Percepción de docentes y estudiantes acerca de la actividad educativa en la escuela de enfermería de la UNMSM y propuesta co-participativa de planes de mejora

Objetivos: Caracterizar la actividad académica, el cumplimiento de las obligaciones, programa, metodología, materiales, actitud del docente, evaluación, prácticas, satisfacción. Establecer las coincidencias y divergencias de la actividad educativa en Enfermería. Y comprometer a los involucrados a participar en el diseño de propuestas. Diseño: Método descriptivo, transversal, cuantitativo, complementado con técnicas cualitativas. Institución: Departamento Académico Profesional de Enfermería, Facultad de Medicina, UNMSM. Participantes: Estudiantes y docentes. Intervenciones: Se efectuó el estudio en 135 estudiantes y 27 docentes (30% del universo de docentes y estudiantes). La escala fue de 1 a 5, siendo 1 definitivamente negativa y 5 definitivamente positiva. Principales medidas de resultados: Calidad de la actividad académica. Resultados: En estudiantes fue 3,57 y en docentes 3,70, indicando que estamos cercanos al punto medio y lejos de calidad ‘definitivamente positiva’. El menor valor fue la dimensión ‘prácticas’, con un valor de 2,74, con ‘opinión negativa’. El valor más alto estuvo en ‘Programa de Enseñanza’, con 3,91, cerca de ‘opinión positiva’. Conclusiones: Hubo dos categorías de resultados, actitud docente y aptitud docente, señalando que los docentes se mantienen ‘sin interés’, ‘poco comprometidos’ con su labor docente. Falta mejorar la planificación de clases, metodología, supervisión y evaluación; un mejor uso del tiempo, para no afectar la ‘práctica clínica o comunitaria’

ILCYM - Insect Life Cycle Modeling. A software package for developing temperature-based insect phenology models with applications for local, regional and global analysis of insect population and mapping

This book describes the application of ILCYM software, which supports the development of process-oriented temperature-driven and age-stage structured insect phenology/population models. ILCYM interactively leads the user through the steps for developing insect phenology models, for conducting simulations, and for producing potential population distribution and risk mapping under current or future temperature (climate change) scenarios. The objective of the present document is to explain how the developed modeling approach works; what type of data need to be generated to develop an insect phenology model, what type of data need to be generated to validate a, how are implemented, and what type of insect population analysis will be provided. With the current version of ILCYM the authors intend to share the knowledge gained in insect pest population modeling research at the Agroecology/IPM unit at CIP and provide an open-source computer aided tool, especially for researcher in developing countries, that facilitates the development of own using advanced modeling techniques without being experts in the field

ILCYM – Modelado del Ciclo de Vida de los Insectos 4.0. Un paquete de software para desarrollar modelos de fenología de insectos basados en la temperatura con aplicaciones para el mapeo y el análisis regional y global de la población de insectos

Este libro describe la aplicación del software ILCYM, que apoya el desarrollo de modelos de fenología/población de insectos estructurados en función de la temperatura y orientados al proceso. ILCYM guía de forma interactiva al usuario a través de los pasos requeridos para desarrollar modelos de fenología de insectos, realizar simulaciones y producir la distribución potencial de la población y el mapeo de riesgos bajo escenarios de temperatura (cambio climático) actuales o futuros. El objetivo del presente documento es explicar cómo funciona el enfoque de modelado desarrollado; qué tipo de datos deben generarse para desarrollar un modelo fenológico de insectos (MFI), qué tipo de datos deben generarse para validar un MFI, cómo se implementan los MFI y qué tipo de análisis de población de insectos se proporcionará. Con la versión actual de ILCYM, los autores pretenden compartir el conocimiento adquirido en la investigación de modelos de población de plagas de insectos en el CIP y proporcionar una herramienta de computadora de código abierto, especialmente para investigadores de los países en desarrollo, que facilite el desarrollo de poseer MFI utilizando técnicas de modelado avanzado sin ser expertos en el campo

Thrombolytic removal of intraventricular haemorrhage in treatment of severe stroke: results of the randomised, multicentre, multiregion, placebo-controlled CLEAR III trial

