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In resource-limited countries, open appendectomy is still performed under general anesthesia (GA) or neuraxial anesthesia (NA). We sought to compare the postoperative outcomes of appendectomy under NA versus GA. We conducted a post hoc analysis of the International Patterns of Opioid Prescribing (iPOP) multicenter study. All patients ≥ 16 years-old who underwent an open appendectomy between October 2016 and March 2017 in one of the 14 participating hospitals were included. Patients were stratified into two groups: NA—defined as spinal or epidural—and GA. All-cause morbidity, hospital length of stay (LOS), and pain severity were assessed using univariate analysis followed by multivariable logistic regression adjusting for the following preoperative characteristics: age, gender, body mass index (BMI), smoking, history of opioid use, emergency status, and country. A total of 655 patients were included, 353 of which were in the NA group and 302 in the GA group. The countries operating under NA were Colombia (39%), Thailand (31%), China (23%), and Brazil (7%). Overall, NA patients were younger (mean age (SD): 34.5 (14.4) vs. 40.7 (17.9), p-value 3 days, OR, 95% CI: 0.47 [0.32–0.68]) compared to GA. There was no difference in postoperative pain severity between the two techniques. Open appendectomy performed under NA is associated with improved outcomes compared to that performed under GA. Further randomized controlled studies should examine the safety and value of NA in lower abdominal surgery.

Patients in the US receive disproportionally higher amounts of opioids after operations compared with their non-US counterparts. We aimed to assess the relationship between perceived pain severity after operation and the amount of opioid medications prescribed at discharge in US vs non-US patients.We conducted a post-hoc analysis of the International Patterns of Opioid Prescribing multicenter study. Patients 16 years and older who underwent appendectomy, cholecystectomy, or inguinal herniorrhaphy in 1 of 14 participating hospitals across 8 countries between October 2016 and March 2017 were included. In hospitals where pain severity was assessed using a 0 to 10 visual analog scale before hospital discharge, patients were stratified into the following groups, depending on the pain severity: none, mild (1 to 3), moderate (4 to 6), and severe (7 to 10). The number of opioid prescriptions, total number of pills, and oral morphine equivalents prescribed were calculated for each group and US and non-US patients were compared.A total of 2,024 patients were included. Eighty-three percent of US patients without pain were prescribed opioids compared with 8.7% of non-US patients without pain (p0.001). The number of opioid prescriptions, number of pills, and oral morphine equivalents prescribed were similar across the 4 pain severity groups in US patients (p0.05). In contrast, the number of opioid prescriptions, number of opioid pills, and oral morphine equivalents prescribed among non-US patients were incrementally higher as the pain severity progressed from no pain to severe pain (all, p0.05).US patients are prescribed opioids at high rates and doses regardless of pain severity. Additional efforts should be directed toward tailoring opioid prescriptions to patients' needs.

Objective:The International Patterns of Opioid Prescribing study compares postoperative opioid prescribing patterns in the United States (US) versus the rest of the world.Summary of Background Data:The US is in the middle of an unprecedented opioid epidemic. Diversion of unused opioids contributes t

