EXCLUSIÓN SOCIAL DE LA ARISTOCRACIA LATENTE EN CONTRA DE LOS EMERGENTES PROVINCIANOS EN HUÁNUCO 2006-2007

El objetivo del trabajo fue analizar, describir y caracterizar las relaciones socioeconómicas entre la aristocracia latente y la emergente población provinciana; y determinar las causas que vienen generando la exclusión social entre estos segmentos poblacionales, partiendo del supuesto “Las relaciones comerciales y serviles, acentúan la tendencia de exclusión social entre la aristocracia latente y la emergente población provinciana de Huánuco”. El estudio baso su procedimiento en el método del análisis y la utilización de la encuesta como principal instrumentos de recolección de información. El estudio reveló que un 77 % de los encuestados sufre una permanentemente discriminación por sus rasgos andinos, demostrando que hoy en día existe una aristocracia latente la cual tiene poder económico, porque son intermediarios y abastecedores de mercancías, productos y servicios de la capital, como por ejemplo, combust ibles, insumos, accesor ios, mercaderías, ropas, hoteles, entre otros y que hace evidente una exclusión social como un fenómeno global, pero que sin embargo, Huánuco tiene su propia configuración, explicada por la masiva migración de las zonas alto andinas, los mismo que viven en condiciones económicas y sociales serviles dependientes directa o indirectamente de la nueva aristocracia huanuqueña, lo cual ha generado que se acentúe la exclusión entre estos dos grupos sociales

EL EMPOWERMENT COMO HERRAMIENTA DE GESTIÓN EN LA TOMA DE DECISIONES DE LA UNIVERSIDAD NACIONAL HERMILIO VALDIZAN. EAP DE SOCIOLOGIA 2005

Esta investigación se ejecutó en la escuela de Sociología de la Facultad de Ciencias Sociales de la Universidad Nacional Hermilio Valdizan (UNHEVAL), tomando una muestra de 12 docentes; se pudo apreciar la existencia de un perfil bajo Empowerment, en diez indicadores establecidos en la investigación. Luego de seis meses de implantar las acciones de mejora por la administración, en la escuela de Sociología, pudimos apreciar la existencia de un perfil relativamente alto Empowerment en la unidad académica, en nueve de 13 indicadores. Se pudo verificar la hipótesis, donde el uso adecuado del Empowerment como herramien-ta de gestión mejora la toma de decisiones en la escuela de Sociología; se apreció que el empowerment es más que un estado de la mente, más que un conjunto de comportamientos en equipo incluso más que políticas organizacionales; se apreció que al cambiar a empowerment de una organización tipo pirámide a una organización circular requiere una serie de cambios de mentalidad; además se pudo apreciar que el empowerment requiere de tres cambios importantes en las resoluciones de todos los que forman una organización: hacia el proceso, hacia la responsabilidad y hacia el aprendizaje. Producto de la investigación salieron a relucir valores presentes en los docentes objeto de nuestro estudio; valores como: respeto, información, control y toma de decisiones, responsabilidad y habilidades

Fosa de purines vs separación in situ de heces y orina en porcino de cebo: producción de purín y de estiércol

El objetivo de este estudio fue comparar, en un alojamiento de cebo de porcino con enrejillado parcial (Laboratorio de Bienestar Porcino), la producción de residuos con un sistema tradicional de fosa de purines frente a un sistema de separación in situ con cinta plana. La fosa se vació cada cinco semanas, y la cinta se vació dos veces al día a lo largo del periodo de cebo. Ambos sistemas tuvieron el mismo tipo de ventilación por extracción bajo suelo. La cantidad de residuos generados con la separación in situ fue el 70,50% de la correspondiente al sistema tradicional, que, a su vez, fue sensiblemente menor que la habida en las explotaciones comerciales. El sistema de ventilación por extracción bajo suelo fue muy eficiente para la evaporación de agua de las deyecciones y la consecuente reducción de la cantidad de residuos generados; asimismo, los resultados obtenidos ponen de manifiesto que la separación in situ permitió una notable reducción adicional de dicha cantidad, en comparación con el sistema tradicional

Mortalidad a corto plazo en los pacientes con insuficiencia cardiaca en estadios finales

