Diagnostico gerencial por demoras durante el desarrollo de tres proyectos de vías de cuarta generación en Colombia bajo los lineamientos del PMBOK

Trabajo de investigaciónEste trabajo de grado es un diagnóstico sobre las casusas a las demoras en la ejecución de tres proyectos de vías 4G analizados bajo la metodología del PMI estudiando las variables de costo, tiempo y riego, basándose en la información oficial emitida por entidades como el Ministerio de Transporte y la ANI, información contractual del SECOP e informes de interventoría.INTRODUCCIÓN 1. GENERALIDADES 2. OBJETIVOS 3. MARCOS DE REFERENCIA 4. METODOLOGÍA 5. PRODUCTOS A ENTREGAR 6. ENTREGA DE RESULTADOS ESPERADOS E IMPACTOS 7. NUEVAS ÁREAS DE ESTUDIO 8. CONCLUSIONES 9. BIBLIOGRAFÍA 10. ANEXOSEspecializaciónEspecialista en Gerencia de Obras Civile

La Dorada, Caldas : un lugar mágico lleno de paz y emociones mil ¡Que viva mi terruño que tanto amo! : recopilación de cuentos folclóricos

En el libro recupera cuentos folclóricos, versos, canciones, juegos y mitos producto de la tradición oral difundida en La Dorada Caldas y le da reconocimiento a los narradores de la cultura oral del poblado.In the book, he recovers folk tales, verses, songs, games and myths that are the product of the oral tradition spread in La Dorada Caldas and gives recognition to the narrators of the oral culture of the town.El fantasma -- Anécdota de la patasola -- Historia del mohán -- El pollito pio -- Nos ayudamos -- La emboscada -- Toño un amigo con diversidad -- El horripilante olvido en medio de un temblor -- Valoremos -- Mito de un arriero -- El juego de la candela -- Canción el capitán de un buque -- Versos -- Multiplicadores de la cultura oral.na66 página

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types

COVID-19 Host Genetics Initiative. A first update on mapping the human genetic architecture of COVID-19

The COVID-19 pandemic continues to pose a major public health threat, especially in countries with low vaccination rates. To better understand the biological underpinnings of SARS-CoV-2 infection and COVID-19 severity, we formed the COVID-19 Host Genetics Initiative1. Here we present a genome-wide association study meta-analysis of up to 125,584 cases and over 2.5 million control individuals across 60 studies from 25 countries, adding 11 genome-wide significant loci compared with those previously identified2. Genes at new loci, including SFTPD, MUC5B and ACE2, reveal compelling insights regarding disease susceptibility and severity.</p

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P &lt; 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)