornés

    Full Text Available Con el objetivo de describir la mortalidad por accidentes de tránsito en Bayamo, Cuba, en el año 2011 se realizó una revisión de los pacientes lesionados y fallecidos a causa de accidentes de tránsito, registrados en Hospital Carlos M. de Céspedes. Se atendieron en emergencias 1365 lesionados, predominando el grupo etario de 25 a 44 años con 372 pacientes (27,3%, y el sexo masculino con 1071 (78,5%. Fallecieron 46 personas, en su mayoría del mismo grupo de edad y de sexo masculino. Los traumatismos múltiples (52,6% y cráneofaciales (34,2% fueron las localizaciones predominantes. Se destacaron los atropellos por vehículo de motor con mortalidad del 26,3%. En conclusión, la mortalidad por accidentes de tránsito predomina en adultos jóvenes masculinos; cuyas consecuencias fatales son debido a traumatismos múltiples por atropellos.

  19. La calidad de los datos de mortalidad del Censo 2010 de Argentina

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    Nicolás Sacco

    2016-07-01

    Full Text Available Objetivo: evaluar las variables disponibles en el censo de población de 2010 para Argentina en lo que a mortalidad refiere. Métodos: Con base en métodos indirectos de estimación demográfica se ofrece una lectura de la calidad de estas estadísticas en comparación con censos previos y estadísticas vitales. Resultados: La comparación de las tasas de mortalidad infantil y adulta con las tasas calculadas a partir de los nacimientos y las defunciones permite dilucidar, en principio, que estos datos no revelan problemas serios de calidad o cobertura y que el nivel (y la tendencia indicado por las fuentes es ampliamente compatible. Discusión: a pesar de que los resultados parecen mostrar coherencia, la posibilidad de detectar y cuantificar los errores se mantiene como un punto ciego del artículo hasta tanto no se publique la totalidad de la información necesaria para realizar un examen cabal, dado el universo limitado de publicaciones por parte del Instituto Nacional de Estadística y Censos. Conclusiones: las estimaciones de población en cuanto a mortalidad son consistentes con los datos del censo previo de 2001 y con las series de nacimientos y muertes del período intercensal a nivel total del país.

  20. Anthelmintic Resistance of Strongyle Nematodes to Ivermectin and Fenbendazole on Cart Horses in Gondar, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Zewdu Seyoum

    2017-01-01

    Full Text Available A study was conducted from November 2015 to April 2016 to determine fenbendazole and ivermectin resistance status of intestinal nematodes of cart horses in Gondar, Northwest Ethiopia. Forty-five strongyle infected animals were used for this study. The animals were randomly allocated into three groups (15 horses per group. Group I was treated with fenbendazole and Group II with ivermectin and Group III was left untreated. Faecal samples were collected from each cart horse before and after treatment. Accordingly, the reduction in the mean fecal egg count at fourteen days of treatment for ivermectin and fenbendazole was 97.25% and 79.4%, respectively. It was significantly different in net egg count between treatment and control groups after treatment. From the study, resistance level was determined for fenbendazole and suspected for ivermectin. In addition, a questionnaire survey was also conducted on 90 selected cart owners to assess their perception on anthelmintics. In the survey, the most available drugs in the study area used by the owners were fenbendazole and ivermectin. Most respondents have no knowledge about drug management techniques. Hence, animal health extension services to create awareness regarding anthelmintic management that plays a key role in reducing the anthelmintic resistance parasites.

  1. Anthelmintic Resistance of Strongyle Nematodes to Ivermectin and Fenbendazole on Cart Horses in Gondar, Northwest Ethiopia.

    Science.gov (United States)

    Seyoum, Zewdu; Zewdu, Alemu; Dagnachew, Shimelis; Bogale, Basazinew

    2017-01-01

    A study was conducted from November 2015 to April 2016 to determine fenbendazole and ivermectin resistance status of intestinal nematodes of cart horses in Gondar, Northwest Ethiopia. Forty-five strongyle infected animals were used for this study. The animals were randomly allocated into three groups (15 horses per group). Group I was treated with fenbendazole and Group II with ivermectin and Group III was left untreated. Faecal samples were collected from each cart horse before and after treatment. Accordingly, the reduction in the mean fecal egg count at fourteen days of treatment for ivermectin and fenbendazole was 97.25% and 79.4%, respectively. It was significantly different in net egg count between treatment and control groups after treatment. From the study, resistance level was determined for fenbendazole and suspected for ivermectin. In addition, a questionnaire survey was also conducted on 90 selected cart owners to assess their perception on anthelmintics. In the survey, the most available drugs in the study area used by the owners were fenbendazole and ivermectin. Most respondents have no knowledge about drug management techniques. Hence, animal health extension services to create awareness regarding anthelmintic management that plays a key role in reducing the anthelmintic resistance parasites.

  2. An application of CART algorithm in genetics: IGFs and cGH polymorphisms in Japanese quail

    Science.gov (United States)

    Kaplan, Selçuk

    2017-04-01

    The avian insulin-like growth factor-1 (IGFs) and avian growth hormone (cGH) genes are the most important genes that can affect bird performance traits because of its important function in growth and metabolism. Understanding the molecular genetic basis of variation in growth-related traits is of importance for continued improvement and increased rates of genetic gain. The objective of the present study was to identify polymorphisms of cGH and IGFs genes in Japanese quail using conventional least square method (LSM) and CART algorithm. Therefore, this study was aimed to demonstrate at determining the polymorphisms of two genes related growth characteristics via CART algorithm. A simulated data set was generated to analyze by adhering the results of some poultry genetic studies which it includes live weights at 5 weeks of age, 3 alleles and 6 genotypes of cGH and 2 alleles and 3 genotypes of IGFs. As a result, it has been determined that the CART algorithm has some advantages as for that LSM.

  3. Automated Cart with VIS/NIR Hyperspectral Reflectance and Fluorescence Imaging Capabilities

    Directory of Open Access Journals (Sweden)

    Alan M. Lefcourt

    2016-12-01

    Full Text Available A system to take high-resolution Visible/Near Infra-Red (VIS/NIR hyperspectral reflectance and fluorescence images in outdoor fields using ambient lighting or a pulsed laser (355 nm, respectively, for illumination purposes was designed, built, and tested. Components of the system include a semi-autonomous cart, a gated-intensified camera, a spectral adapter, a frequency-triple Nd:YAG (Neodymium-doped Yttrium Aluminium Garnet laser, and optics to convert the Gaussian laser beam into a line-illumination source. The front wheels of the cart are independently powered by stepper motors that support stepping or continuous motion. When stepping, a spreadsheet is used to program parameters of image sets to be acquired at each step. For example, the spreadsheet can be used to set delays before the start of image acquisitions, acquisition times, and laser attenuation. One possible use of this functionality would be to establish acquisition parameters to facilitate the measurement of fluorescence decay-curve characteristics. The laser and camera are mounted on an aluminum plate that allows the optics to be calibrated in a laboratory setting and then moved to the cart. The system was validated by acquiring images of fluorescence responses of spinach leaves and dairy manure.

  4. Design of the CART data system for the US Department of Energy's ARM Program

    International Nuclear Information System (INIS)

    Melton, R.B.; Campbell, A.P.; Edwards, D.M.; Kanciruk, P.; Tichler, J.L.

    1991-01-01

    The Department of Energy (DOE) has initiated a major atmospheric research effort to reduce the uncertainties found in general circulation and other models due to the effects of clouds and radiation. The objective of the Atmospheric Radiation Measurement Program (ARM) is to provide an experimental testbed for the study of important atmospheric effects, particularly cloud and radiative processes, and testing parameterizations of the processes for use in atmospheric models. This experimental testbed, known as the Clouds and Radiation Testbed (CART), will include a complex data system, the CART Data Environment (CDE). The major functions of the CDE will be to: acquire environments from instruments and external data sources; perform quality assessments of the data streams; create data streams of known quality to be used as model input compared to model output; execute the models and capture their predictions; and make data streams associated with model tests available to ARM investigators in near real-time. The CDE will also be expected to capture ancillary information (''meta-data'') associated with the data streams, provide data management facilities for design of ARM experiments, and provide for archival data storage. The first section of this paper presents background information on CART. Next the process for the functional design of the system is described, the functional requirements summarized, and the conceptual architecture of the CDE is presented. Finally, the status of the CDE design activities is summarized, and major technical challenges are discussed

  5. CAR-T cell therapy in ovarian cancer: from the bench to the bedside.

    Science.gov (United States)

    Zhu, Xinxin; Cai, Han; Zhao, Ling; Ning, Li; Lang, Jinghe

    2017-09-08

    Ovarian cancer (OC) is the most lethal gynecological malignancy and is responsible for most gynecological cancer deaths. Apart from conventional surgery, chemotherapy, and radiotherapy, chimeric antigen receptor-modified T (CAR-T) cells as a representative of adoptive cellular immunotherapy have received considerable attention in the research field of cancer treatment. CARs combine antigen specificity and T-cell-activating properties in a single fusion molecule. Several preclinical experiments and clinical trials have confirmed that adoptive cell immunotherapy using typical CAR-engineered T cells for OC is a promising treatment approach with striking clinical efficacy; moreover, the emerging CAR-Ts targeting various antigens also exert great potential. However, such therapies have side effects and toxicities, such as cytokine-associated and "on-target, off-tumor" toxicities. In this review, we systematically detail and highlight the present knowledge of CAR-Ts including the constructions, vectors, clinical applications, development challenges, and solutions of CAR-T-cell therapy for OC. We hope to provide new insight into OC treatment for the future.

  6. New Strategies for the Treatment of Solid Tumors with CAR-T Cells.

    Science.gov (United States)

    Zhang, Hao; Ye, Zhen-Long; Yuan, Zhen-Gang; Luo, Zheng-Qiang; Jin, Hua-Jun; Qian, Qi-Jun

    2016-01-01

    Recent years, we have witnessed significant progresses in both basic and clinical studies regarding novel therapeutic strategies with genetically engineered T cells. Modification with chimeric antigen receptors (CARs) endows T cells with tumor specific cytotoxicity and thus induce anti-tumor immunity against malignancies. However, targeting solid tumors is more challenging than targeting B-cell malignancies with CAR-T cells because of the histopathological structure features, specific antigens shortage and strong immunosuppressive environment of solid tumors. Meanwhile, the on-target/off-tumor toxicity caused by relative expression of target on normal tissues is another issue that should be reckoned. Optimization of the design of CAR vectors, exploration of new targets, addition of safe switches and combination with other treatments bring new vitality to the CAR-T cell based immunotherapy against solid tumors. In this review, we focus on the major obstacles limiting the application of CAR-T cell therapy toward solid tumors and summarize the measures to refine this new cancer therapeutic modality.

  7. Paralleled comparison of vectors for the generation of CAR-T cells.

    Science.gov (United States)

    Qin, Di-Yuan; Huang, Yong; Li, Dan; Wang, Yong-Sheng; Wang, Wei; Wei, Yu-Quan

    2016-09-01

    T-lymphocytes genetically engineered with the chimeric antigen receptor (CAR-T) have shown great therapeutic potential in cancer treatment. A variety of preclinical researches and clinical trials of CAR-T therapy have been carried out to lay the foundation for future clinical application. In these researches, several gene-transfer methods were used to deliver CARs or other genes into T-lymphocytes, equipping CAR-modified T cells with a property of recognizing and attacking antigen-expressing tumor cells in a major histocompatibility complex-independent manner. Here, we summarize the gene-transfer vectors commonly used in the generation of CAR-T cell, including retrovirus vectors, lentivirus vectors, the transposon/transposase system, the plasmid-based system, and the messenger RNA electroporation system. The following aspects were compared in parallel: efficiency of gene transfer, the integration methods in the modified T cells, foreground of scale-up production, and application and development in clinical trials. These aspects should be taken into account to generate the optimal CAR-gene vector that may be suitable for future clinical application.

  8. A Novel Biped Pattern Generator Based on Extended ZMP and Extended Cart-Table Model

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    Guangbin Sun

    2015-07-01

    Full Text Available This paper focuses on planning patterns for biped walking on complex terrains. Two problems are solved: ZMP (zero moment point cannot be used on uneven terrain, and the conventional cart-table model does not allow vertical CM (centre of mass motion. For the ZMP definition problem, we propose the extended ZMP (EZMP concept as an extension of ZMP to uneven terrains. It can be used to judge dynamic balance on universal terrains. We achieve a deeper insight into the connection and difference between ZMP and EZMP by adding different constraints. For the model problem, we extend the cart-table model by using a dynamic constraint instead of constant height constraint, which results in a mathematically symmetric set of three equations. In this way, the vertical motion is enabled and the resultant equations are still linear. Based on the extended ZMP concept and extended cart-table model, a biped pattern generator using triple preview controllers is constructed and implemented simultaneously to three dimensions. Using the proposed pattern generator, the Atlas robot is simulated. The simulation results show the robot can walk stably on rather complex terrains by accurately tracking extended ZMP.

  9. Analysis of performance measures to handle medical E-commerce shopping cart abandonment in cloud

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    Vedhanayagam Priya

    Full Text Available The E-commerce zone is crowded with many Internet users. Medical E-commerce has had significant growth in part because of a great deal of growth in the Indian E-commerce field. Medical E-commerce sites use cloud computing to guarantee a high quality of service anywhere and anytime in the world. For online access, the customer's expectations are very high. Medical E-commerce retailers are directed towards cloud service providers based on their quality of service. During online shopping, impatient customers may abandon a specific medical E-commerce shopping cart due to slow response. This is quite difficult to endure for a medical E-commerce firm. The research described herein observed the effect of shopping cart abandonment on medical E-commerce websites deployed in cloud computing. The impact of the idle virtual machine on customer impatience during medical E-commerce shopping was also studied. The ultimate aim of this study was to propose a stochastic queueing model and to yield results through probability generating functions. The results of the model may be highly useful for a medical E-commerce firm facing customer impatience, so as to design its service system to offer satisfactory quality of service. Keywords: Cloud computing, Queueing, Virtual machine, E-commerce, Cart abandonment, Quality of Service

  10. Prediksi Kerawanan Wilayah Terhadap Tindak Pencurian Sepeda Motor Menggunakan Metode (SARIMA Dan CART

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    Pradita Eko Prasetyo Utomo

    2017-07-01

    Full Text Available Motor vehicle theft is a crime that is most common in Indonesia. Growth of vehicle motorcycle significant in each year accompanied by the increasing theft of motorcycles in each year, we need a system that is able to forecast the development and the theft of the motorcycle. This research proposes the development of forecasting models vulnerability criminal offense of theft of motorcycles with ARIMA forecasting method. This method not only forecast from variable of theft but also residents, vehicles and unemployment. The study also determined the classification level of vulnerability to the crime of theft of a motorcycle using a method based on the Decision Tree CART ARIMA forecasting method. Forecasting time series data with ARIMA method performed by each of the variables to produce the best ARIMA forecasting model which varies based on the data pattern of each of those variables. The results of classification by CART method to get the value of accuracy of 92% for the city of Yogyakarta and 85% for DIY. Based on the above, the results of ARIMA forecasting and classification CART can be used in determining the level of vulnerability to the crime of theft of motorcycles.

  11. Developmental status of preschool children receiving cART: a descriptive cohort study.

    Science.gov (United States)

    Potterton, J; Hilburn, N; Strehlau, R

    2016-05-01

    HIV is known to cause neurodevelopmental problems in infants and young children. The impact of HIV on the development of preschool-age children has been less well described. The study was conducted at an urban paediatric HIV clinic in Johannesburg, South Africa. A sample of convenience was used. Sixty-eight medically stable children between the ages of 3 and 5 years were assessed with the Griffiths Scales of Mental Development. Children were excluded from the study if they had severe HIV encephalopathy, which made it impossible for them to participate in the items on the Griffiths Scales of Mental Development. The children had started combination antiretroviral treatment (cART) at a mean age of 8.1 months. The majority of the children were virologically suppressed and did not present with wasting or stunting. Severe overall developmental delay (z-scores perception were the most severely affected. Personal-social development was the least affected with only 13.4% of the children demonstrating severe delay. Despite having early access to cART, children infected with HIV are still at risk for severe developmental delay across a number of facets. Very early initiation of cART may help alleviate this problem. All preschool children infected with HIV should have routine developmental screening. © 2016 John Wiley & Sons Ltd.

  12. Nursing perception of the impact of medication carts on patient safety and ergonomics in a teaching health care center.

    Science.gov (United States)

    Rochais, Élise; Atkinson, Suzanne; Bussières, Jean-François

    2013-04-01

    In our Quebec (Canada) University Hospital Center, 68 medication carts have been implemented as part of a nationally funded project on drug distribution technologies. There are limited data published about the impact of medication carts in point-of-care units. Our main objective was to assess nursing staff's perception and satisfaction of medication carts on patient safety and ergonomics. Quantitative and qualitative cross-sectional study. Data were gathered from a printed questionnaire administered to nurses and an organized focus group composed of nurses and pharmacists. A total of 195 nurses completed the questionnaire. Eighty percent of the nurses agreed that medication carts made health care staff's work easier and 64% agreed that it helped to reduce medication incidents/accidents. Only 27% and 43% agreed that carts' location reduces the risk of patients' interruptions and colleagues' interruptions, respectively. A total of 17 suggestions were extracted from the focus group (n = 7 nurses; n = 3 pharmacist) and will be implemented in the next year. This descriptive study confirms the positive perception and satisfaction of nurses exposed to medication carts. However, interruptions are a major concern and source of dissatisfaction. The focus group has revealed many issues which will be improved.

  13. Allogeneic CD19-CAR-T cell infusion after allogeneic hematopoietic stem cell transplantation in B cell malignancies.

    Science.gov (United States)

    Liu, Jun; Zhong, Jiang F; Zhang, Xi; Zhang, Cheng

    2017-01-31

    Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is considered the cornerstone in treatment of hematological malignancies. However, relapse of the hematological disease after allo-HSCT remains a challenge and is associated with poor long-term survival. Chimeric antigen receptor redirected T cells (CAR-T cells) can lead to disease remission in patients with relapsed/refractory hematological malignancies. However, the therapeutic window for infusion of CAR-T cells post allo-HSCT and its efficacy are debatable. In this review, we first discuss the use of CAR-T cells for relapsed cases after allo-HSCT. We then review the toxicities and the occurrence of graft-versus-host disease in relapsed patients who received CAR-T cells post allo-HSCT. Finally, we review clinical trial registrations and the therapeutic time window for infusion of CAR-T cells post allo-HSCT. The treatment of allogeneic CAR-T cells is beneficial for patients with relapsed B cell malignancies after allo-HSCT with low toxicities and complications. However, multicenter clinical trials with larger sample sizes should be performed to select the optimal therapeutic window and confirm its efficacy.

  14. Mortalidad por suicidios en Colombia y México: tendencias e impacto entre 2000 y 2013

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    Claudio Alberto Dávila

    2016-09-01

    Full Text Available Introducción. Los suicidios son uno de los principales problemas de salud pública a nivel mundial. Objetivo. Analizar la tendencia y el impacto de la mortalidad por suicidios en Colombia y México a escala nacional, entre el 2000 y el 2013, por sexo y por grupos de edad. Materiales y métodos. Los datos se obtuvieron de las estadísticas de mortalidad del Departamento Administrativo Nacional de Estadística de Colombia y del Instituto Nacional de Estadística y Geografía de México. Se hizo un estudio descriptivo y transversal, para el cual se calcularon las tasas estandarizadas de mortalidad y los años perdidos de vida en menores de 100 años de edad. Resultados. En Colombia, la tasa de mortalidad por suicidios disminuyó entre el 2000 y el 2013 en ambos sexos: 28 % en hombres y 38 % en mujeres; en México, se presentó una tendencia opuesta: un incremento de 34 % en hombres y de 67 % en mujeres. Los años perdidos de vida en Colombia alcanzaron 0,32 años en el 2013 en hombres y 0,15 en mujeres, con una tendencia decreciente desde el 2000; en México, se situaron en 0,42 años en hombres y 0,2 años en mujeres, con una tendencia creciente desde el 2000. Entre los hombres, el grupo de edad con mayor impacto fue el de 15 a 49 años en ambos países; entre las mujeres, el impacto fue relativamente uniforme entre los 15 y los 84 años de edad. Conclusiones. La mortalidad por suicidios se incrementó de manera constante en México, en tanto que en Colombia se observó una tendencia opuesta. Los suicidios son prevenibles, por lo que es fundamental implementar políticas públicas en salud mediante acciones de detección oportuna, estrategias integrales de prevención y el estudio de los factores de riesgo asociados.

  15. Fatores de risco para mortalidade hospitalar nas reoperações valvares

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    BRANDÃO Carlos Manuel de Almeida

    2002-01-01

    Full Text Available OBJETIVO: Identificar fatores de risco para mortalidade hospitalar em reoperações valvares. MÉTODO: Foi realizada análise prospectiva de 194 pacientes submetidos a reoperações valvares no período entre julho de 1995 e junho de 1999. As variáveis estudadas foram: sexo, idade, classe funcional, número e tipo de operações prévias, intervalo entre as operações, caráter da operação, creatinina sérica, fração de ejeção do ventrículo esquerdo, diâmetros diastólico e sistólico do ventrículo esquerdo, pressão sistólica de ventrículo direito, atividade de protrombina, relação do tempo de tromboplastina parcial ativada, contagem de plaquetas, tempo de circulação extracorpórea, tempo de pinçamento aórtico, posição e número de valvas, tipo de procedimento, operações associadas e volume de sangramento intra-operatório. Análise univariada e multivariada foi realizada para determinar os fatores de risco para mortalidade hospitalar. RESULTADOS: A mortalidade hospitalar foi de 8,8% (17 pacientes. A análise univariada identificou as seguintes variáveis associadas a maior mortalidade: classe funcional avançada, fração de ejeção do ventrículo esquerdo baixa, atividade de protrombina baixa, creatinina elevada, tempo de circulação extracorpórea prolongado, tempo de pinçamento aórtico prolongado, procedimentos associados e volume de sangramento intra-operatório elevado. Na análise multivariada foram significativas: classe funcional IV, creatinina > 1,5 mg/dl e tempo de circulação extracorpórea > 120 minutos. CONCLUSÕES: As variáveis classe funcional IV, creatinina > 1,5 mg/dl e tempo de circulação extracorpórea > 120 minutos são fatores de risco independentes para mortalidade hospitalar nas reoperações valvares.

  16. Neonatal mortality: description and effect of hospital of birth after risk adjustment Mortalidade neonatal: descrição e efeito do hospital de nascimento após ajuste de risco

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    Aluísio J D Barros

    2008-02-01

    hospitais, cemitérios e cartórios. Dois pediatras classificaram a causa básica da morte, de forma independente, a partir de informações obtidas no prontuário hospitalar e em entrevista com a família. Usou-se regressão logística para estimar o efeito do hospital de nascimento, controlando para variáveis de confusão relacionadas a características maternas e do recém-nascido. RESULTADOS: A taxa de mortalidade neonatal foi de 12,7‰. O risco esteve fortemente influenciado pelo peso ao nascer, idade gestacional e variáveis socioeconômicas. Imaturidade foi responsável por 65% das mortes neonatais, seguida por anomalias congênitas, infecções e asfixia intraparto. Ajustando para características maternas, foi observado um risco relativo igual a três para hospitais de mesmo nível de complexidade. O risco relativo diminuiu, mas persistiu, após controle para características do recém-nascido. CONCLUSÕES: A mortalidade neonatal variou entre hospitais e foi alta, principalmente relacionada à imaturidade. Para entender a fonte de variação da mortalidade neonatal e reduzir sua ocorrência é necessária uma avaliação aprofundada e comparativas com as práticas de cuidado entre hospitais.

  17. Resistencia y susceptibilidad de microorganismos aislados en pacientes atendidos en una institución hospitalaria de tercer nivel, Villavicencio-Colombia, 2012

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    Oscar Alexander Gutiérrez Lesmes

    2015-05-01

    Full Text Available Introducción: La resistencia bacteriana es problema significativo de salud pública y está asociada al uso indiscriminado e irracional de antibióticos, lo que afecta la eficacia de los tratamientos. Objetivo: Estimar la resistencia antimicrobiana a los antibióticos resultado de las pruebas invitro de susceptibilidad en una institución hospitalaria de tercer nivel de Villavicencio, Colombia. Materiales y Métodos: Se realizó un estudio observacional, descriptivo de tipo retrospectivo, análisis univariado, calculando medias de las variables susceptibilidad, resistencia, antibiótico, microorganismos, y tipo de muestra resultados de las pruebas de susceptibilidad realizadas mediante técnica de Kirby-Bauer de 485 pruebas de susceptibilidad de la institución hospitalaria. Resultados y Discusión: Los microorganismos más frecuentemente aislados, fueron: Escherichia coli, Klebsiella pneumoniae ss. Pneumoniae, Staphylococcus aureus ss. Aureus representando el 49% de total de microorganismos, los mayores reportes de resistencia en la pruebas invitro las presentaron Serratia marcescens, Staphylococcus saprophyticus ss. Saprophytic, Enterobacter cloacae, presentan una resistencia media superior al 50%, y una susceptibilidad inferior 40%, la mayor resistencia media se presentó para los siguientes antibióticos, Cefalotina 72,2%, Cefazolina 59,9%, Nitrofurantoina 54,4%, Ceftriaxona 52,7%. Conclusiones: Antibióticos como la Cefalotina, Nitrofurantoina, Cefazolina y Ceftriaxona  pierden su utilidad terapéutica dada la elevada resistencia demostrada por los microorganismos aislados en las pruebas invitro, es necesario reforzar las medidas de uso adecuado de antibióticos para disminuir la posibilidad de adaptación y resistencia a los mismos,  el fenómeno de resistencia bacteriana ocurre fuera del ámbito hospitalario evidenciando la necesidad de iniciar también control y vigilancia en infecciones ocurridas en la comunidad.Cómo citar este

  18. VIOLENCIA HOSPITALARIA EN PACIENTES

    OpenAIRE

    BURGOS MORENO,MÓNICA; PARAVIC KLIJN,TATIANA

    2003-01-01

    El paciente/usuario se presenta susceptible a todos los estímulos y relaciones que surgen en el contexto hospitalario, en una atención que se reconoce como despersonalizada y falta de privacidad, lo que puede convertirle en una potencial víctima de actos violentos. Por la importancia que reviste otorgar una atención en salud basada en el respeto y la dignidad hacia los usuarios, se hace necesario estudiar el fenómeno de la violencia que desde la óptica de los pacientes pudiera encontrarse en ...

  19. Mortalidade de infantil no município do Rio de Janeiro Mortalidad Infantil en el Municipio de Rio de Janeiro Child Mortality in Rio de Janeiro City

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    Lígia Neres Matos

    2007-06-01

    Full Text Available A taxa de mortalidade infantil é considerada indicador síntese da qualidade de vida e do nível de desenvolvimento de uma população. Este artigo analisa a evolução dessas taxas no Município do Rio de Janeiro, no período de 1979 a 2004, e as causas em 2004. Trata de estudo descritivo a partir do total de óbitos infantis e nascimentos ocorridos, utilizando-se os sistemas de informação produzidos pelo Ministério da Saúde. Para avaliação, segundo causa básica de morte, usou-se a Classificação Internacional de Doenças. As taxas de mortalidade infantil por mil nascidos vivos decresceram de 37,4 em 1979 para 15,1 em 2004, sendo o componente pós-neonatal o principal responsável por este declínio. Em 2004, as principais causas de óbito neonatais foram as afecções perinatais e as malformações congênitas; entre os óbitos pós-neonatais destacaram-se as doenças infecciosas e parasitárias, as causas mal definidas e as doenças respiratórias. Embora tenha sido observada queda da taxa de mortalidade infantil, esta não teve uma redução maior, devido ao pequeno declínio do componente neonatal precoce. Observou-se que a assistência à saúde da criança, no município do Rio de Janeiro, ainda deixa a desejar no que se refere à integralidade da assistência desde o período pré-natal.La tasa de mortalidad infantil es considerada indicador síntese de la calidad de vida y del nivel de desarrollo de una población. Este artículo analiza la evolución de esas tasas en la Ciudad del Rio de Janeiro, en el periodo de 1979 hasta 2004, y las causas en 2004. Tratase de un estudio descriptivo desde el total de fallecimientos infantiles y nacimientos ocurridos, usando los sistemas de informaciones producidos por el Ministerio de la Salud. Para la evaluación, según causa básica de muerte, fue usada la Clasificación Internacional de Enfermedades. Las tasas de mortalidad infantil por mil nacimientos vivos decrecieron de 37,4 en 1979

  20. Neumonia adquirida en la comunidad en dos poblaciones hospitalarias Community-acquired pneumonia in patients from two different hospitals

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    O. J. Caberlotto

    2003-01-01

    Full Text Available Se estudiaron en forma prospectiva pacientes con diagnóstico de neumonía adquirida en la comunidad que acudieron a la consulta en un hospital general y en un centro especializado en medicina respiratoria ubicados en la provincia de Buenos Aires, y que requirieron internación. Se evaluaron la distribución por sexo y edad, las comorbilidades asociadas, los agentes etiológicos, su incidencia y la mortalidad. Se incluyeron 52 pacientes (marzo 1998-febrero 1999 del Hospital General de Agudos Manuel Belgrano (HMB y 23 pacientes (junio 2000-mayo 2001 del Hospital del Tórax Dr. Antonio A. Cetrángolo (HCET. Se excluyeron pacientes con tuberculosis o micosis pulmonar, neoplasia de pulmón y diagnóstico serológico para HIV. Se completó una historia clínica y se realizaron estudios microbiológicos para gérmenes comunes, virus respiratorios y micobacterias. Para el estudio de los agentes productores de neumonías atípicas (Chlamydia spp, Coxiella burnetii, Mycoplasma pneumoniae y Legionella spp. y como complemento del estudio virológico, se utilizaron pruebas serológicas. No se observaron diferencias por sexo y edad en los dos grupos. En el HMB las comorbilidades más frecuentes fueron EPOC, diabetes e insuficiencia cardíaca, en tanto que en el HCET fueron EPOC, asma y fibrosis pulmonar. Se obtuvo un diagnóstico microbiológico en el 48% y 65.2% de los pacientes para ambos grupos. Los agentes hallados más frecuentemente fueron Mycoplasma pneumoniae, Streptococcus pneumoniae, influenza A y Legionella spp, este último germen con una incidencia del 12% en pacientes que evolucionaron favorablemente y que en su mayoría pertenecían al HMB. La mortalidad fue similar para ambos grupos (13.3%. En el HMB estuvo relacionada con la existencia de comorbilidades en 7 de 8 casos y en el HCET con el agravamiento de la insuficiencia respiratoria crónica.Patients hospitalized with community acquired pneumonia were studied prospectively in two hospitals

  1. The hypothalamic satiety peptide CART is expressed in anorectic and non-anorectic pancreatic islet tumors and in the normal islet of Langerhans.