Background: Intraventricular haemorrhage is a subtype of intracerebral haemorrhage, with 50% mortality and serious disability for survivors. We aimed to test whether attempting to remove intraventricular haemorrhage with alteplase versus saline irrigation improved functional outcome. Methods: In this randomised, double-blinded, placebo-controlled, multiregional trial (CLEAR III), participants with a routinely placed extraventricular drain, in the intensive care unit with stable, non-traumatic intracerebral haemorrhage volume less than 30 mL, intraventricular haemorrhage obstructing the 3rd or 4th ventricles, and no underlying pathology were adaptively randomly assigned (1:1), via a web-based system to receive up to 12 doses, 8 h apart of 1 mg of alteplase or 0·9% saline via the extraventricular drain. The treating physician, clinical research staff, and participants were masked to treatment assignment. CT scans were obtained every 24 h throughout dosing. The primary efficacy outcome was good functional outcome, defined as a modified Rankin Scale score (mRS) of 3 or less at 180 days per central adjudication by blinded evaluators. This study is registered with ClinicalTrials.gov, NCT00784134. Findings: Between Sept 18, 2009, and Jan 13, 2015, 500 patients were randomised: 249 to the alteplase group and 251 to the saline group. 180-day follow-up data were available for analysis from 246 of 249 participants in the alteplase group and 245 of 251 participants in the placebo group. The primary efficacy outcome was similar in each group (good outcome in alteplase group 48% vs saline 45%; risk ratio [RR] 1·06 [95% CI 0·88–1·28; p=0·554]). A difference of 3·5% (RR 1·08 [95% CI 0·90–1·29], p=0·420) was found after adjustment for intraventricular haemorrhage size and thalamic intracerebral haemorrhage. At 180 days, the treatment group had lower case fatality (46 [18%] vs saline 73 [29%], hazard ratio 0·60 [95% CI 0·41–0·86], p=0·006), but a greater proportion with mRS 5 (42 [17%] vs 21 [9%]; RR 1·99 [95% CI 1·22–3·26], p=0·007). Ventriculitis (17 [7%] alteplase vs 31 [12%] saline; RR 0·55 [95% CI 0·31–0·97], p=0·048) and serious adverse events (114 [46%] alteplase vs 151 [60%] saline; RR 0·76 [95% CI 0·64–0·90], p=0·002) were less frequent with alteplase treatment. Symptomatic bleeding (six [2%] in the alteplase group vs five [2%] in the saline group; RR 1·21 [95% CI 0·37–3·91], p=0·771) was similar. Interpretation: In patients with intraventricular haemorrhage and a routine extraventricular drain, irrigation with alteplase did not substantially improve functional outcomes at the mRS 3 cutoff compared with irrigation with saline. Protocol-based use of alteplase with extraventricular drain seems safe. Future investigation is needed to determine whether a greater frequency of complete intraventricular haemorrhage removal via alteplase produces gains in functional status

Efficacy and safety of minimally invasive surgery with thrombolysis in intracerebral haemorrhage evacuation (MISTIE III): a randomised, controlled, open-label, blinded endpoint phase 3 trial

Acute stroke due to supratentorial intracerebral haemorrhage is associated with high morbidity and mortality. Open craniotomy haematoma evacuation has not been found to have any benefit in large randomised trials. We assessed whether minimally invasive catheter evacuation followed by thrombolysis (MISTIE), with the aim of decreasing clot size to 15 mL or less, would improve functional outcome in patients with intracerebral haemorrhage. MISTIE III was an open-label, blinded endpoint, phase 3 trial done at 78 hospitals in the USA, Canada, Europe, Australia, and Asia. We enrolled patients aged 18 years or older with spontaneous, non-traumatic, supratentorial intracerebral haemorrhage of 30 mL or more. We used a computer-generated number sequence with a block size of four or six to centrally randomise patients to image-guided MISTIE treatment (1·0 mg alteplase every 8 h for up to nine doses) or standard medical care. Primary outcome was good functional outcome, defined as the proportion of patients who achieved a modified Rankin Scale (mRS) score of 0-3 at 365 days, adjusted for group differences in prespecified baseline covariates (stability intracerebral haemorrhage size, age, Glasgow Coma Scale, stability intraventricular haemorrhage size, and clot location). Analysis of the primary efficacy outcome was done in the modified intention-to-treat (mITT) population, which included all eligible, randomly assigned patients who were exposed to treatment. All randomly assigned patients were included in the safety analysis. This study is registered with ClinicalTrials.gov, number NCT01827046. Between Dec 30, 2013, and Aug 15, 2017, 506 patients were randomly allocated: 255 (50%) to the MISTIE group and 251 (50%) to standard medical care. 499 patients (n=250 in the MISTIE group; n=249 in the standard medical care group) received treatment and were included in the mITT analysis set. The mITT primary adjusted efficacy analysis estimated that 45% of patients in the MISTIE group and 41% patients in the standard medical care group had achieved an mRS score of 0-3 at 365 days (adjusted risk difference 4% [95% CI -4 to 12]; p=0·33). Sensitivity analyses of 365-day mRS using generalised ordered logistic regression models adjusted for baseline variables showed that the estimated odds ratios comparing MISTIE with standard medical care for mRS scores higher than 5 versus 5 or less, higher than 4 versus 4 or less, higher than 3 versus 3 or less, and higher than 2 versus 2 or less were 0·60 (p=0·03), 0·84 (p=0·42), 0·87 (p=0·49), and 0·82 (p=0·44), respectively. At 7 days, two (1%) of 255 patients in the MISTIE group and ten (4%) of 251 patients in the standard medical care group had died (p=0·02) and at 30 days, 24 (9%) patients in the MISTIE group and 37 (15%) patients in the standard medical care group had died (p=0·07). The number of patients with symptomatic bleeding and brain bacterial infections was similar between the MISTIE and standard medical care groups (six [2%] of 255 patients vs three [1%] of 251 patients; p=0·33 for symptomatic bleeding; two [1%] of 255 patients vs 0 [0%] of 251 patients; p=0·16 for brain bacterial infections). At 30 days, 76 (30%) of 255 patients in the MISTIE group and 84 (33%) of 251 patients in the standard medical care group had one or more serious adverse event, and the difference in number of serious adverse events between the groups was statistically significant (p=0·012). For moderate to large intracerebral haemorrhage, MISTIE did not improve the proportion of patients who achieved a good response 365 days after intracerebral haemorrhage. The procedure was safely adopted by our sample of surgeons. National Institute of Neurological Disorders and Stroke and Genentech. [Abstract copyright: Copyright © 2019 Elsevier Ltd. All rights reserved.

