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This paper develops the concept of flood problem framing to understand decision-makers’ priorities in flood risk management in the Los Angeles Metropolitan Region in California (LA Metro). Problem frames shape an individual’s preferences for particular management strategies and their future behaviors. While flooding is a complex, multifaceted problem, with multiple causes and multiple impacts, a decision-maker is most likely to manage only those dimensions of flooding about which they are aware or concerned. To evaluate flood decision-makers’ primary concerns related to flood exposure, vulnerability, and management in the LA Metro, we draw on focus groups with flood control districts, city planners, nonprofit organizations, and other flood-related decision-makers. We identify numerous concerns, including concerns about specific types of floods (e.g., fluvial vs pluvial) and impacts to diverse infrastructure and communities. Our analyses demonstrate that flood concerns aggregate into three problem frames: one concerned with large fluvial floods exacerbated by climate change and their housing, economic, and infrastructure impacts; one concerned with pluvial nuisance flooding, pollution, and historic underinvestment in communities; and one concerned with coastal and fluvial flooding’s ecosystem impacts. While each individual typically articulated concerns that overlapped with only one problem frame, each problem frame was discussed by numerous organization types, suggesting low barriers to cross-organizational coordination in flood planning and response. This paper also advances our understanding of flood risk perception in a region that does not face frequent large floods. Significance Statement This paper investigates the primary concerns that planners, flood managers, and other decision-makers have about flooding in Southern California. This is important because the way that decision-makers understand flooding shapes the way that they will plan for and resp

Global warming is having impacts across the Tree of Life. Understanding species’ physiological sensitivity to temperature change and how they relate to local temperature variation in their habitats is crucial to determining vulnerability to global warming. We ask how species’ vulnerability varies across habitats and elevations, and how climatically buffered microhabitats can contribute to reduce their vulnerability. We measured thermal sensitivity (critical thermal maximum—CT) of 14 species of Pristimantis frogs inhabiting young and old secondary, and primary forests in the Colombian Andes. Exposure to temperature stress was measured by recording temperature in the understorey and across five microhabitats. We determined frogs’ current vulnerability across habitats, elevations and microhabitats accounting for phylogeny and then ask how vulnerability varies under four warming scenarios: +1.5, +2, +3 and +5°C. We found that CT was constant across species regardless of habitat and elevation. However, species in young secondary forests are expected to become more vulnerable because of increased exposure to higher temperatures. Microhabitat variation could enable species to persist within their thermal temperature range as long as regional temperatures do not surpass +2°C. The effectiveness of microhabitat buffering decreases with a 2–3°C increase, and is almost null under a 5°C temperature increase. Microhabitats will provide thermal protection to Andean frog communities from climate change by enabling tracking of suitable climates through short distance movement. Conservation strategies, such as managing landscapes by preserving primary forests and allowing regrowth and reconnection of secondary forest would offer thermally buffered microhabitats and aid in the survival of this group.

Evaluar si el análisis combinado de medición del índice de engrosamiento diafragmático en conjunto con las líneas B pulmonares medido por ecografía mejora la predicción de éxito en el destete de la ventilación mecánica en pacientes de la terapia intensiva adultos. Material y Métodos.- Se realizó un estudio observacional, prospectivo en una población de 82 pacientes los cuales cumplieran con un ensayo de respiración superficial exitoso y fueran elegidos para el retiro de la ventilación mecánica, a los cuales se les realizó ultrasonido torácico, midiendo el espesor diafragmático al final de la inspiración - espesor diafragmático al final de la espiración / espesor diafragmático al final de la espiración x 100, y la presencia de líneas B en cinco regiones de la derecha y el pulmón izquierdo.

During the last three decades, FPGA technology has quickly evolved to become a major subject of research in computer and electrical engineering as it has been identified as a powerful alternative for creating highly efficient computing systems. FPGA devices offer substantial performance improvements when compared against traditional processing architectures via custom design and reconfiguration capabilities.