    Science.gov (United States)

    Jensen, P B; Kristensen, P; Clausen, J T; Judge, M E; Hastrup, S; Thim, L; Wulff, B S; Foged, C; Jensen, J; Holst, J J; Madsen, O D

    1999-03-26

    The hypothalamic satiety peptide CART (cocaine and amphetamine regulated transcript) is expressed at high levels in anorectic rat glucagonomas but not in hypoglycemic insulinomas. However, a non-anorectic metastasis derived from the glucagonoma retained high CART expression levels and produced circulating CART levels comparable to that of the anorectic tumors. Moreover, distinct glucagonoma lines derived by stable HES-1 transfection of the insulinoma caused severe anorexia but retained low circulating levels of CART comparable to that of insulinoma bearing or control rats. Islet tumor associated anorexia and circulating CART levels are thus not correlated, and in line with this peripheral administration of CART (5-50 mg/kg) produced no effect on feeding behavior. In the rat two alternatively spliced forms of CART mRNA exist and quantitative PCR revealed expression of both forms in the hypothalamus, in the different islet tumors, and in the islets of Langerhans. Immunocytochemistry as well as in situ hybridization localized CART expression to the somatostatin producing islet D cell. A potential endocrine/paracrine role of islet CART remains to be clarified.

  2. Evolución de la mortalidad infantil, neonatal y postneonatal en Andalucía, 1975-1998

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    Miguel Ruiz Ramos

    2003-01-01

    Full Text Available Fundamento: La mortalidad infantil, y sus componentes neonatal y postneonatal, son importantes indicadores de salud, lo cual justifica su análisis periódico incluso en países desarrollados donde sus tasas han descendido considerablemente. El objetivo de este estudio es describir las modificaciones registradas en dichas tasas en Andalucía en el último cuarto de siglo. Métodos: Se han calculado las tasas anuales de mortalidad infantil, neonatal precoz y tardía, así como post-neonatal en 1975- 1998. Mediante regresión de Poisson se han estimado los porcentajes anuales de cambio de las tasas en los dos intervalos de 1975-1986 y 1987-1998 así como en el periodo completo 1975-1998. Se ha analizado también la mortalidad proporcional por causas infecciosas, respiratorias, congénitas, afecciones originadas en el periodo perinatal y el resto de causas, así como la razón de tasas de mortalidad por afecciones originadas en el periodo perinatal y para el total de causas, en el quinquenio 1994-98 respecto al quinquenio 1975-79, en los periodos infantil, neonatal (precoz y tardío y postneonatal. Resultados: Los mayores descensos porcentuales se han producido en la mortalidad neonatal precoz (6,38% y tardía (4,6%. La razón de tasas de mortalidad por afecciones originadas en el periodo perinatal entre 1994-98 y 1975-79 es 10 para la mortalidad postneonatal mientras que es inferior a 1 para la mortalidad neonatal tardía (0,63, precoz (0,33 e infantil (0,30. Conclusiones: La mortalidad en los periodos infantil, neonatal precoz, tardío y post-neonatal ha descendido acusadamente entre 1975 y 1998. El riesgo de fallecer por afecciones originadas en el periodo perinatal de los niños con más de 4 semanas y menos de 1 año de vida (periodo postneonatal se ha multiplicado por diez entre 1975-79 y 1994-98.

  3. Hipertrofia ventricular e mortalidade cardiovascular em pacientes de hemodiálise de baixo nível educacional

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    Rosana dos Santos e Silva Martin

    2012-01-01

    Full Text Available FUNDAMENTO: A hipertrofia ventricular esquerda é potente preditor de mortalidade em renais crônicos. Estudo prévio de nosso grupo mostrou que renais crônicos com menor escolaridade têm hipertrofia ventricular mais intensa. OBJETIVO: Ampliar estudo prévio e verificar se a hipertrofia ventricular esquerda pode justificar a associação entre escolaridade e mortalidade cardiovascular de pacientes em hemodiálise. MÉTODOS: Foram avaliados 113 pacientes entre janeiro de 2005 e março de 2008 e seguidos até outubro de 2010. Foram traçadas curvas de sobrevida comparando a mortalidade cardiovascular, e por todas as causas dos pacientes com escolaridade de até três anos (mediana da escolaridade e pacientes com escolaridade igual ou superior a quatro anos. Foram construídos modelos múltiplos de Cox ajustados para as variáveis de confusão. RESULTADOS: Observou-se associação entre nível de escolaridade e hipertrofia ventricular. A diferença estatística de mortalidade de origem cardiovascular e por todas as causas entre os diferentes níveis de escolaridade ocorreu aos cinco anos e meio de seguimento. No modelo de Cox, a hipertrofia ventricular e a proteína-C reativa associaram-se à mortalidade por todas as causas e de origem cardiovascular. A etiologia da insuficiência renal associou-se à mortalidade por todas as causas e a creatinina associou-se à mortalidade de origem cardiovascular. A associação entre escolaridade e mortalidade perdeu significância estatística no modelo ajustado. CONCLUSÃO: Os resultados do presente trabalho confirmam estudo prévio e demonstram, ademais, que a maior mortalidade cardiovascular observada nos pacientes com menor escolaridade pôde ser explicada por fatores de risco de ordem bioquímica e de morfologia cardíaca.

  4. Mortalidade por leucemias relacionada à industrialização Mortality by industrialization-related leukemias

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    Carmen Helena Seoane Leal

    2002-08-01

    Full Text Available OBJETIVO: Analisar a distribuição espacial da mortalidade por leucemia na população, buscando identificar agregados e estabelecer sua relação com os níveis de industrialização. MÉTODOS: O estudo foi realizado nas 43 regiões de governo do Estado de São Paulo, no qüinqüênio 1991-1995. Foi construído um "índice de industrialização relativo à leucemia" (IIRL baseado no número de indústrias e empregos industriais por 100.000 habitantes, valor adicionado fiscal, variedade de ramos industriais e indústrias com potenciais exposições de risco para a leucemia. O IIRL foi distribuído em cinco categorias. Verificaram-se os coeficientes padronizados de mortalidade por leucemia em cada uma das regiões, também distribuídos em cinco categorias e comparados ao mapa IIRL. RESULTADOS: As regiões mais industrializadas em ordem decrescente foram Campinas, Piracicaba, Jundiaí, Sorocaba e São Paulo. Não foi encontrada associação entre mortalidade, por nenhum tipo de leucemia, e industrialização. A região de Jales foi a que apresentou o mais alto coeficiente padronizado de mortalidade por leucemia. CONCLUSÕES: A distribuição da mortalidade por leucemia ocorreu de forma homogênea no Estado de São Paulo, não apresentando correlação com o nível de industrialização. Entretanto, aspectos relacionados ao método epidemiológico adotado -- estudo ecológico -- e ao uso do parâmetro "mortalidade por leucemia", doença cujo prognóstico tem mudado muito nas últimas décadas, limitaram a interpretação dos resultados.OBJECTIVE: To analyze the spatial distribution of mortality by leukemia in the population, looking for clusters, and to establish an association with the level of industrialization. METHOD: The study was carried out in 43 state regions of the state of São Paulo, Brazil, in the period between 1991 and 1995. It was created an Index of Industrialization-Related Leukemia (IIRL based on number of manufactures and

  5. Malaria mortality in Colombia, 1979-2008 Mortalidad por paludismo en Colombia, 1979-2008

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    Julio Padilla

    2012-04-01

    Full Text Available


    Introduction. In Colombia, malaria represents a serious public health problem. It is estimated that approximately 60% of the population is at risk of the disease.
    Objective. To describe the mortality trends for malaria in Colombia, from 1979 to 2008.
    Materials and methods. A descriptive study to determine the trends of the malaria mortality was carried out. The information sources used were databases of registered deaths and population projections from 1979 to 2008 of the National Statistics Department. The indicator used was the mortality rate. The trend was analyzed by join point regression.
    Results. Six thousands nine hundred and sixty five deaths caused by malaria were certified for an age-adjusted rate of 0.74 deaths/100.000 inhabitants for the study period. In 74.3% of the deaths, the parasite species was not mentioned. The trend in the mortality rate showed a statistically significant decreasing behavior, which was lower from the second half of the nineties as compared with that presented in the eighties.
    Conclusions. The magnitude of mortality by malaria in Colombia is not high, in spite of the evident underreporting. A marked downward trend was observed between 1979 and 2008. The information obtained from death certificates, along with that of the public health surveillance system will allow to modify the recommendations and improve the implementation of preventive and control measures to further reduce the mortality caused by malaria.


    Introducción. En Colombia, el paludismo representa un grave problema de salud pública. Se estima que, aproximadamente, 60 % de la población se encuentra en riesgo de enfermar o de morir por esta causa.
    Objetivo. Describir la tendencia de la mortalidad por paludismo en Colombia desde 1979 hasta 2008.
    Materiales y métodos. Se llevó a cabo un estudio descriptivo para determinar la tendencia de las tasas de mortalidad. Las fuentes de informaci

  6. Inserción de la gestión por procesos en instituciones hospitalarias: concepción metodológica y práctica

    OpenAIRE

    Hernández Nariño,Arialys; Nogueira Rivera,Dianelys; Medina León,Alberto; Marqués León,Maylin

    2013-01-01

    La Gestión por Procesos es una de las buenas prácticas más utilizadas en el sector de salud en las últimas décadas, pues es una vía apropiada para alcanzar mayor satisfacción de los pacientes y un servicio asistencial más eficiente y eficaz. Uno de sus elementos más significativos es la mejora de procesos; la introducción de sus herramientas, que hace unos años eran escasamente difundidas, se fomenta cada vez más en instituciones hospitalarias. Este trabajo ilustra la concepción de un procedi...

  7. Conciliación de la medicación al alta hospitalaria en farmacia comunitaria: a propósito de un caso

    Directory of Open Access Journals (Sweden)

    Molinero A

    2017-09-01

    Full Text Available Mujer de 86 años (itinerante entre dos comunidades autónomas con fibrilación auricular (FA persistente y fibrilación ventricular (FV controlada con anticoagulación oral, distimia, desorden de ansiedad, temblor esencial e insuficiencia venosa crónica que acude a la farmacia comunitaria (FC después de haber acudido a la consulta de su médico de atención primaria (MAP y que ha sido diagnosticada al alta hospitalaria (en la otra comunidad autónoma de ictus isquémico parietal derecho cardioembólico. No se ha realizado conciliación al alta y al dispensar las recetas del MAP se detecta que hay algunas duplicidades, faltan medicamentos prescritos en el informe de alta y sobran otros según lo que aparece en el informe al alta

  8. Modelo para abordar integralmente la mortalidad materna y la morbilidad materna grave

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    Ariel Karolinski

    2015-05-01

    Full Text Available La mortalidad materna es un importante problema de salud pública y de derechos humanos y refleja los efectos de los determinantes sociales sobre la salud de las mujeres. El conocimiento de la magnitud y las causas de las muertes maternas ha sido insuficiente para intervenir efectivamente en el alcance de los Objetivos de Desarrollo del Milenio. Por ello, se plantea un modelo para abordar integralmente la mortalidad materna, con siete campos: priorización y definición del problema, caracterización contextual, amplitud metodológica, gestión del conocimiento, innovación, implementación, y un sistema de monitoreo y evaluación. Este modelo permite abordar los problemas asociados con la mortalidad materna y la morbilidad materna grave mediante la integración, desde una perspectiva anticipatoria, de las complicaciones potencialmente fatales asociadas con el proceso reproductivo y su vigilancia. Se destaca la importancia de la gestión del conocimiento para la reorientación de políticas, programas y la atención sanitaria. Se debe mejorar la interacción y explotar las sinergias entre las personas, las comunidades y los actores del sistema de salud para potenciar los resultados de los programas sanitarios. Se requiere más información científica validada sobre la forma en que las intervenciones deben aplicarse en diferentes entornos. Para ello, es esencial fortalecer la articulación entre los centros de investigación, las agencias de cooperación y los organismos del Estado y su incorporación a las acciones programáticas y a la definición de una nueva agenda de salud de la mujer para la Región de las Américas.

  9. Morbilidad y mortalidad en pacientes con infarto agudo de miocardio ST elevado en un hospital general

    Directory of Open Access Journals (Sweden)

    Eduardo Carcausto

    2010-10-01

    Full Text Available Objetivo: Determinar la morbilidad y mortalidad de los pacientes con infarto agudo de miocardio ST elevado (IMA STE atendidos en un hospital general y describir sus características demográficas, clínicas y epidemiológicas. Material y métodos: Estudio descriptivo, serie de casos, retrospectivo, en pacientes con IMA STE en el Hospital Nacional Cayetano Heredia, del 1 de enero a 31 de diciembre del 2007. Se registraron variables clínicas y de laboratorio. Resultados: Se incluyeron 30 casos. El 86,7% fueron varones. La edad media fue de 62,8±12,6 años. El antecedente de hipertensión arterial se encontró en 57%, obesidad en 40%, tabaquismo en 40%, y de diabetes mellitus en 30%. El dolor torácico típico ocurrió en 75% de pacientes. El 50% de pacientes tuvieron hipertensión no controlada a la admisión, 33% leucocitosis, y 46% glicemia >110 mg/dl. Sólo 25% recibió terapia de reperfusión, 33,3% de casos de forma exitosa, siendo el tiempo puerta-aguja de 250 ± 114 minutos. Las complicaciones ocurrieron en 26,6% de pacientes, siendo la mortalidad de 13,3%. El 76% ingresó al hospital con un tiempo de dolor menor de 3 horas, Conclusiones: Los pacientes con IMA ST elevado fueron predominantemente varones, mayores de 60 años, ingresaron al hospital con un tiempo de dolor torácico menor de tres horas y un mínimo porcentaje recibió terapia de repercusión. Las arritmias fueron las complicaciones más frecuentes y la mortalidad post IMA alcanzó 13,3 % de los casos.(Rev Med Hered 2010;21:202-207.

  10. Mortalidad en la población galesa de Gaiman, provincia de Chubut, Argentina

    Directory of Open Access Journals (Sweden)

    Caratini, Alicia Liliana

    2005-01-01

    Full Text Available El objetivo de este trabajo es analizar la evolución en el tiempo de las defunciones y de las causas de muerte por edad y sexo de la población galesa de Gaiman, provincia de Chubut, Argentina. Los datos fueron obtenidos de las Actas de Defunción del Archivo del Registro Civil de la ciudad de Rawson, Chubut. El período de estudio se extendió de 1892 a 1961 y para su descripción y análisis se lo dividió en decenios. Se registraron 2103 defunciones de las cuales 1039 (49% correspondieron a galeses y sus descendientes, lo cual representa un promedio de 14.6 muertes por año. Se detectó una sobremortalidad masculina (59%, esperable en una población colonizadora con predominio de varones. Se observó un incremento, en el tiempo, de la edad media de defunción, lo que indica mejoras en las condiciones socioeconómicas y de salud de la población. La mortalidad infantil y los natimortos representaron el 20% y el 11%, respectivamente, de las defunciones y se constató una transición desde una mortalidad provocada por enfermedades de naturaleza exógena a otra de causalidad endógena. Al compararse nuestros datos con los de la provincia de Chubut y el país, se comprobó, en todos los casos, un descenso de la mortalidad en el tiempo, aunque en Gaiman esa disminución fue más significativa, probablemente por la atención que la comunidad le dedicaba a la educación y a la salud.

  11. Factores asociados a mortalidad perinatal en el hospital general de Chiapas, México

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    Rivera Leonor

    2003-01-01

    Full Text Available OBJETIVO: El objetivo del estudio es identificar factores socioeconómicos, gineco-obstétricos y del producto asociados a mortalidad perinatal. MÉTODOS: Se realizó un estudio de casos y controles pareado. Se consideró caso a los nacidos vivos o muertos que nacieron y fallecieron entre las 28 semanas de gestación a los 7 días de vida extrauterina. y control al producto nacido vivo entre las 28 semanas de gestación y los 7 días de vida extrauterina. Los datos se obtuvieron de los expedientes clínicos hospitalarios. Se estudiaron 99 casos y 197 controles. Se hizo un análisis estadístico utilizando Stata 6.0. RESULTADOS La media de edad de la madre fue de 24.82 años y del producto de 37.78 semanas de gestación. El promedio de peso del producto fue de 2,760 gramos. Los factores asociados a mortalidad perinatal fueron: ocupación del padre agricultor (RM ajustada 3,31; IC 95% 1,26-8,66; índice de riesgo obstétrico alto (RM ajustada 10,57; IC 95% 2,82-39,66, antecedente de cesárea (RM ajustada 2,75; IC 95% 1,37-5,51; cinco y más consultas prenatales (RM ajustada 4,43; IC 95% 1.86-10,54; producto pretérmino (RM ajustada 9,20; IC 95% 4,39-19,25. CONCLUSIONES: Los resultados muestran que es necesario implementar medidas de prevención y control que aseguren la identificación del riesgo en las mujeres embarazadas, con el fin de abatir la incidencia de mortalidad perinatal.

  12. Factores asociados a mortalidad perinatal en el hospital general de Chiapas, México

    Directory of Open Access Journals (Sweden)

    Leonor Rivera

    2003-12-01

    Full Text Available OBJETIVO: El objetivo del estudio es identificar factores socioeconómicos, gineco-obstétricos y del producto asociados a mortalidad perinatal. MÉTODOS: Se realizó un estudio de casos y controles pareado. Se consideró caso a los nacidos vivos o muertos que nacieron y fallecieron entre las 28 semanas de gestación a los 7 días de vida extrauterina. y control al producto nacido vivo entre las 28 semanas de gestación y los 7 días de vida extrauterina. Los datos se obtuvieron de los expedientes clínicos hospitalarios. Se estudiaron 99 casos y 197 controles. Se hizo un análisis estadístico utilizando Stata 6.0. RESULTADOS La media de edad de la madre fue de 24.82 años y del producto de 37.78 semanas de gestación. El promedio de peso del producto fue de 2,760 gramos. Los factores asociados a mortalidad perinatal fueron: ocupación del padre agricultor (RM ajustada 3,31; IC 95% 1,26-8,66; índice de riesgo obstétrico alto (RM ajustada 10,57; IC 95% 2,82-39,66, antecedente de cesárea (RM ajustada 2,75; IC 95% 1,37-5,51; cinco y más consultas prenatales (RM ajustada 4,43; IC 95% 1.86-10,54; producto pretérmino (RM ajustada 9,20; IC 95% 4,39-19,25. CONCLUSIONES: Los resultados muestran que es necesario implementar medidas de prevención y control que aseguren la identificación del riesgo en las mujeres embarazadas, con el fin de abatir la incidencia de mortalidad perinatal.

  13. Mortalidad prematura por enfermedades infecciosas en España, 1908-1995

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    Mirón Canelo José Antonio

    2002-01-01

    Full Text Available Objetivos. Las enfermedades infecciosas han sido tradicionalmente una de las principales causas de muerte en los países desarrollados. Los objetivos del presente trabajo consistieron en cuantificar la importancia de las enfermedades infecciosas como causa de muerte prematura en España entre 1908 y 1995, y conocer la frecuencia y distribución de las enfermedades infecciosas con mayor impacto sobre la mortalidad prematura. Métodos. El estudio se realizó a partir de los datos de mortalidad por causas infecciosas publicados por el Instituto Nacional de Estadística en el Movimiento Natural de la Población para el período en estudio. Se utilizan como indicadores de mortalidad prematura los años de vida potencial perdidos (AVPP, la tasa bruta de AVPP por 1 000 habitantes y el porcentaje y la media de AVPP. Resultados. Entre 1908 y 1995, el número y la tasa de AVPP por causas infecciosas experimentaron una evolución claramente descendente. El descenso fue más acusado a partir de los años 50 y se observó en todos los grupos de edad. La tuberculosis fue la primera causa de muerte prematura desde principios de siglo hasta los años 70. A partir de esta fecha toman el relevo las neumonías y el sida. Conclusiones. El impacto de las enfermedades infecciosas como determinantes de muerte prematura en España ha descendido a lo largo del siglo XX, sobre todo a partir de los años 70.

  14. Exploring the social determinants of mental health service use using intersectionality theory and CART analysis.

    Science.gov (United States)

    Cairney, John; Veldhuizen, Scott; Vigod, Simone; Streiner, David L; Wade, Terrance J; Kurdyak, Paul

    2014-02-01

    Fewer than half of individuals with a mental disorder seek formal care in a given year. Much research has been conducted on the factors that influence service use in this population, but the methods generally used cannot easily identify the complex interactions that are thought to exist. In this paper, we examine predictors of subsequent service use among respondents to a population health survey who met criteria for a past-year mood, anxiety or substance-related disorder. To determine service use, we use an administrative database including all physician consultations in the period of interest. To identify predictors, we use classification tree (CART) analysis, a data mining technique with the ability to identify unsuspected interactions. We compare results to those from logistic regression models. We identify 1213 individuals with past-year disorder. In the year after the survey, 24% (n=312) of these had a mental health-related physician consultation. Logistic regression revealed that age, sex and marital status predicted service use. CART analysis yielded a set of rules based on age, sex, marital status and income adequacy, with marital status playing a role among men and by income adequacy important among women. CART analysis proved moderately effective overall, with agreement of 60%, sensitivity of 82% and specificity of 53%. Results highlight the potential of data-mining techniques to uncover complex interactions, and offer support to the view that the intersection of multiple statuses influence health and behaviour in ways that are difficult to identify with conventional statistics. The disadvantages of these methods are also discussed.

  15. Classification and regression tree (CART) model to predict pulmonary tuberculosis in hospitalized patients.

    Science.gov (United States)

    Aguiar, Fabio S; Almeida, Luciana L; Ruffino-Netto, Antonio; Kritski, Afranio Lineu; Mello, Fernanda Cq; Werneck, Guilherme L

    2012-08-07

    Tuberculosis (TB) remains a public health issue worldwide. The lack of specific clinical symptoms to diagnose TB makes the correct decision to admit patients to respiratory isolation a difficult task for the clinician. Isolation of patients without the disease is common and increases health costs. Decision models for the diagnosis of TB in patients attending hospitals can increase the quality of care and decrease costs, without the risk of hospital transmission. We present a predictive model for predicting pulmonary TB in hospitalized patients in a high prevalence area in order to contribute to a more rational use of isolation rooms without increasing the risk of transmission. Cross sectional study of patients admitted to CFFH from March 2003 to December 2004. A classification and regression tree (CART) model was generated and validated. The area under the ROC curve (AUC), sensitivity, specificity, positive and negative predictive values were used to evaluate the performance of model. Validation of the model was performed with a different sample of patients admitted to the same hospital from January to December 2005. We studied 290 patients admitted with clinical suspicion of TB. Diagnosis was confirmed in 26.5% of them. Pulmonary TB was present in 83.7% of the patients with TB (62.3% with positive sputum smear) and HIV/AIDS was present in 56.9% of patients. The validated CART model showed sensitivity, specificity, positive predictive value and negative predictive value of 60.00%, 76.16%, 33.33%, and 90.55%, respectively. The AUC was 79.70%. The CART model developed for these hospitalized patients with clinical suspicion of TB had fair to good predictive performance for pulmonary TB. The most important variable for prediction of TB diagnosis was chest radiograph results. Prospective validation is still necessary, but our model offer an alternative for decision making in whether to isolate patients with clinical suspicion of TB in tertiary health facilities in

  16. GUCY2C-directed CAR-T cells oppose colorectal cancer metastases without autoimmunity.

    Science.gov (United States)

    Magee, Michael S; Kraft, Crystal L; Abraham, Tara S; Baybutt, Trevor R; Marszalowicz, Glen P; Li, Peng; Waldman, Scott A; Snook, Adam E

    2016-01-01

    Adoptive T-cell therapy (ACT) is an emerging paradigm in which T cells are genetically modified to target cancer-associated antigens and eradicate tumors. However, challenges treating epithelial cancers with ACT reflect antigen targets that are not tumor-specific, permitting immune damage to normal tissues, and preclinical testing in artificial xenogeneic models, preventing prediction of toxicities in patients. In that context, mucosa-restricted antigens expressed by cancers exploit anatomical compartmentalization which shields mucosae from systemic antitumor immunity. This shielding may be amplified with ACT platforms employing antibody-based chimeric antigen receptors (CARs), which mediate MHC-independent recog-nition of antigens. GUCY2C is a cancer mucosa antigen expressed on the luminal surfaces of the intestinal mucosa in mice and humans, and universally overexpressed by colorectal tumors, suggesting its unique utility as an ACT target. T cells expressing CARs directed by a GUCY2C-specific antibody fragment recognized GUCY2C, quantified by expression of activation markers and cytokines. Further, GUCY2C CAR-T cells lysed GUCY2C-expressing, but not GUCY2C-deficient, mouse colorectal cancer cells. Moreover, GUCY2C CAR-T cells reduced tumor number and morbidity and improved survival in mice harboring GUCY2C-expressing colorectal cancer metastases. GUCY2C-directed T cell efficacy reflected CAR affinity and surface expression and was achieved without immune-mediated damage to normal tissues in syngeneic mice. These observations highlight the potential for therapeutic translation of GUCY2C-directed CAR-T cells to treat metastatic tumors, without collateral autoimmunity, in patients with metastatic colorectal cancer.

  17. Substance use and adherence among people living with HIV/AIDS receiving cART in Latin America

    Science.gov (United States)

    De Boni, Raquel B.; Shepherd, Bryan E.; Grinsztejn, Beatriz; Cesar, Carina; Cortés, Claudia; Padgett, Denis; Gotuzzo, Eduardo; Belaunzarán-Zamudio, Pablo F.; Rebeiro, Peter F.; Duda, Stephany N.; McGowan, Catherine C.

    2016-01-01

    This cross-sectional study describes substance use prevalence and its association with cART adherence among 3343 individuals receiving care at HIV clinics in Argentina, Brazil, Chile, Honduras, Mexico, and Peru. A rapid screening tool evaluated self-reported 7-day recall of alcohol, marijuana, cocaine, heroin, and methamphetamine use, and missed cART doses. Overall, 29.3% individuals reported having ≥ 1 alcoholic drinks, 5.0% reported any illicit drug use and 17.0% reported missed cART doses. In the logistic regression model, compared to no substance use, alcohol use (adjusted odds ratio (AOR)=2.46, 95% confidence interval (CI): 1.99–3.05), illicit drug use (AOR=3.57, 95% CI: 2.02–6.30), and using both alcohol and illicit drugs (AOR=4.98, 95% CI: 3.19–7.79) were associated with missed cART doses. The associations between substance use and likelihood of missing cART doses point to the need of targeting alcohol and illicit drug use to improve adherence among people living with HIV in Latin America. PMID:27091028

  18. Características psicológicas de los pacientes con larga estancia hospitalaria y propuesta de protocolo para su manejo clínico

    Directory of Open Access Journals (Sweden)

    Juan C. Benítez-Agudelo

    Full Text Available Antecedentes y Objetivo: El impacto psicológico de la hospitalización en los pacientes ingresados en larga estancia es variable y se muestra en respuesta al estrés y en el desempeño del rol de enfermo del paciente hospitalizado. El objetivo de esta investigación fue detectar las principales alteraciones psicológicas que sufren estos pacientes, y diseñar un protocolo para su manejo. Material y Método: Empleamos instrumentos como el Inventario de ansiedad, el Inventario de depresión rasgo-estado y el Cuestionario de estrategias de afrontamiento Sandin y Chorot. Realizamos un estudio descriptivo, guiado por el paradigma empírico analítico, corte cuantitativo, diseño no experimental, con una población total de 50 pacientes y una muestra de 15, muestreo no probabilístico, de tipo intencional, teniendo en cuenta los criterios de inclusión y exclusión propios de la investigación. Resultados: Entre los aspectos más relevantes encontrados marcados estados depresivos, ansiedad rasgo, baja expresión emocional abierta, y alta reevaluación positiva,que es de vital importancia, para el manejo de estos pacientes con larga estancia hospitalaria. Conclusiones: Según los datos de nuestro estudio, la larga estancia hospitalaria se relaciona generalmente con el desprendimiento del individuo de su medio natural, que puede generarle estados de tristeza, ansiedad y desencadenar efectos negativos como la baja expresión emocional. Estas características pueden servir de guía a los profesionales de la salud, por lo que presentamos un diseño de protocolo de manejo efectivo que ayude al paciente a afrontar mejor las dificultades que se le presentan en el ámbito hospitalario.

