Memorial de integración musical factory: rescate de amnesias urbanas

El presente Trabajo de Titulación se enfoca en rescatar la memoria de un hecho que marco a la ciudad de Quito y cobró la vida de 19 personas. Este trágico suceso hasta el momento es recordado año tras año con conciertos y misas campales, razón por la que se pretende diseñar un espacio por medio de un concepto arquitectónico que guarde relación con el incendio en la discoteca “Factory”. En el Capítulo 1 se cuenta la historia del Caso Factory en el año 2008, al sur de la ciudad de Quito, se realiza una descripción de los sucesos y se analizan las razones de la tragedia. El Capítulo 2 consiste en un análisis de la zona donde se encuentra ubicado el terreno, para así entender el entorno, y dar una respuesta coherente, por medio de una propuesta urbana. El siguiente capítulo trata sobre el análisis de referentes arquitectónicos, el primero de ellos internacional, el segundo regional y finalmente un proyecto ubicado en el Ecuador, para de esta forma tener un punto de partida y una pauta en el tratamiento de espacio público y la música en la arquitectura. El capítulo 4 hace referencia al aporte arquitectónico del proyecto, que nace a partir de un análisis del usuario y tiene un enfoque conceptual, en este también se explicará detalladamente la implantación, el uso de cada espacio, circulaciones, estructura, intenciones de diseño y las sensaciones que genera el lugar

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

Perioperative Nivolumab and Chemotherapy in Stage III Non-Small-Cell Lung Cancer

BACKGROUND Approximately 20% of patients with non-small-cell lung cancer (NSCLC) receive a diagnosis of stage III disease. There is no current consensus regarding the most appropriate treatment for these patients. METHODS In this open-label, phase 2 trial, we randomly assigned patients with resectable stage IIIA or IIIB NSCLC to receive neoadjuvant nivolumab plus platinum-based chemotherapy (experimental group) or chemotherapy alone (control group), followed by surgery. Patients in the experimental group who had R0 resections received adjuvant treatment with nivolumab for 6 months. The primary end point was a pathological complete response (0% viable tumor in resected lung and lymph nodes). Secondary end points included progression-free survival and overall survival at 24 months and safety. RESULTS A total of 86 patients underwent randomization; 57 were assigned to the experimental group and 29 were assigned to the control group. A pathological complete response occurred in 37% of the patients in the experimental group and in 7% in the control group (relative risk, 5.34; 95% confidence interval [CI], 1.34 to 21.23; P=0.02). Surgery was performed in 93% of the patients in the experimental group and in 69% in the control group (relative risk, 1.35; 95% CI, 1.05 to 1.74). Kaplan-Meier estimates of progression-free survival at 24 months were 67.2% in the experimental group and 40.9% in the control group (hazard ratio for disease progression, disease recurrence, or death, 0.47; 95% CI, 0.25 to 0.88). Kaplan-Meier estimates of overall survival at 24 months were 85.0% in the experimental group and 63.6% in the control group (hazard ratio for death, 0.43; 95% CI, 0.19 to 0.98). Grade 3 or 4 adverse events occurred in 11 patients in the experimental group (19%; some patients had events of both grades) and 3 patients in the control group (10%). CONCLUSIONS In patients with resectable stage IIIA or IIIB NSCLC, perioperative treatment with nivolumab plus chemotherapy resulted in a higher percentage of patients with a pathological complete response and longer survival than chemotherapy alone

Informe sobre Inflación - Julio de 2019

Actualmente el Banco de la República se encuentra en el proceso de modernizar su informe sobre inflación con el objeto de mejorar la comunicación del análisis de la coyuntura y el pronóstico de la economía. Para tal efecto, a partir del siguiente Informe (octubre), la estructura será la siguiente: 1. Resumen 2. Pronósticos macroeconómicos 2.1 Contexto externo 2.1.1 Demanda externa 2.1.2 Precios externos 2.1.3 Mercados financieros internacionales 2.2 Contexto interno 2.2.1 Inflación 2.2.2 Actividad económica 2.2.3 Balanza de pagos 3. Situación económica actual 3.1 Comportamiento de la inflación y precios 3.2 Crecimiento y demanda interna 3.2.1 El PIB por el lado del gasto 3.2.2 El PIB por el lado de la oferta e indicadores sectoriales 3.3 Mercado laboral 3.4 Mercado monetario y financiero El presente Informe (julio) es una versión transitoria y parcial del documento en su nuevo formato.Recuadro 1. Dinámica del consumo público en 2019. Autores: Juan José Ospina - Juan Sebastián CorralesRecuadro 2. Comportamiento reciente del PIB de la construcción y perspectivas para 2019. Autores: Juan Pablo Cote - Sergio RestrepoRecuadro 3. Efectos en el mercado laboral colombiano de la reciente migración desde Venezuela. Autores: José David Pulid

Inflation Report - June 2019

Banco de la República is currently in the process of modernizing its Inflation Report with the goal of communicating an analysis of economic conditions and forecasts for the economy in a better way. For that reason, as of the October edition, the report will be structured as follows: 1. Summary 2. Macroeconomic Forecasts 2.1 The External Context 2.1.1 External Demand 2.1.2 External Prices 2.1.3 International Financial Markets 2.2 The Domestic Context 2.2.1 Inflation 2.2.2 Economic Activity 2.2.3 Balance of Payments 3. The Current Economic Situation 3.1 Behavior of Inflation and Prices 3.2 Growth and Domestic Demand 3.2.1 GDP with respect to Spending 3.2.2 GDP on the Supply Side and Sector Indicators 3.3 The Labor Market 3.4 The Monetary and Financial Market This report (July) is a temporary and partial version of the document in its new format. Juan José Echavarría GovernorBanco de la República is currently in the process of modernizing its Inflation Report with the goal of communicating an analysis of economic conditions and forecasts for the economy in a better way. For that reason, as of the October edition, the report will be structured as follows: 1. Summary 2. Macroeconomic Forecasts 2.1 The External Context 2.1.1 External Demand 2.1.2 External Prices 2.1.3 International Financial Markets 2.2 The Domestic Context 2.2.1 Inflation 2.2.2 Economic Activity 2.2.3 Balance of Payments 3. The Current Economic Situation 3.1 Behavior of Inflation and Prices 3.2 Growth and Domestic Demand 3.2.1 GDP with respect to Spending 3.2.2 GDP on the Supply Side and Sector Indicators 3.3 The Labor Market 3.4 The Monetary and Financial Market This report (July) is a temporary and partial version of the document in its new format. Juan José Echavarría Governo

BRAF mutational status is associated with survival outcomes in locally advanced resectable and metastatic NSCLC

Background: Immunotherapy-based treatments have demonstrated high efficacy in patients with advanced and locally advanced non-small-cell lung cancer (NSCLC). BRAF mutations affect a small but significant fraction of NSCLC. The efficacy of these therapies in this subgroup of patients is unknown. Materials and methods: Plasma and tissue samples from 116 resectable stage IIIA/B NSCLC patients, included in NADIM and NADIM II clinical trials (NADIM cohort), and from a prospective academic cohort with 84 stage IV NSCLC patients (BLI-O cohort), were analyzed by next-generation sequencing. Results: The p.G464E, p.G466R, p.G466V, p.G469V, p.L597Q, p.T599I, p.V600E (n = 2) BRAF mutations, were identified in four (3.45 %) samples from the NADIM cohort, all of which were cases treated with neoadjuvant chemoimmunotherapy (CH-IO), and four (4.76 %) samples from the BLI-O cohort, corresponding to cases treated with first-line immunotherapy (n = 2) or CH-IO (n = 2). All these patients were alive and had no evidence of disease at data cut-off. Conversely, patients with BRAF wild-type (wt) tumors in the BLI-O cohort had a median progression-free survival (PFS) of 5.49 months and a median overall survival (OS) of 12.00 months (P-LogRank = 0.013 and 0.046, respectively). Likewise, PFS and OS probabilities at 36 months were 60.5 % and 76.1 % for patients with BRAF-wt tumors in the NADIM cohort. The pathological complete response (pCR) rate after neoadjuvant CH-IO in patients with BRAF-positive tumors (n = 4) was 100 %, whereas the pCR rate in the BRAF-wt population was 44.3 % (RR: 2.26; 95 % CI: 1.78-2.85; P < 0.001). Conclusion: BRAF mutations may be a good prognostic factor for advanced and locally advanced NSCLC patients undergoing immunotherapy-based treatments

Prosthetic Valve Candida spp. Endocarditis: New Insights Into Long-term Prognosis—The ESCAPE Study

International audienceBackground: Prosthetic valve endocarditis caused by Candida spp. (PVE-C) is rare and devastating, with international guidelines based on expert recommendations supporting the combination of surgery and subsequent azole treatment.Methods: We retrospectively analyzed PVE-C cases collected in Spain and France between 2001 and 2015, with a focus on management and outcome.Results: Forty-six cases were followed up for a median of 9 months. Twenty-two patients (48%) had a history of endocarditis, 30 cases (65%) were nosocomial or healthcare related, and 9 (20%) patients were intravenous drug users. "Induction" therapy consisted mainly of liposomal amphotericin B (L-amB)-based (n = 21) or echinocandin-based therapy (n = 13). Overall, 19 patients (41%) were operated on. Patients <66 years old and without cardiac failure were more likely to undergo cardiac surgery (adjusted odds ratios [aORs], 6.80 [95% confidence interval [CI], 1.59-29.13] and 10.92 [1.15-104.06], respectively). Surgery was not associated with better survival rates at 6 months. Patients who received L-amB alone had a better 6-month survival rate than those who received an echinocandin alone (aOR, 13.52; 95% CI, 1.03-838.10). "Maintenance" fluconazole therapy, prescribed in 21 patients for a median duration of 13 months (range, 2-84 months), led to minor adverse effects.Conclusion: L-amB induction treatment improves survival in patients with PVE-C. Medical treatment followed by long-term maintenance fluconazole may be the best treatment option for frail patients