espanolContexto: En este articulo se presenta el diseno de un sistema robotico aplicado para la ensenanza en basica primaria, dirigido a la poblacion infantil. El sistema robotico es controlado mediante una aplicacion en un telefono celular, a partir del cual dos equipos de ninos compiten moviendo un robot en una pista cuando responden correctamente una pregunta. El sistema esta disenado para ser operado por personas sin conocimientos avanzados en informatica o robotica. Metodo: Inicialmente se realizo una revision de los resultados de las pruebas Pisa para Colombia, donde se evidencio que en educacion basica primaria existen fuertes deficiencias en matematicas. Posteriormente se procede al diseno del sistema utilizando la plataforma robotica Lego Mindstorm y una aplicacion para telefono celular. El sistema es validado en una actividad con 40 ninos de grados tercero y quinto, validando la actividad por medio de encuestas. Resultados: Las encuestas reflejaron una satisfaccion general de los estudiantes al realizar la actividad, mostrando mucho interes, asi como concentracion. Se evidencio disciplina de los ninos en la actividad. La actividad fue acompanada por el docente del espacio academico, quien considero que el ejercicio realizado fue positivo y contribuye al desarrollo academico de los estudiantes. Conclusiones: El uso de plataformas roboticas contribuye a los procesos de aprendizaje en la poblacion infantil al ser atractivas, interactivas y fortalecer el trabajo en equipo. Este tipo de plataformas deben ser de facil uso, ya que las actividades serian acompanadas por docentes de distintas formaciones. Se debe buscar que las plataformas sean accesibles y de bajo costo, pero con un diseno llamativo para la poblacion a la que va dirigida. Agradecimientos: Este proyecto ha sido financiado por la “Decimocuarta convocatoria interna para el fomento de la investigacion y la innovacion FODEIN 2020” de la Universidad Santo Tomas, Bogota D.C., Colombia, titulado “Optimizacion de trayectorias mediante algoritmos bio-inspirados aplicado a robots moviles con percepcion local”, codigo de proyecto: 2036004. EnglishContext: In this paper, the design of a robotic system applied to learning in primary school is presented. This system is controlled through a mobile application, where two teams competing against each other answer questions about a subject. The robot moves along a racetrack whenever a team answers correctly. The system is designed for easy operation without advanced knowledge in robotics or informatics. Method: First, the results from Colombia’s Pisa tests were consulted, finding that primary school shows a significant weakness in mathematics. Afterwards, a robotic educational platform was designed using a LEGO MINDSTORM robot and a mobile phone app. The education environment was validated by means of perception surveys at the end of an academic activity with 40 students between third and fifth grade. Results: The surveys reported an overall interest and satisfaction from the students with the academic activity and the proposed system. The children were very disciplined in the class with the robot. The activity was supported by the mathematics teacher, who believes that the class yielded positive results, thus contributing to the students’ academic development. Conclusions: The use of robotic platforms contributes to the learning process of children. This is because these activities are appealing and interactive. These kinds of systems are designed to develop teamwork. One important characteristic of these environments must be easy usage since they are conducted by teachers without knowledge in robotics or informatics. These platforms must be more accessible and low-cost, but their design must still be attractive. Acknowledgements: This work was funded by “Decimocuarta convocatoria interna para el formento de la investigacion y la innovacion FODEIN 2020” at Universidad Santo Tomas, Bogota, Colombia, entlited “Optimizacion de trayectorias mediante algoritmos bio-inspirados aplicado a robots moviles con percepcion local” (project code 2036004).

Oil spillage contamination has been one of the most common and challenging problems in marine ecosystems over the years due to frequent petroleum exploitation, washing, and transportation activities. The use of nature-derived surfactants has become an attractive approach to restore the sites affected by oil spillage. Several studies have demonstrated that nutrient addition is an efficient strategy to enhance oil biodegradation since microorganisms can use petroleum hydrocarbons as their carbon and energy source, thus favoring and increasing the hydrocarbons degradation rate. This study aimed to assess the effectiveness of a commercial bio-catalytic agent used in the biological remediation of crude oil-contaminated sites through the qualitative analysis of its properties. The tests applied to this bio-catalyst showed excellent results. For instance, the emulsification (E24) and critical micellar concentration (CMC) assays displayed average values of 74.47% and 40 mg L−1, respectively. A significant reduction of Chemical Oxygen Demand (COD), turbidity, and Total Petroleum Hydrocarbon Content (TPHC) were observed in all the samples with bio-catalytic agent solution and aeration system. The best water quality was achieved by the sample with the highest concentration (10000 ppm) of bio-catalytic agent solution. It displayed a Total Petroleum Hydrocarbon removal efficiency (RTPH) of 81.537% after 30 days of the remediation time., non-ionic surfactant, bioremediation, crude oil, seawater, bio-catalyst, environmental impacts

