Población estudiantil universitaria: percepción sobre la modalidad de clases en contexto de la COVID-19

The effects on different human groups caused by social isolation due to the SARS-CoV-2 pandemic are currently being known. In this context, one of the least favored sectors and that even until the end of 2021 had not resumed activities to a great extent of Latin America was the education sector and, in the face of a new variant of the virus, it is possible that these activities will continue virtually in 2022. In this regard, the present study aims to show the appreciation of the students, mainly university students, in order to know the perception and assessment regarding the class modality types in the context of COVID-19. For this, a quantitative and descriptive study was designed based on the interpretation of information obtained from surveys carried out on 198 students from the National University of San Cristóbal de Huamanga in Peru. The results regarding the qualification of learning in the virtual modality of the theoretical classes show that 58.1% of students mention that it was regular and 31.3% that it was good, regarding learning in the virtual modality of the experimental classes, 43.4% mention that it was regular and 38.9% deficient. Their preferences in most cases is to have theoretical classes virtually and/or blended; and experimental laboratory classes in face to face and/or blended; Likewise, under the current context of COVID-19, 85.4% of students state that they prefer their health over their professional training.Actualmente se están conociendo los efectos sobre los diferentes grupos humanos ocasionados por el aislamiento social debido a la pandemia del SARS-CoV-2. En este contexto uno de los sectores menos favorecidos y que aún hasta finales del 2021 no había retomado las actividades en gran parte de América Latina fue el sector educativo y, ante una nueva variante de virus es posible que continúe de forma virtual el 2022. En ese sentido, el presente estudio tiene como objetivo mostrar cual es la apreciación de los estudiantes, principalmente universitarios, a fin de conocer la percepción y valoración respecto a la modalidad de clases en contexto de COVID-19. Para ello se diseñó un estudio tipo cuantitativo y descriptivo basado en la interpretación de información obtenida de encuestas realizadas a 198 estudiantes de la Universidad Nacional de San Cristóbal de Huamanga en Perú. Los resultados respecto a la calificación del aprendizaje en la modalidad virtual de las clases teóricas muestran que el 58,1% de estudiantes mencionan que fue regular y el 31,3% que fue buena; respecto al aprendizaje en la modalidad virtual de las clases experimentales el 43,4% menciona que fue regular y 38,9% deficiente. La preferencia en la mayoría de los casos es tener clase teóricas de forma virtual y/o semipresencial y clases de laboratorio experimentales de forma presencial y/o semipresencial. Asimismo, bajo el contexto actual de la COVID-19 un 85,4% de estudiantes manifiesta preferir su salud por encima de su formación profesional

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Engineering design and fabrication of the nested orbit corrector prototype for HL-LHC

MCBXF magnets are nested orbit correctors, needed for the upgrade of the large hadron collider (LHC), in the framework of the high luminosity (HL) LHC project. There are two versions with different physical lengths, 1.5 and 2.5 m, which share the same cross section to decrease fabrication costs. These magnets have a large aperture of 150 mm and due to the high radiation dose, a mechanical clamping is necessary to hold the large torque between both dipoles. Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas CIEMAT is developing the short MCBXFB prototype in collaboration with CERN. This paper describes the engineering design of the magnet, which is based on previous magnetic and mechanical calculations. The axial pre-stress on the coil ends is analyzed in detail. Some innovative techniques have been developed for the coil fabrication because of the high number of turns and large aperture

Evaluación del Campamento Universitario Multidisciplinario de Investigación y Servicio 2016, Maniapure, Venezuela.

La capacidad de las comunidades ind&iacute;genas venezolanas de acceder a los servicios b&aacute;sicos, entre ellos un sistema de salud apto para cubrir sus necesidades, se encuentra severamente afectada. Esta situaci&oacute;n condiciona una mayor incidencia de enfermedades. En agosto de 2016, se llev&oacute; a cabo el Campamento Universitario Multidisciplinario de Investigaci&oacute;n y Servicio (CUMIS) por parte de la Sociedad Cient&iacute;fica de Estudiantes de Medicina de la Universidad Central de Venezuela (SOCIEM-UCV), de la regi&oacute;n Maniapure, estado Bol&iacute;var, Venezuela; donde especialistas y estudiantes de medicina brindaron atenci&oacute;n m&eacute;dica tanto en el Ambulatorio Rural tipo II &ldquo;Centro la Milagrosa&rdquo; como en las diversas comunidades criollas e ind&iacute;genas que conforman Maniapure. Previo consentimiento de los consultantes, se obtuvieron los datos utilizados mediante la historia cl&iacute;nica, concluyendo as&iacute;, un total de 352 pacientes atendidos, de los cuales el 57.10% pertenec&iacute;an a la etnia E&ntilde;ep&aacute;, el 53.97% eran adultos y 53.40% eran masculinos. A diferencia de estudios previos, donde el principal motivo de consulta fue diarrea, el de mayor incidencia fue la fiebre (34.37%) seguido de dolor abdominal (24.14%) y diarrea (21.31%). En conjunto con los hallazgos m&aacute;s frecuentes fueron lesiones dermatol&oacute;gicas (52%) y adenopat&iacute;as (20%), y los diagn&oacute;sticos tales como s&iacute;ndrome febril agudo (18,83%), parasitosis intestinal (12,67%) y s&iacute;ndrome diarreico agudo (12,67%) permiten demostrar en este trabajo la posible reincidencia de enfermedades tropicales caracter&iacute;sticas de la zona. De igual manera se atribuye la prevalencia de otras enfermedades al estilo de vida consecuente de la cultura, de la poblaci&oacute;n en estudio.AbstractThe capacity of the Venezuelan indigenous tribes to access basic services, such as a health system in capacity to cover the population necessities, is frankly affected. This situation conditions the growing incidence of diseases. In August 2016, the University Multidisciplinary Camp of Research and Service (CUMIS) a project by the Universidad Central de Venezuela&rsquo;s Scientific Society of Medicine Students (SOCIEM-UCV) took place in the region of Maniapure, state of Bol&iacute;var, Venezuela. In this period of time, medicine students and specialists provide medical service in the type II rural ambulatory &ldquo;Centro la Milagrosa&rdquo;, as well in several indigenous and creole communities of Maniapure. After signing the informed consent, the data was obtained using the medical record. A total of 352 patients were seen, 57,10% of that patients were part of the E&ntilde;ep&aacute; indigenous tribe, the 53,97% were adults and the 53,40% were males. In contrast to previous research, where the main motive of medical consultation was intestinal parasites, the one with higher incidence was fever (34,37%) followed by abdominal pain (24,14%) and diarrhea (21,31%). During the physical examination the main findings were dermatological disorders (52%) and adenopathies (20%). The most common medical diagnosis was acute febrile syndrome (60%), followed by intestinal parasites and acute diarrhea syndrome (both 37%), this allows this research to prove the significant role of tropical diseases which are characteristic of this zone. In the other hand is also important to highlight the influence that the style of living and culture have over these population&rsquo;s morbidity

Role of age and comorbidities in mortality of patients with infective endocarditis.

The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups: A total of 3120 patients with IE (1327  There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in th