Factores asociados a partos por cesárea en un hospital peruano: Factors associated with cesarean delivery in a Peruvian Hospital

Introduction: Caesarean sections carry maternal and perinatal risks. Objective: To determine thefactors associated with cesarean delivery in patients treated in the gynecology obstetrics service atthe Hospital Militar Central, in the 2014-2018 period. Methods: Analytical, retrospective, case-controlstudy; the population was vaginal or caesarean deliveries attended during the years 2014 to 2018. Thesampling was systematic, and the sample size was 988 deliveries of which 329 were caesarean sections.Chi-square and logistic regression tests were applied to calculate the odds ratio; The analysis was carriedout with the statistical program SPSS 23. Results: In pregnant women, previous caesarean section wasa factor associated with caesarean section (OR = 1.55, 95% CI = 1.12-2.15); neither age, gestational age,nor prenatal controls were a factor associated with caesarean section (p>0.05). Educational level wasalso not a factor associated with caesarean section, but the number of children was (OR = 0.83, 95% CI =0.72-0.95). Conclusion: Having previous caesarean sections, few children, an older age, were significantrisk factors for cesarean delivery.Introducción: Las cesáreas conllevan riesgos maternos y perinatales. Objetivo: Determinar losfactores asociados al parto por cesárea en pacientes atendidas en el servicio de ginecoobstetricia delhospital Militar Central, en el periodo 2014-2018. Métodos: Estudio analítico, retrospectivo, de casosy controles; la población fueron los partos vaginales o cesáreas atendidos durante los años 2014 al2018. El muestreo fue sistemático, y el tamaño de muestra fue de 988 partos de los cuales 329 fueroncesáreas. Se aplicó las pruebas de Chi-cuadrado y regresión logística para el cálculo de los odds ratio;el análisis se realizó con el programa estadístico SPSS 23. Resultados: En gestantes, la cesárea previaresultó un factor asociado a cesárea (OR=1,55 IC95%=1,12-2,15); ni la edad, edad gestacional, ni loscontroles prenatales resultaron un factor asociado a cesárea (p>0,05). El nivel educativo tampoco fueun factor asociado a cesárea, pero sí el número de hijos (OR=0,83, IC95%=0,72-0,95). Conclusión:Tener cesáreas previas y pocos hijos fueron factores asociados significativos a parto por cesárea

Los mapas mentales como estrategia en el desarrollo de la inteligencia exitosa en estudiantes de secundaria

Mind maps are usually employed by teachers from all the educational levels as powerful learning strategies. This use enables important pedagogic achievements, but they do not exceed their maximum level, due to the dogmatic use of Tony Buzan's mind map (1996). Situation that would be different if it were entirely internalized, understand and applied. Precisely for that reason, the triarchic theory of intelligence developed by Rober Sternberg (1985) allows students to make decisions in several difficult situations with the suitable use of techniques and orientations in the development of the same intelligence. The research was developed by means of the case study from the qualitative focus, in which through the analysis of the evidences found and the use of an instrument that measured the successful intelligence, its development could be confirmed. However, the empiric analysis was not enough for validating the aforementioned development. For that reason, direct observation was chosen during learning sessions accomplished by the teacher responsible for the strategy to be used, and embodied in the field notebook. Likewise, in-depth interviews were conducted by educational psychologists. It should be noted that the analyzed documents have allowed developing the triangulation not only of evidences but also of methodologies, among them the documentary analysis, in order to reach conclusions that demonstrate how the development of the successful intelligence has been achieved. Finally, it is demonstrated than the use of the techniques of the mind maps with an educational strategy adapted to the applied group, achieves the significant development of the abilities of the analytical, creative and practical intelligence.Los mapas mentales suelen ser empleados por docentes de todos los niveles educativos como potentes estrategias de aprendizaje. Empleo que permite logros pedagógicos importantes, pero que no llegan a traspasar su máximo nivel, por el uso dogmático del mapa mental originario de Tony Buzan (1996). Situación que sería distinta si se consiguiera internalizar, comprender y aplicarla en su cabalidad. Precisamente por ello, la teoría triárquica de la inteligencia desarrollada por Rober Sternberg (1985) permite a los estudiantes la capacidad de tomar decisiones ante diversas situaciones problemáticas con el uso adecuado de técnicas y orientaciones en el desarrollo mismo de la inteligencia.  La investigación se desarrolló mediante el estudio de casos desde el enfoque cualitativo, donde a través del análisis de las evidencias encontradas y el empleo de un instrumento que midió la inteligencia exitosa, se pudo comprobar su desarrollo. Sin embargo, el análisis empírico no fue suficiente para validar dicho desarrollo; por ello se optó por la observación directa durante las sesiones de aprendizaje realizado por el docente responsable de la estrategia a emplear y plasmado en el cuaderno campo. Asimismo, las entrevistas a profundidad fueron llevadas a cabo por psicólogos educacionales. Cabe resaltar que los documentos analizados, han permitido realizar la triangulación no solo de evidencias sino también de metodologías, entre ellas el análisis documental, para llegar a conclusiones que demuestran de qué manera se ha logrado el desarrollo de la inteligencia exitosa. Por último, se demuestra que el uso de las técnicas de los mapas mentales con una estrategia educacional adaptada al grupo aplicado, logra el desarrollo significativo de las habilidades de la inteligencia analítica, creativa y práctica

