Percepción sobre cambio climático de la población en los sectores aledaños al mar de la ciudad de Chimbote

Universidad Nacional Agraria La Molina. Facultad de Ciencias. Departamento Académico de Ingeniería Ambiental, Física y MeteorologíaEl presente trabajo de investigación tiene como objetivo evaluar la percepción sobre el cambio climático de los pobladores de los sectores aledaños al mar en la ciudad de Chimbote, mediante la aplicación de encuestas y técnicas prospectivas. Se eligió esta ciudad por su importancia económica y ecológica, así como por su grave situación de deterioro ambiental e institucional, características que le otorgan alta vulnerabilidad frente al cambio climático. El estudio tuvo dos etapas. La primera consistió en la realización de encuestas mediante muestreo aleatorio simple de 430 pobladores de las zonas costeras, con la finalidad de evaluar su percepción y actitud respecto al cambio climático. La segunda etapa involucró la recopilación documentaria, participación de expertos y uso de técnicas de análisis prospectivo para la elaboración de escenarios de vulnerabilidad al 2030, para lo cual se tomó como referencia los métodos de prospectiva estratégica MICMAC, MACTOR y SMIC, determinándose las variables y actores estratégicos y generándose los escenarios de vulnerabilidad más probables. Se encontró que la población está familiarizada pero poco sensibilizada con el cambio climático y que, al estar expuesta a problemas relacionados a la satisfacción de sus necesidades básicas, la reducción de sus efectos no es considerada prioridad. Sin embargo, un 79% de la población está dispuesto a involucrarse en actividades relacionadas a ello, lo que es un buen precedente para la implementación de cualquier estrategia. Se determinó que las variables con mayor influencia actual y potencial sobre la vulnerabilidad al cambio climático de Chimbote son las relacionadas con los aspectos políticos, institucionales, educativos y sociales (Tabla 20). Se concluye, de acuerdo al escenario tendencial más probable (Tabla 23), que la reducción de la vulnerabilidad al 2030 es posible pero aún poco probable (21.9%), esto último está en función a las acciones que se tomen en el presente tomando en cuenta las variables analizadas.The objective of this research is to evaluate the perception on climate change of the inhabitants of the sectors bordering the sea in the city of Chimbote, through the application of surveys and prospective techniques. This city was chosen for its economic and ecological importance, as well as for its serious environmental and institutional deterioration which characteristics give it high vulnerability to climate change. The study had two stages. The first consisted of simple random sampling surveys of 430 coastal residents in order to assess their perception and attitude towards climate change. The second stage involved the collection of documents, the participation of experts and the use of prospective analysis techniques for the elaboration of scenarios of vulnerability to 2030, for which it was taken as reference the methods of strategic prospecting MICMAC, MACTOR and SMIC determining the variables and strategic actors from which the most likely vulnerability scenarios were generated.It was found that the population is familiar but not very sensitive to climate change and since they are exposed to problems related to the satisfaction of their basic needs, the reduction of their effects is not considered a priority. However, 79% of the population is willing to engage in activities related to it, which is a good precedent for the implementation of any strategy. It was determined that the variables with the greatest current and potential influence on Chimbote's vulnerability to climate change are those related to political, institutional, educational and social aspects (Table 20). It is concluded, according to the most probable trend scenario (Table 23), that the reduction of vulnerability to 2030 is possible but not yet probable (21.9%), the latest is based on the actions that are taken in the present, taking into account the analyzed variables.Tesi

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

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

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

Percepción sobre cambio climático de la población en los sectores aledaños al mar de la ciudad de Chimbote

