Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Osteotomía de base de primer metatarsiano para manejo de hallux valgus y metatarso primo varo en Hospital ISSSTEP

“El hallux valgus es una patología que tiene importantes consecuencias funcionales, pudiendo incluso llevar a la limitación severa. Su corrección se realiza sólo de manera quirúrgica. Para esto, se han desarrollado más de 100 técnicas. En las personas con diagnóstico de hallux valgus con metatarso primo varo se le debe realizar corrección a la angulación metarsofalangica de primer dedo e idealmente realizar una corrección quirúrgica al metatarso primo varo para disminuir el riego de recidiva, por lo que realizando una osteotomía de base de primer metatarsiano disminuiremos el ángulo intermetatarsal y por ende realizaremos una corrección más amplia logrando mejores resultados tanto clínicos y funcionales. El tratamiento quirúrgico del metatarso primo varo influye de manera determinante en los resultados de la cirugía del hallux valgus, ya que no hacer la corrección acarrea recidivas inevitables de la deformidad y por lo tanto, reintervenciones y exposiciones anestésicas innecesarias para el paciente. Aunque en el 80-90% de los casos tratados quirúrgicamente se obtienen buenos resultados, en el 3-5% de los pacientes se llega a presentar recidiva de la deformidad. Realizar la corrección de la deformidad en varo del primer metatarsiano asociada a la realineación de partes blandas contribuirá a disminuir el riesgo de recidiva del hallux valgus”

Physical activity, screen time and subjective well-being among children

Background/Objective: The aim of the study was to explore the differences between physical activity and/or screen time levels on cognitive (Life satisfaction LS) and affective (Positive affect, PA and Negative affect NA) components of subjective well-being (SWB) in children. Method: This cross-sectional study enrolled 1,540 children (1,040 boys, 8---12 years old). LS, PA, NA, physical activity and screen time were assessed with validated questionnaires. Results: Children who reported 3 days per week of physical activity or less had lower LS and PA than counterparts with 6 days of physical activity per week (p < .05). Participants who reported 2 hours per day or less of screen time had lower NA than counterparts with 4 hours per day or more of screen time (p < .05). Also, children who meet physical activity guidelines have higher LS and PA compared to inactive peers, even with high screen time. In contrast, excessive screen time was also related with NA independent of the level of physical activity. Conclusions: Our findings suggest that physical activity is related with positive feelings and LS, but does not eliminate the effect of screen time on negative feelings among Chilean children.This study was funded by the Vicerrectoría de Investigación, Desarrollo e Innovación (Proyectos Basales. Grand number: 051641ZRDAS) of the Universidad de Santiago de Chile (Chile). AGH is a Miguel Servet Fellow (Instituto de Salud Carlos III --- CP18/0150). The funder had role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

El pensamiento crítico y su relación con el pensamiento estratégico y el liderazgo

En el presente trabajo de investigación se realizará una revisión sobre el estado del arte de la incidencia que tiene el pensamiento crítico en el pensamiento estratégico, y estos a su vez en el liderazgo. Por tal motivo, se realizó una selección de artículos académicos relevantes que tratan el tema propuesto y que permitirán elaborar un análisis a profundidad acerca de este tópico. Se analizarán los resultados obtenidos de investigaciones efectuadas acerca del pensamiento crítico, estratégico y liderazgo, mostrando un panorama general de la relación entre estas tres variables bajo estudio. A modo de clarificar el término variable dentro del campo investigativo, en un concepto o constructo que se desea medir en función de otros conceptos (variables), y cuya relación puede ser directa o inversa, y su concepción es dependiente o independiente

Association between insulin resistance and the development of cardiovascular disease

