Evaluación de costos en pacientes con artritis reumatoide de dos hospitales de alta complejidad : Lambayeque 2013 - 2016

Objetivo: Evaluar el costo en pacientes con artritis reumatoide (AR) de dos hospitales de alta complejidad de Lambayeque: 2013-2016 Diseño: Descriptivo-Transversal. Materiales y Métodos: por muestreo aleatorio simple se escogieron 183 y 129 historias clínicas de un hospital de la Seguridad Social (Hospital I) y de otro del Ministerio de Salud (Hospital II). Se extrajeron datos sociodemográficos, de atenciones y costos directos. Los costos indirectos (CIP) se calcularon aplicando el cuestionario sobre impedimento de actividades y productividad laboral. Resultados: La mediana de edad fue 53 años, RI: 43-62; 94,4% fueron mujeres; el costo directo total en el Hospital I fue S/ 5’ 659 050 ($1 689 268, 66) y S/ 2’ 192 490 ($ 654 474,63) en el Hospital II. En el hospital I, el 51,5% del costo directo fue por exámenes auxiliares y en el Hospital II, el uso de biológicos explicó el 45,20%. El CIP del Hospital I fue: S/ 7’ 062 576 ($2 108 231,64) y de 1’ 226 067 ($ 365 990, 15) en el Hospital II. El costo total de la AR en el Hospital I fue: S/ 12’ 721 626 ($3 797 500,3) y S/3’ 418 557 ($ 1 020 464,78) en el Hospital II. El costo promedio paciente en el primero fue S/ 8 207,5 ($2 450) y S/ 11 171,75 ($ 3 334, 85) en el segundo. Conclusiones: El costo en pacientes con AR es elevado en Lambayeque. En el Ministerio de Salud, el costo de la AR por paciente, fue 1,3 veces superior al de la Seguridad Social, siendo en el primero principalmente debido a exámenes auxiliares y en el segundo por el uso de biológicos

Implementación de procedimiento operativo estandarizado de saneamiento de la planta potabilizadora de agua para consumo humano de la empresa Agrícola Cerro Prieto S.A

La presente investigación tuvo por objetivo determinar la influencia de la implementación de un sistema POEs aplicada a la planta potabilizadora de agua para consumo humano N.3 de la empresa Agrícola Cerro Prieto S.A, donde se planteaba mejorar las concentraciones de los parámetros físico químicos, biológicos y microbiológicos para cumplir con los requerimientos exigidos por los Estándares de Calidad Ambiental (ECAs), quien fija los parámetros máximos permisibles para la categoría 1: Poblacional y Recreacional, en la subdivisión A.2 “Aguas que pueden ser potabilizadas con tratamiento convencional”, a la cual pertenece el agua potabilizada antes mencionada y el Reglamento de la calidad del agua para consumo humano DS. N. 031-2010-SA, ya que los parámetros anteriores mencionados sobrepasaban los límites máximos permisibles. Se realizó el diagnostico en base a 05 análisis realizados con anterioridad al agua potable producto los cuales mostraron resultados a base de frecuencias establecidas de limpieza y mantenimiento de equipos, obteniendo como resultado una calidad de agua no aceptable para el consumo humano. En base a este diagnóstico se fijó la frecuencia generalizada de 03 meses en lo que respecta al mantenimiento preventivo de maquinaria, filtros y tanques, los cuales son los principales criterios para el establecimiento de los principios de limpieza y desinfección, realizándose una nueva corrida de análisis obteniendo como resultado una calidad de agua aceptable para el consumo humano. Se definió la frecuencia trimestral validada de mantenimiento general logrando optimizar los recursos proporcionados para dichas acciones, validando así los procedimientos establecidos en los documentos entregados a la empresa Agrícola Cerro Prieto como parte de la documentación oficial de la misma

Influencia del leasing financiero en el crecimiento de la empresa Tarapoto Rent a Car SAC, 2018

La investigación titulada: Influencia del leasing Financiero en el crecimiento de la empresa Tarapoto Rent a Car SAC, 2018; tuvo como objetivo general Determinar la influencia del leasing Financiero y el crecimiento empresarial en la empresa Tarapoto Renta Car SAC, 2018. La muestra estuvo constituida por el gerente y todo el acervo documentario y como apoyo se tuvo a los estados financieros. El tipo de estudio fue básico, el diseño fue no experimental y nivel relacional de corte transversal, el instrumento de recolección de datos fueron la guía de entrevista, observación y análisis documental. Los resultados demostraron que existen deficiencias en el manejo del leasing financiero (Apalancamiento y riesgo crediticio), destacando en primer lugar el cumplimiento de manera oportuna del pago de leasing financiera, por lo que hace referencia a una baja gestión de los recursos disponibles que presenta la misma. Este hecho ha traído consigo el aplazamiento del pago del leasing en 30, 60 y 90 días, por una suma de S/. 5,120.00, S/. 7,680.00 y S/. 17,920.00 respectivamente. Concluye que el leasing financiero influye significativamente en el crecimiento empresarial de la empresa Tarapoto Renta Car SAC, resultado fue comprobado con el análisis realizado a las ratios financieras, identificando variaciones en la rentabilidad sobre los activos de 15.01% a 33.91%; este resultado dio a conocer que la empresa al llevar de manera correcta una gestión de recursos, la utilidad contemplaría un porcentaje mayor a lo registrado por el año 2018, mismo que se vería reflejado por una adecuada planificación considerando el uso de técnicas y métodos direccionándolo a la parte operativa