Los mapas mentales como estrategia en el desarrollo de la inteligencia exitosa en estudiantes de secundaria

Mind maps are usually employed by teachers from all the educational levels as powerful learning strategies. This use enables important pedagogic achievements, but they do not exceed their maximum level, due to the dogmatic use of Tony Buzan's mind map (1996). Situation that would be different if it were entirely internalized, understand and applied. Precisely for that reason, the triarchic theory of intelligence developed by Rober Sternberg (1985) allows students to make decisions in several difficult situations with the suitable use of techniques and orientations in the development of the same intelligence. The research was developed by means of the case study from the qualitative focus, in which through the analysis of the evidences found and the use of an instrument that measured the successful intelligence, its development could be confirmed. However, the empiric analysis was not enough for validating the aforementioned development. For that reason, direct observation was chosen during learning sessions accomplished by the teacher responsible for the strategy to be used, and embodied in the field notebook. Likewise, in-depth interviews were conducted by educational psychologists. It should be noted that the analyzed documents have allowed developing the triangulation not only of evidences but also of methodologies, among them the documentary analysis, in order to reach conclusions that demonstrate how the development of the successful intelligence has been achieved. Finally, it is demonstrated than the use of the techniques of the mind maps with an educational strategy adapted to the applied group, achieves the significant development of the abilities of the analytical, creative and practical intelligence.Los mapas mentales suelen ser empleados por docentes de todos los niveles educativos como potentes estrategias de aprendizaje. Empleo que permite logros pedagógicos importantes, pero que no llegan a traspasar su máximo nivel, por el uso dogmático del mapa mental originario de Tony Buzan (1996). Situación que sería distinta si se consiguiera internalizar, comprender y aplicarla en su cabalidad. Precisamente por ello, la teoría triárquica de la inteligencia desarrollada por Rober Sternberg (1985) permite a los estudiantes la capacidad de tomar decisiones ante diversas situaciones problemáticas con el uso adecuado de técnicas y orientaciones en el desarrollo mismo de la inteligencia.  La investigación se desarrolló mediante el estudio de casos desde el enfoque cualitativo, donde a través del análisis de las evidencias encontradas y el empleo de un instrumento que midió la inteligencia exitosa, se pudo comprobar su desarrollo. Sin embargo, el análisis empírico no fue suficiente para validar dicho desarrollo; por ello se optó por la observación directa durante las sesiones de aprendizaje realizado por el docente responsable de la estrategia a emplear y plasmado en el cuaderno campo. Asimismo, las entrevistas a profundidad fueron llevadas a cabo por psicólogos educacionales. Cabe resaltar que los documentos analizados, han permitido realizar la triangulación no solo de evidencias sino también de metodologías, entre ellas el análisis documental, para llegar a conclusiones que demuestran de qué manera se ha logrado el desarrollo de la inteligencia exitosa. Por último, se demuestra que el uso de las técnicas de los mapas mentales con una estrategia educacional adaptada al grupo aplicado, logra el desarrollo significativo de las habilidades de la inteligencia analítica, creativa y práctica

