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BackgroundIntensive care unit (ICU) prolonged immobilization may lead to lower-extremity muscle deconditioning among critically ill patients, particularly more accentuated in those with 2019 Novel Coronavirus (COVID-19) infection. Electrical stimulation (E-Stim) is known to improve musculoskeletal outcomes. This phase I double-blinded randomized controlled trial examined the safety and efficacy of lower-extremity E-Stim to prevent muscle deconditioning.MethodsCritically ill COVID-19 patients admitted to the ICU were randomly assigned to control (CG) or intervention (IG) groups. Both groups received daily E-Stim (1 h) for up to 14 days on both gastrocnemius muscles (GNMs). The device was functional in the IG and non-functional in the CG. Primary outcomes included ankle strength (Ankles) measured by an ankle-dynamometer, and GNM endurance (GNMe) in response to E-Stim assessed with surface electromyography (sEMG). Outcomes were measured at baseline, 3 and 9 days.ResultsThirty-two (IG = 16, CG = 16) lower extremities in 16 patients were independently assessed. The mean time between ICU admission and E-Stim therapy delivery was 1.8 ± 1.9 days (p = 0.29). At 3 days, the IG showed an improvement compared to the CG with medium effect sizes for Ankles (p = 0.06, Cohen’s d = 0.77) and GNMe (p = 0.06, d = 0.69). At 9 days, the IG GNMe was significantly higher than the CG (p = 0.04, d = 0.97) with a 6.3% improvement from baseline (p = 0.029). E-Stim did not alter vital signs (i.e., heart/respiratory rate, blood saturation of oxygen), showed no adverse events (i.e., pain, skin damage, discomfort), nor interfere with ICU standard of care procedures (i.e., mechanical ventilation, prone rotation).ConclusionThis study supports the safety and efficacy of early E-Stim therapy to potentially prevent deterioration of lower-extremity muscle conditions in critically ill COVID-19 patients recently admitted to the ICU. If confirmed in a larger sample, E-Stim may be used as a practical adjunctive therapy.Clinical trial registration[https://clinicaltrials.gov/], identifier [NCT04685213].

Additional file 2: Appendix II. Scheme of the plantation process of the assisted natural succession.

Additional file 1: Appendix I. Scheme of the plantation process of the assisted ecological succession.

An evaluation of the parameters that define a proposed boundary value problem solved with the finite element method as an approach to emulate the bio-mechanical response of arteries at an instability point. Blood vessels are idealized as cylinder tubes with different geometries and boundary conditions that incorporate an invariant based, hyper-elastic and residually stressed material model as a subroutine in a finite element software. A sequential, three-step, mechanical analysis that simultes the in vivo conditioning and physiological actions is applied; the analysis consists on the application of residual stresses, an imposed axial stretch and the application of uniform internal pressure. The models are restricted to obtain instabilities of bending and bulging bifurcation modes, the first is related to mechanical buckling for the mode m=1, while the second one to the propagation of a bulge in the middle section. The average azimuthal and axial stresses are evaluated along the axial direction; uniform distributions are found at the bifurcation point for models in the bending mode, while peaks in the middle section are found for bulging which indicate radial displacements. Stresses in the axial direction tend to increase due to the stretch in that direction, eventually surpassing the ones in the hoop direction. The critical uniform pressure reached at a bifurcation point defines the corresponding onset of bifurcation in terms of the axial stretch. The bending mode is related to low values of axial stretch, but bulging becomes the onset of bifurcation at values above a defined transition value. The transition value increases for more slender cylinder tubes and for lower values of the magnitude of residual stresses. The critical pressure values at their corresponding transition values also tend to decrease for higher magnitudes of residual stresses. A description of the stages of the mechanical analyses are included in terms of the history of configurations for both bifurcation modes. The bulging mode is characterized for having both maximum critical uniform pressure and stresses at the bifurcation point. For certain axial stretches, the bending mode presents the propagation of a secondary lateral bulge at a post-bifurcation stage at a higher critical pressure applied which is related to abdominal aortic aneurysms.

Floristic inventory of the study areas at the tamaulipan thornscrub vegetation. (DOCX 22 kb)

Análisis del acceso al ser en Schelling. Aclaración, contextualización y valoración del peculiar acceso al ser que lleva a cabo el filósofo de Leonberg especialmente a partir de 1809, tomando como punto de referencia la distinción entre la esencia (das Wesen) en tanto que existe (das aktuale Sein) y la esencia (das Wesen) en tanto que esencia pura (das reine Wesen). Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech.