  19. Comunicación interna hospitalaria: una aproximación desde la creatividad/ Hospital internal communication : an approach from creativity

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    Pablo Medina Aguerrebere

    2015-07-01

    Full Text Available La gestión profesional de la comunicación institucional se ha convertido en una iniciativa estratégica para aquellos hospitales que desean crear una marca sólida. Para ello, la definición de la arquitectura de marca (identidad, valores, misión, visión, cultura e imagen y su difusión entre los stakeholders internos resulta fundamental. El objetivo de este artículo es reflexionar sobre el impacto que tiene la creatividad publicitaria en las acciones de comunicación interna que realiza un hospital para crear marca. Para ello, se realiza una revisión bibliográfica sobre la comunicación institucional hospitalaria, la comunicación interna y la creatividad publicitaria. El artículo concluye que la creatividad contribuye positivamente a dinamizar la comunicación interna del hospital y a crear una marca hospitalaria sólida. The professional management of corporate communication has become a strategic initiative to those hospitals that wish to create a strong brand. To do this, the definition of brand architecture (identity, values, mission, vision, culture and image and its dissemination among internal stakeholders is essential. This paper aims to reflect on the impact of advertising creativity in internal communication actions that takes a hospital to create brand. For this, a literature review on hospital corporate communication, internal communication and advertising creativity is performed. This paper concludes that creativity contributes positively to energize the hospital internal communication and create a strong brand

  20. Remuneración y productividad: el caso de la Fundación Hospitalaria del Estado de Minas Gerais, Brasil, 1992­1995

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    Cherchiglia Mariangela Leal

    1998-01-01

    Full Text Available En este artículo se analiza el caso de la Fundación Hospitalaria del Estado de Minas Gerais, Brasil, a raíz de haberse introducido en sus unidades de servicios de salud a principios de 1993 un nuevo sistema de recompensas, complementarias a la remuneración salarial, por el buen desempeño y la productividad de los funcionarios. El análisis se basó en un estudio transversal de la evolución de una serie de indicadores de producción y productividad en la Fundación durante el período de 1992 a 1995. Se utilizaron como fuentes de información los formularios de autorización para internación hospitalaria (AIH, las guías de autorización de pagos (GAP y los boletines de la Administración de Recursos Humanos. Con la estrategia de remuneración y de incentivo condicional adoptada se procuraba no solo mejorar la producción y la productividad, sino también aumentar el compromiso de los empleados con la institución. El análisis de los valores de los indicadores seleccionados parece confirmar que los resultados de este estudio coinciden con los de otros estudios similares en el sentido de que la remuneración basada en los resultados (o incentivo condicional conduce a un cambio positivo en el nivel de producción de servicios y productividad aunque no se sostenga a lo largo del tiempo. Corrobora asimismo la idea de que esas alternativas pueden utilizarse deliberadamente como parte de una estrategia más general de desarrollo organizacional a largo alcance, y no solamente como un elemento aislado dirigido a lograr mejorías puntuales y temporales en la productividad.

  1. CRECIMIENTO Y MORTALIDAD DEL MONCHOLO (Hoplias malabaricus EN LA CIÉNAGA GRANDE DE LORICA, COLOMBIA

    Directory of Open Access Journals (Sweden)

    Glenys Tordecilla-Petro,

    2005-12-01

    Full Text Available Para estimar los parámetros de crecimiento y mortalidad del moncholo (Hoplias malabaricus Bloch 1794en la Ciénaga Grande de Lorica (CGL se aplicó el análisis de frecuencia de tallas (ELEFAN a la informacióncolectada entre enero y diciembre 2000. Los valores estimados para L¥, K y t0 fueron 48.1 (± 0.09 cm.,0.29 (+ 0.01 año-1 y -0.50 años, respectivamente, con temperatura media anual de 28 °C y límites deconfianza del 95%. Las estimaciones para L¥ y K indican que es un pez de longevidad y tasa de crecimientomedios. La mortalidad total (Z fue estimada en 2.31 (± 0.23 año-1, la mortalidad natural (M en 0.70año–1, la mortalidad por captura (F se calculó en 1.61 año –1, y la tasa de explotación (E=F/Z 0.70. Latalla de su primera captura (Lc es de 29.4 cm., LT, y su talla media de captura (TMC es de 30.0 cm., LT.Como la especie no presenta migración reproductiva, permanece en la CGL, siendo capturada en laausencia de las especies reofílicas tradicionalmente capturadas, la presión pesquera aumenta sobre ella,alcanzando niveles de sobrepesca. La construcción y operación de la hidroeléctrica Urrá (HU y lacontaminación orgánica e inorgánica durante el año 2000 afectaron la dinámica poblacional de los pecesde la Cuenca del río Sinú, por lo que es necesario que se agilice el ordenamiento de su pesquería en elmediano plazo considerando que el moncholo es la tercera especie en la composición de la captura en lacuenca.

  2. Patrón de mortalidad de la población española

    OpenAIRE

    Ramiro Fariñas, Diego; Pujol Rodríguez, Rogelio; Abellán García, Antonio

    2016-01-01

    Enfermedades del sistema circulatorio, tumores y enfermedades respiratorias son las tres causas más importantes de muerte. Son responsables de siete de cada diez muertes de personas mayores y se mantiene esta tendencia en los últimos años.El patrón de mortalidad por edad y causa visualiza cómo afecta a cada estrato demográfico cada tipo de muerte. En los niños predominan otras causas (relacionadas con malformaciones, y afecciones en período perinatal); en los jóvenes, causas externas (acciden...

  3. Mortalidad por enfermedades respiratorias en Chile durante 1999 MORTALITY DUE TO RESPIRATORY DISEASES, CHILE-1999

    OpenAIRE

    JORGE SZOT M.

    2003-01-01

    Se trata de un estudio descriptivo que presenta características sobre la mortalidad por causas respiratorias (CR) en Chile durante 1999. Se muestra que las CR constituyen la tercera causa de muerte en el país. La "neumonía por agente no especificado" (NANE) es la primera causa aislada de muerte respiratoria en ambos sexos con un 64%, seguida de enfermedades respiratorias crónicas que originan un 30% de las defunciones. Por lo anterior se hace necesario prevenir la ocurrencia de la NANE, asegu...

  4. Mortalidade em idosos por diabetes mellitus como causa básica e associada

    Directory of Open Access Journals (Sweden)

    Cláudia Medina Coeli

    2002-04-01

    Full Text Available OBJETIVO:Analisar a mortalidade por diabetes mellitus em idosos e a subenumeração do diabetes como causa do óbito de acordo com estatísticas baseadas unicamente em causa básica de óbito. MÉTODOS:Foram revisadas todas as 2.974 declarações de óbito ocorridas em 1994 de idosos residentes em um núcleo habitacional localizado na cidade do Rio de Janeiro, RJ. Destas, foram estudados 291 óbitos, tendo o diabetes mellitus como causa básica (150 e associada (141. A proporção de óbitos em que a diabetes aparece como causa básica em relação ao total de óbitos por diabetes foi calculada de forma global e segundo sexo e faixa etária. RESULTADOS:Dos 291 óbitos estudados, 138 (47,4% ocorreram em homens, e 153, em mulheres (52,6%. As taxas de mortalidade apresentaram crescimento contínuo com o avançar da idade, sendo superiores no sexo masculino, embora a diferença entre sexos tenha sido menor para a análise baseada unicamente na causa básica. Observou-se proporção elevada de óbitos domiciliares (22%. A proporção de óbitos por diabetes como causa básica foi de 51,5%, sendo maior nas mulheres do que nos homens. CONCLUSÕES:A análise das estatísticas de mortalidade baseadas unicamente na causa básica do óbito pode levar a perfis distorcidos, em função da subenumeração não ocorrer aleatoriamente. Estudos adicionais em coortes de idosos brasileiros diabéticos são necessários para permitir uma avaliação mais acurada da mortalidade nesse grupo.

  5. Mortalidade por causas relacionadas ao aborto no Brasil: declínio e desigualdades espaciais

    Directory of Open Access Journals (Sweden)

    Bruno Gil de Carvalho Lima

    2000-03-01

    Full Text Available Além de constituir causa freqüente de internamentos obstétricos em países pobres, o aborto representa a incapacidade do sistema público de saúde de prover informação suficiente sobre métodos contraceptivos para prevenir gestações em vez de interrompê-las. No Brasil, as altas taxas de utilização de serviços de saúde por abortamentos refletem as dificuldades persistentes de contracepção e planejamento familiar. Além disso, a mortalidade por aborto serve como indicador da qualidade dos procedimentos abortivos, um ponto importante num país onde tal prática é ilegal e, portanto, clandestinamente realizada. No presente estudo, analisamos as taxas de mortalidade por causas relacionadas ao aborto entre mulheres de 10 a 54 anos de idade, incluindo aquelas que morreram por abortamentos espontâneos e provocados, de 1980 a 1995, segundo região de residência. As informações utilizadas foram obtidas do banco de dados sobre mortalidade do Sistema Único de Saúde --Ministério da Saúde. Dados sobre população foram obtidos junto à Fundação Instituto Brasileiro de Geografia e Estatística. Estudaram-se 2 602 óbitos. Do total de óbitos, 15% foram devidos a aborto retido, aborto espontâneo e aborto induzido com indicação legalmente admitida. Oitenta e cinco por cento dos óbitos foram causados por aborto induzido sem indicação legalmente admitida e por aborto sem causa especificada. Os coeficientes de mortalidade por causas relacionadas ao aborto têm decrescido continuamente no Brasil, mas tais avanços têm-se distribuído desigualmente no país. A região que apresentou a menor queda na taxa (38% em 15 anos foi o Nordeste. As mulheres que morreram por aborto tiveram uma média de idade decrescente no período estudado.

  6. Mortalidad en varones jóvenes de México

    Directory of Open Access Journals (Sweden)

    Esperanza Tuñón Pablos

    2005-01-01

    Full Text Available En este artículo se analizan las principales causas de mortalidad entre los varones jóvenes de México, a saber: los accidentes, homicidios y suicidios, a la luz de la perspectiva de género. Este enfoque permite mostrar el peso del modelo hegemónico de masculinidad en las prácticas de riesgo que conducen hacia estas causas y cuestionar la socialización de género como un proceso desencadenante de riesgo para la relación de los varones con las mujeres y consigo mismos.

  7. Tendencias de mortalidad en población adulta, Medellín, 1994-2003

    Directory of Open Access Journals (Sweden)

    Doris Cardona

    2007-09-01

    Conclusiones. La mortalidad de la población adulta presenta diferencias según sexo y edad, estando en condiciones más desventajosas la población masculina frente a la femenina, de fallecer por causas externas en edades más tempranas de la vida, y los de mayor edad principalmente las mujeres, por el incremento de las enfermedades cardiovasculares y los tumores malignos, que representan un problema de salud pública por el alto costo humano y económico que generan.

  8. Panorama epidemiológico de México, principales causas de morbilidad y mortalidad

    OpenAIRE

    Soto-Estrada, Guadalupe; Moreno-Altamirano, Laura; Pahua Díaz, Daniel

    2016-01-01

    Resumen Introducción: En este trabajo se presenta a grandes rasgos el panorama epidemiológico de México. A través de esta revisión se discute la mortalidad y morbilidad general por grupos específicos, los egresos hospitalarios y recursos humanos disponibles para la atención de la salud. Propósito: Analizar las transformaciones en el panorama epidemiológico actual del país en el marco de algunas variaciones demográficas y acordes al crecimiento económico y la evolución del salario mínimo. ...

  9. MORTALIDAD YCOSTES ASOCIADOS A LA DEMORA DEL TRATAMIENTO QUIRÚRGICO POR FRACTURA DE CADERA

    OpenAIRE

    Iñigo Etxebarria-Foronda; Javier Mar; Arantzazu Arrospide; Jaime Ruiz de Eguino

    2013-01-01

    Fundamentos: La intervención quirúrgica en las fracturas de cadera suele demorarse varios días. Nuestro trabajo tiene dos objetivos. Estudiar la estancia preoperatoria de los pacientes ingresados por fractura de cade- ra en los hospitales vascos durante el año 2010 y medir su posible asocia- ción con la mortalidad intrahospitalaria, y estimar el coste económico que supone la estancia preoperatoria. Métodos. Se realizó un estudio observacional analizando los siguien- tes datos del Conjunto Mín...

  10. Factores predictores de mortalidad por accidente cerebrovascular en el Hospital Universitario San Jorge de Pereira (Colombia)

    OpenAIRE

    Cristhian David Morales-Plaza; Claudio Aguirre-Castañeda; Jorge Enrique Machado-Alba

    2016-01-01

    Objetivo: Determinar los factores predictores de mortalidad por accidente cerebrovascular (ACV) en el Hospital Universitario San Jorge de Pereira entre enero de 2008 y diciembre de 2011. Materiales y métodos: Estudio de corte transversal, realizado en los pacientes con diagnóstico de ACV. La información se obtuvo de las historias clínicas, teniendo en cuenta las variables edad, sexo, tipo de ACV (isquémico o hemorrágico), trastorno asociado, antecedentes personales relacionados con ACV, morta...

  11. Identitat, ideologia i argumentació en les cartes al director del diari Levante EMV

    OpenAIRE

    Portalés Llop, Enric

    2017-01-01

    El nostre estudi es basa en l’anàlisi de l’autopresentació dels escriptors de cartes al director del diari Levante EMV. N’hem seleccionat 127 i hem dividit el treball en la identificació dels autors per la informació que ells mateixos aporten (nom, sexe) i aquella que es pot inferir de les tries pragmaestilístiques que han fet. Concloem que els indicis textuals triats (persones gramaticals, possessius, etc.) transmeten tot d’informacions rellevants sobre la identitat dels autors, la defensa d...

  12. Simulation of land use change in the three gorges reservoir area based on CART-CA

    Science.gov (United States)

    Yuan, Min

    2018-05-01

    This study proposes a new method to simulate spatiotemporal complex multiple land uses by using classification and regression tree algorithm (CART) based CA model. In this model, we use classification and regression tree algorithm to calculate land class conversion probability, and combine neighborhood factor, random factor to extract cellular transformation rules. The overall Kappa coefficient is 0.8014 and the overall accuracy is 0.8821 in the land dynamic simulation results of the three gorges reservoir area from 2000 to 2010, and the simulation results are satisfactory.

  13. Putting the horse before the cart: a pragmatist analysis of knowledge

    Directory of Open Access Journals (Sweden)

    Luís M. Augusto

    2011-01-01

    Full Text Available The definition of knowledge as justified true belief is the best we presently have. However, the canonical tripartite analysis of knowledge does not do justice to it due to a Platonic conception of a priori truth that puts the cart before the horse. Within a pragmatic approach, I argue that by doing away with a priori truth, namely by submitting truth to justification, and by accordingly altering the canonical analysis of knowledge, this is a fruitful definition. So fruitful indeed that it renders the Gettier counterexamples vacuous, allowing positive work in epistemology and related disciplines.

  14. New developments of the CARTE thermochemical code: A two-phase equation of state for nanocarbons

    Energy Technology Data Exchange (ETDEWEB)

    Dubois, Vincent, E-mail: vincent-jp.dubois@cea.fr; Pineau, Nicolas [CEA, DAM, DIF, F-91297 Arpajon (France)

    2016-01-07

    We developed a new equation of state (EOS) for nanocarbons in the thermodynamic range of high explosives detonation products (up to 50 GPa and 4000 K). This EOS was fitted to an extensive database of thermodynamic properties computed by molecular dynamics simulations of nanodiamonds and nano-onions with the LCBOPII potential. We reproduced the detonation properties of a variety of high explosives with the CARTE thermochemical code, including carbon-poor and carbon-rich explosives, with excellent accuracy.

  15. Preconception use of cART by HIV-positive pregnant women increases the risk of infants being born small for gestational age

    Science.gov (United States)

    Smit, Colette; Godfried, Mieke H.; Bakker, Rachel; Nellen, Jeannine F. J. B.; Jaddoe, Vincent W. V.; van Leeuwen, Elisabeth; Reiss, Peter; Steegers, Eric A. P.; van der Ende, Marchina E.

    2018-01-01

    Background The benefits of combination anti-retroviral therapy (cART) in HIV-positive pregnant women (improved maternal health and prevention of mother to child transmission [pMTCT]) currently outweigh the adverse effects due to cART. As the variety of cART increases, however, the question arises as to which type of cART is safest for pregnant women and women of childbearing age. We studied the effect of timing and exposure to different classes of cART on adverse birth outcomes in a large HIV cohort in the Netherlands. Materials and methods We included singleton HEU infants registered in the ATHENA cohort from 1997 to 2015. Multivariate logistic regression analysis for single and multiple pregnancies was used to evaluate predictors of small for gestational age (SGA, birth weight Women starting cART before conception had an increased risk of having a SGA infant compared to women starting cART after conception (OR 1.35, 95% CI 1.03−1.77, p = 0.03). The risk for SGA was highest in women who started a protease inhibitor-(PI) based regimen prior to pregnancy, compared with women who initiated PI-based cART during pregnancy. While the association of preterm delivery and preconception cART was significant in univariate analysis, on multivariate analysis only a non-significant trend was observed (OR 1.39, 95% CI 0.94−1.92, p = 0.06) in women who had started cART before compared to after conception. In multivariate analysis, the risk of low birth weight (OR 1.34, 95% CI 0.94−1.92, p = 0.11) was not significantly increased in women who had started cART prior to conception compared to after conception. Conclusion In our cohort of pregnant HIV-positive women, the use of cART prior to conception, most notably a PI-based regimen, was associated with intrauterine growth restriction resulting in SGA. Data showed a non-significant trend in the risk of PTD associated with preconception use of cART compared to its use after conception. More studies are needed with regard to the

  16. Liver myeloid-derived suppressor cells expand in response to liver metastases in mice and inhibit the anti-tumor efficacy of anti-CEA CAR-T

    Science.gov (United States)

    Burga, Rachel A.; Thorn, Mitchell; Point, Gary R.; Guha, Prajna; Nguyen, Cang T.; Licata, Lauren A.; DeMatteo, Ronald P.; Ayala, Alfred; Espat, N. Joseph; Junghans, Richard P.; Katz, Steven C.

    2015-01-01

    Chimeric antigen receptor modified T cell (CAR-T) technology, a promising immunotherapeutic tool, has not been applied specifically to treat liver metastases (LM). While CAR-T delivery to LM can be optimized by regional intrahepatic infusion, we propose that liver CD11b+Gr-1+ myeloid-derived suppressor cells (L-MDSC) will inhibit the efficacy of CAR-T in the intrahepatic space. We studied anti-CEA CAR-T in a murine model of CEA+ LM and identified mechanisms through which L-MDSC expand and inhibit CAR-T function. We established CEA+ LM in mice and studied purified L-MDSC and responses to treatment with intrahepatic anti-CEA CAR-T infusions. L-MDSC expanded three-fold in response to LM and their expansion was dependent on GM-CSF, which was produced by tumor cells. L-MDSC utilized PD-L1 to suppress anti-tumor responses through engagement of PD-1 on CAR-T. GM-CSF, in cooperation with STAT3, promoted L-MDSC PD-L1 expression. CAR-T efficacy was rescued when mice received CAR-T in combination with MDSC depletion, GM-CSF neutralization to prevent MDSC expansion, or PD-L1 blockade. As L-MDSC suppressed anti-CEA CAR-T, infusion of anti-CEA CAR-T in tandem with agents targeting L-MDSC is a rational strategy for future clinical trials. PMID:25850344

  17. Potent anti-leukemia activities of humanized CD19-targeted CAR-T cells in patients with relapsed/refractory acute lymphoblastic leukemia.

    Science.gov (United States)

    Cao, Jiang; Wang, Gang; Cheng, Hai; Wei, Chen; Qi, Kunming; Sang, Wei; Zhenyu, Li; Shi, Ming; Li, Huizhong; Qiao, Jianlin; Pan, Bin; Zhao, Jing; Wu, Qingyun; Zeng, Lingyu; Niu, Mingshan; Jing, Guangjun; Zheng, Junnian; Xu, Kailin

    2018-04-10

    Chimeric antigen receptor T (CAR-T) cell therapy has shown promising results for relapsed/refractory (R/R) acute lymphoblastic leukemia (ALL). The immune response induced by murine single-chain variable fragment (scFv) of the CAR may limit CAR-T cell persistence and thus increases the risk of leukemia relapse. In this study, we developed a novel humanized scFv from the murine FMC63 antibody. A total of 18 R/R ALL patients with or without prior murine CD19 CAR-T therapy were treated with humanized CD19-targeted CAR-T cells (hCART19s). After lymphodepletion chemotherapy with cyclophosphamide and fludarabine, the patients received a single dose (1 × 10 6 /kg) of autologous hCART19s infusion. Among the 14 patients without previous CAR-T therapy, 13 (92.9%) achieved complete remission (CR) or CR with incomplete count recovery (CRi) on day 30, whereas 1 of the 3 patients who failed a second murine CAR-T infusion achieved CR after hCART19s infusion. At day 180, the overall and leukemia-free survival rates were 65.8% and 71.4%, respectively. The cumulative incidence of relapse was 22.6%, and the non-relapse mortality rate was 7.1%. During treatment, 13 patients developed grade 1-2 cytokine release syndrome (CRS), 4 patients developed grade 3-5 CRS, and 1 patient experienced reversible neurotoxicity. These results indicated that hCART19s could induce remission in patients with R/R B-ALL, especially in patients who received a reinfusion of murine CAR-T. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

  18. Políticas efectivas para reducir la mortalidad infantil en el Perú: ¿Cómo reducir la mortalidad infantil en las zonas más pobres del país?

    OpenAIRE

    Beltrán, Arlette; Grippa Zárate, Ana Rosa

    2014-01-01

    El propósito del presente trabajo es hallar aquellos determinantes más efectivos para reducir la mortalidad neonatal e infantil, para que sean utilizados como variables de política por el «policymaker» y se pueda alcanzar el Objetivo de Desarrollo del Milenio # 4: reducir para el año 2015 la tasa de mortalidad infantil a un tercio de su valor inicial de 1992. El trabajo hace uso de dos bases de datos: la IV Encuesta Demográfica y de Salud Familiar (Endes, 2000) y el II Censo de Infraestructur...

  19. Estudio diagnóstico de la mortalidad humana en el Ecuador, en la Provincia de Tungurahua, el Cantón capital Ambato y los principales cantones con el mayor porcentaje de mortalidad. República del Ecuador. 2014.

    OpenAIRE

    Castañeda Guillot, Carlos David; González Miranda, Victoria María

    2016-01-01

    Se realiza estudio diagnóstico de las diez principales causas de mortalidad humana en Ecuador a nivel de país, la provincia de Tungurahua y principales cantones basada la  investigación en  los datos del Instituto Nacional de Estadística y Censos y Ministerio de Salud Pública correspondientes al año 2014 en base al Registro Internacional de Mortalidad Humana. Por orden de incidencia predominan enfermedades cardiovasculares (isquemia del corazón, enfermedades cerebrovasculares y enfermedades h...

  20. Exceso de mortalidad relacionado con la gripe en España en el invierno de 2012

    Directory of Open Access Journals (Sweden)

    Inmaculada León-Gómez

    2015-07-01

    Conclusiones: Uno de los principales incrementos significativos de la mortalidad acontecidos en España en los inviernos de los últimos años, en mayores de 64 años, fue detectado por los sistemas de monitorización de mortalidad español y europeo en la temporada 2011-2012, coincidiendo en el tiempo con una tardía temporada gripal, con predominio de virus A(H3N2, y una ola de bajas temperaturas. Este estudio muestra que la gripe pudo ser uno de los principales factores contribuyentes al exceso de mortalidad observado en el invierno de 2012 en España.

  1. Comparison of single and boosted protease inhibitor versus nonnucleoside reverse transcriptase inhibitor-containing cART regimens in antiretroviral-naïve patients starting cART after January 1, 2000

    DEFF Research Database (Denmark)

    Mocroft, A; Horban, A; Clumeck, N

    2006-01-01

    increase) response in antiretroviral-naïve patients starting either a single protease inhibitor (PI; n = 183), a ritonavir-boosted PI regimen (n = 197), or a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based cART regimen (n = 447) after January 1, 2000, and the odds of lack of virologic...... or immunologic response at 3 years after starting cART. METHOD: Cox proportional hazards models and logistic regression. RESULTS: After adjustment, compared to patients taking an NNRTI-regimen, patients taking a single-PI regimen were significantly less likely to achieve a viral load (VL)

  2. Design of an automated cart and mount for a hyperspectral imaging system to be used in produce fields

    Science.gov (United States)

    Lefcourt, Alan M.; Kistler, Ross; Gadsden, S. Andrew

    2016-05-01

    The goal of this project was to construct a cart and a mounting system that would allow a hyperspectral laser-induced fluorescence imaging system (HLIFIS) to be used to detect fecal material in produce fields. Fecal contaminated produce is a recognized food safety risk. Previous research demonstrated the HLIFIS could detect fecal contamination in a laboratory setting. A cart was designed and built, and then tested to demonstrate that the cart was capable of moving at constant speeds or at precise intervals. A mounting system was designed and built to facilitate the critical alignment of the camera's imaging and the laser's illumination fields, and to allow the HLIFIS to be used in both field and laboratory settings without changing alignments. A hardened mount for the Powell lens that is used to produce the appropriate illumination profile was also designed, built, and tested.

  3. Análisis del impacto de la mortalidad por suicidios en México, 2000-2012

    Directory of Open Access Journals (Sweden)

    Claudio Alberto Dávila Cervantes

    2015-01-01

    Full Text Available El objetivo del presente artículo es analizar la carga de la mortalidad por suicidios en México, a partir del indicador de años de vida perdidos (AVP, entre 2000 y 2012, por sexo, grupos de edad (para menores de 85 años de edad a nivel nacional y por entidad federativa. Se emplearon estadísticas vitales de mortalidad y estimaciones de población para calcular tasas estandarizadas de mortalidad y los años de vida perdidos por suicidios. Entre 2000 y 2012 se dio un incremento sostenido de la tasa de mortalidad por suicidios. En hombres, el grupo de edad con las mayores tasas fue el de 85 años y más; para mujeres el de 15-19 años. El mayor impacto en la esperanza de vida se dio entre los 20 y 24 años en hombres y entre los 15 y 19 años para mujeres. Los estados con la mayor mortalidad se ubican en la península de Yucatán (Yucatán, Quintana Roo y Campeche. La mortalidad por suicidio en México se ha incrementado de manera constante. Los suicidios son prevenibles, por lo que es fundamental implementar políticas públicas en salud a través de acciones de identificación oportuna, estrategias integrales de prevención y el estudio detallado de los factores de riesgo asociados.

  4. Distribuição espacial da violência: mortalidade por causas externas em Salvador (Bahia, Brasil

    Directory of Open Access Journals (Sweden)

    Paim Jairnilson Silva

    1999-01-01

    Full Text Available O presente estudo teve como objetivo descrever a distribuição da mortalidade por causas externas no espaço urbano de Salvador, Estado da Bahia, Brasil, em 1991. Foram calculados indicadores de mortalidade por causas externas e por tipos específicos de violência. A mortalidade proporcional por causas externas foi de 15% e a taxa de mortalidade correspondeu a 78,0 óbitos por 100 000 habitantes. As taxas de mortalidade por homicídios e por acidentes de transporte foram de 32,2 e 21,8 por 100 000 habitantes, respectivamente. Os idosos apresentaram um maior risco de morte por causas externas, seguidos dos adultos jovens e adolescentes. No caso dos idosos, 38% das mortes foram por acidentes de transporte e 28%, por quedas. Em relação aos jovens, predominam os homicídios, especialmente no sexo masculino e na faixa etária de 15 a 29 anos. Constatou-se uma distribuição desigual da mortalidade por causas externas no espaço urbano, penalizando, especialmente no caso dos homicídios, as populações residentes em bairros pobres, com taxas superiores ao coeficiente médio de Salvador. É necessário desenvolver medidas de prevenção e controle, incluindo políticas públicas e ações programáticas de saúde, orientadas para o espaço social sujeito a maior risco de morte por causas externas.

  5. Mortalidade por doenças cardiorrespiratórias em idosos no estado de Mato Grosso, 1986 a 2006

    Directory of Open Access Journals (Sweden)

    Cleber Nascimento do Carmo

    2010-12-01

    Full Text Available OBJETIVO: Descrever a evolução temporal da mortalidade por doenças cardiorrespiratórias em idosos. MÉTODOS: Estudo epidemiológico descritivo com delineamento ecológico de séries temporais realizado no estado do Mato Grosso, de 1986 a 2006. Foram utilizados dados sobre doenças dos aparelhos respiratório e circulatório obtidos do Sistema de Informação sobre Mortalidade do Ministério da Saúde. Modelos de regressão linear simples foram ajustados para avaliar a tendência das taxas específicas de mortalidade por grupos específicos de idade (60 a 69, 70 a 79 e 80 ou mais anos e sexo. RESULTADOS: Houve aumento na proporção de óbitos por doenças respiratórias e diminuição por doenças cardiovasculares. Na comparação de taxas entre os sexos, as mulheres apresentaram taxas 15% menores para as causas cardiovasculares e taxas similares ao sexo masculino para as causas respiratórias. Foi observada taxa elevada de mortalidade por doenças respiratórias e cardiovasculares, com importante tendência de incremento entre os grupos mais longevos. Em idosos com idade > 80 anos o aumento anual médio na taxa de mortalidade por doenças respiratórias foi de 1,99 óbitos e de 3,43 por doenças do aparelho circulatório. CONCLUSÕES: O estado de Mato Grosso apresenta elevada taxa de mortalidade por doenças respiratórias e cardiovasculares em idosos, com importante tendência de incremento entre os grupos mais longevos.

  6. Mortalidade perinatal em duas coortes de base populacional no Sul do Brasil: tendências e diferenciais

    Directory of Open Access Journals (Sweden)

    Menezes Ana M. B.

    1996-01-01

    Full Text Available A evolução da mortalidade perinatal foi estudada em Pelotas, Rio Grande do Sul, através de dois estudos de coorte realizados em 1982 e 1993. Todos os nascimentos hospitalares e os óbitos foram monitorizados com visitas diárias aos hospitais. A causa da morte foi determinada através de informações do prontuário, entrevista com o pediatra e de necrópsias. O coeficiente de mortalidade perinatal sofreu uma redução de 31% na década. O sub-registro que era de 42,1% em 1982, foi de apenas 6,8% em 1993. Dentre as causas de mortalidade perinatal, houve uma redução em 1993 de 58% para óbitos fetais antepartum, 47% para imaturidade e 62% para outras causas. Os coeficientes para asfixia sofreram um aumento de 4,5/1.000 para 8,3/1.000. As meninas apresentaram um coeficiente de mortalidade perinatal menor do que os meninos. Os coeficientes de mortalidade perinatal conforme peso ao nascer e renda familiar sofreram importantes reduções, sendo que a mais notável foi para crianças de baixo peso e de famílias de renda alta, com uma queda de 68%. Assim como em 1982, os recém-nascidos pré-termo tiveram coeficientes três vezes mais elevados do que crianças pequenas para a idade gestacional. Apesar da queda dos índices de mortalidade na década, as diferenças entre os grupos sociais mantiveram-se grandes.