Background and aimsFew studies evaluate the impact of anesthesia providers during procedures, such as colonoscopy, on low-risk patients. The objective of this study was to compare the effect of anesthesia providers on several outcome variables, including major morbidity, following screening colonoscopies.MethodsA propensity-matched cohort study of 14,006 patients who enrolled with a national insurer offering health maintenance organization (HMO), preferred provider organization (PPO), and Medicare Advantage plans for a screening colonoscopy between July 1, 2005 and June 30, 2007 were studied. Records were evaluated for completion of the colonoscopy, new cancer diagnosis (colon, anal, rectal) within 6 months of the colonoscopy, new primary diagnosis of myocardial infarction (MI), new primary diagnosis of stroke, hospital admission within 7 days of the colonoscopy, and adherence to guidelines for use of anesthesia providers.ResultsThe presence of an anesthesia provider did not affect major morbidity or the percent of completed exams. Overall morbidity within 7 days was very low. When an anesthesia provider was present, a nonsignificant trend toward greater cancer detection within 6 months of the procedure was observed. Adherence to national guidelines regarding the use of anesthesia providers for low-risk patients was poor.ConclusionA difference in outcome associated with the presence or absence of an anesthesia provider during screening colonoscopy in terms of MI, stroke, or hospital admission within 7 days of the procedure was not observed. Adherence to published guidelines for the use of anesthesia providers is low. The incidence of completed exams was unaffected by the presence of an anesthesia provider. However, a nonstatistically significant trend toward increased cancer detection requires further study.

David A Lubarsky,1 Jason R Guercio,2 John W Hanna,3,4 Maria T Abreu,5 Qianli Ma,3 Claudia Uribe,3 David J Birnbach,1,6 David R Sinclair,1 Keith A Candiotti1 1Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami – Miller School of Medicine, Miami, FL, USA; 2Department of Anesthesiology, Duke University, Durham, NC, USA; 3Humana, Comprehensive Health Insights, Miami, FL, USA; 4University of Miami – Miller School of Medicine, Miami, FL, USA; 5Department of Medicine, Division of Gastroenterology, University of Miami – Miller School of Medicine, Miami, FL, USA; 6Department of Public Health Sciences, University of Miami – Miller School of Medicine, Miami, FL, USA Background and aims: Few studies evaluate the impact of anesthesia providers during procedures, such as colonoscopy, on low-risk patients. The objective of this study was to compare the effect of anesthesia providers on several outcome variables, including major morbidity, following screening colonoscopies. Methods: A propensity-matched cohort study of 14,006 patients who enrolled with a national insurer offering health maintenance organization (HMO), preferred provider organization (PPO), and Medicare Advantage plans for a screening colonoscopy between July 1, 2005 and June 30, 2007 were studied. Records were evaluated for completion of the colonoscopy, new cancer diagnosis (colon, anal, rectal) within 6 months of the colonoscopy, new primary diagnosis of myocardial infarction (MI), new primary diagnosis of stroke, hospital admission within 7 days of the colonoscopy, and adherence to guidelines for use of anesthesia providers. Results: The presence of an anesthesia provider did not affect major morbidity or the percent of completed exams. Overall morbidity within 7 days was very low. When an anesthesia provider was present, a nonsignificant trend toward greater cancer detection within 6 months of the procedure was observed. Adherenc