In resource-limited countries, open appendectomy is still performed under general anesthesia (GA) or neuraxial anesthesia (NA). We sought to compare the postoperative outcomes of appendectomy under NA versus GA.We conducted a post hoc analysis of the International Patterns of Opioid Prescribing (iPOP) multicenter study. All patients ≥ 16 years-old who underwent an open appendectomy between October 2016 and March 2017 in one of the 14 participating hospitals were included. Patients were stratified into two groups: NA-defined as spinal or epidural-and GA. All-cause morbidity, hospital length of stay (LOS), and pain severity were assessed using univariate analysis followed by multivariable logistic regression adjusting for the following preoperative characteristics: age, gender, body mass index (BMI), smoking, history of opioid use, emergency status, and country.A total of 655 patients were included, 353 of which were in the NA group and 302 in the GA group. The countries operating under NA were Colombia (39%), Thailand (31%), China (23%), and Brazil (7%). Overall, NA patients were younger (mean age (SD): 34.5 (14.4) vs. 40.7 (17.9), p-value 0.001) and had a lower BMI (mean (SD): 23.5 (3.8) vs. 24.3 (5.2), p-value = 0.040) than GA patients. On multivariable analysis, NA was independently associated with less postoperative complications (OR, 95% CI: 0.30 [0.10-0.94]) and shorter hospital LOS (LOS 3 days, OR, 95% CI: 0.47 [0.32-0.68]) compared to GA. There was no difference in postoperative pain severity between the two techniques.Open appendectomy performed under NA is associated with improved outcomes compared to that performed under GA. Further randomized controlled studies should examine the safety and value of NA in lower abdominal surgery.

The La Cira Infantas field is located in the Middle Magdalena basin in the Santander region of central Colombia. This oil-producing development is under secondary waterflood using five-spot and inverted seven-spot patterns. The reservoir has high vertical and horizontal heterogeneity, and there was concern about effectively draining the reservoir. A new hydraulic fracturing design was deployed for the first time in Colombia (and South America) to improve drainage and surveillance. With over 1200 producers and 500 injectors, the La Cira Infantas waterflood is well established. Waterflood surveillance indicated less-than-optimal recovery due to near-wellbore skin in the injectors and suspected poor height coverage. A novel proppant technology was incorporated into the fracture design allowing for consolidation of the proppant pack in the fracture with low bottomhole temperature and minimal stress on proppant, enabling long-term undamaged injectivity. This technology also incorporates an inert tracer into the proppant grains, which provides propped height determination after the treatment using a neutron log. This multi-faceted proppant technology was successfully deployed on one well, and additional wells are planned in 2020. This paper will first review the background of the field development including current completion techniques, along with the challenges being faced with the waterflood recovery. It will review the self-consolidating proppant technology and show the benefits of its use in this application to promote high-conductivity fractures and minimize damage to injectivity. The companion tracer technology will be presented along with plans to perform neutron logging and identify propped fracture height. This information can be fed into fracture propagation models to determine the fracture geometry, which is then used for reservoir and waterflood surveillance analysis. The technique allows for meeting the goal to improve injectivity into both high-skin and low-permeability reservoirs. Although this proppant technology has been used in other frac pack applications, this is one of the first case histories of the technology being used on land for improving injectivity and waterflood coverage in Colombia. This paper will be useful for reservoir and completion engineers working on waterflood fields that contain vertically and horizontally heterogeneous formations, and wish to maintain undamaged injectivity, improve waterflood sweep efficiency, and monitor the proppant pack over time.

Patient: Male, 66-year-old Final Diagnosis: Glioblastoma multiforme • pulmonary metastases Symptoms: Hemiplegia and aphasia • nausea • vomiting Medication:— Clinical Procedure: Bronchoscopy • craniotomy Specialty: Critical Care Medicine • Pulmonology Objective: Diagnostic/therapeutic accidents Background: Glioblastoma multiforme is one of the most aggressive types of tumors that affect the central nervous system. It has an extremely high morbidity and mortality rate despite immediate treatment and advances in chemo-therapy, radiotherapy, and surgery. In the natural history of the disease, extracranial metastases of glioblastoma multiforme are a rare complication that can be localized in the lungs, bone, liver, and lymph nodes. Case Report: A 66-year-old male presented with pulmonary metastasis after the surgical resection of a primary glioblastoma multiforme tumor. Seventeen days after surgery while in the intensive care unit, the patient had leukocytosis with a predominance of neutrophils. An exploratory bronchoscopy evidenced a white lesion that prevented the visualization of the bronchus. Consequently, a sample was taken for pathological study that demonstrated pulmonary metastasis due to glioblastoma multiforme. Conclusions: Surgical resection of the tumor can precipitate the appearance of extracranial metastases, especially pulmonary metastases.

