28 research outputs found

    Wind and turbulence relationship with NO2 in an urban environment: a fine-scale observational analysis

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    It is well known that meteorology plays an important role in the diurnal evolution of pollutants, especially those variables related to atmospheric dispersion. Most studies typically relate the concentration of some pollutants with wind speed from conventional anemometers; however, the use of turbulence variables is less common, in part because the needed instruments are not so typical in standard air-quality stations. In this work, we compare the wind-NO2 relationship with the turbulence-NO2 one using observational data from two field campaigns developed in Madrid (winter and summer). The turbulence data comes from two sonic anemometers deployed at different locations: one close to the street and the other at the top of a nearby tall building. The results indicate that the turbulent variables correlate better with the pollutant concentration than the wind speed when using data from the street sonic, while the contrary is found when using the terrace sonic. These data are also used to perform a fine-scale analysis of the turbulent diffusion-NO2 behaviour during a very-stable period in winter, when the turbulence typically shows a decrease in the evening transition, causing the highestNO2 concentrations. Conversely, under these conditions, the formation of thermally-driven winds is also favoured later in the night, which favours the pollutant dispersion and cleaning of the air. The important role of these dynamical processes on the NO2 evolution highlights the importance of the correct understanding of small-scale atmospheric processes to understand their relationship with the concentration of pollutants

    Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

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    The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

    Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

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    Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

    Sistema clínico para el fortalecimiento de la toma de decisiones y labor social brindada por la corporación CoopeAgri. R.L.

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    Licenciatura en informática con énfasis en sistemas de informaciónEl presente proyecto investiga, desarrolla e implementa un sistema clínico en una plataforma web, para agilizar el manejo, control y asignación de citas, donde se administre la información del expediente digital que permita generar datos estadísticos para la toma de decisiones de la corporación CoopeAgri R.L. Durante el desarrollo sistema, logran crear una agenda para facilitar la administración del servicio médico e incorporan una conexión segura de la base de datos con el sistema principal de la empresa, e integran de manera satisfactoria estándares de seguridad. Una vez implementado el sistema, se aplicó la encuesta como método de recolección de la información a las variables que fueran objeto de medición cuantitativa, el instrumento se aplicó a una población total de 56 sujetos; 6 colaboradores y 50 pacientes. La encuesta refleja la satisfacción de los colaboradores con el sistema, y los pacientes una mejora en la asignación de las citas.This project researches, develops and implements a clinical system on a web platform, to streamline the management, control and allocation of appointments, where the information in the digital file is managed to generate statistical data for decision making of the corporation CoopeAgri R.L. During the development of the system, they managed to create an agenda to facilitate the administration of the medical service and incorporate a secure connection of the database with the main system of the company, and integrate security standards in a satisfactory manner. Once the system was implemented, a survey was applied as a method for collecting information on the variables that were the object of quantitative measurement, the instrument was applied to a total population of 56 subjects; 6 collaborators and 50 patients. The survey reflects the satisfaction of the collaborators with the system, and the patients an improvement in the assignment of appointments.Universidad Nacional, Costa RicaSede Regional Brunca, Campus Pérez Zeledó

    Comparative Study of Infliximab Versus Adalimumab in Refractory Uveitis due to Behçet's Disease: National Multicenter Study of 177 Cases.

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    To compare the efficacy of infliximab (IFX) versus adalimumab (ADA) as a first-line biologic drug over 1 year of treatment in a large series of patients with refractory uveitis due to Behçet's disease (BD). We conducted an open-label multicenter study of IFX versus ADA for BD-related uveitis refractory to conventional nonbiologic treatment. IFX or ADA was chosen as the first-line biologic agent based on physician and patient agreement. Patients received 3-5 mg/kg intravenous IFX at 0, 2, and 6 weeks and every 4-8 weeks thereafter, or 40 mg subcutaneous ADA every other week without a loading dose. Ocular parameters were compared between the 2 groups. The study included 177 patients (316 affected eyes), of whom 103 received IFX and 74 received ADA. There were no significant baseline differences between treatment groups in main demographic features, previous therapy, or ocular sign severity. After 1 year of therapy, we observed an improvement in all ocular parameters in both groups. However, patients receiving ADA had significantly better outcomes in some parameters, including improvement in anterior chamber inflammation (92.31% versus 78.18% for IFX; P = 0.06), improvement in vitritis (93.33% versus 78.95% for IFX; P = 0.04), and best-corrected visual acuity (mean ± SD 0.81 ± 0.26 versus 0.67 ± 0.34 for IFX; P = 0.001). A nonsignificant difference was seen for macular thickness (mean ± SD 250.62 ± 36.85 for ADA versus 264.89 ± 59.74 for IFX; P = 0.15), and improvement in retinal vasculitis was similar between the 2 groups (95% for ADA versus 97% for IFX; P = 0.28). The drug retention rate was higher in the ADA group (95.24% versus 84.95% for IFX; P = 0.042). Although both IFX and ADA are efficacious in refractory BD-related uveitis, ADA appears to be associated with better outcomes than IFX after 1 year of follow-up

    Trabajos Especiales de Grado de ingeniería Geológica 1990-1999

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    Safety of hospital discharge before return of bowel function after elective colorectal surgery

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    Background Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien-Dindo classification system. Results A total of 3288 patients were included in the analysis, of whom 301 (9 center dot 2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4-7) and 7 (6-8) days respectively (P &lt; 0 center dot 001). There were no significant differences in rates of readmission between these groups (6 center dot 6 versus 8 center dot 0 per cent; P = 0 center dot 499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0 center dot 90, 95 per cent c.i. 0 center dot 55 to 1 center dot 46; P = 0 center dot 659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34 center dot 7 versus 39 center dot 5 per cent; major 3 center dot 3 versus 3 center dot 4 per cent; P = 0 center dot 110). Conclusion Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients
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