Estudio de un sistema de transporte por cable teleférico en el distrito de San Cristóbal Calacoa - provincia de Mariscal Nieto

Problema: El distrito de San Cristóbal – Calacoa tiene serios problemas de accidentada topografia, cuenta con carreteras de tercer orden, el sistema de trasporte teleférico fue ideado para zonas con grandes diferencias de altura puesto que en este distrito, existe una gran dificultad para trasladarse entre San Cristobal y Calacoa, la construcción de un sistema de trasporte teleférico ayudaría al crecimiento socio-económico del mismo distrito. Objetivo: El presente estudio, tiene por finalidad realizar el estudio de un sistema de transporte por cable - teleférico en el Distrito de San Cristóbal Calacoa Provincia Mariscal Nieto, a su vez analizar y determinar el recorrido, sistema de cabinas, cables y demás componentes. Metodología: Para el presente estudio fue necesario recopilar datos históricos, características del terreno, la ubicación y el reconocimiento de rutas de acceso. Se entrevistó a los pobladores y autoridades de la zona de trabajo, se realizó un viaje de estudios a la paz Bolivia, para obtener un mejor entendimiento del estudio, con la información recopilada se procedió a definir las mejores ubicaciones de las estaciones y torres de soporte. Conclusiones: Del análisis se concluye que al tener una topografía irregular es viable un sistema de trasporte por cable, para la ruta del teleférico se tomo en cuenta una ubicación estratégica para las torres y estaciones, considerando 08 torres y 02 estaciones de partida y llegada.Tesi

The ecology of diatoms inhabiting cryoconite holes in Antisana Glacier, Ecuador

Published for International Glaciological Society, IGS[EN] In the ablation zone of glacier habitats, cryoconite holes are known to harbor diverse microbial communities, including unique diatom floras distinct from those of surrounding aquatic and terrestrial systems. Besides descriptive studies, little is known about the diversity of cryoconite diatoms and their response to environmental stressors, particularly in low-latitude glaciers. This paper documents an extremely diversified diatom community in Antisana Glacier (Ecuador), reporting 278 taxa found in 54 surface holes, although with low individual abundances. Contrary to our expectations, assemblage structure did not respond to water physical or chemical characteristics, nor to cryoconite hole morphology, but to elevation. We demonstrate that elevation is a driver of diatom assemblages. Both alpha diversity (measured as Fisher's index) and species richness (corrected for unequal sample sizes) correlated negatively with elevation, suggesting a replacement toward simplified, poorer communities along this gradient. The taxonomic composition also changed significantly, as revealed by multivariate statistics. In summary, cryoconite holes are sites of high taxonomic diversity composed of taxa that are allochthonous in originSIThe authors are thankful to the ‘Fonag’, EPMAPS” and ‘Ministerio del Ambiente’, Ecuador, for collection permission No. MAE-DNB-CM 2018-0028-0093. The research was funded by Proyecto de Investigación DII-UISEK-P041516_3, (SC) ‘Índice Biótico de Calidad de Agua para el Ecuador’, Universidad Internacional SEK and Convenio Marco de Cooperación entre la Universidad de León, España y La Universidad Internacional SEK, Ecuado

Defects in memory B-cell and plasma cell subsets expressing different immunoglobulin-subclasses in patients with CVID and immunoglobulin subclass deficiencies

Background: Predominantly antibody deficiencies (PADs) are the most prevalent primary immunodeficiencies, but their B-cell defects and underlying genetic alterations remain largely unknown. Objective: We investigated patients with PADs for the distribution of 41 blood B-cell and plasma cell (PC) subsets, including subsets defined by expression of distinct immunoglobulin heavy chain subclasses. Methods: Blood samples from 139 patients with PADs, 61 patients with common variable immunodeficiency (CVID), 68 patients with selective IgA deficiency (IgAdef), 10 patients with IgG subclass deficiency with IgA deficiency, and 223 age matched control subjects were studied by using flow cytometry with EuroFlow immunoglobulin isotype staining. Patients were classified according to their B-cell and PC immune profile, and the obtained patient clusters were correlated with clinical manifestations of PADs. Results: Decreased counts of blood PCs, memory B cells (MB Cs), or both expressing distinct IgA and IgG subclasses were identified in all patients with PADs. In patients with IgAdef, B-cell defects were mainly restricted to surface membrane (sm)IgA(+) PCs and MBCs, with 2 clear subgroups showing strongly decreased numbers of smIgA(+) PCs with mild versus severe smIgA(+) MBC defects and higher frequencies of nonrespiratory tract infections, autoimmunity, and affected family members. Patients with IgG subclass deficiency with IgA deficiency and those with CVID showed defects in both smIgA(+) and smIgG(+) MBCs and PCs. Reduced numbers of switched PCs were systematically found in patients with CVID (absent in 98%), with 6 different defective MBC (and clinical) profiles: (1) profound decrease in MBC numbers; (2) defective CD27(+) MBCs with almost normal IgG(3)(+) MBCs; (3) absence of switched MBCs; and (4) presence of both unswitched and switched MBCs without and; (5) with IgG(2)(+) MBCs; and (6) with IgA(1)(+) MBCs. Conclusion: Distinct PAD defective B-cell patterns were identified that are associated with unique clinical profiles

