Dr. Ricardo  Rodriguez  Md image

Dr. Ricardo Rodriguez Md

18 Calle Georgetti
Comerio PR 00782
787 752-2750
Medical School: Other - Unknown
Accepts Medicare: No
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: 14467
NPI: 1831285956
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A Genetic Algorithm for the Bi-Level Topological Design of Local Area Networks. - PloS one
Local access networks (LAN) are commonly used as communication infrastructures which meet the demand of a set of users in the local environment. Usually these networks consist of several LAN segments connected by bridges. The topological LAN design bi-level problem consists on assigning users to clusters and the union of clusters by bridges in order to obtain a minimum response time network with minimum connection cost. Therefore, the decision of optimally assigning users to clusters will be made by the leader and the follower will make the decision of connecting all the clusters while forming a spanning tree. In this paper, we propose a genetic algorithm for solving the bi-level topological design of a Local Access Network. Our solution method considers the Stackelberg equilibrium to solve the bi-level problem. The Stackelberg-Genetic algorithm procedure deals with the fact that the follower's problem cannot be optimally solved in a straightforward manner. The computational results obtained from two different sets of instances show that the performance of the developed algorithm is efficient and that it is more suitable for solving the bi-level problem than a previous Nash-Genetic approach.
Hydroxymethylpyridine containing half-sandwich complexes of Rh(III), Ir(III) or Ru(II). - Dalton transactions (Cambridge, England : 2003)
Complexes of the formula [(η(n)-ring)M(NOH){(R)-P1}][SbF6]2 ((η(n)-ring)M = (η(5)-C5Me5)Rh, (η(5)-C5Me5)Ir, (η(6)-p-MeC6H4iPr)Ru; NOH = hydroxymethylpyridine ligand; {(R)-P1} = (R)-monophos) have been prepared from the corresponding dimers [{(η(n)-ring)MCl}2(μ-Cl)2] through routes involving [(η(5)-C5Me5)RhCl2{(R)-P1}] or [(η(n)-ring)MCl(NOH)][SbF6] intermediates. The new complexes have been characterized by analytical and spectroscopic means, including the determination of the crystal structures of [(η(5)-C5Me5)IrCl2{(R)-P1}] (1b), [(η(6)-p-MeC6H4iPr)RuCl(NOH-1)][SbF6] (2c), [(η(5)-C5Me5)IrCl{(R)-NOH-2}][SbF6] ((R)-3b), [(η(5)-C5Me5)Rh(NOH-1){(R)-P1}][SbF6]2 (4a) and [(η(6)-p-MeC6H4iPr)Ru{(R)-NOH-2}{(S)-P1}][SbF6]2 ((R)-5c') by X-ray diffractometric methods. From NMR and X-ray data, the absolute configuration of the new chiral compounds was established.
[Mechanical circulatory support in pediatrics. Experience at the Dr. Juan P. Garrahan Pediatric Hospital. Argentina]. - Archivos de cardiología de México
Mechanical circulatory support provides oxygen to the tissues in patients with cardiac and/or respiratory reversible disease refractory to conventional treatments.The aim of this study is to show our initial results of mechanical circulatory support in children with heart disease.Retrospective cohort between March 2006 and March 2012. Demographic data (age, sex, weight, cardiac diagnosis), surgery (technique, pump, aortic cross clamping time) and mechanical circulatory support (type of assistance, indication, duration, complications and outcome) were collected.Thirty-three patients were supported (1.3% of all surgeries), extracorporeal membrane oxygenation 32 cases and one ventricular assist device. The median age 7.4 months (one day-18 years) and weight 6kg (2.3-75). The most frequent cardiac malformations supported were the transpositions of the great arteries associated with other anomalies and the corrected transpositions (ventricular inversion or double discordance). The most common reason for admission was post-cardiotomy biventricular dysfunction. Twenty-eight patients were supported in the postoperative period, 4 in the preoperative period and in one with myocarditis. Median days of support were 3 days (1-10). The most common complications were infection (21%), bleeding (21%). Elective decannulation was achieved in 94% of cases. Hospital discharge survival: 52%.The mechanical circulatory support in our institution is a safe and standard procedure. We have been using it in a small number of cases with a similar survival to that reported internationally. This complex procedure is widely justified because it allows for the recovery of more than half of the patients who otherwise would have died.Copyright © 2013 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.