Objectives: This study is aimed at analyzing the impact of the main factors contributing to short and long-term mortality in patients at final stages of heart failure (HF). Setting: Patients attended at any of the 279 primary health care centers belonging to the Institut Català de la Salut, in Catalonia (Spain). Participants: Patients with Advanced HF. Design: Multicenter cohort study including 1148 HF patients followed for one-year after reaching New York Heart Association (NYHA) IV. Main measurements: The primary outcome was all-cause mortality. Multivariate logistic regression models were performed to assess the outcomes at 1, 3, 6, and 12 months. Results: Mean age of patients was 82 (SD 9) years and women represented 61.7%. A total of 135 (11.8%) and 397 (34.6%) patients died three months and one year after inclusion, respectively. Male gender, age, and decreased body mass index were associated with higher mortality at three, six and twelve months. In addition, low systolic blood pressure levels, severe reduction in glomerular filtration, malignancy, and higher doses of loop diuretics were related to higher mortality from 6 to 12 months. The most important risk factor over the whole period was presenting a body mass index lower than 20 kg/m2 (three months OR 3.06, 95% CI: 1.58–5.92; six months OR 4.42, 95% CI: 2.08–9.38; and 12 months OR 3.68, 95% CI: 1.76–7.69). Conclusions: We may conclude that male, age, and decreased body mass index determined higher short-term mortality in NYHA IV. In addition, low systolic blood pressure, reduced glomerular filtration, malignancy, and higher doses of loop diuretics contribute to increasing the risk of mortality at medium and long-term. Such variables are easily measurable and can help to decide the best way to face the most advances stages of the disease.Objetivos: Analizar los factores que contribuyen a la mortalidad de pacientes en las etapas finales de la insuficiencia cardiaca (IC). Ámbito: Centros de atención primaria del Institut Català de la Salut, Cataluña, España. Participantes: Pacientes con IC avanzada. Diseño: Estudio de cohortes multicéntrico. Incluyó 1.148 pacientes de IC seguidos durante un año tras el registro de estadio funcional NYHA IV. Mediciones principales: El resultado principal fue la mortalidad por todas las causas. Se realizaron modelos de regresión logística multivariada (1, 3, 6 y 12 meses). Resultados: Edad media 82 años (DE 9), las mujeres representaron el 61,7%. Un total de 135 (11,8%) y 397 (34,6%) pacientes murieron 3 meses y un año después de su inclusión. El sexo masculino, la edad y el índice de masa corporal (IMC) < 20 kg/m2 se asociaron con una mayor mortalidad a los 3, 6 y 12 meses. Bajos niveles de presión arterial sistólica, reducción severa en el filtrado glomerular, malignidad y dosis altas de diuréticos fueron relacionadas con una mortalidad más alta de 6 a 12 meses. El factor de riesgo más importante fue un IMC < 20 kg/m2 (3 meses OR: 3,06; IC 95%: 1,58-5,92; 6 meses OR: 4,42; IC 95%: 2,08-9,38 y 12 meses OR: 3,68; IC 95%: 1,76-7,69). Conclusiones: Los varones, la edad avanzada y un IMC disminuido determinaron una mortalidad a corto plazo más alta en pacientes NYHA IV. La baja presión arterial sistólica, la reducción del filtrado glomerular, la malignidad y las dosis altas de diuréticos aumentan el riesgo de mortalidad a medio y largo plazo. Estas variables son fáciles de obtener, y pueden ayudar a decidir las mejores estrategias para afrontar los estadios más avanzados de la enfermedad

Heart failure labelled patients with missing ejection fraction in primary care : prognosis and determinants

It is common to find a high variability in the accuracy of heart failure (HF) diagnosis in electronic primary care medical records (EMR). Our aims were to ascertain (i) whether the prognosis of HF labelled patients whose ejection fraction (EF) was missing in their EMR differed from those that had it registered, and (ii) the causes contributing to the differences in the availability of EF in EMR. Retrospective cohort analyses based on clinical records of HF and attended at 52 primary healthcare centres of Barcelona (Spain). Information of 8376 HF patients aged > 40 years followed during five years was analyzed. EF was available only in 8.5% of primary care medical records. Cumulate incidence for mortality and hospitalization from 1st January 2009 to 31th December 2012 was 37.6%. The highest rate was found in patients with missing EF (HR 1.84, 95% CI 1.68 -1.95) compared to those with preserved EF. Patients hospitalized the previous year and those requiring home healthcare (HR 1.81, 95% Confidence Interval 1.68-1.95 and HR 1.58, 95% CI 1.46-1.71, respectively) presented a higher risk of having an adverse outcome. Older patients, those more socio-economically disadvantaged, obese, requiring home healthcare, and taking loop diuretics were less likely to have an EF registered. EF is poorly recorded in primary care. HF patients with EF missing at medical records had the worst prognosis. They tended to be older, socio-economically disadvantaged, and more fragile

GATA2 Promotes Hematopoietic Development and Represses Cardiac Differentiation of Human Mesoderm.