  7. Deploying a Proximal Sensing Cart to Identify Drought-Adaptive Traits in Upland Cotton for High-Throughput Phenotyping

    Directory of Open Access Journals (Sweden)

    Alison L. Thompson

    2018-04-01

    Full Text Available Field-based high-throughput phenotyping is an emerging approach to quantify difficult, time-sensitive plant traits in relevant growing conditions. Proximal sensing carts represent an alternative platform to more costly high-clearance tractors for phenotyping dynamic traits in the field. A proximal sensing cart and specifically a deployment protocol, were developed to phenotype traits related to drought tolerance in the field. The cart-sensor package included an infrared thermometer, ultrasonic transducer, multi-spectral reflectance sensor, weather station, and RGB cameras. The cart deployment protocol was evaluated on 35 upland cotton (Gossypium hirsutum L. entries grown in 2017 at Maricopa, AZ, United States. Experimental plots were grown under well-watered and water-limited conditions using a (0,1 alpha lattice design and evaluated in June and July. Total collection time of the 0.87 hectare field averaged 2 h and 27 min and produced 50.7 MB and 45.7 GB of data from the sensors and RGB cameras, respectively. Canopy temperature, crop water stress index (CWSI, canopy height, normalized difference vegetative index (NDVI, and leaf area index (LAI differed among entries and showed an interaction with the water regime (p < 0.05. Broad-sense heritability (H2 estimates ranged from 0.097 to 0.574 across all phenotypes and collections. Canopy cover estimated from RGB images increased with counts of established plants (r = 0.747, p = 0.033. Based on the cart-derived phenotypes, three entries were found to have improved drought-adaptive traits compared to a local adapted cultivar. These results indicate that the deployment protocol developed for the cart and sensor package can measure multiple traits rapidly and accurately to characterize complex plant traits under drought conditions.

  8. Short-Term High-Fat Diet Increases Leptin Activation of CART Neurons and Advances Puberty in Female Mice.

    Science.gov (United States)

    Venancio, Jade Cabestre; Margatho, Lisandra Oliveira; Rorato, Rodrigo; Rosales, Roberta Ribeiro Costa; Debarba, Lucas Kniess; Coletti, Ricardo; Antunes-Rodrigues, Jose; Elias, Carol F; Elias, Lucila Leico K

    2017-11-01

    Leptin is a permissive factor for puberty initiation, participating as a metabolic cue in the activation of the kisspeptin (Kiss1)-gonadotropin-releasing hormone neuronal circuitry; however, it has no direct effect on Kiss1 neurons. Leptin acts on hypothalamic cocaine- and amphetamine-regulated transcript (CART) neurons, participating in the regulation of energy homeostasis. We investigated the influence of a short-term high-fat diet (HFD) on the effect of leptin on puberty timing. Kiss1-hrGFP female mice received a HFD or regular diet (RD) after weaning at postnatal day (PN)21 and were studied at PN28 and PN32. The HFD increased body weight and plasma leptin concentrations and decreased the age at vaginal opening (HFD, 32 ± 0.53 days; RD, 38 ± 0.67 days). Similar colocalization of neurokinin B and dynorphin in Kiss1-hrGFP neurons of the arcuate nucleus (ARC) was observed between the HFD and RD groups. The HFD increased CART expression in the ARC and Kiss1 messenger RNA expression in the anteroventral periventricular (AVPV)/anterior periventricular (Pe). The HFD also increased the number of ARC CART neurons expressing leptin-induced phosphorylated STAT3 (signal transducer and activator of transcription 3) at PN32. Close apposition of CART fibers to Kiss1-hrGFP neurons was observed in the ARC of both RD- and HFD-fed mice. In conclusion, these data reinforce the notion that a HFD increases kisspeptin expression in the AVPV/Pe and advances puberty initiation. Furthermore, we have demonstrated that the HFD-induced earlier puberty is associated with an increase in CART expression in the ARC. Therefore, these data indicate that CART neurons in the ARC can mediate the effect of leptin on Kiss1 neurons in early puberty induced by a HFD. Copyright © 2017 Endocrine Society.

  9. Mortalidade infantil por causas evitáveis em uma cidade do Nordeste do Brasil

    Directory of Open Access Journals (Sweden)

    Suelayne Gonçalves do Nascimento

    2014-04-01

    Full Text Available Estudo de corte transversal que objetivou descrever a ocorrência da mortalidade infantil em Recife (PE entre 2000 e 2009, segundo causas evitáveis. A população foi composta pelos óbitos infantis de mães residentes na cidade do Recife e a classificação de evitabilidade adotou a Lista de causas de mortes evitáveis por intervenções do Sistema Único de Saúde. Para análise dos dados utilizou-se estatística descritiva. Foi observado decréscimo no coeficiente de mortalidade infantil de 20,4 para 12,1 por 1.000 nascidos vivos. Do total de 3.743 óbitos registrados, 2.861 (76,4% foram classificados como evitáveis. Destacaram-se os óbitos reduzíveis por adequada atenção à mulher na gestação. A abordagem da evitabilidade auxilia nas discussões relacionadas à organização, qualidade e acesso aos serviços de saúde, bem como na identificação dos óbitos que poderiam ter sido prevenidos ou evitados por uma adequada atenção à saúde materno-infantil.

  10. Tendencias de mortalidad por cánceres atribuibles al tabaco en México

    Directory of Open Access Journals (Sweden)

    Víctor José Tovar-Guzmán

    2002-01-01

    Full Text Available Objetivo. Describir la tendencia de la mortalidad por cáncer atribuible al consumo de tabaco, particularmente neoplasias del pulmón, en México, durante el periodo 1980-1997. Material y métodos. Se hizo un análisis de tendencias de mortalidad para cada tipo de cáncer asociado con el tabaco, según la Clasificación Internacional de Enfermedades. Las tasas cruda y ajustada de mortalidad fueron estimadas en términos de edad, género, causa básica de la muerte y año, entre 1980 y 1997. Se estimó la razón de género y proporción relativa para los casos que estaban en el grupo de edad entre 35 y 64 años y para toda la población estudiada. Como denominador se utilizaron las proyecciones por edad calculadas por el Consejo Nacional de Población (1970-2010. Resultados. La razón de género para las tasas de mortalidad por cáncer de laringe, esófago, cavidad oral y faringe fue de 2.10:1.00 (hombre: mujer. La razón de género para el cáncer de laringe es enorme: 4.21: 1.00, probablemente debida a la mayor prevalencia de hombres fumadores de tabaco. La proporción relativa estimada, usando la mortalidad total debida a tumores malignos, entre 1980 y 1997 fue la siguiente: cáncer de pulmón 12.31%, laringe 1.71%, esófago 1.55% y cavidad oral/faringe 1.49%. El antecedente de tabaquismo tiene correlación con la tendencia de la tasa de mortalidad por cáncer del pulmón (Beta: 0.910, IC 95%: 1.097-1.797; R² 0.827. Para los grupos sociales mas pobres, por entidad federativa, la correlación está invertida (Beta: -0.510, IC 95%: -0.170, -0.039, R²: 0.260. Conclusiones. En México, la mejoría en el diagnóstico, la transición demográfica y el incremento del consumo de tabaco son, probablemente, los principales factores a los que se atribuye la tasa de mortalidad por cáncer. No obstante, otras variables asociadas con el estilo de vida, como urbanización, actividad física, ingesta de carotenoides y otros componentes dietéticos y t

  11. Mortalidad por causas externas en Medellín, 1999-2006

    Directory of Open Access Journals (Sweden)

    Doris Cardona Arango

    2008-01-01

    Full Text Available Caracterizar el comportamiento de la mortalidad por causas externas en la ciudad de Medellín, Colombia, entre 1999-2006, según sexo, edad y causa básica de muerte fue el objetivo de este estudio descriptivo longitudinal, con fuente de información secundaria de 22 128 registros de defunción por causas externas. El análisis realizado es univariado y bivariado por sexo, grupos de edad y causa de muerte. Las causas externas registradas en el periodo fueron: 72.9 por ciento por homicidio; 15.3 por ciento, accidente de transporte; 7.3 por ciento, traumatismos; 4.2 por ciento, por suicidio, y por otras causas, 0.4 por ciento. La mayor tasa de mortalidad se presentó en el grupo de edad de 20 a 24 años (27.6 por cien mil habitantes, hecho que merece especial consideración por las implicaciones sociales, familiares y laborales que representa el fallecimiento de una persona en su etapa productiva.

  12. Mortalidad por VIH/SIDA en México. Un aporte demográfico

    Directory of Open Access Journals (Sweden)

    Cecilia GAYET

    2014-01-01

    Full Text Available El objetivo del presente artículo es estimar la tendencia de la mortalidad por SIDA en México entre 1998 y 2011, a nivel nacional y estatal, con métodos demográficos comparando dos etapas y discutir el alcance de estas estimaciones para el monitoreo de la epidemia. Entre los resultados destaca que hubo un comportamiento estable de la mortalidad masculina en la etapa de introducción de los antirretrovirales de gran actividad y una reducción entre 2004-2011; para mujeres, existió un patrón creciente de 1998-2007 y desde 2008 una leve reducción. Se dio una disminución de la esperanza de vida por SIDA antes de la universalización de tratamientos y un incremento a partir de 2004 sólo en los hombres. Existen diferencias entre las entidades federativas. Tabasco tuvo menores aportes a partir de los tratamientos. Los resultados basados en el análisis de defunciones deberían considerarse aproximaciones y no necesariamente convenientes para la evaluación de las políticas de salud.

  13. Geografia da mortalidade infantil do Brasil: variações espaciais e desigualdades territoriais

    Directory of Open Access Journals (Sweden)

    Rivaldo Faria

    2016-12-01

    Full Text Available O objetivo deste artigo é analisar as variações espaciais e as desigualdades territoriais nos indicadores de mortalidade infantil do Brasil. O estudo foi feito com todos os óbitos infantis e nascidos vivos registrados em sistemas oficiais nos anos de 2012 e 2013 nas 558 microrregiões brasileiras. Os indicadores foram calculados e estimados através do método bayesiano empírico. As características do território foram analisadas através de um indicador multicritério denominado Índice de Privação Social. Os resultados indicaram elevados coeficientes de mortalidade infantil (CMI nas microrregiões dos estados do nordeste e norte do país e fatores associados relacionados à idade da mãe, doenças infecciosas, vazios assistenciais e falta de acompanhamento pré-natal. Nas microrregiões dos estados do sudeste e sul e parte do centro-oeste os CMI são menos elevados e os fatores associados estão mais relacionados com a prematuridade e baixo peso à nascença.

  14. A boundary-layer cloud study using Southern Great Plains Cloud and radiation testbed (CART) data

    Energy Technology Data Exchange (ETDEWEB)

    Albrecht, B.; Mace, G.; Dong, X.; Syrett, W. [Pennsylvania State Univ., University Park, PA (United States)] [and others

    1996-04-01

    Boundary layer clouds-stratus and fairweather cumulus - are closely coupled involves the radiative impact of the clouds on the surface energy budget and the strong dependence of cloud formation and maintenance on the turbulent fluxes of heat and moisture in the boundary layer. The continuous data collection at the Southern Great Plains (SGP) Cloud and Radiation Testbed (CART) site provides a unique opportunity to study components of the coupling processes associated with boundary layer clouds and to provide descriptions of cloud and boundary layer structure that can be used to test parameterizations used in climate models. But before the CART data can be used for process studies and parameterization testing, it is necessary to evaluate and validate data and to develop techniques for effectively combining the data to provide meaningful descriptions of cloud and boundary layer characteristics. In this study we use measurements made during an intensive observing period we consider a case where low-level stratus were observed at the site for about 18 hours. This case is being used to examine the temporal evolution of cloud base, cloud top, cloud liquid water content, surface radiative fluxes, and boundary layer structure. A method for inferring cloud microphysics from these parameters is currently being evaluated.

  15. DeCART v1.2 User's Manual

    Energy Technology Data Exchange (ETDEWEB)

    Cho, J. Y.; Kim, K. S.; Kim, H. Y.; Lee, C. C.; Zee, S. Q; Joo, H. G

    2007-07-15

    DeCART (Deterministic Core Analysis based on Ray Tracing) is a whole core neutron transport code capable of direct subpin level flux calculation at power generating conditions. It does not require a priori homogenization nor group condensation needed in conventional reactor physics calculations. The depletion and transient calculation capabilities are also available. This manual serves as a self-sufficient guide to use the code. First of all, the various features of the code are explained which encompass various modeling options as well as the basic calculation functionalities. The instructions for running the code are also given with a description of the output files generated. Next, the underlying concepts and principles of preparing a DeCART model for a problem under consideration are presented. Each part of the input needed to specify the geometry, material composition, thermal operating condition, program execution control parameters are explained with examples. The descriptions of all the input cards are then followed. Finally, various sample model inputs ranging from a simple 2D pin cell to a realistic 3D core problem, steady-state to transient problems, and from rectangular to hexagonal core problems are presented.

  16. DeCART v1.1 user's manual

    Energy Technology Data Exchange (ETDEWEB)

    Cho, J. Y.; Kim, K. S.; Kim, H. Y.; Lee, C. C.; Zee, S. Q.; Joo, H. G

    2005-03-15

    DeCART (Deterministic Core Analysis based on Ray Tracing) is a whole core neutron transport code capable of direct subpin level flux calculation at power generating conditions. It does not require a priori homogenization nor group condensation needed in conventional reactor physics calculations. The depletion and transient calculation capabilities are also available. This manual serves as a self-sufficient guide to use the code. First of all, the various features of the code are explained which encompass various modeling options as well as the basic calculation functionalities. The instructions for running the code are also given with a description of the output files generated. Next, the underlying concepts and principles of preparing a DeCART model for a problem under consideration are presented. Each part of the input needed to specify the geometry, material composition, thermal operating condition, program execution control parameters are explained with examples. The descriptions of all the input cards are then followed. Finally, various sample model inputs ranging from a simple 2D pin cell to a realistic 3D core problem, steady-state to transient problems, are presented.

  17. It’s all change for the "carte de légitimation"

    CERN Multimedia

    2009-01-01

    From now on, the Swiss carte de légitimation will be issued to associates and users as well as staff members, and applications will be handled electronically, thus facilitating various procedures. In collaboration with the GS-AIS Group, the HR Department is continuing its modernisation of administrative procedures. Now that MARS forms and applications to participate in the saved leave scheme have been computerised and employment certificates and change of home address forms have been made available on line on a self-service basis, it’s the turn of the carte de légitimation to enter the digital era. In future, when a new card needs to be produced, the member of the personnel’s data will be forwarded electronically from CERN’s database to the database of the Swiss Federal Department of Foreign Affairs (DFAE), eliminating the need for a paper form. Similarly, paper ID photos will no longer be needed as the digital photo taken for ...

  18. Error quantification of the axial nodal diffusion kernel of the DeCART code

    International Nuclear Information System (INIS)

    Cho, J. Y.; Kim, K. S.; Lee, C. C.

    2006-01-01

    This paper is to quantify the transport effects involved in the axial nodal diffusion kernel of the DeCART code. The transport effects are itemized into three effects, the homogenization, the diffusion, and the nodal effects. A five pin model consisting of four fuel pins and one non-fuel pin is demonstrated to quantify the transport effects. The transport effects are analyzed for three problems, the single pin (SP), guide tube (GT) and control rod (CR) problems by replacing the non-fuel pin with the fuel pin, a guide-tube and a control rod pins, respectively. The homogenization and diffusion effects are estimated to be about -4 and -50 pcm for the eigenvalue, and less than 2 % for the node power. The nodal effect on the eigenvalue is evaluated to be about -50 pcm in the SP and GT problems, and +350 pcm in the CR problem. Regarding the node power, this effect induces about a 3 % error in the SP and GT problems, and about a 20 % error in the CR problem. The large power error in the CR problem is due to the plane thickness, and it can be decreased by using the adaptive plane size. From the error quantification, it is concluded that the homogenization and the diffusion effects are not controllable if DeCART maintains the diffusion kernel for the axial solution, but the nodal effect is controllable by introducing the adaptive plane size scheme. (authors)

  19. Loss of the HVEM Tumor Suppressor in Lymphoma and Restoration by Modified CAR-T Cells.

    Science.gov (United States)

    Boice, Michael; Salloum, Darin; Mourcin, Frederic; Sanghvi, Viraj; Amin, Rada; Oricchio, Elisa; Jiang, Man; Mottok, Anja; Denis-Lagache, Nicolas; Ciriello, Giovanni; Tam, Wayne; Teruya-Feldstein, Julie; de Stanchina, Elisa; Chan, Wing C; Malek, Sami N; Ennishi, Daisuke; Brentjens, Renier J; Gascoyne, Randy D; Cogné, Michel; Tarte, Karin; Wendel, Hans-Guido

    2016-10-06

    The HVEM (TNFRSF14) receptor gene is among the most frequently mutated genes in germinal center lymphomas. We report that loss of HVEM leads to cell-autonomous activation of B cell proliferation and drives the development of GC lymphomas in vivo. HVEM-deficient lymphoma B cells also induce a tumor-supportive microenvironment marked by exacerbated lymphoid stroma activation and increased recruitment of T follicular helper (T FH ) cells. These changes result from the disruption of inhibitory cell-cell interactions between the HVEM and BTLA (B and T lymphocyte attenuator) receptors. Accordingly, administration of the HVEM ectodomain protein (solHVEM (P37-V202) ) binds BTLA and restores tumor suppression. To deliver solHVEM to lymphomas in vivo, we engineered CD19-targeted chimeric antigen receptor (CAR) T cells that produce solHVEM locally and continuously. These modified CAR-T cells show enhanced therapeutic activity against xenografted lymphomas. Hence, the HVEM-BTLA axis opposes lymphoma development, and our study illustrates the use of CAR-T cells as "micro-pharmacies" able to deliver an anti-cancer protein. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Heterogeneous surface fluxes and their effects on the SGP CART site

    International Nuclear Information System (INIS)

    Doran, J.C.; Hu, Q.; Hubbe, J.M.; Liljegren, J.C.; Shaw, W.J.; Zhong, S.; Collatz, G.J.

    1995-03-01

    The treatment of subgrid-scale variations of surface properties and the resultant spatial variations of sensible and latent heat fluxes has received increasing attention in recent years. Mesoscale numerical simulations of highly idealized conditions, in which strong flux contrasts exist between adjacent surfaces, have shown that under some circumstances the secondary circulations induced by land-use differences can significantly affect the properties of the planetary boundary layer (PBL) and the region of the atmosphere above the PBL. At the Southern Great Plains (SGP) Cloud and Radiation Testbed (CART) site, the fluxes from different land-surface types are not expected to differ as dramatically as those found in idealized simulations. Although the corresponding effects on the atmosphere should thus be less dramatic, they are still potentially important. From an ARM perspective, in tests of single column models (SCMs) it would be useful to understand the effects of the lower boundary conditions on model performance. We describe here our initial efforts to characterize the variable surface fluxes over the CART site and to assess their effects on the PBL that are important for the performance of SCMs

  1. Mortalidad infantil por malformaciones congénitas en Argentina: análisis del quinquenio 2002-2006

    OpenAIRE

    Bronberg, Rubén; Alfaro, Emma; Chaves, Estela; Dipierri, José

    2009-01-01

    Objetivo. Analizar la distribución espacial y temporal de la mortalidad infantil por malformaciones congénitas en la Argentina entre 2002-2006. Materiales y métodos. Los datos provinieron del Ministerio de Salud. Las malformaciones congénitas se clasificaron según la Clasificación Internacional de Enfermedades, décima revisión. Se calcularon por departamentos, provincias y regiones, componentes de la mortalidad infantil (neonatal precoz y tardía y postneonatal), subconjuntos de malformaciones...

  2. Determinantes sociales de la mortalidad infantil en municipios de bajo índice de desarrollo humano en México

    OpenAIRE

    Duarte-Gómez, María Beatriz; Núñez-Urquiza, Rosa María; Restrepo-Restrepo, José Alonso; Richardson-López-Collada, Vesta Louise

    2015-01-01

    Introducción: Se realizó un estudio con el objetivo de identificar determinantes sociales de mortalidad infantil en zonas rurales en México, y recomendar estrategias para disminuir esta mortalidad. Métodos: Se tomó una muestra por conveniencia de 16 municipios de bajo índice de desarrollo humano. Se identificaron fallecimientos de menores de un año de edad a través de registros oficiales y de entrevistas con autoridades civiles, personal de salud y líderes comunitarios. También se realizar...

  3. Niveles de vida y salud en la España del primer franquismo: las desigualdades en la mortalidad infantil

    OpenAIRE

    Bernabeu Mestre, Josep; Caballero Pérez, Pablo; Galiana Sánchez, María Eugenia; Nolasco Bonmatí, Andreu

    2005-01-01

    A partir del estudio de las relaciones entre la mortalidad infantil y el desarrollo socioeconómico y sanitario de las provincias españolas, se analizan las desigualdades en salud que mostraban las diferentes regiones en las décadas centrales del siglo XX. Junto a los trabajos sobre mortalidad infantil y políticas de salud materno infantil llevados a cabo por la Dirección General de Sanidad, para los datos relativos a las condiciones y los niveles de vida, además de las informaciones socioecon...

  4. La mortalidad por enfermedades del corazón y por reumatismo en la ciudad de bogotá

    OpenAIRE

    Bejarano, Jorge

    2012-01-01

    La alta cifra de mortalidad por enfermedades cardio-vasculares está indicando la urgencia de una campana para contener sus avances. De todas las adquisiciones sanitarias, ninguna ha tenido el alcance y los resultados admirables de los centros o dispensarios destinados al tratamiento de una enfermedad y a la educación del enfermo. Nadie podrá pues, dudar que los dispensarios o consultorios de enfermedades cardio-vasculares, sea una de las armas más eficaces en la lucha contra la mortalidad por...

  5. Determinantes sociales de la mortalidad infantil en municipios de bajo índice de desarrollo humano en México

    OpenAIRE

    Duarte-Gómez, María Beatriz; Núñez-Urquiza, Rosa María; Restrepo-Restrepo, José Alonso; López-Collada, Vesta Louise Richardson

    2015-01-01

    ResumenINTRODUCCIÓN: Se realizó un estudio con el objetivo de identificar determinantes sociales de mortalidad infantil en zonas rurales en México, y recomendar estrategias para disminuir esta mortalidad.MÉTODOS: Se tomó una muestra por conveniencia de 16 municipios de bajo índice de desarrollo humano. Se identificaron fallecimientos de menores de un año de edad a través de registros oficiales y de entrevistas con autoridades civiles, personal de salud y líderes comunitarios. También se reali...

  6. La mortalidad por suicidios: México 1990-2001 Mortality from suicides: Mexico, 1990-2001

    OpenAIRE

    Esteban Puentes-Rosas; Leopoldo López-Nieto; Tania Martínez-Monroy

    2004-01-01

    OBJETIVO: Describir la mortalidad por suicidios en México en 2001, así como los principales cambios en los métodos de suicidio y en la estructura por edades y sexos que se han presentado desde 1990, tanto a escala nacional como por entidad federativa. MÉTODOS: Para este estudio descriptivo se utilizaron como fuentes de informaci��n los registros oficiales de mortalidad del Instituto Nacional de Estadística, Geografía e Informática para el período de 1990 a 2001. Para calcular las tasas de mor...

  7. Reparación del cartílago articular con injerto libre de pericondrio estudio experimental

    OpenAIRE

    Ballesteros Vazquez, P.; Carranza Bencano, Andrés; Armas Padrón, J. R.; Saenz López de Rueda, F.

    1994-01-01

    Ante la incapacidad de regeneración espontánea de lesiones profundas y amplias del cartílago articular, estudiamos la reparación cartilaginosa con plastias de pericondrio tomadas de la región condro-costal e implantándolas con su cara condrogénica sobre una lesión osteocondral realizada en la superficie articular rotuliana. Macroscópica e histológicamente, a la octava semana, el neocartílago formado tenía igual apariencia que el cartílago hialino normal, no existiendo separació...

  8. HRB, Hydrostatically Regenerative Brake system for dust-carts and buses; HRB, ein hydraulischer Hybrid fuer Muellfahrzeuge und Busse

    Energy Technology Data Exchange (ETDEWEB)

    Ehret, Christine; Kliffken, Markus G.; Bracht, Detlef van [Bosch Rexroth AG (Germany)

    2009-07-01

    The HRB, Hydrostatically Regenerative Brake System by Rexroth, saves up to 25 percent diesel in heavy-duty industrial vehicles and also reduces exhaust emissions. Practical tests and field tests with a dust-cart of Haller Umweltsysteme GmbH and Co. KG in the city of Berlin proved this. The dust-cart has been in operation since July 2008. Measurements in practical operation have proved the savings calculated in simulations. Detailed economic efficiency calculations are possible in advance with a software also developed by Rexroth.

  9. Incidencia, mortalidad y prevalencia de enfermedad renal crónica terminal en la región del Bajo Lempa, El Salvador: 10 años de registro comunitario

    Directory of Open Access Journals (Sweden)

    Ramón García-Trabanino

    2016-09-01

    Conclusiones: En esta región la incidencia de ERCT es elevada. Pocos reciben TSR. La mortalidad es alta, aun con TSR. Son mayormente varones adultos (9:1. Los determinantes sociales inciden en la alta mortalidad.

  10. Impact of Portion-Size Control for School a la Carte Items: Changes in Kilocalories and Macronutrients Purchased by Middle School Students

    Science.gov (United States)

    We assessed the impact of a pilot middle school a la carte intervention on food and beverage purchases, kilocalories, fat, carbohydrate, and protein sold per student, and nutrient density of the foods sold. A la carte sales were obtained from six middle schools in three states for 1 baseline week an...

  11. Tendência da mortalidade perinatal em Belo Horizonte, 1984 a 2005 Tendencia de la mortalidad perinatal en Belo Horizonte, 1984 a 2005 Tendency of perinatal mortality in Belo Horizonte, 1984 to 2005

    Directory of Open Access Journals (Sweden)

    Eunice Francisca Martins

    2010-06-01

    Full Text Available O estudo objetivou analisar a tendência da mortalidade perinatal no município de Belo Horizonte no período de 1984 a 2005. A fonte dos dados foi o Sistema de Informação de Mortalidade (SIM. Realizou-se regressão linear simples para estimar a tendência de redução do percentual de informações ignoradas no SIM e das taxas de mortalidade. A melhora da qualidade da informação foi estatisticamente significativa apenas para a escolaridade materna e peso ao nascer. A redução média da mortalidade perinatal no período foi de 57,52%. O decréscimo da mortalidade perinatal nas duas últimas décadas em Belo Horizonte foi significativo, mas esforços devem ser direcionados no sentido de melhorar a completude do SIM para variáveis importantes na elaboração dos indicadores perinatais.El estudio apuntó a analizar la tendencia de la mortalidad perinatal en el distrito municipal de Belo Horizonte en el periodo de 1984 a 2005. La fuente de los datos era el Sistema de Información de Mortalidad. Tuvieron lugar la regresión lineal simple para estimar la tendencia de reducción del percentil de información desconocida en el sistema y de los impuestos de mortalidad. La mejora de la calidad de la información fue los significantes sólo para la educación maternal y peso al nacer. La reducción elemento de la mortalidad perinatal en el periodo era de 57,52%. La disminución de la mortalidad perinatal en las últimas dos décadas en Belo Horizonte era significante, pero deben dirigirse los esfuerzos en el sentido de mejorar el completude del sistema para las variables importantes en la elaboración del perinatais de los indicadores.The study aimed at to analyze the tendency of the mortality perinatal in the municipal district of Belo Horizonte in the period from 1984 to 2005. The source of the data was the System of Information of Mortality. Took place simple lineal regression to esteem the tendency of reduction of the percentile of unknown

  12. Morbi-mortalidad de la endarterectomía carotídea

    Directory of Open Access Journals (Sweden)

    Virginia A. Pujol Lereis

    2011-10-01

    Full Text Available La endarterectomía carotídea (EC en adición al mejor tratamiento médico mostró reducción del riesgo de eventos cerebrovasculares en pacientes sintomáticos y asintomáticos con estenosis moderada-grave del vaso en ensayos clínicos en centros académicos con cirujanos altamente seleccionados. Las principales guías internacionales recomiendan que el procedimiento se realice en centros con morbi-mortalidad auditada menor al 6% para pacientes sintomáticos y 3% para asintomáticos. Evaluamos la morbi-mortalidad peri-procedimiento en nuestro centro. Esta fue definida como la presencia de accidente cerebrovascular, infarto de miocardio y/o muerte dentro de los 30 días de la cirugía. Se indicó el procedimiento en pacientes sintomáticos con estenosis > 50%. En pacientes asintomáticos o sintomáticos con estenosis ≤ 50% se decidió el tratamiento sobre una base caso por caso. Todos los pacientes fueron examinados por un neurólogo y un cardiólogo antes y después de la EC. Se utilizó en forma rutinaria monitoreo intraoperatorio con Doppler transcraneano en los pacientes con adecuada ventana ultrasónica. Se evaluaron 306 endarterectomías carotídeas. No se registraron muertes. La morbilidad perioperatoria fue de 2.6% tanto para individuos sintomáticos como asintomáticos. Estos índices se compararon favorablemente con informes de otros centros de Latinoamérica y Europa. En conclusión, este informe muestra que la EC puede realizarse en la práctica clínica cotidiana con morbi-mortalidad peri-procedimiento dentro de los niveles recomendados por las guías internacionales.