Abstract For many years, cardiovascular disease (CVD) has been the leading cause of death around the world. Often associated with CVD are comorbidities such as obesity, abnormal lipid profiles and insulin resistance. Insulin is a key hormone that functions as a regulator of cellular metabolism in many tissues in the human body. Insulin resistance is defined as a decrease in tissue response to insulin stimulation thus insulin resistance is characterized by defects in uptake and oxidation of glucose, a decrease in glycogen synthesis, and, to a lesser extent, the ability to suppress lipid oxidation. Literature widely suggests that free fatty acids are the predominant substrate used in the adult myocardium for ATP production, however, the cardiac metabolic network is highly flexible and can use other substrates, such as glucose, lactate or amino acids. During insulin resistance, several metabolic alterations induce the development of cardiovascular disease. For instance, insulin resistance can induce an imbalance in glucose metabolism that generates chronic hyperglycemia, which in turn triggers oxidative stress and causes an inflammatory response that leads to cell damage. Insulin resistance can also alter systemic lipid metabolism which then leads to the development of dyslipidemia and the well-known lipid triad: (1) high levels of plasma triglycerides, (2) low levels of high-density lipoprotein, and (3) the appearance of small dense low-density lipoproteins. This triad, along with endothelial dysfunction, which can also be induced by aberrant insulin signaling, contribute to atherosclerotic plaque formation. Regarding the systemic consequences associated with insulin resistance and the metabolic cardiac alterations, it can be concluded that insulin resistance in the myocardium generates damage by at least three different mechanisms: (1) signal transduction alteration, (2) impaired regulation of substrate metabolism, and (3) altered delivery of substrates to the myocardium. The aim of this review is to discuss the mechanisms associated with insulin resistance and the development of CVD. New therapies focused on decreasing insulin resistance may contribute to a decrease in both CVD and atherosclerotic plaque generation

Isolation and Characterization of Cellulose Nanocrystals from Rejected Fibers Originated in the Kraft Pulping Process

In the final process of the bleached kraft pulp there are some cellulose fibers that are separated from the main fibers stream; these fibers are rejected and considered as a low quality fibers, these fibers are known as rejected fiber (RF). In the present work the potential use of these fibers for Cellulose Nanocrystals (CNCs) synthesis was studied. The physical and chemical properties of synthesized CNCs were characterized through different techniques such as Atomic Force Microscopy (AFM), Scanning Electron Microscopy (SEM), X-Ray Diffraction (XRD), Fourier-Transform Infrared Spectroscopy (FTIR), and Thermogravimetric Analysis (TGA). Results demonstrate the feasibility of CNCs synthesis with a yield of 28.1% and 36.9%, and crystallinity of 73.5% and 82.7%. Finally, the morphology and synthesis conditions suggest that this industrial reject fiber (RF) could be used as a source for the CNCs production, thus adding value to the kraft process and opening new possibilities for innovation in the pulp industry

Bullying victimization, physical inactivity and sedentary behavior among children and adolescents : A meta-analysis

Background Physical activity and sedentary behavior are related with psycho-social variables among youth, however its relationship with bullying victimization is unclear. The aim of the study was to clarify the associations between physical activity and sedentary behaviors with bullying victimization among children and adolescents. Methods Two independent authors searched in four databases. The studies were selected/included only if participants were children and/or adolescents and the relationship between physical activity and/or sedentary behavior with bullying victimization was reported. Random-effects meta-analyses were used. Results A total of 18 cross-sectional studies (including 386,740 children and adolescents, 51.8% females) were reviewed. Our study found that not meeting the physical activity guidelines (Odds Ratio [OR] = 1.14, 95% confidence interval [CI], 1.04 to 1.23) and excessive sedentary behavior (i.e., 2 h per day or more of screen time) (OR = 1.21, 95% CI, 1.14 to 1.28) were associated with 14 and 21% higher bullying victimization, respectively. Consistent associations were also found when we analyzed specific forms of bullying for sedentary behavior, including traditional and cyberbullying. Conclusions The present study establishes the first quantitative framework for understanding the influence of physical activity and sedentary behavior on bullying victimization, and lays the groundwork for future studies and interventions aimed to its promotion

Plan estratégico de comunicación factor determinante en la creación del ambiente laboral propicio en el área de manufactura de la empresa SKF planta Puebla

Seminario: La comunicación en la gestión empresaria

Redes y Seguridad

En el desarrollo de las mesas de trabajo se puntualizaron distintos aspectos sobre Redes y Seguridad. En la mesa de trabajo de Seguridad se habló sobre las recomendaciones y herramientas que permitan mantener privacidad, disponibilidad, integridad, confidencialidad y no-repudio de la información. En la mesa de Seguridad en la Red de Colaboración se explicó la conexión de universidades a la Red NIBA y a la Red CUDI. Mientras que en la mesa de Ventajas de la Vitalización en una Infraestructura de Videoconferencia se comentó el desarrolló de servicios virtualizados de video colaboración para el sector educativo y académico. Y por último, en la mesa de ¿Qué sigue de IP? se expone qué es HUAWEI, su estado actual, funciones de forma de aplicación