Chiral transition-metal complexes as Brønsted-acid catalysts for the asymmetric Friedel-Crafts hydroxyalkylation of indoles. - Dalton transactions (Cambridge, England : 2003)
The Friedel-Crafts reaction between 3,3,3-trifluoropyruvates and indoles is efficiently catalysed by the iridium complex [(η(5)-C5Me5)Ir{(R)-Prophos}(H2O)][SbF6]2 (1) with up to 84% ee. Experimental data and theoretical calculations support a mechanism involving the Brønsted-acid activation of the pyruvate carbonyl by the protons of the coordinated water molecule in 1. Water is not dissociated during the process and, therefore, the catalytic reaction occurs with no direct interaction between the substrates and the metal.
Do capuchin monkeys (Cebus apella) diagnose causal relations in the absence of a direct reward? - PloS one
We adapted a method from developmental psychology to explore whether capuchin monkeys (Cebus apella) would place objects on a "blicket detector" machine to diagnose causal relations in the absence of a direct reward. Across five experiments, monkeys could place different objects on the machine and obtain evidence about the objects' causal properties based on whether each object "activated" the machine. In Experiments 1-3, monkeys received both audiovisual cues and a food reward whenever the machine activated. In these experiments, monkeys spontaneously placed objects on the machine and succeeded at discriminating various patterns of statistical evidence. In Experiments 4 and 5, we modified the procedure so that in the learning trials, monkeys received the audiovisual cues when the machine activated, but did not receive a food reward. In these experiments, monkeys failed to test novel objects in the absence of an immediate food reward, even when doing so could provide critical information about how to obtain a reward in future test trials in which the food reward delivery device was reattached. The present studies suggest that the gap between human and animal causal cognition may be in part a gap of motivation. Specifically, we propose that monkey causal learning is motivated by the desire to obtain a direct reward, and that unlike humans, monkeys do not engage in learning for learning's sake.
Streptozotocin-induced diabetes, bile-pancreatic secretion and insulo-pancreon-axis interaction. - Acta gastroenterologica Latinoamericana
The present tests were undertaken in order to analyze in male Wistar rats the changes in the exocrine and endocrine pancreas and on the interactions that normally evolve in the insulo-pancreon-axis. To evaluate this by a single i.p. Boots secretin injection, glycemia (G), amylasemia (A) and lipasemia (L) were determined. In bile-pancreatic secretion, we analyzed, pre and post-secretin, the following parameters: volume (V), bicarbonate output (BO), amylase output (AO) and lipase output (LO). Three groups of tests were done: a) control (C); b) streptozotocin-treated non-diabetic-rats (St-ND) and c) streptozotocin-treated diabetic animals (St-D) which showed morning glycemia values higher than 16.0 mmol/l. Four months later, under Tiopental i.p anesthesia, a bile-pancreatic fistula was done. Following a 30 min basal period, Boots secretin (20 CU/kg) was i.p injected. Bile-pancreatic secretion put in evidence a significant fall of BO in both St-ND and St-D series. In controls, AO revealed a post-secretin increase of 160%, while in the St-D rats showed a depression of 41%. The behavior of L was different, being augmented (+27%) in the C, while in the St-D rats the response was significantly higher (+95%). In bile-pancreatic-secretion, the fall of BO and AO in the St-ND and St-D series in respect to the C, are probably consequence of the diminishing potentiating effects exerted normally by insulin on the secretin-induced water and bicarbonate secretion of the pancreon units. In contrast, the rising of LO in the St-D, an expression of an enhancing pancreocyte's synthesis and secretion of lipase. The blood changes of A (depression) and of L (increase) in respect to the C values, although without reaching significant level, mirror those observed in bile-pancreatic secretion.