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

Ciencia y profesión : el farmacéutico en la historia

474 páginas. Versiones pdf / epubLas IV Jornadas Científicas de la Sociedad de Docentes Universitarios de Historia de la Farmacia (SDUHFE) se celebraron en la Sede de La Rábida en junio de 2016. Esta obra presenta diversas investigaciones y comunicaciones, con varias temáticas que pueden desglosarse en cuatro bloques: 1) En un primer grupo podemos considerar todos los capítulos que abordan la historia de los colegios farmacéuticos así como los avatares de la profesión. Se da cuenta en la provincia de Sevilla de las dificultades del Colegio de Farmacéuticos en el periodo de la Guerra Civil y la Posguerra (1936-1949), del proceso de colegiación obligatoria a partir de 1916, pinceladas históricas sobre los farmacéuticos cántabros del siglo XIX, del Colegio de Farmacéuticos de Filipinas a finales del XIX, de los conflictos de los farmacéuticos en las reuniones sanitarias de mitad del XX, y del papel de los farmacéuticos titulares en la potabilización de las aguas de consumo en Plentzia (Vizcaya). 2) Podemos destacar también todos los trabajos que giran en torno a diferentes medicamentos y productos farmacéuticos, entre ellos estudios históricos sobre piedras preciosas, medicamentos para tratar heridas, quina contra las tercianas, opio, alexifármacos, medicamentos homeopáticos, talidomida o curiosos productos como el Licor del Polo. 3) El papel de los laboratorios farmacéuticos como la Casa Nestlé durante la Guerra Civil española y el franquismo, diferentes laboratorios onubenses durante este mismo periodo, el papel del Instituto de Higiene Militar y la experimentación con insecticidas clorados sintéticos en la posguerra española, aglutinan el tercer cuerpo temático. 4) Finalmente, podemos destacar los trabajos que tienen una componente publicitaria, divulgadora y social entre los que cabe destacar el estudio del NO-DO y los diferentes noticieros y documentales sobre temas farmacéuticos que resultan muy ilustrativos. La propaganda farmacéutica desarrollada en la revista Matronas, el inventario del patrimonio farmacéutico catalán, junto a la percepción social de la farmacia a través de las fallas valencianas conforma este último grupo

Vocabulario de la sociedad civil, la ruralidad y los movimientos sociales en América Latina

El Vocabulario de la Sociedad Civil, la Ruralidad y los Movimientos Sociales en América Latina tiene como objetivo desarrollar vocablos relacionados con temas de gran trascendencia para la vida colectiva de la población Latinoamericana; pretende introducir a estudiantes, personas del ámbito académico y activistas en la comprensión de estas categorías de análisis. A través de la mirada de 70 especialistas que participaron en este vocabulario, es posible comprender muchos de los términos que se utilizan dentro de la investigación social y áreas relacionadas con las ciencias políticas, ambientales y rurales, a partir de una mayor explicación y detalle. Es por ello que se inserta este trabajo desde una mirada colectiva y amplia de los conceptos que se exponen. En este libro podrá encontrar las ideas de varios autores y autoras de distintas universidades, con una visión multi, inter y transdisciplinaria. El esfuerzo que se realizó para conjuntar varios términos y analizar su compleja red de interpretaciones, permitirá que este manuscrito pueda ser consultado por estudiantes, personas del ámbito científico-académico, y ciudadanía; porque contiene el estado del arte, la historia del paulatino avance de múltiples conceptos y su vigencia en el contexto actual

Genetic Testing to Inform Epilepsy Treatment Management From an International Study of Clinical Practice

IMPORTANCE: It is currently unknown how often and in which ways a genetic diagnosis given to a patient with epilepsy is associated with clinical management and outcomes. OBJECTIVE: To evaluate how genetic diagnoses in patients with epilepsy are associated with clinical management and outcomes. DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective cross-sectional study of patients referred for multigene panel testing between March 18, 2016, and August 3, 2020, with outcomes reported between May and November 2020. The study setting included a commercial genetic testing laboratory and multicenter clinical practices. Patients with epilepsy, regardless of sociodemographic features, who received a pathogenic/likely pathogenic (P/LP) variant were included in the study. Case report forms were completed by all health care professionals. EXPOSURES: Genetic test results. MAIN OUTCOMES AND MEASURES: Clinical management changes after a genetic diagnosis (ie, 1 P/LP variant in autosomal dominant and X-linked diseases; 2 P/LP variants in autosomal recessive diseases) and subsequent patient outcomes as reported by health care professionals on case report forms. RESULTS: Among 418 patients, median (IQR) age at the time of testing was 4 (1-10) years, with an age range of 0 to 52 years, and 53.8% (n = 225) were female individuals. The mean (SD) time from a genetic test order to case report form completion was 595 (368) days (range, 27-1673 days). A genetic diagnosis was associated with changes in clinical management for 208 patients (49.8%) and usually (81.7% of the time) within 3 months of receiving the result. The most common clinical management changes were the addition of a new medication (78 [21.7%]), the initiation of medication (51 [14.2%]), the referral of a patient to a specialist (48 [13.4%]), vigilance for subclinical or extraneurological disease features (46 [12.8%]), and the cessation of a medication (42 [11.7%]). Among 167 patients with follow-up clinical information available (mean [SD] time, 584 [365] days), 125 (74.9%) reported positive outcomes, 108 (64.7%) reported reduction or elimination of seizures, 37 (22.2%) had decreases in the severity of other clinical signs, and 11 (6.6%) had reduced medication adverse effects. A few patients reported worsening of outcomes, including a decline in their condition (20 [12.0%]), increased seizure frequency (6 [3.6%]), and adverse medication effects (3 [1.8%]). No clinical management changes were reported for 178 patients (42.6%). CONCLUSIONS AND RELEVANCE: Results of this cross-sectional study suggest that genetic testing of individuals with epilepsy may be materially associated with clinical decision-making and improved patient outcomes