El presente trabajo de grado pretende establecer la manera en que las formas de conocer determinadas por la teoría APOE se relacionan la estructura de dos libros de texto de grado octavo en cuanto a los procesos infinitos que se involucran en la construcción de los Números Reales. Para alcanzar este fin, se analizaron las unidades de dos textos de octavo grado que estuvieran dirigidas a la construcción de los números reales y en éstas se determinó la manera como los procesos infinitos se involucran con la Conmensurabilidad e Inconmensurabilidad, la Racionalidad e Irracionalidad, la Completitud y Continuidad que son aspectos que junto a las formas de conocer establecidas por la teoría APOE determinaron las categorías de análisis.

El presente trabajo, contiene informacion recopilada del cultivo de pina Golden en el valle de Satipo, durante las multiples visitas realizadas al fundo Santa Teresa de la Universidad Nacional Agraria La Molina, como viajes de practicas del curso de Mecanizacion Agricola. La idea fundamental es brindar informacion al lector interesado en desarrollar el cultivo de pina Golden, una vision de las diferentes actividades que intervienen en su produccion, asi como brindar conocimiento del avance obtenido por la Universidad Nacional Agraria La Molina y su metodologia de cultivo en este campo. Asimismo, que pueda servir como incentivo al cambio del cultivo de la coca con uno alternativo de futuro economico promisorio.

In this brief report we propose a simple model based on the properties of an electric capacitor under short-circuit conditions as a possible mechanism of radio emissions associated with earthquakes. This model can be considered as complementary to other models concerning the same problem.

Sub-Saharan Africa represents only a small share of global production and trade while hosting half of the extreme poor worldwide. To catch up with the rest of the world, the continent has no alternative: it must undertake reforms to scale up its supply capacity while better linking its production and trade to the global economy. If it does so, it stands to gain from unlimited demand and innovation along the supply chain. Some progress has been made over the past decade, with the region’s exports and imports growing rapidly. Because most African economies rely heavily on trade for a large share of national income, they will also be more vulnerable to the trade disruptions of external shocks, as illustrated by the recent COVID-19 pandemic. Africa in the New Trade Environment: Market Access in Troubled Times provides a comprehensive, state-of-the-art analysis by a team of renowned trade economists who present a strategy to bolster Sub-Saharan Africa’s market access in the current global environment.

82 páginas : ilustraciones, gráficos, planos. There is literature for other countries in Latin America about the relationship between investments in maintenance and provision of infrastructure and educational performance. For the Colombian case, similar works are unknown. Specifically, there are no studies on the resources invested by the Secretaries of Education and the Educational Services Funds in the face of the results of the knowledge tests of students from public institutions. Secondary data were analyzed and 587 surveys were applied in educational institutions of the Suba Locality of Bogota as the first pilot scenario to develop this analysis at the Colombian level. The results show that there is not enough empirical evidence to show that the resources invested in connectivity, locative maintenance, school feeding and other items, have a positive impact on the results of student knowledge tests. Although, the results should be interpreted with caution, they are clear in showing that one should begin to review the current model of allocation of resources from the Ministry of Education and the institutions to encourage better indicators of educational performance. Existe literatura para otros países de Latinoamérica acerca de la relación entre inversiones en mantenimiento y dotación de infraestructura y desempeño educativo. Para el caso colombiano, se desconocen trabajos similares. Específicamente se desconocen estudios sobre los recursos invertidos por la Secretarias de Educación y los Fondos de Servicios Educativos frente a los resultados de las pruebas de conocimiento de estudiantes de instituciones públicas. Se analizaron datos secundarios y se aplicaron 587 encuestas en instituciones educativas de la Localidad de Suba de Bogotá como primer escenario piloto para desarrollar este análisis a nivel Colombia. Los resultados reflejan que no existe evidencia empírica suficiente para mostrar que los recursos invertidos en conectividad, mantenimientos locativos, alimentación escolar y otros rubros, inciden positivamente en los resultados de pruebas de conocimiento de los estudiantes. Si bien, los resultados deben ser interpretados con cautela, son claros en mostrar que se debe empezar a revisar el actual modelo de asignación de recursos desde la Secretaria de Educación y las instituciones para incentivar mejores indicadores de desempeño educativo. Maestría Magíster en Gobierno y Políticas Públicas