A review of the evidence for active preoperative warming of adults undergoing general anesthesia. - AANA journal
Inadvertent perioperative hypothermia, a common occurrence in the operating suite, is associated with many adverse outcomes. It is the nurse anesthetist's goal to attenuate the incidence of this problem. Although active intraoperative warming is a widely accepted practice, active preoperative warming may be a less explored option for temperature maintenance. A search strategy to identify systematic reviews and investigations in peer-reviewed journals was undertaken to identify evidence examining the efficacy of preoperative warming. Evidence sources meeting the search criteria were randomized controlled trials and a cohort study using historical controls. Most of the studies support the implementation of active preoperative warming by demonstrating that subjects were warmer during the perioperative period. Overall, these differences were statistically significant and likely clinically significant. Future clinical trials should examine shorter warming times and lower warming unit settings, should include appropriate sample sizes, and should consistently employ trained staff using calibrated biometric instruments to measure temperature.
Evidence for using air or fluid when identifying the epidural space. - AANA journal
Lumbar epidural analgesia is frequently employed to provide pain relief for women during labor. Anesthesia providers use various methods to identify the epidural space. Some providers use air, some use fluid, and others use a combination of air and fluid during the loss of resistance technique. Loss of resistance to air has been speculated to result in a lesser quality of analgesia compared with loss of resistance to only fluid. A search strategy focusing on preappraised sources was used to locate evidence from interventional and observational studies. Four evidence sources were located, including a systematic review with meta-analysis of 4 older studies. The evidence reviewed was inconclusive in determining whether a difference in analgesia quality results from the use of air or fluid during the loss of resistance technique. Future studies should include an adequate number of subjects and address other problems such as operator experience, observer blinding, equivalence of subject characteristics, outcomes definition and measurement, and composition of epidural solution. Providers should consider other factors when selecting loss of resistance medium, such as the reported complications of large amounts of air injected into the epidural space and surrounding structures.
Using of magnetic resonance enterography in the management of Crohn's disease of the small intestine: first year of experience. - Revista española de enfermedades digestivas : organo oficial de la Sociedad Española de Patología Digestiva
to describe the experience at two tertiary centres during the first year of use of magnetic resonance enterography (MRE) for the management of Crohn's disease (CD): indications and influence of the technique in clinical decision making.retrospective descriptive study in which patients who underwent MRE were included consecutively. Epidemiological and clinical data were collected from the patients, as well as the indication for the study and how it influenced clinical decision making in the 10 days following the radiological study.24 MREs were performed in suspected CD and 126 known CD; partial bowel obstruction in 53 patients (42%), monitoring of medical treatment in 34 (27%), due to incomplete ileocolonoscopy in 16 (13%), extension study of the small intestine in 15 (12%) and suspected complicated CD in 8 patients (6%). The MRE influenced in a change in treatment in 83 (55.3%) patients: 16 (10.7%) started with immunosuppressants, 41 (27.3%) with anti-TNFα were started on or switched, 15 (10%) were ordered surgery and in 3 (2%) changed from combined therapy to monotherapy. The MRE had less influence on clinical decision making in the group in which the indication was suspected CD (p < 0.05).the use of MRE helped on decision making in more than half of patients, especially with regards to decisions related to the use of biological therapies and the indication for surgery. MRE was less useful in suspected CD patients.
Successful implementation of policies addressing lateral violence. - AORN journal
Lateral violence is a problem in nursing despite policies addressing the issue, which suggests that implementation of these policies may be ineffective. We used an evidence-based approach to locate and appraise evidence about effectively implementing lateral violence policies. Our search strategy emphasized preappraised evidence, and we found 12 sources that met our inclusion criteria. Most evidence was from low-level sources, which is not surprising due to the subjective and sensitive nature of this topic. The evidence did not indicate that there is consistent, effective implementation of lateral violence policies. The appraised evidence suggests the importance of collaboratively prepared implementation strategies. Administrator involvement and relationships with staff members and the presence of a commitment to positive behavior change before lateral violence incidents occur are factors that can lead to successful implementation of lateral violence policies.Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

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