Introduction. Population-based cancer registries provide vital information for planning, prevention and cancer management. Information generated by the registries must be comprehensive, valid and comparable. Because of their importance, regular quality assessments are recommended.Objective. The quality of cancer incidence data were assessed at four population-based cancer registries in Colombia for cancer incidence estimations.Material and methods. Data collected at population-based cancer registries of Bucaramanga, Cali, Pasto, and Manizales were included. Completeness was assessed by the use of graphs in illustrating the mortality incidence ratios and their relation to the survival. Validity was evaluated by the description of morphologically verified cases, cases identified from death certificates only, and the internal consistency of the data.Results. There was a global under-coverage of cancer registration at Bucaramanga and Manizales, whereas a more specific under-coverage for certain localizations was observed in Cali and Pasto. Validity analyses established that death certificates were little used as a source of information, and some inconsistencies appeared among the data associated with the most valid basis of diagnosis and morphology.Conclusions. In Colombia, the data quality at population-based cancer registries can be further improved by considering the use of additional sources of information, such as death certificates, theuse of specialized software for data capture, and automatic validation of internal consistency. Mortality certification must be improved in areas where a population-based cancer registry is operating. doi: http://dx.doi.org/10.7705/biomedica.v32i4.756, Introducción. La información de los registros de población de cáncer resulta de vital importancia enla planeación, prevención y manejo del cáncer. La información generada por los registros debe ser exhaustiva, válida y comparable, por lo que se recomienda hacer evaluaciones periódicas de calidad.Objetivo. Evaluar algunos aspectos relacionados con la exhaustividad y la validez de la información recolectada por los registros de población de cáncer en Colombia para estimar las cifras de cáncer enel país.Materiales y métodos. Se evaluó la información de los registros de población de Bucaramanga, Cali, Pasto y Manizales. La exhaustividad se analizó mediante las razones de mortalidad, incidencia y su relación con la supervivencia. La validez se estableció con la descripción de los casos verificados morfológicamente y los registrados en certificados de defunción. Finalmente, se describieron las inconsistencias generadas.Resultados. El análisis de exhaustividad mostró un subregistro general en los registros de Bucaramanga y Manizales, y un subregistro para algunas localizaciones en todos los registros. El análisis de validez indicó un bajo uso de los certificados de defunción como fuente de información y porcentajes importantes de inconsistencias entre la base de diagnóstico y la histología.Conclusiones. La calidad de la información de los registros de población de cáncer en Colombia puede ser mejorada al considerar fuentes adicionales de información, el uso de software especializado en captura y validación, y fortalecimiento en el registro de la mortalidad en las áreas de cobertura. doi: http://dx.doi.org/10.7705/biomedica.v32i4.756

This presentation was commissioned by the Trade and Integration Network of the Regional Policy Dialogue for the 7th Hemispheric Meeting held on September 11th and 12th, 2006. This presentation discusses the creation of a task force to provide recommendations on how to operationalize Aid for Trade. The author is Claudia Uribe, the Colombian ambassador to the World Trade Organization (WTO).

Forward Error Correction is a key piece in modern digital communications. When a signal is transmitted over a noisy channel, multiple errors are generated. FEC techniques are directed towards the recovery of such errors. In last years, LDPC (Low Density Parity Check) codes have attracted attention of researchers because of their excellent error correction capabilities, but for actual radios high performance is not enough since they require to communicate with other multiple radios too. In general, communication between multiple radios requires the use of different standards. In this sense, Software Defined Radio (SDR) approach allows building multi standard radios based on reconfigurability abilities which means that base components including recovery errors block must provide reconfigurable options. In this paper, some open problems in designing and implementing reconfigurable LDPC components are presented and discussed. Some features of works in the state of the art are commented and possible research lines proposed.

