Frictional interaction properties between geomaterials and geosynthetics

Soil reinforcement interaction is a primary issue for designing reinforced soil structures. The soil to geosynthetic interaction parameters are influenced by a) Interaction mechanism between geomaterials and geosynthetics (pull-out or direct shear), b) Physical and mechanical properties of geomaterials (density, grain shape and size, grain size distribution, water content, and plasticity of clayey soils), and c) Mechanical properties (tensile peak strength), shape and geometry of geosynthetics. The soil to geogrid interface friction parameters (interface friction angle δ and adhesion ca ) for different plasticity indexes, moisture contents, and dry densities were investigated. For this purposes, a large scale direct shear box was used to evaluate the interface friction parameters between four geosynthetics (geotextile 4 x 4 woven, and geogrids BX - 6100, Miragrid 8XT, and BasXgrid 11) and four types of soils (sand, clay 6 PI, clay 25 PI and clay 49 PI). The interaction parameters were determined by separating the soil to geogrid interface friction from the measured combined soil to soil friction. The interface friction parameters were investigated and compared for geogrids with and without their transverse members. Finally, the coefficients of interaction between the investigated soils and geosynthetics were evaluated. The results of this study indicated that (i) cohesive soils can be successfully reinforced with geogrids and geotextile reinforcements (ii) the interface shear strength increases with the decrease in moisture content and increases with the increase in dry density, (iii) the interface parameters obtained for geosynthetics with a rough surface are greater than the ones obtained with a smooth surface, and (iv) the coefficients of interaction (ci) are higher than 0.5 for all tests indicating good bonding between the tested soil and geosynthetics

Satisfacción laboral y su influencia del desempeño de los trabajadores en el área de RR. HH, empresa Polisa, Chiclayo – 2021

La presente investigación tiene como objetivo el determinar la relación que existe entre satisfacción laboral y su influencia del desempeño de los trabajadores en el área de RR.HH. en la empresa Polisa, Chiclayo, considerando como población y muestra a la planilla de la empresa Polisa, Chiclayo, a 37 colaboradores. Esta investigación utilizó de técnica a la encuesta, la misma que contó con el instrumento denominado cuestionario para cada una de las variables, la cual estuvo diseñada a través de la escala de Likert. Para la variable Desempeño Laboral se realizaron 10 preguntas y para la variable Satisfacción Laboral estuvo conformada por 9 preguntas. La presente investigación, tuvo un diseño de investigación no experimental – transversal. Los resultados de la investigación sobre la satisfacción laboral nos mencionan que el 27.0% considera que su nivel es bajo, y del desempeño laboral el 27.0% considera que su nivel es bajo. En esta investigación se concluyó que entre satisfacción laboral y su influencia del desempeño que el nivel de correlación entre las variables del estudio es de ,896 esto indica que la relación es muy fuerte y directa, sobre la satisfacción laboral de los trabajadores el 27.0% considera que su nivel de satisfacción laboral es bajo, un 43.2% considera que su nivel de satisfacción laboral es medio y un 29.7% considera que su nivel de satisfacción laboral es alto, y respecto al nivel del desempeño laboral el 27.0% considera que la percepción del trabajo es deficiente, el 51.4% considera que es regular y el 21.6% considera que es excelente.TesisGestión empresarial y emprendimient

Actividades que se deben implementar en las clases de Educación Física de primero de primaria del Colegio Santa Helena de Baviera cuando no cuentan con el espacio adecuado

El propósito de esta investigación es generar una propuesta metodológica para el profesor de educación física del colegio Santa Helena de Baviera. A veces los niños de grado primero realizan sus actividades en espacios muy reducidos, es decir, no siempre pueden utilizar el espacio adecuado. En este trabajo se pretende, por medio de actividades didácticas que estimulen el desarrollo adecuado de su motricidad y psicomotricidad y así mismo formar valores como el respeto y cooperación, orientar al profesor para que se aproveche el tiempo de la clase para potencializar las habilidades propias de la etapa de desarrollo en la que se encuentra esta población

dfrA thyA Double Deletion in para-Aminosalicylic Acid-Resistant Mycobacterium tuberculosis Beijing Strains.