Topical Atropine in the Control of Myopia

Atropine has been used for more than a century to arrest myopia progression. Compelling evidence of its protective effect has been reported in well-designed clinical studies, mainly performed during the last two decades. However, its exact mechanism of action has not been determined. Experimental findings have shown that the mechanism is not related to accommodation, as was thought for decades. A review of the published literature revealed a significant amount of evidence supporting its safety and efficacy at a concentration of 1.0%, and at lower concentrations (as low as 0.01%)

Signature Activation: A Sparse Signal View for Holistic Saliency

The adoption of machine learning in healthcare calls for model transparency and explainability. In this work, we introduce Signature Activation, a saliency method that generates holistic and class-agnostic explanations for Convolutional Neural Network (CNN) outputs. Our method exploits the fact that certain kinds of medical images, such as angiograms, have clear foreground and background objects. We give theoretical explanation to justify our methods. We show the potential use of our method in clinical settings through evaluating its efficacy for aiding the detection of lesions in coronary angiograms

Articulaciones Narrativas: Semejanzas estructurales de la película “Bandersnatch” de Netflix y el videojuego “Become human” de PlayStation Store del año 2018

En este trabajo de investigación, se hará un análisis comparativo de 2 piezas audiovisuales interactivas: la película “Black Mirror: Bandersnatch” que se encuentra en la plataforma de Netflix y el videojuego “Become Human” que pertenece a la plataforma de PlayStation Store. Ambas entraron al mercado en el año 2018. El problema principal de la investigación buscará determinar cuales son las semejanzas estructurales de la narrativa interactiva de esas piezas. Por otro lado, el trabajo contará con un enfoque cualitativo y tendrán un diseño de investigación de estudio de casos que analizará nuestra población: la película Black Mirror: Bandersnatch y el videojuego Become Human. Para poder lograrlo, se aplicará un análisis de contenido para una recolección de datos de la película y del videojuego

Provenance of the middle Jurassic-Cretaceous sedimentary rocks of the Arequipas basin (South Peru) and implication for the geodynamic evolution of the Central Andes

The southern Peruvian margin is considered a type locality for long-lived, active continental margin and has been the site of almost continuous subduction since at least the Cambrian. Following Triassic rifting, the southern Peruvian margin is supposed to have experimented extensional backarc setting but definitive evidences are scarce. Unlike other margin, the southern Peruvian margin has not been modified by terrane accretion since the onset of subduction and hence the sedimentary rocks of its adjacent basin may have the potential to record the geodynamic history of the margin between the Mitu Triassic rifting episode and the late Cretaceous onset of compression. In this study, we investigate the provenance of middle Jurassic–Santonian sedimentary rocks deposited in the Southern Peruvian Arequipa basin based on the measurement of 42 Sr-Nd isotopic composition, 993 U-Pb zircons ages and 232 Lu-Hf isotopes. The middle Jurassic formation (Puente and Cachios formations) have mean ÎμNd (0) values between from -8.5 (standard deviation (STD): 0.76) and -9.6 (STD:3.05) and are dominated by Brazilian/Pampean (0.5-0.7 Ga) Greenville/Sunsas (0.9–1.3 Ga) zircon U-Pb peak age which suggest an Eastern Cordillera provenance. An eastern provenance is also confirmed by the presence of juvenile to evolved nature of Hf isotopic Permian zircons that may be sourced by the the Eastern Cordillera. The Labra formation is marked by the first appearance of Triassic-Jurassic zircons from the Chocolate formation and by a strong increase in Famatinian zircon contribution but has similar other zircon age population contributions and Æ•Nd(t=0) values to those of the middle Jurassic formations thus suggesting a mixed provenance between Eastern Cordilera and/or Altiplano and Coastal Cordillera sources. The Titonian Gramadal Formation show similar Æ•Nd(t=0) values but distinct U-Pb zircon age pattern with almost similar contribution from all Precambrian sources of the Amazon craton and Eastern Cordillera which suggest a main source located in the Eastern Cordillera or in the Amazon craton. The presence of Jurassic zircons and dominance of Greenville/Sunsas and Brazilian/Pampean zircons population suggest a mixed provenance with sources located both in Coastal and Eastern cordilleras for the Hualhuani formation (Berrasian). Finally, the Santonian Chilcane Formation has the highest Æ•Nd(t=0) value (-5.5) and is characterized by strong contribution of Andean volcanic arc zircon, Jurassic, Permian, and Famatinian zircons which suggest a that these sedimentary rocks are mainly alimented by the Coastal Cordillera. Our multidisciplinary provenance dataset suggests that the middle Jurassic to early Cretaceous sedimentary rocks of the Arequipa basin are predominantly sourced by the Eastern Cordillera and to a lesser extent by the Coastal Cordillera. These associated with recent reevaluation of the depositional setting of the Jurassic to early cretaceous formation and the cumulative proportion curves of zircon age distribution suggest that the Arequipa basin tectonic setting is not that of backarc setting but rather reflect a rift like setting