In vertebrates, GATA2 is a master regulator of hematopoiesis and is expressed throughout embryo development and in adult life. Although the essential role of GATA2 in mouse hematopoiesis is well established, its involvement during early human hematopoietic development is not clear. By combining time-controlled overexpression of GATA2 with genetic knockout experiments, we found that GATA2, at the mesoderm specification stage, promotes the generation of hemogenic endothelial progenitors and their further differentiation to hematopoietic progenitor cells, and negatively regulates cardiac differentiation. Surprisingly, genome-wide transcriptional and chromatin immunoprecipitation analysis showed that GATA2 bound to regulatory regions, and repressed the expression of cardiac development-related genes. Moreover, genes important for hematopoietic differentiation were upregulated by GATA2 in a mostly indirect manner. Collectively, our data reveal a hitherto unrecognized role of GATA2 as a repressor of cardiac fates, and highlight the importance of coordinating the specification and repression of alternative cell fates.Ramón y Cajal Program, Spanish Ministry of Economy, Industry, and Competitiveness, Spanish Cancer Association, FERO, Instituto de Salud Carlos III, European Social Fund, MINECO, PERIS Program of the Generalitat de Catalunya, Obra Social la Caixa-Fundacion Josep Carreras, Spanish Institute of Health Carlos III, Wellcome Trust, MRC, CRUK, NIH-NIDD

Detection of kinase domain mutations in BCR::ABL1 leukemia by ultra-deep sequencing of genomic DNA

The screening of the BCR::ABL1 kinase domain (KD) mutation has become a routine analysis in case of warning/failure for chronic myeloid leukemia (CML) and B-cell precursor acute lymphoblastic leukemia (ALL) Philadelphia (Ph)-positive patients. In this study, we present a novel DNA-based next-generation sequencing (NGS) methodology for KD ABL1 mutation detection and monitoring with a 1.0E-4 sensitivity. This approach was validated with a well-stablished RNA-based nested NGS method. The correlation of both techniques for the quantification of ABL1 mutations was high (Pearson r = 0.858, p < 0.001), offering DNA-DeepNGS a sensitivity of 92% and specificity of 82%. The clinical impact was studied in a cohort of 129 patients (n = 67 for CML and n = 62 for B-ALL patients). A total of 162 samples (n = 86 CML and n = 76 B-ALL) were studied. Of them, 27 out of 86 harbored mutations (6 in warning and 21 in failure) for CML, and 13 out of 76 (2 diagnostic and 11 relapse samples) did in B-ALL patients. In addition, in four cases were detected mutation despite BCR::ABL1 < 1%. In conclusion, we were able to detect KD ABL1 mutations with a 1.0E-4 sensitivity by NGS using DNA as starting material even in patients with low levels of disease

Impact of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients: A nationwide study in Spain

Objective To assess the effect of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients in Spain. Settings The initial flood of COVID-19 patients overwhelmed an unprepared healthcare system. Different measures were taken to deal with this overburden. The effect of these measures on neurosurgical patients, as well as the effect of COVID-19 itself, has not been thoroughly studied. Participants This was a multicentre, nationwide, observational retrospective study of patients who underwent any neurosurgical operation from March to July 2020. Interventions An exploratory factorial analysis was performed to select the most relevant variables of the sample. Primary and secondary outcome measures Univariate and multivariate analyses were performed to identify independent predictors of mortality and postoperative SARS-CoV-2 infection. Results Sixteen hospitals registered 1677 operated patients. The overall mortality was 6.4%, and 2.9% (44 patients) suffered a perioperative SARS-CoV-2 infection. Of those infections, 24 were diagnosed postoperatively. Age (OR 1.05), perioperative SARS-CoV-2 infection (OR 4.7), community COVID-19 incidence (cases/10 5 people/week) (OR 1.006), postoperative neurological worsening (OR 5.9), postoperative need for airway support (OR 5.38), ASA grade =3 (OR 2.5) and preoperative GCS 3-8 (OR 2.82) were independently associated with mortality. For SARS-CoV-2 postoperative infection, screening swab test <72 hours preoperatively (OR 0.76), community COVID-19 incidence (cases/10 5 people/week) (OR 1.011), preoperative cognitive impairment (OR 2.784), postoperative sepsis (OR 3.807) and an absence of postoperative complications (OR 0.188) were independently associated. Conclusions Perioperative SARS-CoV-2 infection in neurosurgical patients was associated with an increase in mortality by almost fivefold. Community COVID-19 incidence (cases/10 5 people/week) was a statistically independent predictor of mortality. Trial registration number CEIM 20/217

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele