17 research outputs found
Seasonal prediction of extreme precipitation events and frequency of rainy days over Costa Rica, Central America, using Canonical Correlation Analysis
Artículo científico -- Universidad de Costa Rica. Centro de Investigaciones Geofísicas, 2013High mountains divide Costa Rica, Central America, into two main climate regions, the Pacific and Caribbean slopes, which are lee and windward, respectively, according to the North Atlantic trade winds – the dominant wind regime. The rain over the Pacific slope has a bimodal annual cycle, having two maxima, one in May–June and the other in August-September-October (ASO), separated by the midsummer drought in July. A first maximum of deep convection activity, and hence a first maximum of precipitation, is reached when sea surface temperature (SST) exceeds 29 C (around May). Then, the SST decreases to around 1 C due to diminished downwelling solar radiation and stronger easterly winds (during July and August), resulting in a decrease in deep convection activity. Such a reduction in deep convection activity allows an increase in down welling solar radiation and a slight increase in SST (about 28.5 C) by the end of August and early September, resulting once again in an enhanced deep convection activity, and, consequently, in a second maximum of precipitation. Most of the extreme events are found during ASO. Central American National Meteorological and Hydrological Services (NMHS) have periodic Regional Climate Outlook Fora (RCOF) to elaborate seasonal predictions. Recently, meetings after RCOF with different socioeconomic stakeholders took place to translate the probable climate impacts from predictions. From the feedback processes of these meetings has emerged that extreme event and rainy days seasonal predictions are necessary for different sectors. As is shown in this work, these predictions can be tailored using Canonical Correlation Analysis for rain during ASO, showing that extreme events and rainy days in Central America are influenced by interannual variability related to El Ni˜no-Southern Oscillation and decadal variability associated mainly with Atlantic Multidecadal Oscillation. Analyzing the geographical distribution of the ASO- 2010 disaster reports, we noticed that they did not necessarily agree with the geographical extreme precipitation event distribution, meaning that social variables, like population vulnerability, should be included in the extreme events impact analysis.Universidad de Costa Rica. Instituto de Investigaciones GeofísicasInstituto Costarricense de ElectricidadUniversity of Costa Rica, Graduate Program in Atmospheric SciencesUniversity of Costa Rica, Center for Research in Marine Sciences and LimnologyUniversity of Costa Rica, School of PhysicsNational Meteorological InstituteUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Básicas::Centro de Investigaciones Geofísicas (CIGEFI
La magia de tus pensamientos : poesías & cuentos
Recopilación de poesías y cuentos realizados por aprendices del SENA de los programas de Mantenimiento de Motores Diesel, Técnico en Sistemas, Automatización Industrial, Electricidad Industrial, Diseño e Integración de Automatismos Mecatrónicos, Mantenimiento de Equipo Biomédico, Animación 3D, Manejo Ambiental, Diseño e integración de Automatismos Mecatrónicos y Mantenimiento mecatrónico automotriz, entre 2015 y 2017.Poesías 2018 -- Dándome tu vida / Brayan Orlando Jaimes Chaparro -- Tierra infinita / Christian Ricardo Caballero Villamizar -- Lamento a la tierra / Jeferson Alexis Montoya Moreno -- Conciencia por favor / Daniel Rincón -- Salvar un hogar llamado tierra / William Gamboa Arguello -- Planeta tierra / Iván Arley jurado -- Salvemos nuestro planeta / Jonathan David Silva -- Tierra bella / Martin Santiago -- Mi planeta / Fabián Moreno -- Generando conciencia / José Alberto Lizarazo -- Añoranza / Javier Casanova -- Sin tierra… / Gustavo Andrés Rodríguez Mendoza -- Planeta vivo y limpio / Yesid Serrano -- Palabras del destino / Osneider David Hernández Otalvaro -- Planeta tierra / Luis Fernando Isidro -- Medio ambiente / Yorgin David Hernández -- Prevenir / Brayan Mauricio Sanmiguel Luengas -- Nada será cómo antes / Jaime Andres Rodriguez Parrado -- Yo…Sol / Jonathan Bautista -- Lamento / Héctor Mauricio Parra Cuesta -- Nuestro hogar / Juan José Amaya -- Te agradecemos / Edwin Andrés Navarro Rozo, Anderson Cardozo Villamizar -- HErmoso milagro / Jhonatan Jaimes Solano -- El creador / Ana Rosa Hernández Santana -- Cuentos 2015 -- Juventud en la zona azul / Jeniffer Solano Ardila -- Los Ucayali y los Cubeo / Oscar Ivan Rueda Quintero -- Vientos de armonía / Ever Edinson Monsalve Salcedo -- El nacimiento de una nueva era / Carlos Leonardo Ardila Alvarado -- Luz de sueños / Hugo Andrés Álvarez -- Sol de medio día / Claudia Ramírez Guarín -- Cuentos 2016 -- Mucha verraquera mano / Héctor Josué Amado Sandoval -- El viaje de irse y nunca volver / Dayana Marcela Fuentes Duran -- “Santander es hermosa” / Kelly Tatiana Pabón Blanco -- Los valores del SENA / Ana Rosa Hernandez Santana -- La fuerza del espiritu y el deseo de cambiar / Pablo Andrés Capera Rodríguez -- SENA, paz y reconciliación / Adrián Benítez R., Rubén Darío Martínez -- Cuentos 2017 -- Cartas a un pasado / Angelita Delgado Pérez -- ¿Por qué así? ¿por qué tan blanco? ¿por qué no de otra manera? / Cristian Felipe Vargas Buenahora -- El gato pacho pacho, el gato más pacho de todos los pachos / Edwin Matajira García -- Freeland “el paraíso perdido” / Dámaso Antonio Morales Palacin -- Un mundo al revés / Fabio Eduardo Contreras Piñeresna91 página
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
Generation of monthly precipitation climatologies for Costa Rica using irregular rain-gauge observational networks
Precipitation climatologies for the period 1961-1990 were generated for all climatic regions of Costa Rica using an irregular rain-gauge observational network comprised by 416 rain-gauge stations. Two sub-networks were defined: a high temporal resolution sub-network (HTR), including stations having at least 20 years of continuous records during the study period (157 in total); and a high spatial resolution sub-network (HSR), which includes all HTR-stations plus those stations with less than 20 years of continuous records (416 in total). Results from the kriging variance reduction efficiency (KRE) objective function between the two sub-networks, show that ordinary kriging (OK) is unable to fully explain the spatio-temporal variability of precipitation within most climatic regions if only stations from the HTR sub-network are used. Results also suggests that in most cases, it is beneficial to increase the density of the rain-gauge observational network at the expense of temporal fidelity, by including more stations even though their records may not represent the same time step. Thereafter, precipitation climatologies were generated using seven deterministic (IDW, TS2, TS2PARA, TS2LINEAR, TPS, MQS and NN) and two geostatistical (OK and KED) interpolation methods. Performance of the various interpolation methods was evaluated using cross validation technique, selecting the mean absolute error (MAE) and the root-mean square error (RMSE) as agreement metrics. Results suggest that IDW is marginally superior to OK and KED for most climatic regions. The remaining deterministic methods however, considerably deviate from IDW, which suggests that these methods are incapable of properly capturing the true-nature of spatial precipitation patterns over the considered climatic regions. The final generated IDW climatology was then validated against the Global Precipitation Climatology Centre (GPCC), Climate Research Unit (CRU) andWorldClim datasets, in which overall spatial and temporal coherence is considered satisfactory, giving assurance about the use this new climatology in the development of local climate impact studies