Predicting climate-change-caused changes in global temperature on potato tuber moth Phthorimaea operculella (Zeller) distribution and abundance using phenology modeling and GIS mapping

Originating from the Andean region and co-evolved with its food plant, the potato (Solanum sp.), the potato tuber moth Phthorimaea operculella (Zeller) has become an invasive potato pest globally. The hypothesis of our present study was that the future distribution and abundance (damage potential) of this pest will be greatly affected by climate-change-caused changes in temperature. We used a process-based climatic phenology model for P. operculella and applied three risk indices (establishment-, generation, and activity index) in a geographic information system (GIS) environment to map and quantify changes for climate change scenarios of the year 2050 based on downscaled climate-change data of the scenario A1B from the WorldClim database. All applications and simulations were made using the Insect Life Cycle Modeling (ILCYM) software recently developed by The International Potato Center, Lima, Peru. The study concludes that there are three possible main scenarios of changes that may simultaneously occur: (1) the P. operculella damage potential will progressively increase in all regions where the pest already prevails today with an excessive increase in warmer cropping regions of the tropics and subtropics. In regions where P. operculella is established and develops >4 generations per year, economic losses are likely to occur; under the current climate, >4 generations are developed on 30.1% of the total potato production area worldwide, which will increase until the year 2050 to 42.4%, equal to an increase of 2,409,974 ha of potato under new infestation. (2) A range expansion in temperate regions of the northern hemisphere with additionally 8.6% (699,680 ha), 4.2% (32,873 ha), and 2.7% (234,404 ha) of the potato production area under higher risk in Asia, North America, and Europe, with moderate increases of its damage potential. (3) A range expansion in tropical temperate mountainous regions with a moderate increase of its damage potential; e.g., in Bolivia, Ecuador and Peru 44,281 ha, 9569 ha, and 39,646 ha of potato will be under new risk of infestation. The ILCYM software allowed a detailed analysis of possible climate-change-induced changes in temperature on P. operculella distribution and damage potential. Further, this tool offers means of overcoming limitations in predictions and mapping experienced with climate data interpolation and resolution by spatial point-by-point simulations at locations of interest. The methodology is proposed as a very helpful tool for adaptation planning in integrated pest management

Calcareous benthic foraminifera from the upper central Peruvian margin : control of the assemblage by pore water redox and sedimentary organic matter

We studied 'living' (stained) benthic foraminifera in the upper border of the Peruvian oxygen minimum zone (OMZ) to determine the relationship between species' distribution and pore water and sediment geochemistry under oxygen deficiency. Superficial sediments were sampled between 2009 and 2011 from 2 bathymetric transects off central Peru (45 to 300 m depth). The quantity (total organic carbon, total nitrogen and chloroplastic pigment equivalents [CPE]) and quality (chlorophyll a/phaeopigments ratio) of organic matter (OM) were evaluated. Benthic foraminifera were sampled in the top 5 cm of sediment. Commonly, the inner shelf sediments were sulfidic and labile OM-rich, whereas the outer shelf and upper slope sediments exhibited postoxic conditions (e.g. anoxic and non-sulfidic) with less labile OM, typical of OMZ core sediments. Mixed conditions were found in shelf sediment samples from April 2010, when the effects of El Nino 2009/2010 were withdrawing. Foraminiferal assemblages exhibited differences according to redox conditions and OM quality, and were concentrated in the topmost sediment. A canonical correspondence analysis and non-parametric correlations indicated that Bolivina costata, Nonionella auris and Virgulinella fragilis were characteristic of sulfidic/labile OM sediments, thriving slightly deeper in the sediment. In contrast, Bolivina pacifica headed the assemblage representative of postoxia/less labile OM. Bolivina seminuda and Buliminella tenuata (both dominant under postoxia) were not associated with any specific measured parameter, although were present in sulfidic sediments, suggesting other factors were involved in their distribution