Fractal and power law distributions have been found in the past to be useful for modeling some reservoir properties following the assumptions of constant shape and self-similarity. This study shows, however, that pore throat apertures, fracture apertures, petrophysical and drill cuttings properties of unconventional formations are better matched with a variable shape distribution model (as opposed to constant shape). This permits better reservoir characterization and forecasting of reservoir performance. Pore throat apertures, fracture apertures, petrophysical properties and drill cutting sizes from tight and shale reservoirs are shown to follow trends that match the variable shape distribution model (VSD) with coefficients of determination (R2) that are generally larger than 0.99. The good fit of the actual data with the VSD allows more rigorous characterization of these properties for use in mathematical models. Data that could not be described previously by a single equation can now be matched uniquely by the VSD. Examples are presented using data from conventional, tight and shale formations found in Canada, the United States, China, Mexico and Australia. In addition, the study shows that the size of cuttings drilled in vertical and horizontal wells can also be matched with the VSD. This allows the use of drill cuttings, an important direct source of information, for quantitative evaluation of reservoir and rock mechanics properties. The results can be used for improved design of stimulation jobs including multi stage hydraulic fracturing in horizontal wells. This is important as the amount of information collected in horizontal wells drilled through out tight formations, including cores and well logs, is limited in most cases. It is concluded that the VSD is a valuable tool that has significant potential for applications in conventional, low and ultra-low permeability formations and for evaluating distribution of rock properties at the micro and nano-scale.

International audience

Entrepreneurial orientation and dynamic capabilities are a set of variables that influence one way or another within the business performance of organizations. When performing an analysis and review of the literature it can be noticed that numerous studies point to a positive relationship between this set of variables discussed above and the need to promote one or the other to increase business performance. That is why this research aims to show a conceptual approach to the notions of each of the exposed variables and interrelationships between each and a theoretical model is exposedvariables to be measured, which will serve as the baseline for an empirical investigation., La orientación emprendedora y las capacidades dinámicas son un conjunto de variables que influyen de una manera u otra dentro del desempeño empresarial de las organizaciones. Al realizar un análisis y revisión bibliográfica se puede notar que numerosos estudios señalan que existe una relación positiva entre este conjunto de variables anteriormente expuestas y la necesidad de potenciar unas u otras para aumentar el desempeño empresarial. Es por esto que esta investigación propone mostrar un acercamiento hacia las nociones conceptuales de cada una de las variables expuestas y las interrelaciones que existen entre cada una de ellas y se expone un modelo teórico de las variables a medir, que servirá como línea de base para una investigación empírica.

En un entorno turbulento y cambiante, las empresas buscan constantemente la manera de desarrollar nuevas estrategiasque les permita diferenciarse de la competencia y a su vez maximizar sus resultados económicos, para este caso medido en aumentode ventas nacionales y exportaciones.Toda empresa sin importar su tamaño o sector a nivel interno posee unos recursos y capacidades específicos, los cuales al seridentificados correctamente pueden potencializar la obtención de mejores resultados de la empresa a nivel económico.En el presente estudio a partir de la aplicación de un análisis empírico a las empresas de la industria colombiana incluidas en elcenso EDIT industria periodo 2011-2012 y con la utilización de herramientas estadísticas proporcionadas por el DANE.Se definieron como objeto de estudio los recursos de tipo Humano y las capacidades de Innovación y ordenar su gestión. Se tomóuna muestra de 2684 empresas y se obtuvo como. resultado de las estrategias usadas por las empresas del sector colombiano eneste periodo medido (2011-2012) que existe una fuerte correlacion entre la capacitación y formación de personal y los resultadosempresariales medidos en términos de ventas y exportaciones.