This is the final version of the article. It first appeared from the American Society for Microbiology via http://dx.doi.org/10.1128/AAC.00253-16Para-aminosalicylic acid (PAS) is a group 4 anti-tuberculosis agent (1). It targets folate metabolism as shown in Fig. S1, which also summarises the known resistance mechanisms to this pro-drug (2). Recently, we reported a multidrug-resistant (MDR) Mycobacterium tuberculosis Beijing strain harbouring a deletion of both dfrA and thyA from Australia (Fig. 1A and Table S1) (3). Since then, we have found deletions affecting both genes in five further MDR Beijing strains (two isolated in Australia and three from Peru) and one extensively drug-resistant (XDR) Beijing strain from China. The Australian MDR strains were recovered from three patients with no apparent epidemiological links and were likely infected in their country of origin (Table S1). The three Peruvian isolates were closely related and consequently shared the same deletion, whereas the remaining strains were distantly related and had deletions that differed in size (Fig. 1A). Consequently, these five distinct deletions were acquired independently, which can be a signal for positive selection of resistance mechanisms. In line with this hypothesis, the strains from Australia and China were PAS resistant when tested with the BACTEC MGIT 960 system and on L?wenstein-Jensen medium, respectively (Supplementary Methods). Two out of the three Peruvian deletion mutants were also PAS resistant on 7H10 medium at 8 ?g/mL, whereas the two closely related ancestral wild-type strains were susceptible (Fig. 1B). We were unable to retest the strains at 2 ?g/mL, the recommended critical concentration by the Clinical and Laboratory Standards Institute and World Health Organization, which would have clarified whether the susceptible result for the third deletion mutant was an artefact (1, 4).This publication presents independent research supported by the Health Innovation Challenge Fund (HICF-T5-342 and WT098600), a parallel funding partnership between the UK Department of Health and Wellcome Trust, and grant SRG2015-00006-FHS from the University of Macau. The views expressed in this publication are those of the authors and not necessarily those of the Department of Health, Public Health England, or the Wellcome Trust. M. E. T. is a Clinician Scientist Fellow funded by the Academy of Medical Sciences and the Health Foundation and the NIHR Cambridge Biomedical Research Centre. E.M. was supported by the Australian National Health and Medical Research Council?s Centre for Research Excellence in Tuberculosis. C. U. K. is a Junior Research Fellow at Wolfson College, Cambridge

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Rediseño de la via existente ancón-Santa Elena

El presente estudio trata del rediseño de la vía existente (aprox. 10.8 km) que comunica el cantón Santa Elena con Ancón, pasando por los asentamientos humanos de El Tambo y Prosperidad, poblados todos ubicados en la provincia del Guayas. El estado deplorable de la vía como consecuencia del último fenómeno natural de El Niño y la falta de mantenimiento por parte de los organismos encargados de hacerlo, incentivó a la población en el área de estudio a dirigirse a las entidades capaces de gestionar su reconstrucción y comprometerlas en el empeño, por lo que es necesario realizar el rediseño de la vía. Este rediseño soluciona los graves inconvenientes de tráfico que presenta actualmente el uso de la vía, especialmente en temporadas de lluvias fuertes y continuas que ocasionan que la vía quede sumergida bajo agua en ciertos tramos. Según los resultados del Tráfico Promedio Diario Anual (TPDA de 100 a 300 vehículos) la vía en estudio se la clasifica como de Clase IV por lo que para el rediseño se han empleado las normas del MOP para Caminos Vecinales de esta clase, excepto donde el trazado pasa por poblaciones existentes. Haciendo uso de los estudios topográfico, hidrológico, hidráulico, Impacto Ambiental, información de la carta topográfica “Salinas” elaborada por el Instituto Geográfico Militar a escala 1:50.000 y pluviosidad obtenida de la estación meteorológica Ancón, determinamos los parámetros necesarios que sirvieron para definir en oficina alternativas posibles de diseño, las mismas que verificadas en el terreno nos llevaron hacia el trazado que proponemos para el rediseño de la vía. Para efectuar un diseño adecuado de pavimento se efectuaron 10 calicatas de más o menos 1.0 m de profundidad a lo largo del trazado y se obtuvieron muestras de suelo, las mismas que fueron sometidas a ensayos de Granulometría, Límites Líquido y Plástico, Proctor y CBR. El diseño de pavimento se basa en las disposiciones técnicas recomendadas por la AASTHO-93 y se desarrollan dos alternativas de diseño estructural de pavimento, uno con base convencional y otro con base drenante y subdrenes. Deseamos mencionar que en nuestro país hasta la fecha se diseña con las Normas de la AASHTO 1972 y se utilizan únicamente pavimentos con base convencional, por lo que esta tesis es bastante investigativa en este aspecto, ya que el método de diseño que utiliza la AASHTO 1993 incorpora criterios y parámetros de diseños novedosos en nuestro medio. De la misma manera se presenta de una manera racional, teórica y ordenada el cálculo de los subdrenes y espaciamiento entre las tuberías de descarga a más del diseño del espesor de capa drenante para la granulometría de material a emplearse para este propósito. Hemos realizado estos trabajos de investigación práctica en el convencimiento que la expectancia de vida de los pavimentos drenantes es superior a la de los pavimentos con bases convencionales