Skin cancer is tne most common cancer in numans. It's responsible for naif of all tne malignant neoplasm in tne United States of America and by tne year 2008 more tnan a million cases will be diagnosed. Tne true incidence of tnese tumors is unknown in Colombia due to tne subregistry of patients witn tne condition and tnat data from otner countries does not apply to our own, due to tne geograpnical difference, witn greater ultaviolet lignt exposure in tnis region, wnicn is tne mayor risk factor for this type of tumors. Of skin cancer. the non melanoma. which includes the squamous cell carcinoma and the basal cell carcinoma constitute 80 % of all tumors. Malignant melanoma is less frecuent and imposes high risk of death if not detected in an early stage. This was the reason for doing a campaign for the prevention and detection of skin cancer searching for the types of skin tumors and other related sun lesions detected in our city. Also education was given to patients about the dangers of the sun and the importance of early consultation. To accomplish this task. people greater than 18 years of age, with rough lesions. cutaneous ulcers that had not healed, or pigmented lesions that changed color 0 size, where invited through the media to a free consult with dermatologist and dermatology residents form CES University. In the 736 volunteers that participated in the campaign there where 58 basal cell carcinoma, 10 squamous cell carcinoma, 6 melanomas, 101 premalignant lesions (Actinic Keratosis and atypical nevus), and 145 lesions related to sun exposure. Incidence of skin cancer in Colombia is not known, the solar radiation is a very important factor in the skin neoplasms pathogenesis and our population, living in the tropics. receives sun all the year. Although studies of screening for skin cancer don't help to study prevalence and incidence of cancer, they give an idea of how frequent are tlie morbidities related to solar radiation and put on alert about the importance, El cáncer de piel es el más frecuente en el ser humano y es el responsable de la mitad de todas las neoplasias malignas en Estados Unidos. La incidencia total de todos estos tumores en Colombia no se conoce ya que no se lleva un registro adecuado y los datos disponibles de otros países no serían aplicables al nuestro, debido a la ubicación geográfica con una gran influencia de la luz ultravioleta, principal factor implicado en las neoplasias cutáneas. El cáncer cutáneo no melanoma (CCNM), que incluye el carcinoma escamocelular (SCC) y el basocelular (BCC) constituye aproximadamente el 80 % de todos los cánceres de la piel. El melanoma maligno (MM), aunque menos frecuente, pone en peligro la vida del paciente y de su detección temprana depende la sobrevida. Se realizó una campaña de detección de cáncer de piel, buscando conocer qué tipo de carcinomas de piel y otras lesiones relacionadas con el sol se presentan en la ciudad, buscando además educar a los pacientes sobre los peligros del sol y la importancia de la consulta temprana al dermatólogo. Por diferentes medios de comunicación se invitó a las personas mayores de 18 años que presentaran lesiones ásperas, úlceras cutáneas que no sanaran o con lesiones pigmentadas que hubieran cambiado de color o tamaño, a la consulta realizada por los dermatólogos y residentes de dermatología de la Universidad CES. En los 736 voluntarios que participaron en la campaña, se encontraron 58 carcinomas basocelulares, 10 escamocelulares, 6 melanomas, 101 lesiones premalignas (queratosis actínicas y nevus atípicos) y 145 lesiones que tenían alguna relación con la luz ultravioleta. La radiación solar es un factor muy importante en la etiopatogenia de las neoplasias de piel y nuestra población, ubicada en el trópico, recibe sol durante todo el año. Aunque los estudios de tamizaje de piel no sirven para estudiar prevalencia e incidencia de cáncer. sí dan una idea de lo frecuentes que son las enfermeddes relacionadas con la radiación solar

La siringomielia no comunicante ha sido descrita en asociación con diversas patologías medulares, pero raramente ha sido reportada en relación con lesiones desmielinizantes. Presentamos un paciente de 39 años, varón, con antecedentes de herpes zoster craneal en 1996 que evolucionó con omalgia izquierda y cervicalgia persistente. La resonancia magnética (RM) de médula cervical evidenció lesión intramedular focal a nivel C4-C5 de aspecto desmielinizante, y la presencia de hidrosiringomielia nivel C6. El paciente rehusó nuevos procedimientos. En 1998 agrega signo de Lhermitte. Una nueva RM espinal mostró reducción de la lesión intramedular cervical con persistencia de la siringomielia no comunicante. La RM cerebral objetivó una única lesión puntiforme en el brazo posterior de la cápsula interna derecha. Las serologías para HIV, herpes, HTLV I-II, VDRL y potenciales evocados fueron normales. En septiembre de 1998 se encontraba asintomático, con examen neurológico normal y sin cambios en el control por imágenes. La evolución clínica y hallazgos neurorradiológicos sugieren una lesión primariamente desmielinizante versus un mecanismo postinfeccioso La patogénesis de la siringomielia no comunicante asociada a lesiones desmielinizantes es discutida: se postula dilatación ependimaria mecánica por obstrucción al flujo del líquido cefalorraquídeo causado por el edema de la placa espinal, versus dilatación ependimaria secundaria a mielomalacia. Pese a su baja prevalencia y a la dificultad diagnóstica que plantea la ausencia de un patrón radiológico característico, la patología desmielinizante debería considerarse entre los diagnósticos diferenciales de lesiones intramedulares asociadas a hidromielia, ya que en estos casos el abordaje quirúrgico no estaría indicado.