El presente trabajo de investigación tiene como objetivo evaluar la percepción sobre el cambio climático de los pobladores de los sectores aledaños al mar en la ciudad de Chimbote, mediante la aplicación de encuestas y técnicas prospectivas. Se eligió esta ciudad por su importancia económica y ecológica, así como por su grave situación de deterioro ambiental e institucional, características que le otorgan alta vulnerabilidad frente al cambio climático. El estudio tuvo dos etapas. La primera consistió en la realización de encuestas mediante muestreo aleatorio simple de 430 pobladores de las zonas costeras, con la finalidad de evaluar su percepción y actitud respecto al cambio climático. La segunda etapa involucró la recopilación documentaria, participación de expertos y uso de técnicas de análisis prospectivo para la elaboración de escenarios de vulnerabilidad al 2030, para lo cual se tomó como referencia los métodos de prospectiva estratégica MICMAC, MACTOR y SMIC, determinándose las variables y actores estratégicos y generándose los escenarios de vulnerabilidad más probables. Se encontró que la población está familiarizada pero poco sensibilizada con el cambio climático y que, al estar expuesta a problemas relacionados a la satisfacción de sus necesidades básicas, la reducción de sus efectos no es considerada prioridad. Sin embargo, un 79% de la población está dispuesto a involucrarse en actividades relacionadas a ello, lo que es un buen precedente para la implementación de cualquier estrategia. Se determinó que las variables con mayor influencia actual y potencial sobre la vulnerabilidad al cambio climático de Chimbote son las relacionadas con los aspectos políticos, institucionales, educativos y sociales (Tabla 20). Se concluye, de acuerdo al escenario tendencial más probable (Tabla 23), que la reducción de la vulnerabilidad al 2030 es posible pero aún poco probable (21.9%), esto último está en función a las acciones que se tomen en el presente tomando en cuenta las variables analizadas.The objective of this research is to evaluate the perception on climate change of the inhabitants of the sectors bordering the sea in the city of Chimbote, through the application of surveys and prospective techniques. This city was chosen for its economic and ecological importance, as well as for its serious environmental and institutional deterioration which characteristics give it high vulnerability to climate change. The study had two stages. The first consisted of simple random sampling surveys of 430 coastal residents in order to assess their perception and attitude towards climate change. The second stage involved the collection of documents, the participation of experts and the use of prospective analysis techniques for the elaboration of scenarios of vulnerability to 2030, for which it was taken as reference the methods of strategic prospecting MICMAC, MACTOR and SMIC determining the variables and strategic actors from which the most likely vulnerability scenarios were generated.It was found that the population is familiar but not very sensitive to climate change and since they are exposed to problems related to the satisfaction of their basic needs, the reduction of their effects is not considered a priority. However, 79% of the population is willing to engage in activities related to it, which is a good precedent for the implementation of any strategy. It was determined that the variables with the greatest current and potential influence on Chimbote's vulnerability to climate change are those related to political, institutional, educational and social aspects (Table 20). It is concluded, according to the most probable trend scenario (Table 23), that the reduction of vulnerability to 2030 is possible but not yet probable (21.9%), the latest is based on the actions that are taken in the present, taking into account the analyzed variables.TesisUniversidad Nacional Agraria La Molina. Facultad de Ciencias. Departamento Académico de Ingeniería Ambiental, Física y Meteorologí

The management of acute venous thromboembolism in clinical practice - study rationale and protocol of the European PREFER in VTE Registry

Background: Venous thromboembolism (VTE) is a major health problem, with over one million events every year in Europe. However, there is a paucity of data on the current management in real life, including factors influencing treatment pathways, patient satisfaction, quality of life (QoL), and utilization of health care resources and the corresponding costs. The PREFER in VTE registry has been designed to address this and to understand medical care and needs as well as potential gaps for improvement. Methods/design: The PREFER in VTE registry was a prospective, observational, multicenter study conducted in seven European countries including Austria, France Germany, Italy, Spain, Switzerland, and the UK to assess the characteristics and the management of patients with VTE, the use of health care resources, and to provide data to estimate the costs for 12 months treatment following a first-time and/or recurrent VTE diagnosed in hospitals or specialized or primary care centers. In addition, existing anticoagulant treatment patterns, patient pathways, clinical outcomes, treatment satisfaction, and health related QoL were documented. The centers were chosen to reflect the care environment in which patients with VTE are managed in each of the participating countries. Patients were eligible to be enrolled into the registry if they were at least 18 years old, had a symptomatic, objectively confirmed first time or recurrent acute VTE defined as either distal or proximal deep vein thrombosis, pulmonary embolism or both. After the baseline visit at the time of the acute VTE event, further follow-up documentations occurred at 1, 3, 6 and 12 months. Follow-up data was collected by either routinely scheduled visits or by telephone calls. Results: Overall, 381 centers participated, which enrolled 3,545 patients during an observational period of 1 year. Conclusion: The PREFER in VTE registry will provide valuable insights into the characteristics of patients with VTE and their acute and mid-term management, as well as into drug utilization and the use of health care resources in acute first-time and/or recurrent VTE across Europe in clinical practice. Trial registration: Registered in DRKS register, ID number: DRKS0000479