  13. La mortalidad infantil, indicador de excelencia Infant mortality, an indicator of excellence

    Directory of Open Access Journals (Sweden)

    Yurima Díaz Elejalde

    2008-06-01

    Full Text Available La mortalidad infantil es un indicador de gran importancia para el Sistema Nacional de Salud cubano y a nivel mundial. Es utilizado para evaluar el estado de salud de la población, por lo que se realizó un estudio descriptivo, retrospectivo y longitudinal con el objetivo de caracterizar el comportamiento de la mortalidad infantil en el municipio de Guanabacoa, desde el 1º de enero de 2000 al 30 de junio de 2005. Se estudió una muestra de 48 defunciones a través de variables maternas y del recién nacido, con la información obtenida de los registros médicos e historias clínicas. Se encontró que la tasa de mortalidad infantil de nuestro municipio, fundamentalmente en los 4 años iniciales, es irregular con tendencia decreciente, siendo las principales causas de muerte las infecciones (37,5 %, la sepsis (14,5 %, la asfixia (10,4 % y las malformaciones congénitas (10,4 %. Las variables maternas afectadas fueron los factores de riesgo en el embarazo: bajo peso materno, la moniliasis vaginal y la anemia ferropénica ; y en el recién nacido, el componente neonatal precoz y el sexo masculino.Infant mortality is an indicator of great importance for the Cuban National Health System and for the world. It is used to evaluate the health status of the population. A descriptive, retrospective and longitudinal study was conducted aimed at characterizing the behavior of infant mortality in the municipality of Guanabacoa from January 1st, 2000 to June 30th, 2005. A sample of 48 deaths was studied through variables of the mother and the newborn obtained from the medical registries and histories. It was found that infant mortality rate in our municipality, mainly in the 4 initial years is irregular with a decreasing trend. The main causes of death are infections (37.5 %, sepsis (14.5 %, asphyxia (10.4 % and congenital malformations (10.4 %. The affected maternal variables were the risk factors during pregnancy: maternal low weight, vaginal moniliasis

  14. Mortalidad y reintervenciones en cirugía general Mortality and reoperations in general surgery

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    Zenén Rodríguez Fernández

    2012-11-01

    Full Text Available Introducción: A pesar de que el gran avance tecnológico actual en los métodos diagnósticos y terapéuticos ha permitido que los pacientes con complicaciones posquirúrgicas sean reintervenidos con mayor seguridad, la morbilidad y la mortalidad a causa de estas continúan elevadas. Métodos: Se efectuó un estudio observacional y descriptivo de 42 fallecidos que habían sido reintervenidos en el Servicio de Cirugía General del Hospital Provincial Docente "Saturnino Lora" de Santiago de Cuba, durante el quinquenio 2007-2011. Objetivo: Caracterizar a dichos pacientes según variables seleccionadas e identificar la mortalidad y sus causas. Resultados: El mayor número de fallecimientos se relacionó con la realización de varias reintervenciones después de 10 días de la operación inicial en pacientes de edades avanzadas. Las principales complicaciones que las motivaron fueron: absceso intraabdominal, evisceración, peritonitis residual y dehiscencia de suturas intestinales. Esta serie representó 24,5% del total de reintervenidos y preponderó en los diagnósticos operatorios iniciales: neoplasia de colon, úlcera gastroduodenal complicada y oclusión intestinal. Conclusiones: La edad, el número de reintervenciones, así como el tiempo entre la cirugía inicial y la reintervención elevan el índice de mortalidad, asociada a fallos multiorgánicos.Introduction: Although the current technological breakthrough in diagnostic and therapeutic methods has allowed patients with postoperative complications are more safely reoperated, morbidity and mortality because of these complications are still high. Methods: An observational and descriptive study in 42 dead patients was carried out who had been reoperated at the General Surgery Department of "Saturnino Lora" Provincial Teaching Hospital in Santiago de Cuba during the period 2007-2011. Objective: To characterize these patients according to selected variables and identify mortality and its causes

  15. Mortalidad infantil por defectos congénitos en Costa Rica, 1981-2010

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    María de la Paz Barboza-Arguello

    2013-11-01

    Full Text Available OBJETIVO: Identificar las tendencias y el impacto de los diferentes tipos de defectos congénitos (DC en la tasa de mortalidad infantil (TMI y neonatal (TMN en Costa Rica para el período 1981-2010. MÉTODOS: Se analizaron datos del Centro Centroamericano de Población, que utiliza las versiones 9 y 10 de la Clasificación Internacional de Enfermedades para clasificar las causas de defunción. Se analizaron tendencias de mortalidad infantil, neonatal y residual. Para cada grupo de DC se construyó un modelo de regresión Poisson Log Lineal. Se obtuvieron las TMI y las TMN y los riesgos relativos correspondientes a las tres décadas 1981-1990, 1991-2000 y 2001-2010, con sus intervalos de confianza de 95% (IC95%. Los estimados se compararon mediante chi cuadrado de Wald. RESULTADOS: Al comparar la década de 1980 con la del 2000, la TMN y la TMI por DC presentó una disminución significativa de 2,37 (IC95%: 2,26-2,48 a 2,13 (2,03-2,23 y de 4,13 (3,99-4,27 a 3,18 (3,05-3,31, respectivamente. Los grupos de DC que registraron una reducción significativa en la TMI fueron: sistema nervioso, digestivo y circulatorio. Con excepción del sistema circulatorio, estos grupos experimentaron una caída significativa en la TMN. En el resto de los grupos se registró un aumento significativo o no hubo cambio. CONCLUSIONES: Se ha producido una disminución de la TMI y la TMN por DC, aunque proporcionalmente estas tasas han crecido debido a un mayor descenso de las otras causas. Esta reducción es mucho menor en la mortalidad neonatal. Se debe fortalecer la prevención primaria y la atención neonatal de los DC.

  16. Envejecimiento poblacional y desigualdades sociales en la mortalidad del adulto mayor en Colombia

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    Juan Carlos Rivillas

    2017-09-01

    Full Text Available Objetivo: analizar la magnitud del envejecimiento poblacional y las desigualdades sociales presentes en la mortalidad del adulto mayor en Colombia. Metodología: estudio ecológico usando datos sub-nacionales de mortalidad, pobreza, barreras de acceso a los servicios de salud y analfabetismo, y de la población adulta mayor para analizar brechas. Se calcularon y compararon tendencias de tres indicadores de impacto: la esperanza de vida (2005-2020, los Índices de envejecimiento y sobre-envejecimiento (2005-2012. Se estimaron tres medidas para resumir la desigualdad absoluta y relativa: el Índice de Desigualdad de la Pendiente (IDP, el Índice Relativo de Desigualdad (IRD de Kunst y Mackenbach, y el Índice de Concentración (IC. Resultados: la proporción de personas mayores será cada vez mayor en Colombia. Las barreras de acceso a los servicios de salud fue la dimensión más inequitativa. Dos patrones de desigualdad fueron identificados: una exclusión marginal en el 60% de los adultos mayores con más ventajas y oportunidades, y un patrón de gradiente lineal presente solo en la incidencia de pobreza. El quintil 3 fue el grupo de departamentos más afectado por la inequidad a lo largo de las dimensiones evaluadas. Discusión: este estudio aporta evidencia sobre patrones de desigualdad en la mortalidad del adulto mayor. A nivel de tendencias, solo fue posible conocer que la brecha ha empeorado en incidencia de pobreza. Conclusiones: las recomendaciones se centran en cinco áreas de acción, para lograr un contexto deseable para el abordaje del envejecimiento poblacional y la reducción de las desigualdades, como desafíos del sistema de salud y de protección social, y que pueden socavar la realización progresiva de la cobertura universal en salud y el logro de los objetivos de desarrollo sostenible para 2030.

  17. EVOLUCIÓN DE LA MORTALIDAD ATRIBUIBLE AL TABACO EN LAS ISLAS CANARIAS (1975-1994

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    Luis M Bello Luján

    2001-01-01

    Full Text Available Fundamento: El objetivo de este trabajo es describir la mortalidad atribuible al consumo de tabaco en las Islas Canarias durante el período 1975-1994. Método: Las defunciones por edad, sexo y causa desde 1975 a 1994 se obtuvieron del Instituto Nacional de Estadística (Movimiento Natural Población. A partir de las Encuestas de Salud de España y Canarias se tomaron los porcentajes de nunca fumadores, fumadores y ex-fumadores de la población canaria por edad y sexo. Los riesgos relativos de muerte se obtuvieron del Cancer Prevention Study II, llevado a cabo en Estados Unidos de América. Se calculó la proporción de muertes atribuibles al tabaco para cada año, sexo y grupo de edad a partir de la fracción atribuible poblacional. Así mismo, se calculó la tendencia de la mortalidad atribuible para dicho período expresada como el cambio porcentual medio anual de las tasas de la mortalidad ajustadas por edad, mediante un modelo log-lineal. Resultados: Durante el período 1975-1994, el número de fallecimientos atribuidos al tabaco aumentó un 64%. Por grandes causas, se observó en el período de estudio, un aumento de las neoplasias del 108%, una disminución de las enfermedades cardiovasculares del 32% y un incremento de las enfermedades respiratorias del 15,5%. Se observó también que el número de fallecidos aumenta con la edad, siendo el grupo de edad de 65 años y más en el que se presentan más muertes por el tabaco. Conclusiones: En las Islas Canarias, más del 20% de todas las muertes en 1994 se pueden atribuir al tabaco. Esto sugiere que las medidas introducidas para controlar el tabaquismo son insuficientes.

  18. Classification and regression tree (CART model to predict pulmonary tuberculosis in hospitalized patients

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    Aguiar Fabio S

    2012-08-01

    Full Text Available Abstract Background Tuberculosis (TB remains a public health issue worldwide. The lack of specific clinical symptoms to diagnose TB makes the correct decision to admit patients to respiratory isolation a difficult task for the clinician. Isolation of patients without the disease is common and increases health costs. Decision models for the diagnosis of TB in patients attending hospitals can increase the quality of care and decrease costs, without the risk of hospital transmission. We present a predictive model for predicting pulmonary TB in hospitalized patients in a high prevalence area in order to contribute to a more rational use of isolation rooms without increasing the risk of transmission. Methods Cross sectional study of patients admitted to CFFH from March 2003 to December 2004. A classification and regression tree (CART model was generated and validated. The area under the ROC curve (AUC, sensitivity, specificity, positive and negative predictive values were used to evaluate the performance of model. Validation of the model was performed with a different sample of patients admitted to the same hospital from January to December 2005. Results We studied 290 patients admitted with clinical suspicion of TB. Diagnosis was confirmed in 26.5% of them. Pulmonary TB was present in 83.7% of the patients with TB (62.3% with positive sputum smear and HIV/AIDS was present in 56.9% of patients. The validated CART model showed sensitivity, specificity, positive predictive value and negative predictive value of 60.00%, 76.16%, 33.33%, and 90.55%, respectively. The AUC was 79.70%. Conclusions The CART model developed for these hospitalized patients with clinical suspicion of TB had fair to good predictive performance for pulmonary TB. The most important variable for prediction of TB diagnosis was chest radiograph results. Prospective validation is still necessary, but our model offer an alternative for decision making in whether to isolate patients with

  19. Prevalencia de infecciones hospitalarias en unidades de cuidados intensivos para adultos en Argentina Prevalence of hospital infections in adult intensive care units in Argentina

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    Guillermo R. Lossa

    2008-11-01

    Full Text Available OBJETIVOS: Presentar resultados consolidados de dos encuestas de prevalencia de infecciones nosocomiales, realizadas en el marco del Programa Nacional de Vigilancia de Infecciones Hospitalarias de Argentina. MÉTODOS: Se realizaron dos ediciones de la Encuesta Nacional de Prevalencia de Infecciones Hospitalarias de Argentina, en 2004 y 2005. De 68 hospitales, 53 notificaron datos de unidades de cuidados intensivos de adultos polivalente (26 en 2004 y 27 en 2005, con un total de 359 pacientes (158 en 2004 y 201 en 2005. La encuesta se diseñó como un estudio multicéntrico, observacional, transversal y descriptivo. El análisis de los datos se realizó utilizando distintos paquetes estadísticos, con variables y tiempos unificados y estandarizados para permitir la incorporación de los hospitales de ambos períodos. RESULTADOS: La prevalencia de pacientes con infección hospitalaria fue de 24%. Sobre 127 episodios, el más frecuente fue la neumonía (43,3%, que en 85% de los casos se asoció a asistencia respiratoria mecánica. En segundo lugar, se encontró la infección primaria de la sangre con 20,5%; en 61% de los casos se la asoció a catéter central. Los pacientes expuestos a asistencia respiratoria mecánica presentaron mayor riesgo (P OBJECTIVES: To present consolidated results from two surveys of nosocomial infection incidence, within the framework of Argentina's National Surveillance of Hospital Infections Program. METHODS: Two editions of the National Survey on the Incidence of Hospital Infections in Argentina were used, those of 2004 and 2005. Of the 68 hospitals, 53 reported data from adult intensive care units (in 2004, 26 units; in 2005, 27, for a total of 359 patients (in 2004, 158 patients; in 2005, 201. The survey was designed as a multicenter, observational, cross-sectional, and descriptive study. Data analysis was performed with several statistics programs, combining and standardizing variables and both time periods in order

  20. Factores asociados a la mortalidad global en los pacientes diagnosticados de enfermedad pulmonar obstructiva crónica

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    Josep Montserrat-Capdevila

    2015-10-01

    Conclusiones: La aplicación de estas variables, fáciles y factibles de recoger en la práctica clínica, permitiría identificar a aquellos pacientes con mayor riesgo de mortalidad y que podrían beneficiarse de estrategias preventivas/terapéuticas para conseguir aumentar la supervivencia.

  1. Mortalidade de adolescentes em área urbana da região Sudeste do Brasil, 1984-1993

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    Lyra Sílvia M. Kawata

    1996-01-01

    Full Text Available Analisa-se a mortalidade de adolescentes no Município de Botucatu, Estado de São Paulo, Brasil, no período de 1984 a 1993, segundo dois subgrupos (10 a 14 e 15 a 19 anos, sexo, ocupação e causas de óbito. Os dados de óbitos foram obtidos no Setor de Estatística do Centro de Saúde-Escola. As estimativas populacionais foram calculadas com base nos censos demográficos. Observou-se variação dos coeficientes de mortalidade nos diferentes anos e maior mortalidade no grupo masculino de 15 a 19 anos, atingindo tanto estudantes como trabalhadores. Houve predomínio de causas externas de mortalidade, principalmente acidentes de trânsito e ferimento por arma de fogo, exigindo averigüação de seus determinantes e o desenvolvimento de programas de saúde destinados aos adolescentes, suas famílias e à sociedade, considerando-se que as causas de morte são evitáveis e preveníveis.

  2. Comorbilidad como predictor de utilización de servicios sanitarios y mortalidad en pacientes con diabetes

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    Patricia Carrera-Lasfuentes

    2015-01-01

    Conclusiones: El sistema ACG permite predecir el consumo de recursos y la mortalidad de este colectivo en nuestro medio. Este estudio confirma la importante carga asistencial que generan los enfermos de diabetes mellitus y subraya la necesidad de tomar medidas al respecto.

  3. Feeding-related effects of cart (cocaine and amphetamine regulated transcript) peptides and cholecystokinin in mouse obese models

    Czech Academy of Sciences Publication Activity Database

    Maletínská, Lenka; Maixnerová, Jana; Toma, Resha Shamas; Haugvicová, Renata; Slaninová, Jiřina; Železná, Blanka

    2006-01-01

    Roč. 12, Supplement (2006), s. 178 ISSN 1075-2617. [European Peptide Symposium /29./. 03.09.2006-08.09.2006, Gdansk] Institutional research plan: CEZ:AV0Z40550506 Keywords : CART peptides * food intake * mouse obesity * CCK Subject RIV: CC - Organic Chemistry

  4. Structure-activity relationship of cocaine- and amphetamine-regulated transcript (CART) by peptide analogs: Importance of disulfide bridges

    Czech Academy of Sciences Publication Activity Database

    Blechová, Miroslava; Nagelová, Veronika; Demianova, Zuzana; Železná, Blanka; Maletínská, Lenka

    2012-01-01

    Roč. 18, S1 (2012), S89-S90 ISSN 1075-2617. [European Peptide Symposium /32./. 02.09.2012-07.09.2012, Athens] Institutional research plan: CEZ:AV0Z40550506 Keywords : CART * neuropeptides * cell line PC12 * anorexigenic effect Subject RIV: CE - Biochemistry

  5. Turning a Common Lab Exercise into a Challenging Lab Experiment: Revisiting the Cart on an Inclined Track

    Science.gov (United States)

    Amato, Joseph C.; Williams, Roger E.

    2010-01-01

    A common lab exercise in the introductory college physics course employs a low-friction cart and associated track to study the validity of Newton's second law. Yet for college students, especially those who have already encountered a good high school physics course, the exercise must seem a little pointless. These students have already learned to…

  6. Genetic Regulation of Hypothalamic Cocaine and Amphetamine-Regulated Transcript (CART) in BxD Inbred Mice

    Science.gov (United States)

    Hawks, Brian W.; Li, Wei; Garlow, Steven J.

    2009-01-01

    Cocaine-Amphetamine Regulated Transcript (CART) peptides are implicated in a wide range of behaviors including in the reinforcing properties of psychostimulants, feeding and energy balance and stress and anxiety responses. We conducted a complex trait analysis to examine natural variation in the regulation of CART transcript abundance (CARTta) in the hypothalamus. CART transcript abundance was measured in total hypothalamic RNA from 26 BxD recombinant inbred (RI) mouse strains and in the C57BL/6 (B6) and DBA/2J (D2) progenitor strains. The strain distribution pattern for CARTta was continuous across the RI panel, which is consistent with this being a quantitative trait. Marker regression and interval mapping revealed significant quantitative trait loci (QTL) on mouse chromosome 4 (around 58.2cM) and chromosome 11 (between 20–36cM) that influence CARTta and account for 31% of the between strain variance in this phenotype. There are numerous candidate genes and QTL in these chromosomal regions that may indicate shared genetic regulation between CART expression and other neurobiological processes referable to known actions of this neuropeptide. PMID:18199428

  7. An "off-the-shelf" fratricide-resistant CAR-T for the treatment of T cell hematologic malignancies.

    Science.gov (United States)

    Cooper, Matthew L; Choi, Jaebok; Staser, Karl; Ritchey, Julie K; Devenport, Jessica M; Eckardt, Kayla; Rettig, Michael P; Wang, Bing; Eissenberg, Linda G; Ghobadi, Armin; Gehrs, Leah N; Prior, Julie L; Achilefu, Samuel; Miller, Christopher A; Fronick, Catrina C; O'Neal, Julie; Gao, Feng; Weinstock, David M; Gutierrez, Alejandro; Fulton, Robert S; DiPersio, John F

    2018-02-20

    T cell malignancies represent a group of hematologic cancers with high rates of relapse and mortality in patients for whom no effective targeted therapies exist. The shared expression of target antigens between chimeric antigen receptor (CAR) T cells and malignant T cells has limited the development of CAR-T because of unintended CAR-T fratricide and an inability to harvest sufficient autologous T cells. Here, we describe a fratricide-resistant "off-the-shelf" CAR-T (or UCART7) that targets CD7+ T cell malignancies and, through CRISPR/Cas9 gene editing, lacks both CD7 and T cell receptor alpha chain (TRAC) expression. UCART7 demonstrates efficacy against human T cell acute lymphoblastic leukemia (T-ALL) cell lines and primary T-ALL in vitro and in vivo without the induction of xenogeneic GvHD. Fratricide-resistant, allo-tolerant "off-the-shelf" CAR-T represents a strategy for treatment of relapsed and refractory T-ALL and non-Hodgkin's T cell lymphoma without a requirement for autologous T cells.

  8. Resting-state subcortical functional connectivity in HIV-infected patients on long-term cART

    NARCIS (Netherlands)

    Janssen, M.A.M.; Hinne, M.; Janssen, R.J.; Gerven, M.A.J. van; Steens, S.C.; Góraj, B.M.; Koopmans, P.P.; Kessels, R.P.C.

    2017-01-01

    Despite long-term successful treatment with cART, impairments in cognitive functioning are still being reported in HIV-infected patients. Since changes in cognitive function may be preceded by subtle changes in brain function, neuroimaging techniques, such as resting-state functional magnetic

  9. Synergistic effect of CART (cocaine- and amphetamine-regulated transcript) peptide and cholecystokinin on food intake regulation in lean mice

    Czech Academy of Sciences Publication Activity Database

    Maletínská, Lenka; Maixnerová, Jana; Matyšková, Resha; Haugvicová, Renata; Pirnik, Z.; Kiss, A.; Železná, Blanka

    2008-01-01

    Roč. 9, č. 101 (2008), s. 1-10 ISSN 1471-2202 R&D Projects: GA ČR GA303/05/0614 Institutional research plan: CEZ:AV0Z40550506; CEZ:AV0Z50200510 Keywords : mice * food intake * CART peptide Subject RIV: CE - Biochemistry Impact factor: 2.850, year: 2008

  10. Wagging the Dog, Carting the Horse: Testing and Improving Schools. Summary of Conference Proceedings. Research into Practice Project.

    Science.gov (United States)

    Herman, Joan; And Others

    The purpose of the conference, "Wagging the Dog, Carting the Horse: Testing vs. Improving California Schools," was to discuss alternative perspectives on testing and evaluation in education and their role in improving teaching and learning. Four papers were presented: (1) "Using Educational Evaluation for the Improvement of California Schools," by…

  11. Tendencia de la tasa de mortalidad en una prisión española (1994-2004

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    Enrique Jesús Vera Remartínez

    2005-01-01

    Full Text Available Fundamento: Hay pocos trabajos sobre mortalidad en el ámbito penitenciario. El objetivo es describir las causas, tasas de mortalidad y su tendencia en una prisión española. Métodos: Estudio descriptivo, de los fallecimientos en una prisión entre 01-01-1994 y 31-12-2004. Se recogieron las variables edad, sexo, fecha del óbito, serología VIH, número de CD4+ en su caso, y causa de muerte según la clasificación: muerte por VIH, por enfermedad no VIH, suicidio, intoxicación por drogas, y accidentes. Previa estandarización indirecta de tasas, comparamos la mortalidad del Centro con la del resto de las prisiones españolas. Establecimos la tendencia de las tasas de mortalidad mediante un modelo de regresión lineal. Resultados: 42 muertes, 41 hombres, 1 mujer. Mediana de edad de 33,10 años (27,72 - 36,12; IQR: 8,40. 30 (71,4% VIH+, con mediana de 177 linfocitos CD4+/µl 20 pacientes (45,24% fallecieron por VIH, 15 (38,10% por enfermedades no VIH, 3 (7,14% suicidios, 3 (7,14% intoxicaciones por drogas y 1 (2,38% accidentalmente. Las tasas crudas de mortalidad estuvieron entre 12,605‰ internos/año en 1997 y 1,758‰ internos/año en 2003, con tendencia descendente a razón de 0,976 muertes‰ internos/año (IC95%: 0,399-1,552; p=0,004. Estandarizando tasas nos corresponderían 28,6 muertes esperadas en el período, con una SMR de 1,4679. Conclusiones: Aunque la tendencia es descendente, la tasa de mortalidad obtenida en el período estudiado fue mayor que la esperada. La principal causa de mortalidad fue el síndrome de inmunodeficiencia adquirida.

  12. O escore de risco de sangramento como preditor de mortalidade em pacientes com síndromes coronarianas agudas

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    José Carlos Nicolau

    2013-12-01

    Full Text Available FUNDAMENTO: A ocorrência de sangramento aumenta a mortalidade intra-hospitalar em pacientes com síndromes coronarianas agudas (SCAs, e há uma boa correlação entre os escores de risco de sangramento e a incidência de eventos hemorrágicos. No entanto, o papel dos escores de risco de sangramento como fatores preditivos de mortalidade é pouco estudado. OBJETIVO: Analisar o papel do escore de risco de sangramento como fator preditivo de mortalidade intra-hospitalar numa coorte de pacientes com SCA tratados num centro terciário de cardiologia. MÉTODOS: Dos 1.655 pacientes com SCA (547 com SCA com supra de ST e 1.118 com SCA sem supra de ST, calculou-se o escore de risco de sangramento ACUITY/HORIZONS prospectivamente em 249 pacientes e retrospectivamente nos demais 1.416. Informações sobre mortalidade e complicações hemorrágicas também foram obtidas. RESULTADOS: A idade média da população estudada foi 64,3 ± 12,6 anos e o escore de risco de sangramento médio foi 18 ± 7,7. A correlação entre sangramento e mortalidade foi altamente significativa (p < 0,001; OR = 5,29, assim como a correlação entre escore de sangramento e hemorragia intra-hospitalar (p < 0,001; OR = 1,058, e entre escore de sangramento e mortalidade intra-hospitalar (OR ajustado = 1,121, p < 0,001, área sob a curva ROC 0,753; p < 0,001. O OR ajustado e a área sob a curva ROC para a população com SCA com supra de ST foram 1,046 (p = 0,046 e 0,686 ± 0,040 (p < 0,001, respectivamente, e para SCA sem supra de ST foram 1,150 (p < 0,001 e 0,769 ± 0,036 (p < 0,001, respectivamente. CONCLUSÃO: O escore de risco de sangramento é um fator preditivo muito útil e altamente confiável para mortalidade intra-hospitalar em uma grande variedade de pacientes com SCAs, especialmente aqueles com angina instável ou infarto agudo do miocárdio sem supra de ST.

  13. The Effects of Direction of Exertion, Path, and Load Placement in Nursing Cart Pushing and Pulling Tasks: An Electromyographical Study.

    Science.gov (United States)

    Kao, Huei Chu; Lin, Chiuhsiang Joe; Lee, Yung Hui; Chen, Su Huang

    2015-01-01

    The purpose of this study was to explore the effects of direction of exertion (DOE) (pushing, pulling), path (walking in a straight line, turning left, walking uphill), and load placement (LP) (the 18 blocks were indicated by X, Y and Z axis; there were 3 levels on the X axis, 2 levels on the Y axis, and 3 levels on the Z axis) on muscle activity and ratings of perceived exertion in nursing cart pushing and pulling tasks. Ten participants who were female students and not experienced nurses were recruited to participate in the experiment. Each participant performed 108 experimental trials in the study, consisting of 2 directions of exertion (push and pull), 3 paths, and 18 load placements (indicated by X, Y and Z axes). A 23kg load was placed into one load placement. The dependent variables were electromyographic (EMG) data of four muscles collected bilaterally as follows: Left (L) and right (R) trapezius (TR), flexor digitorum superficialis (FDS), extensor digitorum (ED), and erector spinae (ES) and subjective ratings of perceived exertion (RPE). Split-split-plot ANOVA was conducted to analyze significant differences between DOE, path, and LP in the EMG and RPE data. Pulling cart tasks produced a significantly higher activation of the muscles (RTR:54.4%, LTR:50.3%, LFDS:57.0%, LED:63.4%, RES:40.7%, LES:36.7%) than pushing cart tasks (RTR:42.4%, LTR:35.1%, LFDS:32.3%, LED:55.1%, RES:33.3%, LES:32.1%). A significantly greater perceived exertion was found in pulling cart tasks than pushing cart tasks. Significantly higher activation of all muscles and perceived exertion were observed for walking uphill than walking in a straight line and turning left. Significantly lower muscle activity of all muscles and subject ratings were observed for the central position on the X axis, the bottom position on the Y axis, and the posterior position on the Z axis. These findings suggest that nursing staff should adopt forward pushing when moving a nursing cart, instead of backward

  14. Conocimientos y actitudes de los médicos de instituciones hospitalarias en Barranquillla sobre donación y trasplante de órganos

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    Rafael Tuesca . M

    2003-01-01

    Full Text Available Objetivo: Identificar las actitudes y evaluar el conocimiento sobre donación y trasplante de órganos en médicos de instituciones hospitalarias en Barranquilla (Colombia. Métodos: Se diseñó un estudio observacional transversal. Muestra aleatoria estratificada de 305 médicos generales (MG y especialistas de instituciones hospitalarias de Barranquilla. Información de tipo primario, mediante encuestas autodiligenciadas. El cuestionario adaptado de Blanca, De Frutos y Rosel consta de 29 preguntas, divididas en tres capítulos. El primer capítulo: identificación personal (6 ítems; el segundo midió el conocimiento sobre donación y trasplante mediante preguntas de selección múltiple (11 ítems; y el tercero evaluó las actitudes con escala tipo likert (12 ítems. Se contó con el apoyo de los centros hospitalarios. Resultados: Se evaluaron 274 médicos (104 MG que presentaron una media de 48.7 años y desviación estándar de 6.37. La razón de médicos especialistas por médico general fue de 1.6:1. Con respectoalconocimientoteórico,seencontróun50.73%defrecuenciamodal derespuestasregulares y el 41.24% en el rango bueno. Al comparar el conocimiento con el área de trabajo se encontró una diferencia significativa respecto al grado de conocimiento entre médicos generales y especialistas, siendo (OR=2.37IC95%1.42–3.93.Losmédicosdesconocenelmarcolegalqueregulaladonación ytrasplantedeórganos.El72.3%delosencuestadosdesconocelaexistenciadelprogramadedonación y trasplante de órganos en Barranquilla. El 35% manifiestó que se actualiza al consultar libros o revistas especializadas. En cuanto al conocimiento general, existe diferencia significativa entre los médicos generales y especialistas, lo cual arrojó una prueba Z de diferencia de proporciones de 3.91 para una p= 0.00007. Conclusiones:Losinvestigadoressugierenentreotrosaspectos:promocionarydifundirlosprogramas de trasplante y donación de órganos para el público en general y

  15. CARACTERÍSTICAS DE LAS URGENCIAS HOSPITALARIAS DEL SERVICIO ANDALUZ DE SALUD DURANTE 2012 A PARTIR DEL CONJUNTO MÍNIMO BÁSICO DE DATOS DE URGENCIAS

    Directory of Open Access Journals (Sweden)

    Juan Antonio Goicoechea Salazar

    2013-01-01

    Full Text Available Fundamentos: La implantación de Diraya-Urgencias en los hospitales del Servicio Andaluz de Salud (SAS y el desarrollo de un codificador automático propio ha permitido instaurar el Conjunto Mínimo Básico de Datos de Urgencias (CMBD-U. El objetivo de este artículo es describir la casuística de los servicios de urgencias hospitalarios utilizando las distintas dimensiones contenidas en el CMBD-U. Métodos: Utilizando el CMBD-U, se clasificaron 3.235.600 registros de urgencias hospitalarias de 2012 en categorías clínicas mediante el código CIE-9-MC proporcionado por el codificador automático. Se definieron reglas de validez para la explotación de los tiempos. Se realizó un análisis descriptivo obteniendo indicadores demográficos, cronológicos, tasas de hospitalización, retorno y exitus y tiempos asistenciales y de permanencia en urgencias. Resultados: Las mujeres generaron el 54,26% de las urgencias. Su edad media (39,98 años superó a la de los hombres (37,61. El 21,49% fueron urgencias pediátricas. La máxima afluencia horaria fue de 10:00 a 13:00 y de 16:00 a 17:00. Los pacientes que no pasaron por observación (92,67% permanecieron en urgencias 153 minutos de media. Más del 50% de las urgencias fueron generadas por lesiones e intoxicaciones, enfermedades respiratorias, osteomusculares y síntomas y signos. Entre los procesos asistenciales integrados se identificaron 79.191 casos de dolor torácico, 28.741 de insuficiencia cardiaca y 27.989 infecciones graves. Conclusiones: El CMBD-U permite analizar sistemáticamente las urgencias hospitalarias identificando la actividad desarrollada, la casuística atendida, los tiempos de respuesta asistencial y permanencia en urgencias y la calidad asistencial.