A cross-sectional-prospective observational and descriptive survey was conducted involving 96 Colombian children aged 2-5 years, randomly selected, (excludying chi1dren with congenital diseases) from the Santa Ana Infantile Refuge, where children from low socioeconomic conditions and with some degree of malnutrition are assisted. The goal of this survey was to detect conditions that would corre late nutritional state with oral tissues health or disease. In 67.7% ofthe children chronic malnutrition was found, 28.2% had acute malnutrition and 4.1 % global malnutrition (acute plus chronic). Malnutrition begins at early age and develops in a chronic way., Se realizó un estudio observacional-descriptivo-prospectivo de sección cruzada. Se tomó al azar una muestra de 96 niños con edades comprendidas entre dos y cinco años de edad y de ambos sexos (excluyendo los que tuvieran enfermedades congénitas), provenientes del Amparo Infantil Santa Ana, que atiende pacientes de clase socioeconómica baja con algún grado de desnutrición. El objetivo de este estudio fue el de identificar factores que permitan correlacionar el estado nutricional con la salud o enfermedad de los tejidos orales. En el 67,7 % de los niños se encontró desnutrición crónica, en el 28.2 % desnutrición aguda y en el 4.1 % desnutrición global (aguda más crónica). La desnutrición comienza en edades muy tempranas y se va desarrollando en una forma predominantemente crónica.

Nuestro objetivo fue mejorar la información disponible sobre la morfología y el estadio del melanoma cutáneo en el registro poblacional de cáncer del Área Metropolitana de Bucaramanga en Colombia. Se calcularon las tasas de incidencia y supervivencia y la distribución de los pacientes con melanoma por edad, sexo, subsitio anatómico y subtipo histológico. Se realizó un seguimiento de los 113 pacientes con melanoma (edad media de 61 años) (tiempo medio de 7,4 años). Este ejercicio (completar la información faltante en el registro mediante la búsqueda manual de la historia clínica del paciente y otra información disponible) produjo más melanomas invasivos identificados y casos con información completa sobre localización anatómica y estadio. Las tasas de incidencia y mortalidad estandarizadas por edad fueron 1,86 y 1,08, siendo ligeramente superiores para los hombres. La mayoría de los melanomas se localizaron en las extremidades inferiores, seguidas del tronco. En el 35% de todos los melanomas, el subtipo morfológico seguía siendo desconocido. La mayoría de los melanomas restantes fueron melanomas lentiginosos nodulares y acral. La supervivencia general global y relativa a 5 años fue del 61,6% y el 71,3%, respectivamente, con una supervivencia peor para los hombres que para las mujeres. Los melanomas en la cabeza y el cuello y los sitios anatómicos no especificados tuvieron la peor supervivencia. Los pacientes sin información sobre el estadio en sus expedientes médicos tuvieron una supervivencia excelente, a diferencia de los pacientes cuyos expedientes médicos ya no estaban disponibles. Este estudio muestra la posibilidad de mejorar la disponibilidad de datos y la importancia de contar con datos poblacionales de buena calidad.