Provenance sedimentary from Arequipa – Tarapacá Basin, based on U-Pb detrital zircons, and Sm-Nd isotopes: implications for southwestern of Gondwana

The beginning of the subduction processes began approximately ~ 530 Ma (Cawood et al., 2005), where an intense magmatism was manifested in the Ordovician that ends at the end of the Devonian (Chew et al., 2007), followed by a process of quiescence magmatic during the Pennsylvanian. The Permico is an assembly of Gondwana where heat accumulation in the Triassic led to a distensive period on a continental scale, which produced the generation of rift processes (i.e. Rift Mitu, Spikings et al., 2016). The closing of the Mitu rift is the reflection of the beginning of an oblique subduction, produced by the subduction of the Farallón oceanic plate under the South American continental plate, this subduction process is known as the beginning of the "Andean Cycle" (Romeuf et al., 1995, Boekhout et al., 2013, Haschke et al., 2006, Ramos & Aleman, 2000, Oliveros et al., 2006). This period is mainly marked by important processes of distention that gave rise to synchronous Mesozoic basins that developed in Western Gondwana. These distension processes were generated by negative roll-back processes (Ramos & Mpodozis., 1989). The Arequipa - Tarapacá basin (Vicente et al., 2006), is an extensive basin developed between 10 ° - 22 ° Lat. South. Where the present work is based on the establishment of sedimentary provenience, for the classic stratotype described by (Jenks, 1945; Vicente et al., 1981) in the valley of the Yura river where approximately ~ 5km of Mesozoic sediments emerge. The present work is based on the presentation of unpublished data of U-Pb in detrital zircons as, Sm-Nd geochemistry in total rock for said sediments. Based on this methodology, we will establish provenance of sediments of the Yura group, as well as the paleogeography of Mesozoic sediments in this portion of the Central Andes

WormBase: a multi-species resource for nematode biology and genomics

WormBase (http://www.wormbase.org/) is the central data repository for information about Caenorhabditis elegans and related nematodes. As a model organism database, WormBase extends beyond the genomic sequence, integrating experimental results with extensively annotated views of the genome. The WormBase Consortium continues to expand the biological scope and utility of WormBase with the inclusion of large-scale genomic analyses, through active data and literature curation, through new analysis and visualization tools, and through refinement of the user interface. Over the past year, the nearly complete genomic sequence and comparative analyses of the closely related species Caenorhabditis briggsae have been integrated into WormBase, including gene predictions, ortholog assignments and a new synteny viewer to display the relationships between the two species. Extensive site-wide refinement of the user interface now provides quick access to the most frequently accessed resources and a consistent browsing experience across the site. Unified single-page views now provide complete summaries of commonly accessed entries like genes. These advances continue to increase the utility of WormBase for C.elegans researchers, as well as for those researchers exploring problems in functional and comparative genomics in the context of a powerful genetic system

The handedness-associated PCSK6 locus spans an intronic promoter regulating novel transcripts

We recently reported the association of the PCSK6 gene with handedness through a quantitative genome-wide association study (GWAS; P < 0.5 × 10(-8)) for a relative hand skill measure in individuals with dyslexia. PCSK6 activates Nodal, a morphogen involved in regulating left-right body axis determination. Therefore, the GWAS data suggest that the biology underlying the patterning of structural asymmetries may also contribute to behavioural laterality, e.g. handedness. The association is further supported by an independent study reporting a variable number tandem repeat (VNTR) within the same PCSK6 locus to be associated with degree of handedness in a general population cohort. Here, we have conducted a functional analysis of the PCSK6 locus combining further genetic analysis, in silico predictions and molecular assays. We have shown that the previous GWAS signal was not tagging a VNTR effect, suggesting that the two markers have independent effects. We demonstrated experimentally that one of the top GWAS-associated markers, rs11855145, directly alters the binding site for a nuclear factor. Furthermore, we have shown that the predicted regulatory region adjacent to rs11855415 acts as a bidirectional promoter controlling the expression of novel RNA transcripts. These include both an antisense long non-coding RNA (lncRNA) and a short PCSK6 isoform predicted to be coding. This is the first molecular characterization of a handedness-associated locus that supports the role of common variants in non-coding sequences in influencing complex phenotypes through gene expression regulation