A Fuzzy Rule-Based System to Predict Energy Consumption of Genetic Programming Algorithms

In recent years, the energy-awareness has become one of the most interesting areas in our environmentally conscious society. Algorithm designers have been part of this, particularly when dealing with networked devices and, mainly, when handheld ones are involved. Although studies in this area has increased, not many of them have focused on Evolutionary Algorithms. To the best of our knowledge, few attempts have been performed before for modeling their energy consumption considering different execution devices. In this work, we propose a fuzzy rulebased system to predict energy comsumption of a kind of Evolutionary Algorithm, Genetic Prohramming, given the device in wich it will be executed, its main parameters, and a measurement of the difficulty of the problem addressed. Experimental results performed show that the proposed model can predict energy consumption with very low error values.We acknowledge support from Spanish Ministry of Economy and Competitiveness under projects TIN2014-56494-C4-[1,2,3]-P and TIN2017-85727-C4- [2,4]-P, Regional Government of Extremadura, Department of Commerce and Economy, conceded by the European Regional Development Fund, a way to build Europe, under the project IB16035, and Junta de Extremadura FEDER, projects GR15068 and GR15130

Evolutionary system for prediction and optimization of hardware architecture performance

The design of computer architectures is a very complex problem. The multiple parameters make the number of possible combinations extremely high. Many researchers have used simulation, although it is a slow solution since evaluating a single point of the search space can take hours. In this work we propose using evolutionary multilayer perceptron (MLP) to compute the performance of an architecture parameter settings. Instead of exploring the search space, simulating many configurations, our method randomly selects some architecture configurations; those are simulated to obtain their performance, and then an artificial neural network is trained to predict the remaining configurations performance. Results obtained show a high accuracy of the estimations using a simple method to select the configurations we have to simulate to optimize the MLP. In order to explore the search space, we have designed a genetic algorithm that uses the MLP as fitness function to find the niche where the best architecture configurations (those with higher performance) are located. Our models need only a small fraction of the design space, obtaining small errors and reducing required simulation by two orders of magnitude.Peer ReviewedPostprint (published version

Prevalence and risk factors of gestational diabetes mellitus: findings from a universal screening feasibility program in Lima, Peru.

BACKGROUND: Gestational diabetes mellitus (GDM) is a global public health concern with potential implications for the health of a mother and her offspring. However, data on the prevalence and risk factors of GDM in Latin America are scarce. The study was designed to estimate the prevalence of GDM and identify maternal risk factors among Peruvian women. METHODS: A cross-sectional study was conducted among 1300 pregnant women attending a prenatal clinic in Lima, Peru. GDM was diagnosed using an Oral Glucose Tolerance Test (OGTT) performed between 24 and 28 gestational weeks using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Depression status was assessed using the Patient Health Questionnaire-9. Multivariate logistic regression models were used to identify risk factors of GDM. RESULTS: Approximately 16% of pregnant women were diagnosed with GDM. The prevalence of obesity and depression were 24.4 and 10.6%, respectively. After adjusting for confounders, mid-pregnancy obesity was associated with a 1.64-fold increased odds of GDM (OR: 1.64; 95% CI: 1.03-2.61). Participants with a family history of diabetes had a 1.5-fold increased odds of developing GDM (OR: 1.51, 95% CI: 1.10-2.07) as compared to women without this family history. Depression was associated with a 1.54-fold increased odds of GDM (OR: 1.54; 95% CI:1.09-2.17). CONCLUSIONS: GDM is highly prevalent and was associated with maternal obesity, family history of diabetes and antepartum depression among Peruvian women. Intervention programs aimed at early diagnoses and management of GDM need to take maternal obesity, family history of diabetes and antepartum depression into account