  16. Uma avaliação do Sistema de Informações sobre Mortalidade

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    Rinaldo Macedo de Morais

    Full Text Available RESUMO O artigo avalia indicadores de qualidade do Sistema de Informações sobre Mortalidade (SIM com profissionais e gestores. Cada indicador foi analisado com uso de oscilador estocástico para avaliação qualitativa de escalas Likert. A avaliação indicou que o SIM possui funcionalidades que atendem os usuários, é efetivo à gestão, apresenta desempenho adequado, possibilita auditoria e rastreamento de acessos e operações, possui mecanismos que garantem a recuperação de dados em situações de falhas e possui uma interface robusta. Os indicadores de interoperabilidade foram mal avaliados, confirmando relatos sobre falta de integração, fragmentação e duplicidade de informações nos sistemas de informação de saúde do Sistema Único de Saúde.

  17. Médicos de la familia ante los traumatismos del sistema nervioso: Pueden disminuir la mortalidad?

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    Ramiro Pereira Riverón

    1998-10-01

    Full Text Available La mortalidad y las secuelas permanentes de los pacientes con traumatismos craneoencefálicos o raquimedulares graves, pueden disminuir por acciones de los médicos generales integrales y otros miembros de las áreas de salud. Aparte del esencial trabajo de prevención de accidentes, impedir o tratar rápidamente la hipoxia y la hipotensión arterial postraumática son factores decisivosThe mortality and permanent sequelae of patients suffering from severe head or spinal cord injuries may be reduced by the actions of the specialists in general comprehensive medicine and other members of the health area. Besides the essential work carried out to avoid accidents, to prevent or treat the posttraumatic hypoxia and arterial hypertension quickly are also decisive factors

  18. Feeding a sustainable chemical industry: do we have the bioproducts cart before the feedstocks horse?

    Science.gov (United States)

    Dale, Bruce E

    2017-09-21

    A sustainable chemical industry cannot exist at scale without both sustainable feedstocks and feedstock supply chains to provide the raw materials. However, most current research focus is on producing the sustainable chemicals and materials. Little attention is given to how and by whom sustainable feedstocks will be supplied. In effect, we have put the bioproducts cart before the sustainable feedstocks horse. For example, bulky, unstable, non-commodity feedstocks such as crop residues probably cannot supply a large-scale sustainable industry. Likewise, those who manage land to produce feedstocks must benefit significantly from feedstock production, otherwise they will not participate in this industry and it will never grow. However, given real markets that properly reward farmers, demand for sustainable bioproducts and bioenergy can drive the adoption of more sustainable agricultural and forestry practices, providing many societal "win-win" opportunities. Three case studies are presented to show how this "win-win" process might unfold.

  19. Food Environment in Secondary Schools: À La Carte, Vending Machines, and Food Policies and Practices

    Science.gov (United States)

    French, Simone A.; Story, Mary; Fulkerson, Jayne A.; Gerlach, Anne Faricy

    2003-01-01

    Objectives. This study described the food environment in 20 Minnesota secondary schools. Methods. Data were collected on school food policies and the availability and nutritional content of foods in school à la carte (ALC) areas and vending machines (VMs). Results. Approximately 36% and 35% of foods in ALC areas and in VMs, respectively, met the lower-fat criterion (≤ 5.5 fat grams/serving). The chips/crackers category constituted the largest share of ALC foods (11.5%). The median number of VMs per school was 12 (4 soft drink, 2 snack, 5 other). Few school food policies were reported. Conclusions. The availability of healthful foods and beverages in schools as well as school food policies that foster healthful food choices among students needs greater attention. PMID:12835203

  20. The Impact of Groupement des Cartes Bancaires on Competition Law Enforcement

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    Piero Fattori

    2015-10-01

    Full Text Available The Groupement des Cartes bancaires represents a key judgment for competition enforcement, as it provides helpful clarification on the notion of “restriction by object” and on the judicial standard of review of Commission decisions. As of the first aspect, the ruling limited the restrictions by object to those which by their very nature and on the basis of the experience reveal a sufficient degree of harm to competition. On the standard required to the Court in reviewing competition decisions, the ECJ underlines the necessity of carrying out a full review, specifying that the presence of economic issues should not dispense the Court with an in-depth review of the law and the facts. The principles expressed in the judgment could have a great impact also at national level, where it could provide useful guidance both to Italian competition authority and to the Administrative Courts.

  1. Latin American Integration: Regionalism à la Carte in a Multipolar World?

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    Cintia Quiliconi

    2017-10-01

    Full Text Available This article presents an analysis of the different approaches proposed by authors who have done research on Latin American integration and regionalism, and suggests that there are three competing initiatives of integration and regionalism in the third wave of Latin American integration: Post-Liberal Regionalism contained within UNASUR and ALBA, Open Regionalism Reloaded in the region through the Pacific Alliance, and Multilateralism or Diplomatic Regionalism with a Latin American flavor envisaged in the recently created CELAC. The study concludes that these new developments of a regionalism à la carte are a product of dislocation of the economic agenda of regionalism towards a set of diverse issues. Hence it demands a rethinking of the theorization of Latin American Regionalism.

  2. Mortalidad de vertebrados en la carretera Guanare-Guanarito, estado Portuguesa, Venezuela

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    Andrés Eloy Seijas

    2013-12-01

    Full Text Available Uno de los aspectos más investigados en relación a la “ecología de la carretera” es el atropellamiento de vertebrados silvestres. Se evaluó la distribución espacial y temporal de los atropellos de vertebrados en la carretera Guanare-Guanarito, estado Portuguesa, Venezuela. Desde 2008 hasta el 2010 se realizaron 26 viajes en carro a lo largo de 74km, a 50-60km/h, para un total recorrido de 1 924km. Se encontraron 464 animales muertos: 66 aves (25 especies, 130 mamíferos (15 especies y 268 reptiles (18 especies. La serpiente Leptodeira annulata (n=119, el rabipelado Didelphis marsupialis (n=39 y la baba Caiman crocodilus (n=33 fueron las especies con mayor frecuencia de atropellos. Excluyendo a los animales domésticos, se localizaron 0.2282indviv./km; cifra 28.30% mayor que la reportada en estudios previos en la misma vía. Los cambios en la frecuencia relativa de atropellos de algunas especies con respecto a los reportados hace 20 años, se relacionan con el incremento en el flujo vehicular y por modificaciones en el uso de la tierra. Se identificaron segmentos donde el número de individuos atropellados supera al esperado por azar. Los atropellos pudieran ser la principal causa de mortalidad para especies como el oso melero (Tamandua tetradactyla y el oso hormiguero (Myrmecophaga tridactyla, esta última considerada como una especie vulnerable. Se recomiendan algunas medidas básicas para disminuir la mortalidad de fauna en la carretera.

  3. Site scientific mission plan for the southern great plains CART site January-June 2000.; TOPICAL

    International Nuclear Information System (INIS)

    Peppler, R. A.; Sisterson, D. L.; Lamb, P.

    2001-01-01

    The Southern Great Plains (SGP) Cloud and Radiation Testbed (CART) site was designed to help satisfy the data needs of the Atmospheric Radiation Measurement (ARM) Program Science Team. This Site Scientific Mission Plan defines the scientific priorities for site activities during the six months beginning on January 1, 2000, and looks forward in less detail to subsequent six-month periods. The primary purpose of this document is to provide scientific guidance for the development of plans for site operations. It also provides information on current plans to the ARM functional teams (Management Team, Data and Science Integration Team[DSIT], Operations Team, and Instrument Team[IT]) and serves to disseminate the plans more generally within the ARM Program and among the members of the Science Team. This document includes a description of the operational status of the site and the primary site activities envisioned, together with information concerning approved and proposed intensive observation periods (IOPs). The primary users of this document are the site operator, the site program manager, the Site Scientist Team (SST), the Science Team through the ARM Program science director, the ARM Program Experiment Center, and the aforementioned ARM Program functional teams. This plan is a living document that is updated and reissued every six months as the observational facilities are developed, tested, and augmented and as priorities are adjusted in response to developments in scientific planning and understanding. With this issue, many aspects of earlier Site Scientific Mission Plan reports have been moved to ARM sites on the World Wide Web. This report and all previous reports are available on the SGP CART web site

  4. Fatores de risco para mortalidade fetal em uma maternidade do Sistema Único de Saúde, Rio de Janeiro, Brasil: estudo caso-controle Risk factors for fetal mortality in a public maternity hospital in Rio de Janeiro, Brazil: a case-control study

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    Sandra Costa Fonseca

    2010-02-01

    Full Text Available A mortalidade fetal, apesar de elevada no Brasil, é pouco estudada quanto à sua determinação. Um estudo caso-controle aninhado foi feito para investigar os determinantes da mortalidade fetal em uma população usuária dos serviços públicos de uma região do Rio de Janeiro, de 2002 a 2004. Os dados foram coletados por meio de entrevista com as puérperas e complementados em prontuários e cartões de pré-natal. Os casos foram óbitos fetais com peso igual ou superior a 500g e os controles foram nascidos vivos no mesmo período. Para análise estatística, usou-se um modelo hierárquico de fatores sócio-econômicos e psicossociais (nível distal, reprodutivos, comportamentais e assistenciais (intermediário e características biológicas do feto (proximal. Destacaram-se vínculo empregatício, situação marital estável, acompanhante na admissão e pré-natal adequado como protetores de mortalidade fetal, enquanto violência doméstica, morbidade na gravidez e crescimento fetal restrito aumentaram o risco. O pré-natal se mostrou importante estratégia de redução do risco nesta população.Stillbirth rate is high in Brazil, and it is important to identify its determinants. A nested case-control was conducted to explore the determinants of fetal death in a population treated at public services in Rio de Janeiro from 2002 to 2004. Data were collected from mothers' interviews and medical records. A structured model was proposed to perform statistical analysis, attributing hierarchical levels: socioeconomic factors (distal level, reproductive, behavioral, and healthcare determinants (intermediate level, and fetal biological characteristics (proximal level. According to the findings, work stability, stable marital status, presence of a companion during admission, and adequate prenatal care had a protective effect against fetal death, while domestic violence, maternal morbidity, and intrauterine growth restriction increased the risk. Quality

  5. A mortalidade neonatal em 1998, no município de Botucatu - SP La mortalidad neonatal en 1998, en el município de Botucatu-SP The neonatal mortality in 1998 at the municipality of Botucatu-SP

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    Kátia Poles

    2000-07-01

    Full Text Available Considerando que a mortalidade neonatal é indicador da qualidade da assistência prestada à gestante, ao parto e ao recém-nascido, realizamos o presente trabalho, cujo objetivo foi identificar as causas e o índice de mortalidade neonatal durante o ano de 1998 em Botucatu-SP. O coeficiente de mortalidade neonatal obtido foi de 8,3/1000 nascidos vivos e o coeficiente de mortalidade neonatal precoce foi de 7,3/1000 nascidos vivos, confirmando a importância dos óbitos na primeira semana de vida. Aproximadamente três quartos dos óbitos puderam ser classificados como reduzíveis por diagnóstico e tratamento precoces, reduzíveis por adequada atenção ao parto ou parcialmente reduzíveis por adequado controle da gravidez, evidenciando que para se reduzir os índices de morte neonatal, deveremos investir na melhoria da qualidade da assistência prestada à gestante, à parturiente e ao neonato.Considerando que la mortalidad neonatal es un indicador de la calidad de la asistencia ofrecida en la gestación, al parto y al recién- nacido, realizamos el presente trabajo, con el objetivo de estudiar la mortalidad neonatal durante el año de 1998 en Botucatu-SP. El coeficiente de mortalidad neonatal encontrado fue 8,3/1000 nacidos vivos y el coeficiente de mortalidad neonatal precoz fue de 7,3/1000 nacidos vivos, confirmando la importancia de las defunciones en la primera semana de vida. Los resultados mostraron que aproximadamente tres cuartos de las defunciones pueden ser reducidas con el control del embarazo, con el diagnóstico y tratamiento precoz o con la adecuada atención al parto, evidenciando que para reducir los índices de mortalidad neonatal, deberemos invertir en la mejoría de la calidad de la asistencia ofrecida en la gestación, en el parto y al recién-nacido.Considering that neonatal mortality is an indicator of the quality of the care provided to pregnant women, at childbirth as well as to the new born, authors developed the

  6. Treatment of acute lymphoblastic leukaemia with the second generation of CD19 CAR-T containing either CD28 or 4-1BB.

    Science.gov (United States)

    Li, Shiqi; Zhang, Jiasi; Wang, Meiling; Fu, Gang; Li, Yunyan; Pei, Li; Xiong, Zhouxing; Qin, Dabing; Zhang, Rui; Tian, Xiaobo; Wei, Zhihao; Chen, Run; Chen, Xuejiao; Wan, Jia; Chen, Jun; Wei, Xia; Xu, Yanmin; Zhang, Pei; Wang, Ping; Peng, Xi; Yang, Sainan; Shen, Junjie; Yang, Zhi; Chen, Jieping; Qian, Cheng

    2018-04-10

    T cells modified with anti-CD19 chimeric antigen receptor (CAR) containing either CD28 or 4-1BB (also termed TNFRSF9, CD137) costimulatory signalling have shown great potential in the treatment of acute lymphoblastic leukaemia (ALL). However, the difference between CD28 and 4-1BB costimulatory signalling in CAR-T treatment has not been well elucidated in clinical trials. In this study, we treated 10 relapsed or refractory ALL patients with the second generation CD19 CAR-T. The first 5 patients were treated with CD28-CAR and the other 5 patients were treated with 4-1BB CAR-T. All the 10 patients were response-evaluable. Three patients achieved complete remission and 1 patient with extramedullary disease achieved partial response after CD28-CAR-T treatment. In the 4-1BB CAR-T treatment group, 3 patients achieved complete remission. Furthermore, FLT-3 ligand (FLT3LG) was highly correlated with response time and may serve as a prognosis factor. No severe adverse events were observed in these 10 treated patients. Our study showed that both CD28 CAR-T and 4-1BB CAR-T both worked for response but they differed in response pattern (peak reaction time, reaction lasting time and reaction degree), adverse events, cytokine secretion and immune-suppressive factor level. © 2018 John Wiley & Sons Ltd.

  7. FLAG-tagged CD19-specific CAR-T cells eliminate CD19-bearing solid tumor cells in vitro and in vivo.

    Science.gov (United States)

    Berahovich, Robert; Xu, Shirley; Zhou, Hua; Harto, Hizkia; Xu, Qumiao; Garcia, Andres; Liu, Fenyong; Golubovskaya, Vita M; Wu, Lijun

    2017-06-01

    Autologous T cells expressing chimeric antigen receptors (CARs) specific for CD19 have demonstrated remarkable efficacy as therapeutics for B cell malignancies. In the present study, we generated FLAG-tagged CD19-specific CAR-T cells (CD19-FLAG) and compared them to their non-tagged counterparts for their effects on solid and hematological cancer cells in vitro and in vivo . For solid tumors, we used HeLa cervical carcinoma cells engineered to overexpress CD19 (HeLa-CD19), and for hematological cancer we used Raji Burkitt's lymphoma cells, which endogenously express CD19. Like non-tagged CD19 CAR-T cells, CD19-FLAG CAR-T cells expanded in culture >100-fold and exhibited potent cytolytic activity against both HeLa-CD19 and Raji cells in vitro . CD19-FLAG CAR-T cells also secreted significantly more IFN-gamma and IL-2 than the control T cells. In vivo , CD19-FLAG CAR-T cells significantly blocked the growth of HeLa-CD19 solid tumors, increased tumor cleaved caspase-3 levels, and expanded systemically. CD19-FLAG CAR-T cells also significantly reduced Raji tumor burden and extended mouse survival. These results demonstrate the strong efficacy of FLAG-tagged CD19 CAR-T cells in solid and hematological cancer models.

  8. Crisis económica al inicio del siglo xxi y mortalidad en España. Tendencia e impacto sobre las desigualdades sociales. Informe SESPAS 2014

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    Miguel Ruiz-Ramos

    2014-06-01

    Full Text Available El objetivo de este estudio es analizar el impacto de la actual crisis económica en la evolución de la mortalidad en España y sus efectos sobre las desigualdades sociales en la mortalidad en Andalucía. Se han utilizado las defunciones procedentes de las estadísticas vitales del Instituto Nacional de Estadística para los años 1999 a 2011, así como la población correspondiente del padrón municipal de habitantes. Se calcularon tasas ajustadas de mortalidad general y específica por sexo y edad. Para estimar las tasas de mortalidad general y las razones de tasas según el nivel de estudios, entre 2002 y 2010 se utilizó la Base de Datos Longitudinal de Población de Andalucía (cohorte censal del 2001. Los porcentajes de cambio anuales y las tendencias se calcularon mediante regresión joinpoint. En España no se observa ningún cambio de tendencia significativo en la mortalidad a partir de 2008. Desde 1999 se mantiene una tendencia descendente, en ambos sexos y por todas las causas, excepto en las enfermedades del sistema nervioso. La mortalidad por accidentes de tráfico acelera su decrecimiento desde 2003. Los suicidios no modifican su tendencia negativa a lo largo del periodo. En Andalucía, las desigualdades sociales en la mortalidad general aumentaron en los hombres desde el inicio de la crisis, en el año 2008, fundamentalmente por un mayor descenso en la mortalidad en los de mayor nivel de estudios que en el resto, en un contexto de descenso de la mortalidad. En las mujeres no se observan cambios en el patrón de desigualdad.

  9. Effect of desipramine and citalopram treatment on forced swimming test-induced changes in cocaine- and amphetamine-regulated transcript (CART) immunoreactivity in mice.

    Science.gov (United States)

    Chung, Sung; Kim, Hee Jeong; Kim, Hyun Ju; Choi, Sun Hye; Kim, Jin Wook; Kim, Jeong Min; Shin, Kyung Ho

    2014-05-01

    Recent study demonstrates antidepressant-like effect of cocaine- and amphetamine-regulated transcript (CART) in the forced swimming test (FST), but less is known about whether antidepressant treatments alter levels of CART immunoreactivity (CART-IR) in the FST. To explore this possibility, we assessed the treatment effects of desipramine and citalopram, which inhibit the reuptake of norepinephrine and serotonin into the presynaptic terminals, respectively, on changes in levels of CART-IR before and after the test swim in mouse brain. Levels of CART-IR in the nucleus accumbens shell (AcbSh), dorsal bed nucleus of the stria terminalis (dBNST), and hypothalamic paraventricular nucleus (PVN) were significantly increased before the test swim by desipramine and citalopram treatments. This increase in CART-IR in the AcbSh, dBNST, and PVN before the test swim remained elevated by desipramine treatment after the test swim, but this increase in these brain areas returned to near control levels after test swim by citalopram treatment. Citalopram, but not desipramine, treatment increased levels of CART-IR in the central nucleus of the amygdala (CeA) and the locus ceruleus (LC) before the test swim, and this increase was returned to control levels after the test swim in the CeA, but not in the LC. These results suggest common and distinct regulation of CART by desipramine and citalopram treatments in the FST and raise the possibility that CART in the AcbSh, dBNST, and CeA may be involved in antidepressant-like effect in the FST.

  10. Actual use of and satisfaction associated with rollators and "shopping carts" among frail elderly Japanese people using day-service facilities.

    Science.gov (United States)

    Kitajima, Eiji; Moriuchi, Takefumi; Iso, Naoki; Sagari, Akira; Kikuchi, Yasuyuki; Higashi, Toshio

    2017-07-01

    Purpose This study aimed at clarifying the actual use of and satisfaction with rollators and "shopping carts" (wheeled walkers with storage) among frail elderly people, who were certified by a long-term care insurance system as users of facilities that provide day-service nursing care and rehabilitation. Methods We identified 1247 frail elderly people who used day-service facilities, and evaluated their actual use of, and satisfaction with, rollators and shopping carts. Results Forty-four (3.5%) individuals used rollators, and 53 (4.3%) used shopping carts. The shopping cart group contained more individuals who were certified as care level 1 (26.4%), than the rollator group (20.5%), and 52.8% of the shopping cart group was certified as care levels 1-3. The scores for "repairs and services" and "follow-up" from the Quebec User Evaluation of Satisfaction with assistive Technology second version (QUEST 2.0) survey were significantly higher in the rollator group than in the shopping cart group. Conclusions The QUEST 2.0 scores revealed that shopping cart users exhibit insufficient "repairs and services" and "follow-up" scores. As frail elderly people with poor care status accounted for >50% of the shopping cart group, these individuals urgently need walking aids that are tailored to their care status. Implications for Rehabilitation We conclude that walking aid fitting must be tailored to each persons care status, and suggest that a system should be established to allow occupational or physical therapists to provide this fitting Moreover, our analysis of the QUEST2.0 service scores revealed that repairs, services, and follow-up are insufficient to meet the needs of shopping cart users.

  11. Preconception use of cART by HIV-positive pregnant women increases the risk of infants being born small for gestational age.

    Science.gov (United States)

    Snijdewind, Ingrid J M; Smit, Colette; Godfried, Mieke H; Bakker, Rachel; Nellen, Jeannine F J B; Jaddoe, Vincent W V; van Leeuwen, Elisabeth; Reiss, Peter; Steegers, Eric A P; van der Ende, Marchina E

    2018-01-01

    The benefits of combination anti-retroviral therapy (cART) in HIV-positive pregnant women (improved maternal health and prevention of mother to child transmission [pMTCT]) currently outweigh the adverse effects due to cART. As the variety of cART increases, however, the question arises as to which type of cART is safest for pregnant women and women of childbearing age. We studied the effect of timing and exposure to different classes of cART on adverse birth outcomes in a large HIV cohort in the Netherlands. We included singleton HEU infants registered in the ATHENA cohort from 1997 to 2015. Multivariate logistic regression analysis for single and multiple pregnancies was used to evaluate predictors of small for gestational age (SGA, birth weight pregnant HIV-positive women, the use of cART prior to conception, most notably a PI-based regimen, was associated with intrauterine growth restriction resulting in SGA. Data showed a non-significant trend in the risk of PTD associated with preconception use of cART compared to its use after conception. More studies are needed with regard to the mechanisms taking place in the placenta during fetal growth in pregnant HIV-positive women using cART. It will only be with this knowledge that we can begin to understand the potential impact of HIV and cART on the fetus, in order to be able to determine the optimal individualised drug regimen for HIV-infected women of childbearing age.

  12. Improving CART-Cell Therapy of Solid Tumors with Oncolytic Virus-Driven Production of a Bispecific T-cell Engager.

    Science.gov (United States)

    Wing, Anna; Fajardo, Carlos Alberto; Posey, Avery D; Shaw, Carolyn; Da, Tong; Young, Regina M; Alemany, Ramon; June, Carl H; Guedan, Sonia

    2018-05-01

    T cells expressing chimeric antigen receptors (CART) have shown significant promise in clinical trials to treat hematologic malignancies, but their efficacy in solid tumors has been limited. Oncolytic viruses have the potential to act in synergy with immunotherapies due to their immunogenic oncolytic properties and the opportunity of incorporating therapeutic transgenes in their genomes. Here, we hypothesized that an oncolytic adenovirus armed with an EGFR-targeting, bispecific T-cell engager (OAd-BiTE) would improve the outcome of CART-cell therapy in solid tumors. We report that CART cells targeting the folate receptor alpha (FR-α) successfully infiltrated preestablished xenograft tumors but failed to induce complete responses, presumably due to the presence of antigen-negative cancer cells. We demonstrated that OAd-BiTE-mediated oncolysis significantly improved CART-cell activation and proliferation, while increasing cytokine production and cytotoxicity, and showed an in vitro favorable safety profile compared with EGFR-targeting CARTs. BiTEs secreted from infected cells redirected CART cells toward EGFR in the absence of FR-α, thereby addressing tumor heterogeneity. BiTE secretion also redirected CAR-negative, nonspecific T cells found in CART-cell preparations toward tumor cells. The combinatorial approach improved antitumor efficacy and prolonged survival in mouse models of cancer when compared with the monotherapies, and this was the result of an increased BiTE-mediated T-cell activation in tumors. Overall, these results demonstrated that the combination of a BiTE-expressing oncolytic virus with adoptive CART-cell therapy overcomes key limitations of CART cells and BiTEs as monotherapies in solid tumors and encourage its further evaluation in human trials. Cancer Immunol Res; 6(5); 605-16. ©2018 AACR . ©2018 American Association for Cancer Research.

  13. Inserción de la gestión por procesos en instituciones hospitalarias: concepción metodológica y práctica

    Directory of Open Access Journals (Sweden)

    Arialys Hernández Nariño

    2013-12-01

    Full Text Available La Gestión por Procesos es una de las buenas prácticas más utilizadas en el sector de salud en las últimas décadas, pues es una vía apropiada para alcanzar mayor satisfacción de los pacientes y un servicio asistencial más eficiente y eficaz. Uno de sus elementos más significativos es la mejora de procesos; la introducción de sus herramientas, que hace unos años eran escasamente difundidas, se fomenta cada vez más en instituciones hospitalarias. Este trabajo ilustra la concepción de un procedimiento para la gestión y mejora de procesos en entornos hospitalarios, con carácter sistémico, holístico e integrador en la búsqueda de soluciones; así como la aplicación práctica de estos instrumentos en un hospital clínico-quirúrgico, como resultados del análisis teórico conceptual de la gestión por procesos y la mejora continua.

  14. Cifras del retroceso: el deterioro relativo de la tasa de mortalidad infantil de Argentina en la segunda mitad del siglo XX

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    José Carlos Escudero

    2006-01-01

    Full Text Available Se compara la evolución histórica de la tasa de mortalidad infantil de Argentina con la de otros países americanos en la segunda mitad del siglo XX. También se compara la evolución histórica de la tasa de mortalidad infantil de la Ciudad Autónoma de Buenos Aires y la del Gran Buenos Aires con la de otras ciudades de América y del mundo. Esto muestra el deterioro relativo de la posición de Argentina con respecto a su nivel de mortalidad infantil.

  15. Causas de mortalidad a consecuencia de la vejez en Jerez de los Caballeros (Badajoz, España en el siglo XIX

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    Francisco Javier Suárez Guzmán

    2015-04-01

    Conclusión. Las enfermedades relacionadas con el envejecimiento causaron 204 defunciones, el 1.1% del total de la mortalidad de la población durante el siglo XIX, correspondiendo a la decimosegunda causa de mortalidad en la población. La mayor mortalidad se da entre los 75 y 84 años con 85 defunciones (41.7%. Las mujeres presentan las cifras más elevadas: 128 fallecimientos (62.7%. Enero es el mes con más óbitos.

  16. Les traces matérielles de la Carte du Ciel. Le cas des observatoires d'Alger et de Bordeaux.

    Science.gov (United States)

    Le Guet Tully, F.; Davoigneau, J.; Lamy, J.; de La Noë, J.; Rousseau, J.-M.; Sadsaoud, H.

    2008-06-01

    Le chapitre évoque les traces matérielles de la Carte du ciel subsistant dans les observatoires d'Alger et de Bordeaux. Les auteurs examinent d'abord l'opération d'inventaire du patrimoine astronomique entreprise à partir du milieu des années 1990. Ils examinent ensuite les éléments concrets constituant aujourd'hui le patrimoine de la Carte du Ciel : lunettes, abris, accessoires, laboratoires, réseaux, plaques de verre, registres, machines à mesurer les clichés, et cartes.

  17. Classification and regression tree (CART) analyses of genomic signatures reveal sets of tetramers that discriminate temperature optima of archaea and bacteria

    Science.gov (United States)

    Dyer, Betsey D.; Kahn, Michael J.; LeBlanc, Mark D.

    2008-01-01

    Classification and regression tree (CART) analysis was applied to genome-wide tetranucleotide frequencies (genomic signatures) of 195 archaea and bacteria. Although genomic signatures have typically been used to classify evolutionary divergence, in this study, convergent evolution was the focus. Temperature optima for most of the organisms examined could be distinguished by CART analyses of tetranucleotide frequencies. This suggests that pervasive (nonlinear) qualities of genomes may reflect certain environmental conditions (such as temperature) in which those genomes evolved. The predominant use of GAGA and AGGA as the discriminating tetramers in CART models suggests that purine-loading and codon biases of thermophiles may explain some of the results. PMID:19054742

  18. Estudios experimentales de los efectos mecánicos sobre la biología del cartílago de crecimiento

    OpenAIRE

    Arriola, Forriol, F. F.

    1998-01-01

    El cartílago de crecimiento es la estructura encargada del crecimiento en longitud de los huesos largos. En el hombre los diferentes cartílagos de crecimiento cumplen su función durante un tiempo determinado hasta desaparecer. Cada cartílago de crecimiento tiene una velocidad de crecimiento y un tiempo de evolución determinado por factores que nos resultan desconocidos si bien se sabe que son tanto sistémicos como mecánicos. En este trabajo se presenta una revisión de trabajos experimental...

  19. Análisis computacional del comportamiento mecánico de cartílago articular basado en un modelo viscoelástico

    OpenAIRE

    Caballero Alemán, Pedro Julio

    2012-01-01

    El Cartílago articular es un tejido biológico, sorprendente como todos ellos, que posee un comportamiento característico dado por sus propiedades físicas y mecánicas. Alrededor del mundo se han propuestos múltiples modelos para describir dicho comportamiento complejo. En el presente trabajo se realiza una simulación del cartílago articular (subdominio) bajo un modelo bifásico poro-elástico lineal, donde se considera al cartílago compuesto por dos fases intrínsecamente incompresibles e inm...

  20. EFECTO DEL SISTEMA DE PRODUCCION, DE LA EPOCA DE NACIMIENTO Y DEL SEXO SOBRE LA MORTALIDAD NEONATAL DE CORDEROS PELIBUEY

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    Rafael Julio Macedo Barragán

    2009-08-01

    Full Text Available Se realizó un estudio en Tecomán, Colima, México con el objetivo de determinar la influencia del sistema de producción (intensivo, extensivo, de la época del año (lluvias, secas y del sexo (macho, hembra sobre la mortalidad neonatal de corderos Pelibuey. En ambos sistemas productivos se registró la causa de muerte, el sexo de la cría y la época del año durante la cual ocurrió y se determinaron los factores de riesgo de mortalidad neonatal por medio de Regresión Logística. Adicionalmente se determinó la prevalencia por causas mortalidad para las variables sistema de producción, época del año y sexo, mismos que fueron comparados por medio de pruebas Z para proporciones. La tasa de mortalidad en el sistema extensivo fue del 30.96% mientras que en el intensivo fue 4.61%. La principal causa de mortalidad fue el síndrome de inanición-exposición con una prevalencia del 20.36 y del 3.41% en el sistema extensivo e intensivo respectivamente con una baja prevalencia de pérdidas por enfermedades infecciosas. Los corderos nacidos en el sistema de producción extensivo presentaron 9.75 veces más probabilidades de morir antes del destete que aquellos nacidos en un sistema intensivo, mientras que los corderos nacidos en la época de secas y los machos tuvieron un 0.69 y un 0.68 más posibilidades de morir que aquellos nacidos durante la época de lluvias y las hembras respectivamente. No se observó efecto entre sexos o entre época del año sobre las distintas causas de mortalidad en ninguno de los dos sistemas de producción estudiados.

  1. Comparacao dos criterios RIFLE, AKIN e KDIGO quanto a capacidade de predicao de mortalidade em pacientes graves

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    Talita Machado Levi

    2013-12-01

    Full Text Available Objetivo: A lesão renal aguda é uma complicação comum em pacientes gravemente enfermos, sendo os critérios RIFLE, AKIN e KDIGO utilizados para sua classificação. Esse trabalho teve como objetivo a comparação dos critérios citados quanto à capacidade de predição de mortalidade em pacientes gravemente enfermos. Métodos: Estudo de coorte prospectiva, utilizando como fonte de dados prontuários médicos. Foram incluídos todos os pacientes admitidos na unidade de terapia intensiva. Os critérios de exclusão foram tempo de internamento menor que 24 horas e doença renal crônica dialítica. Os pacientes foram acompanhados até a alta ou óbito Para análise dos dados, foram utilizados os testes t de Student, qui-quadrado, regressão logística multivariada e curva ROC. Resultados: A média de idade foi de 64 anos, com mulheres e afrodescendentes representando maioria. Segundo o RIFLE, a taxa de mortalidade foi de 17,74%, 22,58%, 24,19% e 35,48% para pacientes sem lesão renal aguda e em estágios Risk, Injury e Failure, respectivamente. Quanto ao AKIN, a taxa de mortalidade foi de 17,74%, 29,03%, 12,90% e 40,32% para pacientes sem lesão renal aguda, estágio I, estágio II e estágio III, respectivamente. Considerando o KDIGO 2012, a taxa de mortalidade foi de 17,74%, 29,03%, 11,29% e 41,94% para pacientes sem lesão renal aguda, estágio I, estágio II e estágio III, respectivamente. As três classificações apresentaram resultados de curvas ROC para mortalidade semelhantes. Conclusão: Os critérios RIFLE, AKIN e KDIGO apresentaram-se como boas ferramentas para predição de mortalidade em pacientes graves, não havendo diferença relevante entre os mesmos.

  2. Efecto protector del apoyo social en la mortalidad en población anciana: un estudio longitudinal

    Directory of Open Access Journals (Sweden)

    Nebot Manel

    2002-01-01

    Full Text Available Fundamentos: El objetivo principal del estudio es analizar la relación entre el apoyo social y la mortalidad en una cohorte de población de 60 años o más, residente en Barcelona y no institucionalizada, observada durante el período de seguimiento de 1996 a 1999, con el objetivo de analizar la relación entre el apoyo social y la mortalidad en las personas que constituyen la cohorte. Métodos: En 1996 se realizó una entrevista telefónica a 755 personas (316 hombres y 439 mujeres que habían sido entrevistadas en la encuesta de salud de Barcelona de 1992, y que en ese año tenían 60 años o más. En el cuestionario se recogían variables socio-demográficas, de morbilidad y estado de salud, de apoyo social y de red social. Se han registrado los fallecimientos ocurridos entre 1996 y 1999. Se ha utilizado la regresión logística para analizar la asociación del apoyo social con la mortalidad. Resultados: El número de defunciones durante este período fue de 55 (5,9% de las mujeres y 9,2% de los hombres. Entre las variables que reflejan el apoyo social para los hombres, únicamente la situación de convivencia mostró en el análisis bivariado una asociación significativa con la mortalidad, que fue superior para los hombres que vivían con otros familiares pero no si vivían con su esposa o compañera (OR=3,7; IC 95% 1,4-9,6. Entre las mujeres, la existencia de apoyo vecinal, el tamaño de la red familiar, el número de contactos con la red comunitaria y la situación de convivencia se asociaron a la mortalidad en el análisis bivariado, aunque en la regresión logística multivariada, únicamente el apoyo vecinal (OR=3,6; IC:1,1-11,1 mantuvo una asociación significativa. Conclusiones: Los resultados muestran una asociación de las variables de apoyo social con la mortalidad. La relación entre las diversas variables de apoyo social, y los posibles mecanismos de prevención deberían ser abordados en futuros estudios.

  3. Mortalidade por armas de fogo no estado do Rio de Janeiro, Brasil: uma análise espacial

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    Szwarcwald Célia Landman

    1998-01-01

    Full Text Available O aumento da mortalidade por armas de fogo no estado do Rio de Janeiro, Brasil, tem tomado um aspecto alarmante. O objetivo deste estudo foi caracterizar a evolução temporal da mortalidade por armas de fogo neste estado, no período de 1979 a 1992, conforme sexo, idade e região de residência (capital, cinturão metropolitano e interior do estado e estudar a propagação da epidemia ao longo do tempo e do espaço, com a utilização de técnicas de análise estatística espacial. No período analisado, a mortalidade por armas de fogo teve o seu maior crescimento entre adolescentes de 15 a 19 anos, do sexo masculino; estas taxas variaram de 13 a 16% para este grupo, conforme a região de residência. Para o grupo das crianças de 10 a 14 anos, a mortalidade por armas de fogo teve um acréscimo de 10% ao ano. Foi nítida a interiorização da mortalidade por armas de fogo. No início da série, observou-se uma direção preferencial de disseminação, ao longo dos municípios situados na costa leste do estado, acompanhando o trajeto de uma rodovia federal. Entre 1990 e 1992, entretanto, a difusão ocorreu em praticamente todas as direções. A constatação empírica da expansão generalizada da mortalidade por armas de fogo nega as afirmações corriqueiras de concentração da violência nos bolsões de pobreza das metrópoles brasileiras. Os programas para prevenir e controlar a epidemia devem abordar o problema sob diferentes aspectos, enfocando questões tanto no plano coletivo (proliferação de armas entre a população vinculada ao contrabando internacional de armas, aumento da criminalidade, expansão do tráfico de drogas e exclusão de oportunidades sociais, assim como no plano individual (relações e interações dos jovens com seu ambiente, em nível da família, da escola e da sociedade.

  4. Morbilidad y mortalidad por enfermedades infecciosas intestinales (001-009: Cuba, 1980-1999

    Directory of Open Access Journals (Sweden)

    Raúl L. Riverón Corteguera

    2000-06-01

    Full Text Available En los últimos 20 años la mortalidad por enfermedades infecciosas intestinales en menores de 5 años en el mundo se ha reducido de manera significativa; sin embargo, en 1998 se registraron en el nivel mundial 2,2 millones de defunciones en los menores de 5 años. En la actualidad todavía la mortalidad seconsidera un problema de salud muy serio, sobre todo en los países subdesarrollados. En Cuba, la mortalidad por estas enfermedades en los menores de 5 años se ha reducido de manera notable, aunque la morbilidad constituye un problema importante de salud en ciertos meses del año por las alzas estacionales de la enfermedad. Este artículo muestra los resultados del trabajo desplegado a partir de 1980 en el cual se puso en ejecución el Programa Mundial de Control de las Enfermedades Diarreicas por la Organización Mundial de la Salud, que en Cuba es una continuación del Programa Nacional de Lucha contra la Gastroenteritis que se inició en 1962. Los datos de morbilidad se ofrecen desde 1985 según diferentes grupos de edades. Las reducciones en la morbilidad han sido discretas; en los menores de 1 año fue del 30,8 %; en el grupo de 1 a 4 años, 8,0 %; en los menores de 5 años del 20,1 %; en los de 5 a 14 años del 3,5 % y en los menores de 15 años del 15,8 %. Las tasas de mortalidad disminuyeron en el período de 1980 a 1999 en el 91,0 % en los menores de un año; el 50,0 % en los niños de 1 a 4 años; 85,7 % en menores de 5 años; en 66,7 % en el grupo de 5 a 14 años, y en 81,1 % en los menores de 15 años. Los elementos fundamentales que han contribuido a esta disminución en la mortalidad por enfermedades diarreas han sido, en primer lugar el uso de las sales de rehidratación oral, en la prevención y tratamiento de la deshidratación, el uso racional de antimicrobianos, el incremento de la lactancia materna exclusiva, la capacitación de los recursos humanos, el tratamiento intensivo por parte de nuestros profesionales de la salud

  5. Fatores socioeconómicos y mortalidad infantil en Ecuador, 1970-1981 Fatores socioeconômicos e mortalidade infantil no Equador, 1970-1981 Socioeconomic factors and infant mortality in Ecuador, 1970-1981

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    Guillermo González Pérez

    1988-08-01

    Full Text Available En Ecuador la tasa de mortalidad infantil se redujo entre 1970 y 1981 en un 35%, a pesar de lo cual su valor sigue siendo elevado en el contexto latinoamericano. A nivel provincial, el comportamiento de la tasa no ha sido homogéneo, observándose fuertes diferencias entre las entidades en cuanto a la mortalidad durante el primer año de vida. Mediante el empleo de técnicas de regresión múltiple, pretendióse identificar aquellos factores socioeconómicos que más han incidido en el descenso de la mortalidad infantil en Ecuador en el período señalado, así como las variables que más explican las diferencias interprovinciales en dicho indicador. La disminución de la natalidad y el aumento proporcional de los gastos del presupuesto destinado a salud por una parte, y la tasa de alfabetización por otra parecen ser elementos claves para una explicación económico social de los cambios recientes en la mortalidad infantil ecuatoriana.No Equador entre os anos de 1970 a 1981 a taxa de mortalidade infantil reduziu em 35%, embora seu valor continua sendo elevado em relação ao contexto latinoamericano. A nível regional, o comportamento da taxa não tem sido homogêneo, observando-se diferenças significativas nas diversas regiões quanto a taxa de mortalidade durante o primeiro ano de vida. Com o emprego da técnica de regressão múltipla, pretendeu-se identificar aqueles fatores socioeconômicos que mais têm incidido no declínio da mortalidade infantil no Equador, no período acima descrito, bem como as variáveis que melhor explicam as diferenças inter-regionais do referido indicador. A diminuição da natalidade e o aumento proporcional de recursos financeiros destinados à saúde, por um lado, e a taxa de alfabetização por outro, parecem ser elementos chaves para uma explicação econômica social das mudanças recentes na mortalidade infantil equatoriana.In Equador infant mortality has dropped by 35% between 1970 and 1981, though this

  6. Lecture matérialiste des Méditations cartésiennes

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    Anne Staquet

    2009-08-01

    Full Text Available Lorsque, à de rares occasions, on envisage le caractère matérialiste de la pensée cartésienne, c'est systématiquement en s'appuyant sur ses textes scientifiques. Les textes plus philosophiques sont dans cette perspective laissés de côté, voire déconsidérés comme le montre de manière exacerbée  Hiram Caton, qui discrédite les Méditations sous prétexte qu'elle ne seraient écrites que pour endormir la censure et acheter une réputation à leur auteur et n'ont donc aucune pertinence philosophique. Or, Descartes n'a cessé d'insister sur l'importance de relier ses deux types écrits : les plus scientifiques et les plus métaphysiques. C'est la raison pour laquelle, à l'inverse de ces considérations, je propose de tenter une lecture matérialiste (au sens leibnizien du terme des Méditations métaphysiques. Pour ce faire, m'appuyant sur les paroles mêmes de Descartes, je commencerai par montrer l'usage que fait le philosophe de la dissimulation dans l'ensemble de ses œuvres. Je montrerai ensuite comment le dualisme cartésien permet de fonder un matérialisme. Et je terminerai en montrant comment les preuves de l'existence de Dieu et la distinction âme-corps ne contredisent en fait pas réellement une lecture matérialiste des Méditations cartésiennes.Materialistic interpretation of the Cartesian MéditationsWhen, on rare occasions, we consider the materialistic nature of the Cartesian thinking, we systematically refer to scientific texts. In this perspective, more philosophical texts are not taken into consideration or are even ignored, as Hiram Caton showed it by discrediting the Méditations because they would only have been written to dupe the censure and buy a reputation for their author. They would therefore have no philosphical pertinence at all. But Descartes never stopped to insist on the importance of combining both writing types: the scientific one and the metaphysical one. For that reason, contrary to these

  7. Incremento na mortalidade associada à presença de diabetes mellitus em nipo-brasileiros

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    Gimeno Suely Godoy A.

    1998-01-01

    Full Text Available OBJETIVO: Como parte de um estudo envolvendo migrantes japoneses (issei e seus descendentes (nisei, residentes na cidade de Bauru no Estado de São Paulo, descrevem-se e comparam-se os coeficientes de mortalidade (CM observados para o período de 1993 a 1996 em indivíduos com graus diferentes de tolerância à glicose. MATERIAL E MÉTODO: Nesse estudo, em 1993, a coorte era composta por 530 nipo-brasileiros (236 issei e 294 nisei, de ambos os sexos, com idade entre 40 e 79 anos, sendo que 91 indivíduos (17% foram classificados como diabéticos não dependentes de insulina (DMNDI, 90 (17% como portadores de tolerância à glicose diminuída (TGD e 349 (66% como normais quanto à tolerância à glicose. Em 1996 foram identificados os óbtos ocorridos e obtidas informações dos familiares e dos certificados de óbito para o registro da data e da causa da morte. Calcularam-se, para os três grupos de indivíduos, os CM brutos e ajustados, por todas as causas e por causas específicas (doenças circulatória e renal. O modelo de Cox foi utilizado para a comparação dos CM ajustados segundo idade, sexo, geração, creatinina sérica, presença de hipertensão arterial, de dislipidemia e de obesidade. RESULTADOS E CONCLUSÕES: As razões entre os CM brutos de indivíduos diabéticos e normais foram 2,95 (IC 95%: 1,10 -7,62 para os óbitos ocorridos por todas as causas e 4,75 (IC 95%: 1,31 - 16,48 para os óbitos por causas específicas. Não foram observadas diferenças estatisticamente significantes entre os CM brutos de indivíduos com TGD quando comparados aos indivíduos normais. Após o ajuste simultâneo pelas variáveis de controle, observou-se que, entre os indivíduos diabéticos, a força de mortalidade por causas específicas foi aproximadamente 4 vezes aquela observada entre os indivíduos normais (Razão dos CM: 3,86 e IC 95%: 1,11 -13,38. Os resultados em nipo-brasileiros são consistentes com outros obtidos em populações diab

  8. Veulent-ils encore une carte de presse ? Les jeunes journalistes de Belgique francophone

    Directory of Open Access Journals (Sweden)

    Olivier Standaert

    2013-12-01

    Full Text Available Cet article questionne les formes identitaires développées par les jeunes journalistesbelges lorsque se pose à eux la question de la possession de la carte de presse. La méthodologie s’appuie sur une étude descriptive du profil professionnel des jeunes journalistes et sur des entretiens non directifs menés auprès de journalistes, encartés ou non, ayant moins de cinq ans d’ancienneté. Il apparaît qu’une part importante d’entre eux ne répond plus, et ce durant une période de plus en plus longue, aux critères stricts d’obtention de la carte de presse tels que définis par les autorités belges. La carte de presse est par conséquent souvent sollicitée après l’insertion effective sur le marché du travail. Ceci peut s’expliquer par la précarisation des conditions d’insertion dans le groupe professionnel des journalistes. La montée de la précarisation au sein des médias d’information générale est une des hypothèses explicatives du décalage fréquemment constaté entre les formes identitaires traditionnelles, attachées à la carte de presse, et celles des jeunes journalistes, dominées par la figure de l’individu précaire, flexible et substituable en dépit d’une vocation affichée. Les entretiens mettent cependant en évidence un discours ambivalent où une rhétorique d’indifférence, de questionnement, voire de rejet par rapport à tout document se donnant un pouvoir d’authentifier qui est journaliste et qui ne l’est pas, côtoie un discours de conciliation et d’adhésion, mettant en avant la force symbolique de cette carte et la forme d’aboutissement identitaire que sa délivrance continue d’incarner. Il est significatif de noter que les instances d’agréation adaptent leurs pratiques, plus que leurs discours, à ces nouvelles situations professionnelles et aux identités qui en découlent : la délivrance de la carte de presse se fait de plus en plus au cas par cas, et avec une certaine

  9. Desigualdades sociales en la mortalidad de enfermedades por causas externas, tumores, enfermedades metabólicas en el departamento de Caldas 2010-2013

    OpenAIRE

    Marín Ocampo, Angela María

    2017-01-01

    Objetivo. Determinar las desigualdades sociales en la mortalidad de enfermedades por causas externas, enfermedades metabólicas y tumores en los municipios del departamento de Caldas en el período 2010-2013.

  10. Tráfego veicular e mortalidade por doenças do aparelho circulatório em homens adultos

    OpenAIRE

    Habermann, Mateus; Gouveia, Nelson

    2011-01-01

    OBJETIVO: Analisar a associação entre indicadores de exposição à poluição por tráfego veicular e mortalidade por doenças do aparelho circulatório em homens adultos. MÉTODOS: Foram analisadas informações sobre vias e volume de tráfego no ano de 2007 fornecidas pela companhia de engenharia de tráfego local. Mortalidade por doenças do aparelho circulatório no ano de 2005 entre homens > 40 anos foram obtidas do registro de mortalidade do Programa de Aprimoramento de Informações de Mortalidade do ...

  11. EXCESOS DE MORTALIDAD EN ESPAÑA DURANTE LA TRANSMISIÓN DE GRIPE PANDÉMICA EN EL AÑO 2009

    OpenAIRE

    Imaculada León Gómez; Víctor Manuel Flores Segovia; Silvia Jiménez Jorge; Amparo Larrauri Cámara; Rocío Palmera Suárez; Fernando Simón Soria

    2010-01-01

    Fundamento: El sistema español de monitorización de la mortalidad y el «Programa Europeo de monitorización de excesos de mortalidad para la acción en salud pública» detectaron dos excesos de mortalidad en España en noviembre y diciembre de 2009. El objetivo de este trabajo es valorar su posible asociación con la transmisión de gripe pandémica. Métodos: Se analizó la evolución de la mortalidad en España en los meses citados utilizando métodos de análisis de series temporales basados en las ser...

  12. Circulating serovars of Leptospira in cart horses of central and southern Ethiopia and associated risk factors.

    Science.gov (United States)

    Tsegay, K; Potts, A D; Aklilu, N; Lötter, C; Gummow, B

    2016-03-01

    Little work has been done on diseases of horses in Ethiopia or tropical regions of the world. Yet, Ethiopia has the largest horse population in Africa and their horses play a pivotal role in their economy as traction animals. A serological and questionnaire survey was therefore conducted to determine the circulating serovars of Leptospira and their association with potential risk factors in the cart horse population of Central and Southern Ethiopia. A total of 184 out of 418 cart horses from 13 districts had antibody titres of 1:100 or greater to at least one of 16 serovars of Leptospira species in Central and Southern Ethiopian horses. A significantly higher seropositivity (62.1%) was noted in horses from the highland agroecology followed by midland (44.4%) and lowland (39.8%). Serovar Bratislava (34.5%) was the predominant serovar followed by serovars Djasiman (9.8%), Topaz (5.98%) and Pomona (5.3%). Age and location proved to be associated with seropositive horses with older horses being more commonly affected and the districts of Ziway (Batu) (Apparent Prevalence (AP)=65.5%), Shashemene (AP=48.3%) and Sebeta (AP=41.4%) having the highest prevalence. Multivariable logistic regression found risk factors significantly associated with Leptospira seropositive horses were drinking river water (OR=2.8) and horses 7-12 years old (OR=5) and risk factors specifically associated with serovar Bratislava seropositive horses were drinking river water (OR=2.5), horses ≥13 years (OR=3.5) and the presence of dogs in adjacent neighbouring properties (OR=0.3). Dogs had a protective effect against seropositivity to serovars Bratislava and Djasiman, which may be due to their ability to control rodents. The high seroprevalence confirm that leptospirosis is endemic among horses of Central and Southern Ethiopia. The predominance of serovar Bratislava supports the idea that serovar Bratislava may be adapted to and maintained by the horse population of Central and Southern Ethiopia

  13. Morbilidad y mortalidad por afecciones benignas del sistema biliar: Nuestra experiencia

    Directory of Open Access Journals (Sweden)

    Jorge Reyes Cardero

    1997-04-01

    Full Text Available Se realizó un estudio descriptivo y prospectivo sobre morbilidad y mortalidad por enfermedades benignas del sistema biliar en 4 266 pacientes operados en el Hospital Provincial Clinicoquirúrgico Docente "Saturnino Lora" de Santiago de Cuba, en el que se precisó la incidencia de diferentes variables. Las enfermedades más frecuentes fueron las colecistitis y colecistosis, en pacientes del sexo femenino, y un número importante de operados superaba los 60 años. Las complicaciones más comúnmente halladas en el período preoperatorio fueron: la litiasis coledociana y la pancreatitis aguda; en el peroperatorio: sobre la vesícula, la vía biliar y el hígado y en el posoperatorio inmediato las inespecíficas, que prevalecieron sobre las específicas. La mortalidad se consideró dentro de límites aceptables, y como causa fundamental de muerte en los ancianos se destaca el síndrome de disfunción múltiple de órganosA descriptive and prospective study on morbidity and mortality of bening diseases of the biliary tract was performed on 4 266 patients operated on at "Saturnino Lora" Provincial Teaching hospital, Santiago de Cuba with the aim of assessing the incidence of different variables. The most frequent diseases were found to be cholecystitis and cholecystosis in female patients, and a great number of surgically treated patients were over 60 years of age. The most frequently complications found within the preoperative period were: cholelithiasis and acute pancreatitis; during the perioperative period the most common were the complications of the gall bladder, the bile duct, and the liver, and during the immediate portoperative period the most frequent complications were found to be nonspecific which prevailed over the specific ones. Mortality rate was considered to be within acceptable limits, and the syndrome of multiple organ failure was found to be the principal cause of death among aged patients

  14. Vólvulo del sigmoides: Morbilidad y mortalidad. Estudio de 63 pacientes

    Directory of Open Access Journals (Sweden)

    Eddy Sierra Enrique

    1997-08-01

    Full Text Available Se realiza un estudio de 63 pacientes que presentaron obstrucción intestinal por vólvulo del sigmoides, los cuales fueron tratados por diferentes métodos en el Hospital Yekatit 12, de Addis Abeba, Etiopía, durante el período de agosto de 1988 a julio de 1990. Esta afección se presentó en el 87,3 % de los pacientes con más de 50 años y es la causa más frecuente de obstrucción intestinal en dicha región, pues representa el 75,0 % de la serie estudiada. Se trataron médicamente de urgencia por medio de la reducción no quirúrgica del vólvulo del sigmoides un total de 12 pacientes, para el 19,0 % de la serie; en el 75,0 % de ellos se obtuvo la reducción del vólvulo, mientras que en el 25,0 % restante se fracasó. Los resultados del tratamiento quirúrgico de urgencia por la técnica de la desvolvulación, mostraron una recurrencia del 55,5 %. La mortalidad por tratamiento médico es cero, y por tratamiento quirúrgico es de 13,7 %. Dentro de las distintas formas de tratamiento quirúrgico, el de resección y anastomosis primaria presenta el 23,8 % de mortalidadA study of 63 patients presenting with intestinal obstruction due to a volvulus of the sigmoid is carried out. Patients were treated by different methods at Yekatit 12 hospital, Addis Abeba, Ethiopia from August, 1988 to July, 1990. This entity occurred in 87,3 % of patients over 50 years of age and it is the most frequent cause for intestinal obstruction in the region accounting for 75.0 % of the series studies. Twelve patients (19.0 % of the series were treated by nonsurgical reduction of the volvulus of the sigmoid; in 75.0 % of them the reduction of the volvulus was satisfactory, while in 25.0 % the results failed to be good. Results from the emergency surgical treatment by disvolvulation showed a recurrence rate of 55.5 %. Mortality from medical treatment is null, while mortality from surgical treatment is found to be 13.7 %. Among the different forms of surgical treatment

  15. Core Follow Calculation for Palo Verde Unit 1 in Cycles 1 through 4 using DeCART2D/MASTER4.0 Code System

    International Nuclear Information System (INIS)

    Jeong, Hee Jeong; Choi, Yonghee; Kim, Sungmin; Lee, Kyunghoon

    2017-01-01

    To verify and validate the DeCART2D/MASTER4.0 design system, core follow calculations of Palo Verde Unit 1(PV-1) in cycles 1 through 4 are performed. The calculation results are compared with the measured data and will be used in the generation of bias and uncertainty factors in the DeCART2D/MASTER4.0 design system. The DeCART2D/MASTER codes system has been developed in KAERI for the PWR (Pressurized water reactors) core design including SMRs (Small Modular Reactors). Core follow calculations of Pale Verde Unit 1 in Cycles 1 through 4 have been performed. Reactivities, assembly powers and startup parameters such as EPC, RW, ITC and IBW are compared with the measured data. This work will be used in the generation of bias and uncertainty factors in DeCART2D/MASTER4.0 design system.

  16. Environmental assessment for the Atmospheric Radiation Measurement (ARM) Program: Southern Great Plains Cloud and Radiation Testbed (CART) site

    International Nuclear Information System (INIS)

    Policastro, A.J.; Pfingston, J.M.; Maloney, D.M.; Wasmer, F.; Pentecost, E.D.

    1992-03-01

    The Atmospheric Radiation Measurement (ARM) Program is aimed at supplying improved predictive capability of climate change, particularly the prediction of cloud-climate feedback. The objective will be achieved by measuring the atmospheric radiation and physical and meteorological quantities that control solar radiation in the earth's atmosphere and using this information to test global climate and related models. The proposed action is to construct and operate a Cloud and Radiation Testbed (CART) research site in the southern Great Plains as part of the Department of Energy's Atmospheric Radiation Measurement Program whose objective is to develop an improved predictive capability of global climate change. The purpose of this CART research site in southern Kansas and northern Oklahoma would be to collect meteorological and other scientific information to better characterize the processes controlling radiation transfer on a global scale. Impacts which could result from this facility are described

  17. Environmental assessment for the Atmospheric Radiation Measurement (ARM) Program: Southern Great Plains Cloud and Radiation Testbed (CART) site

    Energy Technology Data Exchange (ETDEWEB)

    Policastro, A.J.; Pfingston, J.M.; Maloney, D.M.; Wasmer, F.; Pentecost, E.D.

    1992-03-01

    The Atmospheric Radiation Measurement (ARM) Program is aimed at supplying improved predictive capability of climate change, particularly the prediction of cloud-climate feedback. The objective will be achieved by measuring the atmospheric radiation and physical and meteorological quantities that control solar radiation in the earth`s atmosphere and using this information to test global climate and related models. The proposed action is to construct and operate a Cloud and Radiation Testbed (CART) research site in the southern Great Plains as part of the Department of Energy`s Atmospheric Radiation Measurement Program whose objective is to develop an improved predictive capability of global climate change. The purpose of this CART research site in southern Kansas and northern Oklahoma would be to collect meteorological and other scientific information to better characterize the processes controlling radiation transfer on a global scale. Impacts which could result from this facility are described.

  18. Single-cell multiplexed cytokine profiling of CD19 CAR-T cells reveals a diverse landscape of polyfunctional antigen-specific response.

    Science.gov (United States)

    Xue, Qiong; Bettini, Emily; Paczkowski, Patrick; Ng, Colin; Kaiser, Alaina; McConnell, Timothy; Kodrasi, Olja; Quigley, Máire F; Heath, James; Fan, Rong; Mackay, Sean; Dudley, Mark E; Kassim, Sadik H; Zhou, Jing

    2017-11-21

    It remains challenging to characterize the functional attributes of chimeric antigen receptor (CAR)-engineered T cell product targeting CD19 related to potency and immunotoxicity ex vivo, despite promising in vivo efficacy in patients with B cell malignancies. We employed a single-cell, 16-plex cytokine microfluidics device and new analysis techniques to evaluate the functional profile of CD19 CAR-T cells upon antigen-specific stimulation. CAR-T cells were manufactured from human PBMCs transfected with the lentivirus encoding the CD19-BB-z transgene and expanded with anti-CD3/anti-CD28 coated beads. The enriched CAR-T cells were stimulated with anti-CAR or control IgG beads, stained with anti-CD4 RPE and anti-CD8 Alexa Fluor 647 antibodies, and incubated for 16 h in a single-cell barcode chip (SCBC). Each SCBC contains ~12,000 microchambers, covered with a glass slide that was pre-patterned with a complete copy of a 16-plex antibody array. Protein secretions from single CAR-T cells were captured and subsequently analyzed using proprietary software and new visualization methods. We demonstrate a new method for single-cell profiling of CD19 CAR-T pre-infusion products prepared from 4 healthy donors. CAR-T single cells exhibited a marked heterogeneity of cytokine secretions and polyfunctional (2+ cytokine) subsets specific to anti-CAR bead stimulation. The breadth of responses includes anti-tumor effector (Granzyme B, IFN-γ, MIP-1α, TNF-α), stimulatory (GM-CSF, IL-2, IL-8), regulatory (IL-4, IL-13, IL-22), and inflammatory (IL-6, IL-17A) functions. Furthermore, we developed two new bioinformatics tools for more effective polyfunctional subset visualization and comparison between donors. Single-cell, multiplexed, proteomic profiling of CD19 CAR-T product reveals a diverse landscape of immune effector response of CD19 CAR-T cells to antigen-specific challenge, providing a new platform for capturing CAR-T product data for correlative analysis. Additionally, such high

  19. Rotavirus morbidity and mortality in children in Brazil Morbilidad y mortalidad por rotavirus en niños en Brasil

    Directory of Open Access Journals (Sweden)

    Ana Marli Christovam Sartori

    2008-02-01

    Full Text Available OBJECTIVE: To study the epidemiology of rotavirus and estimate rotavirus-associated morbidity and mortality in children OBJETIVOS: Analizar la epidemiología del rotavirus y estimar la morbilidad y la mortalidad asociadas con las infecciones por rotavirus en niños < 5 años de edad en Brasil en 2004, antes de incluir la vacuna contra el rotavirus en el Programa Nacional de Inmunizaciones (PNI. MÉTODOS: Para estimar la morbilidad por rotavirus se revisaron los estudios publicados (1999-2006 que abordaban la incidencia de diarrea aguda en niños < 5 años de edad y la frecuencia de las infecciones por rotavirus en niños con diarrea en Brasil. Los casos de diarrea se dividieron en tres categorías de gravedad según el nivel de atención que requirieron: casos leves que solo requirieron atención domiciliaria, casos moderados que requirieron la visita a un servicio ambulatorio de salud y casos graves que requirieron hospitalización. Para estimar la mortalidad por rotavirus se utilizó el número de muertes registradas por diarrea en niños de < 5 años, según el Sistema de Información sobre Mortalidad (SIM del Sistema Único de Salud (SUS de Brasil, y se calculó la proporción de muertes causadas por este virus. RESULTADOS: Se estimó que las infecciones por rotavirus causan anualmente 3 525 053 casos de diarrea, 655 853 visitas a servicios ambulatorios de salud, 92 453 hospitalizaciones y 850 muertes en niños < 5 años de edad en Brasil. CONCLUSIONES: Las infecciones por rotavirus constituyen una importante causa de morbilidad y mortalidad en Brasil.

  20. Tendências na incidência e mortalidade por acidentes de trabalho no Brasil, 1998 a 2008

    Directory of Open Access Journals (Sweden)

    Flávia Souza e Silva de Almeida

    2014-09-01

    Full Text Available O objetivo do estudo foi avaliar as tendências na incidência e mortalidade por acidentes de trabalho no Brasil, de 1998 a 2008. Trata-se de estudo ecológico de séries temporais, que incluiu, para a análise, os acidentes de trabalho registrados nas estatísticas oficiais do Governo Federal. Foram calculadas as variações percentuais anuais (APC nas taxas de incidência e de mortalidade, através da modelagem pelo método Joinpoint, usando o ano calendário como variável regressora. Observou-se tendência significativa de decréscimo na taxa de incidência de acidentes de trabalho, o mesmo ocorrendo para os acidentes de trabalho típicos. Para ambos, o número de casos aumentou nesse período. O número de casos de acidentes de trabalho de trajeto e sua incidência mostraram tendência significativa de aumento. O número de óbitos e a taxa de mortalidade registraram tendência de decréscimo. São discutidos como fatores contribuintes para o declínio das taxas de incidência de acidentes de trabalho e de mortalidade por esta causa: melhoria das condições de trabalho, maior crescimento do setor de serviços do que do setor industrial, subnotificação dos acidentes de trabalho e terceirização dos serviços. O aumento dos acidentes de trabalho de trajeto sugere a influência da violência dos centros urbanos.

  1. La obtención y proyección de tablas de mortalidad empleando curvas. Spline

    Directory of Open Access Journals (Sweden)

    Alejandro MINA-VALDÉS

    2011-01-01

    Full Text Available Una de las herramientas del análisis numérico es el uso de polinomios de n-ésimo orden para interpolar entre n + 1 puntos, teniéndose casos en donde estas funciones polinómicas pueden llevar a resultados erróneos. Una alternativa es la de aplicar polinomios de orden inferior a subconjuntos de datos. Estos polinomios conectados se llaman funciones de interpolación segmentaria (spline functions. En este artículo se presenta la herramienta que el análisis numérico proporciona como instrumento técnico necesario para llevar a cabo todos los procedimientos matemáticos existentes con base a algoritmos que permitan su simulación o cálculo, en especial, las funciones splines definidas a trozos (por tramos, con interpolación mediante ellas, dando lugar a el ajuste de curvas spline con base en la serie de sobrevivientes lx de una tabla abreviada de mortalidad mexicana, con el fin de desagregarla por edad desplegada, respetando las concavidades que por el efecto de la mortalidad en las primeras edades y en las siguientes se tienen en la experiencia mexicana. También empleando las curvas splines se presentan las simulaciones que permiten obtener escenarios futuros de las series de sobrevivientes lx, que dan lugar a las proyecciones de la mortalidad mexicana para los años 2010-2050, las que generan las tablas completas de mortalidad para hombres y mujeres de dicho periodo, resaltando las diferencias entre sexos y edades de sus probabilidades de supervivencia y las ganancias en las esperanzas de vida.

  2. Endothelial Activation and Blood-Brain Barrier Disruption in Neurotoxicity after Adoptive Immunotherapy with CD19 CAR-T Cells.

    Science.gov (United States)

    Gust, Juliane; Hay, Kevin A; Hanafi, Laïla-Aïcha; Li, Daniel; Myerson, David; Gonzalez-Cuyar, Luis F; Yeung, Cecilia; Liles, W Conrad; Wurfel, Mark; Lopez, Jose A; Chen, Junmei; Chung, Dominic; Harju-Baker, Susanna; Özpolat, Tahsin; Fink, Kathleen R; Riddell, Stanley R; Maloney, David G; Turtle, Cameron J

    2017-12-01

    Lymphodepletion chemotherapy followed by infusion of CD19-targeted chimeric antigen receptor-modified T (CAR-T) cells can be complicated by neurologic adverse events (AE) in patients with refractory B-cell malignancies. In 133 adults treated with CD19 CAR-T cells, we found that acute lymphoblastic leukemia, high CD19 + cells in bone marrow, high CAR-T cell dose, cytokine release syndrome, and preexisting neurologic comorbidities were associated with increased risk of neurologic AEs. Patients with severe neurotoxicity demonstrated evidence of endothelial activation, including disseminated intravascular coagulation, capillary leak, and increased blood-brain barrier (BBB) permeability. The permeable BBB failed to protect the cerebrospinal fluid from high concentrations of systemic cytokines, including IFNγ, which induced brain vascular pericyte stress and their secretion of endothelium-activating cytokines. Endothelial activation and multifocal vascular disruption were found in the brain of a patient with fatal neurotoxicity. Biomarkers of endothelial activation were higher before treatment in patients who subsequently developed grade ≥4 neurotoxicity. Significance: We provide a detailed clinical, radiologic, and pathologic characterization of neurotoxicity after CD19 CAR-T cells, and identify risk factors for neurotoxicity. We show endothelial dysfunction and increased BBB permeability in neurotoxicity and find that patients with evidence of endothelial activation before lymphodepletion may be at increased risk of neurotoxicity. Cancer Discov; 7(12); 1404-19. ©2017 AACR. See related commentary by Mackall and Miklos, p. 1371 This article is highlighted in the In This Issue feature, p. 1355 . ©2017 American Association for Cancer Research.

  3. Frontline Science: Functionally impaired geriatric CAR-T cells rescued by increased α5β1 integrin expression.

    Science.gov (United States)

    Guha, Prajna; Cunetta, Marissa; Somasundar, Ponnandai; Espat, N Joseph; Junghans, Richard P; Katz, Steven C

    2017-08-01

    Chimeric antigen receptor expressing T cells (CAR-T) are a promising form of immunotherapy, but the influence of age-related immune changes on CAR-T production remains poorly understood. We showed that CAR-T cells from geriatric donors (gCAR-T) are functionally impaired relative to CAR-T from younger donors (yCAR-T). Higher transduction efficiencies and improved cell expansion were observed in yCAR-T cells compared with gCAR-T. yCAR-T demonstrated significantly increased levels of proliferation and signaling activation of phosphorylated (p)Erk, pAkt, pStat3, and pStat5. Furthermore, yCAR-T contained higher proportions of CD4 and CD8 effector memory (EM) cells, which are known to have enhanced cytolytic capabilities. Accordingly, yCAR-T demonstrated higher levels of tumor antigen-specific cytotoxicity compared with gCAR-T. Enhanced tumor killing by yCAR-T correlated with increased levels of perforin and granzyme B. yCAR-T had increased α5β1 integrin expression, a known mediator of retroviral transduction. We found that treatment with M-CSF or TGF-β1 rescued the impaired transduction efficiency of the gCAR-T by increasing the α5β1 integrin expression. Neutralization of α5β1 confirmed that this integrin was indispensable for CAR expression. Our study suggests that the increase of α5β1 integrin expression levels enhances CAR expression and thereby improves tumor killing by gCAR-T. © Society for Leukocyte Biology.

  4. Efecto de cohorte en la evolución de la mortalidad por enfermedad de la motoneurona en España, 1951-1992

    Directory of Open Access Journals (Sweden)

    Llorca Díaz Javier

    1999-01-01

    Full Text Available FUNDAMENTO: Se ha descrito un aumento en la mortalidad por enfermedad de la motoneurona (EMN en España en las últimas décadas; se ha sugerido que este aumento se debe a un efecto de cohorte, pero esta hipótesis no ha sido comprobada. MÉTODOS: Los datos de mortalidad por edad y sexo debido a la EMN se han obtenido del Instituto Nacional de Estadística. Se han calculado las tasas de mortalidad específicas por edad y las tasas ajustadas por edad. Mediante regresión de Poisson se ha analizado el efecto de la cohorte de nacimiento en la mortalidad por edades; el efecto de cohorte fue también analizado por métodos gráficos. RESULTADOS: La mortalidad ajustada por edad descendió hasta 1969 y aumentó desde entonces. Cada cohorte quinquenal de nacimiento aumenta en un 8,5% el riesgo de morir por EMN. CONCLUSIONES: El aumento de la mortalidad por EMN en España está causado por un efecto de cohorte.

  5. Análisis de la mortalidad expósita de la Inclusa de Toledo (1900-1930

    Directory of Open Access Journals (Sweden)

    Martín Espinosa, Noelia M.

    2016-06-01

    Full Text Available The aim of this work is to analyze the mortality and its causes in the abandoned children of the Children’s home of Toledo, who were born in the Maternity House, because it was a homogeneous group which had the same conditions in their delivery and they were abandoned at the moment of their birth. It allows us to compare the mortality of this group of foundlings with the mortality of the general population and with the mortality of those abandoned in other Charity Institutions. This paper explains the different factors which could determine the mortality.El objetivo de este trabajo es analizar la mortalidad expósita y sus causas en una cohorte de niños abandonados en la inclusa toledana, aquellos que nacieron en la Maternidad aneja, como grupo homogéneo que partía de unas condiciones de alumbramiento similares y fueron institucionalizados al nacer. Ello permite comparar esta mortalidad expósita con la de otras inclusas españolas y con la mortalidad poblacional, a la vez que explica los distintos factores que pudieron condicionarla.

  6. Classication of Status of the Region on Java Island using C4.5, CHAID, and CART Methods

    Science.gov (United States)

    Syaraswati, R. A.; Slamet, I.; Winarno, B.

    2017-06-01

    The indicator of region economic success can be measured by economic growth, presented by value of Gross Regional Domestic Product (GRDP). Java island has the biggest GDP contribution toward the Indonesian government, but not all of the region gives equality contribution. The C4.5, CHAID, and CART methods can be used for classifying the status of the region with nonparametric approach. The C4.5 and CHAID methods are non-binary decision tree, meanwhile the CART methods is binary decision tree. The purposes of this paper are to know how the classification and to determine the factors that influence on classification of the region. The dependent variable is status of the region which is divided into four categories based on Klassen typology. The result shows factors that have the biggest contribution on classification of status of the region on Java island based on C4.5 method are economic growth rate, electricity, gas, and water sector, and area. The factors that have the biggest contribution based on CHAID method are growth rate, manufacturing sector, and electricity, gas, and water sector, while based on CART method are growth rate, manufacturing sector, and electricity, gas, and water sector.

  7. Therapeutic potential of CAR-T cell-derived exosomes: a cell-free modality for targeted cancer therapy.

    Science.gov (United States)

    Tang, Xiang-Jun; Sun, Xu-Yong; Huang, Kuan-Ming; Zhang, Li; Yang, Zhuo-Shun; Zou, Dan-Dan; Wang, Bin; Warnock, Garth L; Dai, Long-Jun; Luo, Jie

    2015-12-29

    Chimeric antigen receptor (CAR)-based T-cell adoptive immunotherapy is a distinctively promising therapy for cancer. The engineering of CARs into T cells provides T cells with tumor-targeting capabilities and intensifies their cytotoxic activity through stimulated cell expansion and enhanced cytokine production. As a novel and potent therapeutic modality, there exists some uncontrollable processes which are the potential sources of adverse events. As an extension of this impactful modality, CAR-T cell-derived exosomes may substitute CAR-T cells to act as ultimate attackers, thereby overcoming some limitations. Exosomes retain most characteristics of parent cells and play an essential role in intercellular communications via transmitting their cargo to recipient cells. The application of CAR-T cell-derived exosomes will make this cell-based therapy more clinically controllable as it also provides a cell-free platform to diversify anticancer mediators, which responds effectively to the complexity and volatility of cancer. It is believed that the appropriate application of both cellular and exosomal platforms will make this effective treatment more practicable.

  8. HIV-associated cognitive performance and psychomotor impairment in a Thai cohort on long-term cART.

    Science.gov (United States)

    Do, Tanya C; Kerr, Stephen J; Avihingsanon, Anchalee; Suksawek, Saowaluk; Klungkang, Supalak; Channgam, Taweesak; Odermatt, Christoph C; Maek-A-Nantawat, Wirach; Ruxtungtham, Kiat; Ananworanich, Jintanat; Valcour, Victor; Reiss, Peter; Wit, Ferdinand W

    2018-01-01

    To assess cognitive performance and psychomotor impairment in an HIV-positive cohort, well-suppressed on combination antiretroviral therapy (cART), in an Asian resource-limited setting. Cross-sectional sociodemographic and cognitive data were collected in 329 HIV-positive and 510 HIV-negative participants. Cognitive performance was assessed using the International HIV Dementia Scale (IHDS), Montreal Cognitive Assessment (MoCA), WAIS-III Digit Symbol, Trail Making A, and Grooved Pegboard (both hands). Psychomotor test scores in the HIV-positive participants were converted to Z-scores using scores of the HIV-negative participants as normative data. Psychomotor impairment was defined as performance on two tests more than 1 standard deviation (SD) from controls or more than 2 SD on one test. Multivariate linear and logistic regression analyses were used to investigate associations between HIV and non-HIV-related covariates and poorer cognitive performance and psychomotor impairment. HIV-positive participants, mean age 45 (SD 7.69) years received cART for a median of 12.1 years (interquartile range [IQR] 9.1-14.4). Median CD4 cell count was 563 cells/mm 3 (IQR 435-725), and 92.77% had plasma HIV RNA performance (tests all P 90% on long-term cART, we found that inferior cognitive performance and psychomotor impairment were primarily associated with non-HIV-related factors.

  9. Psychometric properties of the Belgian coach version of the coach-athlete relationship questionnaire (CART-Q).

    Science.gov (United States)

    Balduck, A-L; Jowett, S

    2010-10-01

    The study examined the psychometric properties of the Belgian coach version of the Coach-Athlete Relationship Questionnaire (CART-Q). The questionnaire includes three dimensions (Closeness, Commitment, and Complementarity) in a model that intends to measure the quality of the coach-athlete relationship. Belgian coaches (n=144) of athletes who performed at various competition levels in such sports as football, basketball, and volleyball responded to the CART-Q and to the Leadership Scale for Sport (LSS). A confirmatory factor analysis proved to be slightly more satisfactory for a three-order factor model, compared with a hierarchical first-order factor model. The three factors showed acceptable internal consistency scores. Moreover, functional associations between the three factors and coach leadership behaviors were found offering support to the instrument's concurrent validity. The findings support previous validation studies and verify the psychometric properties of the CART-Q applied to Belgian coaches of team sports. © 2009 John Wiley & Sons A/S.

  10. A Car Transportation System in Cooperation by Multiple Mobile Robots for Each Wheel: iCART II

    Science.gov (United States)

    Kashiwazaki, Koshi; Yonezawa, Naoaki; Kosuge, Kazuhiro; Sugahara, Yusuke; Hirata, Yasuhisa; Endo, Mitsuru; Kanbayashi, Takashi; Shinozuka, Hiroyuki; Suzuki, Koki; Ono, Yuki

    The authors proposed a car transportation system, iCART (intelligent Cooperative Autonomous Robot Transporters), for automation of mechanical parking systems by two mobile robots. However, it was difficult to downsize the mobile robot because the length of it requires at least the wheelbase of a car. This paper proposes a new car transportation system, iCART II (iCART - type II), based on “a-robot-for-a-wheel” concept. A prototype system, MRWheel (a Mobile Robot for a Wheel), is designed and downsized less than half the conventional robot. First, a method for lifting up a wheel by MRWheel is described. In general, it is very difficult for mobile robots such as MRWheel to move to desired positions without motion errors caused by slipping, etc. Therefore, we propose a follower's motion error estimation algorithm based on the internal force applied to each follower by extending a conventional leader-follower type decentralized control algorithm for cooperative object transportation. The proposed algorithm enables followers to estimate their motion errors and enables the robots to transport a car to a desired position. In addition, we analyze and prove the stability and convergence of the resultant system with the proposed algorithm. In order to extract only the internal force from the force applied to each robot, we also propose a model-based external force compensation method. Finally, proposed methods are applied to the car transportation system, the experimental results confirm their validity.

  11. Effects of pushing height on trunk posture and trunk muscle activity when a cart suddenly starts or stops moving.

    Science.gov (United States)

    Lee, Yun-Ju; Hoozemans, Marco J M; van Dieën, Jaap H

    2012-01-01

    Unexpected sudden (un)loading of the trunk may induce inadequate responses of trunk muscles and uncontrolled trunk motion. These unexpected perturbations may occur in pushing tasks, when the cart suddenly starts moving (unloading) or is blocked by an obstacle (loading). In pushing, handle height affects the user's working posture, which may influence trunk muscle activity and trunk movement in response to the perturbation. Eleven healthy male subjects pushed a 200 kg cart with handles at shoulder and hip height in a start condition (sudden release of brakes) and a stop condition (bumping into an obstacle). Before the perturbation, the baseline of the trunk inclination, internal moment and trunk extensor muscle activity were significantly higher when pushing at hip height than at shoulder height. After the perturbation, the changes in trunk inclination and internal moment were significantly larger when pushing at shoulder height than at hip height in both conditions. The opposite directions of changes in trunk inclination and internal moment suggest that the unexpected perturbations caused uncontrolled trunk motion. Pushing at shoulder height may impose a high risk of low-back injury due to the low trunk stiffness and large involuntary trunk motion occurring after carts suddenly move or stop.

  12. Bacterial Contamination and Disinfection Status of Laryngoscopes Stored in Emergency Crash Carts

    Science.gov (United States)

    Lee, Jung Won; Shin, Hee Bong; Lee, In Kyung

    2017-01-01

    Objectives To identify bacterial contamination rates of laryngoscope blades and handles stored in emergency crash carts by hospital and area according to the frequency of intubation attempts. Methods One hundred forty-eight handles and 71 blades deemed ready for patient use from two tertiary hospitals were sampled with sterile swabs using a standardized rolling technique. Samples were considered negative (not contaminated) if no colonies were present on the blood agar plate after an 18-hour incubation period. Samples were stratified by hospital and according to the frequency of intubation attempts (10 attempts per year) using the χ2-test and Fisher exact test. Results One or more species of bacteria were isolated from 4 (5.6%) handle tops, 20 (28.2%) handles with knurled surfaces, and 27 (18.2%) blades. No significant differences were found in microbial contamination levels on the handle tops and blades between the two hospitals and two areas according to the frequency of intubation attempts. However, significant differences were found between the two hospitals and two areas in the level of microbial contamination on the handles with knurled surfaces (pdisinfect laryngoscope blades and handles; handles should be re-designed to eliminate points of contact with the blade; and single-use, one-piece laryngoscopes should be introduced. PMID:28605891

  13. Delay In The Issuing Of D-Type Swiss Cartes De Legitimation

    CERN Multimedia

    DSU Department

    2007-01-01

    The Permanent Mission of Switzerland to the International Organisations in Geneva has informed CERN that, for technical reasons, the Federal Department of Foreign Affairs (Département fédéral des Affaires étrangères - DFAE) will be unable to issue D-type cartes de légitimation until after 15 December 2007. This is because, following the introduction of a new graphic design decided by the Swiss Federal Council, stocks of this type of card have run out. In the meantime, the Mission will issue E-type cards to the individuals concerned. These are valid for six months and will be gradually exchanged for D-type cards between December 2007 and February 2008. The Mission points out that the holding of an E-type card for a limited period will have no impact on the status of the officials in question, who will continue to benefit from immunity from jurisdiction in the discharge of their duties and be exempt from the payment of the annual tax on vehicles (a special note to this effect will be sent to the relevant...

  14. Delay in the issuing of D-type Swiss cartes de légitimation

    CERN Multimedia

    DSU Department

    2007-01-01

    The Permanent Mission of Switzerland to the International Organisations in Geneva has informed CERN that, for technical reasons, the Federal Department of Foreign Affairs (Département fédéral des Affaires étrangères - DFAE) will be unable to issue D-type cartes de légitimation until after 15 December 2007. This is because, following the introduction of a new graphic design decided by the Swiss Federal Council, stocks of this type of card have run out. In the meantime, the Mission will issue E-type cards to the individuals concerned. These are valid for six months and will be gradually exchanged for D-type cards between December 2007 and February 2008. The Mission points out that the holding of an E-type card for a limited period will have no impact on the status of the officials in question, who will continue to benefit from immunity from jurisdiction in the discharge of their duties and be exempt from the payment of the annual tax on vehicles (a special note to this e...

  15. Site Scientific Mission Plan for the Southern Great Plains CART site: January--June 1994

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, J.M.; Lamb, P.J. [Univ. of Oklahoma, Norman, OK (United States). Cooperative Inst. for Mesoscale Meteorological Studies; Sisterson, D.L. [Argonne National Lab., IL (United States). Environmental Research Div.

    1993-12-01

    The Southern Great Plains (SGP) Cloud and Radiation Testbed (CART) site is designed to help satisfy the data needs of the Atmospheric Radiation Measurement (ARM) Program Science Team. This document defines the scientific priorities for site activities during the six months beginning on January 1, 1994, and also looks forward in lesser detail to subsequent six-month periods. The primary purpose of this Site Scientific Mission Plan is to provide guidance for the development of plans for site operations. It also provides information on current plans to the ARM Functional Teams (Management Team, Experiment Support Team, Operations Team, Data Management Team, Instrument Team, and Campaign Team), and it serves to disseminate the plans more generally within the ARM Program and among the Science Team. This document includes a description of the site`s operational status and the primary envisaged site activities, together with information concerning approved and proposed Intensive Observation Periods. Amendments will be prepared and distributed whenever the content changes by more than 30% within a six-month period. The primary users of this document are the site operator, the site scientist, the Science Team through the ARM Program Science Director, the ARM Program Experiment Center, and the aforementioned ARM Program Functional Teams. This plan is a living document that will be updated and reissued every six months as the observational facilities are developed, tested, and augmented and as priorities are adjusted in response to developments in scientific planning and understanding.

  16. FY16 Safeguards Technology Cart-Portable Mass Spectrometer Project Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, Cyril V. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Whitten, William B. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-02-01

    The Oak Ridge National Laboratory project for the Next Generation Safeguards Initiative Safeguards Technology Development Subprogram has been involved in the development of a cart portable mass spectrometer based on a Thermo ITQ ion trap mass spectrometer (referred to simply as the ITQ) for the field analysis of 235U/238U ratios in UF6. A recent discovery of the project was that combining CO2 with UF6 and introducing the mixture to the mass spectrometer (MS) appeared to increase the ionization efficiency and, thus, reduce the amount of UF6 needed for an analysis while also reducing the corrosive effects of the sample. However, initial experimentation indicated that mixing parameters should be closely controlled to ensure reproducible results. To this end, a sample manifold (SM) that would ensure the precise mixing of UF6 and CO2 was designed and constructed. A number of experiments were outlined and conducted to determine optimum MS and SM conditions which would provide the most stable isotope ratio analysis. The principal objective of the project was to provide a retrofit ITQ mass spectrometer operating with a SM capable of achieving a variation in precision of less than 1% over 1 hour of sampling. This goal was achieved by project end with a variation in precision of 0.5 to 0.8% over 1 hour of sampling.

  17. Site scientific mission plan for the Southern Great Plains CART site: January 1997--June 1997

    Energy Technology Data Exchange (ETDEWEB)

    Peppler, R.A.; Lamb, P.J. [Univ. of Oklahoma, Norman, OK (United States). Cooperative Institute for Mesoscale Meteorological Studies; Sisterson, D.L. [Argonne National Lab., IL (United States)

    1997-01-01

    The Southern Great Plains (SGP) Cloud and Radiation Testbed (CART) site is designed to help satisfy the data needs of the Atmospheric Radiation Measurement (ARM) Program Science Team. This document defines the scientific priorities for site activities during the six months beginning on January 1, 1997, and looks forward in lesser detail to subsequent six-month periods. The primary purpose of this Site Scientific Mission Plan is to provide guidance for the development of plans for site operations. It also provides information on current plans to the ARM functional teams (Management Team, Data and Science Integration Team [DSIT], Operations Team, Instrument Team [IT], and Campaign Team) and serves to disseminate the plans more generally within the ARM Program and among the members of the Science Team. This document includes a description of the operational status of the site and the primary site activities envisioned, together with information concerning approved and proposed intensive observation periods (IOPs). The primary users of this document are the site operator, the Site Scientist Team (SST), the Science Team through the ARM Program science director, the ARM Program Experiment Center, and the aforementioned ARM Program functional teams. This plan is a living document that is updated and reissued every six months as the observational facilities are developed, tested, and augmented and as priorities are adjusted in response to developments in scientific planning and understanding.

  18. Site scientific mission plan for the Southern Great Plains CART site: July--December 1997

    Energy Technology Data Exchange (ETDEWEB)

    Peppler, R.A.; Lamb, P.J. [Univ. of Oklahoma, Norman, OK (United States). Cooperative Inst. for Mesoscale Meteorological Studies; Sisterson, D.L. [Argonne National Lab., IL (United States). Environmental Research Div.

    1997-07-01

    The Southern Great Plains (SGP) Cloud and Radiation Testbed (CART) site is designed to help satisfy the data needs of the Atmospheric Radiation Measurement (ARM) Program Science Team. This document defines the scientific priorities for site activities during the six months beginning on July 1, 1997, and looks forward in lesser detail to subsequent six-month periods. The primary purpose of this Site Scientific Mission Plan is to provide guidance for the development of plans for site operations. It also provides information on current plans to the ARM functional teams and serves to disseminate the plans more generally within the ARM Program and among the members of the Science Team. This document includes a description of the operational status of the site and the primary site activities envisioned, together with information concerning approved and proposed intensive observation periods (IOPs). This plan is a living document that is updated and reissued every six months as the observational facilities are developed, tested, and augmented and as priorities are adjusted in response to developments in scientific planning and understanding.

  19. Site scientific mission plan for the southern Great Plains CART site, January--June 1998

    Energy Technology Data Exchange (ETDEWEB)

    Peppler, R.A.; Lamb, P.J. [Univ. of Oklahoma, Norman, OK (United States). Cooperative Inst. for Mesoscale Meteorological Studies; Sisterson, D.L. [Argonne National Lab., IL (United States). Environmental Research Div.

    1998-01-01

    The Southern Great Plains (SGP) Cloud and Radiation Testbed (CART) site is designed to help satisfy the data needs of the Atmospheric Radiation Measurement (ARM) Program Science Team. The primary purpose of this site scientific mission plan is to provide guidance for the development of plans for site operations. It also provides information on current plans to the ARM functional teams (Management Team, Data and Science Integration Team, Operations Team, and Instrument Team) and serves to disseminate the plans more generally within the ARM Program and among the members of the Science Team. This document includes a description of the operational status of the site and the primary site activities envisioned, together with information concerning approved and proposed intensive observation periods (IOPs). The primary users of this document are the Site operator, the Site Scientist Team (SST), the Science Team through the ARM Program science director, the ARM Program Experiment Center, and the aforementioned ARM Program functional teams. This plan is a living document that is updated and reissued every six months as the observational facilities are developed, tested, and augmented and as priorities are adjusted in response to developments in scientific planning and understanding.

  20. Site scientific mission plan for the Southern Great Plains CART Site, January--June 1999

    Energy Technology Data Exchange (ETDEWEB)

    Peppler, R.A.; Sisterson, D.L.; Lamb, P.

    1999-03-10

    The Southern Great Plains (SGP) Cloud and Radiation Testbed (CART) site was designed to help satisfy the data needs of the Atmospheric Radiation Measurement (ARM) Program Science Team. This Site Scientific Mission Plan defines the scientific priorities for site activities during the six months beginning on January 1, 1999, and looks forward in lesser detail to subsequent six-month periods. The primary purpose of this document is to provide scientific guidance for the development of plans for site operations. It also provides information on current plans to the ARM functional teams (Management Team, Data and Science Integration Team [DSIT], Operations Team, and Instrument Team [IT]) and serves to disseminate the plans more generally within the ARM Program and among the members of the Science Team. This document includes a description of the operational status of the site and the primary site activities envisioned, together with information concerning approved and proposed intensive observation periods (IOPs). The primary users of this document are the site operator, the site program manager, the Site Scientist Team (SST), the Science Team through the ARM Program science director, the ARM Program Experiment Center, and the aforementioned ARM Program functional teams. This plan is a living document that is updated and reissued every six months as the observational facilities are developed, tested, and augmented and as priorities are adjusted in response to developments in scientific planning and understanding.