Impacto de las políticas sociales en la calidad de vida del adulto mayor

El artículo tuvo como finalidad exponer la evaluación de las políticas sociales implantadas en el Perú, específicamente del Programa Pensión 65, en el mejoramiento en la calidad de vida de una población específica (adulto mayor en estado de vulnerabilidad). Para esto se utilizó una metodología cualitativa y evaluativa de programas sociales, cuyas técnicas utilizadas fueron la observación directa a beneficiaRíos focalizados, entrevistas a expertos en programas sociales, análisis documental que permitieron triangular con los hallazgos encontrados en el trabajo de campo. En este proceso se pudo determinar que la subvención al adulto mayor no ha mejorado su bienestar social y condición de vida, dejando evidencia que la inversión realizada en los últimos cinco años asciende a más de 3,000 millones de soles (aprox. 1 millón de dólares)

Near real-time change detection system using Sentinel-2 and machine learning: a test for Mexican and Colombian forests

The commitment by over 100 governments covering over 90% of the world’s forests at the COP26 in Glasgow to end deforestation by 2030 requires more effective forest monitoring systems. The near real-time (NRT) change detection of forest cover loss enables forest landowners, government agencies and local communities to monitor natural and anthropogenic disturbances in a much timelier fashion than the thematic maps that are released every year. NRT deforestation alerts enable the establishment of more up-to-date forest inventories and rapid responses to unlicensed logging. The Copernicus Sentinel-2 satellites provide operational Earth observation (EO) data from multi-spectral optical/near-infrared wavelengths every five days at a global scale and at 10 m resolution. The amount of acquired data requires cloud computing or high-performance computing for ongoing monitoring systems and an automated system for processing, analyzing and delivering the information promptly. Here, we present a Sentinel-2-based NRT change detection system, assess its performance over two study sites, Manantlán in Mexico and Cartagena del Chairá in Colombia, and evaluate the forest changes that occurred in 2018. An independent validation with very high-resolution PlanetScope (~3 m) and RapidEye (~5 m) data suggests that the proposed NRT change detection system can accurately detect forest cover loss (> 87%), other vegetation loss (> 76%) and other vegetation gain (> 71%). Furthermore, the proposed NRT change detection system is designed to be attuned using in situ data. Therefore, it is scalable to larger regions, entire countries and even continents

Marejadas rurales y luchas por la vida, vol. iv: permanencias, resistencias y luchas por la vida

Volumen 4. Permanencias, resistencias y luchas por la vida, coordinado por: Elisabeth A. Mager Hois, Miguel Ángel Paz Frayre y Carla Zamora Lomelí, integra 15 capítulos y está dividido en tres secciones, la primera denominada Permanencia, contiene 5 capítulos que intentan establecer como eje común la lucha continua en las comunidades campesinas para continuar con la vida rural. La segunda, Identidad y resistencia, está compuesta por 4 capítulos que reflexionan sobre varios procesos de resistencia de la vida rural ante los cambios globales e internos en su propio proceso de vida, otros trabajos intentan encontrar aquellos elementos que generan y mantienen alguna forma de identidad, y la tercera sección, Lucha por la vida, contiene 6 trabajos que demuestran todas aquellas posibilidades que existen en el medio rural para sostenerse y mantenerse, generando diferentes formas y estrategias que los une en la continua lucha por vivir con pocas pretensiones y con difíciles perspectivas pero siempre encontrando alternativas.ASOCIACIÓN MEXICANA DE ESTUDIOS RURALES, INSTITUTO DE CIENCIAS AGROPECUARIAS Y RURALES (ICAR), UNIVERSIDAD DE GUADALAJARA, FACULTAD DE ESTUDIOS SUPERIORES ACATLÁN-UNAM, ECOSUR, CUCOSTA SUR GRANA, EL COLEGIO DE MICHOACÁN A.C., UNIVERSIDAD MICHOACANA DE SAN NICOLAS HIDALG

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation